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03030138 CI BUILDIING DIVISION PERMIT CNTRACTOR INFORMATION$ ' BUILDINGADDRFSS: EDEN LANDSCAPE MGMT PERMIT"03030138 ^"NER'S NAME: 1481 GINGERWOOD DR. PERMIT Iss8PSDnS/2003, ANA BERGER V "E (408) 858-9085 SANITARY NO. CONTROL NO, ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH (� l� u00 LICENSED CONTRACIOR'SDECLARATION Job Description F I hereby arum that 1 an limmud under pmvisiau of Chapter 9(commencing `�' with Seelig.7 )of Division 3 of the Businass Professtou Code.and my license is 'rtMin in mom derc{q ^ Dn��r,$'4 TRELLIS/SPA/JACUZZ /� j�2 Liceme, w L�•I Lk.g Tea /x-- FI NALE® Z=, Date Con or 4 3 ^, CHITECPS DEi. TION K �m�ssu^ ,I�' ,sh•II Zicme:rM, MAY 2 2 2003 OEU ;off Lccnscd Prumeno OWNER-BUILDER DECLARATION �r f I hereby oRrm Nat I am cxcmm N pi from Contractor'.License Law for the BUILDING s a o following won.(Section]03I.5,Bui.vss and Professions Cade:Any city or county which mquiru a Permit to esu g.,.alter borrow:.demolish,or repair any atmctum �sla� prior ha its issuance,also requirtthe s applicant for such permit to rile a signed aunt Law temeCy 5Vt7® � < that he is licensed pursuant to Ne previsions of the Contractor's license, w(Chapur 9 Sq. Ft. Floor Area tion geC (commencing with Section 7")of Division 3 of thc Businw and Proftuiam Cock)or that be,is exempt therefrom and Ne basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a Permit subjecu the applicant W a civil penalty of 3 462`191t"erO 0 Occupancy Type not mote Nan live hundred dollar(S5001. 0 1,as owner of the property,or my employes with wages u Inch sole compensation, will do the work.and the swuure is not intended or offered for age(Sec.]Oae.Businw — d Inspections and Professions Cade:The Contractor's License Law dors Out apply to an owner of 10 2 — PIERS p property who bull&or improv thereon,and who doea,uch work himself per through his Own employes,provided lust such improvements as not inundoi aro@ad possum.If. 103 — UFER uoweve.Ne building cur improvement is sold within one year of completion.Ne owner. Wilder wits have the buaden of proving that W did not build or improve for purpose of 104 — REBAR sale) 105 - ANCHOR BOLTS 0 1,u owner,of the progeny.am exclusively contracting with licensed contractors to 10 6 - SEWER & WATER consume.the project(Sce.]Dao,Businw and Propessums Code:)The Contractor's Li- too. aw does no,apply Wan owner ofpmany who builds or improvrs thereon.and 202 — UNDERFLOOR PLUMBING Lic nuc Vwu for such projects wiNamnuactoame rts)Hd pursuaContractorsthe Cantor'. 203 - UNDERFLOOR MECHANICAL 0 l am exempt under Sec. ,B d:P C for this reason 204 - UNDERFLOOR FRAME lfr Dt1C 205 - UNDERFLOOR INSULATION WORKER'S COMPENSATION DECLARATION (hereby afOrm under penalty, peduane err ooftha following declarations: 301 — ROUGH PLUMBING 7haveand will mai.W.a CerdOcarc of Convent W self-imam ror worker'.CO-'-' 302 — TUB & OR SHOWER .' cation,as provided for by Section 3700 of Ile tater,Code.For the 11fotmanee of the 303 — ROUGH MECHANICAL work for which this Permit is leaned. 304 - ROUGH ELECTRICAL 0 1 have and will maintain Worker's Compensation Ineu aures,as required by Section 3700 of do labor Code,for the performance of the work for which this permit is issued. 305 — FRAME My Worker's Comp, mires lnsuranaonkr and Policy numbc 306 - HOLDOWNS C. =n Policy No.:� 307 - INSULATION �TIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE 308 - SHEETROCK (Tuissecti^n nadno.hecomplcud ifthe pmmitlsf^ronehundneddollm(SIIX) 309 - EXTERIOR LATH ^rk•a) 310 - INTERIOR LATH I ecnify that in do performance of the work for which this permit is issued.l shall not 311 — SCRATCH COAT employ any person in any manner ser as W become subject W the Worke,i.Compass on, Iawsof Calif.mia.Date ' 313 - ROOF NAIL Applicant NOTICE TO APPLICANT if.after metingthis Cenificam or Exemption,you should 501 - FINAL ELECTRICAL ENERGY Wcome.ubjen W the Workm'.Comlcrtm.ion provisions of Me IaMv Code,you must .0 Z mnhwith comply with such provisions or this permu shall be decmcd revoked. 5 0 2 — FINAL PLUMBING ENERGY zo503 - FINAL MECHANICAL ENERGY E N CONSTRUCTION I.FNDING AGENCY Ihemby.Rose that thea isaeonxtrnelinn lcndingagemy fm the pedormat.cc of 504 - FINAL BUILDING ENERGY > Me work for which his pemiitlsissuod(S..309].Civ.C.) 505 - FINAL ELECTRICAL 0. lender's Name Z)z Len&rrrrr dmx. 506 - GAS TEST U 1 certify that I have mad this application and sum that Ne above information u 507 - FINAL PLUMBING U.(—' comm I agree W comply with all city and county ordinances and auu levo tolating to OU building comuiction,tend hereby authorise mptoomwives of this city to enter upon the FINAJ, MECHAN CAL r Lt1 ahovo-mentioned property for ina sec9on purposes c. 09 FIN / O. (We)agme to save,indemnify and kap harmless the City of Cupertino against '7 HN liabilities,judgments.coast and..penes which may in any way•ce,ue against said City 55 U APP CANTeu"thegmnuNng ofA'sDWILLCOMPLY WITH ALL NON-POINT Issuedby:5 WORKS Date SO CE RE S. - Re-roofs Signature ofA be HAZARDOUS MATERIALS DISCLOSURE ate Type of Roof Will the applicant or future building Occupant store or handle ha mous mmerial as dc6ned by the Cupertino Mun'eiPal Code.Chapter 9.13.and the Health and Safcty Scedon lsssl(.r All roofs shall be inspected prior to any roofing material being installed. Nu Will the applicant or future building Occupant use equipment m devises which If a roof is installed without first obtaining an inspection,I agree to remove emit hau dour air Condamine jx defined by the Bay Arca Air Quality Management all new materials for inspection. 0Yes Nu Ihave read the huaNsaumaterials mquitcmcnts underChapter6.95 of the Caliror- nia)k.lth@SafclYCodc.Sec J.25505.25533 amI25534.1 unue,suil Na irthe ilding des ort curtcmly h cne i4 al it u my rcsponsibilily W noulj cu f Ne yim ntswnf b�e ,Waunanr,adEa rrol n. Signature of Applicant Date ownernratrmrr ed.gen, D,W All roof coverings to be Class"B" or better I CITY OF CU P]ElRTINO BUILDING DIVISION PERhUf � BUILDING ADDRESS: EDEN LANDSCAPE MGMT PERMIT NO03030138 (408)858-9085 SANITARY NO. CONTROL N0, ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 LICENSED CONTRACT'OR'S DECLARATION Job Description 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Sectin 79M) of Division 3 of the Business -Professions Code, and my license is in a elrggtar7 �l Lie p�d. �� US Licenses ass Q,. l," r/ en m. TRELLIS /SPA/ JACUZ Z Date Con r Date CHITECTS DE TION �{ndErstan p hall cd a;/pyY tc mrnods t Licensed ProfcssoLrcensed f OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signal statement that he is licensed pursuant io the provisions of thc Contractor's License Law (Chapter 9 Sq. Ft. Floor Area $ 51,��8tion (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of 3 4&2i53q 1"er0 0 Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, - d Inspections p will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Conuactoes License Law docs not apply to an owner of 10 2 — PIERS property who builds or improves thereon, and who does such work himself or through his own employers, provided that such improvements are not intended or offered for sale. If, 103 — UFER however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or improve for purpose of 104 — REBAR sale')' 105 — ANCHOR BOLTS ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to conswct the project (Sec. 7044. Business and Professions Code:) The Contractor's Li. 106 - SEWER & WATER cense Law does not apply to an owner of property whn builds or improves thereon, and , 202 — UNDERFLOOR PLUMBING who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. 203 — UNDERFLOOR MECHANICAL ❑ 1 am exempt under Sec , B & P C for this reason 204 — UNDERFLOOR FRAME Owner Date 205 — UNDERFLOOR INSULATION WORKER'S COMPENSATION DECLARATION ' 1 hereby affirm under penalty of perjury one of the following declarations: 301 — ROUGH PLUMBING 302 — TUB & OR SHOWER Ihave and will maintain aCertificate ofconsenttoself-insure for workeesCompen- sallon, as provided for by Section 3700 of the Labor Code, for the performance of the 303 — ROUGH ME CHAN I CAL work for which this permit is issued. 304 — ROUGH ELECTRICAL ❑ 1 have and will maintain Workers Compensation Insurance, as required by Section 305 FRAME 3700 of the Labor Code, for the performance of the work for which this permit is issued. — My worker's Compe tion Insu ri carrier and Policy number c�, 306 — HOLDOWNS Ca ' r. Polity No.:--.!_ / 307 — INSULATION IFICAT'E OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE 308 — SHEETROCK (This section need not be completed if the permit is foronc hundred dollars ($100) 309 — EXTERIOR LATH or leas') 310 — INTERIOR LATH I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Wo� Gong sation 311 — SCRATCH COAT Laws California.Date 313 — ROOF NAIL Applicant APPlicant licant - NOTICE TO APPLICANT: If, after making-this"Certificate of Exemption, you should 501 — F I NAL ELECTRICAL ENERGY become subject to the Worker's Compensation -provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 502 — F I NAL PLUMBING ENERGY a CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY I hereby affirm that there is a construction lending agency for the performance of 504 — F I NAL BUILDING ENERGY ' the work for which this permit is issued (Sec. 3097, Civ. c.) Lender's N amc 505 506 — FINAL ELECTRICAL — GAS TEST Lender's Address I certify that I have read this application and state that the above information is 507 — FINAL PLUMBING correcL I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to toter upon the F I NA ME CHAN CAL , above-mentioned property for inspection purpom& a 0 9 r WORKS Date ,- SO CE ale HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Code, 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes No 0Yes If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit hat Anus air contaminannj defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ Yes No 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health & SafetyCodc, Sections 25505,25533and25534.Iunderstand thatifthe ,ilding docs not currently h en t, at it Is my responsibility to notify cu f the ' sire rtoissuance ofaCertificate ofOcLup ey. Signature of Applicant Date All roof coverings to be Class "B" or better Owner or author sdagent Date