01080044CITY OF CUPERTINO -
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BUILDING DIVISION PERMIT C
BUILDING ADDRESS: P
PERMIT NO.
10296 ALPINE DR (A B C), A
ARGONAUT WINDOW & DOOR 0
01080044
OWNER'S NAME: A
APPLICATION SUB DATE
SAM HOLMES 1
10624 S DEANZA BLVD 0
08/08/2001
PHONE: S
SANITARY NO. CONTROL NO.
(408)996 -9670
Z ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
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BL ELECT PLUMB MECH
0
LICENSED CONTRACTOR'S DECLARATION J
Job Desc ' ion
I hereby affirm the I am licensed under provisions or ns a. (commencing "
"
is in S
U License Cl cj C
Cmia
Dam L'I FA N S
S DECLA
pLicensed Professional
OWNER - BUILDER DECLARATION
oi I hereby affirm that I am exempt from me Contractor's License Law for the
following reason. (Section 703 I.S. Business and Professions Code: Any city or county. $
$16595
D which requires a permit m consumer, alter, improve, demolish, or repair any structure
E...prior to its issuance, also requires the applicant for such permit to file a signed statement, -
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that he licensed pursuant t drop visions of the Contractors License Law (Chapmr9 1
1, �('� apr!`a,µp�tppC a a - • ,_t, V
Valuation
m ng with S
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-of Section 7031;5 by any applicant for a permit subjects the applicant m a civil penalty
of not more than five hundred dollam(5500) 5
'c,l: r i Occupancy Type
516APNV� BUILDIN '
❑ 1, es r of the properly, or my employees with wages es their sole co manta. ion,
own¢
- wiR'0e the
'and Professional Code: T e is not intended d License Law for sale apply to an -
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Who C
at such, a
er for s s
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c p
prove o
❑ 1 her f the Propmy vin B
Business l
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and who,commer,s. focsuch projects ..with a convaaor(s).licensed . pursuam to the.._...___.__...__.
Contract License La
❑la pt dde Sec t `' v' B &PCf �h; o f
fQti 6 - Cl, .iY�p
O Dole I ) i
WORKERS COMPENSATION DECLARATION
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❑ 1 have' "and will t n C nit at f C nuns to s ... e for Worker's !
O
Compensation. s Provided f by Section 3700 of the Labor Code, for the
pert rmanee -of thew k f i h this peennu issued.
.
❑ I have and`will m tin Worker's Co pe sat n immo " - of required Cy Section -
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of Rai work for uh "'pe t
: ad MyW krsC pe to If o
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t CERTIFICATION OF EXEMPf10N FROM WORKERS 5
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C mpen a4n a
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shall t
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rr CONSTRUCT ION LENDINGAGENCY t r
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1 he by ff th t A s c..tued (
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(Sao o
'Letd rs Namc' w
LendersA1dm,s
.1 cemfytha 16 a read this upPl ton and smm th t th bo inform Lion is
:LVtrecr p.9. 1. eomply,with all city and county ambulances and state laws relating:
;lo building mnstdwuimn rind hereby amharim representatives ofthis city to enter upon
r7 )h ha t led p p y f inspect purposes.
V (W lag ec is v c ode Try and keep haradai th Cty'ofC p lino gainst
II 1 bIlI'l luagmart i d Houses, hch may in any way accrue against said
C Cry fa e9 ce of the gran gofths d Q
^ APp \NTUNDLRSFANO AN WILL COMPLYWTHALLNON- DINT'" I
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Sg t 1 heart ntrnctoq -.:• ..' <.'• {; ..pDaie ,.,;'; R
Re -roofs
v HAZARDOUS MATERIALS DISCLOSURE ,
:- WII to S (¢ant nr future hu ld d.us mater.1 „
„ Type Of.ROOf.
,nd Sarery '
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pt n z
t :
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All. roofs. shall be ms ¢steel rior to.anf
worn ppl r f m¢b li g c p m se eq p mar devices which I
If a roof is installed Without first obtaining 3n'inspectlon;''Iiagree ` to remove
,.it hazardous r contributions s deft d by lie Ba yAre A Q aI ty Manag me t
District? ". :
all new materials .
i�pl a
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have rev Ath ha \vabou�s'matenals requirements tinder Chapter 6.195 of the
,Cihfornia Health'& Safety Code. Sections 25505: 25533 dad 25534. I- understand that!
IftheWlli gdoesnotc a tly ha at n nt th t u y p brtyt 'btry the
I
p nt f fl qu rem nt h, 'must b�n t tin t o f emfcm t _
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