05100110 CITY OF CUPERTINO
BUILDING DIVISION PERMIT °(.''O T"t 0 ��� -�Z
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BUILDING ADDRESS: FINN BROTHERS CONSTRUCTIO PERMIT No.05100110
10745 N DE 7
PERMIT LSsua DATe
R'S NAME:
BAY COLONY INVESTORS II INC1475 SARA
SANITARY NO. CONTROL N0.
PHONE:
(408) 252-9131
BUILDINGPERMITINFO
ARCHTfECT/ENGINEER: BLDG ELECT
PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION lob Description
I hereby affirm Jus I w Ikcued under provulons of Chap-9lcammon"t
ttJ� with Somata 7")of Division 3 of Na BuJrrcu and Profcuiuu Cade,am my amoub
in full ram ameffm J2 NEW CONDO-1, 178
Z
r Licenm Class Lie.4
i F _J _�p Dau _f%_ _Conuanor L
'�' �� RCHITECTS DELLA A
I n i 1 ammomi nd my puns shall he used u public mord,
tyU
Gf' Licamed Pmfessionsl
5 OWNER-BUILDER mPi from
mDECLARATION
pr I hereby a1Rrm Net I am comps from the Contruwr'a License law for dN
1 p O following mean.(Section 70314,Business and Pmludum Cade:My city or munsy
e$9e which mquitn a Parent to ennsuom,alar.Improve,dcmaluh,or repair my structure
prior to its issuance.also requires the applicant for such permit w file a signed nawm.m Valuation
G dot hewpotential tLicenseLaw(L7uPwr9 Sq.Ft. Floor Area
(commenting with Secdon 7000)of Division 3 of the Business and Professions Cods)m
5452 mat M is uempt memBeen and the bash for the alleged aempdm.Any violation of
Schon 70314 by any applicant for a permit subjects the applicant as a civil penalty of Occupancy Type
not mart man raw hundred daluts(55001.
❑1,u owner of the property,or my employm with vagus u their into compewtion,
will elo the work,and me structure Is Out mounted ar offered fouam(Sm.7W.Butlness Required Inspections
and Prormalom Cade:The Comemor's License Law don nos apply 10 an owner of
property who builds or im proven thermn,uW who dart such work himself u luau{h his
own employe,provided that such improvements am rat Incased arofkmd forme If.
hawcvm.de building or Impm`ement is sold within One year of mmPledan,the owhe"
builder will have the murder of proving that ho did rot build or Improve for purpose of
sale.).
❑1,as awmr of the property am uelusiwly contracting with licensed Contractors to
construct the pmj.a(Sec.7044,Business and Profnsimu Cade:)The Contractor's Li-
come law dant act apply in an owner of pmpeny who mullds or impmvn demon.and
who common for such projects with a eamacwr(0 licensed pursuant to the Contractor`s
License Law.
❑ I oro umap,under Sec. ,B A P C fu this mann
r Date
WORKER'S COMPENSATION DECLARATION
�i hereby affirm under penalty of perjury one of the following declination:
13700
iw and w0I melanin a Certificate of Contin w mif•Iasum for Woods Compcn-
provided Int by SeNon 3700 of Jin lobar Cade,far Ju Perform---of the
or which this permit u Issued.
haw and will maintain Worker's Compensation Insurance,u required by Section
of me labor Code,for me performance arms work for which this permit is Issued.
M Wa ogroyymad IIr meaanrtierand Policy
Cara PIg fiI1 Polity No.
CERnFICATEOFEXEMPnONno WO S-
COMPENSATIONINSURANCE
(Thts section need nation completed If the permit Is foram hundred dollars($100)
or less)
1 coldly dont in the perrmmeme of the work far which thio permit is issued.1 dull nos
employ anyperann in my manmr an u in became subject to Je Worlxn ComPasumn
Laws of Cnlifomia.Dan
Applicant
NOTICE TO APPLICANT:If.afar making this Certificate of Ezempsion,you Amid
become subject in the Wukces ComperuaJon provisions of the Labor Code you muse
O formwid comply with such provisions u this Permit shad be domed rooked.
Z► CONSTRUCTION LENDING AGENCY
[ti Ibeuty affum that mem Is.Conimution undingagemy far the perf.....f
a> did work for which this permit is kuued(See.3091.Civ.C.)
4aLender's Name
M. z Lenders Addme
U0 I certify that I have mad this application and suns dos the abova Information u
U. F' coram.1 agra an comply with W city and county ordinaam and sum laws mlating to
0U Wilding construction.and hereby authorim reprnenutivea alibis city to enter upon the
r CU ahovc-matimed property far wipemion purposes.
y (We)acme to saw,indemnify and kap harmleas the City of CuPm1m.against
nF"y Nl But,Iidn,jar 4-cmts rad espensn whichmay In y way amu.againstaid City
in cansryw a me{p {of mice Permit• Date
v.. APPLIC rf DE 6 ANDS AND WILL CO LY WITH ALL NON-POIM Issued by: 7i
SOURC RE /''0,L Re-roofs
Signm ol'App sm tit antracmr pis of Roof
HAZARDOUS MATERIALS DISCLOSURE Type
Will the applicant or future Wilding occupanuwm orhmdle havudaus material
dermad by Use Cupertino Municipal Cade.Chapter 9.12.and the Health and Safety
section 25532(a)? Imo/ All roofs shall be inspected prior to any roofing material being installed.
❑Yrs
If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or future building=open(use equipment a devices which
.sols hmArdnu ale com aro mmu as nomby de Bay Arc,Air Quality Management all new materials for inspection.
District?
❑Yes u
aqui mI havet mad Ne huunabredamuest mpda�w1ordtaalmmmmam.n aM.r ChePur695 old
se Gli(or
uHcol fcy , and id. understand mulfma Wildingndm dy umyresp, IbllitywnotiyJ¢a.cupentofo
Date
a meaw � Signature of Applicant
Ower or autharicd ccnl i
Dow All roof coverings to be Class "B"or better