05100120 CITY OF CUPERTINO %h ' tr'4J++wcaxe §^T ' ' `� Mzf„+r; "
BUILDING DIVISION PERMITCt1N`C'�'tt' CT�1,R Ym1I
BUILDING ADDRESS: FINN BROTHERS CONSTRUCTIO g"'u "D.05100120
10745 N DE PERMIT ISSUE DATE
R'S NAME:
BAY COLONY INVESTORS II IN 1475 ATQGA AVE P'/l '7
PHONE: SANITARY NO, CONTROL NO.
(408) 252-9131
BUILDING PERMIT INFO
ARCHITECTIENGINEER:
BLDG ELECT PLUMB MECH
O
Ioj LICENSED CONTRACTOR'S DECLARATION lob Description
i U F I hereby affirm me,1 w licensed under provisime,of Chapter 9(commencing
S4 with Section 7000).f Division 3ofthe Business and Prefeasiore Code,end my licensee
i s infullforcetdcffmL L NEW CONDO-1, 178
t!aIn License lata Lk.K
JJ Dam Consnttar
yq. ARCHITECI•SDECLA A
i a I understand my plans shall he used As public records
i�
•u.
Licensed Pmfcssianal
i N Oat I am exempt
front
DECLARATION
:0 C I heathy affirm.71 1. ausi fent the fe n..ars License Law for the
O o fallowing mmon. mem s 7 o m Business and Improve.
co u l Cale:Any cityof county
l$E which mquirs,a permit m cnmtmct alter.impmw.dcmoiLN,or repair any tectum $252527
.zi prioraits issuance,tlsu mquimslW mpPlictt(orsoch pewitafile asigned,uldment Valuation
Nat he is liccand portent he the provislormaf the Contractor's License law(Chapter 9 Sq.Ft.Floor Area
`
�g (commencing with section 7")of Division 3a1'me Bancesand Profeuiam Cosmic,
the,M is esemm IWmfrom and the base Its the alleged Aswpdm.My violation of
Section 7031.5 by M'applkant for•Permit subjects the Applicant a a civil penalty a( API4 Pillilffitiler v u Occupancy Type
not man dun five hundred dollars(SSW).
❑1,as owner of t e Property,of my wpioyom with voiles as deb ask campenandon,
will do the work And theatfacae a net Intended of offered for (Sec.7044.Bmircas Required Inspections
W Ptlasiom Cade:The Contro mrs Liartu law dam net apply in an owner,of
properly who Wilda,improws tlwmo.and whodoesnuchwork himselfm through his
ownemployma,proH dthnsuchimprn mmuwmtinmWcd,offemdfmsale If.
however,Ne building or improvement e,old within one yev of c—Pled-r.the awuen
builder will haw Um burden of proving del M did Out build,improve for purpose of
sal.j.
❑1.As owner of the pmpeny.am etlusively camacting with licensed entrecmn he
com nxi the ptlect(Sec.7044,Bminee and PonicsA m Code:)The Cornmeal's U-
cense law does not apply An an mover of Property who Wilds or improves thereon,and
who contracts for such pmjects with acommcher(s)limned pursuant the the Communes
License Law.
❑lam exempt under Sec ,B&P C for thin meta
Dae
WORKER'S COMPENSATION DECLARATION
I hereby Arum under penalty of perjury occur the following declwtiam:
1 haw and will maintain a CwHiimte of Come neo relf4mum fmwerkerr Compere
..tion,as provided f,by Section 37W of the Labor Cade,for the pertafmanee of the
ro r which this permit u issued.
w 1 new and will maintain Workers Compensation Intrence.as required by Section
37W of de fab,Code,fm Ne peR,mance of tie work f which the mit peris issued.
Myworke pemadm insurance artier mM Policy
0.Cartier. 09` Policy No.
CERTIFICATE OF EKEMPI30N FROM WORKERS'
COMPENSATION INSURANCE
(na sections mN net bo cwpked if the permit is foram Andred domam(SIM)
or kin)
1 certify that in the performance of the work for which this permit is wood,l Sul not
employ any person in soy manmrm a on become subject to de WOfk,3 CmrPcmNar
Laws of California.Date
Applicsm
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject a the Worker's Compcmsstian previsions of Ne Labor Code,you mum
O forthwith comply with such provisions,this permit shall he deemed wvokcd.
.Ziv CONSTRUCTION LENDING AGENCY
[r I hereby affirm that there Ina construction lending agency for the performance or
rl > the work for which this permit in issued(Sec.3097,Civ.C.)
W Q Undoes Nwc
z Landers Md.
U Q 1 cmify that I haw mad this Application and sure that Ne show information is
ly F correct.I agree a comply with all city and county oNinmaes and sok laws slating Io
0 O building
(We).,ce to ..iml.nd yauthond mpreunuttviceve City Of locneroprn tM
W abovomothumd property for inspection purtums.
G (We).,me a sew,indemnity and kap humless de City of Cvpcnino mgeinst
yr I• I Iiabilides,judgmenu.e uudespema which yin any way ammo against said City
UZ in eanaeq of tM dog of the Pewit
^•� APPLIC N UN TANDS AND WILL OMPLY WITH ALL NON-POINT Issued by: Date
SOUR R NS. (sAA AA" �'��`
]t Y Re-roofs
Sigtutumof AppliaRDOr MenHAZA
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the a Copeniter futw Wilding e,Chantmom,and h Health a material
dcOned by the Cupenina Municipal Code.Chapter 9.11.and the Health mJ Safety
Section 15531(,,)+ / All roofs shall be inspected prior to any roofing material being installed.
❑Yea gli
If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or Noun building Occupant an equipment or devices,which
emit 11444rdnm air conuminanu as fined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes Nu
I haw mad the hatrdms materials requirements under Chapter6.95af thc Califon
nie &S%L-tyC Sea -15505,155 and]5534.1 undcrsuM that if the Wilding
docs at ntly ho ¢nth dot It in omibility a notify the mcupent Of me
my mr Wlin Ibcmet prior 1.iu manC1;raeg,�raeiaray. b Signature of Applicant Date
�,f �lY,. �I "O All roof coverings to be Class "B" or better
Owmr or muthmiecd agent Dam