05100127 CITY OF CUPERTINO '$�^ '*`� �`a*"qf -Fn9° ap1 ' ��T'� '
BUILDING DIVISION pFiRMIT T(CQ 1�[^� ,R -1 '%K �.T�L\
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BUILDING ADDRESS: FINN BROTHERS CONSTRUCTIO S N "°05100127
10745 N DE ANZA BLV
R'S NAME: PERMIT ISSUE DAM
BAY COLONY INVESTORS II INC1475 SARATOG
PHONE: SANITARY NO. CONTROL NO.
(408) 252-9131
ARCHRECf/ENGiNEER: - BUILDING PERMfr INFO
BLDG ELECT PLUMB MEOCH
oZ' LICENSED CONTRACTOR'S DECLARATION lob Description
i t F t hereby afRrm that 1 am licensed under provisions of CMpmr 9 momentums
E4 with Section 7001)of DiWdon Saf and e SimmonsBuvneProfassman Code,and my license is
in fall fareeand Cilium.a NEW CONDO-1, 320
q z Cicero ase u.La
F Date CoOECLAntDECL g
ARCHITECTS A
V1 uMersund my plans shall h used as publi<rtcords
G� Licensed M feuunal
m OWNER-BUILDER DECLARATION
i CC 1 hereby strum that I am exempt from the Communes License Law for the
.O O following reason.(Section 7031.5,Business and ProWsinm Code:My city or county
5$ which requires a permit m eon,wet wiser,improve,demollah,or repair any structure $282968
.z_i prior in its issuance.also maim the applicant for such permit to file a signed naument
G that W is licensed pursuant to den,pravisions;of the Contractor's License Law(Chapter 9 Sq.Ft. Floor Area Valuation
i€$ (commencing with Section 7000)of Division S of the Business and Profession,Code)or
that he is exempt shertfrom and the basis far the alleged escmptiom My violation of
Secdon 7031.5 by any applicant for a permit subjects the applicant m a civil penalty of r Occupancy Type
not more than five hundred dollars($5011).
I,an"net of the property,or my employ=with wages at their sola eonspenradon,
will do the work.and the structure is not intended oroIfrod for sam(Sec.7044,Business Required Inspections
aW PerfeadOm Cade:The Commmo's License Law loci net apply m ns an Owner a( 9 P
property who builds or imptoms thereon,andureas does such wort himself or Nnugh his
own employee.provided Nat such Improvements am not intended or offered for sok.If.
however,the Wilding or Improvement Is mid within oro year of completion,the owner-
Wihimr ww have star hordes of proving that he did wt Wild a impmm fm propose a(
sale.).
❑1.u owner of the property,am esclusively,contracting with Immune contractors in
construct the project(Sec.70".Business end isroRssloss Coda:)M Coevacmr's Li.
came law docs not apply as m awoer of property who Wilds or Improves thereon,and
who convectsfcar such ymjecui with a conracmrU)licensed pursuant in One Communes
License law.
❑I Out exempt under Sec ,B 4 P C far this reason
Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty a(perjury ane of We following declaration
I have and will maintain a CuNrmte of Cowman self-Insure fa Warker'sCampen-
ssd
dprovided far by Section 3700 of the IaWr Code.for Nperformance,e perfoanof W
wo r which this permit Is Issued.
1 have and will maintain Wakie's Compensation Insumna,u required by Section
3700 of the Labor Cade,for the performance of the work f whlch Nu permit is issoed.
My War euatian In,ummm aortia and Policy m art:
Grtim. Polity N -
111
CERTIFICA ^OF EXEMPTION FR
COMPENSATION INSURANCE
mus section rued not be completed lithe permit is(mane hundred dollars(SIM)
or teas.)
1 certify that in to performance of the work for which this permit is brand,1 shall nes
employ any person in any manncrm u in become subject to the Workers'Compensation
Laws of California.Dau
Applicant
NOTICE TO APPLICANT:IL after making this Contrition of Exemption,you should
become subject to the Worker's Compensation peOuiaiou of she labs Coda%you most
�O foMwith comply with such provisions a Nu permit unit tic damW revoked.
z5i CONSTRUCTION LENDING AGENCY
[–r I hereby afar slut there its a construction lending agency for the performance of
Cw > the work fa which this permit Is issued(Sec.3097,Civ.C.)
W QLender's Name
7 z lendeeiAddress
U0 1 anify that I haves read Nis application and suite than the above uforakn Is
F cones.I agree in comply with all city and county Ordinances;and suis law slating m
O Wilding construction,and hereby authorrm mnu
presenivas of Nm is city enter upan the
V
r It] luddli mcmiunedproperty far inspectionpurposes,
theor `^!/
gy We)agree m oa indcmni(y and ha mless N Ci y of Cup rtino ageing
tipq liebiliti dgmcnu,c and expanauw in ly in any wyaccmc agaimt aid City
U Z In ca re a of N ndng car this pe . Date
'••' APP CA STANDS AND LL COMPLY WITH ALL NON-POINT Issued by:
SO CE E' __w/
Y/� Re-roofs
sighliffic 4407fis 9MM!
WrAypliclul,17.11UNE01 Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wl n
Bovine g occepanc mom a handle harommon;material
Bond by Oar Cupertino Mrns 1 Code.Chapteand r 9.12. the Health and Safety
Sline 25532(,)7 All roofs shall be inspected prior to any roofing material being installed.
❑Ye Na
Will the applicant or future b 'Jing occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hovartim,air conumiman
u _'nasi by Itis Bay Area Air Quality Management all new materials for inspection.
District?
❑Yu Nu
i'man
mal thehaarNasmaur3-14
vimmams under ChapterQ95aftheCalifonnu Wcty Cady octiats2551J25Ad.lumuntax1ftlfdu Wilding
doenatyy / unapt Wt hponsihlllty m notify du=want of thereq (ic� stbemetpdaraf.c.runcide mlwuy Signature of Applicant Date
• 06 All roof coverings to be Class"B"or better
Ow roti ausharizeJ agent Dau'