06020136 CITY OF CUPERTINOse ; " `-
BUILDING DIVISION PEF IT CONT CTnR INFURM�T O
BUILDING ADDRESS: G T BUILDERS PPAMITNG'06020136
19780 DRAKE DR
NER'S NAME: PBRMTf ISTUHDATE
SANTANU SINHA 18630 OVERLOOK RD 02/22/2006
PI.ONE: SANITARY NO. CONTROL NO.
(408) 354-9406
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
Sop LICENSED CONTRACTORS DECLARATION
rd 1 hereby afnrm Net I un licensed under provisions of Chapter 9(commencing Job Description
with Section 7010)of Division 3 of the Business and Professions Code.and my license is
ai mfullmmeandeIfa �a INSTALL SKYLIT-MINOR FRAMy SNSULA;T510 ,
jgz cam. I a Contractor
g Z SHEETROCK �Q
Dees ConDECL
ARCHITECTS DECLARATION
Q 1 undenunJ my plus ahatUncured As public mcwJs
0
itaps Licensed Profesunnsl ,t(� 2800
.1 OWNER-BUILDER DECLARATION
I 1 botchy A mo that I am exempt from the Conuactofs Linea Law for tic
O f011nwin recon.(Saxon]0713.Business and Profuuoos Code:An dr Or count spy �;•r. { y�
$ which requires a Permit m construct,alcor.Improve,demolish,or repair any swcturc
t' Prior In its Women.Alan requires cher applicant for such permit to File a signed suumcm
that he is licensed pursuant to the prevision of the COMMINs License Law(Chaptu9 Sq.Ft.Floor Area '=/o Ulj O �ValUVtl
Y $ (commencing with Section 7000)of Division J of the Business And Professions Cade)or
that he,exempt therefrom and We buts for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit objects the applicant An•civll penalty ofApN j�V�r�lt�er 0 0 Occupancy Type
t mm
noothan five hundred dollars(550a, 3 16 3
0 1,As owner of tis Property,a my wplayous with wages As their sole compensation.
will do Newark.and the.annum Is not h maded mortared Tarsale(Sec.7044,Bulinus
and Professions
Code:The m
COnumYcen
s Lise law durin
a t appy owe of an owof Required Inspections
propertywho buildswtreprmes thereon,anawhodoesauchwmk himself or Wvugh ho
Own employ=.provided that inch Improvements art notinanded mortem l fatale.IL
however,the Wilding or improvement is mid within can year of ample ton,the owner.
builder will have the burden of proving chat he did not Wild or improve for purpose of
Asia.),
❑I,as=set of the properly,am exclusively connecting with licensed consacmn to
construct the project(Sec.7044,Business and Profusions Code:)The Common's Lb
cense Law dace not apply man Owner of property-who Wilda or Improves tiurea,and,
who contend,for such projects with a contractor(s)licensed pursuant to 0n Contractors
License Law.
0 Iamuemptundu See .BBPCfmdO3.
Dun
WORKER'S COMPENSATION DECLARATION
I hemby&Mm under pertly of Perjury me of chs following declarations:
❑I haw and will maintain•Cenincate of Coment m sel6lnmre far Workoes Compen.
urian,u provided for by Section 3700 of the Labor Code,for the performance of the
work for which this Permit is luued
❑1 have and will maintain Wishes Comperwlion lasuruce,As required by Section
J]On Of me Labor Code forth peRorma of Ne wart for k,.:is pumltbivued
My Work tpeuatimtl uric WPoliry number art:
GMer. Policy No.:
CERTIFICA OF^XEMPTION FROM WORKERS
COMPENSATION INSURANCE
('Drs,MWOO need not hecanpleted If the permit,foram hundred dollars(SIM)
or lana)
I certify that In the performance of the work for which this permit Is issued.I shell not
employ any person in any manner mum become subject orWore iCwnpensstion
Lawsof CalifO ya
Applicant
NOTICE TO APP CANT.Ir.CMr Ing than a roest of E mption,you should
become subject m e Wwka's om sox p siow of the Labor Code,you menu
.,Zforthwith counp wire mh provisous or Thu p it shill be(tamed matted.
Z O tiCONSTRUCTION LENDING AGENCY
[. 1 hereby&M m that there las ewuuuctinn rending agency for ties performance of
a 7 the work for which this permit Is issued(See.3097,Civ.C.) ,
aQ Lender's Nam
:0 z Lender's Address
U O 1 certify that 1 lase read thin application and sum that the AWse InformNun is
it, correct.I agree to comply with all city and county ordinances and sum laws reining in
.C) buildingcansuction,mdhembyauthOtiMMPmxnutisesofthiscitymenmrupnn the
W eWvcmendonAd Property fan inspection Purposes
gy (We)agree in use,indemnify and kap harmless the City of Cupertino against
y liabilitiesjudgments,casts and expenses which may in my way acerae against said City
U Z FURCER
fthe grand bpd
^' UNDER NDS A VI COMPLY WITH ALJ.N N-POINT Issued by: Date
LATION. Re-roofs
lin onteacOemAZAR USMATERIALS DISCLOSUREType Of ROOF
p licuturfu reWIldingoccupantamrcmbaMlchai dusmatedal
CupeninO Municipal Ade.GeP,r 9.13.and the Health and Safety
ode.Section 25533(x)+ All roofs shall be inspected prior to any roofing material being installed.
❑Yes Na
Will the opplicanl or future Wilding occupant one equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hwani us air contaminants as Jeflncd by ane Bay Area Air Quality Management eat ma ❑al5 TOC 1 peCtion.
District?
C]Yen u
Ihow mcy he Codevtrdnus aaria25505i5533a d255hents unJcrChapmr cnand tg5ofthe Califon
MIA Henith@ Safety Code,Senium 75505,35573 uJ 215J4.Iundenund thvifthc Willing Z—
J rrenlly how a u4 Nu It u epouib.l. m nodry the occupant of the
quire. Lswhichmuu mmpnar u ceofaCauOcaaofOccupmry, Slg tureofAppli ant Dale
Z t
E-7—ormthonv gem Da, All r coverings to be Class"B"or better