08040088]KI
aro
�uF
n zj Z.
knyLL�
0
nySy_
`ac
`ORR
v
_z>
gc
0z
a>_
aQ
oz
UO_
FN
�z
CITY OF CUPERTINOtx�ty
^` %-�'.
BUILDING DIVISION PERMIT
C01�ITRt1CTQRIIVFf1�LMATION,
BO.
UILOINO /TTURDEN GATE DR
GD DEVELOPERS & ASSOCIATES
PERMIT840088
NELLR'SUNAME:
ifite
PERMIT ISSUE DAIS
HAIM GABAY
1850 REDONDO AVE STE 202
05/19/2008
PHONE:
(562) 597-5060
SANITARY NO. CONTROL NO.
ARCHITECT/ GINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
t= C= (� 0
LICENSED CONTRACIOR'S DECLARATION
Chapel9
Job Description
I hereby alarmhis t 1 son I'�mW under provivm's of (commencing
vide Sation 7").lDivision 3 ofthe Bosinem and Professions Code,md my license i,
ADD 48 SF, PORCH ENCLSR, REMODEL KITCHEN 429'
.trsd elrat.uconLle.g
BATHROOM 21'. -SQ FOOTAGE ADJUSTED PER BOB S. /JO
Dam Contawmr
ARCHITECTS DECLARATION
BV
1 undmsuml my pies anal eo oned an public records
Liconsed Protean ... I
OWNER -BUILDER DECLARATION
1 bcmhy vlTirm that I am exempt from the COntswTofs License Law for Ne
following moon. (Section 71171.5, Business and Professions Code: Any city or county
which requires a pmmi, to combust. alms improve. dcmalLN. ar repeir any mneture
%Prior
on lso its Wormed. arequirestheapplicant for such permit to file a sighed statement
dOd W is licensed puruwt to the pmiSiom of Use Canuacm(s Usenm Law Chapter 9
Sq. Ft. Floor Area Valuation
(commencing with section 7000) of Division 3 of the Business and Professions Code) or
$65000
Nat he is exempt therefrom and the basis for the mleied exrmptiws My violation of
section 7031.5 by any applicant for a permit Nbjecu the apPllewt to a civil penslty of
32633018 g�Number
Occas ane -Type
rodead Ow hmdreo delios(5300).
❑ L u owws of thopropmy, a my employes with "tau thew sok compeuadon,
will dethewoh wdthe he Comeoatkmndes Law dofa.1a(Sec.to OcrOf
and oW Cade: The Conmcmfs License Law des rot apply If an ower
Required Inspections
his
property w is
emy who hullos imputes thereon.and who daevwhwort himuRedth
i for sale IL
man reals
OwncmPlayeWiding or outsuchial.
antsartnce fear
h olEwagered
debuildinganimpatememksolowithinot Yewwcwopanfortheowner-
sold
gilder will haw the Mvden M proving that k rid not huge w impose for PURru of
ed'.).
ukJ.
Ed 1. u owner of the property, am exclosiwly, contracting with licensed contractors to
( commect the project (Soo 70th, Hnunus and Professions Code:) The Coouaeme,; Li-
cease U. des a., apply as an. of property who builds Or Improves demon, and.
.
who conuacu for such pojees with acontrasnortU licensed pursuant to the Conoanofs
LY -ns taw.
❑lam exempt under Sec , B k P C for this mason
n I 1 1 ('� 1 Dee n May ��-
ter Y a
WORKWI COMPENSATION DECI.aRAIat
1 hereby ahem older penalty of perjury one of the following oecWatio r:
❑ 1hawaMwdlmainWnaCenifinmof Conventtoulf-inurefwWO sCompen-
titian, u provided for by Section 3700 of the labor Code. for the performwco of the
wok for which this Permit is issued.
❑ I but and will maintain Wortefs Compnuauon Insurer¢, u rryained by Section
3700 of the labor Code, for the Performance of the work for which this Penni, is issuer.
'
My Warman Conpensadon imurwco artier and Polity number are:
C.nim,policy No.: _
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
CIM, ac=e. nwo autbeeonpkutl if the per e"fwonehutndreo deBus ($100)
or less)
1 certify Nos in de performance of the work for which this permit is Issued, I shell nm
employ any person in any mvtmcrm u m hceome s�bVo the `�arken' CampeasWOn
-1
laws of California. Due MA - W /
ApplicatZ if
NOTICE TO APPU : If. •W making this C,mfinm of Exemption, you shook
-
them. subject m the Workch Compensation provio.. of the Lecher Code you mus
raMw4h comply with swh provisions or this Permit shall k deemed re oolot
CONSTRUCTION LENDING AGENCY
1 homey affirm that dem k a conswxinn lending agency for the perfwmuro of
the, wok for which this permit u insw.d (Sec. 31D'T, civ. C.)
Lender's Name
Lenders Address
I certify that I haw read oda spplicuico and sum this the abut iff ..don Or
correct. I agree to comply wit all city and =aunty Ordinances aM sum laws reining m
Moldingconsuwdon,andhembywthoommp mamof Nucitymcomrupnn ere
above-mrntioned property for inspection purposes,
(Wer) agree to ext, indemnify and keep to nnleu the City of Cupcnina agairut
espesp which may in any myoases against said City
in f thecramand
in conugwnce of de grwtini of this permit
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -PO NT
SOURCE REGULATIONS.
Issued by: Date
Re -roofs
01
/ /
1U
Sngnsone of Almlicantrconuacoar Date
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
WIII site oxupw,more m handle hauAou muerisl
forum Wal
a Coon, en
u defined by the C2(.)? Municipal Coder. Chapter 9.12 wo dm Health and Wcty
Co
/
. radon 255J2(a)7 J
E] Y. Ly Na
All roofs shall be inspected prior to any roofing material being installed.
Will Ne applicant or forum building occupantum equipment w devices which
If a roof is installed without first obtainingan inspection, I agree to remove
pe
emit hocaronus air conmmimnu as defined by the Bay Area Air Quality Management
all new materials for inspection.
Distrix?
0Yc -0 No
I haws mad the hazudmm maerials nOtIO ncmenu under Chapter 6.95 Of the CAilm.
nix HcaIlh&Safety Cade, See6om25M5,25533nx125534.lundermandthuifthc building
does not calrently ham a tenwt. that It is my responsibility to nolfy the, occupant of the
rtyuvemon �fh/nmmxmet poor to serer wof Occas
Signature of Applicant
hof,
�ho %� L �T 9 f�
Date
All roof coverings to be Class" "
g xi. or better
Owner or wmomcd es=m Dam