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BUILDING ADDRESS:
MI WU
PERMIT N0. 06070067
10280 MORETTI DR
OWNER'S NAME:
PERMIT L4UE DATE
09/21/2006
SANITARY NO. CONTROL NO.
ARCHRECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0
LICENSED CONTRACTOR'S DECLARATION
Job Description
P
1 hereby sRlrm Nn I am licensed under provimona of Chapter 9 (commencing
with Satim7Ofg1) art Division 3 aide Business and Professions Codc.and my licence Is
imm�farm andeffen.
SFDWL W/HABITABLE BASEMENT 2953'
L rm0ass, a
Dam
GARAGE 432'
-ARCHITECT'S DECLARATION
I understand my plans &hall W used a public records
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby atTtrm that I am exempt from the Conuenafa License Law for the
following reason. (Section 703 L5, Business and Pr.fessimu Cade: My city or county
which requires a permit m construct, also. impmvn. demolish, or repair any mmnum
prior a its isstwca, also require Me appliant for such permit to file &signed wlemem
Committers Licence LAw(Llupar 9
Sq. Ft. Floor Area
Valuation
that he u licenced pursuant ro to provisions ofthe
(commencing with Section 70DO) of Division 3 of the Bumnoss and Peefeuiom Cade) tar
$657391
Out M u exempt rhemrmm and the basis far the alleged exemption. Any violation of
pI N Number Occupancy Type
Section 7031.5 by nay applicant far • permit W ricol the applicant to s civil penalty of
trot mom than fan hundred dollars IM
❑ I, as owner cribs property. or my =plays= with wages a thea sale eompemdon,
willdothework,andthesunclumismtlemndeda,oQered forsale(sec.7014,Bummss
Required Inspections
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and Profession Cade TW Connnors License Law don cot apply in an Owner of
property Wilda or Uoparmelt emnn. andapeddamaueuwmkhumel(" thmugls his
owoemployers,provided mwmanutaemt earofaaraReed fm tale R,
howler,, due Wilding or Impmwment u cold within arc Year or mmpleda due Owner.
promoiati
r
Miller will ban the Wrdcn of proving that he did not Wild or improv f" purpose of
Sala.).
ft 1, n awn, of da property, am exelminly counseling wish licensed conweon ro
conamct ted project (Sec. 70th. Business and Profession, Cade:) The Connector's U.
cone law don cot apply he an owner a property who Wild, or Wprows derma, and
who con4MLL for
nof Mc followingdeclam0am:
have and will mammina canines ofcementamlf-insure re werkars compen.
sation, as provided for by Section 3700 of the Labor Code. for the performance of the
work for which this permit Is issued.
❑ 1 Mn and will maintain Workees Compensation Imuratem, a required by Section
3700.fdue labor Code, for the performance aide wads for which line permit u lasued.
'
My Worker's Compensation Imwance artier and Policy number are:
Caller. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thkmction need notes completed if the permit k forum hundreddallars (glen)
or less)
I certify duce in the performance of she work fa which this permit k fssued.I Nell not
fC9mpemWm
employ any person in any muuer as as a became Subject 4W'
law& of Calif.r.m. 72,
7��-l/��a--
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Applkam
NOTICE TO AP
of the labor Cede, you mum
comply with two provision m Nu permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby a fran dun them k a saturation lending agency for de performance or
the work for which this permit Is Issued Iso. 3097, CN. C.)
Lenders Num
Lenders Addnm
I omify dust I haw mad this application all moa that the grow information Ix
I agree to comply with all city and county amilmnen end Sue laws elating a
building consuuction, and hereby euthorim mpresennives or this city to enter upon the
for inspection
a1mve-mentioned pm,crty purpous.
(We) agree to Save, indcmni fy and keep barmless the City of Cupertino against
liabilities. judgments. caw and expenses which may In any wry Mame against Said City
in consequence of the granting of this permit.
/
APPLICANT
Occupant mom orhandlc haasrdous macriBI
So dunned by the Cupertino Municipal Code, Chapter 9.13, and the Health and Safety
Cods. Section 255334)7
All roofs shall be inspected prior to any roofing material being installed.
❑Yrs 5Na
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applkam or future Wilding aempani tax equipmmt"devimv which
It he7ardoes air comminanu as defined by the Bay Area Air Quality Management
all new materials for inspection.
Duuict7
❑Yes lewd
I haw mad the insertions materials requirements under Chapter 6.95 of the Califor.
Sala Hcal &Safety Code. Sections 25505,25533 and 25534.1 umkreand dim ifde Wilding
dam
Data