05100081 CITY OF CUPERTINO * ' �' '
BUILDING DIVISION PERMIT ;.CON ILA CTORANFORMATION "rc
at
BUILDING ADDRESS: ELEANOR WENG PERMITNo.05100081
7575 NORMANDY WY
R'S NAME: PERMR ISSUE DATE
ELEANOR WENG
PHONE: SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
l� l�
i o o LICENSED CONTRACTORS DECLARATION I Job Description
I hominy amrm Nm I am licensed under pnwisions of Chapter 9(commencing P
<tl wish Session]OrI(y)of Division 3 of the Business and Prifesswru Code.and my license is
n full forceme e REMODEL/EXPAND KITCHEN
�E License Class Lc.g
e n Dam conmemr 2 BATHROOMS
Amy ARCHITECTS DECLARATION
f W U 1 understand my plans shall be=it as Public records
a
sad Licensed Professional
3 Oat I am exempt
fo DECLARATION
0 f 1 hereby slum Not 1 1. exempt from the Contractors License Law for the
O o following reamns permit
t 7113 L5,Basi••..and professions,Calc:Any city m county
Q which rtgvs u n permit re cowroct aper.improve dcmolW,or repair any uiumme
3Zi
prior msl issuance,pimenn us thrcse
theapplicanto for Cohpcamitw.n.Law(chate a signed mem
m< Naluriseing whpursuant wine of Diniau of thehe Business
IJccrollaw(Chapter9 Sq.Ft.Floor Area VaIU 3n1232
€~$ (commcrm exempt Sersian70nd thams nlaf al BedcousarWon.Any
Code)in
e
that W u exempt thmefrom Intl Ne bssu for the alleged eamption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of ppj�Number Oecu Inc T e
Out mors Nan Dae havered dollars ISM3 6 611156 . 00 p y yp
❑i,o owner of Ne properly,m my eroPloy.with wage ss theirmly cOmpeusetion,
will da NC Wmk.Nd Ne SWnnR Y nal intended mnReRd(or Y1C(See.7044.Business
and Profeasiou Cade The Conuecmrs License law dons Wl apply an an awns of Required Inspections
property who builds m improves therem,and who doessuch work himalforNmugh his
"a anployeu,provided Nal inch improvements an:not intended moffesd for sale If.
bolder.the Wildingorden of provviinumidwithinoneyear OrImrove fr the pupwnvf
builder will have the Widen of proving Nu W did race WiW m improve far purpose of
sats.).
❑1,as owner or the propen,,am commonly canuacting with Ilescomil cmevamam in
construct the pmjen(Sec.7064.Business and Professions Code:)TM Contractors U.
ccme Law dots not apply in an wmer of pmpertywho Wilds or improves thereon,and
who contracts for such ryojccts vi vatnrts)licanxd Ounvanlm Ne Contrcloh
EjIwe IoW.
❑lam exempt under Sic. ,Bg:PC far Nu moon
Dae 0
WORK CO ENSATION E LARATION /
I hereby affirm under y Pasjmy n of following declmaniou:
C3 have and will maintain a Cera morConant to self imum fm Worker's Compen- E
inion.as provided for by Section 37W Of Ne labor Code,fea Nv Performance of tW
work for which this permit is issued.
❑1 have and will maintain Workers Compensation lemurs¢,ss requited by Section
37011 of Ne labor Code,for Nc performance of the work for which this permits issued.
My Workers Compensation Inmvntt extra and Policy number are:
Cartier. Policy No,
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(ITusemim reed Out W completed if she Permit he for one hundred do0an(3100)
or less)
I cannily shat in the performance of the work for which this Permit 4 moved,l shall nm
employ any person in any manner.as in mb'eet eWMar Compeuaon
Laws of California.Case L .l
Applicant
NOTICE TO APPLICANT:If,after mn this Certification of Exemption,you should
bcaomn subject w Ne Woheri Comps ad n provisions of the La Wr Code you mute
.J z forthwith comply with such provuioro oW s permit shall W doomed revoked.
ZN CONSTRUCTION LENDING AGENCY
[—i IMmbyarrirm Nat thein i,.e.mmuctinn tomingagnmr,for ete Ptrrormm.of
a> Ne woh for which this Permit 4 issued(Sec.3097,Civ.C.)
W Q Lenders Name
z lenders Address
U O 1 certify Nat 1 have mad We application erW sum tha ec above infom itivn is
tf. cormtt 1 agree w comply wish all city and county onlinances and state laws slating w
building construction.and hereby amhoda mpreantatiru or Nu city m enter upon the
4 ahovcmenuovedproperty for C-Pc on purposewhich ms
(We)lgrm to ove,indemnify and keep hemles tW City of Cuportin t!g cos,
ti Z in COiniesoemoC mus,filen costs and expcmcsemit. may in any way¢cmc agaimisue City
U vZ in APPLICANT
of thegranting of this permit
^ APPLICANT UNDERSTAND WILL C MPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Iola L Re-roofs 4
Signaaus of ApplicanVCantraao Data,xAzpaoo MA A OrsttosuRR Type of Roof
Will Ne Cupertino
forum Wilding anlsmreurandhhanNOusmlterial
,defined by 25 Cupertino Municipal Code.LTopwr 9.12.and the Health and Safety
aJc,Section 25532(x)?
❑Yu QHo All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtainingan inspection,I agree to remove
Wndmor al ixorteirfusas difding att BayAcy Air Qualityent or Miouscomit P g
emit haraNnus air canmmiruns u JcOncd by Ne Bay pro Air Quality Management all new materials for inspection.
Dissim?
C]Yes (ya Nu
I have mad don hvaNmos materials requirnmems under Chapter 6.95 of ftCalifor-
nia Health&Safety Code.Seetimu 25505,25533 aril!M534.I undoom it Nat if dee Wilding
dace not currently have a ten It's my ser 'hility m rotiry Ne oecupant of the
requirements which mow met pri wism ofa CeruGcatcofa
071"R 0 Signature of Applicant Date
owner or authwxcd agrn Dte All roof coverings to be Class"B"or better