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CONTRA CTORINEORMATION •:
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
SAV -AWN ALUMINUM PRODUCTS
PERMRN0.06070156
19805 STEVENS CREEK BLVD
W NER'S NAME:
PERMIT ISSUEDATE
CHUCK E CHEESE
850 ALDO AVE
08/29/2006
NE:
SANITARY NO. CONTROL NO.
(408)988-4444
ARCHI'IECTYENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hereby affirm Out 1 am Handed under pmvivwu of Chapter 9 (mmmercing
with Section HIM)of Division 3 of the Buvnass and Professions Code. and my license is
in full face andeQeel. 219772
77.
h�
TRASH ENCLOSURE CANOPY ALUMINUM
license Class e, -C/ C47 Lm.R S -
W XA4
Dow �-'a9 /tJr--�— Colonnade
Dow
ARCHITECTS DECLARATION
I understand my plans shall he used u public ¢cords
Licensed Pmfcuional
OWNER -BUILDER DECLARATION
I bercby .(Erns that I Law for the
uusi. from the Coardwfaced. ors
Code: Any city or county
following reason. (Section 71D I.S. amass and a c: Any c
permit m canau0. almm i Improve. rtil or cash any structure
woirM1 inquires strB.
$6800
t for such
n Alan h permit t
for Contractor's License:
fens:te a : Law(gned Laamem
In sl lensed do, the
Sq. Ft. Floor Area
Valuation
pursuce.
Runher ant to ovisiosof
tharacisctogi
his Seamanta0cprovisionsoftheBusinesslisrcnalaneChopmr9
exe Division she Cook) of
Business anO Proose.
Satirom
'at lue is Any
that he u exempt lmrtfrom and the buss for the vlcgc0 exemption. Any violation of
exempt and the r the alleged
cr
Occupancy Type
Section 7031.5 by any applicant for a Permit Subjects the applicant m a civil penalty of
eat mom Nan Bvt handled dollars (5500).
wi L u ower of Oe properry. mY with wags u the'v sole tompcnation,
Required Inspections
al Planet
win dotheworlt s arafruad m. or
wdo does
Code: cors License Law don ink apply b an away
The Contractor's
and Code: The Apply owner
q P
improves thm is
property who builds w improves thereon, and whodassuchwark himul(ar through his
property who builds
ed for ale
awncmPlayeWipingor Natsuchimprovsmmtsarttort earofo
yyv�
"�
mple r.
the Wilding or bnprovernant u all within mu year or, mpro a for are ewer-
Wild.,however,
Wilder will have the Wrden of proving Nat he did not Wild or improve far puryose of
sale.).
❑ I. u r doe p of the property. am 704. B exclusively contracting with licensed mnvxmrs U.
consumer the pmKtt (Sec. ]014, Business and Cade:) The Conveners
((®
b
rty who Wilds n
cense law ears not apply b an owner of property who builds or Improves C.n. ea
who caamess for such projects with a contrdetor(s) licensed puraant m Oe Conuacrors
' y „
License Law.
ry
❑ 1 am exempt under Sec . B A P C for this won
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Af q��
err Data
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WORKER'S COMPENSATION DECLARATION
1 hereby affirm under ramify of perjury One of the f011owing dmlandwase
/J�%�j
UG
1 ❑ I bvemd will maintain a CLtifiom of Comcnt to self -insure far WoM1aYs Cumpert.
�j
ration, as provided for by Section 37M of the Labor Code, for the performance of the
work for which this permit is issued.
1 have and will maintain Workers Compensation Irts .. u rationed by Section
of are labor Codc. for the performance of the work far which Nu permit u issued.
'
My Workers Compensation Insurance canner and Polity number are:
Carrier: 52T4i7- r r.� Policy No.: Cay 7k 2iu (a
CERTIFICATE OF EKEMPT10N FROM WORKERS'
COMPENSATION INSURANCE
-
(This action recd not becomplemd if the permit is furore hundred dollars (SIM)
err less)
I certify that in me performance of Oe work for which this permit is issued, 1 shall not
employ any person in my mannas u t^ become subject a the Workers' Compensation
Laws of California. Data
Applicant
NOTICE TO APPLICANT: If. after making this Catalano of Exemption, you should
become subject m the Worker's Comperust o t provisions of the Labor Code. you most
comply with such provisions or Nu permit shall be lamed motel.
CONSTRUCTION LENDING AGENCY
I hereby affirm that them u a conmuctino lending agency for the performance of
Ota walk for which this pemmit b issued (Ser. 3097. Civ. C.)
finders Name
Lenders Addw
1 certify that 1 have rad this application and sue thL the above information u
corms. 1 agree m comply with all city and county ordinances and sum laws relating m
building conauction. and hereby authorre mismanutives of this city to cnwr upon Ove
move-mentionedpropertyfond
purpowhich
(We) agree to save, indcmni fy and keep armless the City of Cupertino against
m.
epences may in anyway accmc Against said City
cf
uunce
ofuecasuand
inthis pmerit. Titch
A APPLICANT
" APPLICAM UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
NDER TAN err leisD WILL
SDIIRfF RFGULA,BO"S.
Issued by: Date
91� /
Re -roofs
$IB^LYm of ApplicaHAZARDO Data
eofApp
HAZARDOUS USMATERIALS DISCLOSURE
Type Of ROOF
WIII theeCuanswfo�um Wildingoccupantawe2, adth
Heardeusmamdai
As defined by the Cupertino Municipal Code. Chapter 9.12, inti the Health and Safety
Sectionde. 2ss3z(a)7
Yu.�Nu
All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or devices which
If a roof is installed without first obtaining an inspection, I agree to remove
P g
emit haxardaus air contaminants as defined by the Bay Area Air Quality Management
all new materials for inspection.
Distrim7
❑Ya redo
I have mad the hacardms maeriab rttuitemcnu unlet Chapter 6.95 Option Califor-
nia Health & Safcty Codc, Sections 35505,35533 and 25534.1 unkrstand thatif the building
does not Conrad, have a emant that it is my resporuihilit, m notify roc acupmt Of dre
rctuimmcna winch m met arta issumea ora Ccrureae or Gcep y. /
��
Signature of Applicant Date
All roof coverings to be Class "B" or better
g
Owner Or authorized agent Dau