05080055CITY OF CUPERTINOtHagWp^«x
BUILDING DIVISION PERMIT
CONTRACTOR INFUI2MA.TIOIV
BUILDING ADDRESS:
TAYLOR WOODROW HOMES
1ERM7No'05080055
R'S NAME:PERMIT
ISSUE DATE
TOWN CENTER ASSOCIATE
2300 CAMI
05
NE:
SANITARY NO, CONTROL NO.
(925)365-3100
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT' PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 hereby ". met l am ibions licensed under prru of Chapter 9 (cam r.rcul
with Section 70M) of Division 3 of the Business and Profcsdam Code, and my license 1,
I. tell rata and err -
I. fallcen
REVISION - - FOUNDTION . ATS /
Lk.g
Dau Canaram(Tfr-?wrro¢c„�
NO NEW PERMIT ISSUED/ORIG. #05020006
ARCHITECTS LARATION
PAID PLAN CHK REPEAT FEES $348.56 (INCLUDING BL
ImdS ndm Tissot atoll ilk
U
iccnsed actamud
OWNER-BUILDER DEC RATION
1 hereby 4fthat I am exempt From Commerce, License Law for the
liem
following tenon. (Section 703 1.5. Business and Professions Cade: Any city or County
which m9ulres a pear 1, to construct, alter, improve, demolish. or repair any stncturn
prior in its issuance, also requires the applicant for Much permluo file a signed onumem
mat he is licensed pumuntta the provisions of the Co uncer'i License law(Chapter 9
Sq. Ft. Floor Area
Valuation
(commencing with Section 7000) (Division 3 of the Business and promote. Cram) a,
G O
Met he is exempt tMmfrom and the basis for the alkgcd assumption. Any violation of
Y
APN Number
Occupancy Type
Section 7031.5 by airy applicant for a permit subjects the applicant in a civil penalty or
our mare dun nue thea ted dollars ($500).
❑ I,uowner of Ne paperty, cea wire campenuness
Re uired Inspections
9 p
mu encs r edeirsek
will da thew.., Cadets r notodrns,La a for Wapply Was. Business
do
an Ccaemear's
and artyProfwho
ons carie: The ConvaclorS Uceaue Law dee, not apply lf r through ownu is
thermrve who aucltwmkh roffredmrsak his
owpertyvhas. proideddevu
am m offered toe tole. It,
awn employes, D m am
m yearod c
however, the building or Improvement la told ore Weld at completion, owner-
building or i mashasuch cit is mid
a did purpose
builder will have the burden of proving ren he did not build or Improve fur pugoa of\}
V
ask.).
❑ 1, as owner of the am exclusivelyssand confessions with licensed eanuumss m
i
construct the Sec.7property.
not (Bey. 70 Busiand Code:) The Contractors Li•
ceres n ownerof propertywhoWildsImprnN3 thermn.Caress Nd
LBWdocsnotapplyman awn.arpmpeny
icesedt hate
who.Lfor such projeeu with a conuacmrtU licensed puMuanl m rix CmBsnnen
whocoronets
Lice ase law,-
❑TomexemptunderSec. ,Bd:PCfor Ibis moon
. _ .......
r Dau
WORKERS COMPENSATION DECLARATION
1 hereby ufiem under penalty of perjury one of the following declaralions:
❑ 1 ham and will maintain aCmOficam or Consom malt-insure fm Wmkees Compcn-
udon, as provided for by Section 3700 of the labor Cade, for the permara ms of the
_
work for which this permit Is issued. - .
0 1 have and will mumuin Worker, Compenssuon Insurance, a requited by Section
3700 of the lather Code, for the Performance of the work fmwhich this parent is ivad.
My Workers Compensation Insurance artier and Policy number are:
Carrtma''4"r}P rnrn. Polity No.:
CERTIFICA OF EMPI70N FROM WORKERS'
COMPENSATION INSURANCE
(This section need not becomplemd If the permit is rormchundoOdollate (SIM)
or mss)
I certify mot in the performance of the .,it for which this permit is boned, I shall am
employ any person in my manner an as in become subject to the Worked Compensation
,
Lam of California. Dam
Applicant
NOTICE TO APPLICANT, If, after making this Ccniffate of Exemption. you should
become subject in the Worker's Compensation prevision, of the labor Code. you must
forthwith comply wit such Provisions or this permit shall be decreed revoked.
CONSTRUCTION LENDING AGENCY
I hereby aRmn that inert is a Construction lending agenry far me perfarmmce of
the work far which this permit is issued (See 3097, Civ. C.)
Lenders Name
'
Lenders Address
1 cenity that I have read thin application and sum met the show information is
correct. 1 agnm to comply with all city and county ordinances and Aute law, relaung to
building conahacti9n. and hemby aufhodre mpasen s ices of this city in enter upon the
slow-mentiaad pmpeny Fm impeeuon purposes
(We) agree re ave, indemnify and keep humtees the City of Cupertino against
liabilities, judgments, costs and expenses which may In any way acme agalM Mid City
In con mote of the granting of this permit.
AP UNDERSTANDS AND WI COMPLY WITH ALL NON-POINT
Issued by: Date '
S CE RE ULATIONS.
(,
4 Ile O$
Re-roofs
Type of Roof
pbantrcamnmor DateHAZARDOUS M TERIA ISCLOSURE
cep" .a'r furorebuilding Occupant nom or handle huudous material
e Cupertino Munbcip I Code, Chapter 9.12. and Old Health and Safely
r
5532(,)7
All roofs shall be inspected prior to any roofing material being installed.
a
If a roof is installed without first obtaining an inspection, I agree to remove
applicant or (alum builJing mcupant tea cyuipmenl or devices whlcM1
emit huardous air conuminanu u nerd by Old Bay Arte Air Quality Management
all new materials for inspection.
Dist ict7
❑ Yen u
I have mW the hasaedous materials requirements under Chapter 6.95 of the Caliror.
ni afctyCode.&v6mu25505.25533uu125534.1undcrs dmubfda: Wilding
sen not carte y haw a tenant, mat it as JO m,pMe ihility to notify tbe oceupart of dre
re kemcntsw ich mast 'u m uanccaraccrtincamo(Occupmyy.
Signature of Applicant Date
(q,�cmet
Y DS
All roof coverings to be Class "B" or better
own
authariredAgent o
. CITY OF CUPERTINOa�
x
BUILDING DIVISION PERMIT
CO TR' ,CTO'R M;�.ORRMATTiQ1V ;
BUILDING ADDRESS:
SOUTH BAY CONSTRUCTION CO
�"'04080255
OWNER'S NAME:
PERMIT ISSUE DATE
HUNTER PROPERTIES
c;1 I T)TNTTLqTQN STREET
ONE:
SANITARY NO. CONTROL NO.
408 379-0400
CHmScriENGINEER:
BUILDING PERMIT INFO
BLDGO ELECT PLUMB MECH
O
LICENSED CONTRACTOR'S DECLARATION
o
Job Description
I hemby affirm Nat I am licenProvisionsunder Provisions of Clupter 9 (cemmencing
wish Section 70(10) ol'DivWon 3 often Business and Professions Code. and my license Is
I.fnfarmandof.,.
u
ON-SITE DEVELOPMENT PACKAGE
LicenseClass L is N
Date Contractor
ARCHr1EC1'S DECLARATION
1 understand my plans shall W used as public mcnNs
D
Licensed Professional
OWNER-BUILDER DECLARATION
`,l.=p
I hereby affirm that I am exempt from the Cmnlnctmrs License Law for the
following reason. (Section 703 1.5. Business and Pofm(ons Cmk: My city ar County
which acquires a permit to consumer. atwr. Improve, demolish, or repair my structure
g1Qt,
! prior m its Ismarue. also acquires den applicant rot such Perming file ulgned sukment
he is licensed ConrscturaUceaue Uw(CMplar9
Sq. Ft. Floor Area
Valuation
that premeditation provisions nfthe
(commencing with Section 7000) of Division 3 of the Business and Profeulnru Code) or
15 0,0'0:0 0
that he Is exempt thorniness and the basis for the alleged emerption. Any violation of
APNNumber
q
�;i I �lOccupancy\`Type
Seetlon 7031.5 by my applians fora permit iabjeclo the applicant tea civil penalty of•
.ata mthanevehundreddollars(S50o).
0 L as mwmr ofthe Property, ar my employm with wages u thcir sole cempewdon,
,
Required Inspections
will dm the work, mul the souctuw imotimended oraffered funale(Se:.7044, Budms
and ProfeWons Code: The Committers License Law d= set apply he an own al
property who Wilds or impasses themen, and who d=such work himself or through his
awn employ=, provided that such improvements art ms imand ed croRo ml forule. IL
however, the building or Improvement is sold within aro you of Completion, the owner-
huilder. will have the burden of proving that k did not build or Impose for purpae of
.In ).
0 I, as owner of the prepare- am exclusively contracting with licensed mntratrers k
construct the project (Sec. 7044. Business and Professioro Code:) The Camamm's U.
cense law dm not apply to an owner of property who builds or Improves du man, and,
who Conmca for such projee wlthaeontnster-Wlicensed ns he the Contractor.
License Law.
❑lam exempt undo a .B&PCfor u n
Own '� Dak ifi PS
- - - - —
YORKERS COMPENNSS/` ON DECLARATION
1 ruby aRitm under penalty or me one of 0n following declantians:
sum and will maintain a Cutifcam mrCanse n in self-imum far WorkeYs Compcn-
-
n, as provided for by Section 37011 of the labor Coda, for the performance of the
k for which this permit is banned.
01have and will maintain Worker's Compmsadon Imoramm, a acquired by Section
0of the labra Cotic, for the performance of don work fm which this peamittsLeaned.
My Workers Comlensation Insunnce nnia and Polity number m:
Carder. Polity No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section send not he completed Ifsbe permit is forms: hundred dollm, ($100)
mins)
1 certify that in the Perform f th:nrk for which this ppornfit is Instead, I shall not
employanypcnanlnany net an as or pttome mbj orkcra CmnpmesaOan
Laws of CaRfomia. D§y
Applicm1 /ems
NOTICE TO yrp ANP. If. after maki%8 k of Ere
''2'
Tot=
tcEnific
become subj I w the WorkeM1 Compenss " n p%visions of tine lade Code, you muse
roMwith eon with tech prwiaians or Nis permll shall b: deemed rooted.
CONSTRUCTION LENDING AGENCY
1 hemby aRrenNn Nem its canstructirm lending gency far the perfonnama of
the work for which this pmrsh is valued (Sec. 3097, Civ. C.)
I milers Natne
Leaders Addrm
I certify that I have read this application aM slow this the above Information is
mrect. I agree in Comply with all city and county ordinances and sow laws oxides k
building Contraction, and hereby amhorms, repmsentnivn of this city in enter upon the
above-medoad property far inspedon Purposes
(We) agme to ave. indemnify and kap harmless the City of Cupertino against
Ilabilides, judgements. and expenses which may In my way name atishur said City
1. of .c�cam
Y
DERSTANatingOS ArND WILL PLrmit
APPLICANT WITH ALL NO -POINT
Issued by: Date
SOURCE LAT1 NS. .--
-
Re-roofs
Type of Roof
�1 /
_ �' �4 �f
si ar ApplinHA nuamI TE Ds
HAZARDO MATERIALS DISCLOSURE
Will the st no fou building ar9re war handle material
Heallous
e.0 Chapter
a defined by the Cupenlnm Municipal Code. Chapwr 9.12. and the Health and Safely
Cupertino ni
cads. Section 25532(a)?
All roofs shall be inspected to any roofing material being installed.
❑Yes ❑No
0
prior
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building amupenl use equipment or device, which
Ir haca dous air cansamiounlo a defined by tee Bay Area Air Quality MMSCMCRL
all new materials for inspection.
uict7
❑Yes CNo
Ihavc acW thehuurdasmmriabacquirem:numdcrChapkrd95ofthaGlifor-
nhHmlN&Safety Cocc.Scdou 25505,35533 amI25534.1 dcruntldmifde building
dm Iron cutrentiy are a.0L that It h my mchidry m nedfy the mmitant of the
mqulmmcnts mass'- ngdorml ofacctdOnwofocapan .
Signature of Applicant Date
4
All roof coverings to be Class "B" or better
mthoriod agent / Da