05060186 CITY OF CUPERTINO
BUILDING DIVISION PERMIT COiTRACTURnINF'UIiMATION, :�;
BUILDING ADDRESS: PARAMOUNT SIGN CONTRACTORS PERMIT ND'05060186
ARU CTR DR
R'S NAME: PERMIT ISSUE DATE
HUNTER PROPERTIES 2201 ROAD 05
PHONE: SANITARY NO. CONTROL NO.
(707) 485-7555
ARCHI77ICf/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
t� t�
Sop LICENSED CONTRACTOR'S DECLARATION Job Description
I 1 hereby affirm Net I am licensed under provisions of Chapter 9(commencing
with Sadon 71110)x(Dlvi n3ofthe eudess dPmIn m yllemuts
+'+ kfuBmreeanderc • I:+ SIGN--30 SIGNS (CIVIC PARK)
?�b LicenxC a Lica (BETWEEN TORRE AVE & DE ANZA BLVD)
3 Deis ARCHITECT9D TI
1 tooko N
tl and my plans shxl M used u public me
y
h� Licensed Pmfcasional
b� OWNER-BUILDER DECLARATION
1 hereby.(sero that 11. exempt from Ne Contractor's C License Law for IW
O O following massa permit
t 7 cots,Business and w,demolish.
Cade:Any city OF mumy
$Pi pow t requires r pamil las construct pito ice fmw,demolish.ar mash any structure
Met
iuisau edpurs pursuant
she apPlinntfar soohpermit m file aaigmd xakmMt Valu$68000
< Nat W is licensed Pursuem m Ne provisions or Ne Conwemr's limn law(Chapter 9 Sq.Ft. Floor Area
(commencing with Section 7000)of Divhion 3 of the Business and Profewioru Cam)or
Nat he la exempt therefrom and Ne basis for the alleged exemption.Any VinlNan of
Sermon 7031.5 by arty applicant for a permit subjects the applicant he a cool penalty of APN Number Occupancy Type
nal mart Nan Eve hundred Miami,(5500), _
❑1,u owner of de property.of my employes with wages as their sole compensation,
will do the warkmd Motorman.IF.1 inunded aroffcred fonele(Sec.7044,Business Required Inspections
and Professions Cade::Ihe ComsecmN
r's LICCe Law mons not apply Owner /�
an Owner of l P
property who builds or i mprowes thereon,and who does s uch mark himself or through his
own employes,provided Nal weh improwmenu are netkknded orortmed forsale.If.
hamar.the building or improvement is said within am 3'ar of mmpleum,the Owner.
Wilder will haw the Written of proving that W did Ran build or improve for purpose of
sale.).
❑1.u moor of Ne progeny me coolumnly connecting with licensed cenuamars k
cunstmm the pmjm(Sec.7(I44.Business art Professions Cade:)M Comemme,U.
came Law does not apply in an owner of property who builds or improves Noreen,and,
who contracts for such projects with a common r(s)licensed pension,in the Connacmr's
License Law.
m exempt under Sec. .B&P C far thla won
Dam
.s WORKER'S COMPENSATION DECLARATION
I hereby afNm under penalty of perjury aro of de following a mlarations:
❑1 hawaW wBl mainWn a CeNOam of Comas N ulf.iuum for Wo&-ezCompen-
nation,as provided for by Salon 3700 of do Labor Cade,far de performsem of the
work for which this permit Is issued.
❑1 haw and will mainWn Worker's Compensation Insurance,an mquimd by Section
3700 of the Labor Code,for Ne performance of Ne wart fa which this permit is mood.
My Wo Compemad grana caniuend Poliyn �heer�em'
Carrier: . n Policy No.:11QLp1L1_
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This semam Reed nor W comPksd if Ili permit Is foram hundred dollen(SIM)
or less.)
I cenify that in the Performance of the work fon which this permit is mood,I shall not
employ any mo en in my maamr W as in became subject to tis WorkCn'CompeMadon
Laws of California,Data,
Applicant
NOTICE TO APPLICANL`If,after making this CeelMm of Exemption.you should
became subject in to Worker's Compcusedon Irmitlans of Ne Labor Code.you must
.J,Z, forthwith comply with such provisions Or this Permit shall be doomed ranked.
z O CONSTRUCnON LENDING AGENCY
Iheeby affirm Nat there u a croswcdon lending agency for the Performance of
a> the work for which this permit is Wood(Si,.3097,Civ.C.)
~n. lender's Name
0.Z Laxder'sAddress
L)O I certify that i haw read this applicxfan and auk that the awn Information Is
Econes I agme in comply with all city and county ordinance ok and slaws mixing k
DWilding construction,and hereby authorise representatives of this city to soler upon the
W shove-me tioned property far Inspection purposes.
(We)agree to un,indemnify and keep harmless the City of CYPMIoo against
In liebilides,judgments.eesu arta which"you any way acemeagunst Wd City
U In consequence ofth this
permiL
APPLIC U RSTA S AND WILL COMPLY WITH ALL NON-POINT Issued by: �zw Date
SOURC A N a
ho Re-roofs
"'Minamol'A Ii on kr GainTypeof Roof
AZ US MATERIALS DISCLOSURE
Will the app' future Wilding uceupent atm OR Wodle hmardaus material
fined by Ne Commits,Municipal Code,Charter 9.13,and the Health and Safety
.Secden 3.5533(x)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes )(No
WIII the applicant or future Wilding net um equipment of devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit haurdsus air contaminants u defined by Ne Bay AMR Air Quality Management all new materials for inspection.
District?
0 Yes VN.
I haw mad the hummort smakriabnquimmenu under Chapter6.95afdm Celifor.
meFkarN stye 5.35333 anJ3553a.1undcraknd NeOfte Wilding
does not cu mly a toxo I h e my muportsihility he Rotil'Y the sou ant err the
u 9 T&m1afu•ek_c.'raCeYRamafOc Signature of Applicant Date
Owner ar Ruth dva e I Om All roof coverings to be Class nBa or better