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0804000722 CITY OF CUPERTINO BUILDING DIVISION PERNIIT��-��' �^F F y BUILD NG ADDRESS: �Z3400 VIA VENTURA #19 HANKINS CONSTRUCTION INC PMMIT NO. 08040007 38227 FREMONT BLVD 05/16/2008 PHONE: SANITARY NO. CONTROL NO. (510)795-9654 ARCHITEC IENGINEF.R: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH o a a o LICENSED CONTRACTOR'S DECLARATION Chapter 9 Job Description 1 hereby affirm that I am licensed under provisions of (commencing with Section 70og) of Division 3 of the Business and Professions Code, and my license is ADD 5 ' 0 " X 8 ' 0 " HANDICAP RAMP , ADD 1 HAND I C P in full force and effect. �� ✓ Lie t m. tl DR , ELC TRC L Dale Contractor CT'S DECLARATION I d my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION ' i hereby affirm that i sun exempt from the Conv=or's License Law for the following reason. (Section 7031.5. Business and Professions Code: Any city or county which requires a permit to conantct. alto. improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to rile a signed statement that he is licensed to the of the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation pursuant provisions (commencing with Section 7000) of Division 3 of the Business and Profession Code) or $10 0 0 0 that be is exempt tbercfttrm and the basis for the alleged exemption. Any violation of 34254999 Afy Number Occupancy P cY TYPe Section 7031.5 by any applicant for a permit subjects the applicant to A Civil penalty of not more than five hundred dollars (uoo)- Q L as owner of the property, or my employees with wages as their sole compensation, Required Inspections will do the work. and the suuct)= is not intended w ofrered for Sale (Sec. 7044, Business and Professions Code: The Contraemrs License Law does not apply to an owner of property who builds or improves themon, and who does such work himself or through his own employers, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner - builder will hive the burden Of proving that he did not build or improve for purpose of ❑ L as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business and Professions Code:) The Coauacmr's Li- eense Law does not apply to an owner of property who builds or improves themon, and, who contracts for such projects with a contractor(s) licensed pursuant o the Contractor's License LAW. C] I am exempt under Sec B & P C for this reason Owner Date WORKER'S COMPENSATION DECORATION r hereby affirm under penalty of pejury Dee or the following declarations 1 hive and will maintain A Certificate of Consent Ica self-insum for Worker's Compost - cation, as provided for by Section 3700 or the Labor Code, for the performance or the work for which this permit is issued. ❑ 1 have and will maintain Woticces Compensation instuancc, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued ' My Wo (This section nerd not be completed it Cite permit is forone hundred dollars ($IOU) or less_) , I certify that in the performance of the work for which this permit is issued, 1 &ball not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date AppBant NOTICE TO APPLICANT: If, after making this Certificate of Preemption, you should become subject to the Workcfs Compensation provisions or the Tabor Code. you must forthwith comply with such provisions or this permit shag be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the worts for which this permit is issued (Sec. 3097, Civ. C) Lersder's Name Lenders Address 1 certify that I have read this application and state that the above information is ' correct. I agree to comply with all City and county ordinances and state laws relating to building construction. and hereby authorize mpmsentwivcs of this city to enter upon the above -mentioned property for inspection proposes. (Wc) agree to save, indemnify and keep harmless the City of Cupertino against liabilities. judgments, costs and expenses which may In any way Aceme against said City ice conse q c Of the granting of this permit. APPLICA -roofs Type of Roof .� S' o App scant/ n Date HAZARDO MATERIALS D[SCLO RE Will the applicant or future building Occupant atom orhandle hazardous material as defined by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety Code. Section 25532(a)7 Cl Yes 7fNo j All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air ccntaminans as deflncd by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes �No 1 have mad time hazardous materials requirements under Chapter 6.95 of the Califor- Real Safety Code, Sections 505.25533and25534.1undaandtlatifthebuilding dotes nomndy haitismyresponsibililytonotifythe rthe i ;c priDrto.issuanaOra cenifiatcDr Signature of Applicant Date All roof coverings to be Class " '' or better g fir cnt - Date ' or authomcd �