08100089 CITY OF CUPERTINOP.4 ,
BUILDING DIVISION PERMITCORACO,Ii INF,OI2MATION ,;
BUT IT ESS: PERMIT NO.
�227�1U CRICKET HILL RD ARGONAUT WINDOW & DOOR, INC 08100089
NER'S NAME: PERMIT ISSUE DATE
LYNELLE D LEWIS—RAYMOND TRUST 1901 S BASCOM AVE STE 800 10/16/2008
PHONE: - SANITARY NO. CONTROL NO.
(408) 378-4018
ARCHriECnENGiNEER: BUILDING PERMITINFO
BLDGELECT PLUMB MECH
I!
3o p LICENSED CONTRACTOR'S DECLARATION Job Descrl tion
U 1 Wrtby affirm that 1 am ftheed under provisom of Chapter 9(commencing t,..1. p
^z1
with Secres70l8Bect. sonlafthcBusmssaMPrm(ctsomCade.aedmylicenms RPLCMNT WNDWS LIKE4LIKE, BURNS TO MEET EGRESS
m full force.ed eRecL
j i License Clan
Dam Connector
RQURMNTS
o F q
e 7W ARCHITECTS DFCL DECLARATION
?-U
[understand my pons still be used as
public records
9.
O� Licensed Pmfcssional
3OWNER"BUILDER DECLARATION
iE 1 berehy my.Not 1 am exempt from the Contractors License Law far Lie
cc following reason.(Section 7011.5.Business aad Pmftedons Cade:Any city or county
i U F which rectums,a permit m conmrtet,alcor.improve.&.NW,m mi air any structure
_iEprim,m its issuances.9.requires tic applicant for such permit to file a signed summent
<
that he is licensed pursuant to the provisions of the Contractor's Licenm Law(Chapter 9 Sq.Ft. FIOOL Area Valuation
Y�G (commencing with Section 70M)of Division i at the Business and Professions Code)or $19747
It $ that he is eaempt them(sur,and the bass for the allegcA exemption Any violation of
Section 7071.5 by arty applicant for a Permit subjects tic applicvn W a civil penalty ofNumber Occupancy T e
Our mots Nen five hundred dollars(SSWI. 34235012 ! ( p y YP
❑1,u awnv of dm property.m my employee wIN wags ss Heir role compenadon,
MR da the wmk,and the a Com semes Livens ora o,do far apply
as Lot ow.of
and arty wh ons Cade:The Conuanor. std who Isw does art apply lf rt owner mf Required Inspections
property play b,pmAdtice impmve.chimprve who..amhwork himselfarulwuLb hs
own play=,the bs,provided than such improvements au not ino:ofs oro@sed fmal.IC
badder,,the Wilding m impmrproAn4 cold within mm Wild of Improv for the owner-
budder will live ties burden M pmNne Net be tlitl not ddW m improve Ito purpose of
yyl/.u owrcr of the Property.am exclusively comMial,with liccnmd con,acme in
construct use project(Sec.7044.Business and Professors Cade:)The Cobacmes U.
came Lew dee notayyply to an owner of property who Wilds or improves Nemon,and
who conwe�miue/b projects viNacon o,(s)I`nmd pursmm toNeC toh
❑I am elemys.m(u Sec k P C fm y 7e J�
WORKER' 4011 PENSATION DEO ION
1 hereby aQum under pemltY of perjury uric air Ne allaxing dr<laaamtc
❑1 htve ted will malnssin a Cenificam ofConum m self-imam Ito Wortcfa Compen-
union,as provided fm by Section 1700 of Ne Lobar Code,far the perfmmenee of the
wort fm which this permit is leaned.
0 1 have and will m.inuin Wortres Compensation Insurance.m rryuired by Sectio -
37W of the LaUOr Code,fm tic performanecof the work for which N4 permit is issue
My Workers Compensation Tmmmna carrier anal Policy number are:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Ohssectio need not be completed if Ne permit Is fmone hundred daRan(SIM)
or less)
I certify t N performance a the work for which this permits' .I snail nm
cmploYI inanym rm o comes lac Ih Worker mpemaa
bows of C p W� / .,d\
Applica LIK
NOTIt PUCANT:If.. aWag ths Cern c e of Exemption. tt��shOn"
become subject m the,Workers Compemasan pmvisom of Ne Lobos Cod.yoolnuu
.J O forthwith comply with such Provision.m thisPermit shall be d emed revoked.
'Z y CONSTRUC`nONLENDINGAGENCY '
[-a I Mrshy IM.Net Nero I..c..do.lending agency far tic perfarm.of
LYi Um wart far which this Permit s issued(Sec 3097,Civ.C.)
Q Leaders Name
z Leaders Address .
U Q I testify that T have mad thisapplicdion and cute that the above information is
It, P correct.T aLme to comply with all city and county on Inman and ram laws relating in
V Wilding comtnxtian,and hereby.uthosixe representatives of Ns city to cmvupon tic
W above-mentioru l property for impeaio purposes
C (We)agree to ave,indemnify and trop harmlea the City of Cupertino agalem
^ In liabilities,Judgments.crtramd capenw which ma y way..against said City
V z in ca ear Ne Lranting ofthis permit
^ PP A UNDERSTAND ND WI OMP W ALL NON-POINT Issued by: Date
v
Re-roofs
Si oaf Appli on sur Dam
A]A OUSMATi;o DISCLOSURE Type of Roof
Will tic applicant.,Cupirem future Municipal
Co eauPantmre m ands hamNomd Safer l
de0ned by 25 32(.)? MuniciW 1 Code.chapter 9.11,and Ibe Health and Safety
. 0 en zss7z(.)7 All roofs shall be inspected prior to any roofing material being installed.
❑Ye �J No
Will IW applicant or future boldin,aecupam use ectipmcnl Or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit h.rsrdnm air conuminants u defined by tic Bay Area Air Quality Mamgcmcnt all new materials for inspection.
Osselet?
0 y No
lb—mal the haavtlr mmderials n:quirommusunhr Chapter G95afNe Calif.,. ,
out Health k Safety Code.S,.+'—.755115.25577 Lod 25534,1 understand thmifde building
dos cot currently have.Ian.L that It s my reapomib"ty an notify tic occupant of the
requirements which must be met prior an issuance of fiewe araapmry. ft Signature of Applicant Date
!� 11_ l.(� D4-3 -4
All roof coverings to be Class'A¢'or better
DWner.mramthorifad cm Data