06090060 CITY OF CUPERTINO ��-��.x•.xr��.tiYMg " �' '
BUILDING'DIVISION PERMIT OR I
,CONTRACTNk'ORMA TIQkYc ,
BUILDING ADDRESS: PETER' S CONSTRUCTION 06090060
11063 BEL AIRE CT
OWNERS NAME: PERMrr ISSUE DATE
EVELYN PAN 100 CONCORD CIRCLE nq/2e/2nois
SANITARY NO. CONTROL NO.
(650) 906-8788
ARCHfn:R/FNGINFan. BUILDING PER,0171 O
BLDG E1ELT PLUMB MECH
ZZ 0 0 0
�Op LICENSED CONTRACTORS DECLARATION lob Description
I an y alTcm d a I w lisnml uMn Perm'of Claper 9(mmmmcint
d Batton 701K0 ofDirimaJofthc aM ProfvsaN Codc,aM myHena4
>> mmBO c marrm aal�a RELOCATING LAUNDRY & REMODELING BREAKFAST NOOK
1xrYnclav LK.. .
ata Dem C..
ARCHfrELTS DECLAR TION
S C�C I Y Pla sham be coad u Public rccordt
JyU
Liavcd
10 Pmfwwml
OWNER-BUILDER DECLARATION
f 1 hermr aRrm that I ran rump,from t c Cwvacmrs Lkuuc Law for de
0 C fcib ,t mown.(Scrum 7031.7.B�rcas and PmfcviaN Ccdc:My my or cnuNy t
'w .
S s LL hich mNalles.P it 10 Cpm1Y ales,bn, d,00alm.M Rpm'any LNc1Ym $5500
_zy prior Mita ivunce.Woregwry the.pplkantfarach pami,m Ru.alPtcd Nlpllnll
< datmlaBnNmwmYllo a .n.r9aaeoflmcmlmalnr,L..La.(O.P�.9 Sq. FC Floor Valuation
L SF S (rnnmencint wl Savor 70DO)of Di.ivan 3 of the Busuc W Pmfeuiov Code)or
dw be a ossmp,the tfmm,ad Linc hula fm tho 940 a Pdm.MY violation of
Setion 7031.5 by any tipplic.at for a tr,ni„ubje Lbe-Wianl 1n,cit Pta.ItYd ALPN Mffibtr v u Occupancy Type
no more than fiw Yoodred dolMn(5500), ��
LY PMrr Of de la"Polty.U MY G •✓
nPloymlin WI YdltlrIDICcoolo-
•.,W
add dothc'.at todance°oc'ore u notowndcd or aQued for,ale(Sm 70N,Bnmmr Required Inspections
and Pmflont Code The Caavamar's U Law docs not"Py m.n..aq pe
Kopmty who builds or=,ao,ea N O,and who dca such wmk hi—if o lhmulFt bV
atw aoploym.Provided that nch ImpmKmenu w ort udentrd oroBemd fm salt if.
M1awme.,de bwWi,or improemcnt'v aoW Whin me Y of cerploiio,d.e oww.
builds w Q ha,v d1e 1, of prow z than he dM Ont WM a iron , for Purpo¢of
alaA
❑L u owner of tie N.p M.am a rclar1 1Y comrcunt with licemed cmNanore to
mNvtmt de r*ct(Se-706x.Butinm am Pmfvdarta Code)The C000aaor'.LL
cove L�docs ea apply m an ovna a PropmY wdo bu5dr ar inn r den0on,and.
who NMfY.1 far,OLl pmjLl34 with SCOrIVCat(.)BRItSd peaaaft w the(,•ane
0 laoo aw,
wvemP node see ,BdPCfor lbu.
r Date
WORKERS COMPENSATION DECLARATION
I hoeby.fli lander penalty W Perjoy asalino following hely n...'
❑1 ha.e.ad w01 mairvio a CetlBam or Con¢u b u3f-ie.v.e fa Warkc/'Cenpeo-
satin,Y provided for by Sectio^37()0 of.de Iadbor Cod,%far de performance a de
wet far which Nis Knoll u Wood.
❑I hate and will mainam Wo6a,C.Pemalion lanot u m4wrtd by Sectio .
3700 dde Ibor Code,far the pufomuoe of do wart fa whim this Knott 6 imxd
my Wor s Came^,„"Innowz catmr and Policy tomb tie:
Gmcr. POIKy Na: .
CERMCATE OF EXEMPTION MOM WORKERS
COMPENSATION INSURANCE
(Thu sum need not bo mmPlcictl if de pcnmh u for.M1andncd0o0at.(5100)
or leu)
I enlfY dot In de pufontuaro of do.ort for whim di,PermI141auM,1 shall eor
employ any,Own in any ntaorcrsoon bccortt sdjrcl n dlc Warton'Cpentium
L of C.lifoia Dam v
Applicant
NOTICE TO,Wft W. 1 mating d4 Cadfro of Fumpdodyou alcuM
becowith..P y 1M Wo ,Comp.dins pmrimat de labor Calc,gala m1m
.J 0 raMrid..Ply with such proaivm'or du permit'hall h devnN rovnkN.
z� CONSTRUCTION LENDING AGENCY 7
[r .-• I booby Jlum that them u a covuuction WLding atcocy far do irrormale of
a the wort for which diai pemtil1.titled(Sec 3M.Co.Q ,
LQ Q LcMd'Name
z Lander Addrw
UC I anUy da,1 lute and this application and'tate dw de above iofamtaum 4
U. E-' conn.l a Pre to conply with 01 city and cowry ooll cea and nye laws olauntm
OU building coouOclian,and hcmby aulbooac mp,owntauvcs of d4 city to coo upon do
.ncd
fro,c
G aabili judgrO Pone for oc tion purposes,
(WO)agme 10 saw.indemnify and trop harolev tine City of Cuperdno.P.inat
UZIiabililia.judgmfUrcZwaM eapewwhkM1 may loomnyamuearyon'ald Ory
U z, In mrtwgumaa o<Il trS'fAN S A D WILL
'—' APPLICANT UNDERSTANDS AND LL COMPLY WITH ALL NONPOINTIssued by: Date
SOURCE REGUI.tT1ON5.
96t �2' gLl�—0 Re-roofs
Sigaa,am of ApplioHAZ US MATERIALS DISCLOSURE Due Type of Roof
WIIl de appUcanl or fear bWldlog oactpant aam or baMM havNou'mumul
u dcRrcd by the Copwtm Municipal Coin.Cha tOr 9.11,lad Ne Heald aced Witty '
Coda sccdon 155324)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yv yao
W II dm aPW'..N wart ddlhnt RupaN aw eywpmml m dawn'which If a roof is installed without first obtaining an inspection,l agree to remove
emit nu air cmuminants u dc0ncd by th0 Bay Ma Air Qwhy Manapcmcr, all new materials for inspection.
haaaN
D4n1c17
❑uta Nu
I hue road line hay.dw,mamri.0 rt phor nu mlc,CMpcs 695 of do"ifon
nu Hal&S.fay Coin,Smau25A15,25533and25536.Iwdnavdd d&bwmnt /.
docs na nai'have.vow,dtt it u my m OalhllitY m notify ft oauM,of lac
requlmmcm'whKh nova be mct or Musa caf.C=ritWar0.c,.PWY S ignatLire of Applicant Date
ower orae ea. Da6m. All roof coverings to be Class"B" or better