08060037 CITY OF CUPERTINO # 8�• ss-9 .�a `��r >'� '� '
BUILDING DIVISION PERNIITO1�I;TRACTQR I1P1F®,RMATIO ;
BUILDING A DRESS: PERMIT NO.
1.8880 HANNA DR TBD - TO BE DETERMINED 08060037
WSR'S NAME: PERMIT ISSUE DATE
07/22/2008
PHONE: SANITARY NO, CONTROL N0.
ARCHI'IEC(ENGINEER: BURRING PERMIT INFO
I� Q PLUMB
I� (�
O LICENSED CONTRACTOR'S DECLARATION
b F° 1 bmeby arOren than I am Iixmed under provisions err Chapbr 9(mmmmbin[ Job Description,
with Section7)(10)of0iviaion3ofdxBusiness andlPofessiamCode.sMmylicence u 2 STORY SFDWL 2, 194 ' GARAGE 425 ' -SANITARY IS
in full forceand effm
Uccmeaax Uc.0 SUNNYVALE' S JURISDICTION-NO INSPECTION REQD
c_� Date Conuaatcr
4�4aARCHrrECI'S DECLARATION
JW U I understand my pWs sill to used u public sword. .
O t; Licensed Professional
I OWNER-BUIIRER DECLARATION
s� f 1 hereby,flim that 1 am exempt from due ConvacaMa License law for the
following memo.(Section 7031.5,Business and profession Calc:Any city or county
S$ which mquises a permit b cm 4w..improv.d WW.ormpairayswmum
z i pHar b its iuua .a mquires the appliemt fmrmch P it m ftle a signed suxment
Y� that he is licensed pursuant to the provision of the Connector's Uccnc Law(Chapter 9 Sq.Ft. Floor Area Valuation
I- (cmmmcecing with S<don 7000)of Division 3 of the Business and Profession Code)or $480000
`3$
that he b exempt Wemfmm and the huts for the sileged eaemptlarc Any violation of
Section 7031.5 by any applicant for a permit subjects the
applicant to a civil cnty of
notmambanBvahmdreddollan(t035729044 Number Occupancy •7Pe
0 1,u owner of the property,or my employees with wagon u Bob sale eomperuadon,
will do the we&and destruction is son intended or offered for antic(Sec.70u,Business
and Pmfessnon Cade The conurtor's License law does not apply to an owner of Required Inspections
property who builds a improves thoomm.and wha doessuch it himself ar dumgb his
owo emplayw,proWded dw such improvements am not Inxndnd oroRcrnd forsab B. .
however:theherrhngawnmtilcoldwithinateyearofmmplNm.theawnes-
huil0 i0 haveve ft dx burden of pmvin6 dna K did not build or improv for purpose of
isle.
u owner of the property-w exclusively contracting with littered comedos,to
wet the project(Sec.7044.Business and Profession Cade:)The Contractor's U.
cove law does out apply b m owner of pnopersy who builds or fmprovea them.rod.
who convects for such projects with a commensals)licensed pursuant us the Comuse mes
License Law.
l em onempm
DECLARATION
I hereby of rce under penalty of perjury one of the following dmWetimts:
❑Iltawand w0l mainuin•CerdOota of Concnttoxlf-insurt fne Wadtofs Compere
andm,as Provided for by Sodium 3700 of time lebar Code,for Be perform..of dx
work for which this permit is bound.
0 I have and will maintain Workers Compensation losuanco,u acquired by Section
3700 ofthe labor Code.far the perfomanttofthe work for which utas pc mil b issued. '
My WarkceS Compeuadon lomrmtt carrier W Policy number am:
Carrier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
finis muco need not Ise completed If the Permit is forms,hundred dollars($100)
or bet)
I certify thmL in the perfamanee of a woh for which NB mitis issued.)shall rot
cmployanypermtinatt ewmrters'CamprnsNm
Laws of California.Dam
Applicant �-
NOTICE TO APPLICAN7 If.after maksyyyyyy th Ccrt !of Exemption,you should
become subject b the Worker.Compcnp0onrm
provisions of de tabor Cade,you mora
.J O faMovision widm comply with such pro this peit shall We dnemnd revoked.
?vy CONSTRUCTION LENDING AGENCY
[r Thereby affirm Wt the.is a conswctimn londin.gemy for the perform¢of
ori the work for which this Permit is issued(Sec.3097,Civ.Q
W�Q Lend,ts Name
Lenders Addow
U O 1 mtffy that I have read this applie Tan sed sox that the.bow information is
Uy CmtxL I agme b comply with all city and county oNinanew and sob law.totaling to
O budding conatncBon.and thereby.0.6.represcutstiws of this city to enter upon the
above-mentioned property for inpectin purpaxt
i-m y of Cupertino
f�'jI liablliues,judgments.mas and ummpc uawnd h may In my myoul.the imiccme agunaok City
U z ren cano4uerae of the tin[
PPLICA f Nu permiL Z
r. AD SEAN S AND L MPLY WITH A�N -POI Issued by: Date -),Ir
SOURCEEG ONS.
sign qre o Re-roofs
ppb UCon USMATERIADISCRE non Type of Roof
SWBtheapplimnter LutISIRSU
e Wilding eecvPIALaone N handle hmNon material
Bond by the Cupertino Mnnieip Cade,Chapter 9.12 and mfr Heaith and Safety
ScLUom 75532(.)7
Oyer All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtainingan inspection,I agree to remove
3Y01 dx applicant or rub.building acupant use equipment or devices which Pe
a iLhuadons air conumiw r u fined by the Bay Area Air Quality Management all new materials for inspection.
0 Yes
I have mal the haaaduus mabaiaisrequi cnts under .Chapxrii.95mfthe Celifor.
cab HnnhdtSdmyc de,Savant 25505.7553 25534.1 understand do if the Wilding
dens est cuyya By wax L the' m nubility b noufy the occupant of ties
. mqulrePdo�i moth (net tai to •Cwfxax of TETT/v
II/. Signature of Applicant Date
owner err the; ' Da All roof coverings to be Class'W'or better