06090222 CITY OF CUPERTINO " �"'''^��" °' t
BUILDING DIVISION PERMIT COmRACTQR IdNF4RMAT�IU
BUILDING ADDRESS: IGNS INC PERMIT NO.06090222
7335 BOLLINGER RD # B
OWNER'S NAME: PERMIT ISSUE DATE
MING CHEN 1982 STONE AVE 09/25/2006
E: SANITARY NO. CONTROL N0.
(408) 280-6500
ARCHITECrfENGINEER: BUILDING PERMIT INFO
BLDG O PLO MEOCH
loo LICENSED CONTRACTOR'S DECLARATION lob Description
i u I hereby arum Nal 1 me licensede
under provisions of Chapter 9 mummcles
with Section 70M)afDlvision 3 of Ne Business and ProfessiumG and my license is
imm�faleeandaIT L �3� D "NEW FASHION HAIR" INDIVIDUAL CHANNEL LETTER SI
:Lq z Licen.c1w Lie.p NEON.
ik- Date S DECLARATION ARCHITECTS DECLARATION
I understand my purr Nall be used u public records
52!
Gto Licensed Professional
0 OWNER-BUILDER DECLARATION
E I hereby arium,the'I am wrap,from Ne Contractors License Law for the
00 following roams.(Section 71131.3,Business and prorusiuv Code:Any city or County
$ which ogobm a Permit m cnnswe4 slot,improve,demolish,or repair any structure
�zpdormiu iauercc.also roquirm tbe applicant far such permluo file ulgncd wemcm Valua[ a O
<
Mat hclalkenscdPuauuuoMeprovisionsafMeContractorsUcenxlAw(CMpor9 Sq.Ft.Floor Area
S€B 12
that he s exempt
antes ]00 d the
bases f r Th the Buinwmd on.Anynvi Codo)or
u .. that io k eampl Ianrefrom and or burs far the alleged pp]ICUan,Any l Penalty of pp7.�N h
Seaman that by any sad d.nt a(a permit abjecs the applk-m to•Civil pcultY of 3 5 92 3 dT8er O O Occupancy'I)'Pe
nal mare that fiw huM.d dallw(5500}
❑L as owner of Jte property.cr my employ es with"gas"Ne'u aleeampewtion,
will do the work,and lheawcwre is rwtinundedar Orland farank(Sm.71)44,Business Required Inspections
ad Proressimu Cade:The CormaclMa Liven Law n mm do ,apply a owner of q P
propsmy who builds Or i mpmwa therms,and who dam such wand,himself or thmugh his
awn cmployem,provided dwsa:h imprmemenu sm twl marled oroEered!male.If,
however,Ne Wilding or improvement Is sold within are year ofeunclud ,theawrcr-
builder will have Ih Wrden of Pmving that be did nal Wild Or Mpmve for Purpose of
ale.).
❑L.u owner of to property am escludvely conascting with IlmnsW Conuecmn m
construct Can project(Sec.7064.Business sad Profaslona Code)The Contracmrs Li-
cew law dam not apply m ret owner of property wW Wilde or Improves therms,and,
who con®cls for such projects with a contractor(;licensed puauan,to Ne Convectors
License Law.
❑Item cmgpt under sere Bd P C for this wase.
Owner Dae
WORKER'S COMPENSATION DECLARATION
10 I hemby afnrm under penury of perjuryone of tha folbwing declamdom:
❑11amandwillaimmusa Ccrtifimeaf Cansentoself-le-urofa W-dece-Compm-
ation.u prervidc l for by Section 3700 of the Isbo Code.for Ne performance of Ne
work for which this permit is issued.
tI have and will maintain Workers Compewtion Insurance.as required by Section .
3 ofthalsbm Code.for Ne peIIarmarce of Ne were fm which this permit as issued.
My Worker Compema de Insur-nce carrier and Policy number ate:
Cartier. ryi Polley No.: 7
CERTIFICATE 0•EXEMPTION FROM W RS'
COMPENSATION INSURANCE
(This action need not W completed If Ne permit is foram;hundred dollas(5100)
or less.)
1 certify Nat in the Performance of Ne work for which this permit is Issued.I shall not
employ any person In any mmocrm as to become subjcctto the Workers'Comin madon
Lam of Celifamia.Dao
Applicant
NOTICE TO APPLICANT.Ir, net making this cenincae of Eaempeon.you Mould
become subject m tie Workers Compensation provisions of the Labor Cade,you must
.,O roMwith comply with such provisiau or Nu permil shall be domed molded.
Z.m y CONSTRUCTION LENDING AGENCY
Fv I homey warm Nat tic.u a ctenstm sten lending agemy for the p ufmot.of
G'> the work for whim this permit is issued(Sec.3097.Civ.C.)
WQ Lenders Namecl. '
Q z Lenders AM.
U Q I caddy that I have mad Ods application and mm Nn Ne Mew inrormatiun is
t~ Correct.l agree to comply with all city art county ordinances and sue laws relating m
CU building construction,and hereby authorise reprcacnmiwx of Nis city to enter upon the
a asovcmc judg a ds.propertycosts
for inspection purposes.
(Wer)agree to sew,indemnify and keep harmless the City Of Cupertino against
mi"wy IiebillUu,judgmenY.coos and expense which may lnany way scene against aid City
U Z in consequence of the gaming of this permit
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date —
SOU EG ATIO � ,
Re-roofs
Sign um of Ppli onuecmr Dae
HAZARDOUS MATERIALS DISCLOSURE Type of ROOF
WIII Ne pliant or Boom Wilding oecupm,core or lsndle haudou material
as defined by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety
Cade,Section W32(a)7 All roofs shall be inspected prior to any roofing material being installed.
41 ❑Yin ❑Ne
Win the applicut Or future building Occupant use equipment or devices whim If a roof is installed without first obtaining an inspection,I agree to remove
cmh hmammu air contaminants as defined by the Bay Arca Air Qaallly Management all new materials for inspection.
risHealt
lIh Yea ❑Na .fes
I haw roaJ thehaard,ss materials requirements;under Chapter 6.95ofde Califon- \p
Tia Health&entlyham.Sections otitis5. 5533md35534.1 tnotifyundermined occup Wilding ..`)
dos net currontly how a tenant Nal Itis my responsibility Ip notify tbe ocupul of time
mquiremcns which must be met prior w issumm ora Certificate of Occupancy. Signa ure Of pp cant Date
Owme,or authadred age., Dae All roof coverings to be Class "B"or better