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08050058 CITY OF CUPERTINO ;� +k^• +,ws : .#.G P+� '��^�`��'" t3'eP2rc= 'f`$�!3_ BUILDING DIVISION PERMIT � COrITRAiCTQRi iVFORMATION, , FERMIT NO. BUILQt1yQply 'bREENLEAF CT LOT 1 NEXGEN BUILDERS, INC. 08050058 FWSUNbAbME: PERMIT LSUE DATE CUPERTINO GREENLEAF LLC 225 DEMETER ST 05/13/2008 PHONE: SANITARY NO. CONTROL NO. (650) 322-5800 ARCHITECT/ENGINEER: BUILDING PERMIT INFO 0 PLUMB � (� �Op LICENSED CONTRACTORS DECLARATION m I hcleby Oland that I am liccmed under provisions of Chapter 9(commencing Job Description 4i2 with Section 7000)ofDhizen3ofthe Busi�ssaMFoolmo en,Code.and myliccaonire REVISION–TRUSS CALLS–STRUCTURAL FOR FRAME BEING n<ts. in full forte aM ea ;°y= Date =I_ c —Lr.g UPDATED ORIG#07020037 .: Dale Contractor 01 A CHll kmin DECLARATION 01 nI� u I undenunJ my Plain shall W Ihmd m public rrsoNs 4ON LICLM1SI Pmfdy.frl 5 OWNER-BUILDERexamptOE DECLARATION E 2 f 1 Wmby.(Scc that 1am 1. .Duna from the C scond Co License taw for tic E20 O which reuom.(Section)crourn Business and Pro,e.de imu Cole:Any city or county S_ which requiros a Permit m cmWUCL alar,tit for W,demaill.t o repair any atsuaum that,kor W slummaMe,aILIonto fle,then provisions Of for Condrch er1111l laftimele a n Law rl F < wlonciue ifliSetim7 wofDwulaofd=anB..iaraniPme�w(cnodu,9 Sq.Ft. Floor Area $100 Valuation ER- that M lai cremiNSccJon]and of Divuioa3 of Ne Bud mumpton.my ACode)of Nat m V ea1.5 b anrtrrma and or bun it be alleged euicant 0 Any it peroky of Semon fluor by any"replicant rem a permit subjects the applicant m a tivil penalty of Number Occupancy e sal throe man Rae hundred dWlan Tanto). 32 63 3107�V P Y TYP ❑i,u awnes of die plopmy,a my wployeu with wags u lair salecompenudon, will do mewerle and Inclination,is col intended croRered fomle,(Sem.7044,Business and Prolamines Code:Tim Conuxmfs Licence Law don not apply in an owner of Required Inspections Impomy wW buildsaimprow mmrtnn,and wbodou nuchwok himmlfmduough his Own employees.movided mat such improl'emeenu are not intended or offered for sale.If. however.me building or improverealt Is sold within one year of complaints.the ow'rter- builder will haw Ilan burden of proving that M did not build or Improve far purpose of pelt.). . ❑1.u owner a the property,and eatlusiwly conuaNng wim Demand cromeaam to coesm act de project(See.T(lnal,Busira.and Prefesrioes Cade:)The Coouumra U cove law date not apply m an owrwr of proWry who Wilds or Impmws meman.ad. who contracts for such projects with a conductorial liuimed pursuant m the Conuacro's Lice.law. ❑lamucmplunder See ,Bk PCforthis. Or Date- WORKERS auWORKERS COMPENSATION DECLARATION I booby alarm under penalty of perjury one of me following declarations: Ihawand lmalnWn.Ce Jf mof Cammntmalf-iuutefmWokNsComP.- cation,as provided for by Section 3100 of the Isbor Code.for tW performance of me work for which this permit is imucd. ❑1 haw and will maintain Workers CompeuaDnn Ionization,as me,fired by Section 3700 of the Mbar Code,for the perfosmace of the wart for which this permit is iuued. My Warteh Compeuadon Imatruton caries and Policy number are: Cavia,.. rATG Co„1P PollyNo.: 7/�{bex�/27 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (7ihusnmiots deed MI W completed ff the permit ts fecone hunthMdoWn(2100) or leu) 1 certify mal In Jur performance of the work for which this permit in issued,l shall not employ any potion in any manners as In become subject in the Workma'CorepenuJm Laws of Caliramia.Date APPlicanl NOTICE TO APPLICANT:If,after making mu CeniEcate of Emorptian,you should tecame subject or tlm Wmkera GampenYtion powisioN of me IJhW COdn you mune .J O forthwith emmPIY with such pmviaoes or min permm it Nall W deeed.1ted. z'(n CONSTRUCTION LENDING AGENCY f~ Ihereby al,—tion mem u a couuuction lending agency for the performane of �i the wmk fur which oris permit is iuned(Sec.34191,Civ,C.) W Q Lenders Name z Lenders Add. UO 1 comity mal I haw reed Ws application W sate that me show information la . U.E cmrta I"Ince m..Ply with all city and county remittances aM mu laws relating m O rVbuilding constriction.and hertby"umanx rtpreunmiics.1 this city to comrupen the W "hove-mcndarnod property fm cmpeNoa pu pons,6, (We)agree to all .indemnify and keep harmlev the City of Cupertino agaiut En liabilidn,judgmomu.cos;and emotions which may in any way monad against aid City U z in cansegdedee of the grating of than permit. ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date �./�f'-Z SOU REGU 0 S. —tt – 5- 13-0 ,8- Re-roofs big...of ApplicanW.moracmr Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will con applicant or future building Oecupwt peon mlundle humdou matenal u deBeN by me Cupenim,Municipal Code,Chapter 9.12 and f Health and Safety Section 25532(,)1 [:]Y. b". 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 Will 104 applicant or filum Wilding aemupant use equipment or devices which P � itC`odmar air conumiunu u de0utl by me Bay Atha Air Quality Management all new materials for inspection. ❑Yu ANo I haw real the haaaNa;mamrialucquimmcnuumkr Ch"w&95 ofine Caliror. ria HcalmhSafcyCade,Smou25505.25533 md25534.1 uncenund maifthc Wilding dens not currently haw a tm;nL mat it u my n a,moadodly or andry the aemupal of dte n men;whichmuuW mmuatemofacomJ53 tie rDee Signature of Applicant Date L� I " ^ S 1 © All roof coverings to be Class'%"or better Oumm Ormthadm .gent Dad'