06060031CITY OF CUPERTINO
77"
BUILDING DIVISION PERMITONTitAad'1I'
BUILDINGAODRESS:
DONG CHUL CHO
PERMIT 110. 06060031
10094 JUDY AV
R'S NAME:
PERh9T SUE DATE
DONG CHUL CHO
09/11/2006
a.E:
SANITARY NO. CONTROL NO.
(408)206-8369
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
Mab, aff on that I am licensed under provisions of Chapter 9 (comme.mg,
with Section 70(10) of Division 3 ofde Business and Pro(clum u Code, and my lice= is
N full torn ane effect
HOUSE DEMO
License Clara Lk. t
Date Centimeter
ARCHITECTS DECLARATION
1 understand my plans Nall he uud as public records
Licensed Professional
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Conlraaofs License Law for the
following mason. section 7(013, Stedman Nd Pm(e adiona Code: Any City or county
$10000
which requires a permit to conmuct, stem. hnpmw. demtubs. or Muir any nmcum
prior m its issuance, also requires the applicant for such permit to rile a signed sidemen,
Contractor's Name Law 9
Sq. Ft. Floor Area
Valuation
that he is licensed pursuant m use, pmviaWne of the (Chap=
(Commcmin{ with Section 7000) of Division 3 of the Business and Prafessiov Code) or
that he is exempt Ncrefmm and the avis for the alleged vemp tan, My vlatslfan of
r U U
Occupancy Type
Section 7031.3 by any applicant for a permit subjects the applicant to a civil penalty of
nut mart than five hundred dollen 430o).
❑ 1. u owner of the property, or my employers w W wags u dteb hale canpewden,
Required Inspections
9 P
will do site work, and The Moore is net extended or offered formic (Sec. 7044. Business,
and Professions Coda The Commoner Liana Law doer not apply m a owner of
propertywho WildanrimpmveachimoandwW hu
amnotchweded ar ffeerNmu{e
awn em. d n. for vie, It.
Na such impsowmau as nmyear
the WipmgorO
. the Wilding inninOwafteaL or upicti the r.
halt within mm year of reprove
Pavlots fo.
ase of
Wilder will have the burden of proving Na he Cid rat Wilt or improve (err purpose of
Wilder u
talc.).
❑ 1. as awns of the property, am exclusively conuaaint with Ilanced Comre seam m
Conaoes U.
Consumer the project (Sec. 7044, Business ad Professions Cadet Than m
cove Law dors not apply bah owner of property who Wilds or Improves thereon. and
who contracts for such projects with a anwctor(s) demand pursuant in use Com ands's
Lkertse 4w.
❑lam veep der See ark,BAPC (or
r 1 Dau -e��
O
/
WOWO '3 COMPENS N DECI.aRAAON
0 /
lip 1 hemby a under Ne iy of perjury rex of the following declatatimsa
(yp
❑ I have and will maintain s CenlReamof Consem m self-insum for WoratesCompen-
cation, an provided for by Secdon 3700 of the Labor Code. for Ne performance of to
work for which this permit is issued.
❑ 1 haw am will m Liman Workers Compensation Insurance, as required by Section
3700 of the Labor Code, for the performma of the weak for which this Fenmkis Issued.
'
My Warke's Compemadon Insm ance canna and Policy number am:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
,
COMPENSATION INSURANCE
Tads auction need rmtbocempleed I(te permit is (moa hundred dollar ({100)
or less.)
1 certify that in the performance of the Ark poywhic is permit I. issued. I shall not
employ any Persian in My m c s t/Pc s uattoth arons Oompmewl
-
Laws of California. Dam
Apid -at
NOTICE TO APPLI A! : If.all ki Nis Ccni cats of Es mption, you Should
become subject w the WaheYs povatlm pmvisiov of the labor Code, you mute
forthwith comply with such pmvisimm or this permit shall be daemon naked.
1 CONSTRUCTION LENDING AGENCY
1 hereby affirm that them H anamcding agency for the perfononce of
s 30
' Newark for which tits permit V issued (Sue.. J097,7. Civ. C.).
Lsndels Name
Lcndele Aedmss
i 1 certify Nat 1 have mail this appliadon and ate Na the above information in
' correct. 1 agree as amply with all city and county ordinances and sou laws relating m
building construction, and hereby autborive representatives Of this city to cater upon me
about.mentioned pmpcny for im,cuon purposes.
(We) agree to saw. indemnify and keep harmless the City of Cupertino agalnal
RabR,da. judgments, casts and eRpcnYJ which may in my way aCCNe agalnal said City
in Consequence of the granting of this permit.
i APPLICANT UNDERSTANDS AND WILL 0 LY WITH ALL N0t}P01tff
r/jj f% ,G�
Issued by: Date <–� C
SOURCE RE D ATIONS. /� S{// q��,
LljNl\
Re-roofs
Type of Roof
Signaua ofAppli— drncmr Dale
ARDOUS MATERIALS DISCLOSURE
H
Will Ism appliantor tutmc Wilding cecupantstem or handle hi undous material
' as duRnen by Ile Cupertino Municipal Cade. Chapter 9.17, and de Heath and Safety
sada. 23333(U?
Cl Yen t}Mu
All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant Or future Wilding meapant use equipment or devices which
emit havmnns air man ivuu a defired by Ute Bay Ansa Air Qvlity Managcmenl
all new materials for inspection.
District?
'EN.
❑tics
Ihawmad Nehenrtlav requirements under Chaaardth3ofthc Califon
nu HcalN&SaeryCode,Satisxts73503, 25577 SN.lundcsnylbacefthe Wilding
2SS0S
does non cu rely haw a Cement, that It u my m vibilily ao notify No osis a of
requlmmc hichmuabcmet 'ruiss a f.Ondrimia.f0cm, ,e
S ignature of Applicant Date
i�
All roof coverings to be Class "B" or better
Owner or mhorir gent Data