01050031 I.% 2_ rBUIL OF IVISIONNO PERMIT CONTRACTOR INFORMATION:
BUILDING ADU2101200 LUCILLE AV # 89-96 ROYAL ROOFING PERMrr NO. 01050031
OWNER'SNAMITRAhIMEI_I_ CROW RES SERVICES 1.345 VANDER WAY ' APPLICArIONyyPt`tlAl03/2001.
1 I
PHONE: f(toe/279-2332 SANI'LARY NO. Cooll Rol.NO.
n-Z ARCHITECT/ENGINEER:
BUILDING,'luluMl'I'INFO
F-.00 BLDG ELECT PLUMB MECH
ad
S N G Llcl:rvsm coN'rlancroR's DEa.nRATB9N Job Description
Z. I hereby intimi;hut I ant fix"ead under Purvis......,of co.nm"9(eomnrenemg
o'—o .Wised..on7lXBndnivi,ionn3ofatenusinex., nerrnfe.,inn.c,We.nnemvucen,e RE—ROOF 'REMOVE SHAKES R• INSTALL 1/2"
F-�'� i,
6,1^ m fall force ff
Hca,
Liver" Clsh ` °'�.5 Lie.a_](p CERTAIN
SHINGLES.
Oii owe 37uI ConraIA KTIP9 S q
waw ARCf11r1iC1"S UECI.ARAr o,�
C t='O�' n 1of my plan: roll be eof us public record,
uai L' aJ Nnlcsommot
O W Nf:R-BUII .,CUaRATION
ww 1 humby union that I ori rpt from the Connector"I.icuna Law for the
1-Z a fidl,wing reason.(Section 7031.5,Business and Prdcss'ie is Calc:Any city m county
F FCi p which rryuim,a mn
pcir
ee I' m nmstmm,alcor,improve,Demolish.or repair any ztmnum
prim.....issu;ace,also requires the applicant for%ach permitm file u%ignedsmtcmcnt
is tneaneiyrcenocdtl
pursuan ..thepnvisin n
nanneC..tuallaraLiecn,,elaw(Chapter9 Sq. FL Floor Area Valuation
(commencingwithtiredtm 7a)(hof Division3efthe Inteirce and Ptnfe,%inns Ctde)
a that he is exempt therefrom and the basis for the alleged exemption.Any violation +�
ill S¢tlon 7031.5 by eny applica l fol a perntia'amorous the it,,I hart to a ctrl pamalty AVN Number
of not more than live bandred dinar,( ay, Occupancy YPe
❑Las owner ohne Propcny'w my employees with wage.as their sole mmponwtion. 7
will do the work.,and the ltfuclate Is not intruded oms 63
f ohlot vale(See.74, - - " -
Ilu,incas and professions Code:The Comoros,License Law,does nm apply to on Required IOSpeCtlOHs
r of property Who huikk or improves thereon,and who does such work himself
owner
biv own atnployeev provdod den loch lmpnwometto,am not imended or 305 — FRAME
offered for vale.If,howaver,the building or improve hent is wld within one year of
u
, nction.me ow err-builder will have the burden of leaving that he did not Fuad or 307 — .I hisi-ii_AT I ON
nmrove an puopowal a ale')' 601. — ROOF TEAR OFF
Cl.asowner ofthe pmpery.amexclusively eonttxdng with licensee sumorcmmm 602 — ROOF PLYWOOD NAIL
outmW
ct the project(See.7a.Rosiness and Professions Code:)The Cnm
nraor's
I,Icuaa Lilo doe,not apply to an owner of property who bdld,or in luoves tl emon.
and who contracts for such project,witb a cmonfOuryd licensed pursuant m the 603 — ROOF BATTENS
Contractors mon ,cl"i Law.on&P Cl Sr this mm,on 604 — ROOF IN—PROGRESS
Calu.. ,et p:e s, . S
Owner Dae
WORK12R'S COMPBNSA'I ION DECLARATION
I hereby affirm under Penalty of Pscjury one of the following dcelamtions: F I N A L E 13
p 1 have and will mainutin a Cundilate of Conant no 1111'-imurc for Wodciv
CmnPcrtmtinn. as Provided for by Section 3700 of the labor Coda. Es the MAY 2 2 2001
,uhurnewe of the work torr which this fail is issued.
I bove and will nuanmio Worker\Cmialli,miun in,mm se.a,myuired by Seal....
3(k1 of the Luba Cale,fnr the Performance of the work for which this pat is BUILDING
,xucd.My Worker's Compensation Insurance carrierandPolicy number are:
/1_Policy No.: L,5R,ou Ot-I-Y-7 U I
CER IFICAI10, OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This wetion neal not be annpfeted if the permit i%for one hundred dalbm
IS11Xs)mr lesal
I comfy that in the farfunnance of the work for which this permit is is.,ued.1
,hull not employ any person in any manner so a%to becunm snhject a)the Worker,'
Coiupen,adnn I,awx nl'Cullimniu.Mule
Applicant
NMICH 1O APPLICANT:If.after staking this Certificate of Exemption,you should
become subject to the Worker',Cmnpcnnado.i sru,kion,,,f the Labor Cade,roil nar,
'O 0 fonleahh cotnply with auto provision.or Ink Perrot shall be deemed revoked.
F r�iCONSTRUCI]ON LENDING AGENCY
lite
1 hereby anion that there is a conametiou lending agency the perfortuunce
I ..f the wad fnr which this permit is issued(Sec.3097.Civ,C.)
gL, A Leadds Name
�::) 7 LeadLYs Add....
V O�-•,t 1 ccnify that I have mad this application and%tate that above information is
Is !"t concO I "'uc m comply with all city and enunry aMlnunce,and state lows relating
O V m handing amstmnion.anti hereby suihnrim rcprcmf
ntatien.. Nis city l..enter roam
the above.meationed property far inslcaf m purymes.
(We)ague tusuec,Indenmi 1y and keep hufmle,sthe City ori Calcium,uguinst
Zi Iiabll'nles,judgments,atattl and expense,which stay in any way ucunte uguinst said
C.7 Z City in conscyaence of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NO'-POINT DatetoURUy.tttG I.ArIQNs S. Issued by;
U
u aurc,if mIIAZ RIout101 a�— ate Re-roofs
ill/// fIA%ANUOUS MAT' Mf LOSIIRE
Will the appncam or foam Chadd' wpm atom or andle ha ardour,matcdaf Type of Roof
as defined by the Cupertino Municipal Cult.Chapter 9.12,and he Health and Safety
Code,Section 25532(u)'l
CS'e% J411 All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building orcupam use etrvirmem or devices which If a roof is installed without first obtaining an inspection, I agree to remove
"hit ha.:ndous air aantal mon,.twdefined by due Bay Arca A.,Quahty Management
D"tach all new materials for inspection. Applicant understands and will comply with
❑Ye, eFio all non-point source regulations.
` I Imn
re read the haNm
ous out rcmw
yuinem � under Charter 695 of the
California H.11h R Ssfay Cede.Sections 25505,25533 au12553J.I undemond that
it the building dues not eaurently n ve a tenant,that it is my respomihilky tr notify the
e tr n t a1 the requitetncus which inaso be amt prior no "ic c n1'a Cunificme of
OOcouniey' nature of Applicant Date
3
o»-_ nomnd9ed oeent - ate All roof coverings to he Class "B" or better
OFFICE
I.% 2_ rBUIL OF IVISIONNO PERMIT CONTRACTOR INFORMATION:
BUILDING ADU2101200 LUCILLE AV # 89-96 ROYAL ROOFING PERMrr NO. 01050031
OWNER'SNAMITRAhIMEI_I_ CROW RES SERVICES 1.345 VANDER WAY ' APPLICArIONyyPt`tlAl03/2001.
1 I
PHONE: f(toe/279-2332 SANI'LARY NO. Cooll Rol.NO.
n-Z ARCHITECT/ENGINEER:
BUILDING,'luluMl'I'INFO
F-.00 BLDG ELECT PLUMB MECH
ad
S N G Llcl:rvsm coN'rlancroR's DEa.nRATB9N Job Description
Z. I hereby intimi;hut I ant fix"ead under Purvis......,of co.nm"9(eomnrenemg
o'—o .Wised..on7lXBndnivi,ionn3ofatenusinex., nerrnfe.,inn.c,We.nnemvucen,e RE—ROOF 'REMOVE SHAKES R• INSTALL 1/2"
F-�'� i,
6,1^ m fall force ff
Hca,
Liver" Clsh ` °'�.5 Lie.a_](p CERTAIN
SHINGLES.
Oii owe 37uI ConraIA KTIP9 S q
waw ARCf11r1iC1"S UECI.ARAr o,�
C t='O�' n 1of my plan: roll be eof us public record,
uai L' aJ Nnlcsommot
O W Nf:R-BUII .,CUaRATION
ww 1 humby union that I ori rpt from the Connector"I.icuna Law for the
1-Z a fidl,wing reason.(Section 7031.5,Business and Prdcss'ie is Calc:Any city m county
F FCi p which rryuim,a mn
pcir
ee I' m nmstmm,alcor,improve,Demolish.or repair any ztmnum
prim.....issu;ace,also requires the applicant for%ach permitm file u%ignedsmtcmcnt
is tneaneiyrcenocdtl
pursuan ..thepnvisin n
nanneC..tuallaraLiecn,,elaw(Chapter9 Sq. FL Floor Area Valuation
(commencingwithtiredtm 7a)(hof Division3efthe Inteirce and Ptnfe,%inns Ctde)
a that he is exempt therefrom and the basis for the alleged exemption.Any violation +�
ill S¢tlon 7031.5 by eny applica l fol a perntia'amorous the it,,I hart to a ctrl pamalty AVN Number
of not more than live bandred dinar,( ay, Occupancy YPe
❑Las owner ohne Propcny'w my employees with wage.as their sole mmponwtion. 7
will do the work.,and the ltfuclate Is not intruded oms 63
f ohlot vale(See.74, - - " -
Ilu,incas and professions Code:The Comoros,License Law,does nm apply to on Required IOSpeCtlOHs
r of property Who huikk or improves thereon,and who does such work himself
owner
biv own atnployeev provdod den loch lmpnwometto,am not imended or 305 — FRAME
offered for vale.If,howaver,the building or improve hent is wld within one year of
u
, nction.me ow err-builder will have the burden of leaving that he did not Fuad or 307 — .I hisi-ii_AT I ON
nmrove an puopowal a ale')' 601. — ROOF TEAR OFF
Cl.asowner ofthe pmpery.amexclusively eonttxdng with licensee sumorcmmm 602 — ROOF PLYWOOD NAIL
outmW
ct the project(See.7a.Rosiness and Professions Code:)The Cnm
nraor's
I,Icuaa Lilo doe,not apply to an owner of property who bdld,or in luoves tl emon.
and who contracts for such project,witb a cmonfOuryd licensed pursuant m the 603 — ROOF BATTENS
Contractors mon ,cl"i Law.on&P Cl Sr this mm,on 604 — ROOF IN—PROGRESS
Calu.. ,et p:e s, . S
Owner Dae
WORK12R'S COMPBNSA'I ION DECLARATION
I hereby affirm under Penalty of Pscjury one of the following dcelamtions: F I N A L E 13
p 1 have and will mainutin a Cundilate of Conant no 1111'-imurc for Wodciv
CmnPcrtmtinn. as Provided for by Section 3700 of the labor Coda. Es the MAY 2 2 2001
,uhurnewe of the work torr which this fail is issued.
I bove and will nuanmio Worker\Cmialli,miun in,mm se.a,myuired by Seal....
3(k1 of the Luba Cale,fnr the Performance of the work for which this pat is BUILDING
,xucd.My Worker's Compensation Insurance carrierandPolicy number are:
/1_Policy No.: L,5R,ou Ot-I-Y-7 U I
CER IFICAI10, OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This wetion neal not be annpfeted if the permit i%for one hundred dalbm
IS11Xs)mr lesal
I comfy that in the farfunnance of the work for which this permit is is.,ued.1
,hull not employ any person in any manner so a%to becunm snhject a)the Worker,'
Coiupen,adnn I,awx nl'Cullimniu.Mule
Applicant
NMICH 1O APPLICANT:If.after staking this Certificate of Exemption,you should
become subject to the Worker',Cmnpcnnado.i sru,kion,,,f the Labor Cade,roil nar,
'O 0 fonleahh cotnply with auto provision.or Ink Perrot shall be deemed revoked.
F r�iCONSTRUCI]ON LENDING AGENCY
lite
1 hereby anion that there is a conametiou lending agency the perfortuunce
I ..f the wad fnr which this permit is issued(Sec.3097.Civ,C.)
gL, A Leadds Name
�::) 7 LeadLYs Add....
V O�-•,t 1 ccnify that I have mad this application and%tate that above information is
Is !"t concO I "'uc m comply with all city and enunry aMlnunce,and state lows relating
O V m handing amstmnion.anti hereby suihnrim rcprcmf
ntatien.. Nis city l..enter roam
the above.meationed property far inslcaf m purymes.
(We)ague tusuec,Indenmi 1y and keep hufmle,sthe City ori Calcium,uguinst
Zi Iiabll'nles,judgments,atattl and expense,which stay in any way ucunte uguinst said
C.7 Z City in conscyaence of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NO'-POINT DatetoURUy.tttG I.ArIQNs S. Issued by;
U
u aurc,if mIIAZ RIout101 a�— ate Re-roofs
ill/// fIA%ANUOUS MAT' Mf LOSIIRE
Will the appncam or foam Chadd' wpm atom or andle ha ardour,matcdaf Type of Roof
as defined by the Cupertino Municipal Cult.Chapter 9.12,and he Health and Safety
Code,Section 25532(u)'l
CS'e% J411 All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building orcupam use etrvirmem or devices which If a roof is installed without first obtaining an inspection, I agree to remove
"hit ha.:ndous air aantal mon,.twdefined by due Bay Arca A.,Quahty Management
D"tach all new materials for inspection. Applicant understands and will comply with
❑Ye, eFio all non-point source regulations.
` I Imn
re read the haNm
ous out rcmw
yuinem � under Charter 695 of the
California H.11h R Ssfay Cede.Sections 25505,25533 au12553J.I undemond that
it the building dues not eaurently n ve a tenant,that it is my respomihilky tr notify the
e tr n t a1 the requitetncus which inaso be amt prior no "ic c n1'a Cunificme of
OOcouniey' nature of Applicant Date
3
o»-_ nomnd9ed oeent - ate All roof coverings to he Class "B" or better
OFFICE