00100089CITY OF CUPERTINO
CONTRACTOR INFORMATION:
BUILDING DIVISION PERMIT
HUILDING ADDRI'.I'1!RMI'I'
X59664 STEVENS CREEK BLVD
ALLEN SIGNS
No,
001.00089
OWNER'S NAME:
SILK BEDDING
1982 STONE AVE
APPI.ICAf1ON SUH DNFE
1.0/12/2000
PRONE.
P,
SANITARY No. CON Fluff. NO. .
(408)280-6500
GLRC'EC17ENGINERR:
BUILDING PERIII'r INFO
O
NhDG IiLEC' I'LUMIS MliCll
r
I
ji. CENsEr) cost-RAMO R'S DECLARATION
Job DL'SCPl ptl Il
lemby ads rte mat I a:n Iicemcd under moki..n, of Chupler 9 (mon mein,
Jlinn7(XX))ofDivisiolido!!beHminensanJl'ndissiamCodc.-nJmyllvcn.wsrrnlfrce
and elle( /�UClaw
1 -f, f�4
ISh Commclor_
ARcjinifa"S DECLARATI N
1 undmmnd mY plans,hall he used as public rca,rJ,
'
p facer ed PrvRss...... al -
y OWNER -BUILDER DECLARATION
1 herchy arfrm thm 1 um &III' f tom the Conlraemf'I License Law for the
a following ream.. (section 7031.5. Bminen, and P fir,,ions Cud, Any c:ly or county
which require, a permit to motto., after, improve, demolish, or repair any mmcture
,g
4,
pant .- Iso 1 the IPlicu .I p Fitt 11 leer.( runt
L that he is licensed prsua t to the p a% of theContrrafcfne,Lc E (Chaper9
-
Sq. Ft. Floor Ar a' Valuation
!aro) fn,i. J nn B nes dProfession, Code)
oaf s 'n Seel '
$2000
lir but he is exams therefrom and the bas.. fnr the alleged exemption. Any vmation
of Section 7031.5 by any applicant for a permit object, the appficam u, a civil IMnulty
I
APN Number Occupancy Type
,if ao.:o...cmanEvnIf.ntied dodar,N50o ,
3690E009. 00
'❑1,mowneroflife progeny.oranym„ lisec,widtwage,a,theirsofammpOmmion,
-
Required Inspections
rill do the work, and the slmclure is not intanded lir offered for safe Isco 91144,
aces
Business and profession, Codc'Me Contractor', Licenm Wx not apply m an
,wriarorpmpanywhohnIII, lir impmvc, finenn, and who dart, nch work hiurw1f
101 — FOUNDATION
or through his own employees. moided that such improvement, arc not intended or
improvement is
103 — LIFER
offered for nate. It, however. the building lir sold within one rear of
ompledon. the ow:fepbwlder will have me burden ofpwving mal be did not build or
mpnweforparl•,,cef.ale.).
104 — REBAR -
❑has°war, of me progeny. am exclusively contracting with licensed contractor, to
1.05 — ANCHOR BOLTS
construct the project (See. 704ss 4. Busineand I+life., ons nXleo *fie Contractor:
.cense Law Ill., u oro apply , an owner of progeny who hada,, or in fruve, merc:m.
X04 — ROUGH EL T
v EC R I CAL
and who contract. for such pmjw % with a mntmctorfs) licensed pursuant to the
505 — FINAL ELECTRICAL
C...fl,cau, meo.eLaw.
❑ I .,if e,ema bad,, Sec. .11& P C for cid, reason
514 — FINAL PUBLIC WORKS
O.rcr Eric
W'ORKER'S COMPENSATION DECLARATION
I hereby affirm under penally of perjury one of the following declarations:
❑ 1 base and will mumemn a Certificate of Consent to sellfinsum out Worker's
Com,romion. ax provided to, for by section 3710 of .he IabCode ,n Ce. for the
'
performmmc of life work far which this permit is k%ac,i,
❑ I have and will maintain Worker's Compensation Insurance, as required by Section
3700 of the Labor Crile, for .he plituou ante nf,he work fin which this peon;. is
MY Worker', Cort,maton,Ifln,urene, carrier and Policy n°mMr arc:
C.
tie ,S Cr" r T1,.nLA Pnlicr Na.: 33z—t?
CERTII'ICA ION OE EKEMPnONFRONI WORK
COMPENSATION INSURANCE
rfhls action need nal be mnmleted if the pmmi. is for one hundred dollar
IS lat m 1e„ 1
I certify that it, the patornwnce of the work fnr which Ids permiI i, issued. 1
.
.hall not employ any person in any manner so as to become subject to the workers
Co:npcn,i ah. of Calif....4 Date
Applicant
,
NOTICHTO API'LICAN-E IL after making.his Cenlfcre of Exemption, ,.should
bcconm subject an he W aacr', C..mpcnwtion pmvi,inn, it the lath... Gado, on mus.
forthwith comply isith .such pmvi,ions or this permit shut[ he deemW revoked.
CONSTRUE I' ION I.ENDING AGENCY
I hereby affirm that mere is a construction lending agency for the performance
of the week to which Ilan, paunu it w,au1(Sec. 3897, Cu, CJ
lander: Name
GLender', Addrea,
7 1 ennify then1 base mad this application and state that the above inforrr:atiun is
ecl. I ngrce,n..,n,ply win, all city and wanly mdimmee, and ame laws rcl.ili.g
j) m building comwction. and hereby amhorim representatives of this city to enter upon
ten above-nocali ed property for impeniun pamn,e,.
y (We)agree o„ave. indemnify and keep harmless he City of Cercnlnn against
A liabilities, judgments, costs and espen.w, which may in any way news, ...... I said
'
Z Chy In umwyum¢c nl Ilia gnmting af,hlr pOnnit
WITHA NON///'''OINT
L 'Ov
APP ANT U{�DERST NUS Afft,++���WILL COMPLY
Issued by: Date
-
Re -roofs
.'ignawrc fApplican liter seer Lime
IIA' AI OUS MA'1'IiR1Al.5 DISCLOSURE
wiRmeapprcam-amrcwimingoccapam.mmmnandleha�rdon,material
Type of Roof
7
ax dc, by the532(a) inu Municipal code. Chapter 9.Iz, and the Hcahh ane Safe.,
.
Gila smi.n 23532(.)7
❑Yee �Na
All roofs sh� I be inspected prior to any rooting material being installed.
W 11 the applicant orimure building no ..... I use eg.ipnmm or device,which
If a roof is installed without first obtaining an inspection. I agree to remove
tit lvalts nit com.min:un, as defined by .he Hay Area Air Quality Management
all new materials for inspection. Applicant understands and will comply with
oY°s"°
all non -point source regulations.
1 hall read the hazardous mamriok requircmmnls .niter Clmptcr 6.95 of he
Cub fornia Heabh & Sudety Code. Section., 255115.25533 and 25534, 1 understand that
if the handing docs not eurreonly have a tenant, that it Is my rerynn.ioiby to until, the
I pant of.tie requircmcut, which must be met prior to issuance at a Cerfi icale of
ecttpamy' 'l
Signature of Applicant Date
All roof coverings to be Class "B" or better
awn=,ora mornedage ole
U vrna.o