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07090131 � TCfR Z��T������. CITY OF CUPERTINO ��Tr RT'�' �,,���� • pERMIT NO. BUILDiNG DIVISION ltl►,u 0709013 ' BUILD A � WELKIN INTERNATIONAL IND IN PE � T �� DA � �'� �� U SFLORA VI STA AVE ____ R'S NAME: 19 9 2 r j STI � VENS CREEK BL CONTROL NO. SANITARY NO. MR XIE PHONE: BUILDING PERMiT INFO BLDG ELC? PL� 1 " 1 � DEMO 1 �TORY SFD. L� ARCHITECTl�NGINEER: JOb DeSCTIpL10(1 i O Z LICENSED CON'IRAC'COR�S DECLARA'170N�r y(commencing � I hcrcby a(Ci[m that [ am licenscd undcr provisions oC Chap I�censc is 'V : z � with Sccuon 7000) of Division 3 of ihc Busi^css �d �ofcssiuns Code. and my �< a in full force and e[CecL L � . * j� Z Licenu Class �---� Contcacw� O �a� qRCHITECTS DECLARATION :'� lans shall tx us�� as Public rccords i a a i undcrstanJ my p jaV : Q N l.icenscl Pcu�cssional �W NER-BUILDER DECLARA'I'ION a t trom thc Convactors Liccnsc laW �or thc ��'� 1 hcrc6y alTrm that i am excmp VglU3U air any swMU[c � p o [oilowing 2ason. (S�c�c�°W�c anp � li. h�r��cpy city or caun y c� Ft. Floor Area �' which ccquires a 1k ��� � app rtnit to fiic a signcd statcment , �icant tor such pc u= y rior u� ��s issuancc. alsu rcq Occupancy Type '?< ihat hc is licensed pursuan� �o thc provisions o[ the Contract�r's Li�ens� �w (�aptcr 9 � $ i �� fr � �d � buis (or the alicged acempuon. Any ��o��a� 01 ApN Number F �(commcncing with Scction 7000) of Division 3 of thc Busincss f� V;�� af i�,, that he is exe�P a a I��t for a pem+it subjecu �he aPP Section 7031.5 by �Y PP � not more �ha� five hundecd dollars (5500)• az �� compensation Required Inspections �(, ss owner oC tl�e propettY. oc my employces with wa8� wiII do Ihe work. and the st:uttuce is not mtendtd or o We a�o��� Pp w�sn� owner of and Protessions Code: 'R�e Conuacwrs l.icense 1-a or otiered [or sala I[. Pro �ny who 6uilds oc impcoves th�re�n. and who dces such work himult or thmugh his own emp�oyces:providcd ihat wch impro�m�n� � not intended y� 5 rovement is sold within one yasr oC comptetion. ihe owner- however. Uu bmld�ng or imP vc Cor �� a builder will have the burden of pmving �a� hc did nM b�ild or imp� W sale.). wi�h I"kensed rnnvaanrs w � as owner o[ �he proP�rty am enclusively conuacting The Convacm�s IS- rnnstruct the Projett (S�e. 7044. Business and Pro who bui ��i PfOVes thneon, aod . cense Law does aot apply to an o�er of pcoPenY ursuant to the Conuactars who coMracu for such projec�s `+'�� a con�caao�( ��u°�d p License Law. . B dc P C for this reaso� n 1 yn ezempt undu S�c ` � L 1 �� � . Date "* WORKER'S COMPEN A'�'�ON DECLARAT[ON 16ereby �i� under penalty o[ p«7��Y a� o � following declara6ons: �► h;re and wilt main�ai Se uon 970U o[ che [ab°T Code� for�th� °�� sation, as pra��ded for by work tor whicd this pertnit is iuued. tion insuran«. %� �luircd by Section • � I�,rc y�d wiU maintain Wo �o�ancco f � w�� for which this parn'ii is issued. g7pp o( �hc labor Co ��� carticr and Policy numbcr aze: pqy V Compe Policy No.: WO � S � Cartier. • CERTIFiCATE OF EXEMPf[ON FRO COMPENSATION INSURANCE �is sccaon need not be complcted i[ the P��'�� � �Of °nc hundccd dollazs (51001 nr Icss.} rtnit is issuc4 I sha�l not � Workers Compansalion 1 cenify ihat in thc perCo manncr so as to bc o r� hib ��h�s pe employ any p��n in� Y / tl Laws of Cau�o � uon. You �ouiJ ppplicant tliis CcrtiC�cate of Excmp N�pCE 7'p APPLICANT: If. aCtcr m �t�on provisions of � 1-a�r Cod¢. You must become subject la �+c Wo��s v s ons or this pecmi� sha116c decmed ��d. z forthwith compty with such pro � � CONS1'RUC7'1 F„N.., 1 hcrcby affirm U� et� s ss c ic�d (�Sc�ua�nCivgC.� cY �� thc work (ur which this P W Lendc['s Na+na p.i A C,cnder's Address r� � � ��[y �hat 1 havc rcad �his application and sia� thal �� a�ve informatiun is V � cortcct. I a rce �o camP�Y M''�' a�� ���y and counry ardinances and stata �a'�s ��atinB �o �'' E"' building conswction, and hcrcby authoti�e repres�nuu� of �is ciry to cn�cr u�n thc Q(� ro rt for inspccuon pur{wses. rtino against ������ abovc-mcntio�cd p P� Y ,,, c«r a� ��a. Date ,�+ W (We) a6ree �o save, indcmnify and keep H p " liabilitiu, judgmcnts, costs and expcases Which may in any Way accrue aBa'"S� sa'd City in con:equencc ot �c g�ang o( this permit. V r' APPLICAN7' UNDERS'fANDS AND W1LL COMPLY �'41TH ALL NON-P01NT ISSUE d}� � SOURCEREGUL.A'n�NS 'i le7 (( (C7 Re-r�ofs �2��.. ;� oe Typ,; of Roof Signature o ApplianUConuuar HpZpRDOUSMATE an �yp� the aPpGcantor futwc buildi�S °��°P �� 9 12 and th� Hcalth and SaCety rior to any roofing material being installe . All roofs shall be inspected p ree to remove 'efincd by th� CuPenino Municipal Code. C1�ap g Ch 3 C, $ection 25532(a)? � If a roof is installed without first obtaining an inspection, ❑ Y� which µ/ill thc app����� or Cuwrc building oaupant usc cyuipmcnt or dcviccs cmit harardous air contamina��s u cfcfincd by thc BaY Arca Air Q����Y �`'�anagcmeni all iew materials for inspecrion. Disirict? No � Ycs tcr 695 a( �hc Cali�a�- 1 havc rcaA the ha'ard`ws ma�crials reyuircmcn� undcrChap Date nsibiliry to notify ��up�� nf thc licant niaHcalih&SafcryCodc.S����u�5'Z5533and7S534•�undcrstandUw��« ���d1O$ Si� nature of App ' or better docs not cucrcntly havc a tcnan4 rior w issuan ��[ a Ccrtificatc of Occu h'• rcyuiremcn�s which must be met p �� All roof coverings to be Class ��B � � � Da�c [lwncr or authorized agcn�