02040164C
CITYIL OFDIIVIISSIION o
CONTRACTOR INFORMATION:
PERMIT
BUILDING ADDRESS:
PERMIT NO.
10446 ANSON AV
CHUN CHI TUNG & YI GED C
UNG 02040164
OWNER'S NAME:
APPLICATION SUB DATE
^.HUN CHI TUNG & YI GED CHUNG
04/30/2002
ZONE:
SANITARY NO. CONTROL NO.
O ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
z, LICENSED CONTRACTOR'S DECLARATION
Job Description
heaby affirm that 1 am licensed under provisions of Chapter 9 (commencing
wills Section 7")of Division 3 of the Business and Pmfessiou Code. and an, license
CONVERTING 48 SQ.FT. GARAGE TO DWELLING &
-j in full force and affect.
a �iana<Cmsa Lie.#
Dam Contractor
ssoARCHITECT'S DECLARATION
I understand my plans shall be used as public o cerds
REMODEL KITCHEN
/
eP
0 Licensed Profice,m it
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Conuacmr's License Law for the
< fallowing reason. (Section 7031.5, Business and Professions Code: Any city or county
V
O which requires a permit to construct, alter, improve, demolish, or repair any structure
er prior to its issuance, also requires the applicant for such permh to file a signed statement
-.........
— did sL Is (Chapter)
cit p- a ulh p - sof the Ce Business
(cont withS m
(commencing fD' Division Bumneas dP f Code)
S Ft -Floor Area,.,
s
1 J' :• i tt/ 9,
a]UdhOn
ex om-
or that he rs exempt mcicfmm and the busts for the alleged ea'emption. Any violation
1A
of Section 9031.5 by any applicant for a permit subjects the applicant m a civil penalty
11
9 261 I'll
of not mare man five hammed dollars (5500).
A Number
.. .. Occupancy Type
01. az owner ofma Foprny, or my employees with wages as their sole compensation,
I_
'will 'do'the work: aha me mmnurc is not intended or offered for sale (Sec. 7044,
102 - PIERS Required Inspections''
Business mid Professions Code: The Contractor's License Law aces not apply to an
owner r ofpropcny Who builds or improves thereon, and who does such work himself
orr mroagh his own employees. provided that such improvements arc not intended .r
103 - UFER
is sole within one year or
ye
offered e. If. however, the Wilding or urden
10 4 - REBAR '
c omplciton. me owner -Wilder will have he burden of proving mm he did out build or
1f,m
improve `purposeafaale).
105 - ANCHOR BOLTS
. _s
Ws owner onhc p(Seenyam
106 - SEWER & WATER
Businivelycunvaceingwimr«n.4e Conametatn
ted `eon,
License the project (sec. ]pot, Business and Professionsilds or The improves
License Law toes not apply man owner of property woo) or improves
"
202 - UNDERFLOOR PLUMBING '
ond.whu contracts. for such projects with a.commnor(s) licensed pursuant. to the
lice umthe
Cuonsairp,trLicense
aw.
_
—" " 203' "- "UNDERFLOOR MECHANICAL ----
Sec
0 1 .. cmmpoondcr ice. ,B&P C train. rcazon
204 - UNDERFLOOR' FRAME`"
owner' utC �'/jo/zoos
205 - UNDERFLOOR INSULATION
•' ORKER' COMPENSATION DECLARATION
301 — ROUGH PLUMBING
I hereby affirm under pannitvof perjury one of the following declarations:
302 - TUB & OR SHOWER
0 I have aad dill maintain, . Cell peata of Consent to ser -Mame far Worker's
303 - ROUGH MECHANICAL
Compensation, as. provided for by Section 3)00 of the Labde, or Cofor me
pet`rmoomeeafineworlforwhimmispemtil,sissued.
304 - ROUGH ELECTRICAL
❑ 1 have and will maintain walkers Compensation humince, as repaired by sera°"
305 - FRAME
3700 of the Labor Cade, far the performance of me work for which this permit is
'used. MyWorkesCompe"sum. Insurance carrier and Policy number are: -
306 - HOLDOWNS
cho 'Pal;cyrv.:. .:,
307. ".INSULATION._
CERTIFICATION OF EXEMPTION FROM WORKERS'l ,
s s ' 3 O.8 a `PSHEETROCK;
COMPENSATIONINSURANCE"
ton at oNdew,Wratnvletea red p nit far n Brea donor'
30.9-,; EXTERIOR —LATH--
fslp0)anesa.)
310 - INTERIOR LATH
-311-
,'- 1' nIY that nth pct sopa ce !III kf h hIM1.K t'-ssued.l
- SCRATCH --COATI -'
'hail hot employ any person in any manner so as to become. elan to da Workers
313 — ROOF NAIL '
CompCultism.. ensation laws of C a. Date '
Api11cam -' '-
NOTICE TOA after ..king of you st
Cart.nsof
.brommiTOelto
-- 501 - FINAL ELECTRICAL ENERGY --.-
to Ire WorkersCor..kinnnis
he sw,,ir ,ardome
Loom,60ne,youmo
me Laborom e, you most I
502 - FINAL PLUMBING ENERGY
forthwith comply w,In such proviainnaarthis pe.it >hall lxaeemedrevake°
-"
503. - FINAL MECHANICAL ENERGY_.-
•"" CONSTRUCTION LENDING' AGENCY
'�
, 1 hereby affirm that mere is a construction lending agency for the performance
_
504 - FINAL BUILDING ENERGY-
bwark tar wmeh misp moria iamea (s«: 3o)9. civ. c.)
Lender's
505 - FINAL ELECTRICAL
Nothe
Lend eranaarcaa
._ .... — ..
506 - GAS TEST,
- I certify that I have rcaJ IM1is application and tame In., the above information is
5 0 7 - FINAL PLUMBING
tract. I agree to comply with all city and county ordinance: and state laws ralain
mWildim, oriotrunion. a ad flesh, author orpoammtives oild,',to
508 - FINAL MECHANICAL
anterupon
t ,he above.memomeg imp rty fpr im,ceiion patio,,.,
509 - FINAL GRADE
(we) nitrite save; indemnify and keep harmless me City of Cupertino against
liabilities, judgments, costs and espensrs whrtn may in any way acme against said
510 - FINAL PLaNNING
City in consequence of the gtanling of this permit.' - -
' APPLICANT UNDERSTANDS' AND WILL COMPLY WITH ALLNON-POINT
n
5141 _ N I WORKS
URCB REGU�ATIOJ♦5, i`' `, ,�
Issued by: Date
Zva�
Stgmmrc o. s plaanuu-Co moor'Dae
Re -roofs
HAZARDOUS MATERIALS DISCLOSURE
W Il the pheant or future b lJ g occupant st handle hasuct mahnnal
'v
,
Type of Roof....ti
eefnel by the C I=r M
I cae Chapter m HM1a Safety
.. .. _-......,. -.. .. _. -.,.. . _
•
Sea 2553 tai,
oY t C�Na - I
f' a . ` 1 „ %5 .
�_
+ l
Will m o r t b`addingoccupantsaeequipment °tdeviceswmeh
All roofs shall be inspected prior to any roofing material being installed.
our ortu
Bit hats d mm i. as toed by th Bey Aaa'Au Qua ty Management
i""'oY
If a roof is installed without fust obtaining an inspection; I agree to remove
-_ o -
all new materials for inspection. Applicant understands and will comply with
3Q 66n -point SOUCCe regUlatlOUS.
i
1 he read ma,haurdo uddc Collar, 6.95
vealed&Safety
•1 1 1, '
of the
Califo cod 5lctionlsl15505.25533 an
rid 15534 I understand,hal
-ifthe building does not cutrcndy have anion, that i, is toy aspon:ibility ro nmifythe
occupant 6f the' repuitements which must be mel prior su
to isance of a Cenifam cof
-
rppaney. -
Signature of Applicant Date
_
All roof coverings to be Class "B" or better
o ^=_ed age. I Dam
- -" - OFFICE