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08070171 CITY OF CUPERTINO BUILDING DIVISION PERMIT ,. COIV'lR[�cTaRI `QWAAIO, N BUILDING ADDRESS: PERM"N0. 10225 S BLANEY AVE TONY SU 08070171 OWNER'S NAME: PERMIT ISSUE DAIS :PONY SU 10225 S BLANEY AVE 07/24/2008 NE: SANITARY NO. CONTROL NO, ARCHrrECTfEIGINEER: BUILDING PERMIT INFO BLDG EIF-CT PLUMB MECH 0 0 0 Oo LICENSED CONTRACTORS orders DECLARATION I hereby alfim that l,m IRmnseO under provisions of Chapter 9(commencing Job Description rim Section 70W)or Division 3 of the Buvora'and Professions Code.and my liceve is RPLC EXTNG 75 GAL NATRL GAS PWRVNTD WTR HETR = y in full farts Nd effect p n Z License Clsu Lia.0' - n JF Dam Contractor ARCHITECTS DECLARATION U 1 undcrsund my Plana sM1all be used m public recartls e� C Licensed Profesdan'1 3 OWNER-BUILDER DECLARATION CO E 1 hereby a(Su that 11. Csempl arum the Comracmh IJen y c Law far the i O O fallowing massa germs a]cardamom LS, W ho.s sad Pmfecdoli Calc:Any cBy car uuure S$ whheh mquim a permit mi..dWer,impmw,dMrnitt es repair any nrunmm iy primmihacensed Womquim lheapplheant for Committee w arra Lncdautement xx< Fsfast W pmwanl to the provisions of dm Buslars,and Pvelsw(CMpmr9 Sq.Ft. Floor Area Valuation (commencing withScnion]000)ofDivisionJaftheBusincsaandProfuaVomCodc)or $1500 this he is exempt therefrom and the basis for We alleged esempti.My violation of Sermon 7071.5 by say,applicant for a permit subjecu the applicant as a civil penalty of rot mom Nan five hundred dallan(SSW). 36932009 .WNumber Occupancy P Y Type ❑L e owncrk.Use Paanou a is wplarees wild wglf u the'v role cmnpcns,dw, and dm Newark and that strunumurotinhamhed da,officialdo for ask to aa,B neer of and Prtyw1dnna Cade:Tate Canuacmr,License does dm rot apply lf rot owner or Required Inspections price ywlm Wildaesimprowethemmaand who aausochwork M1imvdfestNoughh. own empheym,prorldw that ouch improwmuha are not ear fc esoeerw fes sate,a. Wild..the .tine orders owmenttaseldwithinone yearofcmnow,1.the owncr- builder will love The buAen of proving Nu he did act build or improv far puryose or :1. 1,a owner of the pec.704.B use es; ad comractinL with licensed contraction;m deram La the project(Sec.7044.Budnmand Profudmns Cade:)The Cotheeam,Li. ceou Law d supply m an swat of props ho wilds es imProwa thereon,and. who con esauch pojttts vith'rontrac lirrsnsdptmuantmthe Conuamola License V'111` ❑1 ern uery under Sec this mason Owncr Dam K MP is N DECLARATION 1 hereby aILum ower ly f perjuryone of the following dcleredonm I haw'w vitt meinwna Cervi camof Commuloself-inwmfm'WorlmraCompen- andon.as Provided far by Sectio 700 of the labor Code,for the performance of dam work far which Nu permit is iv ll�w caw will maintain Workers pusadon Iruuruue,n mquiretl by Section )]00 of the latmaCed,for that performance of Ne work for which this permit is issued. My Wacker,Compematim Wurenu mrtier and Policy number are: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE masstttim cord ro'w completed If the Permit talesman huntltd do0srs($I00) es leas) I....:fy that I e performance of the voy which this Permit u iasue4l slWl not employ any peg min any mevncrma/uf5rovncmbjcct he Ne Workcri Components. Laws of ifs tae Applicant 1 NOTICE TO AP ��((011fffr ma�f�ng Nista tum of Exemption,you diamond baome subjem m e WertcrI�'OmpeAaadm 6mKvons of Nat labor Cade.yes mon .J z forthwith camply withsuch Pro mu or this Mind shall be deemed mmkod. ?O CONSTRUCTION LENDING AGENCY I hereby affirm that there tam conswcdm heading agency for the perfmmmme of �i Ne work for which this permit ta iuued(Sec.7(19],Ci,C.) Lenders Name .7 z Irnder's Addmv V O 1 unity that I haw mad this application and sum that theinformation'bow infoation is LI.^ comet.I agree to comply with all city and county onlinuaxs and sham Iwo Miami,to 0SV^ Wilding conauuedon.and hared,wtnorise mPmunhativu of Nu city m enter upon Ne r II.1 show-mutioind property fm inspection forpecea F„P. (We)cap t`aw,indemnify and keep ity to the City of Cupertino againstty t)V) IiaNlitica' and tape""",whheh mky to anrvv+r anciuc.gaiwuid city z in coiueq afdm grandngofthtait/ / Issued b ^ APPUCA UNDERSTANDS AN W LL C MPLY WITH ALL NON-POIM y: Date 2 ?-�- SOURCER U TIONS. Re-roofs Signatures Contncmr DISCIDam HA tIlSM ALSDSURE Type of Roof --- Wit de applicam es moue antics ig occupan'no a or domain hruNens mamrial as defined by the Cupertino Municipal(title.Chapter 9.11.had the Hulth and Safety ewe'p ti 15531(a)] �Na \��l All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtainingan inspection,I agree to remove Will time applicant or future Wilding amupam use equipment m ties=Mich Pe i locardnu'air concealments as infined by the Bay Area Air coolly Management all new materials for inspection. ❑Yu �No I mkilUehvallom m,tedW mqulm under pterh.95 ofIM Califm- niame.1 safmycumsrNesha7SSOA2557.I ISs3s.1 Naifde Withal dimes rot cyq city haw•aawc that l'es my pili'm awry the occupant of the mquimmcnY hi uubemetpn miss/nuef.c ficmnof«apanry. Signature of Applicant Date owdmar inammilred.gut pateAll roof coverings to be Class')q.'or better CITY OF CUPERTINO • 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . . 36932009 . 00 DATE ISSUED. . . . . . . : 07/24/2008 RECEIPT # . . . . . . . . . : BS000005568 REFERENCE ID # . . . : 08070171 SITE ADDRESS . . . . . : 10225 S BLANEY AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : TONY SU ADDRESS . . . . . . . . . . : 10225 S BLANEY AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3184 RECEIVED FROM . . . . : TONY L SU CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY TONY SU ADDRESS . . . . . . . . . . : 10225 S BLANEY AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3184 - TELEPHONE . . . . . . . . : • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL --------- -------- ------ --------- ---------- ------- -------- 1BSEISMICR VALUATION 1, 500 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40. 79 0 . 00 1PRWHEATR UNITS 1 . 00 24 . 48 0 . 00 24 . 48 0 . 00 1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 106 . 56 0 . 00 106 . 56 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ------- --------------- -------------------- CREDIT CARD 106 . 56 DISCOVER --------------- TOTAL RECEIPT 106 . 56 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 518 WATER HEATER • &)�70i 7 CITY OF CUPERTINO 'D` WATER HEATER • OF CUOF PERTINO PERMIT APPLICATION FORM APN # 3 oZ UO g Date: v U July 24, 2008 Building Address: 10225 S . Blaney Avenue Cupertino, CA 95014 Owner's Name: Phone #: Tony Su 408 255-8906 Contractor: Phone #: . Homeowner Fax #: Cupertino Business License #: Contractor State License #: Contact: Phone #: Fax #: Building Permit Info: Bldg ❑ Elect Plumb ❑-- - Mech Residential Q Commercial ❑ Job Description: Re lacin 'existin 75 p g g gallons natural gas , power-vented water heater. Strapped On Platform CO— Bonded [�]— New Location ❑ Replacement 0- Valuation (cost of project): $1 , 500 .00 Project Size: Express Standard ❑ Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Green Building Points achieved: �- Revised 6/16/08 SelmaCITY OF CUPERTINO WATER HEATER CUPEI,TINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Permit Type Group 1PCWHEATR Commercial Water B PCWHEATR HeaterNent 1BSEISMICOM Seismic Commercial B 1PRWHEATR Residential Water B PRWHEATR HeaterNent 1BSEISMICRE Seismic Residential B 1PPERMITFEE Plumbing Permit P 1 TRAVDOC Travel & B Documentation I BUSLIC Business License B a r File Edit Actians DetaJlls Links Favorites Help f Permit Information . .. _ ... .___. Location Information - - ------- ----- - --- - - - mit Number° 03O20097 µ � I rAddress• 10490 CYPRESS DR J - �— Status" " City/State(Zip CUPERTINO h I"'' Master Number Notes 011' ' APN 3163004900 Project —� (Q Unit Apply Date02/24/2003 ps 1 Operator conniewR Owner Entity Information___._____.. _ Permit Issue Date 08/22/2003 Operator conniew E - � r�rOwner Name Y_OON SIL_KAE - _ �_ � ,t I Certificate Issued I _JI Operator � � - t I I ;Use Default J7, Certificate Type ' Address Itome Certificate Number •' City/State/Zip 71 F71 F_ - Permit" l Property Zoning li Applicant l Conhactor Defined Relds I j " -Permit Details - . _ - _ --- - . ._ _ .__.__ _ _._ -- __..-__� Permit TypeSFDWL-ADD Purpose/Special Conditions 1 �Q ' ADD 459.25 SOFT. SINGLEFAMILY DWELLING ADDITIO PERMIT REACTIVATED $04090084/PAID HALF Usage Class" DWL-WNEW DWELLING TYPE 5 WOODNEW ppliedValue' 45900 QUARE FT, 459ij ---------------- Calculated Value 49195 US C-404 Type 1434 . jQ J I ADD: RESIDENTIAL ` Permit Form JAUTOPERM PERMIT Ownership 1 Private Project Sae ---------------- f� , �You have chosen to bypass the holds for this permit parcel ,Enter per mit status • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408) 777-3333 SCUPERTINO Building Department JOB ADDRESS: 113:)ZS S- itWtaEY lam. PERMIT # CUPa , OWNER'S NAME: PHONE—#4pi - _ , GENERAL CONTRACTOR: - _ FAX # 4, l MEC I am not using any subcontractors: --�, SigKature Date Please check applicable subcontractors and compkte the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock T' • -7 zy Owner/tllcr Signature Date