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05020081
CITY OF CUPERTINO ?KF s +•�3s.-.+'�`€� ` '��-x, `- :i BUILDING DIVISION PERMIT .CONTRACTOR+INF.ORMATION �,. -rs�.a`I• BUILDING ADDRESS: DRAIN DOCTOR PERMIT N005020081 9-1)9 RROOK(IRM7R. TN OWNER'S NAME: PERMIT ISSUE DATE Aift MARIO LING 1775 WTNCHEqTP.R RMM __..02/11 /2005 E: SANITARY NO. CONTROL NO. (408) 370-3082 ARCHITEC,ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH = o0o LICENSED CONTRACTOR'S DECLARATION Job Description in� 1 hereby affirm Net 1 am limned op under provisions of Chapter 9(commencing with Seniors 7011(1)of Division 3 of the Businea and Professions Code,and my license is in fullfomcandefinet, INSTALL PROPERTY LINE C/O License Class L..M F Date Contractor �!yy ARCHITECTS DECLARATION ?Ct< I undersand my plans shall be used az public records 3 a Licensed Professional s'0OWNER-BUILDER DECLARATION > 1 hcaby.]Tom that I ma exempt from the Comanmr's Liecnse law for the EOG following Ramon.(Section 703 LS.Business and Proressions Code:Any city m county K m( which requires a permit in consuum,alun,improve,demolish,OF repair any swcture d $j sno poor to its issuance,also Requires the applicant for such permit to file a signed statement that he is licensed Vommmun the provisions of do C....",License,Law(Charter 9 Sq. Ft. Floor Area I/ �` � Valuation wl-c' (commencing with Scetion7")of Division 3 of the,Business and Professions Cede)or � f y that he u exempt thcRfmm and the basis for the alleged exemption.Any violation of /I /!w Section 7031.5 by any applicant for a permit subjects to applicant to a civil penalty ofe�nn '2m. not mom Ram five hundred dollars(SSW). 3 7/yy,I�I©W rmiel�0 "88 TOccupancy Type (:)I,as ow=of this property,W my employees with wages as their talc compenuthon. 19% _ d• '/C1 �J will do the work and Ne swmute is not intended.,offered for go(Sm.7W,Busirry ��ABBArrrrrr tern.. pro property h bol Code:The wn dacton,License Law dols not apply lf an owner of IZeQU1 IDSpeC[lOfls Own eny who builds arimpmvu thereon,and who ar ee¢ucb work himulfor through his Own employee,provided than such rt is mid are net ear,o c m peered for aide.me Owner. burlde, ,Nebuildingorden of mitis soldwithinone year of completion,Ne owned builder will base the burden of proving Nat he did not build or improve for purpose of salt.). ❑h as Owner of the property,am enclusively contracting with licensed commeters to const ct the pmject(Sec.]OSA,Business and PmfGtVons Cedc:)TIC Comas emis Li- mnse law docs not apply in an owner of pmpeny who build¢of Impmw themon,and who contracts for such projects with a contractor(s)licensed pursuant In the Contmemta License law. ❑1 am ucmpt under Sec. .B&P C for this recon Own 7307W pr�---- Day(• . WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ALK and will maintain aCenificam of Consent to self-insure for Worker's Compete n,u provided for by Section 37W of On labor Code,for the perfom nee,of the for which this permit is issued. have and will maintain Worker's Compensation Insurance,as required by Section of do labor Code for the peRormanee f the woh for which Nis remtit isissued. W16a Insunn c and Policy numbe¢ licy No.: // IgCATE OF EXEh ON FROM ORKE ' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) 1 cenifv that in ON perfmmmee of the work for which this permit a name.I shall not employ any Notion in my mannerm as In become subject to sM Workcri Compensation Laws of California.Date Applicant NOTICE TO APPLICANT.If.after making this Ctruflun of Exemption,you should become subject to me Worker's Compensation provisions of the labor Code you most 0z foMwith comply with such provisions or this permit shall be deemed revoked. z CONSTRUCTION LENDING AGENCY [-ate Ihereby affirm that them is a construction lending agency for the performance of !Y me work for which this permit is issued(See.309],Co.C.) W Q Lender's 1 Lciif's Address az U Q I certify that 1 have mad this application and soon that the above information is ly F coned.I agree to comply with all city and county ordinances and soon laws relating to Q U building construction,and hereby mdumm representative of this city to enter upon in, r[CI aMve-mendoned pmpersy for inspection purposes. 4 (We,)agree Id save,indemnify and keep harmless me City of Cupertino against a(—rw In liabilities,judgments,costs and eapcnsce which may in my way accrvc against sold City U Z A APPLICANT Ofmcgr rANDfthis permit APPLICANT ] ANDS AND W PLY WITH ALL NOyrPj�� Issued by: Date U SOURCE 0.EG 5. y/iJ signature✓ff Applican/Contracmr Dan Re-roofs HAZARDOUS MATERIAL DISCLOSURE Type of Roof Will the applicant or future Wilding occupant store or handle haatallous material az defined by the Cupert 0 Yrs j�'jNu ino Municipal Code,Chapter 9.12.and the Health end Safety code, ea zss33(an All roofs shall be inspected prior to any roofing material being installed. 7Will the applicant or future Wilding occupant use equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove Dixurictl tha.allous air contaminants as deMcd by me Bay Arca Air Quality Management all new materials for inspection. ❑YesI have Rad the hasardousmaterials requirements underChaper6.95 Orme Califor. Health @ Safety Code,Sections 25505,25533 and 35534,1 undersand that ifine building s not currently have a tenant,mat it ii my rts nsihlllty m notily the o eupant of me niRmen" It metlanuctocm 9f.Certie..cfOm.P ey. Signature of Applicant Dale Owner nr mm.ri.ndagent Dan All roof coverings to be Class"B"or better Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 UPERTINO Building Department JOB ADDRESS: 9o-7 I3Ro&�C7aovE LA . PERMIT # OS ozOORI col�,E/e7iniv, e 1 7.soly OWNER'S NAME: /f 1991'o 1,;N,-1 . PHONE # ya - 7iL/ o /e GENERAL CONTRACTOR D991n/ Por�To,0- . FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete 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 5/ Plumbing Dei?-/N 6 3(1 .ff ( C-30 Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO REPIPE/SEWERS/MAIN SERVICE CUPEkTINO PERMIT APPLICATION FORM APN# ,5753 5 a Date: 2 - ii- Boas Building Address: c709 Ne00k-6<70vC [-,t/, CGi�DE�TilJ0 (/i9 9,5-0/y Owner's Name: �f3�lo Phone #: X08- Contractor: Phone: License#: �Q�/N. ISOC�TOk goo- 9zl - I/s� 643gff (<-36) Contact: Phone: C/�/ AJ (TEc(-1, /O# 73 Cupertino Business License#: rt/oy- X ,77- 0.7z Building Permit Info: Bldg ❑ Elect ❑ Plumb R) Job Description: di( 70 YNSY/?/C I CLGj-,V 0(,tr ovu pReAir y/jQ/) jr�< /5iC(CUY To &2,19,"ni dl(,4iv LING CLtf}�u:NC>, C�fRt7�/U7 Ce,61% 644 iJ Residential ® Commercial ❑ OF 7/99Ust= Cost of Project: 7 o Qty. if Ap2licable Fee ID Fee Description Fee Group PPERMITFEE Plumbing Permit Issuance PLUMBING BPREPIPE Re i e of Fixtures PLUMBING BPERMFEE Bldg. Permit Fees BUILDING BPFIXTURE Pbl . Fixture PLUMBING BPWSVCS Main Water Service PLUMBING BPSEWER Sewers PLUMBING BPSEWAGE Sewage Disposal PLUMBING BUSLIC Business License BUILDING s 7//�/cl