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04060034X00 YWCC aiW noR !' w CU JaU iLLG 04 hoc _Z> iFC 02 z r; C[T'uIOnINc r4I' oPER'�NNO PERMIT =G®NTRAGTf ORM.A -. N BUILDING ADDRESS: CHEN'S CONSTRUCTION CO PERMIT NO04 O 60034 902 COTTONWOOD OWNER'S NAME: PERMIT ISSUE DATE YANG CHARLES I AND TRACY T 1271 WASHI 'ONE: SANITARY NO. CONTROL NO. (510)639-0853 ARCHITECfIENGINEER: BUILDING PERMITINFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION I IOb Description rovitior Chapter 9 (ncing rm that I am licensed under pos comme 1 hcrcby affins p with Section 7") or Division J of the Business and Professions Code, and my license is REMODEL (E) KITCHEN,. UPGRADE ELECTRIC L esfnrceanderten. =a u«nm lav Date .-- Contractor bS ARCI 1' DECLAR9TION - I understand my plans shall M used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm the, 1 am xempt from the Commnor's License Law Tor the following reason. (Section 71131.5 Business and ProfesNnm Code: Any oily nr county which requires a permit to construct. alter, improve, dcmulixh, Or repair any structure prior to its issuance. also requires the applicant for such Permit o Glc a signed statement that he is licensed pursuant m Ne pmvismas of the Contractor's License Law(Chapler 9 Sq. Ft. Floor Area Valuation (commencing with Section 70011) or Division 3 of the Busincts and Professions Code) or Nal he is exempt Bactefrom and the basis for Be alleged exemption. Any violation of Cr OO Occupancy Type Section 7031.5 by any applicant far a permit subjects fie applicant to a civil penalty of not mom than Bve hundred dollars (5500). I, a5 owner of the property, or my employees with wages as their Sale compensation, Required Inspections will do Be work and the structure is not intended or offered for sale (Sm. 7W, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who buildsor improwas thereon, and who doessuch work himmff or through his Own employees, provided that such impravemnnu an, not intended or offered for sale. If, however, the building or improvement is mid within mic year of mo plcuan, the owner • builder will have use burden of proving that he did not build or improve for purpom of sale.). 1, as owner of the proper.. am exclusively emaruaing with licensed contractors to construct the project (Sec. 704,1, Business and Pra fusion Cade:) Tits Convector's Li. cense law docs not mprY to an owner of property who builds or improves thereon, and . who contracts for such projinne with a conlractar(s) licensed pursuant to the Contractoes License law. 1 am exempt under Sec. . B & P C for Nis reason Owner Data WORKERS COMPENSATION DECLARATION I hcrcby affirm under penalty of perjury one of the following daelmatio ne ❑ 1 have and will main eia a CeniGca¢ of Consent to selFinsom for Worker's Compery ration, as provided for by Section 37W of the labor Code, For the performance of the work for which this Permit is issued. ❑ 1 have and will maintain Worker's Compensation Insurance, u required by Section 37W of the labor Code. for the performance of Ne work for which this permit is issued. ' My Wark,0g oripns;lTsmana carrier and Policy number a rt- /- Carrier. - Policy No.: % � Z o •• CERTIFICATE OF EXEMPTION FROMW/ ES COMPENSATION INSURANCE Tuf section need not be completed tribe parran is far me hundred dollars (51 W) or less.) 1 certify that in the pcffmrnmea of the work for which Nis permit is issued. I shall nut employ any person in any manner to as to became subject a the Workers'' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT. IL after making this Certificate of Exemption, you should Became subject to the Worker's Compensation previsions of the Labor Cade, you must forthwith comply with such provisions or this permit shall he deemed revoker. CONSfN LENDING AGENCY I hereby off rte that theret it is a a coem nstruction lending agency for the performance of m ' the work for which thu permit u issued (Sec. 7097, Co. CJ Lenders Name Lenders AOtlmss j 1 certify that 1 have read this it,licmion and more that the above information is ' cortca. I agree to comply with all city and county ordinances and sum laws relating to building construction. and hereby euthorim rcpmacnmuves of this city to enter upon the 1 above-mentioned property for inspection purposbs. (We) agree to save, indemnify and keep harmless the City of Cupertino against j liabilities, judgments. ensu and estimates which may in any way accrue against said City in consequents or the granting or this permit. ' APPLICANT UNDERS7ANDS AND WILL CPJMPLY WITH ALL NON -POINT Issued by: Date SOURCE REGUL, S. Re -roofs Type Of ROOFWill ��Lr'"%�G t tU�i/6 � Sign urs or h oai/Cmunal ! /,Date HAZARDOUS MATERIALS DISCLOSU ERIA SDISrcorhandlc me eppii=antmfumrUSMA hazardous materialat rdprif defined by the Cupertino Municipal Code. Chapter 9.12. and the Health and Safety Code, Section 255320)? All roofs shall be inspecany roofing material being installed. ❑Yes 0 N If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building Occupant use equipment ordcvices which can it hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yo ON. 1 have mad Ne Bitterroot materials requirements under Chapter 6.95 ofd¢ Califon ria Health &Safety Cale, Sections 25515.25537 and 25534.1 un&rswd Nu if the bobbing Jms oat <uncn0y hme s tenant, mat i ' my responsibility m n IY d¢ oeCUPmL or the mm<ma whr oat be mein Iocam ora ceN to ar a=anan=r. Signature of Applicant Date All roof coverings to be Class "B" or better d LLNoar ar m1 ri'. igeB,1 10'-3" File: MichelleD(N)Kitch(E) 06-02-2004 Owner: Michelle Dong Li 902 Cottonwood Dr. Cupertino, CA. 95014 C� (408)781-3860 DINING 140 sq ft Drawn By: John Chen 1 Chen's Construction Co. O 1271 Washington Av. \ / PMB 638 San Leandro, CA. 94577 W C INS. 1719135 Of State Fund Ins. Corp. 0 State Lic.: 702842 Cel.(408)655-9488 \ O/Fax(510)639-0853 co GFI 1). Remodel the (E) \\ Kitcher& replace 9 p cabinet counters as the -------------- (E) sizes. - - C° M _ I /7 1 2). Upgrade the cel electridWircuits and - I Flu. Light outlets in compliance with the City Codes. ' 3). Install some (N) Fluo. Lights and Recessed \ Lights in Kitchen and Dining Area. APPROVE \ 4). Replace Appliances. D`NPACCORDANCE WITH TM Cv os 1 KITCHEN 5). No window or layout orf"o CODES Alvo oe I"A"CES changes in the areas. s c ED � _3 ( 104 sq ft \' i his set of plans and— o e 7 l -f- De kept on the job at aq h al on ;MSU lawful to make an , Id it is un rn same Y changes or zll r tT without written perm-; sic 1 from he building Dept., Cit of M1 The Stam ir"g Y cuperi no — P b of this plan and spe ifi U (� SHALL NOT be held to1--­­ ofV �proual the violation Of any or jav Cifv D dnxnce anY projisinr 11-0n nr SrarP t 21 -811r1._3.. 10'-3" WORKING AREA 244 sq ft M CO N N • C JUN 03 2004 CITY OF CUPt^TING BUILDING r)FPAf-°v1ENT IV5 0 0 A n 8 2 g T_ O m m0 xKN o o K o04 4 Rog 0 � o�p O 1p2m Z oho VT. a � m 0 I U LJ d I I I N I m I Z 10'- 0 • JUN o ° ZD -14 CITY OF CUP -7nphlC BUILDING DTPA c- � m m v I m m 10'- 0 • JUN o ° ZD -14 CITY OF CUP -7nphlC BUILDING DTPA c- J auoms CITY OF CUPERTINO PITY OF CUPERTINO 0 PERMIT APPLICATION FORM oyo6(003v APN # 34 l Date: Building Address: Mailing Address if dif rent from building address): u Owner's Name; P one : I _ Contractgr, License #: I eO Contact: V Ph Cupertino Business License#: Fax BBOILER4 Building.Permit Info: Bldg — Elect Plumb Mecham Job Description: U �yCU.{� /&,/, EA( .Residential ,r ,+ Cor ❑ Sq.Ft. Floor Area: S/Sq.Ft.: Cost of Project: Occupancy Group: BCONSTAX Ind/Off/Comm/Quasi Type of Construction: Please check this box if the project is a Con. Tax for BQ Zone second -story addition: ❑ Project Size: Standard ❑ Large ❑ Major ❑ Hotel and Motel Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> IM to 1.75 M Btu MECHANICAL BBOILER5 Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING LJ 1 of 3 319.6) CITY OF CUPERTINO CITY OF CUPERTINO* PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP . New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER , Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfin MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation bf Furnace MECHANICAL BREMFURNOV Relo Furnace > I OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 1 J gon OF CUPERTINO 1 4PITY OF CUPERTINO i PERMIT APPLICATION FORM uantily Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Sips, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING r LJ • 3 of 3