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05090074 CITY OF CUPERTINO mmaP' ^aa 3i 'm Q j tlU1LDI CU VIR PE1! r,T ,C�fiCI',NTRACT(IR INFOR1�TI®_N BUILDING ADDRESS: ARK CONSTRUCTION INC PERMIT NO05090074 364 D 7R'SNAME: PERMITLSSUEDATE JOE & ELAINE FENG 44962 PAWNEE DR 09/12/2005 PHONE: SANITARY NO. CONTROL NO. (510) 770-0668 ARCHITECTIENGINEER BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 °00 LICENSED CONTRACTOR'S DECLARATION Job Descri tion s U C I hereby affirm that 1 am liecood under provisions or Chapter 9(commencing P U wiManin7")of Division 3 of the Businecsand Professions Code,a^d my he..is 1<m nfullforteandcffcct REVISION--REPLACE WINDOW (24" X 1211 ) jai in Class ��Lb, �, Dag�(1_ CTSDEmr F O NEW PERMIT ISSUED/ORIG. #05070070 Y ARCHITECTS DECD TION ms lundamtn plans shall bid as public records OE EA L cycl,liAdcadminal OWNER-BUILDER DECLARATION I noon,affirm that 1,mxempt from Ne C^nloolui s License Law for the D n o following re re .(Section 7031.5 cBusiness and Professions Codon Any city or county K$ which m4mms a recruit to construct,altar.improve,demolish,of repair any structure mom" prior toils issuance.2110 requites the applicant for such permit to file a signed stammenl =zp Mid IM islicensed particular^the provisions ofthe Contractor's LimmeaLaw(Charter 9 Sq.Ft.Floor Area Valuation 0 al— (commencing with Section 7M)of Division 3 of the Business and Professions Code)or E that he is exempt Memfrom and the basis for Ne alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects Ne applicant to a civil penalty of APN Number Occupancy Type not more Nan five hundred dollars($500). 32647076 . 0 0 0 1,as owner of the propmly,or my employees with wages ax their mile compensation, will do Ne work,and Ne swclum is not intended or mtemd forsak(So,.7W.Bess. and Professions Code:The Comemor's Limme,Law docs not apply to an owner of Required Inspections "property who builds orimproves Hereon,and who dmsssuchwork himself or through his own employees,Isrovided that such improvements ase not intended or offered forsale.IL however,Mebuildinguimprovement ishold tbe within year of completion,Ne owner- \ howev will have the burden of proving i Nal he did not build or improve for purpose or sale.). 0 1,as owner of Ne property,am exclusively contracting with licensed contractors to ccnawn the project(Sec.7064,Business and ity,wh Protectionist ds or Thew,;the mr's Lid \ Genu law docs not apply m an owner of propeny.who Wilds or improves thereon.and who contracts for such projects with a contractor(s)licensed pursuant to the Convenors Lkense law. ' ❑tare exempt under Scc. .B hPC for Nis mason Dale WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 0 1 have and will maintain a Cumficam of Consent to of Mom for Worker's Compere cation,as provided for by Section 3700 of Ne labor Code,for Ne performance of the work for which Nis permit is issued. 0 1 have and will maintain Worker's Compensation Insurance,ate mquired by Section 37110 of Me labor Code.for Ne performance of Ne work for which this permit is issued. My Workers Compensation Insurance carrier and Policy number art: Carrier: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (oftseclinn need not W completed if tie permit is fm enc hundred dollars(Sloo) nr leas.) I mnify into in the performance of the work for which this pi by issued.l shall nut employ any person in any mango o erpma sup tolme Workers'Camrcnsmom LawsO alifomia.:0� ` f/ Applican NOTIC T PPLICA :If.after making M1lx Cenificam of Exempt n,you should become uh cl 10 the Workcr's Compensation Prow of Nc Lah�/r C de.you must .Z forthwith comply with such provisions or this permit shall W Jccmcd 1kcJ. Z O CONSTRUCTION LENDING AGENCY Iherehy affirm that Nem is a construction lending agency for the pcomane of rL� the work for which this permit is issued(Sec.301 Civ.C.) 032i Lender's Namc G lenders Address - U O 1 certify that I haw read this application and mule that He above immoreaiun is 0 f" bunging construction, comply with yantll uyand county ordinances of and Cute]'.aenter upon Me - OU almyringconsned mo,and hereby author vereoesenutives or this City menmrupnn Ne G above(Wed are mortally for inspectionnifkeep purposes. (~ (Wc)agreeto save,indemnifyand kith harmless the Ciryof me against against h incorc quencmcnts.granting ex penuamay in anyway creme againstsaid City U z APPLICANTe Of Me UNDERSTANDSthis AND Permit.WILL COMPLY WITH ALL NON-POOT. Issued by:9 Date OURCE REATION 0� Re-roofs ingfiric of Applicano Contracur Dam HAZARDOUS MATERIALS ISCLOSU E Type of Roof Will the applicantmfuture NdIdin iiedIp t store or handle hmardous material defined by the Cupertino Municipal Code.Chapter 9.12,and He Health and Safety m.Sexlron 25532(.)7 All roofs shall be inspected prior to any roofing material being installed. Yes Nu Will Ne applicant or future building Occupant usee t or dcvien which If a roof is installed without first obtaining an inspection,I agree to remove pp s v a Air n emit hmardnas air contaminants az defined by Ne Day Area Air Quality Management all new materials for inspection. District? ❑Yes //YII No — thrive mail Ne Wood(us�materials requirements under Chapmr695 of Me Califnr nix Health S Safny Cote Sections 25505,25533 and 75534.1 undersand oundNe building dues not cu rently haw a omom,Nat it is my respnmitudo,to omily Ile occupant nofMe / quimmenmwIhichmust W mFrmrtoissaaowof`aCa.Furmof capar=y. Signature of Applicant Date lnararaalbnri,eaagem /Z DateAll roof coverings to be Class "B" or better F TY OF CUPEWrINO -wBUILDING DIVISION PERMIT n CoNTRAC�TOR�INFORMATIONDING ADDRESS: ARK CONSTRUCTION INC PERMIT NOQ 5090074 364 DEM STRR AV F.R'S NAME: PERMTC ISSUE DATE JOE & ELAINE FENG 44962 PAWNEE DR 09/12/2005 NE: SANITARY NO. CONTROL NO. (510) 770-0668 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 woo LICENSED CONTRACTOR'S DECLARATION >: C I hereby affirm that I am liccruc l under provisions of Chapter 9(commencing lob Description U with Section 7140)of Division 3 of the Business and Pfofessions Cade,an myliccvc is ^_ew imm�mreeandefra % REVISION--REPLACE WINDOW (24" X 12" ) E n Fz License Class Lb" ,,I, Dat Co...., O NEW PERMIT ISSUED/ORIG. #05070070 i��jARCHITECTSDEC TION -i 1 me in plana shall he d u public rec rtls 7y a =ififesoUnal `-Oa OWNER-BUILDER DECLARATION fI hereby affirm that 1 am exempt from dm Contractors License Law for the a O following reason.(Section 7031.5,Business and Professions Code:Any city or county x$� which,¢quires a permit in construct,alter,impmve,demolish.or repair any someone Prior It,its issuance,also requires the applicant for such permit to file a signed sutomeno that he is licensed pursuant m the previsions of the Commctori Liccnm Law(Chapter Y Sq. Ft.Floor Area Valuation 0 SFO (commencing with Section 7")of Division 3 or the Business and Professions Code)or to OR he is exempt tkmfrom and the basis far tk alleged eumind.h.Any violation of Section 7031.5 by any applicant for permit subjects the applicant to a civil penalty,of APN Number Occupancy Type not mom them fin hundred dollars($900). 32647076 . 00 0 1,as owner of the pmpeny,or my employees with wages u their sole compmuetion, will do he work and be structure is not intended oroRcmd I...1.(Sec.7004,Business and Professions Cade:The Contractor's Lt..Law doe not apply b an owner or Required Inspections �s progeny who builds or impraves thereon,and who does suchwark himselfor through his ` � \ own employees,provided that such improvements arc not intended oroRemd formic.If. however,the building or improvement is sold within one year of completion,the owner builder will have the burden of proving Out k did not build or improve for purpose of J+ \ sale.). 0 1,as owner of the property,am exclusively contracting with licensed commetcos to construct Nc pojcct(Sce.7004,Business and Profwions Codc:)The Contracor's Li- who Law doenot apply ean owner ofproperty who buildsorimproves Cmitm and, whocontractsLa<u for such projects with a conoanor(s)Iiara¢tl pursuant to ok Conlncorr's 0 1 a.Uw. 0 1 am exempt undo Sec. .B k P C far Nis..an Dam WORKER'S COMPENSATION DECLARATION 1 hereby affirm tarda penally of perjury nne of the following dalerchims: 1 have and will maintain a Ccnifream of Consentto ulf-inswe for Workers Compere salon.as provided for by Section 3710 of the tabor Code.far the performance of the work for which Nis permit is issued. 0 1 have and will maintain Worker's Compensation Insurance,az requiad by Section 37W of the labor Code,for Nc performance of the work for which this permit is issued. My Worker's Cam pen cation Insurance carie and Policy number am: Citric': Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thos saloon need not kcwnplemJ if the proton is faraa hundred dollars($101) or less.) 1 cenify Nat in the perfurmance of out,work for which this permit is issued,I shall not employ any person in any man vc me sex jeer to the Workeri Compcosaoian Laws ifo ;Sit i n Applican NOI'IC A LICA :es after making s visi n s o i Fscmyyyt ,you u must become b n o the Workers Compensation provisions of Ne Labdr yde,you must .J,Z foMwith comply with such provisions or Nu permit sball beda'ned ked. z O CONSfRUMON LENDING AGENCY Thereby amrm that there is a cordwction lending agency for Rise performance of one work for which this permit is issued(Sec.3097,Co.C.) fA Q Lender's Name 6. Z Lender's Add. U V Q 1 cenify Nat 1 have fwd this application and sum that Ne above information mtatiun is 0 U builder 1 agree m comply with all city and county ordinances and sure laws r upon t e �(7 building co^swctiomand hereby auNorirzrcprosenrmives of this City ocnmrupan Nc r 4 akvc(We)agree d to cn,save forindemnify an dromkeep (We)agree o use,indemnify and kap harmless dymw City of against s against �I Uret liabmoscq em000 Orcoarsing of this Which may in any way aara against said City C)Z in APPLICANT of UNDERSTANDS log of this per mit. �- - APPLICANT UNDERSTANDS ANO WILL COMPLY WITH ALL NON-P Issued by: Date ;OURCERE ATION Re-roofs sere ofApplicanVCanuacoor Date HAZARDOUSMATERIALS ISCLOSU E Type of Roof Will the applicant or future building oa�pa t sore or handle husolous material erib d by the Cupenino Municipal Code.Chapter 9.13.and Ne Health and Safety i Section 2553z(a)7 All roofs shall be inspected prior to any roofing material being installed. C3 Yes (kNrWill thea scant or future buildi^ uccu ant use c o or devices whichIf a roof is installed without first obtaining an inspection,I agree[o remove pp g p yuipmcn hsrardoe air contaminants u defined by the Bay Arta Air Quality Management alI new materials for inspection. uict7 0 Yes No (have mal NehvaN ms mamdals mquimment underChapmr 6.93ol Ne Cali(oo- ria H..IN,SafctyCrdc.Sccu=s %5.35533mdZ5534.1undcmand Nairtho Wilding docs not currently have a¢mint.Nat it is my resWmihility o nutily dtc Occupant Of quimmcntswhichin W el pno'tuiamoo.a.ccod f agony Signature of Applicant Date V11ncr o,ininu sed agent Dam All roof coverings to be Class "B"or better ® CITY OF CUPERTINO Item 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32647076 . 00 DATE ISSUED. . . . . . . : 09/12/2005 RECEIPT # . . . . . . . . . : 31154 REFERENCE ID # . . . : 05090074 SITE ADDRESS . . . . . : 10364 DEMPSTER AV SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : JOE & ELAINE FENG ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JONATHAN HOANG CONTRACTOR . . . . . . . : JONATHAN HOANG LIC # 27025 COMPANY . . . . . . . . . . : ARK CONSTRUCTION INC ADDRESS . . . . . . . . . . : 44962 PAWNEE DR CITY/STATE/ZIP . . . : FREMONT, CA 94539 • TELEPHONE . . . . . . . . : (510) 770-0668 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- - - ----------- ---------- ---------- - --------- ---------- ----- - ---- BPLANCKREP HOURS 1 . 00 87 . 14 0 . 00 87 . 14 0 . 00 ---------- - --------- ---------- - - - ------- TOTAL PERMIT 87 . 14 0 . 00 87 . 14 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER -`--------------- ------------ - ------------ - - - - - OTHER 87 . 14 AMEX TOTAL RECEIPT 87 . 14 • ;aug CITY OF CUPERTI4 CITY TYOF O PERMIT APPLICATION FORM ®CU APN # Date: Building Address: J Mailing Address (if different from building address): Owner's Name: /,,0 Phone #: Con actor: License#: E3 _ Contact: hones/0- Cupertino Business License#: Sokm,e— . ax: / Building Permit Info: ' C��� 2t���� _lam_ —rKQL.6tati� �Qxc I J Bldg ❑ �t^� Elect El Plumb ❑ Mech Job Description: Cf2_ A � Residential Commercial ❑ Sq.Ft. Floor Area: q.Ft.: Cost ofProject: 14 Occupancy Group: (T� Type of Construction: Please check this box if the project is a second-story addition: ❑ Project Size: Standard ❑ Laze ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOlLER3. Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M 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 1 of *-)CITY OF CUPERTA CITY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUC0M2AE 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 Pb1g 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 rinkler/Backflo 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 cfm MECHANICAL BREMAIRHAN A/C Units<= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l 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 2of3 AY OF CUPERTINO CRY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL 13REMSIGNS 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 Insection 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 PLLONGRNGC Planning LR Comme/Multi-Fa m PLANNING PLLONGRNGR Planning Long Ran a Residential PLANNING ZADDCHG Address Change BUILDING • 3of3