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