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06060155 CITY OF CUPERTINO � •BUILDINas DIVISION PERMIT ;xC,ONTRAGT(TRTNFORMATI BUIIDDLGADDRESS: SCL CONSTRUCTION CO. PERMITNo.06060155 929 FERNGROVE D OWNER'S NAME: PERMIT ISSUE DATE CONNIE WANG 1664 SAMEDRA 91 06/16/2006 NE: SANITARY NO. CONTROL NO. (650) 678-8311 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH O 30o LICENSED CONTRACTOR'S DECLARATION IOb Description hereby am.Nn I am lived under provision of Chapmr 9(commencing nth Seedon 7000)of Diviaan 3 o(dto Buaoess and Profeasiuv Coh.and my license u e� in Ern roreeam a@6 REPLACE SLIDING WQ S (2) AND PICTURE WINDOWS p� Llata Claes rice rk as �- Data-ComDECL �t [+� ARCHITECTS DECLARATION E® lundensand my play slWlaused u public rtcorW M ;w Liccesed Pmfessionel OWNER-BUILDER DECLARATION i01 herchy e1Rnn that 1 1. exempt from the Csid..Co License law far de, 1006 O O which ing renes a permit i 703 1.5,a situs and roe. a mull Code:Any oily err[aunty l� 19 which its i ma•e,alm re convect.aline,nt ferment nt cmM,or repair my structure $4000 _Z� poor els anedpursarequiru dm applicant the Consomme' Livenso file Lmed stemmem E€; thathclelmcesedpuwantlo heproaifiovaftheConuuwfeLhevelaw(ChaPtt9 Sq.Ft. Floor Valuation s (commencing with Sudan 7")9 Division 3 of the Bonn=aM Pmfeaion Cade)rc guXURG that he ts exempt u1s mfram and the basis for de alleged assumption.Any violation of Section 7031.5 by any applicun for a permit sebjum the applizarst.a civil penalty of Occupancy Type not roam than Rw hundred talion(5300). O 1,u owner of the progeny,m my employm wW wages u Web role compmuadon. will do the work,and the snmctum is natinanded"offered permits(Sm.704.1,Bulinus Required Inspections and Pmfvam Com:The Contractors License law does hint apply m an manes,of q P property who huddle orimprom thumn.Md who doessuchwork himselfmthrough his own employees,provided that inch improvements are nntintanded artificial for sale.If. however,the building or improvement is said within one year of(omple ami.ase owner- builder will haw dm burden of proving that M did sea build or improve for purpose of , u ). 1,a owner of the property,am exclusivity connecting wild licensed anwemn w co We pmjen(Sec.7044.Business and Professions Cade:)The Coamscums Li. awe favi docs eat apply to Ln owner of prepeny who wilds as,Improves themes,and, who convects for such projects with a cenwcwr%)licensed pusumt he the Comm�uh License Law. ❑I am aempt under See'' 11 ,B d P C far Wier Owoer W M.� WORKER5COMD9 SATION DECLARATION 40 1 hereby Llano under penalty of perjury m of the following dcctuadmhr. 1 ham and will maintain a Cer ifhaw of Consent te self-insum for Worker's Compos orlon.u provided for by Section 3700 of the Labor Code,fm the Performance of the work for which this permit is issued. ❑1 haw and will maintain Worker's Compensation lasumses.as inquired by Scrim 3700 of the Labor Code.for the pcaarmmce aide,wink far which this permit if ismu. My Woran's Compemaudon Ivurim a anis and Policy number roe: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (rhis sennas aced an,Ise campineG if to permit is form hundred do0us(SIM) or lest) 1 cenify that in the performance or the work for which this Penni,u issued.I gal nd employany person in my mewrspastobeca g stjeu aoat�ewabsun'Campenaton laws of Callfo0 Dam �f 60 Alm NOTICE TO APPLICANT:If.ager mµ)g this CeniOcate of Exemption,year should become mbba m the Workefs Com. nine provisions of the Lehor Code.you sun .J 0 farNwiah comply with each provinces or this Permit shall W deemed revoked. z^y CONSTRUCTION LENDING AGENCY EI hereby Morro that these I. unswNtan lending agency par the perform.of rY „ ash �„ the wart for which this permit is armed(Ser.3097.Civ.C.) 4 Q Lh Name ;0 Z Ladies Address U Q 1 codify that i have read this appliadon and auto that the show ofomudun h, IL F coma 1 agree to comply with all city and county ordinances and also,laws mladng w 0 building construction,and hereby authorire repmacoadws or this city to enter upon We W .hove-mentioned property for inpcction purposes. (We)agree to saw,indemnify and keep hu nieu the City of Cupertino agavt h,y y Ififli idu,jodgmcno,cma u atexpenses which may In my way Lcaue agaivtated City in consomence of the ntritiofU APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. c.J-•--- Re-roofs Signuu.of ApplianVCantrsemr Date HAZARDOUS MA"DISCLOSURE Type Of Roof Wel the applicant or forum building occupant mart or handle haainNau materia - u deOnul by dte Cupertino Murtict Cath.Chapter 9.13,and the Heath and Safety Cah.Bud..25532(x)? a All roofs shall be inspected prior to any roofing material being installed. ❑Yu Will the applicant or raw.building Occupant use egmlpmem or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit beeschous air amummants as defined by the Bay Am&Air Quality Management all new materials for inspection. District? ❑y. I hew mad the ha manus materials reqme ulmms under Chapter 6.99 afthe Calier- .1aNcaWk5detyCede,Since.25505,35333 and 25334.I understand this lfhhe building does not cumenly haw a wnam,that It u my respoesihility in notify the cuupnt of the requirements which muse be met prior to!no=of a CerdOateof parry Signature of Applicant Date �6 All roof coverings to be Class"B"or better Owner or wthadad agent Dam Community Development 10300 Torre Avenue aClOF Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 *UPEkTINO Building Department JOB ADDRESS: ( PERMIT # r��ZNC7��d( OWNERS NAME: rir tee. PHONE #(46,x )772- D 66 GENERAL CONTRACTOR: �Q FAX # I am not using any subcontractors: �--� / �1 C11/2'`-� Signatur 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 Plumbing Roofing Septic Tank Sheet Metal Sheet Rock • Owner/Contractor Signature Date CITY OF CUPERTINO �m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37539057 . 00 DATE ISSUED. . . . . . . : 06/19/2006 RECEIPT # • • • . . . . . . : 34906 REFERENCE ID # . . . : 06060155 SITE ADDRESS . . . . . : 929 FERNGROVE DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : CONNIE WANG ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : CONNIE WANG CONTRACTOR . . . . . . . : STEVE LAI LIC # 25726 COMPANY . . . . . . . . . . : SCL CONSTRUCTION CO. ADDRESS . . . . . . . . . . : 1664 SAMEDRA ST CITY/STATE/ZIP . . . : SUNNYVALE, CA 94087 TELEPHONE . . . . . . . . : (650) 678-8311 �EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 104 . 76 50 . 28 0 . 00 50 . 28 0 . 00 BPERMFEE VALUATION 4 , 000 . 00 104 . 76 0 . 00 104 . 76 0 . 00 BSEISMICRE VALUATION 4 , 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 BPLANCHK PERMIT FEE 104 . 76 139 . 80 0 . 00 139 . 80 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT .295 . 34 0 . 00 295 . 34 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ OTHER 295 . 34 AMEX TOTAL RECEIPT 295 . 34 • • tidy it N N s N N M • gkgW Occupational Licensing-Business Records D j�� IgUERY'� NEXT[ , ElY01 US E(UT, �FtrAST 1K ,__� __ Looku - I I BUSINESS NUMBER 25726u �� SCL CONSTRUCTION CO. T (Cancel _ I � •. CATEGORY 24 (CONTRACTOR -- GENERAL- _._._,___ ..__...—.,.—_. � quit JI + LICENSE No. 25726 J BALANCE 105. 00. STATUSIJJ PRIOR CATEGORY —J "ISSUE DATE 07/12/2004 TRANSFER AMOUNT T O. 00�J EXPIRATION DATE 06/30/2006f1 15T PENALTY AMOUNT, v O. 00�I h UNITS . {; — 0. 00 2ND PENALTY AMOUNT 0. 0 FEE AMOUNT 105. 00 3RD PENALTY AMOUNT 0. 00 EXEMPT CODE. 4TH+ PENALTY AMOUNT `O. 00j EXEMPT 'AMOUNT 0. 00�i LATE REGIST PEN r _..._._� PENALTY ADJUST FEE ADJUSTMENTS _ 0. 001 BALANCE LAST YEAR 0. 0 -01 - — — I AMOUNT- PAY F_-T. 001 - - - - — SAL. INSPECT. , FEES ACCOUNT 'CD BYPASS J� CLOSE [ "1�( Inbox-.,, tinamp Occup �tinamp,,.Ir Occupa `� y®b 3.55 PM 1� • CITY OF CUPERTINO GW(10155 CUPERTF PERMIT APPLICATION FORM APN#376— 37 oS7 Date: Buildin Address: Mailing Address (if different from building address): Owner's Name: Phone o�� vel -�) 7 Z 7 -- Contractor: o �G License #: Contact: Phon &T77-01Cupertino B,gsiness License#: �1L Fax: t 2 5.2 2 6 Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job Description: S fw sYs (2� �i C5 Residential Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Pro, ct: Occupancy Group: cSLSv,a� Type of Construction: Please check this box if the project is a second-story addition: ❑ ro'ect Size: Standard ❑ Large ❑ 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 BBOILER3 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 CUPERTINO CUPS 0 PERMIT APPLICATION FORM uanti 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 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 Fumace> I OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Mise 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 CITY OF CUPERTINO CUPEf�0 PERMIT APPLICATION FORM QuantityFee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, 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 PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Chane BUILDING • 3of3