The URL can be used to link to this page

05120118 CITY OF CUPERTINO »+a:, .�sszr 3x BUILDING DIVISION PERMIT CONTRACTORJNF,01 ION tet. A , N'-.'` BUILDING ADDRESS: PERMIT NO.05120118 19405 GREENWOOD OW NER'S NAME: PERMIT ISSUE DATE LORETTA & KEVIN JEW 12/20/2005 NE: SANITARY NO. CONTROL NO. ARCHITECPENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH coo LICENSED n ti..dCTOR'S DECLARATION of chapter Job Description ❑ 1 hcmby affirm Nal I am limed umkr provisions of C7tapmr 9(commencing P �A, of[if ian70l.ffee Diviaion3af Ne Businea and Profession Cade,and mylicense is <H Nmummeandarra RELOCATE 2 WASHERS, . 2 DRYERS, D M Z Litton Class Lie.a Ern Dam contractor 4 OUTLETS/PLUMBING RELOCATE ARCHITECTS DECLARATION m < 1 undernd my plans shall be used u public records JyU C Licensed Professional OWNER-BUILDER DECLARATION °�<f 1 hereby affirm that I am exempt from to Convenors License Law for the O o following mason.(Section 7031.5.Business and Pmfernion Coda:Any city or county K m which reyuir.A permit to comma,she,improve,demolish,or mini,any srucmm prior to its issuance.also retinues@e applicant for such permit to file a signed statement < that he islimnsed pursuant to the pmvisiom 4 of the Comment's License Law 9 Sq.Ft.Floor Area Valuatio YFG (commencing with Section 7")of Division 3 of Ne Business and Pro2ssions Cada)or i Nat he u exempt chemfmm and the basis for to allcgcd cxetnpuon.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 mom than fiw hundred dollars(SSW). 37504030 . 00 P Y YP El I,az owrmr of Ne pmpeny.or my cmploycm wiN wageaas Noir sole compensation. will do the work,and the structure,is not hounded or offered for sale(Sec.70ol,Business and Profession Cade:The Canuacmri Littre law does Out apply In an owner of Required Inspections property who bulling,improv Ncrnt is and whoin one earo,kompledarNmugher- .wn employees,provided Not such improvements Are not intended otoRaed forsale.If. ] buwarn the building Orden of proving is sold within one year of completion.Pa owner- builder will base Ne burden of proving dist he did wt build or improve for purpose of ole.). cons,As owner of project property,em excessively confessions Cod:)The m ceasena d pmnot (Sec.7134,1.Business and Professions Code:)Theverthe Contractor's rod a(v\ come law dose not apply a an owner of property who sed p or improves Nereon,and whocontractsLacrs for such pmjecu with a convanor(s)licensed pursuant m the Canwnah License IoW. ❑lam exempt under Seca .B&PC far N)muon Do., Data ?- WORKER'S COMPENSATION DECLARATION 1 hemby aRrm under penalty of perjury are of the following deoleratiom: 1 haw and will maintain s Certificate of Covent m self-insum for Worker'sCompen- sation,u previded for by Section 37W of Om tabor Code,for the performance of tc work for which this permit is issued. ❑1 have and will maintain Workers Compensation Insurance,u required by Section 37W ofthe labor Cade.for the performance of the work for which this permit is issued. My Warkds Compensation In..cam.And Policy numb,art: Cartier. Policy No, _ CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (This section need not ho completed firm permit is for one hundred dollars($100) or]to .) I certify that in the Pcsfmmama of the work for which this permit is issued,I shall not employ any person in any manssc I�brcome subjecno Ne Workers Compensation Laws of Ckifomia.Dam ) -+' LN Applicant (,(, 4T�� NOTICE TO APP�ANT:If,after making this Certificate of Exemption.You should become subiact in to Wooker's Compcmauon pmvisiom of Na tabor Code,you most .JO faMwiN comply wit such provisions or to permit shall M deemed revoked. ,Z.,,' CONSTRUCTION LENDING AGENCY Ihereby affirm Nat Nert is a construction lending agency fn,the performance of a the work for which this permit is issued(Sec.3097.Civ.C.) LQ Lender's Name n' 2 1<nders Add. U V Q I certify that 1 have read this application and sum Nat theand above information is ly H toilet I grce m comply with all city and county ciativ ordinances and stsm laws relating e �V abovengcononed propend hereby auNon purposes.rexnutiws of tis city mann,upon dte perty for Q. (we)sju agme m save,indemnify and with harmless the City of accrue A against Uh incoisequnce of tu,enuang expinlaof thisumit. may in anyway acme regains said City Vz mconsequenceof>ERSTANDStispermit. APPLICANT 1111N ERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date _ ZCI—Oir— SOURCER7ATIO ry II i;C(� Re-roofs Signawreof tar Da pplicaHAZ m HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Na a Cupertino or Tamm building occupant stem or handle Health And U defined by the Cupertino Municipal Code.Chapter 9.12.mJ Ne Health and Safety Code,SpctYiu25532a)? as L]Na All roofs shall be inspected prior to any roofing material being installed. Will Nc applicant or fmare Wilding occupant=equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove Tit hasardaus air contaminants u defined by dm Bay Arta Air Quality Management all new materials for inspection. i]lrict? ❑Yea 1 have read Ne hannious materials requirements under Chapterri.95 of to Cabral. niaH N&Safety Code.SeeuomnM5.35533and7553a.1understarM iftho Wilding docs o t sally have a tenant,tm it is my mspomibility m ninny No occupant of dm mqui cnuw ' must W met poor ut issuance of a Certificate of Occupancy. Signature of Applicant Date ownero„oto ,dasant h Dam All roof coverings to be Class"B” or better Community Development 10300 Torre Avenue pe Crtino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408) 777-3333 UPERTINO Building Department JOB ADDRESS: n4.0004 bw PERMIT # %4o�- trot( S 2 a / OWNER'S NAME: L<oun i lw4gw PHONE # Q 83- 996 z_ GENERAL CONTRACTOR: C FAX # b 633 9-9C8 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 Electricaltti CGv�f tuctw Excavation Fencing Flooring: Carpeting ® Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing {/eta CI C /Z7C ��i�ll0 Roofing Septic Tank Sheet Metal Sheet Rock Tile z62,k Owner/Contractor Signature Date CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM 6S_/ 2--o ll CUPERJINO N # Date: zoos Building Address: 2 1f4 Mailing Address (if different from building address): 41� CkeenwvociMPr l 69Iy Lar Fella,/P}: 6--e~l (J Owner's Name: Phone#: Lpze-6 -e keon --1otzj (<-10 -tea Contractor: License#: I vew Cl ctj,' Jy77AG g B 3a R gl D Contact: Phone: Cupertino Business License#: Nil �!Vt4f(A 4,. Fax: (crc) 683-8ev3 Building Pernut Info: Bldg ❑ Elect 0 Plumb R� Mech ❑ Job Description/ �LiGC�tTe oufCese ( �G1ri qt/ um Ira+�lo[yQC Residential Ltd Commercial ❑ Sq.Ft. Floor Area: q.Ft.: Cost ofProiect: Occupancy Gr o: jfAW �fl2so Tape o Construction: Please check this box if the project is a �/( I second-storyaddition: ❑ ro,ject Size: Standard I' Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> I OOK to 500K Btu 1 ECHANTICAL BBOTLER3 Boiler> 500K to 11\4 Btu 1 ECHANTICAL BBOILER4 Boiler> 1M to 1-.751VI Btu MECHANICAL BBOILERS 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 —ResifMobile BUILDING BELEC1000 Elec 600V <= 1O00A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING �-' 32N 1 of 3 � F CITY OF CUPERTINO CITY-OF PERMIT APPLICATION FORM CUPERTINO Quanti Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Alit. Fee BUILDING BNUCONII4B New Comm Electric ELECTRICAL BNUC0l\QvDvl New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIDf Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum . PLUh4:BA�TG BPCESSPOOL Cesspool PLUMBING BPERNIFEE Bldg Permit Fees BUILDING BPFLXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUADING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Re eat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUAMLNG BPSEWAGE Selvage Disposal PLnIBING BPSEIVER Sewers PLUMBING BPSPRINK Lawn S rink]erBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBNG BPVENT Alt of Drain &Vent PLUMBING BPWATER InstalVAlter Water Pipe PLUA'IBING BPIVHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BRENLACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BRENlAPPLI Appliance Install MECHANICAL BREABUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMffURN Relocation of Furnace MECHANICAL BREAg'URNOV Relo Furnace> IOK btu MECHANICAL BREAE-IEAT Heater Installation AfCHANICAL BREA=OOD Installation of Hood MECHANICAL BREMNflSC Misc Apparatus ELECTRICAL BREND RAP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPONVER Power Device/Apparatus ELECTRICAL i� BREAMECEPT Rc tl, Switch & Outlets ELECTRICAL BRETA ELOCA Relocation of Hood MECHANICAL AL BREMREPALT Repair/Alter Heating AgCHANICAL BRFMRESAPP Remodel Res Appliance ELECTRJCAL 2of3 ti CITY OF CUPERTINO Ory or PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Sips, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREAIVENFAN Vent Fan Single Duct MECHANICAL BREAWENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISAIICOM Seismic Commercial BUILDING BSEISAUCRE Seismic Fee Res BUILDING BSPECLU S ecW Inspection BUILDING BSWIM Swimming Pool BUILDING BTEAIT Temporary Power ELECTRICAL BTEAIPPERAI Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC El(-ctrical sq foot ELECTRICAL / EPERAUTFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mecbanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERAIITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fees foot PLUMBING PLLONGRNGC Planning LR Comme/ AInIti-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Cbange BUILDING 3of3