08010157 CITY OF CUPERTINOe�a7;�r+.�s,k��.ynr;T '+ °"' may' e:x-BUILDING DIVISION PERMIT COl\r111114TQA�Fl � ��aOly'
e`k�was,_t-.;Y'A�911
UID 'GADYSE AVE RICHARD HONG "'OM"!0 15 7
OWNERS NAME:
PERMIT ISSUE DATE
RICHARD HONG 873 HYDE AVE 03/27/2008
NE: SANITARY NO. CONTROL NO.
7A!RC'H=/ENGlN13ER BUILDING PERM"INFO
ADD 70 SQFT & RMODEL DINING 'BLDG ELECT PLUMB MECH
LICENSED CONTRACTORS DECLARATIONIOb DCSCO hOn
4 1 hereby arEm Nal 1 am licensed under previsions of Clupler 9(commencing pSection7000)of Division 3 of the Businces and Professions Codd,and my license is
-bll face and offal.
Ce Class Lk.P 0muscbr
4 ARCHITECTS DECLARATION
[understand my plow still m used as probit.recartll
O
k G Licensed Professional
OWNER-BUILDER DECLARATION
5i I hereby affirm that 1 am exempt from the Commemea License law for de
ZOO following roman.(Section 7(131.5.Buslws and Pre(essioas Cale:Any city or county
which required a permit to emuuuct.slue.improve,demolish,an repair easy slmctum
Siy priar to its issuance.also reautro the applicant for such Permit o rile a signed statement
mm< that bo is licensed pursuant te the previsions of the Connector's Limwc Law(Chapter 9 Sq.Ft.Floor Area Valuation
F$ (commencing with Section 7000)of Division 3n(the Business and Professions Cale)or
.. that he Is eaempt thae0om and the basis for the alleged assumption.Any violation of
Section 10313 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not mom than tiro hundred dollar($SDD),
0 1.asawles of the property.sur my moployess with wagesas theta sole mnpemtion,
will do the wOd[,and Ale elNelure Is not Intended or offered for ask(Sm.7016.Business
and PatfWION Cade:The COMitaYa Lt.law does not apply baa owner of Required Inspections
property who Wilds%improwes Ncmn,andwho desssuchworkhMWforthmugh his
awncmployces.provided that such lmpmwemanu art nmintanded oreffeered fa red.If,
marover•the building or improvement Is mid within aro yasr o(complanon.die owner.
Wilder will have the human of proving that he did not Wild her Improve for purpose of
as�laJ.
v'•u owner of Lha props",,am exclusively commodes with licensed ronut5un in
construct the project(Sec.7044.Business and Professions Code)The Conhacbr's Li.
awe law does eat apply be an mutter of preporty who Wilds or improves thereon.and.
wbocon for projects with•ronumter(s)liransed puruunl he the Commoner
L42va
❑tun a roti S ,BhP for Nu m(y�on
Owner Dau, 06
ORK• 'S COMPENSATION D CLARATION
14reby sBhm under penalty of perjury oro of the following declensions:
i haw and will maintain a Cmineate of Consent to vlf-swum fa Workees Cempen.
al.t provided for by Section 37M of done Lalms,code,for w performance of flea
work(or which this Permit is issued.
❑1 have and will maintain Wa Imes Compensation Insurance,u acquired by Section
3700 of the Labs Code,for Use performance ofthe work f%which this permit u issued '
My Werime.Campensaden Ime.curia and Policy,number sod:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
MR,ac%ien heed an,he completed iflive permit Is fmone hundmddallara($100)
or los)
I cYti'Y that I th —(O MC of ipe,roll IOf which thls pYmil is blued,I sIWI n%
employ anype n an b bjrotmthe Wortrn'Compensation
I�Wl of Cali
NOTICE
TO AP mskin thV Certificate of Exa l�'on,you uShould
a m,
become subject y the worker's Compensation rtisprevisions of doe rubor Cede,you must
Oforthwith comply with such provisions or Nu pemsil shall bo deemed turreted.
r~N.. CONSTRUCTION LENDING AGENCY
[r I Wmby afrinn thudame las cnnummi n landing agency far Ne performance of
Cli > the work for which Itis .it B issued(Sec.3D97,Civ.C.)
Q undoes Name
=)z IsndeYS Address
U0 I cavity that I have mad boa applicWod W sus dol Re above information u
^' colmet I agree 0 cheaply with all city and county oNi.and awe laws rtladng 0
Wildingconstruction,and hereby•uthomm repre¢nWims of this city to ansa upon the
W above-mentioned property fm inspection purposes
pry (We)ago to save,indemnify and trop harmless the City of Cupertino against
N bilidca. d{mcnta.costs and expenses which may in my way..against said City
t.)7 n mac
0o graT+NDf A D WILL
•7 P IC U ERST NDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date J Nom'
` E TO O
eL Re-roofs
Si Yurt of AppliesHAZA DO Data
HAZARDOUS MATERI do Mout Type of Roof
WI0 fledC.Iscnta(Muni bottlingaavpmt Yom%and the
hasudawmaedsl
u damned by de 32(x)7 o Municipal Cale.Chapter 1,11*and Ne Health and Safety
cala,Somlen us31(a)7
C]Y. ,, All roofs shall be inspected prior to any roofing material being installed.
QNO
r' If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or foam building occupant use a Air ant her devices which
p hmaMnw tis cdnteminanu Jennetl by Ale Bay Area Air Qwlily Management all new materials for inspection.
uia7
Dates Nu
1havemadthehvudwsmaterialsmquhe mundcrChaper6.95ofNeCalirer-
HraW&S yCmaSa.n5D5.n533a2553a.lulm%am "ir&Wilmng
les c N a enanL des II u my meponsihilily u ratify tic¢ropans of Jus
Ire an h beWnPoor toissuanceefaCcnlrOu, putty Signature of Applicant Date
1 e
nor her auto Sed gem Date All roof coverings to be Class'nsr or better
CTTY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACT.ORJNFORMATION,
-,BulTan'WBE AVE RICHARD HONG PERE010157
NEWS NAME: - PERITISUEDATE
RICHARD HONG 873 HYDE AVE 03/27/2008
NE SANRARY NO. CONTROL NO.
ARCHIIECT/FNGINEER:
BUILDING PERMRINFO
ADD 70 SQFT & RMODEL DINING BLDG ELECT PLUMS MECH
0 0 0 0
o LICENSED COMRACNas DECLARATION Job Description
1 hemby alRrm that 1 am licensed under provision of Chapter 9(commencing P
i NN Seedon 70M orDiviaion 3 of Ne Business and Professions Code,and my Ike=is
<� in con form and elfin.
Z LI' chis Lu.• .
p Dau Con..,
7W ARCHITECTS DECLARATION
< 1 utalmsuod my plans shall be used u public records
G(n Licensed Pretend otnI
OWNER-BUILDER DECLARATION
iF I hereby alErm that I am co empl from the Contractor's L.ieunm Law far the
:O O moron.n.(Section 7W 1.5.Buslneu and Profesdou m
Code:Any city car anly
l$p which¢quire a permit to construct.ally.improw,demolish,or repair any stmclum
prior b its issuance,also requires""applicant for such permit to file a signed statement .
that M u licensed pursuant u the provisions of the Contractor's Limnse Law(Chapter 9 Sq.Ft.Floor Area Valuation
O (commenclng with Section 71)00)N Dwition 3 of the Business and P.r.inna Coca)a,
$ that be is exempt therefrom and the bash for the alleged eumption.Any vlohtion of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not mom than Taw hundred dollars($5M.
❑Luouner of lh<propelry,umy wpbyea with wage uthe'vsole compemdon, '
will do Newark,and the swnum knot inunded oronerW forsale(Sec.70N.Businaa
and Professions Cade:The Contravenes Li.law does rot apply to se..or Required Inspections
property who builds uimprova thereon,and who doessuahwork Watelfu Wengh his
own employees,pmWded that such improwneenu art not interested unlisted forsale.If.
however,to building or honowmmt is sold within arc year of.plNon.the owtn-
builda ll luso the burden of pmalng that den did not hale or improve for purpose of
u
1.a owner of the property.am exclusively contracting with licensed ccnwnon e
corutmet the Project(Sec.7(344,Bealmea and pmfesears Code:)The Comment,.LI-
cava Law dote not apply to an owner of property who builda or impmms Neuron,and
who con foaoi;EE
p.at a the Cmarlxe.
License
rl lam a t .B&P for Nis m(�yon
rev Dau-
08
RATION
I bemby aabm Codes penalty a perjury on,of tie following declarations: .
❑I l�w oral will maims scathm M of the Labor
code.
(u Performance u provided for by Sec"on 7-NO of the Lahar Cade.for the performance of the
wok fu which this permit is issued.
1 haw and will maintain WukeYs Compevatlon Ima ranm,u required by Section
M the Wer Code,In,Ne p afmmaime of the work fur which this permit is Issued.
WorkeYs Compensation Insurance arrier and Policy number am: .
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS' -
COMPENSAnONINSURANCE
mdaseNon used not be cumpleed Ethe penal,is farm hu ul.1dollan(SI00)
or Ws)
I ratify thvt i N no tree of,e wort fu @hicIt is Permit is Loved.1 shall not
employany'; n ant s b dhbjec,uthewnrkeri Compensedoo .
Irxa or Cali .Dte VVV
ApPllmn, mir
NO77CE TO AP Oar matin ie Cenificeu of Ex ion.you should
become subject a the Wohces Compensation provisions of the
'Pon.
Code.you mute
OfoMwith comply wit such MASA at or this Permit Shall de deemed mated.
ryyi CONSTRUCTION LENDING AGENCY
1 herby amrm that Nem is a co auectinn lending agency for the Nrfame.of
Y.> the work for which this Permit I.turned(Sec 3097,Ch.C.)
YQ I<ntlefs Name ,
= Z Lender's Address
Q 1 celery that I haw rad this application and State that the show Information is
y ^ 'coma I agree to comply with all city and roomy ordinances and sue laws mladng m .
building construction,and hemby mthorirs npmmnutim ofthis city to enmrupnn the .
W ahmc.mentioned property for inspection purposes -
(We)agree,o saw,indemnify and keep harmless the City of Cupertino against
y rjj bili"¢, dgments,ease and expensed which may in any way accme.,eines said City �—
•77 TIP nIC a eUf ERRST NDS ANof this D WILL COMPLY WITH ALL NON-POINT Issued by: Date
E nollj
I—%—
3a7 0 Re-roofs
Signature tuornppliczaXonuuer Data `
HAZARDOUS MATERI CLOSURE Type of Roof
W;S theapplicant or form building occupant sure orhandle hudou
ars material .
ns dnOned by the Cupertino Municipal Code.Chapter 9.M and the Health and Safety
U.kethm 25532(a)7
0Ya All roofs shall be inspected prior to any roofing material being installed.
MRWillthe applicant or futum building occupant use equipment or dcvtms which If a roof is installed without first obtaining an inspection,I agree to remove
It husrdev air cCauminx W dcMed by the Bay Area Air Quality Management all new materials for inspection.
Dis
tr cR
❑Yca mad the WroaloNu
I haw us materials requirements underChapuer6,95 of,he Caiifv-
Health&g yCade,Sce.23503.25533 and 25534.1uMersund that if f building
aro c haw a Imam,dun It h my responsibility m entry ate omupmt of de
ins en h bcme,prioruissuatsxofaCcnifinteof pancyB� Signature of Applicant Dale
` 2
weer u.ae <d grin nae All roof coverings to be Class'%W'or better