01080140 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20706 KIRWIN LA CUPERTINO CONSTRUCTION IIJC01080140
OWNER'S NAME: APPLICATION SUB DATE
SHERMAN TUAN & YUN ZHENG 10079 SAICH WAY 08/29/2001
7-H<
HONE: SANITARY NO. CONTROL NO.
408) 253-9000RCHITEC`ENGINEER: BUILDING PERMIT INFO
ELECT PLUMB MECH
IILICENSED CONT'RACTOR'S DECLARATION Job DescriptionZO I herabyalErmNat I am licensedunderprovisionofChapmr9(commencing
p. wird Senion]000)of Dis,o.a)of the easiness and Pm sion+Cole.andmylianseMO.acsm full force and effect.LismCI ssLic.p
Dam Cnnvacm,
tw5•a w0 ARCHITECT'S DECLARAT
N } I understand my plans shall be used as public records
i i p O Licensed Professional
OWNER-BUILDER DECLARATION
' R I hereby affirm that 1 a empt form the Cantmm
cr's License Law for the
C?< following reason.(Section]1131.5 eBusiness and Professions Cade:Any city or county $15000
E F❑
which requires operatic t construct,alter,improve,demolish or repair any structure
63�-prnrartts,s e.al reg res the...Icantzorwch a m ,m file a s,gnedatamment. - - - E- �47ep F¢-
(Commencing
encilicegor4sedhSeclmtot&' visions.fibsContmctOlsLccnulzw(Chapmr9 r r,Yesl:3 'a10U7.ft�U_a. y - , , Valuation
(c mmertc BM1 Sect on 7600 of Division 3 of the Business and Pmfeszsons CWe) 7,
or drat he t5 axe o%thercfounnand the hosts for,he alleged exmrp,E..Any violation
-of Section]031.5 by any applicantfors permit subjects the applicant to a civil penalty
' qqegN�,p�
t of not note than rive hundred dollars($500) NO AnS INSPECT ONS''" " Occupancy Type
0 Las owner of the property,or my employees with wages as their sole compensation.
--wiil'dothe work:and the swcture,is not intended or offered for sale(Sec:TOu; Required In$peCIIOD$''
(Business and Professions Cade:The Contractor'snu LiceLaw does not apply to an -
owner of pmper,y Who builds or improves thereon,and who does such work himself
or h In, employees pmv doci,. h P em. t intended
offered nr ethe-IL However the buave th i n en of proving
s sold w th n one yearbuild of -
improvtion,the owner-budder will have the burden of proving Nm he did not buil)or
improve for purpose of sale.),
❑Las owner of the m n
p pey,am exclusivelyd Professions
rowinionsCocensed,onwemrs,'t
Li
consortia,th p jot sec.7044 owners d f ss ons Gds)The ve thereon.
o L des f apply t n owner f property ho builds or improves thereon.
ho. attracts f o.. ch Pr jata.w N mrucmr(s),I censsd.pursuant to.the
Contmctoc License lv
01 m ct t B&P C for this rtason
Ow cm
R MPENSATIO DEC RA ION ��
IM1 em,affirm d penalty of p.rjiy: m,,, fdo following declarations.
r./ ❑ 1 have end will'aaimin'a'+Certlftcaie of Conem m self assum for Worku's
5._ Compensation, as provided for by Section 3700 of the Labor Code. mr-the
= perfomtance of the work,for which this permit is issued.,,
❑Ilutc7mdwill{iian, WA 'sCoup ",cular 'q red by Sat
"fon ,
37W 6e the Labor Code for the pifformanin,of the work,ho n h N permit is
gsuW MyW Worker Co opens tb 1 ranee carom nil rumbi am:p
Cart P 1I V'=Po1 cY No Z/�'/ /OOA(J 7.. r+.•.e......-.-
F
t ERTIFlCATION OF EXEMPTION FROM,WQR ERGS �— i ` , r•-s .'i , +1`i 1 r'L
COMPENSATION INSURANCP,` ) _
.�. ._.................
_.
of 't(Thio sect an need nut b t comish,,red,f the perms is for one hundred dollars " i 'I s' -.• t ,)'.• ie Ic ,
($100)0,Istat
--cit Icenfrdicam the performance of thework 1-...... .. a....�,.. -
thallpiant employ any r elr�n any mdnnc s to bernm 1auble 1 to the lVurkxrs
v
mja
-APPICuo_ .Laws bfC if J:,D^�!... ..,_ v.. _._ :.: . __ . -1. .. __1_..1 __,... .._,. '
NOTICE TO APPLICANT':IL hfmr milking this Cedifmmepf Ex<mption.yuu should + +
become subject 1.the Worker's Compensation provisions of the Labor Code,you most
O O fanhwith conpyt with such provisions.,,his pc.itshall be deemed revoked
(' ♦CONSTRUCTION LEN DING AGENCY - '
I.h ,by affiran th t litem,,acpmourclumlead'n ag cy fn to p rf,mance t '
of the
wt k which th lenum, ty y gg s
W.❑ :ueU(Sc 309] Ci.C) .,r .._... _.. _._. _ ._. .. _ .- _. .. .
a, Lender'sName ' ." .- -_ •'
, ,U-� I«nify,haPan
I have read this application d state that the above information is
"O(U_E•" nsomu.I agree w comply with all city and county ordinances and start laws relating
to huh Wing construction,and herehy,authorize representatives ofthis city torrunruipon
'theb m nth ned property f inspection
E. ps I We,
age to savcindemnify and keep narml<xthe C D of Copes 'n uga nat
N
liabilities. dg r ts,costs and e.penes buh may,n any y ace g inxt said
C.1.Z City iv q nee of the TI
granting of thispe L
APP(ICA VT UVDF ST DS AND WELL COMPLY WRHIALL VPO NTT" Date
5 RCA RE S t p Issued b
ig , lie 'ire r t U air. . Re-roofs
t. '. HAZARDOU TERIAhS(D6CLOSU "
ward pplicamaf t Wing pant store handlehazmd mate I Type of Roof-
as tlefn d by,h Caperton.M n p(•Pod Chapter 913 and th<H Health and Safe,,
_
Code.SGcYon 25532(x! L,)Ltf1fN/`' + t mf t ' :.. 'A
+1 _.,All roofs shall be Inspected prior_io.any roofing.material being installed
RJI the apple t rruwrc bu lel g c p t se equ proem tae i«x n n' If a roof is ins tall'ed'without first obtaining an inspeeti6n;4 agree to remove
emn h z rdnm atr contemlwnn as mW by the Bay Aien A r Qual ty Management
District? t all new materials for inspection.. Applicant understands,and will comply,with
,* ❑v<5 pN. all non-point source regulations.
I rooe mad the hanrdous o tench m,almo cnts tinder Chapter 6.95 of the,
Cul+fornm Health&safety Ccde.Sections 2-550.5.25513 und25534.I undermund thud
if the b IJ8-doenot rY haleat amtitc, v ePo i b tyt mR fy,1
. . .. _
occupant of t r mems h h must be not p t issue a of.a ttificute of
Oc upon _r
Signature of_Apphcant Date
raw dirge, e All roof coverings to be Class `B"or better
,
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