06030035 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION
BUILDING ADDRESS: COL CONSTRUCTION, INC PERMIT N006030035
10735 MARTINWOOD WY
NER'S NAME: PERMITISUBDATB
JENG UNG N 1671 CANYON VIEW DR. 03/08/2006
HONE: SANITARY NO. CONTROL NO.
(408) 891-2449
ARCHITECUENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
30o
LICENSEDCONnRd underSDECLARATION
rd� 1i mb ).f Nallaml dw B.si u,wd P.ImiufC oula, Y(ammcndng Job Description
nz1 wiNSauan7g10)efDivlsisnlafdeBuainessodPro(eexionsCode,andmylicenaie INSTALL PROPERTY LINE CLE Cr
in fall force and effect AL®®
Lucnsu Class Lk.N
Dau Carbonate
� ARCHITECTS DECLARATION� I uMenand my phos eWll ll be W used as public records
g a Licensed Prrcssinnal L n/ p(p�
bth Oat I am eUILDER DECLARATION Com etc prK I— 2OOY
I hereby s(Drm o n I em exempt from the CanionCo License Law for be
i p O following moon.(Section 71131.5,Business and Protection Code:Any city at counmy O 0
5$2 which requires a permit to construct,altar,improve,dcmmlisle or repair eery structure
prior,m its its uena.also requires the applicant far such Permit to rile a signed ateumem
g <
that he islicensed pursuant to the provisions,ofNeContractor's Uccose Law(Chapter 9 Sq.Ft.Floor Area
$ (commencing with Section 7000)of Division 3of the Business and Professions Cole)or
Nat W is exempt therefrom and the Wars for the Jleged compder.My vlalauan of
Sectun 7D31.5 by Any applicant for a permit objects the applicant to a civil penalty of "A 18Ue—T
nal ore than five hundred delta.(5500). Occupancy Type
m
❑I.as owner of Ne property."my employee wish wages a their rte compensation,
willda to work.and lheauueram is not intended oranered forsau(SaJ044.Business Required Inspections
end Professions Code:The Conuscon's Licerue Law don set apply m an owner of Q p
prapeny who bui Ids or im proves thereon,and who does suc h work himsel f or through his
own employcca.provided that such improvements tie not Intended ao0ered fasals.If.
however,the building or improvement is old within ane year of completion,the owner
Wilder will have the burden of passing that W did not Wild or Improve for purpom of
"lc.).
❑1,as owner of the property am exclusively contacting with licensed contractors to
mnsuuct the prject(See.7044.Business and Profesdana Cade:)The Con radar's U.
care Law don nom apply to an owner of prsperty.who Wilds or Wharves thereon.and
who contracts for such projects with a contractor(s)licensed pursuant in the Cantrotor4
LKena law.
❑la can
gal undq(3 B&PC this on
•mer'" Data D a
WO0.K 5 COtFENSATION DECLARATION
I hemby arfnn under XrW ty at pegay ore of the folltwing dalaadom:
I WYe and will maintain Aeersileamut L'arenl aself-Insure for Wader aCompeT
station,m provided for by Section 37M of the Labor Code.for the performance of the
work(or which this Permit is issued
❑I lave and will maintain Wurloc s Compensation Insunance,as required by Section
3700 or the laWr Code,for the performance at the wruk for which this permit is issued.
My Worker's Compenaadon W ussna carrier and Policy number art:
Canner, policy No.: _
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This seclim mad rat W compleu l lithe permit 4 foronc hundred dolhrs(SIW)
or lest)
1 ceNfy shot in Ne performance of t e work for which this permit is issued.I shall not
employ any peropi any man s EgRte,Qm2ctlatMWorkeri Campenutlon
Laws of Celi au vleII�
Applicant ( A w--
NOTICE TO APPLICANT.If. tar m g this Ccnificate of Exemption.you should
become object to the Wohets nmpen lion provisions of the Labor Cole,you must
wJ O forthwith amply wit such provisloas a this permit hall W deemed revoked.
'Z ► CONSTRUCTION LENDING AGENCY
[—i t hereby afrirm that then is a conslrctian lending agency for the performocc of
the work for which this permit is issued(Sec.3097.Civ.C.)
Q Lenders Name
z
Lender's Address
O 0 1 certify that I have read this application random that the W.mfoemuiun is
U, " correct.I a&me to comply wit all city aW county ordinances and show laws relating to
0 rV` building convection.and hereby,uNanm mpreanwhes of this city to cnur upon she
11.1 a1mve-mcmionW property for imacun purposes.
(We)agree to ate,indemnify and kap hamlet{tie City of Cupertino against
gal liabilities,Judgments,costs and expenses which may in any way accrue against said City
C)Z In consequence of the¬ing of this Permit.
I APP LI ANT UND RSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:S - �&o Date
R EREGU IONS,
Re-roofs
Signmureaf Appli n r Ga
AZA US MATERIALS DISCLOSURE Type Of ROOF '
Willy the Cupertino
Wildingeaupatr 9.12,and
Hcaadsamateriat
ex defined by the Cupertino Municipal Cade.Chapter 9.Iz.and she Health And Safety
see0yeazss3z(.n All roofs shall be inspected prior to any roofing material being installed.
❑Yat ON.
Will the ePPlicol or future building occupant boa equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
troll hesardous air contaminants as defncd by the Bey Area Air Quality Management all new materials for Inspection.
DisuicR
❑Yes ❑Nu
I hes read du hnaNnus mnerlals requiremcnu underCWptar4.95 of the Califory
nia HcalNkSafetyCak.Rctioru25505.25533md2573d.iun rvmdNuirft Wilding
Jas o t cammly a arrant.that Itis my res maul ility u notify the occupant of than
i nuvahic LW Met Poor la aaraeenifeataarOccupaney. Signature of Applicant Date
V
Owner or amhonzcdgent pati All roof coverings to be Class "B"or better
' CITY OF CUPERTINO
lin 1 of 1 PERMIT RECEIPT OPERATOR: kiereaw
COPY # 3
•s
Sec: Twp: Rng: Sub: Elk: Lot:
APN . . . . . . . . : 36936032.00
DATE ISSUED.. . . . . . : 03/08/2006
RECEIPT #. . . . . . . . . : 33493
REFERENCE ID # . . . : 06030035
SITE ADDRESS . . . . . : 10735 MARTINWOOD WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . JENGAUNG CUEN y
ADDRESS . . . . . . . . . . . °
CITY/STATE/ZIP . . . . CA r
RECEIVED FROM . . . . : HSIU JUNG LIN
CONTRACTOR . . . . . . . : PHUNG NGUYEN LIC # 25450
COMPANY . . . . . . . . . . : COLOA CONSTRUCTION, INC
ADDRESS 1671 CANYON VIEW DR. '
CITY/STATE/ZIP . . . : SAN JOSE, CA 95132
TELEPHONE . . . . . . . . : (408) 891-2449
•
FEE '.ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
__________ _____________ __________ __________ __________ ----_----- __________
BPSEWER SEWER SYSTEM 1.00 21.58 0.00 21.58 0.00
PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00
TOTAL PERMIT 59.95 0.00 59.95 0.00
F
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ----_____-__-__-__
CHECK 59.95 3186
TOTAL RECEIPT 59.95
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
106 SEWER & WATER 202 UNDERFLOOR PLUMBING
301 ROUGH PLUMBING 507 FINAL PLUMBING
F Community Development
10300 Torre Avenue
f "
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
OUPERTINO
Building De artment
JO � PERMIT #oo a Lam, 0 6j,3 063x'
OWNER'S NAME:^ n c Ur- Cued PHONE # 'I S ?23 7
GENERAL CONTRACTOR' 4 CGS FAX #
Dg O
I am not using any-subcontractors: c �
Siginatu6 Date
Please check applicable subcontractors and complete the following information
60 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
Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO
• REPIPE/SEWERS/MAIN SERVICE
CUPERTINO PERMIT APPLICATION FORM
APN# Date:
3&, 1- !�,a- o�5�u 3_
Building Address:
0 � aiNWOore) W
Owner's are: 0 8 Phone#:
C ntractor: CC604 Phone: License#:
$ 2-&4
Contact: Phone: Cupertino Business License #:
Building Permit Info:
Bldg ❑ Elect ❑ Plumb /
Job Description: I,� ?t , V9gvJ k N 6
0 "u �' 6"U
Residential E] Commercial ❑
Cost of Project: $ � �
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg. Permit Fees BUILDING
BPGAS Gas Piping System Fee PLUMBING
PPERMITFEE Plumbing Permit Issuance PLUMBING
BPREPIPE Repipe of Fixtures PLUMBING
BPFIXTURE Pbl . Fixture PLUMBING
BPWSVCS Main Water Service PLUMBING
BPSEWER Sewers PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BUSLIC Business License BUILDING