07110102 CITY OF CUPERTINO 'g-^� '
BUILDING DIVISION PERMIT CONTRACTORINFURMATION` '
Q
PERMIT
BUILDIUCr.ApDRESS:C, CLELLAN RD (PARCEL TBD — TO BE DETERMINED 07118102
L=WSS 7NA7MZEE 1°1 PERMIT ISSUE DATE
tONGJIAN WANG 06/11/2008
PHONE SANITARY NO. CONTROL NO,
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
300 LICENSED CONTRACTORS DECLARATION I Job Description
m I hereby affirm that 1 am licensed!under provivam of Chapter 9(mmmencin6 P
Z� with section 7000)of Divison3ofth=Business and Professions Code,and my license is NEW 2 STRY SFDWL, 4316 LVNG, 672 GARG, 45 PORCH
is in full force and effect.
j12,i License Clan Lk.t
gDam Comracdar
ARCHm]Crs DECLARATION
< 1 undersand my plans Nall W used as public rtcnNs
JyU
yob Licensed Pmfecammit
OW NER"BUILI)ER DECLARATION
1 Wrthy aRrm that I am exempt xpt from the Cantractofs License Law for the
00 following....(Section](131.5,Business and Pmf tion Code:Any city or roomy
$ which requires a Permit to construct.alter.improve,dcmolim,ce repair any structure
prior to is issuunce,also requires tW applicant for such permit to file a signed sutemut
m< that he isli¢nseepurmantwthcprovisimuoftheConuuum'sLi¢nmLaw(Chapter 9 Sq.FC Floor Area Valuation
yl-$ (cammendngwith Secuan7000)of Divuion3afdw BusineuandP fesaiom Co )or $964839
20_ thus he u exempt therefham arms die basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
.1...than BK hundred dollars(MW0 35608055 .jVbN Number Occupancy Type
❑I.uowmr of the propm[y,tar mY eoploycu with waghu their not=campenadon,
wed Prthewon,and theswerveumtintemsed Lawdosno,a(Sec.to aa,Business
and property
W Code:The Canuenols and
Law doh not apply w an ower of Required Inspections
property who busily m improemee,improvements
ams who doenot ma,ork himselfm Wr We his
owneer.the
eWiprogor i that sect ntisosemmtstienot inteMmsmpletion,far We.It.
builder.die Wilding or improvementishathwithinet year a completion,pdue urpose
Wilder will Luer tW burden of proving that he did riot huiW m improve for purpose of
cals.).
I,
as.erten of has propenY•w exclusively contracting with licensed censacwn an
sum the project(Sec 7014.Business and profound...Code:)The cmmeaeors Li.
came Law does not apply w an oww.r of property who Wilds or improves tMmon,and
who conranu for such projects with a eanusmar(s)Reasoned Pursuam to the Contractors
License Law.
Itmuemp riderSec ,Ba PCfm is
Dara ��I
WORKER PENSATION DECLARATION
I hereby alnrm undo rally of perjurym of the following declumiom:
0 l love ams will maintain a cm rlmm of comeni w self-imure fmwartefaCmnpen-
mion,as Provided for by Section 3700 of the labor Code.for the performance of the
work for which this Permit is issued
0 1 haw:and will maintain Wortces Compensation Imuran+,as required by section
37W of the Lubm,Cade,for die performance of the wale for which this permit is iuwA.
My Wmkcfs Compensation I..tinier and Polity number are:
Cartier. Polity No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thuscctim need not be,completed if the permit is fmono hundred cobalt nlW)
or Ica.)
1 ersufy thus in the perfortnetec of the work for which this Permit is iuve 1.I shall nm
employanyperhan in my men w 'coo tM 'Coen don
Lawn
of Califs
Applicant
NOTICE TO APPLICA .If.after m enincaw of Exemption.you should
becmne aubjm b N s Compcnaud "sions of the Labor Cove,you muss
.J O forthwith comply ori such pmviainm or rmi,shall be deemed revoked.
Z h CONSTRUCTION LENDING AGENCY
(-r (hereby aurum Nus there is a conserved..lending agency for theperfommnceof
C
the work fm which thus Permit is tut(Sec.3091,Civ,C.)
0. Lender's Name
7 z Undoes Address
V Q 1 cutify than I Mw mad this application and sate Nat the Wow information is
f!.Eco omM I agree le Comply with all city and=only militantnessand sola laws totaling to
.C) Wilding eonsuumion,and hereby auhorim h
npremauvm ofths, w mor ter upon ft
r Irl shove-mcnudgm property for inspection Purposes
E~0. (We)agree to save,indemnify and keep hamnksa the City of Cuperuno against
c,iZ inconam,"dgmetlegras anhafthi.m whr in any way accrue stimulated Cit
(„)z in cansegmrwe of N=granting of Nis
^ APPLICANT UNDERSTA ILL C PLY WITH ALL NOggqq-POINT Issued by: Date
SOUR E AT1oN �+ /( 0l (J
(� V UX Re-roofs
Signa of Apple onueb.her Da
teAZARDOUS TER( 1SCLOSURE Type of Roof
Will theapplicant or forum WalCoe.Chaptdtre or and harsNommawrial
tined by the Cupertino Municipal Cade.Chapter 9.11,and the Health ad Safer
.section 25532(a)7
Oyer ���/// All roofs shall be inspected prior to any roofing material being installed.
®Na
Will the,applicant or future Wilding occupant use a al If a roof is installed without first obtainingan inspection,I agree to remove
PP g e y pment or devils which P
District?
[3y.
air conaminan�u/u defied by the Bay Arta Air Quality Managcmcm all new materials for inspection.
OYh tgNo
I haw read die hvallous materials requiremrms under Chapterfi.95ofdre Califw
niaHulN&Seety Cade,ScedesnM5.75533md15s34.1um1cuund dusif Nc Wilding
does no,currently haw a smnL that it 4 mitilit to roof Y the t of tha
require nu wha-h mm cpmr an oft Cemrcateofa panty
� Signature of Applicant Date
ower arathariu sem DateAll roof coverings to be Class')W'or better
CM OF CUPERTINO
BUILDING DIVISION PERNIIT
C1 CTAYi`4'T'-'
._ .. ...
BUILDING ADDRESS:
TBD - TO BE DETERMINED
PERMrr N0.
07110102
OWN'USNAME:
YONGJIAN WANG
PERMtrL13MDATE
06/11/2008
PHONE
o
SANITARY Na CONTROL NO.
ARCHITECT/ENGINEER: PHONESNEW
A*� ' aS�:a "ya `a ;y �"� � ( f �'�?'
ii35PFnS ` ' t ``�? "
z
2 S7'RY SFDWL, 4316 LUNG, BUrt�INGPERMTCINFO
BLDG U= PLUMB MECH
672 GARG 4S PORCH
TO ARRANGE INSPECTION 70B DESCRIPTION
Call 777-3228 between 7:30 a.m. and 3:30 FeI
m., RDErrrrar'
Monday through Friday, at least 24 hour before ❑ SFDWL 13 IOTMMN REMADE
required Inspection. Job address and Permit Number ❑ ADDITION ❑ PLUMBING RE -PIPE
are needed when requesting an inspection. C3MULM-UNM 13sTRucTURAL
MODIFICATION
FNnAL COMMERCIAL OTIMR ❑ RvOROV77�ff1fT ' ❑ II� POOLS 0MOFET REPAIR
FTA7sgpOLIS FIRE AREA ❑ BATH REMODELJREPAIR ❑ DEMOLITION
❑ OTHER
❑ YES Ir M . I mdu=d char a C= A mof u=nmy is squired.
C3 No tniri�l I.C9.a
EXISTING ROOF COVERING ❑ NEW BLDG/ADDMON ❑ DEMOLITION
❑ TENANT Cl FOOD SERVICE
of eiisting coverings IMPROVEMENT
❑ OTHER
be gemmed To be retained
p
FOUNDATION/PMRSIRD.S. 'dI 6�
UFER i G
u
PAD/SETBACK-CERT /)/,
GARAGE SLABS/PREGUNTTE -L3
PflLI1N0 ("l`}k�1C:RET> FI1�iIl=.AC?VEFiiX$:�EFS`�I'�i •> i'
UNDERGROUND/SLAB
c UNDERGROUND PLUMBING
$ UNDERGROUND EL.ECiRICAL
I�a'.i1( eo17i�IT;Oc}It Oi t'gB EI`('3LGL�EETJ .`;''
UNDERFLOOR PLUMBING ' is
UNDERFLOOR MECHANICAL
UNDERFLOOR ELECTRICAL
UNDERFLOOR FRAMING VENTS '
UNDERFLOOR INSULATION to.,
TYPE OF ROOF COVERING
EXISTING: PROPOSED:
❑ Bwlt•Up Roof ❑ Builo-Up Roof
❑ A�I1°It Shing) N%�/✓(%SI (,� j tphdt Shing) f}� 1
SCkeI aad Shokcs r9V" /" ✓ /N�
❑ Wood Shingles ❑ Woad Shingles
❑ Od-(Spedfy) ❑ Other(Sped%)
NO FINAL INSPECTIONS Provide I.C.B.O. Report Na
UNTIL ALL REQUIRED BUSINESSpmide Mfgr.1—Halan Spm.
SPECIAL INSPECTION REQUIRED C1DATE IHs
Is
PGACENO,Fk'IiAH(ErHfCS$V=SIGNELI
ROOF SHEATH/DIAPHRAGM 61-
PLUMBING Y7-1'7 96—
TUBS & SHOWER PAN — i3
MECHAMCAL
ELECTRICALIPOOL BOND
FRAMING/STAIRS/E. EGRESS _
INS ULATION/VEN TILATION
co E�tvaw - 4,
EXTERIOR SHEAR/HOLD DOWN
INTERIOR SFIEAR/EfOLD DOWN 6-104 A6.INSPEcrION
SHEETROCK/SHEETROCKSHEAR Z
EXTERIOR LATH/W-SCREED
SHOWER LATH t)
�V P5'7?t/ks
t CA,P6t1 T!LA�kF t.IJN'Sl '@i 1 4'SI E7' • `.
SCRATCH COAT —
SEWER/WATER
TEMPORARY APPROVALS
OCCUPANCY
_
CUPERTINO SANITARY DISTRICT
Closed circuit video Inspection of property line cleanout, paint of connection
and street lateral required prior to passing FINAL CITY PLUMBING
INSPECTION. Call the District (408-263-7071) for an appointment.
IMPORTANT
When a permit has expired, a charge totaling one-half the fees to
obtain a new permit must be paid to reactivate the permit.
U a permit has been expired for more than one year, a charge totaling
the full fees to obtain a new permit must be paid to reactivate the
permit
rZ t'5".; sa-n1•�y .� 1.it ts� mid: isf[a., x .:_:
p
y PLANNING 777-3708
> GAS TEST
p GRADE (P.W. 777-3354)
ZZ FIRE . CALL (408) 3784010
. HANDICAP
ELECTRICAL
p� PLUMBING
rn MECHANICAL
Z
ENERGY
VISUAL FINAL ONLY
BUILDING
OCG );EF IPI 4'40,� itCm!'
G;• • t�,
Itfet;eTbt �i� <' ' 1
CERTIFICATE OF OCCUPANCY C1
PRE•OVSPECTlON:
PLYWOOD:
INSP. DATE INSP. _
TEAR OFF INSPECTION: BATTENS:
EN -PROGRESS:
DATE INSP. DATE
FINAL
INSP. DATE INSP. DATE _ INSP. DATE
ninTG• ncNe &PpRnVFn ACCESSTO ROOF SHALL BE PROVIDED FOR INSPECTION