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080502000 z z a>_ d 0 �z UO_ OE Fa U CITY OF CUPERTIN'O ;;;� "'*';7757_1. BUILDING DIVISION PERMIT %° CONTRAC,TQR I�NF„O .RMATI -•�N': BmLTgtG�3�i�mE"AERRIMAN RD D & D CONSTRUCTION PERMrr NO. 08050200 NERDS NAME: PERMrr ISSUE DATE JONATHAN H HUANG & QIONG 1447 HAMPTON DR 05/27/2008 nONEd' n T7� SANITARY NO. CONTROL NO. (408)666-5298 ARCHITECT/ENGINEER: BUILDING PERMIT INFO -BLDG ELECTPLUMB MECH M 0 LICENSED CONTRACTOR'S DECLARATION lob Description 1 herby affirm that I am licensed under pmvitions of Chapter 9 (commuting with SYdon 7000)of Divtdan 3ofthe Rod. and Professions Cade, and my license is TEMP POWER POLE ' in full force am cffcct Liana Glass Luc. Dam Comricter ARCHITECTS DECLARATION 1 understand my Pena shall W used as public records Licensed Pmfcssional OWNER -BUILDER DECLARATION I hereby affirm that I am exempt (race tht Centimes License law for tW fallowing madam. (Soman 7111I.S. Buimss and Professions Cade: Any city or county which requires a permit to Connex, alter, improve. demolish. or mot any structure ' prior to its issuance. also acquires the applicant for such permit to file a signed comment that he at licensed to the of the Cono-ecutes Liceluc Law(Chaper 9 Sq. Ft. Floor Area Valuation pursuant provisions $200 (commencing with Section 70DO) of Division 3 of the Business and Pumuions Code) or ,at M is exempt therefrom and tee buns for the alleged exemption. Any violation of Section 7031,5 by any applicant for a permit subjects the applicant to a civil penalty atNumber 34216074 OCCU Occupancy Type .at mmethan BKhundred dullasD500) ❑ 1. as owner of the property, or my employees with wages as that, alc compensate., Required Inspections will do the work. and lbs soaelOa Y not lammed Of oRCRd forme (Sce. 70m. BLLLmas and Professions Cade The Comnnaes Llan law does, not apply an in owner of - property who Wilds or balsam tbeseem.aM wMdousuch wait himulfor through he awn employers, pro ided that such depmumrou art not intended oraResel for uls.B, however, the building or impmvemat Bald within am year mf earepleuon. the owner - builder will have the tarda of proving that a did not Wild or improve for purpose of sale.). xcI, u owner of the M cny, am calumuly contracting Nth licensed contractors o nsimct use project (Sec. 7014. Business as Professions Code:) M Canuanm'a U. cents law does not apply in an owner of property who W ilos Of impress thamon, and, who camels for such pmjecu with a coneramor(s) licensed purmum, to the Convinces License taw. Ianeaemptunder5e�e ,B&PCfmtheresson y� �T Data SI2� W, D'i�C/ ORKER'S COMPEN ON DECLARATION I thereby alum, under penalty of perjury mu of the fallowing daentims: . IhaKand will meinuinaCeniBnte of Comma tel( -insert for Warkees, Compen- aeon. as Provided for by Sanson 3700 of the Labor Coda, fm the performance of the wort fm which this pernoin u issued. ❑ 1 have and will maintain Workeea cooperation Insu . as r Cleared by Section 37M of that Labor Code, for the performance oftle work for which the Permit is issued. ' My Warkees Compensation Insurance artier and Polity number are: Carver, Paltry No.: _ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ' (Dais ration rcW mtbccomplcu i ilthe punish Is roam hundred dollar, (SIM) or leu) 1 artily and in the perfotmance of the wart fm which this Permit a issued. I shall on, employ any pots. in mYmanera ob o 'ala the Womers'CompentadM Laws of Califomia. Date Applicant NOTICE TO APPLICANT. IL after making the Ccnifiau of Exemption, you should become subject in ,he Worker's CDMNMdun provision, of the Labor Code, you most ' forthwith comply with such proviilons or Nu permit mail Is, deemed mmkod. CONSTRUCTION LENDING AGENCY 1 hereby affnnm that Neu iso comvucan lending agency far the if..of to work for which don permit is issued (Sec, 3(197, Civ. C.) lender's None — Lender's Md. 1 Century that 1 bas read this application and sou that to mase inforemon is toren. I &&rte o comply with all city and county ommwrmvs and sou laws achdng to building conan¢uon and hereby authotse upusenuuws of this city to enter upon the save-menuamd gapeny fan ie pecuoa which (We) agree a ave, indemnify and loop harmless the City of Cupertino again, caste admay which maY in anyway accrue against aid City in consequence of theof Us ps of thegranting of the permit. A APPLICANT APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Dale SOURCE REGULATION Re -roofs Signature ofApdiWIR7Cordmc1WDta HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant in future Wilding accupantume orhandle haallow material u deBnud by the Cupertino Municipal Code. Chapter 9.12, and Ile Health and Safety . Sermon 15532(+)7 ❑Yes No All roofs shall be inspected prior to any roofing material being installed. Will thea licat or future building aeeu ,n, use equipment ardevlas which PP g P q If a roof is installed without first obtainingan inspection, I agree to remove P emit ha>adnus air conuminanu u defined by Ne Bay Arta Air Quality Management irQ all new materials for inspection. P Dialdtn ❑Ya 9NO I hart read the hvamaurnaeriaertquirenenu under Chmdo&95 of tau Califm- neHealth & Safety Cadc. Sm.Ums255115, 25533"25534. iurmertand thadaw Wilding tiros Mt eurtenty has a mann, that, II ny respansildlhy m Mary dic aceam, of the requlremena um It rola 1 pilaf uanKi' Of s CCNrKaa of a aMy. Signature of Applicant Date 2 roof coverings to be Class in" or better ownema 7,adagenl ate IAll 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ......... 34216074. -00 - DATE ISSUED.......: 05/27/2008 RECEIPT #.........: BS000004893 REFERENCE ID # ...: 08050200 SITE ADDRESS .....: 10640 MERRIMAN RD SUBDIVISION ......: CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: patg COPY # : 1 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT AMOUNT --------------- 102.48 --------------- 102.48 VOICE ID DESCRIPTION -------- ---------------------------- 402 TEMPORARY POWER ,. REFERENCE NUMBER -------------------- AMEX VOICE ID DESCRIPTION ------------------------------------ OWNER ............: JONATHAN H HUANG & QIONG ZHANG ADDRESS ..........: 10640 MERRIMAN RD CITY/STATE/ZIP ...: CUPERTINO CA, 95014-3924 RECEIVED FROM ....: JONATHAN HUANG CONTRACTOR .......: ENDE WU LIC # 23939 COMPANY ..........: D & D CONSTRUCTION ADDRESS ..........: 1447 HAMPTON DR CITY/STATE/ZIP ...: SUNNYVALE, CA 94087 TELEPHONE ........: (408)666-5298 FEE ID ---------- UNIT QUANTITY" - ------ PSIOUNT,--� PD -TO -DT THIS REC NEW BAL IBSEISMICR ---------- VALUATION 200.00 ---------- ---------- 0.50 ---------- 0.00 0.50 ---------- 0.00 IERT2001K UNITS 1.00 61.19 0.00 61.19 0.00 1TRAVDOC FLAT RATE 1.00 40.79 0.00 40.79 0.00 TOTAL PERMIT ---------- ---------- 102.48 ---------- 0.00 102.48 ---------- 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT AMOUNT --------------- 102.48 --------------- 102.48 VOICE ID DESCRIPTION -------- ---------------------------- 402 TEMPORARY POWER ,. REFERENCE NUMBER -------------------- AMEX VOICE ID DESCRIPTION ------------------------------------ Is CUPEI�TINO CITY OF CUPERTINO TEMP POWER PERMIT APPLICATION FORM Ok0S ozv 0 APN # Date: Building Address: Fee Group Permit Type (0640 IERT>IK Res. Temp Power>IK Amps E 1REAP14 Owner's Name: Res. Temp Power <200 Amps Phone #: Jomat2aw / 62rU15 Z17a"tpa 40,p-863-991'2 Contractor:�,", E Phone #: - A'? de UVu IEPERMITFE Fax#: 4`(9S -G66-3 /0 Contact: Phone #: jot, Electric Plan Check e-(-_oCf4jo-99j 2 - AfAa, I 1BSEISMICR Contractor Contractor License #: B Cupertino Business License #: Travel & Documentation Fee Job Description: Residential [r Commercial ❑ Valuation (cost of project): $200 Quantity Fee ID Fee Description Fee Group Permit Type IERT>IK Res. Temp Power>IK Amps E 1REAP14 IERT<200 Res. Temp Power <200 Amps E J IERT2001K Res. Temp Power 200-1K Amps E IEPERMITFE Electric Permit Issuance E 1 ELCPLNCK Electric Plan Check E I 1BSEISMICR Seismic Residential B 1TRAVDOC Travel & Documentation Fee B CITY OF CUPERTINO S«' TEMP POWER CUPEkT`lNO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group Permit Type 1BSEISMICO Seismic Commercial B 10EAP14 IECT<200 Commercial Temp Power <200 Amps E IECT>IK Connnercial Temp Power >1K Amps E 1 ECT2001 K Commercial Temp Power 100 -IK Am s E 1TRAVDOC Travel & Documentation Fee B 1BUSLIC Business License B