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05120127CITY OF CUPERTINO 11 1 &sin' sw 5 >A11 BUILDING DIVISION PERMIT M' CO1�iTRAC7OR INF>CIRMATION.." xrar 'e €ro >_ Asa BUILDING ADDRESS: 187 METEOR nR LNB CONSTRUCTION, INC PPRMITND.05120127 EWS NAME: PERMIT ISSUE DATE LIHONG ZHANG 581 BELLE 2005 NE: SANITARY NO. CONTROL NO. (415)585-3884 ARCHITF-CTIENGINEER: BUILDING PERMIT INFO BLDG MECH FO r__11= t� LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm Nm 1 am limned under provisions of Chaptor 9 (commencing op with Section 7000) or Division 3of t e Buvneaand Professions Code, and my license is dcffLiceneClass REMODEL -GAS LINE/APPLIANCES/CABINETS Lk.g Dow Contractor MODIFY LIGHTING/CEILING SOFFIT/BATHRM ARCHITECTS DECLARATION I underatand my plana'hall be usW as Public records Licensed Professimui OWNER -BUILDER DECLARATION I hereby affon that I am exempt from the eantuactare License Law for the following resume. (Section 7031.5, Business and Professions Code: Any city or county which requires a Permit to cneswm, altar. Improve, demolish, or repair any structure prior to its issuance, also requires the applicant forxuch Permit to BIC a signed suacrocat th.Lhe is licensed pursuant to the provision, fthe Conmcw,'s Licen%Law (chapter 9 Sq. Ft. Floor Area Valuf$iD0000 (commencing with Section 7raw) of Division 3 of the Business and Prohmona Cnde) m that he is exempt therefrom and the hub for to alleged exemption. Any violation of p umber Occupancy p y ' T1 Scdm 7031.5 by any applicant for a permit objects IIIc applicant to a civil penalty ofanC ant mom Nan five hundred doll. (5500).. 7 001, u Caner of the property, or my employees withwgu u dekole Compensation. will do the wok, and the,huedere is not intended &offered immune (Sac. 7Ow. BecomesR IM 1616 Required Inspections and Prof comm, Cade: The Commences Lioness Law, does set apply to an an= of property who build, orimprews thereon, and whodoeasuch work h(m%Ifor Mough his ownemployea, provided that improvements. not intended aaffeaed for ala If, �� „�)� however, Ne building or Improvement i' old within ane year of completion. the owner- S 0 builder will have the burden of proving that he did not build or improv for purpose of cons) WILibi ❑ 1. u owner of the property, am exclusively conoming with licensed contractors to the bui door:) The emnrmen. moan jota (sec. low, Business and Py � nue Law doss not apply to ts owner of prnperty.wan buildo or (reproves Noreen, and La an who d who fC such Projects WN a mnwctor(q liaised purstunt b the Caneactots emmtraN License ❑lam ucmpa un SenI .Bk PCfer umaon "a ' er 1. 1�� ' Dam I L WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury am of the following declantiorm I Mw and will maintain a Certificate efCcumem to%If4mum for Workers Compere Callon, u provided for by Section 3700 of dm IAbm Code, for too Performance of tm work for which this Permit is Issued. ❑ 1 haw and will maintain Woftes Compensation Insurance. u required by Section 3700 ofthelAbor Code, for the performance of the work forwhich this permit is issued ' My Workers Competition Insurance crier sad Policy number.: Carrier. Policy No.: CERTIFICATE OF EKEMP ION FROM WORKERS' COMPENSATION INSURANCE (Thb%etion mad notbec xaplemd if the permit is firame hundred doll. (SIM) M loos.) I certify that in the performance of the work for which this Permit is Issued, I shall not employ any person in any manor o mbCCemn;bzl m the Woriza3 Competition 6w of Cardona. Dam. n_ / 1 Applicant r C'� NOTICE TO APPLICANT: R. after making this Ccnifhmm of Exemption, you should become Subject to she Worker's Compensation provisions of the Ioba Code, you most foMwith comply withsuch provisions or this permit shall he dames makes. CONSTRUCTION LENDING AGENCY 1 hereby affirm that Bert is a construction lending agency for the performance of Ne work for which than permit b issued (Sea. 3097. Civ. C.) Under. Name Lenders Addles I certify that 1 haw rut this application and sum that the show informaven is caner 1 agree to comply with all city and county ordinances and aisle Laws relating to ' building construction. and hereby'uthorice representatives Of this city he enter Circus the .Ipve-mentioned property for iespeNmn parlor et (We) agree in now, indemnify and kap harnkss the City of Cep amino against Iiabilites, judgments, cuts and expenses which may in my toy acme against mid City In consequence of the gaming of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT '^/ Issued by: Date 2- —,2 ( 6-r SOURCEREGULATIONS, Re -roofs Type of Roof -L. L—.— Signadurt of ApplianUCanvacmr Dam HAZARDOUS MATERIALS DISCLOSURE Will the applicant m (atom building omopantstom or handle haallou material u defined by the Cupertino Municipal Code. Chapter 9.13. and the Health and Safely ' . es 25532(4725532(47❑Nu All roofs shall be inspected to any roofing material being installed. 0u Y prior If a roof is installed without first obtaining an inspection, I agree'to remove Will the applicant or future building Occupant um equipment or devices which I havudnu air contaminants u corned by to Bay Area Air Quality Management all new materials for inspection. iavict7 ❑Yu ❑Nu I have read the heurdous mamrbbmqulremem a underCNpmr6.95ofthe Califor. n a HealdkSafayCode, Sectiahs35505,3l533 mil luMe out Chad if Che building does nor currently Mw a tenant, that It b my responsibility to notify too occupant of too requirements which mutt be mel prior to issuance ofa CcniOnm of Occ of Applicant Date ��, 1 U'�, f �' 1 AlSignature All roof coverings to be Class "B" or better ' OW , Ol amlali]Ld agC(I Iter I Dam 4 F_ L a, - CITY OF CUPERTINO • CITY OF CUPERTI FERMIT APPLICATION ORM 051,;? 0/a�;7 N# �2/10 10S Building Address: Mailing Address (if different from building address): Ue Ciwr i"o 21387 CF]gsO(,+ Owner's Name: I d�;hon Gtn Phorie #: 4o$ -73S -7o83 Contractor: Llug C jte-4 cii„ License #: p 3'813 6f� MECHANICAL 13BOILER2 Contact: �oN� Phone: 4o873S74Cupertino Business License#: Fax: Building Permit Info: �l Bldg ❑ Elect E1 Plumb `m Mech%L Job Description: #No ¢laor Plan ckA'Ja . wo s+nHc{.,•QI CLo,,Z�e, ) 145'41 44> I'hu+e uok d z) ,UQU Residential 5Z a ,aj', ; UAV-1Commercial ❑ Sq.Ft. Floor Area: 4)M*4.ij so�,,i e,rew. q.Ft.: S t n„ ma oti rq 1 ,Cc w ; G Nc l roo-h �d U Cost of Proiect: �0 i Occupancy ouD: Type of Construction: Please check this box if the project is a BCONSTAX second -story addition: ❑ ro'ect Size: Standard ❑ Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL 13BOILER2 Boiler > 100K to 500K Btu MECHANICAL BB.OILER3. Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler > 1M to 1,75 M Btu MECHANICAL BBOILERS Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING is 1 of 3 As CUPERTINO a CITY OF CUPERTIhW PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTD E Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum . PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING MIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING. BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING 13REINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cim MECHANICAL BRENiAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install NfECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFLYT Lighting Fixtures ELECTRICAL BRENIFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREA NHOOD Installation of Hood 11IECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating AfECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL L 2 of 3 C*Y OF CUPERTINO I Y0 PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISNIICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING ESPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEATPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance 1VIECELANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/ Multi-Fam PLANNING PLLONGRNGR Plannin Lon Range Residential PLANNING ZADE Address Change BUILDING 3of3 • 11 a,Tyo S'1DEC—. TINO � Assessor's Parcel Number: Name of owner. k I h oil q -2 N Project address.' 21 3 g -7 Contact person. �i�oh� ��Oth�1 Phone. 40 Fax. Net square footage of lot. Existin Square footage: First floor: Proposed Second floor: Garage: TOTAL: Are there at least two 10 foot by 20 foot clear spaces inside the garage? Y Is privacy protection planting required for the project?. Y— On what floor(s) is workb mg done7 ci t, Ree M -ICA ') �h��a�l (ray l;ha fvy a„kfop Brief description of work. I Z) rn"I"4i-n 11I amr, 1. Code editions: 2001 CBC (Y - N)2001 CFC (Y - N)2001 CMC (Y- N) 2001 CPC (Y - N)2001 NEC (Y - N) CV Effective 11/1/02 Plan Review Process Work Book Page -8-Revised 4/28/04 12.+. t�m•.jo� I� n ay-d+r" (,JtirA,) elecik-;Cal /ply w, ,L ME 1 I Ni m m y W Q nn� r' � r N T s 7 r�4 s 0 h � n r n w S.► FFes. 1 I Ni m m y W Q nn� r' � r N T s 7 r�4 s 0 r' h � n r w I S 01` 33{• �� IBY" ~ /1L IDA 17 °°a4 m i5 S 0. d �a 5. W GtlI (0 N S a s 7 r N •m w C whit a a ° m°a C u „ w > O ................................... o ��F o r wS � i -- -- z ......._.E �:�Lpwl a" 21�RI. deor fpr. C14 vtrA1n7 GN ISO W ivg.LJ - Pf",V-I<A 0 36 a �e q WI..k I) b qf- ro 0K I e1Y1o�Gl — heti $�ra �}h ral • 0 n �i U