08080119 CITY OF CUPERTINO
BUILDING DIVISION PERMITC�NTRACT(TR INFORMAT'Iq ' ,
BUILDING ADDRESS: PERMIT No.
06%9 M_INFTTE PL WENSHEN YU 08080119
OWNER'S NAME: PERMIT ISSUE DATE
), 10679 MINETTE PL 08/18/2008
NE SANITARY N0, CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
300 LICENSED CONTRACIOR'S DECLARATION Jpb Description
1 hereby affirm"t 1 am licensed under provision of Chapter 9(commencing
Z with Sadm 7")or Divison 3 offs Buaixu and Profession,Code.and my license is TEMP POWER
e m in full Tome and effect.
3 Lima.Class Ile.N
7 Dam Contractor
ARCHITECTS DECLARATION
1 undcruand my plans tan l k used u public records
i u
S C Licensed Professional
-
OatNER-B ompt fr DECLARATION
coo krchy Affirm e. 1 am exempt from An Ne Contractor.sCock:
License Law for ns
coo o following maw n. emit t 760 I.S.Business and Profusions Code:Any m m county
which acquires•permit m rim a6 alcor,impmva,h demolish.a repuig ed aaudunt
xi that heor istiensedpAim requires lk sisions o for each Permit LmnX3 file A LAW(utemcnt
s< ernkrlkenscd pursuant roma of Division
orae Cmuiness W:enmlaw(Chapter Sq. F[. Floor Area p Valuation
ERE (on he
mem
iNSenion iman nd basis for the
the Business And Professions Cod)of y1000
ERE fest Session
ream pt therefrom and the aper far be cs the eampnt W Any violation of
Section wase by any reddantfar s(apermitsobjecutheapplmammacivilTensityof Number Occupancy Type
at eras than five hundred adios(g5r10) 37532039 .' p y YP
1,as owner of the property,or my employees with wages As their=Is compensation,
will ds the work and the structure r not intended or affemd for sale(Sm.70".Business Required Inspections
and Profeulons Cade:The Conuacmr't Liame Law don not apply m e ns an owner of q p
property who buil"or Im proms Neman,and who does such work Mnuelf or through his
awn employees,provided door such impmvemmts are not immude5 mortared for sue 11.
however,the Indicting or improvement is sold within one ymrof oaepiatia.the awoer-
builder will haw Ile burden of proving Nat he did err build or improve fa purpose of
L u
owner of the Property,am exclusively contacting with Ikea,Cmnfaer's m
coosuuct the project(See.uOan Suer of and Professions Code:)The Conuaeon.and,
who hem fan not apply m ts owner of progeny who bed puns lm or the
thereon.and
who LaNforcath gojeeu win,aconuecmrta)liauued portantm Ibe Conuactars
Llanse law. '
❑tom ,B&PSr' ow
ar this n
'AmerOwr Dam
oUV KER'S COMPENSATION DECLARATION
1 hereby arm under Family of pesjury ars of the following decrradon e
I haw,and will maintain•Cerofcam of Content m self-imam for WorkersCompen-
mion,As provided for by Section 3700 of the labs Code.far me Performance of the
work for which this permit is Issued.
❑1 have and will maintain Workers Compensation Iauraa,As required by Section
3700 of me Labor Cade,for the performance of the work for which this permit clamed.
My WorYers Compensation Insurance artier ad Policy number are:
Cartier, Policy No.: '
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Crib section need rot kcanplesd U the permit is furaoehundred"Bus($IBD)
or lea)
I certify that in the performance of the work for which this permit is issued,1 shell not
employ _grg0subject to thWi
e Wars'Compenadon
Laws of Califommiiyy Fpuucc D
Applicant
NGnCE To P ,after making Nu Certificate of Exemption,you should ,
become subject an the Workers Compemadon provisions of ft labor Code,you most ..
.J z raMwiN comply with such provisions or this permit shall be deemed revoked.
z` CONSTRUCTION LENDING AGENCY
(~ Ibemby affirm war them is a commucdnn lending agency for the performance of
CLfu work fm which mus permit In issued(Sec.3097,Clv,C.)
Lendu's Name
CL a
= z Landers Address
U O� 1 certify mu I haw mad this application W plicatisum thin the above information r
D.V contact. m I some comply with all city and county ordinances and mwn m laminding m
ng
C) building construction,urd bereby commis representatives of this city an cater upon ft
LD ahwe.mendowed property for inspection purposes
LL (We)agree to now,indemnify ad kap harmless the City of Cuperdes aoupet
,.y N liabilities,Judgments,cast and expenses which may in any soy acme against aid City
in mrilturrecance of the growiofU APPLICANT UNDERSTANDS ArND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE
�� Re-roofs
SegoduceofA n n nusomr Dam
HA ARDOUS MATERIALS DISCLOSURE Type of Roof
WIII tic
' pe defned by ticapCu psenrtnoro Municipal
Wpal Coode.vCpeaaptetsrm9rc.12o.c ahendndIlele hHleaaNleroaadmSamafrietuy
Coca.Section
'
Section 25532(a)7 All roofs shall be inspected nor to an roofing material beim
❑Yes $Na P P Y B g installed.
iIWill the applicant or future building occupant man equipment or dcvica which If a roof is installed without first obtaining an inspection,I agree to remove
t haardpec air contaminants a dcRoed by the Bay Area Air Quality Mmagcmmi all new m rials for inspection.
Diatnc,7
❑Yes BNu n ///111
I have mal the hmrdea matedua aerial remmu under Chapmr&95 of the Califon
nil Health&SafdyC%w,Sectors 050,25533 and 2594.1 undcmand thatdthe Wilding o a
does not currendyan
haw a tenmL mm it is my mspouibility m notify me cam Pt of me
im ta which most k metpriarm Women ors Cool of OcclPapry�/ Signature of Applicant Date
owner uthmisedagent Das All roof coverings to be Class'nW'or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37532039 . 00
DATE ISSUED. . . . . . . : 08/18/2008
RECEIPT # . . . . . . . . . : BS000005808
REFERENCE ID # . . . : 08080119
SITE ADDRESS . . . . . : 10679 MINETTE PL
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : WENSHEN YU
ADDRESS . . . . . . . . . . : 10679 MINETTE PL
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : WENSHEN YU
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY . . . . . . . . . . : WENSHEN YU
ADDRESS . . . . . . . . . . : 10679 MINETTE PL
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE . . . . . . . . :
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------ ------ ---------- ---------- ---------- ----------
�].BSEISMICR VALUATION 1, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
IEPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
7.ERT2001K 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 143 . 27 0 . 00 143 . 27 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
-- --------------- --------------------
CHECK 143 . 27 #663
---------------
TOTAL RECEIPT 143 . 27
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------ ------------ ------- -------- ----------------------------
402 TEMPORARY POWER
•
oeC2
CITY OF CUPERTINO
'a TEMP POWER
® CUP'E"VIN0 PERMIT APPLICATION FORM
AIN '2753 ,2,C)
275 3 ,2,C) 3 0c-) Date:
Building Address:
10 7 2 N;,4 f e C c
Owner's Name: Phone #:
Contractor: Phone #:
Fax #:
Contact: I.� Sk / V� Phone#:
2�0
Contractor License #:
Cupertino Business License #:
Job Description:
D BW�'✓
Residential Commercial ❑
Valuation (cost of project):
Quantity Fee ID Fee Description Fee Group Permit Type
IERT>1K Res. Temp Power>1K E 1REAP14
Amps
IERT<200 Res. Temp Power<200 E
Amps
J IERT2001K Res. Temp Power 200-1K E
Amps
/ 1 EPERMITFE Electric Permit Issuance E
IELCPLNCK Electric Plan Check E
1BSEISMICR Seismic Residential B
1TRAVDOC Travel & Documentation B
Fee
i
CITY OF CUPERTINO
TEMP POWER
CUPEkTINO PERMIT APPLICATION FORM •
Quantity Fee ID Fee Description Fee Group Permit Type
1BSEISMICO Seismic Commercial B 10EAP14
IECT<200 Commercial Temp Power E
<200 Amps
1 ECT>1 K Commercial Temp Power E
>lK Amps
IECT2001K Commercial Temp Power E
100-1K Am s
1TRAVDOC Travel & Documentation B
Fee
1BUSLIC Business License B
e