06050162 CITY OFCUPERTINO ei� �n�',� '' ' '` '
BUILDING DIVISION PERMIT ,.CO,NTR-6T OR INFORMAIFJ!
BUILDING ADDRESS: NATIONAL CONSTRUCTION REN �NTNO'06050162
10381 MIRA VISTA AV
OWNER'S NAME: PERMIT ISSUE DATE
MARTHA KANG 1355 FILIPE AVE OS/18/2006
Et SANITARY NO. CONTROL NO.
(818) 221-6057
ARCHITECT/ENGINEER: BUILDING PERMRINFO
PIL MB MOECH
loO LICENSEDCONmusi under P.Am.or hap lob DesCrl VOA
1 hembY AB of ON I Na Ilan,rd under pmviof m of Chaper 9(commencing P
i� with Swtio,n]gMO of Division Jo(NeBusiness.rtd Pmfeuwn,Code.and mylkense4
infullfamc.ndeffat. -¢����[ INSTALL TEMPORARY POWER POkAy If— 2006
i�2 Lecnso a . IJc.g
, p Dam C S DECr L,/L ®a,
�rGG3y3y ARCNTIECTS DECL.RATI i B ILL"N C.I ode nd my plem Shall he used u public record. U
F
s 0 Licensed Professian,l
OWNEm wrDER DECLARATION
1 hereby.(Eros Not 11. .Barone from vire Contractor's :Any c Law for the
O O which
hire moan.(Salon]031.5 Business and Improve.
do mli Code:Any city or county
$f<i whleM1,its Woman.
aim re eonnroeL aitv,hapmw,h permit t rie a sig any ummem 50(]
_Z[ra pnarwi6 isssedpuruantto the theapplicanto for sucComasmitoamuse Law
(Chamem
pp G Namencringwithusman(10the adDivlomafofOnBuxmrWccnuclaw(Coder9 Sq.Ft.Floor Area Valuation
i€$ thaw at ft is exa pi Sednom and O basis n 3 of Al egad co and PafMY vi Code)Of
e —
Section 7031.5'by any for.permit bcNlcNe applicant u AcIvillpenalty of
Occupancy Type
ant mart than five huadmd dolWa ISMi
❑1,u owner of Bk popmy,w my aoployee with wage u deo mtcconnpemadon,
will do the werk.nd the r0uctuw is noNmmnded or offered BOSNIA,(Sec.7044.Business Required Inspections
and Profedan,Cade The ConnmApw an
wel Lim=Law deny t Apply maw of q P
property who hui1N«{mpmvm Ihmeon,And who d«s suN work hivseJr err through his
own employee,pmvlded Natsuch Improvements Am notimmrded aroffemd fmwlC if.
however,the building or Improvement B mid within oro Year o(wmple ion.the awn«•
builder will haw the burden of pmvtng Butt he did rot Wild err impmm far purpose N
.ale.).
❑1.as owner of the property,am aelmively conbuting with licensed conu.cmts lo
construct Na project(SO—7044.Business and Pm(esion,Code:)The Conuacw'a U
cen,a law Bae at apply to to own,of prone,who builds or in,a acs Ocmon.And.
who contracts for such gojeN with a contractor(s)licensed pursuant w dw Contrmmr's
License Law.
❑I Am exempt under See ,B&PC fm this won
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby aRim under penury of perjury oro of dm following declaration:
I haw atM will mainuin a Certificate AID ouse Atto Anti-Wum(«WorkaY.Campmo-
radon,As provided f«by Section 3700 of Ne Labour Cade,fm the performance of Be
work for which this permit is issued.
❑1 haus and will maintain Worleces Compensation Imoance,an required by Section
3700 of the Labor Code.far peRormuee order work f«which this permit B Issued. '
My Workers Compe nun login Insurance canier and Policy number
Canier9.�`'- Polley Na.:
CEgfIFI TE O�PIGON FROM WORKERS
W yi/UMPENSATION INSURANCE
fih6.ccdan used not be comploled Bae permit B faranc hundred dallau(S100)
or less.)
I certify that in Bus performance of the work(w which this permit is banned,I Nail not
employ any person in any am o n,AN as to bceume subject to ON Warim s'CmnpemWoet
Laws of Cai LOMB.Dam
Applicant
NOTICE TO APPLICANT:If,after malting Nit Ccnirmam of EAssurnan.You thouW
become subject in On Wohe's Compewdon provision,of the lab«Code.Taut men
0 foMw(h comply with such ArOABion or Nu permit 0411 be dectnnd rewked.
ZCONSTRUCTION LENDING AGENCY
Ethat d
I Wmby affirmem 6 a construction lending agc« fon the pem.nm rforof
> the work fon which this permit 6 Bound(Sac.3097,Civ.Cd
QLendue.Name
U O lender's Address .
I certify that I have read thin Application and mm ON the above information B
Iy F coronet.I a{me to comply with JI city and county Ordinances;and sok laws mlating w
DU Wilding construction,and hembyaulhmin reprrsnmivcs of Nis city to cnmr upon the
W Shove-menti.nod property for impccdon purpasea.
(We)agree to save,indemnify and keep harmless the City of Cupcnina-INest
Date
y Iimilities,judgments.emu and e.pwtte which may In my myrNarm agaimt mid City
U 2 m consequence of Be{naming of this permk
+—' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: ( d
SOURCE REOU S. s e
Re-roofs
1by
pliean tar 'lo of Roof
HAZARD US MATERIALS DISCLO E Type
ll de appiicam an room building occupant now«handle hatudous material
As deflated by Ilse Cupertino,Municipal Code.Chapter 9.11,and the Health and Safety
Con15531(a)? All roofs shall be inspected prior to any roofing material being installed.
ell the applicant err future building ace upam use equipment or devlce whichIf a roof is installed without first obtaining an inspection,I agree to remove
edam air comamiaanu u refined by Ne Bay Area Air Qality Management alt new materials for inspection.
DYex ve mad Be huudwu maetia6 mquhemmusundurChapW6.95 ofN Uifm-
n &Safety Code,Savant 15507.15533 uW15534.1 undeswd thnlfta Wilding
darmo ly haw A mnam,that it is my respontlMlity se notify Be oaupant of the
mnuwh I W met prior In issmnm of a Certificate of Signature of Applicant Date
owner aratharue . ant ,m All roof coverings to be Class"B"or better
CITY OF CUPERTINO 0 tp 050-71��
TEMP POWER
IWUCITY OF
PEkTINO PERMIT APPLICATION FORM
APN # 3.57 —07` 4'3 Date: —,5/ Z.-.(,
i
Building Address:
/0)'c� 7
Owner's Name: Phone #:
r,�2 �iiJ Ar✓� ,&- 390 S/ z
Contractor: hone: / —eoo. License #:
Conta t: / Phone: Cupertino Business License#:
Building Permit Info: WOW `% 10
Elect V
Job Description: S�
Residential Commercial ❑
Cost of Project:
Qty. if
Applicable Fee ID Fee Description Fee Group
BTEMP Temporary Power ELECTRICAL
EPERMITFEE Elect. Permit Issuance ELECTRICAL
BUSLIC Business License BUILDING
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
WUPEI�TINO
Building Department
JOB ADDRESS: PERMIT #
/038 7 x1219 vis •� 6O
ONERS NAME: iJ� k�JG PHONE # .� Sn- z
W
GENERAL CONTRACTOR FAX #
I am not using any subcontractor/s:
ign a Date
Please check applicable subcontractors and complete a following information
60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Floorm* g: 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 /y
er/ tractor Signature bate
CITY OF CUPERTINO
am 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35702043 . 00
DATE ISSUED. . . . . . . : 05/18/2006
RECEIPT # . . . . . . . . . : 34447
REFERENCE ID # . . . : 06050162
SITE ADDRESS . . . . . : 10387 MIRA VISTA AV
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : MARTHA KANG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : MARTHA KANG
CONTRACTOR . . . . . . . : NATIONAL CONSTRUCTION RENTALS LIC # 22537
COMPANY . . . . . . . . . . : NATIONAL CONSTRUCTION RENTALS
ADDRESS . . . . . . . . . . : 1355 FILIPE AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95122
TELEPHONE . . . . . . . . : (818) 221-6057
�EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BTEMP FLAT RATE 1 . 00 62 . 10 0 . 00 62 . 10 0 . 00
EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 100 .47 0 . 00 100 . 47 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 100 .47 VISA
TOTAL RECEIPT 100 .47
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
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103 UFER 304 ROUGH ELECTRICAL