03010019 CITY OF CUPER•I'INO r',
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: YUANPENG ZHANG PERMIT NO.
21837 MONTE CT 03010019
OWNER'S NAME: APPLICATION SUB DATE:
YUANPENG ZHANG 01/06/2003
PHONE: SANITARY NO. CONTROL NO.
ARCI IITEiCfIENGINEEiR: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECll
Met, LICENSED CONTRACTOR'S DECLARATION
U U 1 ncrehY affirm mal 1 am licensed under provisions of Chapter 9(commencing Job Description
w with Section 701XB of that
3 ofthe Business and Prmevaionx Code,and my rcerm is
a in full force andeffeel. REMODEL KITCHEN/BATHRMS &
201fi'� License Clens Lic.N
Olt, Dale Comacmr REPLACE GARAGE DR. /WINDOW. Fa.���
�'5tj ARCHITECTS DECLARATION LE®
isa 1 undersunJ my plans shall M uttJ as public recoof,
6owu
1 LL01 LiccnceJl'nrfcssin^a1 APR 2 5 003
OWNER-BUILDER ifr DECLARATION
efa" 60 I hereby affirm that I am exempt v a @c Contractors Co :Any c Law for the
w 11 O o following reason.(Section II13L5.Business and Profession Calc:Any city Or county
u X m� wnirM1 reBircs a permit to cores the alar.impnwe,demolish,or repair any suucmre BU
w—m matte s ernaarce.also dpursuantto der,the provisions
ofthe ontrucmit uLieco Lra, nmcmcnt
�i< that he is licensed pursuant to the provisions of the Cnnmucmr's Liccnm law(Chapmr9 Sq. Ft. Floor Area Valuation
(commencing will Sttthln7IXIB)of Division 3 of the Business and portentousQsJe)or
that he
y — is exempt Ocmfnm and dreas;bfor m $30000
e alleged exemption.Any violation of 4
Section 7031.5 by any applicant for a permit subjecu the applicant o a civil penalty of APN Number Occupancy Type
not more thane hundred dollars($500). 32619073 . 00
❑ I.as owner of Bee property.or my employees with wages as Ned sole compensation.
will Jo me work.and the structure is not intended or offered for We(Sce.70&1,Business
said professions Code:lTe Conm secs s License Law dues not apply to an owner of 101 - FOUNDA',-_ M,d Inspections
property who builds or imporm thereon,and who docssuch work himself or through his
Own employees.provided mataach improvements are not intended or offered for sale.If. 102 — PIERS
however,the building or improvement is sold within one year of completion,the owner.
builder will have the burden of proving mat he did not bails or improve for purpose of 103 — UFER
sale.). 104 — REBAR
1,as owner of the property,am exclusively contracting with licensed contractors to 10 5 — ANCHOR BOLTS
construct the project(Sec.7(W!.Business and Profession.,Cale:)The Commmom's Li-
scladoes not apply manowner ofproperty who builds orimproves thcreon,and 106 — SEWER & WATER
Li-
cense
o contacts for such projects with a contranovs) iaanor:
licensed pmorod to the Ct ' ' 202 — UNDERFLOOR PLUMBING
License Law.
)]lam exempt oder Sea ,B&PC fmthisrcazon 203 — UNDERFLOOR MECHANICAL
Owner G('1 m 1-6—o 3 204 — UNDERFLOOR FRAME
WOgnoburPENSATIONDECL ATION 205 — UNDERFLOOR INSULATION
I hemby alum+under ponaBynrperjury one urine following declarations: 301 — ROUGH PLUMBING
1 have and will maintain aCenibcam of Consent to self insum for Worker's Compcm
tion,as provided for by Section 3700 of the Livor Code,for the commerce of the 302 — TUB & OR SHOWER
work for which this ,.I,isismed, 303 — ROUGH MECHANICAL
1 have and will maintain Worker's Compensation Insurance,as required by Section 3 04 — ROUGH ELECTRICAL
371X)of the labor Calc,for de performance of the work for which this permit is issued.
My Worker's Compensation lnsuance carrier and Policy muni art: 305 — FRAME
Carrier: policy No.: 306 — HOLDOWNS
CERTIFICATE OF EK EMP]ON FROM WORKERS'
COMPENSATION INSURANCE 307 — INSULATION
moseedrm neednor308 - SHEETROCK
MmmDlemJi(Urc permitisfnn+rehundrtJdollars lSllgll
..leas') 309 - EXTERIOR LATH
1 ccnify that in rive perlimmancc of rive work for whicihc Cthis permit m issued.1 shall not 310 — INTERIOR LATH
employ any per in any man sn son M'nmcs T iO the Wnrkcrs Cnmpcnsmion
aw.,orcal — 311 — SCRATCH COAT
Applicant
NOTC- OA IC aft tpg thisCeoirmmcofExemption,youshould 313 — ROOF NAIL
hca+m ubjemromework :c en AtmproviahrnonheLaMacode.roulpas' 501 — FINAL ELECTRICAL ENERGY
O O forth stn comply with such provisions or this permit shall ho deemed revoked. —
? 0 CONSTRUCTION LENDING AGENCY 502 FINAL PLUMBING ENERGY
P 4 1 hereby affirm Oat there is a consumption lending agency for the Performance Of 503 — FINAL MECHANICAL ENERGY
C > the work for wrich this hermit isissurd(See.30D.Cm.C.) 504 — FINAL BUILDING ENERGY
W 0 Lender's Name
a, Leader Address 505 — FINAL ELECTRICAL
UO 1 certify Nat 1 have read this application and sum than the above information is 506 — GAS TEST
f•' come,.l agree to comply with all city and county ordinances and sum laws mlating to +
U building wnswnion.anJhereby autho aaprc Doti xofthisciymcnmrupmth 5 FINAL PLING
abnvomentioned unfairly for inspection pur,awas. OB AUMB
L
(We)agree lu mve,indemnify and mcp harmlem the City N'Cupcnino againm.F. fA liabilities.juJgmcnu,costa and expenses which may in any way attac against mitl Ciry 5D / / 7V Z in consequence of live granting Of this Permit. I( �f0 C/�.APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL ON-POINT Issued by51 - NG Date
S RCER, ULATIONS.
G Re-roofs
Signature
air APplican naqq I Dam
HAZAIW0 ATCRIALS DISCLOSURE Type Of ROOF
Will me at"Beam orrmone wilding uccuparn.vom or handle hamd..o mamdal
as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code.Section 25532(a)'I All roofs shall be inspected prior to any roofing material being installed.
0Yes J2(Nn
will the aPplicum or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
hamodous air comamimmor as defined by the Bay Arca Air Quality Management all new materials for inspection.
El j
Yo; ftlYeA
1 have mad the hwerdous materials m1mo men s under Chapmr fi 95 of the Califor-
ninHeahh&Smmy COdc.Scamnew 25505.25533 and 2553x.1un4 d¢huiWing
does Out currently have a reason.that it is my ms@+nibilly mnodl r t <upanulfmc
rcquiamcu wmhm�athemeI r;omiaau cofacenmcamor paney. Signature of Applicant Date
I - 6- All roof coverings to be Class "B" or better
ecrortudiQifiveJagot Dam