06020003 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CON'rIZA.CTUR;TN 'UtMAION, .
BUILDING ADDRESS: CLEAR CHOICE ps"MITNO'06020003
21837 MONTE CT
leER'S NAME: PERMIT ISSUE DATE
YUANTENG ZHANG 325 LOS GATOS-SARAT 02/01/2006
PHONE: SANITARY NO, CONTROL NO.
(408) 213-1128
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
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pp LICENSED CONTRACTOR'S DECLARATION
I hemby affilm Nat l am licensee under provisions of Chapter 9(commencing Job D lIypItlon`'Vi L
with Section O O
700(r)of Division 3 ofthe Business,and PmfcWou Code.and my licrm is
p to fell tome
meq"" and200 MP UPGRADE
LImN t •, • 2006
L
ARCHITECTS
DECLARATION
I understood my pleas shall W used As public mmrM n 1f IJ,LI
Licensed
y G] Licensed ProfenI... kftl I[t#IIf'lq( IIL$T:J!3 U
OWNER-BUILDER DECLARATION
iy�E I thereby affirm that I am exempt from Ne Commmi rs License Law for the
02 following mason.(Sceh m 70313.Business and Profession Code:Any city or County
which enquire a Permit to onstmcs,alter.Wpron.demolish,a mpM my elm one $3200
_ y prior to its issuance,also require the applicant for such permil to Ole a signed mmmcm
<
that he is licensed pursuant sen provision of the Contracurs License law(Chapuf 9 Sq.Ft.Floor Area Valuation
(commencing with Section TODD)of Division 3 of the Buainea and Penns OuS Co tis)Or
that he is exempt therefrom and the bub for the Wetted exemption.Any violation Of
Section 7031.5 by any applicant for a permit subjects the applicant m a civil petWty of a Occupancy Type
rot mom was Ove hundred dollars(SSM),
❑I,an owner of the property,Or my employm with wages As their sele compenaaton,
will do the work and dus "onm is not uuWcd uOBemd for sale(Sec.7016,Business Required Inspections
and Pmfestlau Code:The Commences Licwe law dm rot apply m an awm of q P
property who Wilda At Wproves thereon,and who deessuchmnk himselfor Wough his
own employees,provided that men Improvements am notin ended orortemd far Wa It,
howem,the building or Improvement Is Sold within arc year of completion,the owner.
builder will be"Om burden of proving that he did Sol Wild or improve for Purpose of
sakJ.
❑1,a Owen of the property.am exclusively contracting with Keened conuactm to
contract the project(Sec.7044.Business and pmfesions Cade:)The Communes U.
cave taw dm not apply in an Owner of property who Wilds or improm Income,and
who contra for mch pmjecm with a conuactor(0 licensed Inurement an the contractors
License Lew.'
❑14mexemptunder See .BkPCfuthismamn
u Dau
WORKER'S COMPENSATION DECLARATION
I Wmby affirm under peulty of perfuy arm of the following declandou:
❑1 now and will maintain sCerdOcam of Covent m self4mum far Worker's Compete
cation.u provided for by Section 37W of the Labor Code.for the performance of the
work for which this permit is issued.
❑1 have and will maintain Workers Compensation luurmce,An required by Section
3700 of the tabu Code.for the performance of n work for which this permit is issued.
My Workees ,oro ns tion1 urmsecaurierand Polmynu�m/bbenam:
purer. S11 .N3.:
CE PICA OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thissection need hent hecanpleand lithe permit b for onc hudmd dollani($10(l)
or les)
I certify that in the performance of the work for which this permit is luted,I Mall not
employ any person in my manncrsu as to become subject in the Wod¢rs'Compenudon
LAWS of California.Dau
Applicant
NOTICE 70 APPLICANT:It,after making this CeniOute of Exemption.you Mould
become subject in the Work&,Compenndon provisions of the labor Code,you most
O forthwith comply with Such Pmvisiau u this permit Mail W comment revolted.decrevolted. - .
,z., CONSTRUCTION LENDING AGENCY
I hereby alarm that them is acoutmctin lending agency for the performance of
lY> the work fee which this permit b issued(Sec 3097.Civ,C.)
a Q lenders Name ,
lenders Address
U 1 costly that I have and this application and sum Wt dm town information is
V,r"'! cornea.1 agme be comply with all city and county ordinances and sum laws mbdng to
0 SV' Wilding conswnion,and hereby authorize mpmsmutim of this city to cntu upon the
Cgl Mon-mentioned property for inspection purposes
G (We)agree be an.indemnify and knee harmless the City of Cupertino spial
y liabilities.judgments.cuts and expenses which may in my Soy amara agent said City
s,)7 in consequence of the Slon ing of this permit.
F7 APPLICA�R�AND WILL MPLY WITH ALL NON-POINT Issued by: Date
SOURCE UL S.
02-0 -o�o Re-roofs
Signetum al'Appliem onum r Dam
HAZARDOUS M ALS DISCLOSURE Type of Roof
Will the appllant or future building Occupant pose brhaMlc hasandou material
IldeRud by n CupeNno Municipal Code,Chapter 9.11,and the Health and Safety
e.Section 155310)? / All roofs shall be inspected prior to any roofing material being installed.
[:]Ye 04.
Will the applicant or future Wilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hanshms air control nants as de0ncd by the Bey Anne Air Quality Management all new materials for inspection.
District?
❑Ye
1 have red the,hunudousmauriala requirements under Chapurb.95 often Califor•
nb Health k Safety Code,Secdm 73505.15533 ad27534.1 understand thatitthe Wilding
dm not curse veamnanL den it my u 'ilYim
ant of the
requimmc whi m tprior Signature of Applicant Date
y Owner or authorized agant m All roof coverings to be Class"]i"or better
Community Development
10300 Torre Avenue
✓� Cupertino CA 95014
Telephone(408)777-3228
�PCITY OF EI�TINO Fax(408)777-3333
Building Department
JOB ADDRESS: 2/J?3 7 /1iOvle ' PERMIT #
6Zoa�3
OWNER'S NAME: 4,4nl¢w PHONE # yo (o —5 78a'
GENERAL CONTRACTOR: , FAX #
I am not using any subcontractors: e-2— V/-0(0/
SignaturC Date
Please check applicable subcontractors and complete the following ' ormation:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: 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
Owner/Contractor Signature . Date
CITY OF CUPERTINO
ILYIti 1 of 1 PERMIT RECEIPT OPERATOR: kiereaw
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32619073.00
DATE ISSUED. . . . . . . : 02/01/2006
RECEIPT #. . . . . . . . . : 33034
REFERENCE ID # . . . : 06020003
SITE ADDRESS . . . . . : 21837 MONTE CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : YUANTENG ZHANG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . CA
RECEIVED FROM . . . . : CLEAR CHOICE COMPANI
CONTRACTOR . . . . . . . : GREG SHARP LIC # 26300
COMPANY . . . . . . . . . . : CLEAR CHOICE
ADDRESS . . . . . . . . . . : 325 LOS GATOS-SARATOGA RD.
CITY/STATE/ZIP . . . : LOS GATOS, CA 95030
• TELEPHONE . . . . . . . . : (408)213-1128
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW HAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BENERGY PERMIT 'FEE 1.00 34.86 0.00 34.86 0.00
BELEC200 METERS 1.00 29.43 0.00 29.43 0.00
BSEISMICRE VALUATION 3,200.00 0.50 0.00 0.50 0.00
EPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00
BUSLIC FLAT RATE 1.00 105.00 0.00 105.00 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 208.16 0.00 208.16 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 105.00 5201
CHECK 103.16 5202
TOTAL RECEIPT 208.16
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
0
ON CITY OF CUPERTINO �toOaOc��
li
0 PERMIT APPLICATION FORM
CUPEkTINO
Date:
02
Building Address: ✓v � pp 7 Mailing Address (if different.from building address):
Z 041 C-- -
Owner's Name: Phone#:
UOS- 92- 57- 7s 9
Contractor: License#:
Contact: Phone: ypa - 7G/-yq Cupertino Business License#:
* Fax:
Building Pemrit Info: /
Bldg ❑ Elect 9 Plumb ❑ Mech ❑
Job Description:
Residential Commercial ❑
Sq.Ft. Floor Area: 0q.Ft.:
Cost of Proiect: Occupancv�ouR
I J1
Type of Construction: Please check this box if the project is a
' v N second-sto addition: ❑
roect Size: Standard l� Laze ❑ Ma'or ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL
BB.,OILER3. Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1-.75*M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
13CONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for B Q 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
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�. CITY OF CUPERTINO
CUPERTINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOM vM New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIMB 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 Lawns rinkler/Backflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER InstalVAlter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Fumace MECHANICAL
BREMFURNOV ReloF=ace> IOKbtu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood DH;CHANICAL
BREMMLSC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BRFN20LE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Devi ce/App aratus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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CITY OF CUPERTINO
CUPEIZTINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTIEATR Theatrical Li&ti2g Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electdcal sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MYERMITFEE 114ech Permit Issuance MECHANICAL
PPERMITFEE Phimbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Chane BUILDING
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