00030006 CITY OF CUPERTINO -
BUILDING DIVISION PERMIT - CONTRACTOR INFORMATION:
IIUILDINC,ADDRESS: PERMIT NO
7549 ORANGE BLOSSOM DR 00030006
OWNER'S NAME: - APPLICATION SUB OATH
LEEKO—MET AND YANG SHU—NU ET 03/022/2000
NE: SANITARY NO. CONTROL NO.
O z V. ARCHT rCTIIiNGINEER: BUILDING PERNU IINFO
BLDG HLIACf PLUMB MECH
w
D n LICENSED CONTRACTOR'S DECLARATION
Job Description
Z Z= I hacny shim:that 1 am ieensal$intro nrovi.donn ofrnamar v ma.ntnendng
with 1, bit i700tuof Dlvinie.30 the Iluvi nom,and Protuxsions Calle,andmy liceme
ey in .11lure,andetfcct. REMODEL
O U License Clues I-ic,k
yDar Contractor
3 ae y ARCIIII'ECI'S DECLARATION
t_a O S 1 understand my plant shall be tmed av public records
at p p Licensed I'nifcssinwl
OWNRRI11111.IlElt DECLARATION
W= I eerehy anlnn tea:I an."'Co",Imus tee Commctnr.L¢mtxm Law ILI It,
s-Z
following.,,at (Section 7031,5,throo,o and profession,Cide:Any city or county
fes,F G which q ' peroult Consul II r, rap c J linh 'Clan ny.wcwrc
a,5 m prop t Iso" .theIprca tf h croon t flsigned.tatement
e. — math .m ,alpursuant tto p ': nx of c t t esI a L (Chapte'r9 Sq. Ft. Floor Area Valuation
(eomm nc ns with Secti 7000) f Division
I theBusiness eand et. x code) $70000
or that he is exe.npt therefrom and the basis for the alleged excmp.mn.Any violation
of section 9031.5 by any applicant fee a.permit xuhieetx the appucem ui a Civil penalty
of not mere than ivr M1naleed domirs($500). APN Number Occupancy Type
C)1.asowneronbe pri nuoyemployce,with wages as nimir.wc coniprnsalov' 36611053. 00 .
will Jct the work,and the$euchre is not...tended or nflCrcd to,sale(See.7044. Required Inspections
Nosiness and Pmfcedons Cod,:The Counimor's Liceree Law,does not apply to an q p
ovrthr ofpro�peny Who Wild,or improve,mcrean.and who due,such work himself 101 — FOUNDATION
rough his own employers.provided that such not,ruscumbas are not intended or
uttered for sale If.M1nwevcc the bui.Jiog or improvement is sold within ane year of 2 —
,tnpletlnn.Iheowner.builder will have the burden of rowing mat he rid no.build or "L RtG PIERS
on"ovefor,.pnwofsmc.). 103 — UFER
01.as owner of inepropcnY.ainescmd,cly contracting with:ceasedcoii.mct"st" 104 — REBAR
Construct the prnjem(Sec Tco.Business and Professions Code:)The Commnt
License Law does nm apply to an owner ofproperty who mii.m nr improvms mr a 105 — ANCHOR BOLTS
and who contracts fur such project,with a cimtmctnrpl IicrnseJ punuam ni
Contractor's license laws r 1.06 — SEWER & WATER
❑Ian Csempt majet See. .x&rc[or this reason
owner Dan, — UNDERFLOOR PLUMBING
- WORKER'S CGMPENSmtON DECLARATION 203 — UNDERFLOOR MECHANICAL
Ihereby affirm under penalty ofperjury one othe folloongdeclarations, 204 — UNDERFLOOR FRAME
1 have and will maintain a Certificate of Commit to self-insure lot Worker', 205 — UNDERFLOOR INSULATION
Compmom,.Co. it, n,aided rat by section 37011 of the Labor code. tot he 301 — ROUGH PLUMBING
pcHom.ance ohne wand roe we'�eh ods hent$,ix:.sisal.
0 l have and will oral ain Anokc,\Compensation lnsumnce,as required by Section 302 '— TUB & OR SHOWER
3710 of the Labra Code,for the performance of the work for which this permit is
'"tied. WorkcrsCompe�nmtuiornlnvuranceCarrier and policy nu e: 303 — ROUGH MECHANICAL
cammr TAT&f�'�oicyNo.... 304 — ROUGH ELECTRICAL
CI7 RI I FICAT11NO li%T;MPTIONI' OM )RKE S' -
cOMPENSAr1uNINSURANCE 305 — FRAME
renis..echonnecanothecoapletedinnepematislmone hundred dollars
306 — HOEDOWNS .
HID(Hor Bas.) 307 — INSULATION
I meniry .at in t peHamianCC of work h ,eni this permit.s bsara'1 308 — SHEET ROCK
shall net mss h r on any marmot m m b em to the\Corkers'
nnnpon,"lit� ChfouinDate -� �°r�1 309 — EXTERIOR LATH
NOOI'ICE'IOAI'I'I,IIA saner makins tnl.crduteae of r.c.npien.rot.,howd 31.0 — INTERIOR LATH
become object to A c nkere,Con"C'alon Pmvl.io"x til'Im Labor Cid..you.....
O ronnw;mC,)cply .m ucnprovision,orodapermi,naBlttarrniedrevoked, 311 — SCRATCH COAT
'ONSTRUCTION LENDING AGENCY 313 — ROOF NAIL
1 hemhy of i thio throe is a ctmsweion lending agency for the prfnmtance
nfthe work for which this p<nnhisi...Ca(s..3097.Co,C.) 501 —
FINAL ELECTRICAL ENERGY
(] Lendmr's Name
� z Lainersndihasx 502 — FINRI_ PLUMBING ENERGY
U O 1Certify that Ihave mad[Iiisapplication and sanethameabove mfonnailnis 503 — FINAL MECHANICAL ENERGY
�. F..
Correct.1 g t ply with City J County I cc nal:,am. slat ng
o U orb m s Mh r m p t n=• nn 'tn a tcrapon 504 — FINAL BUILDING ENERGY
me bo t ap ports n:pet port- 505 — FINAL ELECTRICALLY
F0. (Wig ityadkeep harmlessthe City fCrtinglnv
Zl .i,iblt . Idg ....t . spa: Much may in any y m against said 506 — GAS TEST
U4 C11y i t cawegi C 'e l the r n i. .. ... pc rat. /
APPLICANTU .RT )S AND WILL COMPLY WITH ALI NON}/'DINT Issued by: — GTtx101 G) IIMRTNG Dale (J^2'�l(/V
SOURCE RED / ./v- y' �
(2 ELI—
Sigtawm of Applicant/ o tractor nam Re-roofs 500 — FINAL MECHANICAL
H INDUS h1ATERIAIS DISCLOSURE
i Will the applics t rfuture buildingrce,eantstore orhandle hazawouxmaerial Type of Roof 509 _ FINAL GRADE
as define by the C. ioMuni,;ra code.Ch::pmr 9.13.and me Health atw Safely
510 FINAL PLANNING
Code Section 25532(
0Yes is
All roofs shall �ji4pea[e¢'(pp4MLo aPV&L)fM l"@FQM.9)eing installed.
Will theappliicantorfatumlmlldingoccapamuserqulrm=ntordevice,which If a roof is installed without first obtaining an inspection. I agree to remove
•tit ha menus air contaminants as defined by the Bay Area Air Quality M"nagutmm�t
onno
Yes IQ No all new materials for inspection. Applicant understands and will comply with
all non-point source regulations.
1 Co.rea
ut Cum v regni remmotx tinder Chapter(x95 of the
Collfornln lleolthetions 255'5.25593 m.AY551J.l ondm a,"thio
:Rine nuilAing Ae a mount.rant it.amyrespnn ilily mootily themoa be met prior In issumbe of a Cc ifiemC ofSignature of Applicant Dale
yi ��..,ase All roof coverings to be Class "FJ" or better
OFFICE