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BUILDING DIVISION PERMIT
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BUILDING ADDRESS:
WELKIN INTERNATIONAL IND I
MITNcb4120093
10260 PHAR LAP DR
OWNER'S NAME:
PERMIT ISSUE DATE
WEI-SHIN CHOU
19925 STEVENS
NE:
SANITARY NO. - -' ' ' CONTROL NO. -
(408)252-3396
ARCHOECf/ENGiNEER:.
BUNTING PERMIT INFO
BLDG ELECT PLUMBMECH ”
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LICENSED CONTRACTOR'S DECLARATION
- Job DBSCflpu00
1 hereby 'from Nn I am licensed under provlsians or chapter 9 (commeming
with Suiten7")d Division Sof the Basin. and Professions Coda. and my license is
mmnf. andeBul.
REVISION -CONVERT POWDER ROOM
o mrtxeaas. Lk. trrxem
TO FULL BATHROOM
ARCHOTC17S DECLARATION
1 undetatand my pians shall be used as public mcords
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Liccnsed Professional , ..
. - OWNER-BUILI)k DECLARATION
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I hereby affirm that I em numpt from the CONOuster{ License law for the
following mason. (Sudan 7031.5, Busines, and Profession Code: My City or roomy
which requires a Permit to Construct. alter, improve, demolish, Or repair any MUMMO
prior to its iseuauc, ithm requires the applicant for such permit to rile a signed sammcm
dm he is licensed pursuant to the Provisions of Mm Comractors License Law (Chapter 9
Sq. Ft. Floor Area
Valuation $0
(cmmmencing with Section 70D0) of Division 3 of the Business and Professions Cade) or
that he is exempt therefrom and the basis far to alleged exemption. Any violation of
APN Number
Occupancy e
p YTyp.
Sedan 7031.5 by airy applicant for a permit subjects the applicant m a civil penalty of
nota mMancawhundredsdcllan,(M).
32639027.00
❑ I'm ownerof Mm property, ormyemployera with wages" thebsele Compensation,
_
Required Inspections
e
.7a ,BaMneaa
willdothewark.anduteawnumlanoummndedwoner foraale(Seans
License Law demol apply m an owner or
and ProressiaCade: Tate Coctores
nt a
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property who builds or Improves thereon, and who does such work himself or Waugh his
awn employees, provided that such lmprowmuu art not intended or offered fare state. If.
however. Me building or improvement is mid within hem year of completion, Ne Owner-
-
holder will have the bardrn of proving this o did not Wild or Improve for purpose of
cola.).
1. as owner of the progeny. am "elusively convecting with licensed ommu ren to
mussed Mm (See. or rope Codei 7h Cmhemon.
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who Whiston,
to an wneBusr
Mmtean.and,
es not Property and,
ttnselaw doesnotor woepursuant
who contracts far each projects withecontracmr(a)Ilunsed punuammlhe Conuutorh
suchplymmaith a
-- --^-•T - , -- �`
Licvrse Low.
❑lam esemptu Sec ;Bk PC for Wsrrasm
vena Dam D
-'Q ""' "'
WOR 'SCO NSATIOND R O •-
hem y e(BOn under pen of perJury ore of tlm Ile g daluatians:
_ _ .
Iha=1 -1
dwillmuntaine Cerdficam of Cotuent to a\If-Insure fo rkeh Compen-
_ - - "
urian, u provided fu SmUon 3700 of the labor Code, far Mie Hermanoe of the
' - ' - -
workforwhichthispermitisissued. • -
❑ 1 haw and will maintain Worker's Compensation Insurance, as mqulred by Section
- - - - — • .:•-_ t •
37WofNclaborCada, fu Use performance ofthe woh for which this permit is ieaud.
.. ` -
MyWorkersCompensationlnsurancecarrierandPolicynumberam:
-
Cartier, Polity No.:
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CERTIFICATE OFEXEMPTION FROM WORKERS'
'
COMPENSATION INSURANCE
(This section need not bmcomplemd ifthe permit Is forone hundred dollars ($100)
or lose)
1 unify Net in sic performance of the work fu which this permit is issued. l snail not
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employ any parson In any mMmr an, as m become subject to f Workmf L'arepenaadan
-. .�.
lawsof Califomla. Dem
- ..
Applicant
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NOTICE TO APPLICAND IC alcor meting this Cenificam of Exemption, you Mould
become subject m Mm Worker's Compenutlon provisions of me labor Cattle. you mot
forthwith comply with such provisions or this permit Moll be deemed mated.
CONSTRUCTION LENDING AGENCY
,
I hereby affirm that Nem ler construd an lending gemy far the performance of
the work for which this pernut is issued (Sec. 3097, Civ. C.)
Lsndees Name
Leaders Address
I certify that I ow red this application and sum mu me show information is
"
cor I Mgme, in comply with all city and county aNinsreas and state laws misting to
building conMwction, and hereby authorise representatives of this city to cnmr upon the
above-memioned property for inspection purposes.
(We) 49. to ave, indemnify and keep harmless the City of Cupertino against
j IlabiliMes,judgments. emu and expenses which may in any wayaomue against said Cly
In Consequence of the panting of this permit.
APPLICAT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date
SOURCER ATI
Re -roofs
Type of Roof
cure pplicanVCon em
xnznR o
MAigneo
ua
WIIl the applicant orfwum WlldingaavPant seam or khrrWons material
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as defined by the Cupertino Municipal Cede. Chapter 9. 12, and the Health and Safety
Cada. S cdon 355330t)7 ..JJJJJ
Dyes XNa
All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building Occupant use equipment or devices which
emit haunlaus air contaminants u dcMed by the Bay Am, Air Quality Management
all new materials for inspection.
Diwia7 • '
CYes hDN.
I have mad the haurdouus'''maicriats requirements underchapmr 6.95 of the Collar.
niaHuttha Ssfctycade,Senmm 25585, 25533wW 25534. t andeuwtd MwBMm building
docs not Currently haw a Conant, that it is my responsibility m manly the occupant of the
reyuimme hien bCmetpdormi aneaer nlficamorOccupancy.
Signature of Applicant Date
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All roof coverings to be Class "B" or better
wee awhorixed egcnl m