08040015BUILDING ratVISIONI ` PERMITf'1.1.1�C+7✓.""
BUI 1 G DRESS:
�4�° PLUM BLOSSOM DR
AAA ELECTRIC
PERMIT NO.
08040015
OWNER'S NAME:
PERMIT L95UH DATE
WANG JIN C A AND VICTORIA
3249 STEVENS CREEK BLVD
04/03/2008
PHONE:
SANITARY NO. CONTROL NO.
(408)557-8899
CHITECl/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB - MECH
0 0 0 0
j LICENSED CONTRACIOWS DECLARATION
Job Description
P
1 hcrcb affirm mut I am liceucd under provbiopppsss of chapmr 9 (commencing
3 with See )ar rvlmon3arumanonesygpdPreByt'uOadj amlmyncmuela
REPLC MN PANEL(UPGRD TO 200 AMP)
n in full fume an eR lT1Li ((
MCI Lia. N
Dam Contractor
ARCHITECTS DECLARATION
1 understand my plans shall be mind in public record,
U
Licensed Professional
OWNER-BUILDER DECLARATION
I hereby slim that l am u)mpt from the Contractors Licenm Law far mm
reticeO ing moon. Business and um Co dc: Any city err ca
aura improv), demolish. pair ane
arch t comment,w. de or
which rcquirts a Permit ac
which
umn am
mires due t ed
also requites the inion Of for such pentiuo file a LaM smlemem
y prior b its issuance. e
<(cnhe is to the 6w
Sq. Ft. Floor Area
Valuation
wit pursuant
Cnde)
Bminmaand Code)
Business
$2000
or
ion ofDivimmaror ft and Professions or
til s,
B bes for them
.. b eaemps 0crerrom and the bub for the alleged )¢¢ante Any violation of
that(cohe s exampthherefrom and the
that
e.i31�T Number
36610065
Occupancy e
P yTyp
Section ,permit mhjccb the applicant to ,civil penally of
ant ¢ort than neve hmnama daBua ($500).
.I.. them 11.
.'VV'
I, as owner within property, or my employees with wages a their sale compensadon,
Required Inspections
will do thework, and thetsmclue 13 rmumended oronercd formula (Sec. 7D44,Businw
and Profession Cattle: The Communities Liam) Law does not apply be an Manor of
9 P
property who builds a improves thereon, and who does such wart himsel f or through his
Own employees,providedthat each improvcmuls are wt intended oraRered for aide. If.
bee ever. the building or improvement Is sold within on your of completion, the menta-
Wilder will have the burden of proving that he did not build or imprave for purpose of
ale.).
(] 1. as awn. of rhe Property, am madusively contracting with licensed comractors to
construct the pmje. (Sec. 7814. Business eM Formation, Code:) The Commcmr's U.
corms law tlas not apply to an ownmr of property who build, or improves daemon, and.
who common; for such pmjecu with a commends) licensed pursuant to the Contractors
License Law.
❑ I are exempt under See , B Its P C for this mount
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 hemby win m uMcr permit of perjury an of the following deelan0on:
I ham and will maintain • Certiry mof Covent M.lf luum f. Workers Compem
n, u provided for by Section 3700 of the Labor Cade. for the performance of the
dr far which this permit is issued.
I hate and will maintain Worker) Compematln, IaSUMa, as acquired by Section
7700 of the labor Code, for the performance of the winds for which this permit is bound.
My Workers Compensation Insurance seri. and Policy number we:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
..
('fhb seemon wed wt be com pleted it the permit Is foram hundred dolbra ($100)
nr leu)
1 certify that in da performance f e wph r which this Permit is Wood. l shall not
employ anype ni any ma INAac a subject a the Workes'Compensamin
Laws of Glif am �((//
ApPliant
NOTICaTb_API(12116AW If. ells ,king Ceninum Exemption, you
nshould
in=
Co pcndtlon pmvbihal of Ne rah¢ Code, you mtn
becmne subject the Wmh r n p the
fMMwith comply with each prevision or this Permit shall he Mimed rooked.
y e
CONSTRUCTION LENDING AGENCY
I hemby aRm that Nem is a construction lending agency for the performance of
' the work far which this permit is bawd (Sat. 71197. Civ. C.)
Zanders Nmc
lenders Addrus
z
') 1 certify that I have need this application and sum that the about infannatian is
Carmel. I agree to comply with all city and county andinawes and sum lam elating to
jbuilding commoution, and hemby aulboden mpmsermam ordain city to on= upon the
move-mentioned property for Inspection purpoms
y (W)) mg. to ave, indemnify and keep harmless the City of Cupcnina against
n !iabili "Judgminets,col dexpenses which maymanywayaeerw intmid City
in canseq eco g of thb pastil.
'+ APPLIC N DS D LL COMPLY WITFj AI, NONr
Issued by: Date
SOUR R U +iy
Re-roofs �-
Si ApplicaHDataHAZARAZAR
nuurt of
HAZARDOUS
S MATERIAu psSCLOSURE
Type of Roof
Will applicants m forum building store or handle oat manorial
u dcM)d by the Cupertino Manan" CaM. Chapter 9.13. mtl the H.Ith and safety
y t e. Chaps Hinalt
Code. Section 25532/,)?
All roofs shall be inspected prior to any roofing material being installed.
❑Yes - No
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or fulurt building Occupant use equipment or devices which
11 hmssdnus air comaminnb as defined by the Bay Area Air Quality Management
all new materials for inspection.
Met?
IO
❑Yes N
I hie mW the ha�idI ria] isemab under Chapterb.95 of Cables.
ria H)alth&SafclyC oro 50 5"33t225534.1 unMlsmntl Nui building
don itot currtmly h a et i utuny he notify Jae up of tryk
rtquimmcnu whit o ficsmar P fa/
Signature of Applicant Date
All roof coverings to be Class'W' or better
Owner err authariac0 )gem nam
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT
Sec: Twp; Rng: Sub: Blk: Lot:
APN ........: 36610085.00
DATE ISSUED.......: 04/03/2008
RECEIPT #.........: BS000004342
REFERENCE ID # ...: 08040015
SITE ADDRESS .....: 7445 PLUM BLOSSOM DR
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
OWNER ............:
WANG JIN C A AND VICTORIA
ADDRESS ..........:
7445 PLUM BLOSSOM
CITY/STATE/ZIP ...:
CUPERTINO CA, 95014-5303
RECEIVED FROM ....:
AAA ELECTRIC
CONTRACTOR .......:
WILLIS TANG LIC # 27828
COMPANY ..........:
AAA ELECTRIC
ADDRESS ..........:
3249 STEVENS CREEK BLVD
CITY/STATE/ZIP ...:
SAN JOSE, CA 95117
TELEPHONE ........:
(408)557-8899
• FEE ID UNIT----- QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
-
---- --- -------------------- ------------------------- ---- ----------
IBSEISMICR VALUATION
2,000.00
0.50
0.00
0.50
0.00
1EPERMITFE FLAT RATE
1.00
40.79
0.00
40.79
0.00
1TRAVDOC FLAT RATE
1.00
40.79
0.00
40.79
0.00
TOTAL PERMIT
----------
----------
82.08
----------
0.00
----------
82.08
0.00
METHOD OF PAYMENT
-----------------
AMOUNT
REFERENCE
NUMBER
---------------
CHECK
82.08
-----
#1226
--------
---------------
TOTAL RECEIPT
82.08
0
0�og06/
w o CITY OF CUPERTINO
i o
CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# to D p5r O
Date: i% Q
Building Address:
Mailing Address (if different from building address):
Owner's e: r� �
Vf G oer A
Phone #:
Contractor
Phone�l(arp
Fax:
Contractor License #:
Cupertino Business License #: c27?
Contact:
` `
Phone'
�i '/'�O
Fax:
Residentiwo Commercial 11
Job Descri tion:
ct ,J , A-1v2k C bfP 10AW 2,6v�
Building Permit Info:
Bldg ❑ E Plumb ❑ Mech ❑
Type of Construction (Usage Class):
Occupancy Type:
1 FR, I IFR ❑ 11, 111,V -IHR ❑ 11, 111, 1V V -N
3
Valuation: 9 Square Footage:
,-1,00U —2 --
Project Size: Standar6E' Large ❑ Major ❑
0
CITY OF CUPERTINO
GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
1 BTEMPPER
Temporary Building Permit (good for
B
30 days)
1BBOILERI
For the installation or relocation of ea
M
boiler/compressor to & including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h 29.3kw
IBBOILER2
Installation /relocation of ea
M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption ss over 100,000 Btu/h
1BBOILER3
Installation/relocation of ea
M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ea
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
1BBOILER4
Installation/relocation of ea
M
boiler/compressor over 30 hosepower
to & incl 50 horsepower, or for ea
absorption sys over 1,000,000 Btu/h to
& incl 1,750,000 Btu/h
1BBOILER5
Installation/relocation of ea boiler or
M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1BAPPLOTH
For ea appliance or piece of equip
M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
IELECINSP
Other Electrical Inspections (per hour)
E
1MECHINSP
Other Mechanical Inspections (per
M
hour)
IPLM13INSP
Other Plumbing & Gas Inspections
P
(per hour
1MEETING]HR
Application Meeting
B
0
is
G� CITY OF CUPERTINO
CUPEf�TINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
0
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW
SFDWL/Duplex New
B
IACOUSRESAD
SFDWL/Duplex-Addition/Alteration
B
IACOUSCOM
Multi-Family/Commercial
B
CHIMNEY'S
1CHIMNEY
Chimney
B
1 CHIMNEYR
Chimney Repair
B
FENCES
1FENCE>6FT
Non -masonry, over 6 ft in height
B
1FENCEMAS>6
Masonry, over 6 ft in height
B
FIREPLACES
1FIREPLMAS
Fireplace Masonry
B
IFIREPLFAB
Fireplace Pre-Fabricated/Metal
B
1FLAGPOL>20
Flag pole (over 20 ft in height)
B
1MODUSTRU
Modular Structures
B
FOUNDATIONS
1FOUNDREP
Foundation Repair
B
1PILECAST
Pile Foundation Cast in place concrete
B
1PILEDRIV
Pile Foundation Driven (steel, pre-
stressed concrete
B
•
3 of 5
CUPEI,TINO
0
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN
Standard (up to 50 ft)
B
IRETSP310
Special Design, 3-10' high (up to 50 `)
B
IRETSPIO
Special Design, over 10' high (up to
50'
B
1RETCRB<
Gravity/Crib Wall, 0-10'high (up to
50 ft
B
1RETCRB>
Gravity/Crib Wall over 10' high (up to
50 ft
B
SIDING
1SIDESTBK '
Siding, Stone & Brick Veneer
interior/exterior
B
1SIDEOTHER
Siding all other
B
SKYLIGHTS
1 SKYL<10 SF
Skylight less than 10 sf
B
1 SKYL>10SF
Skylight greater than 10 sf or
structural
B
1STAIRS
Stairs -first flight/ea addt'l
B
STORAGE RACKS
1 SRACKS<=8
Storage Racks 0-8' high (up to 100 sf)
B
1SRACKS>8
Storage Racks over 8' high (up to 100
st
B
1STUCOAP
Stucco Applications (up to 400 sf)
additional stucco application
B
CUTS.]
E
11
•
CUPEkTINO
0
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
]GENRES or
1 GENCOM
1 WINREP
Replacement windows/sliding glass
door (ea 8 windows
B
1WINMEWSTR
New Window -structural shear
wall/masonry includes plan ck fee
B
IEPERMITFEE
Electrical Permit Fee
E
1MPERMITFEE
Mechanical Permit Fee
M
1PPERMITFEE
Plumbing Permit Fee
P
1ELCPLNCK
Stand Alone Electric Pln Ck (hourly)
E
1MECPLNCK
Stand Alone Mechanical Pln Ck (hrly)
M
1PLMPLNCK
Stand Alone Plumbing Pln Ck (hrly)
P
1 STPLNCK-(3 Hr Min
when not over counter)
Standard Plan Check (when no E/M/P)
hourly -stand alone
B
/
1BSEISMICR
Seismic Residential
B
1BSEISMICO
Seismic Commercial
B
/
1TRAVD0C
Travel & Documentation
B
1BUSLIC
Business License
B
I.J
WITIV,
Community Development
10300 Torre Avenue
' ✓ Cupertino CA 95014
Telephone (408) 777-3228
CITY OF Fax (408) 777-3333
CUPEkTINO
r j3uilding Department
JOB ADDRESS:
PERMIT #DV 0L/ OO / �
ONER'S NAME:
W
PHONE #
GENERAL CONTRACTOR:
FAX #
I am not using any subcontractors:
411-
st5ai=4ate
Please check applicable subcontractors and complete the following information:
0 Owner/ Contractor Signature
Date
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
0 Owner/ Contractor Signature
Date