06090030 CITY OF CUPERTINO a •� e z"<< e.
BUILDING DIVISION PERMIT CONTRACTQR TNFOR
, MATION, ,
m N .
BUILDING ADDRESS: FUR CHEUNG HO PERMIT"006090030
18615 RALYA CT
OWNER'S NAME: PERMIT ISSUE DATE
QI LIN 647 TORREY AVE 09/29/2006
g; SANITARY NO. CONTROL NO.
(408) 605-9807
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
j LICENSED
C u s 1 hmm that affiramliconaes!under DECLARATION
with Sprovisians ofChapel9(commencing
Job Description
iZai Section 3 of the Business and Professions Code,and my license is
�F in fall force and effect. REVISION- SIMP . STRONG WALL IN GARAGE WITH SW
34License Class Lic.g
-mo o Dam Contractor 22 X 7 X 6 — 7/8"0
'££� ARCHITECT'SDECLARATION ORIGINAL PERMIT# 05060155
E W U 1 understand my plans shall he usedused as az public¢emus
C Lbecrosel professional
3 OWNER-BUILDER DECLARATION
i S I hereby oIf.that 1 am exempt tram Ne va
Cancrors License Law for Ne
0 O following reaness son.(Second 7031.5,Busiand Proa fcssiuCoda:Any city or county
I
m which requires a pedmia to conwuel aper.hnprose,dcmnlLN,or repair any swcto.
^I< prior m ca its alsu dequirthe applicant for such Permit m file a signed aumm
mn
RQ that he is licensed pursuanttothe pmvislonsofdicCOntrcctur'sLiconseLaw(Chapter 9 Sq.Ft.Floor Area Valuation
$ (commencing with Section 7")of Division 3 of the Business add Professions Cose)or $140306
— that e is esempt dertfmm and Cc basis for the alleged resumption Any violation of
Section 7031.5 by any applicant for a permit subjects to applicant to a civil penally of APN Number Occupancy Type
not more than firm hundred dollars(SSW}
p I,uowner ofthe Property.Ormyemploye.wit wages.deirukcampe.atian,
wit ea to work,and thcarrunureuoatmmndcd Or orteree faraalefscr.70N,Business aired Inspections
slid Pmfessiaa Cade:The Conuacmrs License Law does not apply m Re an owner of q P
property who Wi lds or im proves demon,and who does suc h wart himself ser through but
wnemployers,provided tat such improvements art undiminished orofferW for sale If.
however,the building or improvement is sold within one year of completion,to owner-
builder will have the burden of proving that he did rat Wild or implaw for purpose of
.U.).
• I.a Owner of to pmpcny am exclusively conv.6ng with licensed mnuanors in
,met the.led (Sec.7044,Business and property
wh i In Code:)Teves thectn Vit
loss,Law docs not apply m.......f prapeny who builds or improves Cordon,and \
who.Line.ufor such projects with a contneaor(s)Iicenae0 Puranam m to Contractor's
Litz
❑ lam empt sue .B&P C for is season
der
a-
WORKER'S PENSATI URATION A �
1 hemby afro under ponelty,of perjury one of to fallowing declarations:
❑1 hare and will maintain a Certificate of Consenuo self-insure Ira WOrkeraCompen-
souon,we Provided for by Soldiers 3700 of its,Labor Code,for the performance of the
work for which his permit is issued.
❑I have and will maintain Workcra Compcnsatiun Ruunnce,as required by Second
37W of Co labra Colic.for the performance of de wardi for which this Permit is issued.
My Workers Compenaatidn launrec carsior atW Polity number arc:
Cartier: Polity NO.: _
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(ITIS section..door be camplcmJ irde permit is for one hundred dollars(SIM)
or less.)
I certify tat in de porformanec Of the work for which tis Pro h u issued,l shall not
employ anyperson in any manncrsoazmecome subjcc Wmscri ompensation
oflaws of California.DatApples
Laws nr
NOTICE TO APP f r making rsc nm of Eaoof pt
become subject in the Wohcr's Compensation provisions of the labor Cade,you must
.J O foMwid comply with such provisions or this permit shall be decided revoked.
Z` CONSTRUCTION LENDING AGENCY
[—t Iherchy affirm that tem is a communion lending agency for the peremmnrof
FL> the work for which this permit IS Lssered(See 3W7,civ.C.)
600. Q Londonm
Nae
g" ..
Undoes Add.
U Q I certify that 1 ham mad this application and state that the above informnum is
(y f" correct.I agree to comply with all city and county Ordinances and state laws missing to
0 building construction,and hereby audhorim mpmunutiaes of this city to enter upon the
a1Wm mentioned property for inspection pugroses.
(We)agree in save,indemnify and keep harmless the City of Cupertino against
.F.fn liabilities,judgments.costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NO POINT Issued by: Date - 'z�.g
SOURCE REG NS./f/i ,^
Signature of App uComr'd6rc --Y " Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building mcupant store or handle hvardous material
.defined by the Cupertino Municipal Code.puprer 9.12.and the Heald and Safety
Cock,Seem.25532(ld? ///111
40 ❑Yes )(No All roofs shall be inspected prior to any roofing material being installed.
Will she applicant or furo`re Wilding occupant use rquipment Or devices which If a roof is installed without first obtaining an inspection,I agree to remove ,
coil]MOm ous it conumirem"as defined by the Bay Arca Air Quality Management all new materials for inspection.
District? ✓✓✓
❑Yes B No
1 have mad be hvarddws id-lbik requirements under Chapter b 95 or he Califor-
nia Health&SafmyCOde,SOCUM,2596.25533 and 25534.1 understand that if the building
tines Out emOcntly have a tenant that It Ice my,responsibility is notify'de occupant of to
requimmcros which muss prior Or arms ora Ccmficam nice
Y Signature of Applicant Date
IC All roof coverings to be Class "B"or better
Owner or amhorir<e ascot Dam g