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08010065CITY OF CUPERTINO �w,ri BUILDING DIVISION .PERMIT :.�dx7s°}r��g�'��}}�a',,�rr�g.y a,c`o ,�ioR,TL�,>Cj©Ll1YJlA1T011 �e BUNDN DDRESS: �1�385 RANCHO VENTURA ST LEON MASONRY INC PERMIT NO. 08010065 OWNER'S NAME: PERMIT ISSUE DAIS TSANG 240 MOSELLE CT 01/11/2008 NE SANITARY NO. CONTROL NO. (408)365-1660 ARCHITECTI ENGINEER: BUILDING PERMIT INFO BLDGELECT PLUMB MECH l� t 0 0 LICENSED CONTRACTOR'S DECLARATION IOW Description 1 heroby &M m that I am licensed under provisions of Chapter 9 (Commencing with Section 7") IqIfDivision 3 ofdte Business and pnefcasions Code, and my Reason is CHIMNEY REPAIR SHOULDER AREA I fu 11 fame and nX Cl_.7p y Lmmon Cl s lei LIc.Y Dem Contncmr Fjgr� IARCHITECTS O F '� 1 understand my plans shall W used as c nxnrd, i Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from we Cantra.ors License Law for the fallowing reason. (Section 7n3l.5. Business and Rofestiuns Cade: Any City Or County which requlrm a permit to construes alien improve, demolish. Or repair any aVYcture ! prior m its issuance. also rcquirns we applicant forsuch permit to file a signed smmment the Contractor's Iiceme Law 9 Sq. Ft. Floor Area Valuation that he is licensed putsuant to the provisions of (Chaplet 3 Business Profession Cant) $3000 (commencing with Section 7000) of Division of the and or : that he is eumpt therefrom and the basis for the alleged exemption. My violation of 3 5 7 010 7 4� Occupancy Type Section 700L5 by arty applicant for a permit subjects the applicanuo a civil penalty ofNumber ore Come than five hundred dollars (SSW). 01, nowscroftlie property, army employes with waguudmiraommmpeasumn, ' Required Inspections e ns Willem the wer"mal thestrucfure is notimmnded afanemd fmsale(Sec. 70th, Butinex and Profunsions Code: The Communes License law does Cot apply On an owner of q p property who build, or improves thereon, end w bo dun such work himself or through h0 own employees, provided that such Improvements ate not intsnded ornacred fmsale. B. however, the building orimpsevemem Issold within am year of Completion, the Owner. build. will have the burden of proving that he did Cot Wild or improve for purpose of 0 1, as Owner of me property, am exclmi ely contracting with licensed mnuanass In conict ere proj.l (Sec. 7W. Business and PmfGVlans Code;) The Contractor's U. twome law dons not apply In an owner of property who builds or improves memom, and - who contracts for such PmjeCw with a eonuutm(s) licensed pursuant on the Contractors License Law. ❑ l am exempt under See. . B & P C for W, mason Own. Da¢ WORKERS COMPENSATION DECLARATION I hcroby starts under Malty of perjury One of the fallowing dmla nohow 1 ham and will maintain a Certificate of Come. m self -insure for Workers Compen- on, m provided for by Section 3700 of the labor Code, for to performance of the work for which this permit is issued. ❑ 1 have and will maintain Workers Compensation Insurance, as required by Section 37M of the Labor Cade, for the performance of the Werk for which this permit is issued. My Worker's Compensation Insurance artier and Policy number am: No.: Ob A%')3 e/ Gmder.5L9CjRTP FlCG-e EMPolicy OF MON FROM WORKERS' COMPENSATION INSURANCE (Thlsseetion need notbocomplemd if the permit Is Forane hundmddollan ($100) or leas) 1 unify that in the performance of the work for which this permit is issued, 1 shall ant employ any peon in any mannerso as to become subject in tin Wortun' Compensation Laws of California. Dam Applicant NOTICE TO APPLICANT: If. aMr making this Certificate of Exemption. you should become subject to Out Worker's Compensation provision, of the Faber Code, you muse ' forthwith Comply with such provisions or this permit shall he dcemcd revokad. 1 CONSTRUCTION LENDING AGENCY I hereWhich thi that men is construction lending agency, for dm performance of s d (Sec.30 me work for which this permit i, issued (Sec. 3097, Civ. C.) Lenders Name r Lenders Address 1 certify that I have mad this application and sum Out the above information a Compact. I again in Comply with all city and County mdiaaMes and sow laws relating W building Construction, and hemby suthodn represmtstim mi'thu city to occur upon the above-mentioned property for impectian purposes (We) agree to vve. indemnify ad keep harmless, dm City of Cupertino agaiml I Ilabilitles,judgmems, casts and expenses which may in anyway acme against mid City in consequence of the granting of this permit. e / APPLICANT UNMASTANDS AP WILL COMPLY WITH ALL NON -POINT Issued by: Date SOURER 5110141. /O� Re -roofs Type of Roof Sig um pplican✓C [attar Dam HAZARDOUS MATERIALSDISCLOSIIRE Will dm applicant or future building occuPanssmrc or beadle hamdom mum id as dcMcd by the CuMnino Municipal Code. Chapter 9.12• aad the Hcalm and Safety Cade, Section 255320)7 All roofs shall be inspected to any roofing material being installed. 0y. prior If a roof is installed without firs[ obtaining an inspection, I agree to remove Will the applicant Or fumes building a trapant use equipment. devices which it harardnm air cnmami... .y e Bay Arca Air Quality Management all new materials for inspection. trictT ❑Yes No I have mad the hvardms materials mquiromems undcrClutpmr6.95ofthe Califor- amHealth& SafetyCode. Scemm,25505, 25533and25534. [understand thmifine building does rant carte ase a Conant. that It i responsihllisy m notify the occupant tar e roquiremc w muBbemeI ' asuanceofaCeneOcatpofpctv�an5yu Sig nature of Applicant Date -` All roof coverings to be Class "B" or better o n mama as t Dam u • • CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35701074.00 DATE ISSUED.......: 01/11/2008 RECEIPT #.........: BS000003668 REFERENCE ID # ...: 08010065 SITE ADDRESS .....: 22385 RANCHO VENTURA ST SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER TSANG ADDRESS ..........: 22385 RANCHO VENTURA CITY/STATE/ZIP ...: CUPERTINO CA, 95014-2735 RECEIVED FROM ....: RICHARD LEON CONTRACTOR .......: DAVE LEON LIC # 17323 COMPANY ..........: LEON MASONRY INC ADDRESS ..........: 240 MOSELLE CT CITY/STATE/ZIP ...: SAN JOSE, CA 95119 TELEPHONE ........: (408)365-1660 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- ------------- 1BSEISMICR VALUATION ---------- 3,000.00 ---------- 0.50 ---------- 0.00 ---------- 0.50 ---------- 0.00 1CHIMNEYRE EACH 1.00 490.00 0.00 490.00 0.00 TOTAL PERMIT ---------- 490.50 ---------- 0.00 ---------- 490.50 ---------- 0.00 METHOD OF PAYMENT ----------------- AMOUNT REFERENCE NUMBER --------------- CREDIT CARD 490.50 -------------------- VISA --------------- TOTAL RECEIPT 490.50 • 0 z aj CUPERTINO CITY OF CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM /ilkh I ()N o S 1 # '5, 7 O f i, U Date: Building Address: oN'-1,3`3j RArVcho �e�✓'fLnA- Mailing Address (if different from building address): Owner's Name: one #: A -N -N- -7 Contractor: Contractor: Phone: 346-5-:-16 46 p 1_2o►-� Y►1 Fax: 3(05-/loloy Contractor License 1114 ;2 33 $ y Cupertino Business License #: `322 / / Contact: Ii AVi or PC «ti Phone: 5,,,�+� Fax: Residential I Commercial ❑ Job Description: 6AM C �o, W e,, -A - Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1 FR, I IFR ❑ 11, 111,V -IHR F]11, 111, lV V -N EL t"J Valuation: _f Square Footage: Project Size: Standard Z Large ❑ Major ❑ 1 CUPERTINO CITY OF CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM Quantity/Sf Fee ID Fee Description Fee Group Permit Type 1GENRES or 1 GENCOM 1BTEMPPER Temporary Building Permit (good for B 30 days) IBBOILERI 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 1BBOILER2 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 1BBOILERS Install ation/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. 1ELECINSP Other Electrical Inspections (per hour) E 1MECHINSP Other Mechanical Inspections (per M hour) IPLM 3INSP Other Plumbing & Gas Inspections P (per hour 1MEETINGIHR Application Meeting B • • CUPERTINO • CITY OF CUPERTINO GENERAL BUILDING APPLICATION FEE SCHEDULE 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 1CHLMNEY Chimney B 1 CHIMNEYR Chimney Repair B FENCES 1FENCE>6FT Non -masonry, over 6 ft in height B IFENCEMAS>6 Masonry, over 6 ft in height B FIREPLACES 1FIREPLMAS Fireplace Masonry B 1FIREPLFAB 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 1PILEDRW Pile Foundation Driven (steel, pre- stressed concrete B 3 of 5 CITY OF CUPERTINO GENERAL BUILDING APPLICATION FEESCHEDULE Quantity/Sf Fee ID Fee Description Fee Group Permit Type 1GENRES or 1 GENCOM RETAINING WALL(CONCRETE OR MASON= 1RETSTN Standard (up to 50 ft) B IRETSP310 Special Design, 3-10' high (up to 50 `) B IRETSP10 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 1SIDEST/BK Siding, Stone & Brick Veneer interior/exterior B 1SIDEOTHER Siding all other B SKYLIGHTS 1 SKYL<l0 SF Skylight less than 10 sf B 1 SKYL>10SF Skylight greater than 10 sf or structural B 1 STAIRS Stairs -first flight/ea addt'l B STORAGE RACKS 1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B I SRACKS>8 Storage Racks over 8' high (up to 100 st B 1STUCOAP Stucco Applications (up to 400 so additional stucco application B 4of5 E • • ao CUPERTINO i CITY OF CUPERTINO GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Group Permit Type 1GENRES or 1GENCOM 1 WINREP Replacement windows/sliding glass door (ea 8 windows B j 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B IEPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbing Permit Fee P IELCPLNCK 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 1TRAVDOC Travel & Documentation B, 1BUSLIC Business License B • 5of5 r—1 0 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 Building Department JOB ADDRESSS � 2offw PERMIT # 0061- OWNER'S NAME: PHONE # 3 (o S = (ems GENERAL CONTRACTOR: Jv?A-_501v4W FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Laffiffig Masonry i�Gc r t e, -so Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Signature Date