01080104 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
11221 REDONDO CT SHOWCASE KITCHENS 01080104
OWNER'S NAME: APPLICATION SUB DATE
ROGER YIP & WENDY CHIUE 12333 SARATOGA—SUNNYVALE RD08/21/2001
PHONE: SANITARY N0, CONTROL NO.
(408) 253-0412
G O zo ARCHITECT/ENGINEER: BUILDING PERMIT INFO
w_ BLDG ELECT PLUMB MECII
,caw LJ LJ IJ GI
LICENSED CONTRACTOR-S DECLARATION
z 5 y z 1 hereby retm that 1 am licensed under Job Description
p z__ provisions cnapter9mommenaog KITCHEN REMODEL.
F_Fw with Section)OOO)of Uivisia Sof he Business find Pmfensio y[ode,and mylicenu
=y al Lmfull force and eflU I
s z a Got, Clazs_r`t Lic.p tfJ
aw Dare ^�-11 Comrmmr
rat ARCNITECf'S DECLAR ON /
C—Nt�og 1 underamd my plans shall be used us public rccmrds /
w>
1,z p O Licensed Professional /,l
x OWNER-BUILDER DECLARATION V
a^—w I heresy.(Sten that I din exempt from the Cessions Ce License Law lou the
t z< meowing Kasen.(Section 7031.5.Business and Professions ewe:Any city or musty Q $26883
5=8 which requima a permit to construct.alter,improve,demolish,or repair any structure
to 3 prior to itsqt thepplic' f v hto
pe fl g.' vemem
mitis 11 s .It ' tt I� t t t jw lChiflarll ,, r 1 u Valuation
(commencing �thscto muse) fIi 'c 3 nn B ., a5 dl r:' ,Cwe3 (' t, ,''3f§�'� .'(��8' O f.'. ,
.,,bar he rs exempt therefrom and the basis for the alleged es empuon Any violation
Of Section 703 1.5 by any applicant for a pemtit subjects the applicant to a civil penalty
forint more man B«hundred dollar.asap, 10 Pp4 -N ATI ON " Occupancy Type
01,as owner of the pmpeny,or my employees with wages as their sole mmpcnsaiion.
will do the work.and the aructum is not intended or offered for sale(See.7014,
Buiinck.i and Professions Conde:The Contractor's License Law docs not apply to an 103 — UFER Required Inspections
owner of property Who builds or improves thereon,and who does such work himself
or through his own employees. building that such improvements art not intended or 104 — REBAR
offered for foisthe:Jr.Owner builder
have
t car improvement n sold he did vaie year or 10 5 — ANCHOR BOLTS 1'
mmpmtion,me ownernuaaer wen naee me burden or proving that he did not wua or
improv`rnrpmrma.foal`')' 106 - SEWER & WATER
° acting _ ._.
- La�bw�erni5n<P6;p�;ly:�df2.dusivelycummmingwlthba<nawmm.actorsro 202--- -UNDERFLOOR- PLUMBING
construct the project(Scc.70314.Business dna Pmf<saiom coda The Contractors 203 — UNDERFLOOR MECHANICAL ;'
- Lic<nu Law docs not opplY to an owner of progeny wM10 Wi1dz or improves tnercon,
and who mmmcen for such projects whh.a eontractoas)licensed porsaanLlo the _ _ 204 ---UNDERFLOOR- FRAME
Contractors License Law..
0lamesemptundc-Sce. ' .B&PCformismasan205 — UNDERFLOOR''
INSULATION
Owner Date 301 — ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 — TUB & OR SHOWER
Inet<byafemtunder Penalty ofperjury,nnenthe following declarations: 303 — ROUGH MECHANICAL
0 1 have and will maintain a Certificate of Con,ent to salr-inum fn;workers 304 — ROUGH ELECTRICAL
Compensation, as.provided for by Section 37M of the Labor Cash, for the
pLrf mance mzhe work.far ainali mis Pgmh is iasaaa. 305 — FRAME _
01 have and will maintain Workers Compensation Insumme.as Kquinad by Section 306 — HOLDOWNS
3100 of me Labor Cade.for cob Performance of the work hr which his permit is
307 — INSULATION
pinned,�lty WW�mke(�<Co��m.ee``nsmmn{�sumneecaoia,mdPolic numherare:
�1.0.,V�.T1' . . O lb - Cm (o0.- !308...;. SHEETROCK _.. ,_ .. ..... .........._... ...
Galilee- Policy No.:
CERTIFICATION OF EXEMPTION FROM.WORKERS't l'. ` ' 3Oa9 '' EXTERIOR 'LATH•
COMPENSATION INSURANCE '
_..- ._. ...3.1.0_...;...INTERIOR"LATH
tilt s-pcalimi need not be,completed if he pesmlt is for one hundred dollars
(SIM)m1cso,) 311 - SCRATCH COAT
313 ._...ROOF NAIL
I«nplyht terpenan of he weak which th3pemitin cWorke;' 501 - FINAL ELECTRICAL ENERGY ' S
shall' t r sat.,,a become cob cis to the Workers
Compensationlicat. La a fC51'lom a.Detcn
NOTICE - . - - -: _—_ _ — 502— FINAL PLUMBING -ENERGY
NOTICE TO APPLICANTorkers Cornter ationisosimorate Of the Labption.youshould
ost
becomesubjectco ay the Workers Comps orlon pmvisionso hadeciand Cwc.you mon 503 - FINAL MECHANICAL -ENERGY
z0 mmnwhmm�tplywanamnproiaionnormisprtnhsnml deetra'K"°kw' 50.4. FINAL BUILDING. 'ENERGY .
CONSTRUCTION LENDING AGENCY 505 — FINAL ELECTRICAL
a,? 'I hereby affirm that there isacunstmetion lending agency for he performance
Or the work for which thin crmhinissued(Seb.3W7.C,,C.1 506 GAS TEST
L Q - Lender's Name - _-.._ _ _ .. .. .. .__.
aersAWms< ' 507 — FINAL PLUMBING. ,
U O 1 certify that I have read his application and.,site that me abova info„nminn is 508 — FINAL MECHANICAL
comet.1 agree to cmmpl3:with all city and county ordinances and state laws relating 509 - FINAL GRADE
O U building
toa n. dodo aamr p utme. lincity t ewer upon
y to b e a cep p then"" al"I'lorpor,ow, , 510 — FINAL PLANNING
L
(We)agomm,loc:ianderanify and keep ha I..s the City f Cup<rino against
'r-Vr liabilities,judgments.cot and&c ,,i,s,hwh may in any ay accme gain.sad 514 - FINAL PUBLIC WORKSZ City. 4 shh g- pe t,1CANT1DEItSTAND.` :L COM PLYWITHAL.KON-POINT �/� l
u. .E Er ATIONS'. Issued by: Dale
natuWll�M1c
picas applicam ser futurt building occupant stoic m n,n pace', Re-roofs
�.
HA DOUS MATERIALS DISCLOSURE
r me harardous mateam Type of Roof .. . ._ - ._ -_.... _.. .. _.._. .
as defn<d by he Cuperino Municipal Code.Chapter 9.12,and he Health and Safety ,t'
Code 5 i 55320 I
r OY' - '1 All roofs shall.be inspected prior.to.any_roofing.material being.installed.. _ ._..._.
wd the applie int r,rl halding occupant one arplilaracto Ordea«s which If a roof is instaou
lled witht first obtaining an inspecti6n, I'agree-t6 remove '
emit huearrous air eamtmninamts en palmed by the Bay Area Air Quality Manngiment
Dkariee all new materials.for,inspection._Applicant understands and will comply with
'O ,, �. - - - ' . all non-point source regulations. . 1,
.. I nave read me hoar-cm,ma¢rials requircmemi under Chapter 6.95 of ha
Califomia Heath 3 Sat.IY CWe.Sxtions 25505.25533 and 25534.1 understand that _
italic building dons not pmemly lime a tenant.that it is my responsibility to notify he
oampamt of the namo?""1111.11th must be met prior m issounce of a Car ireme of
Occupy y -
�„ Signature of Applicant - Date .
o : moriaea gepr -.
Data All roof coverings to be Class "B"or better
_ .. . . .OFFICE _ -..