01050111 CITY BIG DI?ERONNo
BUILDING
PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10324 RICHWOOD DR 01050111
OWNER'S NAME: APPLICATION SUB DATE
CHEN JIE-NAN AND WONG CHIEN- f2 05/11/2001
• PHONE: SANITARY NO. CONTROL NO.
O OO O ARCHITECT/ENGINEER: BUILDING PERMIT INFO
w— BLDG ELECT PLUMB MECH
j d
z .n LICENSED CONTRACTOR'S DECLARATION Job Description
O Z ln—
I hereby affirm that I am licensed under provisions of Chapter 9lcommencing
F,yr 1_w with Seeuon70007of Diviskm3off Businessand Professions Code,and my license 1377 SQ. FT. ADDITION, /
ayy� is rtrn force am 438 SQ. FT. GARAGE &
se License Class Lic.#
0" G Dat` Contrac1of REMODEL 1531 SQ. FT.
ARCHITECT'S DECLARATION
1 traditional my plans shall be used as public records
wat
ve Licensed Professional
n a OWNER carramEto DECLARATION S
m 1 hereby,`Orth ohm 1exempt ansa the Nwom,CammanarCoo License Low for he /
G z following reason.(Section 7011.5.Business ond Pre.de o demolish,
Code:Any cloy st rouure r—r
E 2 O which regnims a permit m construct cher,improves demolish,nr`'pair any structure V
i 3 r _Prig +. a vl 'til Iio rl I Ira a L ( t
nn l Cup �, twd-p ;° nnL rt License' 1 Ica Pt<r9 Sy. Ft. Floor Area cation
mat heel,samaptmmfAanandhemisnodmeBaine' ndlofA,on.cw<) + • _ . , `'', ' $1100
or Shat io is 31.5 b ih<rtfmm'and rile per for me cts thel contraption.m Any l Pennon
of not on]onn v any dredd llfarapermit,unjecrs theapplicant Occupancy Type
or not more man five hundred don':.asaa 3 6�ftq���
°I,as saw,net of the property,or my employees with wages as their sole compensation,
will do She work,and the ,mature is not intended or offered for sale(Sec.71l
Brcorml,and Emissions Cade:The Cimmanr,Llcen,n Law does am apply to in 101 - FOUNDAT]ItBIIJtired Inspections
tons,of property Who builds m impromdoes
ves Sh< oa,and who such wort himself
othrough his ow102 - PIERSn employees.provided that such improvements am not intended o' ._. ..-. .. _
offered for.sale.If.however,the btrudinB sr iaPs,vement is.old within one year of 103 - UFER
completion,the owner builder will have the burden of proving that he did not build or
improve rorpurposeor ale.). 104 — REBAR
_-
gT/. <r:::owaonh<prnp<ny:e reiaci.�ely coraxrng with licensed eomm<mnm - 105 - ANCHOR -BOLTS . '
comma the postal(Sec.7044,Business and Pro@c ions Cads:)The Contractors 106 - SEWER & WATER
r- License Law does not apply to an owner of property who builds or improves thereon,
and.who contract.,for such.proiecn With a contactortaLBcenced pursuant m.the. . 202 — UNDERFLOOR PLUMBING
Coma,nm,Liccnsc Law.
❑lame. pttrner ".9&PCforthisreaan 203 — UNDERFLOOR'MECHANICAL
��e� 204 — UNDERFLOOR FRAME
ORKER'S COMPENSATION DECLARATION 205 — UNDERFLOOR INSULATION
`.� Ihereby oreren under penahyofperjury one ofinefollowing declarations:ma301 _ ROUGH PLUMBING
0 1 have and will intain a Certificate of Course.,seres Klf.insarc for worker, 3 02 TUB & OR SHOWER
Compensation, an provided for by Section 37W of the labor Cade. for She
performance of the w°rk•for wIichthis par., is issued. 303 — ROUGH MECHANICAL
°1 have Cad will tadntain Worker,C°mpni.v:ninhlptaaace,as required by Scmmn 3 04 — ROUGH ELECTRICAL
337W of me Labor code.for the pe,(..act ofrne work for which mi,permit is 3 0 5 - FRAME
issued.My Workers Compensation Insurv¢e carrier and Party number arc: _ _ .. ._ .. ._ _._..
ca;tied• :r r't f Pofi<yNa.: 306 '— HOLDOWNS
'CERTIFICATION OF E(Eh1PTION FROMWORKERS' 307 INSULATION '
COMPENS.ATION INSURANCE,- ' '
- ...--- 309_-' SHEETROCK— — —
l7Tii«ction need not be completed ifine permit is for one hondrwi dollars EXTERIOR LATH '
($IoO+or lass)
malraot em lu p` of
soasko for
310 — INTERIOR LATH
1 cenil that in the Romance or She work fur which this permit is issued I
comp=mdrio'Lasayrfcs n in any instar aahiscr m m<workers 311 - SCRATCH COAT
- 313 ROOF -NAIL -- - — —.
NOTICE TO APPLICANT:I C atter making,thia Cermlicare of Ensman,a n,you should 501 — FINAL ELECTRICAL ENERGY +
become oct Sbn Workcr's C:itnpcnaaian provisions of tic Labor Code,you'nam
C) hicm forthwith comply with such unwinds,or this Permit hall le,deemed mWond. _ 502 — FINAL PLUMBING ENERGY _
CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY '
> Ihereby affirm that there_isacon.swm
construction 504 — FINAL BUILDING ENERGY
Q o1'thc work fur which this perm,is issued(Sec.3097.Civ,C.)'
C. nder,Name- 505 — FINAL ELECTRICAL
Leader's Address"'
uOI Certify mai I nave mail this application and state that the above information is 50 6 - GAS TEST
comet.I agree to cmnply x lth all city mrd county ordinances and late laws relining 507 - FINAL PLUMBING
O.0 to hailding construction and hereby authorize representatives of this city to enter upon 508 — FINAL MECHANICAL
W the ubovens<naoned progeny for'aspnnti°n Parpoxs .
y.c, iwel agree to save.indemnify and keep harmless the City of Cupertino against 509 - FINAL GRADE
V] liabilioa,.judgment s,costs and enpemes which may in any way accrue against said
U Z Cay in snmxquence nfohe gaming offfik Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY W'ITHALL NON80INf Issued O ING Dale � �ti�
SOURCE REGULATIONS. "' '
Signmcof Aplan"Comm"'r hS
Date. Re-roofs
'uHIZARDOUuiI DISCLOSURE
Will' hec""Let "'are
tSdi g
O P t,mm ur handle hazardous meten'tl Type of Roof
as defined by She u Cupe Mparicipal C < Chapter 9.12.and the Health and Safety
Code:Section 11532od' - '. '
°Yr' " hr;,.,.-_, All roofs shall be inspected prior to.any roofing In
being installed._ ..
Will the appfcam°rfomgbuilding ncca,annuse<giiptnemordesicc,which If a roof is installed without first obtaining an inspection, I agree to remove
emit hazardous air conemintim,as define yore Buy Arca Air Quality:ueegcment
District' all new materials for inspection., Applicant understands and will comply with
°Ye, - ',,,. p all non-point source regulations. .
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 35505,25533 and 25534.1 undersand that
if the budding does not currently have a unant,tbar it is my responnibilily m notify me
bcrnpam or the rc u inn which muse be or a iisuunce ofp Certificate of
Occupaticy. ram '
7 y u Signature of Applicant Date
- o croratrmorizedageat Date All roof coverings to be Class "B" or better
OFFICE