The URL can be used to link to this page

03050086.t I TY OF CUPERTINO , TN on ONIy,R BUILDING DIVISION PERMIT rR EC 'U,C,,DINO ADDRESS: c;88 RQSARTQ All CUSTOM CRAFT PERMIT N003050086 ISR'S NAME: IS 166 KENNEDY AVE EN TEYAO AND HUI M ONE: (408)374-2093 SANITARY NO. CONTROL NO. ARCHI=/ENGINEER: BUILDING PERMIT INFO BIRO ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description I thereby artim that I am Ilmosed under pumleflons of chapter 9 (mearrecencint �mSoelorl(Xl 3ofdoB:7mdI R.m.Code. is I fell to. File REPLACE WINDOWS Oats cool 'HITECTS DEQXRATI� I understand my plansuall Im used as public necords JUL 2 3 2003 Licensed Pocifishund OWNER -BUILDER DECLARATION I hereby affirmi that 11. exempt from the Conlrector', License Law for the BUILDING Following reason. ($.do. 7031.3, Busincssud Poshosiona, Code: Any city at county which mquires; a Permit in construct, antes improve. demolialb. or repair any structure, 2 prim to its Issuance, also require, the applicant formch Permit to filc a signed rudemont t that lx� Is licensed pursuant to the provisions of the Comouctor's Licenum Law (Chapter 9 Sq. Ft. Floor Area $ 1 4x&�tion (commencing with Section 70rx) of Don 3 of the Business and Profession. Code) or that he Is exempt therefrom and the heelsfor the alleged exemption. Any violation of 3 WN_9,&"cr 0 0 Occupancy Type Section 7031.5 by any applicant for a permit subjects IM applicant to a civil penalty of net more then fin hundred dollars ($500). 0 l.0owner ofthe pmpedy.mmyemployes with cages uferrule mmpenudon, -L U 1"OUN'jAi640�d Inspections will do the work, and instruction Is nolinecanded or offered forsale (Sec. 7044. Business does and Professions Code: The Con=Ws License not apply in an owner of 102 — PIERS proporywho bull& or improve, therom,and who doessuchwork hmoulforthrough his onvacurployces, provided thatuch intinnowmeants are not intended reoffered fiereade. If, 103 — UFER however, the building or Improvement Is mid within can year ofmanpledon, the none - builder will have the burden of pm,i.g that he did am Wild or improve for purpose of 104 — REBAR sale.). 105 — ANCHOR BOLTS E] 1, as owner of the property am exclusively contracting with limned conceneures to construct the pmjmt (Sec. 7044. Business and Profiesdones Code:) The Contraccer's U. 106 — SEWER & WATER mass Law does not apply to an owner of property who Wilds or brown, income. and — UNDERFLOOR PLUMBING who mourects for such pm?.ces with a commactor(s) licensed pursuant to ft Contractors202 License Law. 203 — UNDERFLOOR MECHANICAL 0 1 am exempt under Sm. . B A, P C for this exteen 204 — UNDERFLOOR FRAME Dam — WORKERS COMPENSATION DECLARATION 205 — UNDERFLOOR INSULATION I herby argon under penalty of perjury one of the following doelatertions: 301 — ROUGH PLUMBING 0 1 haw and will malnumaCcurdficalcolconsent to welf-hamne ficrWorker'sCom,ce. 302 — TUB & OR SHOWER cation, as provided for by Section 3700 of the Luor Code, for the performance of ft 303 — ROUGH MECHANICAL work hich this parent 1. Issued. 304 — ROUGH ELECTRICAL haw and will maintain Worloces Compensation Insumence, as nolulmd by Secti no �fm. La1W, Cede. for me pmfomnuca.fft work for which this Permit Is Issued. 305 — FRAME My Worker's OurnantatijnsuV nucramlp leymnalocrue, 306 — HOLDOWNS _Vft19_tA 307 - INSULATION CERTIFICATE WORKEIR? COMPENSATION INSURANCE 308 - SHEETROCK (Ihls union need not W completed If the Permit Is for one hundred dollars (SIM) 309 — EXTERIOR LATH mine.) 310 — INTERIOR LATH I conity Oil In the performance of the work for which this permit Is Issued. I hall not employ any person in any manner so a a) become object to the Workers'Conspeasuadcon 311 — SCRATCH COAT Laws ofCalirtmem. Data 313 — 501 — ROOF NAIL FINAL ELECTRICAL ENERGY Applicant NOTICE TO APPLiCANT. If. after making this Certificate of gumption, you should becorm, subject to the Workers Comacnudoo previsions or the Labor Code. you must r forthwith comply with such provisions or this permit shall Ito deemed ranked. 502 — FINAL PLUMBING ENERGY I i CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY I hereby afirme that then Is a construction Imcling.gency for the, performance of 504 — FINAL BUILDING ENERGY the work for which this paroull I, Issued (Sec. 3M. CI,. C.) Lenders Name 505 — 506 — FINAL ELECTRICAL GAS TEST Leaders Addoccur I certify that I he. read dr. ppilced.. and sude the, the how information It 507 — FINAL PLUMBING Morml. I agree to Comply with all city and county ortfirances and smuc law relating in Wilding mostrowfime, and hereby authorize repeconsedw, ofthis city to enter upon ft FIN MECIHIAMN CAL above-mentioned Property for Inspection purposes. LC' (We) agree to a., indemnify and keep hummut the, City of Cupertino against 09 F I Imbilitics, judgments. cuts and as which may in my my semen, against said City "n Pcf- 5% A NG &N sa 4 "m "mcco' 'm 76 p) W1,1L COMPLY WITH ALL NON -POINT APPLICANT A 7 Issued by:5 5 WORKS Date W( U NS Sc� f Re -roofs Type of Roof Dam Waver, e( RM HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future Wilding occupant lorn or handle hazardous essential jdadcfincdb,meC.panm.M ic C�.Ch.pWrg,12.ted the Halm ted Sfcty All roofs shall be inspected to any roofing material being installed. ❑vee Na prior If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant orlure ex alone power a device, which cre 14 "dith. mines our Quality Management all new materials for inspection. 7Dh'uticl? 0 yes No N Mal "ou"o"m I have 11, outdoes mudcl�,!Ig 131mm�nuunderChapwr6.95ortheCalitor- a Is' C _ So_ exte nI.Health&S.F." cdo.Smic . 2M )5 25 3 and 255M. 1 understood Lhadfidt, building r, o o direct come rat, is MmmodleftiLY to notify the WCUpost ofthe m meet meet m i n c. or . Certificate oxcru�,� 2gnature ofApplicant Date All roof coverings to be Class "B" or better y4y00 fVU 5 N 7 Z LUU 3Wt— �01 A�r N Yin0 xo,� Vl F?Q yF0 01 0z z�-: L4 f1. � �z UC Lk 0�� Fa ►-t C/ U CITY OF CUPERTINO BUILDING DIVISION PERMIT BUILDING ADDRESS: CUSTOM CRAFT PERMIT NOO 3050086 215 OWNER'S NAME: 166 KENNEDY AVE PERMITISSJdFiDgrrfi 9/ 2 0 0 3 CHEN TEYAO AND HUI M PHONE: (408)374-2093 SANITARY NO, CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Div n 3 of the Bustncs and Professions Codc, andic nsc is inmlliccnsctoreea f1^ ffce� LClass L ,r REPLACE WINDOWS ' Date -- -- Contra / S(CHII'ECCS DEC I understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area $1410�tion (commencing with Section 70('10) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of 3 .�iN�dl�P.rO O Occupancy P Y Type Section 7031,5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). E] I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business Professions Code: The Contractor's License Law does to an I01FOUN — d Inspections and not apply owner of 10 2 - PIERS property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, 103 — OF E R however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or improve for purpose of 104 - REBAR sale'). 105 - ANCHOR BOLTS 0 1, as owner of the property, am exclusively contracting with licensed contractors to 106 construct the project (Sec. 7044, Business and Proressions Code:)The Contractor's Li. — SEWER & WATER cense Law does not apply to an owner of property who builds or improves thereon, and , 202 — UNDERFLOOR PLUMBING who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. 203 - UNDERFLOOR MECHANICAL 0 1 am exempt under Sec. , B & P C for this reason 204 - UNDERFLOOR FRAME Owner Dam WORKER'S COMPENSATION DECLARATION 205 - UNDERFLOOR INSULATION I hereby affirm under penalty of perjury one of the following declarations: 301 - ROUGH PLUMBING C-)Ihave and will maintain aCcrtifreateorConsent toself-Insurcfor Worker's Compen- 302 — TUB & OR SHOWER sation, as provided for by Section 3700 of the Labor Code, for the performance of the 303 - ROUGH MECHANICAL work rwhichthispermitisissued. 304 - ROUGH ELECTRICAL 1 have and will maintain Workers Compensation Insurance, as required by Section of the Labor Code, for the performance of the work for which this permit is issued. 3 0 5 — FRAME My Worker's Compensation , n"sura`n{�c \carrierandP rcynumberare: 306 — HOLDOWNS ria l`\fit--1 i--� p�2�cl) 6E ' 307 - INSULATION CERTIFICATE OF E OM W ORKERS' COMPENSATION INSURANCE 308 - SHEETROCK (This section need not becompletedifthcpermilisforonchundred dollars (SI00) 309 - EXTERIOR LATH or .) 310 - INTERIOR LATH Icertify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation 311 — SCRATCH COAT Laws Applicant of California. Date Applicant 313 501 - ROOF NAIL - FINAL ELECTRICAL ENERGY NOTICE TO APPLICANT: If, after making this Certificate of Exemption. you should become subject to the Workers Compcesation provisions of the Labor Codc, you must forthwith comply with such provisions or this permit shall be deemed revoked. 502 — FINAL PLUMBING ENERGY CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY 1 hereby affirm that there is a construction lending agency for the performance of 504 - FINAL BUILDING ENERGY the work for which this permit is issued (Sec. 3097, Civ. C.) s Name Lender' 505 506 - FINAL ELECTRICAL - GAS TEST - Lender's Address I certify that 1 have read this application and state that the above information is 507 - FINAL PLUMBING cored. 1 agree to comply with all city and county ordinances and state laws relating to building construction. and hereby authorise representatives or this city to enter upon the FI"IM�ECHAN%WCAL above-mentioned property for inspection purposes. indemnify keep harmless City 0 9 FIliabilities, (We) agree to save, and the of Cupertino against judgments, costsand expo ses which may in any way accrue against said City 5 G in consequence of the gra permit. APPLICANT A S D WILL COMPLY WITH ALL NON -POINT Issued by. -5 WORKS Date SOUR ). NS_ 1 �� I ` —� — Re -roofs Type of Roof S.ighature of licaq/Contracto Date HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hasardous material as defined by the Cupertino Municipal'Code. Chapter 9.12, and the Health and Safety Codc, Section 25532(a)1 All roofs shall be inspected to any roofing material being installed. ❑ Yes No prior Will the applicant or future mldtng occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove emit ba-/.ardous air contaminants defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ Ycs Nu Ihave read the hasardousmaterials re uirementsunder Chaptcr6.95ofthe Califor- nia Hcalth&Safety Code.k255�6.25 3and25534.iundcrsundthatifthchuilding docs not current - to aresponsibility to notify the occupant of the rcquve ich must mssu cc of a Certificate op cupancy.gnature / of Applicant Date Otv ur au 'ud easel_ Date aN CITY OF CUPEI�TINO C..'Y OF CUPERTINO PERMIT APPLICATION FORM APN #�,�° .w,% Date: l Fee Group BAPPLOTHER Building Address: , �� Q (off t� ►�� .�P��t�.o ,Zt , Owner's Name:Q Lc � Phone #: _ Ac6 ._ -I Contractor: � n �1 License #: Contact: Cupertino Business License#: Building Permit Info: Boiler > 100K to 500K Btu Bldg' Elect ❑ Plumb ❑ Mech ❑ Job Description: r -k) OU. VA .--,Ji --Ai Residential J�r� Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Proj ZN, ��, Occ a qy Grqup: .— Type of Con traction: Boiler > 1.75M Btu Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permit sq. foot BUILDING BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler > 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax - Resi/Mobile BUILDING BELEC 1000 Elec 600V <= I OOOA ELECTRICAL BELEC 1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of 3 x L -t fY OF CUPERTINO CITY of PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Famil Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING TM BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn SprinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREN[AIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > 10K btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2 of 3 CITY OF CUPERTIl`..j GTY of PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3 8998-9U-80tr VL096 -I1VO ` ONIlH3dno 3AV OIUVSOH 889 2 T 30N30IS38 NAHO 3Hl —J° �Oo HOIH31X3 V SMOGNIM 1N3W3OV ld3U $ W ~1 v,oz r�lox LU z U z W U - cc LXX M: ujoa Z99 tm' o Q �� Q w � to Q t3 a� d 9cz 80 NNw'wNz p X>l XX 82XX 99 XX a g z w U t a z Y z w cosN Wxx g XO XO DIX x cr 9 a z 1 g0X p8CL � I-� 1 X0 X0 �g� -'S Q ca z�srns <02 t��zm�aQ 0� �z_Sp-. a '00 U. xx LOX w �xx � 0,., Z. c� pp z x CZir;zyz Qr3�3 8w amw O5:Waw m 2 9z- c= �gEaa gE M :s > EL CD 0 CL S HOS Z.E 0 LU j] pj; !Ali a j! E.1i 2 g - g g- C J�s .a o tsiz-'. is A NIP 21- 1: A a N 3:yOg8 E 0 W j! E s g.man ;1E CLL HU 4) , in 0 15: MiR N H I o 0 j 9 Is ou, LU -cc 92 119 cl 0 2. 3 �8 Em., IIE24 I I ES � 1 11 1s H it iffli Hi, is_- .. 111-10 H,1 E3 Im 4) . T gg Mitts C Is H 1.1 It I Nt I 1 2 1 C lSf E 75 M I Mg Im His 0 $it mn-j 1 111 I M. to C1fL Ii MUM HUY s 1 111118 a8 11 huP itM pf Si J am 2 . m❑. . o I ❑ o dill S Mi f,11flI2 .4 HIP allg�,H W1 g H it Fi ig -1 Ug m Est isH Hi �fit 1 N I& !t it! i. Him 29E JiM IM HE E I V. s !911 i � s I Eli tills, it :L it i9iMs R M, fil'l 0 r c 1 CL 'i JIM— HIM 0 Z41 1 a El 81,1111i ill d I Ma EM H it 11 1 — I Hill is Iffifig it - 111 If ip 4 I I's 11 it It fill ill h M Im H it WT' Has HIM M 3 C3 cl 0 0 0 0 n :1 !3 A h Ell Ins; 1 1110 1111 s , ". II I III UH1 III 611H 11110112 11111HII M11i lilt M 1 # 46 v 2 v Eg C: P t Ut Hil to o Pluill, I if I is = 1 tag j Us co qu 11!t As tit o c 1 1 9 1 4) 4) 1 lilt. CLO 0. dc to z 0.. 02 Iwi, 111Ls S!R�gOA- Mfl-lilt 01 it! 1 .11 -611. 1 VS, i '41 Vowto 2�11 1k, 1 fa i �2 �p 1 ❑MA Ka.; a. ; I "S8 'L - g 1 B. - Z 0 :1 W M Zoo,, MHHIONINGH12 0 o 0 g uktion. tRs�.%gamma '2 H V39 41 SRI 0 E 0. E Z aaf C" 0 go 1'go 0 . N 1 = , c CO 0 2 R 20 hi u. SEien U3 M a r4 M 'w ism I Ma EM H it 11 1 — I Hill is Iffifig it - 111 If ip 4 I I's 11 it It fill ill h M Im H it WT' Has HIM M 3 C3 cl 0 0 0 0 n :1 !3 A h Ell Ins; 1 1110 1111 s , ". II I III UH1 III 611H 11110112 11111HII M11i lilt M 1 # 46 v 2 v Eg C: P t Ut Hil to o Pluill, I if I is = 1 tag j Us co qu 11!t As tit o c 1 1 9 1 4) 4) 1 lilt. CLO 0. dc to z 0.. 02 Iwi, 111Ls S!R�gOA- Mfl-lilt 01 it! 1 .11 -611. 1 VS, i '41 Vowto 2�11 1k, 1 fa i �2 �p 1 ❑MA Ka.; a. ; I "S8 'L - g 1 B. - Z 0 :1 W M Zoo,, MHHIONINGH12 0 o 0 g uktion. tRs�.%gamma '2 H V39 41 SRI