00100098 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
HU1I.DINGAl)IdRts1909 SAN FERNANDO ` PERMIT NO.
�/.�� �/ � ` 00100098
OWNERS NAME: Z - --- APPLICATION SUB DNI 1:
WANG
6y8 lir�i Py- f, 10/12/2000
1'H(lNl!: /O � / / SANII'AIiY NO. CUNT I2OI.NO.
rG-to Z ARCHITECIENGINEERRUIIAING PERMIT INR
BLS .E PLUMB
MIC8
<w _
I.ICENMiDCON1 RAM OR S DPCI,ARNrION Job Description
O I n sy n t t l I' 1 I fu pt 11 encins
F z r-°w as Station anal f Di J f h I d l r.. Cod d y teens .
���,
,in II
full d n t p SFDWL — 5716 LIVING/1052 GARAGE
ljw,d,�Class
D Dart c I�
3 m — MC)Tfl'�Cr S DI CLARMcQN�/ /61/1. U
lu til..mJ rypl.,..hull narwd a. public records
�Y—
w c O LinnaJ thomnsiawl
OWNER$I111,IJER DIiCLARATION
a 1 hmeby affirm tha I am-ra.,st from the Cnn na'mrl,Llcen,w law for roe
F Z S 4dlnx'ing rtnwn.(Stt'tion]U31.5,Nu,irao and 1'mle,.ions Gale:AnY city nr coumy
5.x❑ which termites a pennif to unnhom,aha,improve,demolish,or¢pair any or mere
i3� pr'rrt r .. Inn n IPRa II II 'nt 11 'y d,rt mat
- mars I,tt vdp t. n p . Im Caturrifer,I 1 (Chptcry Sq. Ft. Floor Area Valuation I
(Crummeneing with\cd z(¢ao ofD io .(if the Business andv r Code)
a dw he;s e.ompt,lc;ermn,awl me Duni,I le,all sed ex,n pilon.Any eoladon $578740
of S«tion 7031.5 by any opplicam hu a pemnit wnjna..the x,hsam art civil milt,
of not mom than for hundred dollars(x5001. APN Number Occupancy Type
❑
3571.5047. 00
I,a.owner ohne pmpcnr.m ter enmmyees wide wage,ua mdr,tde tompcns;nh,n•
will do the work,and the awcmre i,nor imemled ar oBereJ for sale(Sec.]BW,
Hu'pets.and Pmm,sions Code:The Commmora ueenw I.uw tore,am apply to an Required Inspections
cowne,of pal<ny who build—rhnpmve,memos,and who due,Imin work hi;awlf 101 — FOUNDATION
or through his own empmyees.provided that such impmvemmnts are not intended or
offered mr sale.If,however,the building or mrpeavement i,,old wahm one rear of 102 — PIERS
mpleuowo
n,Intoer.naader will haat tea burden of pro ing mill nn did non build or
iispovmforpurpo'tofsmt.). 103 — UFER
C L: co me It Perry,;; aelu.;,aly eourawlia,wpm lmea.m eomua lut,Io 104 — REBA R
erwtire pmjea(Sec.7(W.Bmias,and Pmfc..inns Ctxle:)'I'he Contruaorls
Lim,wccnw Lnw doe,not apply 6,an owner of pmpeny shit build,or inipari mersou, 105 — ANCHOR BOLTS
Cand woo contracts r r such project,with a comrndorM lieemn ed purst ato me
onms,au,uemnw Low. 106 — SEWER & WATER
❑l am ex,1177—r Sec. .if&P C fonhi,reason 202 — UNDERFLOOR PLUMBING
owne,_ —a—owe 203 — UNDERFLOOR MECHANICAL
Wr mile,"eraly :Ne.juarONDftheloATION G
Inatny mann unnen,emdty to pe;inuy am onna rdlow;ns detmmron.: 204 UNDERFLOOR FRAME
b I have and will maintain a Cenireate of Consent to self-Insure for worker, 205 UNDERFLOOR INSULATION
Gm...emueaa, to provided for ny Seeman J]fal of ata Labor Coda, ter me 301 — ROUGH PLUMBING
perfomname of the work far which Im,permit Ix i...ed.
El nrave:Iml will luamtam Wake,',Cii,,ano.r m.urame,.,required by Serino 302 — TUB & OR SHOWER
J]al of the Luno,code.Io.me p do aurae of fle work lar white Ihis Perana 1, 303 — ROUGH MECHANICAL
teed.My Worker',Com tion In,umnce carrier and Polity...iher are:
artier:Sfs fo ,/h,,I;eyN., 304 — ROUGH ELECTRICAL
C:RI fiICAI IONI I![EMIn IONIFOM D Rens' 305 — FRAME
COMPENSATION INSURANCE
(GiNseaionneednotNecompme
lJirepenn
thitisforone hunldollars 306 — HOLDOWNS
<mgnmle".) 307 — INSULATION
1 n oily that in the Icrfamunce of the work for which Ibis permit i,issued,1 308 — SHEET ROCK
shall not employ any person in any team e,so a,an become subject ,,the Workers'
C.....pe .ati:,n Lawsof Culitarnia.Dale 309 — EXTERIOR LATH
Applicant
NOI ICE TO APPLICANT.If.after making Ibis Certificate of Exemption.you should 310 — INTERIOR LATH
Z becona,wiea m the Worker,Conmca'aioo provision.,ante Lal,ur Cmlo,you most 311 — SCRATCH COAT
6
Q O nhwhh comply wllh such......pun, pn or this d,shall he decmre
ud voked. ,,,,
COt there s a ON LENDING l AGENCY 313
— ROOF NAIL
a ' 1 hem.,allium that chert i,a t,,uodN . kgO.C,sunny for the pufnrmunce —
afthcwmAfurwhichthi.pcmniti,is,utJ(See.J(n].Civ.C.) 501 FINRL ELECTRICAL ENERGY
aQ Lender',Name
D 7_ Lemltr,Ad,h.ess 502 — FINAL PLUMBING ENERGY
U O 1renifytha Ibeto,madIlini,phearonaod,mtethat the abus<mfornmdonis 503 — ,FINAL MECHANICAL ENERGY
w F- 'o"t I.Insreetucomplywih;llti,yamI ,,oat,ordiaantt'and,I.asInw,retaing 504 — FINAL BUILDING ENERGY
O U mnadding eonumcth,n,and herenyamnomec repmsemmlves onhis city m anerupo;,
he above-mentioned prn,emy for ins ttdon purpose'. 505 — FINAL ELECTRICAL
F" p, (WO ugreu lu hive,'nulcmnd'yand keep harnde,the CdyofCnpcnino against
ti Imnnities.juas;aam.co.I atmtxl n hitt, y ymerrreas:dna.:;id 06 Ap TEST
U Z Chi in am.e uence of c 6mneng IMI n. � .��JF(+���
AYI'h1 D STANDS 11 .4^.DMPI .I'I'I ALL NO PO ISSUCd b i I a o1 �V
'U CC RE�GI ONS / �JJ Y' G
s. amao app/ Ilt.,nJ mmetor - --"gate — Re-roofs 508 — FINAL MECHANICAL
uAYAUDDUS M <I<I I'S DISCLOSURE 509 — FINAL GRADE
smltnc upNicume,mare failttm,w,,ap;ad,mmm handle haamoa,mmedal 'type of Roof
as defined by the Cusenmommmmip,dCdr.chapter 9.I2.Lad mH
e mlth and safety 510 — FINAL PLA
C...r.Seen Iz55az(a)r
L3 ye, No All roofs shall bc5 j,pectcd(plp0jA,La r L Ing in 'd.
will he;,ppucar,,,,rBnurennildingt.cup,intuwctltiipnicanorctcameswllich If a roof is insialIgLhwithouKfe513 btQiP 1�j 'p c 1 L t nove
I emit l iaurdoes air conu;ninunr,its defined ny the Bay Area Air Quality Manaptmenl
Di,rmc 1 a� all new material: ns}Iec p fan will c y with
CyeV all non-point souLkL �je ulat �sti
I base road he ha,mdou..mammal,n ader Chapter 6.95 of me p b�4 g— �OOF T N— 0 RESS
California.1 llcul1 Safety Gala Sections 2.that 255JJ an SSJJ.I unJ :tend thin
Inht M1uilJlnµAcre,n: n;rruntiy a awn t.Thal lr' Dry; ,pomihilinutity the
t t- 'h mmlha;net — Dance al til roof
ccupun remen
`Y. m al Signature of Applicant Date
( nmhori..cdagent f Dam / All roof coverings to be Class "B" or better
OFFICE