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08040051 CITYqF CUPERTIN0 �'a# BwLom $3COk�P�R cDIVts1oN PERMIT 'AC.'�A IN'I0'Q.RM T Oe BUIWING ADDRESS: PERMIT NO. - 10585 SAN LEANDRO AVE NATIONAL CONSTRUCTION 08040051 OWNER'S NAME: PBRMRL^fiUBDATE ERIC YONG 15319 CHATSWORTH ST 04/08/2008 PHONE: SANITARY NO. CONTROL NO. (818) 221-6057 CHIIER/ENGINEER: BURRING PERMIT INFO BLDG EIECf PLUMB MECH Sop LICENSED CONTRACTORS DECLARATION IOW Description rd 1 hereby,term Nat I am licensed muter provisions of Chapter 9(commencing i with Schon 70(10)of Division 3 of the Business ant Proniou Code,and my liceruc 0 TEMP POWER POLE, 100AMP OVERHEAD ^< in full fora and effete jf�nZ Llcease Cl Dole Ik.g E DaC.nt11 ARCHITECTS OECLA ATION Z 1 undo W my privet shall he std u puM1lic rtcnNs C Licensed Profrssionel OWNER-BUILDER exempt I DECLARATION 0 i I hereby affirm that I 1 exempt from the Contacmh e:A n c Law for the S� following moon,Permit t 71171.3,Business up Pmfnunu Code:Any city os county which rtqulres•permb re construct.alms dmpmve,dearmil l or mpsir al structure _t� prior to its iuvana.alw requires the applicwtforwch permit to Okaaignod sutemem• - a that heislicensed purawmtothe pmt, visioofthw eConuwfsUauq.Ft. Floor cLaw(Chapter9 SArea F 9 $385 Valuation r (comeneiSectiong with Section 7000)of Division 3 of then Business and Poefeeniou Code or S m that he ts cumpt themrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicwt in a civil penalty ofNumber Occupancy Type not more than five hundred dollars(Sero). 3 5 7 0 5 012 ❑I,uo of Nepmpertymmywpioyanwithcagesuthatwleenmpe Um, willdo dm wart wd dmarructum is not intended oroRered for sale(Sec.7044,Bu usine .itProreaaimu,Code:The Conuacmra came Law don not apply m,n owner or Required Inspections property who builds or improves thereon,end who does such work himsel f or through his awn crop areas,provided that such improvements ate amt intended oroRered for rade.It. however Nebuilding or Improv( ,4 sold within one your orompletion.the mares, builder will Mw the burden of proving that W did not build or improve for purpose or sale.). 1,or owner of the property,am exclusively...anteing with licensed eonuaemss to construct the project(St.7061,Business and Professions Code:)The Coovanor's U. cease law alae not apply in w owner of property who Wilds or bnpovn thereon,and - who contracts for such projects with a consacmr(G licensed runabout in the Conuacmh License Law. ❑I am exempt under See ,B&PC for this mown Owner Dam WORKERS COMPENSATION DECLARATION - 1 hereby affirm under pmWly of perjury ante of the following declarations: 1 ham and will maintain a CeNOum of CDment in self-iuure for WerkeesCompen- n,u provided for by Section 7700 of tie labor Cods.for da perfmmana of the IM for which this permit is iasued. ❑1 haw and will maintain Workers Compensation Instance,as required by Section 3700 ofthe Labor Code.for the performance of the work forwhich this permit is issued. ' My WorkeYr pro ensed.n Ino ncc taoier and Policy number an: gyp, Carver. Yy e�'A/�Policy N..:00710 '•r]^V0�Z CERTIFICATE F E% FnON FROM WORKERS' COMPENSATION INSURANCE Crhtswctmer need not W completed if the Permit Is font hundeadd.11N(5100) or lett) I certify that in Be performance of the work far which this permit Is issued.I shall raw employ say pawn in my in.,an as to become subject to the Worker'Comperwdon Laws of Colifomia.Dam Applicants NOnCE TO APPLICANT:If,sil making this CenifIca a of Exemption.you should become wb)m in the Wmk s Compensation provisions of the Lobo Code,you muss O Q forthwith comply with such provisions or this permit sha11 be thermal revoked. CONSTRUCTION LENDING AGENCY (r I hereby aRnn that dart is a couwadon lending agency for the performance of CL> the waft for which dda permit Is issued(Sec.3097,Civ.C.) 0 Lender's Nam^ , Z)z Icndefa Address U Q 1 cmily Nat 1 have mad this application end..in this the above information la IL ^ coma I agree m comply with N city and county oMnance,and slow law misting us - .00S.'7 building construction.and hereby wthorien reprnenstiws of this city to enter upon me Ira 'how.mcruhoncdl property far inspection pur(wtes. (We)agree to now,indemnify and kap harmless 0te City of Cupcnino against f�A labiliJa,judgments,costa and expenses which may In my my acme against sial City O in can".of theANDS (reit. Y APPLICANT UNDEW COMPLY WITH LL ON-POINT Issued by: DateSOUR OVCA7 � a /_ i7� /�1 Re-roofs Signa pp .A DCH Dem HA2AItD0U5 MATERIALS DISRO RE Type of Roof Will the appllant or future Wilding ovmpwt man,or handle harardoet material as dented by the Caparison Municipal Code.Chapter 9.13.and the Health and Safety Code,Section 75532(,)71 All roofs shall be inspected prior to any roofing material being installed. C]Y. 6-U9 WIII the applicwt or forum W' mg aauPam sac equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove It sound sir..,... Oned by the Bay Ama Air Quality Management all new materials for inspection. ❑Yo Nu I have mad the buaNwsmatethds requlrcmenu under Chapec6.95 ofthe Califm- nu Health&SefmyCade,Sa astanN5.25533 and 25534.1 understand!thuif the Wilding does rent cmr.ntly haw a amane y responsibility m rmtifY occupant of de mgDiamentswhichrr"W or wannc 'r roypA Signature of Applicant Date owner.f r agent Dam. All roof coverings to be Class'W'or better okogo o5l i, CITY OF CUPERTINO TEMP POWER COF CUPERTINO PERMIT APPLICATION FORM APN # ^ D� � � � Date: Building Address: Owner's Name: Phone #: /C Ye/I 4o$ �g �q--beRL Contractor: l,S'/C0� ;AvC4. 17p Phone #: y / / Na�FQ„a �l Gs'I4Ct� Fax #: � ql 'Y(p OV Contact: q� 0 , ^, B� / 7 Phone #: n S 30, Contractor License #*Z7/ p Cupertino Business License #: Z2� Job Description: . l v a Residential Commercial ❑ Valuation (cost of project): 2 y� Quantity Fee ID Fee Description Fee Group Permit Type IERT>1K Res. Temp Power>1K E 1REAP14 Amps I IERT<200 Res. Temp Power<200 E Amps IERT2001K Res. Temp Power 200-1K E Amps 1 EPERMITFE Electric Permit Issuance E IELCPLNCK Electric Plan Check E 1BSEISMICR Seismic Residential B CITY OF CUPERTINO GSD TEMP POWER 0 or CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group Permit Type IBSEISMICO Seismic Commercial B 10EAP14 IECT<200 Commercial Temp Power E <200 Amps IECT>lK Commercial Temp Power E >1KAm s IECT2001K Commercial Temp Power E 100-1K Amps ITRAVDOC Travel & Documentation B Fee 1BUSLIC Business License B CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35705012 . 00 DATE ISSUED. . . . . . . : 04/08/2008 RECEIPT # . . . . . . . . . : BS000004401 REFERENCE ID # . . . : 08040051 SITE ADDRESS . . . . . : 10585 SAN LEANDRO AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ERIC YONG ADDRESS . . . . . . . . . . : 48357 SAWLEAF ST CITY/STATE/ZIP . . . : FREMONT, CA 94539 RECEIVED FROM . . . . : SIN C YONG CONTRACTOR . . . . . . . : NATIONAL CONSTRUCTION RENTALS LIC # 22537 COMPANY . . . . . . . . . . : NATIONAL CONSTRUCTION RENTALS ADDRESS . . . . . . . . . . : 15319 CHATSWORTH ST CITY/STATE/ZIP . . . : MISSION HILLS, CA 91345 TELEPHONE . . . . . . . . : (818) 221-6057 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------ ---------- ---------- ---------- --------- ---------- 1EPERMITFE FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00 1ERT<200 UNITS 1. 00 40 .79 0 . 00 40 .79 0. 00 1TRAVDOC FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 122 .37 0. 00 122 .37 0. 00 METHOD OF PAYMENT _AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 122 .37 MC --------------- TOTAL RECEIPT 122 .37 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- '-,------ ---------------------------- 402 TEMPORARY POWER • Community Development r 10300 Torre Avenue M Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408) 777-3333 CUPEkTINO • Build* Department JOB ADDRESS: �t PERMIT # Q D DOST lOS�S' a /;Vz C tc /-k) OWNER'S NAME: 6�r)C- I PHONE # GENERAL CONTRACTOR: IFAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 21 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile • caner Contract r Signature Dke