01060026 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20556 SCOFIELD DR TONG JOHN & MICHAEL HU G01060026
OWNER'S NAME: APPLICATION SUB DATE
TONG JOHN & MICHAEL HUAN 06/05/2001
PHONE: SANITARY NO. CONTROL NO.
e O z0 ARCHITEC rENGINEER: BUILDING PERMIT INFO
8L'4— BLDG ELECT PLUMB MECH
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CJ I I__I 1_1
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�,�P,j LICENSED CONTRACTOR'S DECLARATION Job Descriptio))
1 hereby uW...i'but I ant licensed under pruvieiuns of Chap,ct 9(commencing
w�ai xi,h Sce ion]000)of Divisinn3 of the Business and Profession.Code.and my license
in full force and effcce.
ares< U....eClass Lic.a CHANGE 100 AMP TO 200 AMP.
O E u Date Criminal.,
3 ca G ARCHITECT'S DECLARATION
t`0 4 1 undersandmy plans shall be used as public remNs
to
r
?pSO Licensed Professional
OWNER BUILDER DECLARATION
I Thereby affirm that I am axetnpl from the Comruemr's License Law for the
C Z< following reason.ISectian]113 L5,Business and Ilnlce,ions Gale:Any city or county
Y FM which q erinti1 t t.alter,inilirove.damolish,or P any structure
he 2 tior adds Lm requires the ppl t him suchpe no File -gned vdhenemP
that n<ildhosedp ,u Imthe provisions oft Contractor's License La (Chapter9 Sq:Ft. Floor Areal" $20�ah011
(commemem,with Senced7000)of Dr,Who 3 ofnc BusinessddPmhas ns Code)
or the,he is nsenpt themfmin and,he basis for the.))egad ese rldod.Any violation
-ofSmion 7031.5 by any applicam for a .it subjects the applicant m is civil pent
or a.,mnrt Dan Bve hundred dollars(5500). 3 5 9diP1M'4nb8r0 Occupancy Type
°1,as owner of 0e property,or my employees with wages a,their sole compensation.
will do the work,'and the structure is not intended or offered for sale(sec.70a
Buslness and Professions Code:The Contrucmr's License Law dues not apply to nn 304 — ROUGH E1fErltp` djle. tions
owner of property Who builds nr improves,here un,and who doe,such work himself
nr throughhisown employees.prnv,deg that such improvements are not intended err 7.—FINAL--ELECTRICAL .ENERGY
-oRuied odr sale.If.'wwcver,the building or improvemeni is-sold w'imiedne year of 5 0.1.. F I NAL__ELE TRI A ..
impletion.the owder.wileer will tave the burden nfproving that he did not baud or 505 — FINAL ELECTRICAL
improve for p r"'e or sale.).
un�o the
cease
apply,.
P YY61J.Business
essi ns Cad,:)
The Cmtaots m ......
as ow j
Lice
mn the p ) ons Cad )Th w vector. x, �/-(,-�L•s
, w docs nota 1 t Owner of M1 build ip thereon,
contmontcacv.for h p j ¢with e t t lsl I ee W p t.m the .. . .. . . . ._. .. . . t _ .
cmrs , , .:713
❑lam e.en angers- ' .n&PCi m,a maenn 19 � -
Owner Date 4, 'C, A 1
WORKER. OMPENSATIO DE LARATION
1 hereby affirm under Fenahy of pe rjory ihon of the following declamlicat
:I. ° 1 Rose and will maintain n C<nincate Of Consent to self insum for Wart:er's
}} Compensation. as provided for by Section 37W of the Labor Codc:'for the
_ pvrformancebf the work for which this peemit is Issued,,,.
°1 have and will maintain.WnAcr,Compensminn Immune,m mquidd by Section
_ 37W of the Labor Code.for,he performance of the wad'fur which this Brom,is
issued.MY Wotkcr's Cbmpenwfon Imii hcecorricr n,id policy inmber
Carter .a' Pali Y No. ' loll i 1-.•: '�)..'
CERTIFICATION OFEXEMPTION FROM WORKERS
...,. COMPENSATION INSURANCE
IThii ttmidn nmi Dat be romplcled if the permit is for one hundred dvllors t'1•` " ';I. ..
ISIOO/or less) '
.._. .. _ L_ .. ..-._-......�. .. .... ... .. ..... ..... ...
1 ttn fY'thm in the performance of Ih k for which h pe I' rssucd I j _
sha11'nnt con"or"ad'pecan,,n:toy manner so as m wcitme u,b3cet to IM1c Workers
Cnmpcnsa'.00 Caws of Culifinmar "hie
t NO TICETOAPPLICAM':If.Ofmr mvkin
Applicant
gtmac<mfcam of exemptlod.rnn-s,nnald� -
O Qbecome'ubject m the Workers Compenmuon provisions of the Wwr Cade,you mu.a
forthwith comply with men provisions Or this permie shall be J¢meJ revoked.
.--. -. _ ._ - _. ---_ _ ._. .-
F,'(A) " "' '''r CONSTRUCTION LENDING AGENCY ' --- -
Ci > I hereby affirm that there is a construction lending agency for the perfdmiantt
W n!Lerthe work d<r AddmsiHch n permit is issued(S 3097.Civ.C.)
Z)
V 0I certify that l have read tbls application arta sate otaune above information is
W F., closet .I agree to romply with all city and cvumy mJinances and state laws reltsm,
0-U to building construction.anE hereby anatomic represemmives of this rosin enter upon
>; tirc above-mentioned propcov for inspection purposes.
(We)agrccmmvc;indemnifyandkccpharmlessine City of(upcnno against
(0r) liabilities,judgments,costs and expenses whichmay in any way accrue against said
city flit
GARY UNDERSrAYDStA�D WILLCOMPLY N'ITHALL NON-POIYf
SU R E uLrtrro-Nis. '" r '• �,�-/D� Issued by: Date
: /S,pnanreofAppncantfctrn<tm. T Re-roofs
RUOUS'MATERIALS DISCLOSURE
boll theapplicant fjium wilding merchant sloro or lieaT h.refdas,dmenal ...Type of Roof.
as defined by the Cupsi -Municipal Cod Coapt 9.12,a I h Health and Safely
Code,Section 25532(aR - s •. f „.
❑Yes .._ .. .Il:,`'°No -,.. ,,,vel :.s1, .e 5.: 1
_ „y ._.All.roofs shallbe.inspected.prior to any.roofing material.being installed.
Will the applicant or future Wilding Mapantuse egnipmemardevices which If a roof is insialled'with'out first obtaining an inspection, 1 agree:to remove
emit hazardous air contaminants as derided by the Bay'Arca Air Quakily Management
Dwrial".- - . . all new maI. terials for inspection. Applicant understands and will comply with
°Y' ° all pori-point source regulations, "
, I
I h lead the h iCode.Sectral r y is ai 255 4.1 un 6.95 of he,
the
Celifomia Health Y<Suf<Iy Cole.Sections 25505.25533 and 25514.1 understand thin ,
,ftnK!'dIca JYh len n, that) mY rc.po 'tilryt otify the .- ._
assirt m. swra tp its a c f Cemfdate of
� 7 .11 �/�/•p Signature of Applicant ., - _ Date
woe oritialm redagene„ DI m All roof coverings to be Class "B"or better
OFFICE