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02010092 CITY OF CUPERTINO BUILDING DIVISION PERMIT 1vT GORACTOR INFORMATION ,t BUILDING ADDRESS: NICE & RIGHT CONSTRUCTION MITNO02010092 228 N STRT.T.TNC� RT) OWNER'S NAME: PERMIT ISSUE DATE JASON LIN 10663 SANT 2 .E: SANITARY NO. CONTROL NO. (408) 861-0928 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT' PLUMB MECH 0 0 0 Lop LICENSED CONTRACTOR'S DECLARATION lob Description 1 bereby aflirm don I am licensed under provisions of Chapter 9(commencing with Section 7")af Division Sof Oc Ettarevaand fessimu Colc.and my It..is sorrel oro and en y� SFDWL-LIVING SPACE 3795 ' j a License Cl s Lic.e ^Fp DdLL' COnVacbrVC 'J' ARCHITECTS DECLARATI N �^ / (/�/ /; I U dmstand my Plana shall be used az public rxmds O/ ,y T LLLL ell 0� 1 L DyU Y/{ 3Licensed Professional /I L i), /y��J �t� /,`- `./ OWNER-BUILDER DECLARATION (i Gl/�. f•L ✓ cr ✓TGLGC:A 0 0 I hereby amen that 11. exempt from the Conlnc,ari License Law for the /.'''^ 0 0 following reason.(Section 71D LS,Business and Rofesdmm Cade:Any oily or county b alt/' F.. which requires a permit on construct.altar.Imprew,demolish,or repair any stmemm F Z< pdo to its issuance,also requires the applicant fhrsuch permino Bic a signed statement that be is licensed punuenuo,he pmvisiond ofthe Conuacoms license Law(L7mpmr9 Sq.-Ft.Floor Area Valuation ,cc 3 (commencing with Section 7000)hf Division 3 of the Business and Profcasiau Ccde)or $370088 that ha a ucmpt thmefrom and the baso fm the alleged exemption Any violation of Section 7031.5 by any applicant fon permit subjects the applicant to a civil penalty of APN Number Occupancy Wmom man five hundred unit...($coreane. P Y Type ❑1,u owner of the pmKny,or my employees with wages as their sole eompenm0on, will da the wog.and the swctu.e is not mantled aroRened forsake(See.706x,Business; and Prefessiom Cade:The Conuuturs License Law does act apply at an owner or Required Inspections property who Wildsorimproves thereon.and whodeas such work himselfor through his own empkoyace.provided Na,such improvements arc not intended oroRered for sale.If, , huRde, thebuildingtrrimpromoving uhathe sold id out year of completion,meows.- builder wiB Mw the When of proving that K did no,dd10 or improve for puryose of smeJ. ❑1,as owner of she propeny,am exclusively contracting with licensed contractors to cences La the es not (sec. s an Business and rry whoa.m Code:)Them thectuh Li- ' cane Law docs not apply m is owner of prapeny who Wilds or improves thereon.and whocontractsLacm for such pmjecm with a conmec,ar(m licensed pursuant m the Convumrs Licence Lew. ❑I am cmmp,under Sec. ,B B P C for this mason Ow r Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under Penalty of perjury one of the following declarations: 1 have and will maintain a Certificate of Consent to self-imoa for Walkers Compen- �+ sation,az provided for by Section 3700 of the labor Cade.for the Performance of the work for which ill maintain is issued. ❑1 have and will ode.fon Walkers anceo t bon work which az his Per by Scnion My of NCs Co Code.for meperformanceof d work for wbiramu permit is issued. My Worker's Compensation Luua�lna tinier and No.:number./ �Y O� Carrier. �) /TTC IN6 Polity FROM CERTIFICATECOMPENSATION ON PRAM ORKERS' COMPENSATION INSURANCE (This section need not 4 completad Rose Permit is for one hundred dollars(SIM) or less.) 1 cerofv that in the performance of the work for which this Permit is issued.I shall not employ any Person in any mannerw az,o become subject 10 the Workers Compensation Laws of California.Dam Applicant NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should become subject on the Wo,hcrs Compensation previsions or the Labor Code,you must .JZ forthwith comply with such provision or this Permit shall be deemed revoked. , ZYl CONSTRUCTION LENDING AGENCY E-' lhemhy affirm that mere,is a mtuvuction lending agency for the perforesmee of C'rte+ the work for which this Permit is issued(Sec.3097,Cih,C.) OW. lender's Name =z Lenders Address J C) 1 easily that 1 have seed this application anW sesta that the above information u IL.t" correct,1 agree to comply with all city and county ordinances and sale laws raising to 17building construction.and hereby authorial representatives of this city to enter upon ftU aWwtmentioned property st fm impenses poopcwhich a (We,)agree m mw,indemnify and keep harmless the City of Cupcnino q thea H y inconsequence ftheShaming expenses which may in any way ettrue against said City yy U Z, A consequence of UNDERSTANDS S A permit. Issued by: Date 7 ^ F-o S' r. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT SOURCE REGU A NS. n 4wam /Y Re-roofs Signature of ApP San onarc AZADOUS MATERIALS DISCLOSURE Type of Roof RDO Will Oe appl am or future building occupant sham or handle hazardous material az defined by 0e,Cupanmo Municipal Code,Chapter 9.I2,and the Health and Safety code.SectionYes ns3z(a7 All roofs shall be inspected prior to an roofing material beim ❑Ye. � P P � Y g g installed. _ will thea applicant ter future building occupant use a If a roof is installed without first obtainingan inspection,I agree to remove PP 6 p Ana uordeviceswhich P mit hazardous air conumimnm m fined by the Bay Ama Air Quality Management all new materials for inspection. Distrix? ❑Yes Nu - 1 have read the hmardousmawrials mquimmenm under Chapwr6.95 of the Cakifor- riaHcal"Smc,yCeset Sccgwm25505.35533aod2S534.l wdcrstaM mazifmc Wilding does rot c ml haw a tenant.that it is my responsibility an notify thc arupent or dr .equiremcnm ch most Inel prior Uh isammeeofa Ccnificata or C cp y. volt d!l" Signature of Applicant Date Owner or , riald agent c6te All roof coverings to be Class "B"or better - _ v • CITY OF CUPERTINO ) iy,- '•�'i. ,a�gav, %, BUILDING DIVISION PERMIT CgNTRAC�'TOR INFORMATION:-' 'ti BOu.DING ADDRESS\: TAI WONG CONSTRUCTION PERMH NO. 10228 N STELLING RD 02010092 NER'SNAME: 20940 STEVENS CREEK BLVD APPLICATION SUR DATE. ,JASON LIN 01/23/2002 ZONE: (408) 253-2522 SANITARY NO. CONTROL NO. ARCIO EC IENGINISER: BUILDING PERMIT INFO BLDG CLECT PLUMB MECH pp LICENSED CONTed unOR'SDECons of CON /i^�� e U F I Section affirm That I am IireeBJ under provisions of Chapter 9(commencing 10b DCSCEJjZI(//p 2di withlt ace ad Division Sol the Business and Professions Codc,and my license is �©"" `"' F<io fmlfmce and effect. SFDWL z Licence Class Lie.N oNDate-Comments,TSDLIVING SPACE 3795 SQ. FT. ARCIIIILCT'S DECLARATION rO u U I understand my plans shall be used as public records u.F- Licensed Professional OWNER-BUILDERexempm Ce Comm ON aS 1 hereby affirm that 1 L.S.exempt from the Cssionso License Law for the V, m pO followingreason.(Section 703 construct. Business and Professions Code:Any city or musty V� which myucs a issuance,,also u+nmss the ahcp i applicant norsu dcmnikb,or repair ed sbement Nis Barr sliensedprsuant to the lhovisis(inorsuch file a Law Ihat he is licensed pursmntmthc Provisions mf NC Contractor's License Law(Chapmr9 Sq. Fl. Floor Area U �pj Valuation 6t—$ (commencing with Section 7000)of Division 3 of the Busineu and Professions Code)nr .vva5 $$ Nal he is exempt themfmm and the basis for the alleged exemption.Any violation of Y Section 7031.5 by any applicant for a Permit ubjects the applicant to a civil Penalty of APN Number not more than five hundred dollars(s5o113. Ceupancy Type Las owlm,.rdm + n 32630011 . 00 ❑ pit pe ct remyemntende withwagnnthei((Sec. compensation. will Ju the work.and the structure is not intended or offered for sale(Sec.7W4,Business and Pmfenions Codc:The Contractors License Law does not apply to an owner of 101 - FOUNDAfg95qed Inspections property who builds or improves thereon,and whodoes such work himself.,through his own employees.Provided Nal such improvements arc nm macraledornlfined for sale.If, 102 — PIERS however,fie building or impfovcmcnt is sold within one year ofcompletion,the owner- builder will have de burden of proving Nat be did not build or improve for purpose of sa10. 104 - REBAR ❑I.as Owner of the property,am exclusively contracting with Incensed conuacmm to 105 — ANCHOR BOLTS construct the project(See.7044.Business and Professions Code:)The Contmetm's U. Genu law does not apply to an owner or progeny who builds or improves Brecon.and 106 - SEWER & WATER Lhcnse Law. rmr s.rn proj«¢withamntmanr(al3menxd pursuant contma°r's 202 - UNDERFLOOR PLUMBING ❑ I am exempt on or Scc. ,B&PCfo ythS asoo 203 - UNDERFLOOR MECHANICAL e w(/ TVIU(!�- m 1 13 Od 204 - UNDERFLOOR FRAME WORKER'S COMPENSATION DECLAR)T 205 - UNDERFLOOR INSULATION I hereby affirm under Penalty or perjury,one Of the fon' ing declaration: 3O1 — ROUGH PLUMBING Ihavc arta will maimaina Ccnihcam.rconwmmacR-maure for wmk,ricompcm SO2 - TUB & OR SHOWER sation,u provided for by Section 3700 of the labor Code,for the performance of me work for which this permit is issued, 303 - ROUGH MECHANICAL ❑1 base and will maintain Worker's Compensation Insurance,as required by Section 3 04 - ROUGH ELECTRICAL J71y1 nl mc,Labor Cndc,for the performance of the work for which this permit is Issued, My Worker's Compensation Inmmncc carrier and Policy number sure: 305 — FRAME Carrier: Policy No.: 306 - HOLDOWNS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE 307 - INSULATION missectirm need not W completed'(the pem,h is forms,hundred dollars(MOO) 308 - SHEETROCK "rlCs.$) 309 - EXTERIOR LATH I ccnify Nat in the f ante of the work for which this permit is issued.)shall not 310 - INTERIOR LATH sm In rs,m anlmr t ,s tics m Ne Workers'Compensation Laws of Caalif,rniat m s'SB3a3';' '7'0�) rc 311 - SCRATCH COAT App, N /N F r NOTI@EI�APPLICANT:If,ager making this Certificate of Exemption,you should 313 - ROOF NAIL become subject to[be Worker's Compensation previsions of the Lahor Codc,you must Z, fIhwimcomply with such pmvrmnxm, his prmi,ah.nbedecmedrr„,kid, 501 - FINAL ELECTRICAL ENERGY z O CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY F Ihemhyafrom Natthereisaconswctionlending agency h,rthe performance of 503 - FINAL MECHANICAL ENERGY Qi the work for which Nixpermi t is issued(See 3097.Co,C.) w Leader'aName 504 - FINAL BUILDING ENERGY � z and rsAadmas 505 - FINAL ELECTRICAL U O 1 ccnify that 1 have th this application y o cute them the shove ws relatiinn is 506 - GAS TEST w c.nccl.l agree to comply with all city and county ordinances and mala laws relating to OU building connnaion.and hereby authomcrcpreunmtivcsnfpis City mcnmrurymthe 5 FINAL PLUMBING W trove mentioned progeny for inspection purposes. O8 FIN LL (We)egret to save,indemnify and keep harmless the City of Cupertino against CHAN (.' L F h Iiabilitics,judgmcne,cosu and expenses which may in any way sane against said GlY 5 N E V z in consequence of be granting of this permit / APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by51 G pale / SOURCEREG IONS. / �`3' Re-roofs 602 - OF PLYWOOD NAIL lure of Applican mmam me H .ARDOUSMATERIALSDISCLOSURE Type OfKOO - ROOF BATTENS Will Ne applicant'or future building occupant store or handle haarduus material 604 - ROOF IN-PROGRESS defined by the Cupertino Municipal Code.Chafer 9.12,and the Health and Safety .Sccuon LCI All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit ha,ardoes air contaminants as derided by the Bay Area Air Quality Management all new materials for inspection. Diurinl ` / P C]Yes 14i'N'1 1 have mad the ha nJoas materials,equir,men¢under Chapter 6.95oftheCalifor- aia I lcalth d,Ster Cale,S,eum,255(p.25533 and 25534.1 understand Nal if Ne building dices not currently have a tenant,Nal it is my responsibility to fairly me occupant of the requinarers ' hmuubemetpdnrinissuanceofaCendicamofQeup/eye Signature of Applicant Date / Ort iter or atihome gent u,c All roof coverings to be Class "B"or better CITY OF CUPERTINO + `�'� "� j4 Ift But DIVISION PERMIT C®NTRACTOR INFO$MATION BUILDING ADDRESS: P WONG CONSTRUCT 0201009 O E: PERMrf ISSUE DAIS 20940 STE CREEK BLVD 12 3/2002 SANITARY NO. CONTROL NO. 253-2522 ARC HITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 300 DCO RA OR'S DEC ATION �u 1 hereby affirm that 1 em limnxd under provisions Chapter 9(commencing SCrlpt]On ¢ with Section 700X)of Dlvlalon3of NC Buaimy aPLProfcssio Code,md myliccnsc is '+< in full tome o etre aJ( D2y,z a«nm cissa Lica SFDWL AqDe Corinna Iundentandmyplanschallbeusesdaspublic.coN N 'ARC SDEQRV1FtAGON LIVING SPACE 379,5 SQ. FT. 506 CHANGE CONTRACTOR: P & T CONSTRUCTION 05/20/03 au. Lkcnxhereby 103 OWNER-BUILDER DECLARATION I P hereby.(firm o n I am exempt from 0e GOnRamCo License law for the O O following mom.(Section 7011.0.).musts and rn.demolish. e nm h.or Any city her county 5^ which requires•perms m cnruwcl.ells.impmac.dcmnot I II.pair any Snide. _z> prior mslicensedpumrt to thnc,e provisions mfla,Common's kens,aw(Chmmcm, YF�< that(com iacingwitpurttion7 epmvisioiu 3ofMe usinesisniComclaw(Chepter9 \ S PI. Floor Area Valuation (commis exemithherefrom Rod drDieekion3M alleged Businessland 1Godt)or i $ Nn io 7 exempt therefrom and Ne peo for the cts Me exemption.Any viohtion of not Section Man by my applicant farepermit Subjects Nc epplicem toacivil penalty of \ / APN Number �t not.ort Nan Rve hundred dollen(5500). s 3�l�my gape ❑I,as owner of the property,or my employme with wages as their Sole cempensnion, will do the work,and Ne nroaure u not intended oreRe.d for Sale(See.7Odd,Business end Profession,Code:The Commcan s License Law docs not apply to an owner of 3 2 6 3 0 011 . 0 0 Required Inspections pooperty who builds or impro ms themon.and who does such work himself or Muough h4 own..playas,provided that such improvements arc notinlended oroRerW for asle.IL however,the building or improximno is sold within one ye.of Completion.theowner- 101 — FOUNDATION �k,cr will have the Wmen of proving that W did not build or improve for puryox of 1P2 - PIERS D 1,as vane,of the property.am eaelmivcly convecting with licensed convene.to 10.3 — UFER comtruct the project(Sec.7044,Business cod Professions Code:)Ties:Cenvamors V-/ ecru.Law does not apply in an owner of properly who Wilds or improves thereon,and, 104 REBAR who Contracts for such projects with.convacmrts)Baled pursuant in the Comvad68 105\ ANCHOR BOLTS License Law. 0 Ism exempt under See. ,B A,P C for this.aeon 106 - SEWER & WATER Own" Date 202 J— ]DjERFLOOR \ ERFLOOR PLUMBING WORKER'S COMPENSATION DECLARATIDN 203 ERFLOOR MECHANICAL Ihercby affirm under penalty of perjury one of the following dation.: 204 ERFLOOR FRAME bale and will maintain a CertificateefConscm to acv-insum for Worker's Confer. 2OS INSULATION 1307. n,as provided for by Section 37M of the labor Code,for the performnce of Nek for which this perm it is issued. O1 GH PLUMBING bale end will maintain Worker's CompensWon insurance,m raluimd by Section �j02 &\OR SHOWER 0 ofthe labor Code,for the performance of the work for whictithiti permit la issued. O3 GH MECHANICAL Worker's Compensation Imorence c ria and Policy number am:Policy .: -Z O 304 - ROUGH ELECTRICAL CERTIFlCATE OF :FMPTION FR WORKERS' 3 5 - FRAME COMPENSATION INS CE 306 - HOLDOWNS (Thissatinn need trotbe Completetliftbe Permit itiforene hundred dollars(gl ) 307 - INSULATION\ m Iw.) 1 unify that in the performance of the wmkda which 4,permit is issued,1 shall not 308 - S HEETROCK employ any portion in any manner an m m become subject to the Workeri Compemalled Law, 309 — EXTERIOR LATH of Califomia.Dam NCTC Applicant / 310 - INTERIOR LATH N come subject70 APPLICANT:IL Co making this Cenifn:ate th Lam o d you should baome mrVy,the WorkersCompensation or isprovil mai of thelate.Code,you must 3 C COAT =O forthwith comply with Such proviaiom Cor this permit shall be deemed revoked. IL Z rN. CONSTRUCTION LENDING AGENCY 5 3 - 1MVLECTROREICAL ENERG 1 heathy affirm that there is a construction lending Agency for the performance of 3~'s > the work for which this permit h issued(Sec.3097,Civ.CJ Lender's Name 5 0 2 - FINAL PLUMBING ENERGY Y Q r ] <nd Z r'.Add= 503 - FINAL MECHANICAL ENER Jp Icenlfythat Iban ad thisapplicadonand stake Mrs,thcaborcinformation,is SO4 — FINAL BUILDING ENERGY marectF Wilding IgreemComply ,andhereby misting re 5 5 - FINAL ELECTRICAL \ JV Wilding cmirmcd restudy forimamhorimmp¢unuuvuof this city mrnter upon the [fa aWve-mentioned property for impcnion puyroses U&- GAS TEST ti gL (We)agree m sew,indemnify and tap humleas the City of Copatimo agaimt Vy Iiabilidm,judgments,emu and eaprncs which may in any way sec="Sint said City 07 — FI J,'� A APPLICANT or Negra ngof this permit ^Z APPLICANT UNDER ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: S - ICAL Date 5 SOURCE REGULA S. - Re-roo H RDO fs 510 INAL PLANNING \ I ppit en oUSMATERIALSDISCLOSURE D' Type ofRoR14 - FINAL PUBLIC WORKS Will the Are ant ,future building occumm store or handle hr-olmis material 602 - ROOF PLYWOOD NAIL m defined by the Cu Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532W7 All roofs s e insP� �7ri pYm BrNe q � "tfi' f � �j�aterlal being installed. �T If a roof is m t led WI O fir ob I I g S ect]on,I agree to remove Will the epplicem or forum Wilding occupant use equipment or devices which I haaardoas air cuntiminams as defined by Ne Bay Area Air Oualiiy Management trictall new materials for inspection. / ❑7 Yes pNu I have rob site haaardnos materials requirements under Chapter 6.95 of the Celifnn ria Heal"SefetyC Sttvom 25505.n533 it 2553x.l unendiand that if the building docs nos curcntiy ha a mount that h u ery m.pomibility u notify r thoriaed eel occupant m dm exquiremcnrtwdh 'nxerelpeiatubjec,ceoracalincm,or PU . 1 ignature of Applicant Date ' Date e3 All roof coverings to be Class"B" or better i i JIM LIN 20940 StevaaS Creek Btv& a athxk CA,95014 (408)253-2571 05/23/03 P&T Congrncdon P.O.Box 360999 Mapitas,CA 95036 RE: 10028 N Ste]Tog Road,CopatiDa,CA 95014 Dear Mr. Peter Lu&Tommy: I baebyto costw shecoohaet,theaagmadcoanact witlitbe sipemne deed on 45/19103 . is in my possasi m same 4500/43,I do not read and wrote Eagfisb,4=016re,she coaftad aha&be void and MA please rWan the aSMOVW Phn back to tae as Soon as possl1e.Thaak You If you have aay gincstioa;pkse:don't heskatt to ca&my aaomey Mr-1 iuk Shraeder_ At(408)249-7750 Smo�re,Iy, Jim Lai CITY OF CUPERTINO 'm 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32630011 . 00 DATE ISSUED. . . . . . . : 05/20/2003 RECEIPT # . . . . . . . . . 21897 REFERENCE ID # . . . : 02010092 SITE ADDRESS . . . . . : 10228 N STELLING RD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . : OWNER JASON LIN ADDRESS 10228 N STELLING RD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : P & T CONSTRUCTION CONTRACTOR TAI WONG LIC # 23861 COMPANY TAI WONG CONSTRUCTION ADDRESS 20940 STEVENS CREEK BLVD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE (408) 253-2522 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - --------- ------------- ---------- -- -------- -------- - - - --------- - --------- BENERGY PERMIT FEE 1 , 872 . 00 561 . 60 561 . 60 0 . 00 0 . 00 BMITIGATR SQUARE FEET 3 , 795 . 00 4060 . 65 4060 . 65 0 . 00 0 . 00 BPERMFEE VALUATION 371, 000 . 00 1872 . 00 1872 . 00 0 . 00 0 . 00 BPLANCHK PERMIT FEE 1 , 872 . 00 1591 .20 1591 . 20 0 . 00 0 . 00 BSEISMICRE VALUATION 371 , 000 . 00 37 . 10 37 . 10 0 . 00 0 . 00 BCONSTAXR FLAT RATE 1 . 00 467 . 53 467 . 53 0 . 00 0 . 00 BUSLIC FLAT RATE 1 . 00 100 . 00 0 . 00 100 . 00 0 . 00 PPLBG SQUARE FEET 3 , 795 . 00 265 . 65 265 . 65 0 . 00 0 . 00 ELECTRIC SQUARE FEET 3 , 795 . 00 265 . 65 265 . 65 0 . 00 0 . 00 EPERMITFEE FLAT RATE 1 . 00 35 . 52 35 . 52 0 . 00 0 . 00 MPERMFEE SQUARE FEET 3 , 795 . 00 265 . 65 265 . 65 0 . 00 0 . 00 MPERMITFEE FLAT RATE 1 . 00 35 . 52 35 . 52 0 . 00 0 . 00 PPERMITFEE FLAT RATE 1 . 00 35 . 52 35 . 52 0 . 00 0 . 00 -------- ------- -------- -- ---------- TOTAL PERMIT 9593 . 59 9493 . 59 100 . 00 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER -- - -------------- ------------ ------------- ----- ` CHECK 100 . 00 350 TOTAL RECEIPT 100 . 00