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CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO,
10358 S STELLING RD
01040097
OWNER'S NAME:
APPLICATION SUB DATE
LAN, CHUN HUNG
04/19/2001
IPHONE:
SANITARY N0. CONTROL NO.
ARCHITECT /ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
r—1 1_:I I__7 I -1
LICENSED CONTRACTOR'S DECLARATION
Job Description
p
1 hemby affirm mm 1 am licensed under provisions of Chapter 9 (commencing
with Seem 700)1 of Division 3 of the Burins and Pmfessiom Cale, and my becose
1ST FLOOR ADDITION,
In full fans aI e'. L 7d' /o j
/ r
LIVING SPACE 754 SQ.FT
License Class Lic. N
Dam Commemr
,
GARAGE 221 SQ FT
ARCHITECT'S DECLA TIO.
. .
1 underaand my plans shall W used as pubic curts
g�
Licensed Professional
OWNER-BUILDER asamptDECe CanumON
1 Heathy that 1 license for me
exempt from the Cosions
y�tl It �®
eae
es city o
following ransort (Section .031 J. Business and Profcsiom Code: or county
. (Sect 1J o
whicM1 enquires a l sw , aher, i ep n e
or mpmr any wee
111
JUN
nt
e.alwm ui t ft. w, hwnia gradaaptem
..'norm a. Imreg resdmvisionanrfeCon=tois
- S
Lit
otmn sr n. a� .mbntt mep oaormeconlmamrsL rcnaatt9
Icom g ai va)BI The onfineBUyilexa darrin : nsCoda
f. _ Sq.-Ft. Floor Area t
�i�•ri . {( >.+ SL: -4 .. `.{ C. +,Ih3.'.I lye '
ation CUUZ
• 7 $2000 ff
basis
of that he i7 eacmpt mem0om and the Weis for ube e1Byed uemanN. Any violation
mIpt
- of Section 70315 iv any applicant fora permit subjects me applicant m a civil penalty
'of not moi< than r . ehundred aonarassBO).
35Phi�t+fnb�r0 1
Occupancy Type
❑ 1. as owner of the property, or my employees with wages as their sale compensation.
'will- da'in. work, and me swaare a mat intended ur- oBered for sale (Sa- N4. •
';will d'Profmsinns Code The Comrmmr's L tense Law does not .,Ply to an
101 - FOUNDAT Id�dtllired Inspections
ortt r of property Who amido as improves hencoa and wha does s a'll won himself
102 - PIERS
or errough hie own employees. provided that such improvements teems art not intended of
-, oacrta for sale. IL Wwcver, w building or i am n sold within one year of
103 - UFER
Witter of
completion, the owner -W ildtt will have the WNcn of proving Mat W did not Wild or
imptor<rar ppgse N.me.).
104 _ - REBAR '
01.a n - - y -- -g
❑Las owner of exclusivd commnm with licensed contractors
105 - ANCHOR BOLTS _. _-
mama the Project (See. 7044. Business an! Professions Coaef The Coamdors
10 6 - SEWER & WATER . � . . .� ....
License Law does nil apply to an matter of property who Wilds or improves Macon,
_sane who cmn.s.far.weh prujccs with,. smamdnns) licensed p °fwant.tn the
t
202 --- UNDERFLOOR .'.PLUMBING._,,,.,- __.._._... ..
commaors License Low.
❑ I am exempt under Sec. .B &PC famiamason
203 - UNDERFLOOR''MECHANICAL
Dare " -
204 - UNDERFLOOR FRAME
WORKER 'SCOMPENSATIONDECLARATION
2OS - UNDERFLOOR INSULATION
Inereny arum nneq penalty err per }IirY,om or,me foBmwing aedaarmns:
301 - ROUGH PLUMBING
❑ 1 have grid will mainiism ". Cinificaic'of CrrmmK mu el6lawm far Wavers
3 02 - TUB & OR SHOWER
Compensation, as provided for by section 37W mf the LaWr Cafe, for the
performance orate won far which this 'emirs is issued. ,,
303 - ROUGH MECHANICAL
❑ I have and will 'm imma' �Y rLers Comansalimn lms ,mates, as required by Section
3 04 - ROUGH ELECTRICAL
3700 of heL,Wf Cade: for'tne psiformone of me work. far which this p<r;nh is
.mcd. My Worker Compensation I nce c d Policy Wr arc
3 05 - FRAME
t QO1P- T^IpsicYN 3
_. �- -, .___.. -�
306 7' HOLDOWNS
't'.t Gil,
'tl Cm
. CERTIFTCA ONOP,E%EMFnONFROM.WORKERS'I -''
r • t
3O7}- INSULATION" 1
...; INSURANCE''' " ""
COMPENSATION .- p
HEETR K._ _ _ 1 :' i�.i „,.
coed va WcoSAT10N
mpiaied OlW permit is fa anti hmdmd aaaars
rnlu
.. ,..:i1):;•i, v
309 - EXTERIOR LATH
IEllgl
_ '31'0- --,INTERIOR- LATH. ''••..•._ ,_ _•.•• °•. -. •.._• -_ ..
i comfy maim me perto nca oflW onfar Tchtln a'. it isnmce.i
t hdl mot eaploy any: a. n n any manna, asm WCbme'sybiecu this wooers'
a �
311 - SCRATCH ' . ...1 „, u.,. .: I-
Compeawtion L°ws of Califmmia. Ddte ” " "'
Appheant ..... ,.. .. . ........ ........
313 - ROOF NAIL _,.. .. .. _ ... _
NOTICE TO APPLICANT: if.'afer making his CeNfi<ae of Esentpaan.ynush,°ld'
501 - FINAL ELECTRICAL ENERGY
becomesuhjentothe Wooer's Compcnwtionpiovisions'oftheI rfade,youmust
famwit6'mahpiywim such Inavi,iom, thispamits bull Wdeemedrev.kcd,
502 - FINAL PLUMBING_'ENERGY .
CONSTRUCTION LENDING AGENCY,
503 - FINAL MECHANICAL. ENERGY' L
Ih by aPmn thanhere' n conshuaion lending agencyllr the performance
anhebak(orwbmh this pen�ll is.I....d lSee:'um'f.'Civ. e.).
504 - FINAL BUILDING ENERGY
- Iknd N _ . ,_, _.. .. ..�...
Leaaer.Address -
.. .. - .
505 - FINAL ELECTRICAL ,
`
and
506 - GAS•TEST
mm 1 have stem that me above mmrmatlon is
read II this ity
oo
g. with adtimn
burn1acmemcom'lydheallcityand conprsommwcoaibi sate ].,a relining
507 - FINAL PLUMBING
to building entionedorperty fora amnia i Iepri£imtive >of tents city meater upon
meaWve. meammapmrenyrariapdrmapmrpases.
508 - FINAL MECHANICAL
(We) agree to save, indemnify and keep hammers the City of Caperton against
liabilities, judgments. costs and expenses which may in any way °°cope again° said
509 - FINAL GRADE
City in consequence of the granting of this permit.
_
NA P ING
APPLICANT UNDERSTANDS' AND WILL COMPLY WITH ALL Spoo INTO
Issued Date
0 NbA
aweRkS
nature of App, q
' HAZARDOUS MATERIALS DISCLOSURE
RIc LSD
Ifumre
Re -roofs
p `
wtumed Icom W Iling vac a handle h Fdoue material
_y
-TypeofRoof . -. -�- ----- . >-
as de(nad by me Cupenmo, Municipal Code. Chirac. 9.12. and me Health and Safety
Code. OmYes :355J2(v) ^ -, v.;1Ca❑ ri
No�r,s' ,R,'; I • t,i, 1:: ii "4!t. :,., .`
°' +• ' •I r'
All roofs •shall, be.inspected. prior to any_roofing. material being-installed..
.-
.•n Will the° pp, iean, orfularebuildingoccupantuseequipment ordevicc 'white
__ ... -.. ..
If a roof is install edwith' out first obtaining aninspecti6f ,'Ildgree'to`ferfnove
emit h Nos t ono a t a. d f n d by the Bay A A Quality M agement
roes t
new materials for inspection. Applicant.kinderstands and will comply with .
❑Y ON. -. ' r.
,
_all
all'non -point source regulations; ,,,,•., i ,q .
I have read the h r S,ms innienal mqutremcnts under Chapmr'6.95 of the
Cafifomia Health & Safety Code. Sections 25505.25533 and 25574. 1 understand mat
if the building does not cunemly have a tenant. that it is my responsibility to notify the ,
-
e
ae6piht of me riquir menu which mba W'md prior m ii.ivanre of,. Cenificatn of
°" "p ° "qr�
Signature of Applicant Date
All roof coverings to be Class "B" or'better'
owner or aammHae agent,; Dam
- - OFFICE