02120099 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFOMATION
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BUILDING ADDRESS: LIANG LEE PERMIT NO.
10708 S TANTAU AVE 02120099
WNER'S NAMIi: 24010 PRINCESS ELENA CT APPLICATION SUB DATE
ALFRED & MONICA WONG 12/27/2002
DONE: 650 917-9666 SANITARY NO. CONTROL NO,
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
RLDG ELECT PLUMB MECH
0 0 0 0
�00 LICENSED CONTRACTOR'S DECLARATION
umG I hereby affirm that 1 am licenced under provisions or Chapter 9(commencing Job Description
<� with Section 700(Pof Division 3of NC Business and Profesomns Cathedral my Secure is
I full form and effeel. REVISION--IN HOUSE USE ONLY
a° If
ZY: iiawn" clura Co�traelor NO NEW PERMIT ISSUED ORIG. 01080045
<=Z�� ARCHITECTS DECLARATION f
K y t 1 understand my plans shall M incites public mends
dO�U
u3.G Licensed 1'nrfcssinwl
OatNR-exempt R DECLARATION
z 0$ 1 hereby.diem that 1 1. cacntpt from the Cumrns Co License: nylaw for the
ti a 2O which ing reamn.permit
it 7(131.5,Business dna Professions Code:Any city of conmy
$ which reyuirea a e.also mairiconstruct,after,lie iropmw,demolish Permit i fi repair any structure
Hoa that hnitsiensedpmsnntto the thcsnt Ru sucConcrerminoicensle.e Law
< Nn M1cincing With
section
mlM provisionsDvsion oftheBusines aLimnulaw(Chapmo9 Sq. Ft.Floor Arca Valuation
uFzer�3
(Commencing exempturainn711dd of Diviaioar ofthe rssandam.Any1n5CMC)or $333000
y�� Nal bo is exempt thcre0om and dm basis for the alleged exemption.Any violation of
Section 703 L5 by any applicant for a Permit subjects the applicant to a civil penally of APN Number Occupancy Type
not more than five hundred dollars 15500). 37537003 . 00 - P Y YP
❑1,as owner of the property,or my employees with wages as their rule compensation,
Will do the work.and the suuaure is not intended or offered fondle(Sec.7W,Business
and Professions Code:The Contractors License law does nut apply to an owner of 101 - FOUNDArilftqed Inspections
property who W ildsar improves themon,and who doessuch work himselfor through his
own employees.provided that such improvements are not intended or offered for We.If. 102 — PIERS
however,the Wilding or improvement is sola within one year of completion.Ne owner.
W ilder will have Nc burden of proving that he did not Wild or improve for purpose of 103 - UFER
`ale) 104 - REBAR
❑1,as owner of the property,am exclusively contracting with licensed contractors in 105 - ANCHOR BOLTS �\
n
covect the project(Sec.7044.Business and Profession&Code:)The Conmator's Li
aLaw does not apply aman with
peculiarly who sedpurrimprovu thcscpn.and, 106 - SEWER & WATER \�C
LMC^se Law. for such pmjecu wiNacontactor(glimnxd pursuant to Be Conualors 202 - UNDERFLOOR PLUMBING fib`\l
❑ IamexemptunderSec. ,B&PCforNirmxson 203 - UNDERFLOOR MECHANICAL
net Dam 204 - UNDERFLOOR FRAME
WORKER'S COMPENSATION DECLARATION 205 - UNDERFLOOR INSULATION
I hereby aRimt under Penally of perjury one of the following declarations: 301 — ROUGH PLUMBING
❑I haw and will maintain a Certificate of Com enuo self-insam for Worker's Compan.
Wain,as provided for by section 3700 of the Labor code.for the performance of 302 - TUB & OR SHOWER
work for which this pennRisIssued. 303 - ROUGH MECHANICAL
[D I have and will maintain Worker's Compensation Insurance,as required by Section 3 04 - ROUGH ELECTRICAL
3701 of the labor Code,for Ne performance of the work for which this Permit is issued.
My Workers Compensation Insurance carrier and Policy number am: 305 — FRAME
Carver: Poll,No.; 306 - HOLDOWNS
GIiRTIPIG MPENSATIONTE OF ION INS RA CEORKERS' 307 — INSULATION
(This section need not he completed iftM Permit is forone hundred dollars(3101) 308 - SHEETROCK
]a..) 309 - EXTERIOR LATH
I certify that in the performance of the work for which this Permit is issued.1 shall not
em310 - INTERIOR LATH
ploy anma
y pervm in any manner m as In Mm
coe subject the Wnrkcri Compensalinn
Iawaofcaluomia.Dow 311 - SCRATCH COAT
Applicant
NOTICE TO APPLICANT.If.ofc,making this Ccnifcate of Exemption,you should 313 - ROOF NAIL
Wcome subject to the Worker's Compensation provisions of the labor Code.you must 501 - FINAL ELECTRICAL ENERGY
0Z forthwith comply with such provisions or this Permit shall W deemed revoked.
CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY
t-. IWrehya0irmthat them isaconstruction lending agency lot the oforturneol 503 - FINAL MECHANICAL ENERG
w > the Work for which this Permit isissued(See.3097,OV.C.) 504 - FINAL BUILDING EN ERG
ul 0 lenders Name
5 z enaerrAddress 505 - FINAL ELECTRICAL
U O 1 minty that I have read this application and sure that the above information is 506 - GAS TEST
W {. correct.I agree to comply with all city and county ordinances and state laws relating to
Q building construction,and M1cmby authorize representatives of Nis city menmrurym rM 5(D--4\ FINAL PLUMBING
W douse-Oze)agree
property roremnifyan keepe&. O8 FIN C L
Pr (We)agree m saw,indemnify and keep harmless the City of Cupertino against
fA Iiabilities,judgmenea,costs and expenses which may in any way acme against said City 55 N
U Z in cores mote of the looming of this permit.
^t APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by 1 NG Date 9A
SOURCE REGULATIONS.
rur
Re-roofs 602 - OF PLYWOOD NAIL
Signature nl ApplimBAZA roam Dam
IIAZARDN SMATERIALS DISCLOSURE Type of R8pf3 - ROOF BATTENS
Willy the Cupertinant oro
Municipal ngsaruhaptr9.12,store handle the Health and Safety 604 - ROOF IN-PROGRESS
al
a defined by the Cupertino Municipal Calc,Chapter 9.12,and the IIcaIN and Safety
de,Section 25532001 All roofs shall be inspected riot to an roofing material being installed.
Trs E]No P P Y g g
Will the applicam or future Wilding oecupam useequiproma devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as divined by the Bay Area Air Quality Management all new materials for Inspection.
Dkilicfl
❑Yes No
1 have read Ne huvaNrms materials reyuiamems under Claim,A 95 of the Cali Rx-
niaHendon&Safely Cole.Sections 25515,25533 and 25534.I undersand thin if Ne Wilding
aces not currently haw a tenant,that it is my Rsprdishility in notify 1M occupant of the
requirements which must W met prior to issuance of a Certificate of Occupancy. Signature of Applicant Date
Owncrnr authnriied rom nam All roof coverings to be Class "B"or better