06070118 CITY OF CUPERTINO �••'a fes" (¢'*�"' '" ° "` ^'
BIJILDING DIVISION PERMIT CONTRACTOR INFORMATION
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BUILDING ADDRESS: WILLOW GLEN ELECTRIC INC P"""N"06070118
18725 TILSON AVE
OWNER'S NAME: PERMIT ISSUE DATE
YUCHI TAY 1085 WARREN AVE 07/18/2006
NE:
SANITARY NO. CONTROL NO.
(408) 289-9725
ARCHITECf/FNGLNEER:
BUILDING PERMTT INFO
BLDGELECT PLUMB MECH
0 0 l 0
'ipa LICENSED CONTRACTOR'S DECLARATION
wJob Description
C 1 hereby affirm Nat 1 am lived under pmisi
voru oen
f Chapter 9(commcing
�IW with Solution 7")of Division 3 of Ne Business and Pramual Code,and my lkcosc is
13� kftrn0maander. - Sg17f� 200 AMP UPGRADE
n y�z Liccnu Clan Lk.a
Fo Dau
Commissar —P
ARCHRECTS DECLARATION F9 +.]r-,.,�
U1 uneorsmnd my plans shall W used u public records lft/11 yU] Pf[g(},i1—'2',r
•n In Licensed Professional
5 OWNER-BUILDER DECLARATION
C C 1 he.M1y o(Sec on I a1.sumps from Ne Canons Con Liccnu Law for Nc �`
.CC O fallowing mason.(Suisun 7(131.3.Business and Pm(cstium Code:Any city of county JUL Z• ; �OOL
$9 which aqui.a permit to conurucL alto.improve.dcmulLsh,ter repair any Stromlo. $2700
.miprior m its issuance.also requires Ne applkantforsuch permit to file a signed statement
that he is licensed pursuant o the provisions of the Contractor's cense Law(Chapter 9 Sq..Ft. Floor Area (p777p (f Valuation
exp (commencing with Section 7W)of Division Sof Ne Business and Professions Code)or it t7 �/r'7A
s`C
that he k exempt therefrom and the basis for the alleged exemption MY violation of
Section 7031.5 by a y applicmn fora permit subjects Ne applicmt to anvil penalty of r U U ' �d Il VJ�ceupaney Type
not more Nan fin handled cultural(5500).
❑Leowrc4ofdie gvpmy,amyomPloyeeswdh wageu.1a sokcam.Busi n,
will dolewart.anile: he CatracotsLkaorawMffercul strut(Sly.in as,Boer of
and Professions Code:The Cansecmrs Liana Law does ore apply lf an owner is Required Inspections
Property who Wildsor dm tethereon.andwhodmssuchwort oroffeor Nusad h6
awn employes,provked Nat pkh improvements art nut sun f c nspicu eE for ole 1f.
bailees.the building or impmvem m 4 cold within arc year of completion.the owner-
balo.).r
will have Nc burden of proving that M tlitl test build m imProvc for purpom of
ole.).
❑1,u owner of the property.am exclusively contracting with licensed com odors m
construct the Project(Sec.7014,Business and Professions Cede:)The Consumes Li-
ccnu taw docs not apply us an owner of inual who builds or improve thermal and.
who contracts for such projects with a conincul s)licensed pursuant m Ne Contractors
Lic"m taw.
❑T am stomps under Sea ,B&P C for this mason
Owner Dau
W ORKER'S COMPENSATION DECLARATION
T hereby affirm under penalty of perjury one of the following decimations:
1 ha..and will msinuin a Cenificau of Consent to self-insum for Wortrr'sCompen-
ution,as prmided for by Section 37M of the Labor Code,far the performance of the
work for which this permit is issued.
C I basic and will maintain Worker's Compensation Insurance,as required by Secuon
37M of de Labor Code,for the performnrccofthe work for which this permit B issued. '
My Workers Compensation Insurance artier and Nil usher ale:
Cartier. Poliry No.: Zw O G
CERTI�MON FROM WORKERS'
COMPENSATION INSURANCE
(This rection need not W completed if Ne permit is forone,hundmddollars(SIM)
or less)
1 ceni( Net in the performance of the work for which this Permit B issued.I shall not
employ anyperson in any manner u as to become subject to the Worsars Compensation
Laws of California.Oak
Applicant
NOTICE TO APPLICAN-T:If,after making NB Certificate of Exemption,yes should
bmmme subject In the Workces Compcnvtion previsions of the Labor Code,you must
.J O forthwith comply with Such provivnrs or Nu permit shall be ticemcd mated.
z C7 CONSTRUCTION LENDING AGENCY
[-+ 1 hereby affirm that Neu is a construction lending agency for the performance of
IY the work fur which this Permit is issued(Sec.3037,Civ.C.) -
GQ tenders Name
a z Loaders Addy as
1)0 1 certify that 1 have red this application and sok Nat the above information is
lL corucL 1 agree to comply with all city and county ordinances and sum laws relating m
C) building construction,and hereby antborim reprounutivu of ihisciy m enter upon the
[L1 abovomonudgm us,PoOc s for a pence,puquus
C6 (We)agree to mare,indomnt fy and step hareales Ne City of Cupenino agsinst
h I.coisequeneorth,caand.t ofhis emiich cosy in any way acmk gainst aid City
[)z in consequence of tM granting ofhis permit. //'y n a
v^ APPLIC INDERSTA ND WILL PLY WITH ALL ON. OI Issued by:s4te� Date /.�/(""�4
SOU EGULAT 07
(7�
Re-roofs
Signaz a Appl o or ete
H MATERI SDISCLOSURE Type of Roof
ill Ne app mor future bui1=99 cspant able m handle hauaNae material
u deRned by thcCupertino Muninpl Caec.Cbapter 9.I2,and dw Hca]h and Safety
Cale,Section 25532(.)? All roofs shall be inspected prior to any ro ng material being installed.
Will the applicant ter mm.Wilding a¢a cot nes If a roof is installed without first obtaini an ins coon,I agree to remove40 -
pP 6 pa cquiVmcnlorderias which Pe g
omit hanaNnus air cmnerminanu as defined by the Bay Ara Air Quality Managcmem all new materials for inspection.
DisnicR
0 Y Nu
I have mad the hanarduusmaterials.quiumenu under Chapter 6.95a1'the Califor. ^ �s
ni.Fk.IN&Safety Cao,Sccuau25MS,25533and25534.1undcrsund NmIft Willing
Jae not cunendy hast a tenant, u my uS o Pity@�wdl'Y ted ceuD t or
The
.genre ntswnknmuu'pre, mit we ml. certirkateara G (� Signator f applicant Date
ow autharirludagcnt Dote All roof CO e, S be Class "E"or better
Community Development
��`
CITY OF 10300 Torre Avenue
Is
,'� �, „ Cupertino CA 95014
�:t'V Telephone(408) 777-3228
Fax(408)777-3333
*PEkTINO
Building Department
JOB ADDRESS: �e PERMIT #
18 2S o ,s�
OWNER'S NAME: PHONE # F
GENERAL CONTRACTOR: G FAX # O —2 - C/
I am not using any subcontractors:
S' a Daie
Please check applicable subcontra or d com e e followin information:
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
Owner/Contractor Signature Date
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37518001 . 00
DATE ISSUED. . . . . . . : 07/18/2006
RECEIPT # . . . . . . . . . : 35305
REFERENCE ID # . . . : 06070118
SITE ADDRESS . . . . . : 18725 TILSON AVE
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER YUCHI TAY
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : WILLOW GLEN ELECTRIC
CONTRACTOR LONDRE, MARK T LIC # 15897
COMPANY WILLOW GLEN ELECTRIC INC
ADDRESS 1085 WARREN AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 289-9725
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------ - - ----- ---------- ---------- ---------- --- - ------ ---- ------
BELEC200 METERS 1 . 00 29 . 43 0 . 00 29 .43 0 . 00
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00
EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
BSEISMICRE VALUATION 2 , 700 . 00 0 . 50 0 . 00 0 . 50 0 . 00
--------- - ---------- ---------- ----------
TOTAL PERMIT 103 . 16 0 . 00 103 . 16 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ --------- ---------
OTHER 103 . 16 VISA
TOTAL RECEIPT 103 . 16
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
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MM01l8
i CITY OF CUPERTINO
CUP�I�TINO
PERMIT APPLICATION FORM
• �
APN#
Building Address: 1 /
825 T•1 S�7)o v2
Owner's Name: v I _ Phone#: �� C
Contractor: �f / � n i G License#: c �I
Contact: r Cupertino Business License#:
Building Permit hifo:
Bldg ❑ Elect Plumb ❑ Mech ❑
Job Description:
Residential A Commercial ❑
Sq.Ft. Floor Area: $/Sq.Ft.: -
Cost of Project 2Occupancy Groin
Type of Construction:
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILER1 Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL
BBOILER3 Boiler>500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILERS Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX hid/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V <= IOOOA ELECTRICAL
BELEC1001 Elec 600V> IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
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S(��- CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
hQuantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Si s Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
( BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicalsq. ot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
PLLONGRNGC Planning LR Comme/ Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Change BUILDING
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