02020107 OF
CI sun DUNE.DIVIiSiO NO PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20870 TULA CT 02020107
OWNER'S NAME: APPLICATION SUB DATE
till YUEN JOHN K AND YUN W 02/27/2002
luPHONE: SANITARY NO. CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH
sc.
6 L'J L-J L._7
�w= LICENSED CONTRACTOR'S DECLARATION Job Description
Z=O 1herebytiff the.Iain licensed under provisions of Chapter 9(commencing
m l_W warn se<dnn]trod)a,rDivi,nn3axnne Ruxinexxanarrorexxmmx Code,and ntrlicense REPLACE WINDOWS & ADD 2 WINDOWS .
Cm2 is in full tutee and effect.
z u License Clnss Cotr �IfI�,297d+n W. IIF'9
o Dine S DECLARATION
S a O ARCHITECT'S DECLARATION
1 understand my plain shall be used as public rccmrds
�; MAY 2 s 2002
.Cc..p O Licensed Professional
OWNER-BUILDER DECLARATION
1 hereby.Tann that 1 am exempt from the m,im s Code:
s License Law for the
hZ< is hichinga ermitt ]1131s, t.aincsiandove.deinli Co at:Anycityoraunty BUILDING $9000
I s O whirhitsasrequires n permit to rims the
,plic improve,demolish,or repair any swnutt I� VI
a.32 ,pox t d I- y Pr is�f and for suchpermittt is greedatammcm. ----- - ata- -- - -
(codesh ctrlccnsN pun a u theProvisions rexof the Ce Sistine,Cs Lse PrU (n,Coo 9 _ _ _
t mntn with Seu ]m ad he sis a he.1l geld and im. n vi GtA<) ` r . .Ase .( .,, Valuation
or Sectio is 31.5 b therefrom and the barn for the subjects
th h i6raapplicant
to Any violation
of Section]1131-.5 by any vppllcam torn pnmit auhjcas the nPPlicam to.civil penalty
.ofnot room than five hundred dollars(55W). 1OlAPN ��ATION 1 ' " Occupancy Type
01,as owner of the property,ur my employms with wages as their sole compensation, A 02 _ RTRRS
-will do the work,and the structure isnot intended or offered for sale(sec.TIW , Required Int 1i
Baiincs:'and Profession:Code:The Camraao:s License Law docs not apply to an 103 - UFE R 9 Inspections -
owner of property Who builds or improves themon.and who does such work himself
or through his own cmpinyees.provided drat such improvcmems rte rear(mended or 104 _- RE BAR ,
offered fm s,e.IL however,the building Lir impmvcniao is.old withinoneYmr of --`-'- -- - --
dmpletion,the owmcrbuiMer wall have the burden of proving that he did not Wild or 105 - ANCHOR BOLTS
improve for paPo,eofxale')' 106 - SEWER & WATER
---
1 : - -nhcpmpt Held. .,iac,s r C mnstaeanmduseretn 202 - UNDERFLOOR PLUMBING _..... ..
on.t t o project(Sm )to a Bus nes and Professions Code)The improves
trector'a
License Low apex nm apply man owner of property who bale,or mpruvex mcrean 203 — UNDERFLOOR MECHANICAL '
and-who contracts for.such projects with.a.<otmmchods)licensed pursuant to the -..____. .
' CommttnrsLiemseLaw., 204 - UNDERFLOOR FRAME _..._ — ----
❑LmeaemPAtunds see. :B&Pcfar his m... 205 - UNDERFLOOR' INSULATION
owpe. � nN ' a-TI(5N 301 - ROUGH PLUMBING
Y\ g K EN ON DF.CLARATI N
I hereby affirm underpenult °r' rjryOOeOu fine following dechratmns: 302 - TUB & OR SHOWER
° 303 - ROUGH MECHANICAL
❑ 1 have and will maintain a Certificate of Comers tin self-immm firer worker's 3 04 — ROUGH ELECTRICAL
Compensation, as provided for by Section 37M of the Labor Code, for the
permimmu<e of the work for which this pemou i:issued.
305 - FRAME
❑1 have and will maintain Worker's Compensation Insurance,as Scquircd by Section 3 06 — HOLDOWNS
370 of the Labor Code,for due perforn tr m of the work for which this permit is
issued.My Workers Compensation lnsurancecarrier and Policy`number are: 307 - INSULATION
_.
. Came,: '. ` t te' Policy Nn ,,
.a , 308.; „SHEETRQ•CKy:,r
CERTIFICATION OF EXEMPTION FROKWORKERS•'' °�` " f t '3Oa9''�L
COMPENSATIONINSURANCE " t ` '`EXTERTOR'aLATH'
y ' ; _._
_3T0' " ;INTERIOR'-LATH
•' (Ten sect on need not be,completed if the Permit is for ons hundred dollar, ^ '
alao)mless.) 311 - SCRATCH COAT
I cemry that the pert tuna<e or tot wok fur wbien�h�:pcnnn is L�xued I -, .. - ''3 13 -...ROOF NAIL:'. ` .. `•"_ - . `- .
dean t play any pr 'n any manner so as to become subject to the Workers 501 — FINAL ELECTRI CAL; -ENERGY
Compensation Laws of California,Date'
Appicant ' provisions -'502 "- -FINAL PLUMBING 'ENERGY--- - --
.NOTICE TO to
the Workers
oCompensation
omthis C<nd<me of Labor Code,
youshould '
Z bcmmithiio cnntht suchprvompcnmthis commit 503 FINAL MECHANICAL ENERGY
Z C rrnhwimenmplywimxaenprovcmnsnrtmxP ,hall ba,dmmedrevoked
. 504 -.— -FINAL BUILDING .ENERGY
CONSTRUCTION LENDING AGENCY' 505 - FINAL ELECTRICAL
; "I hemb fbnn that them is a conewctmn lending - for the Performance 506 — GAS TEST
wQoftheworkfrwhiehthis rvi isi...cd(Scc.3097.Civ C,)y . .. _.._...... _ _ ._ .. _- ..
-Lenders Nemc. ' ""- L; k k _ _... ...__ ._
�.z UnderaAddress 507 - FINAL PLUMBING -
U'O5 0 8 - FINAL MECHANICAL•
I certify that l have react this application and state that the above information is
come.I agree to comply with all city and county ordinances and state laws relating 509 — FINAL GRADE
. Q V to building construction,and hereby auteadre representatives of this city to enter upon
w,
the doeve-mentionselproperty far inspection purposes. 510 - FINAL PLANNING
(We)quic tb save.indemnify and keep haitnless the City of Cupertino against
M liabilities.judgments.costs and expenses which may in any way accrrue op'. said 514 — FINAL PU I C WORKS
V.Z Chy in consequence of the granting of this permit ""'1
APPLICANr 'N ;RSTANDSANDWILLCOMPLYWITHALLNO POINT'• Issuedby:
Date t/ (/
URCE R TIONS% a-2-yL 2.
. . - Signature yYnc for, .. ,Dai. Ke roofs
HA OUS MATERIALS DISCLOSURE
Will th ppl c in tut budding occupant store or handle-haurdous material , ,,Type Of ROOF .. .-..- ..•. -..er- ...
oadefitand,by th<C pen M c pal Codc.Chapter 932.and the Health and Safety
Code Sen ors 2553207 a"^ j a a` ,y .r 'rZ
h"
OY �t '.I:�:_j.-' a'' _ _ _ All roofs shallbe ms acted rior'to,an roofin material,bein installed.
P P Y g_ g _--.. . .
W 11th .pplicmt f t m buildi g rc pot asccqu p ent a vires which If a roof is installed without first obtaining an inspection; I agree to-remove
cm t ha ado 'r cont t as defined by the Bay Aria Air Quality Management
Orlin all new materials for inspection. Applicant understands and will comply with
01 oYe, all non-point source regulations.
1 have Hread ealth
&Se hazardous Sn tions s req.25533 a under Chaper understand
of the
California Heahh&of cur Code.Sectionant.tet itis and25534.sponsi1understand that
iftne bunt of gdocs not mems.w have h most tenant.that itis myresponsibilityoility Sonority the -
oceupanS of the requirements which must be met prior m issuance or o CeniOiate of
ccupa cYJ
� �-D7— JY Signature of Applicant Date
C,v2y.ammanizvo,sh,'; Dmc All roof coverings to be Class "B"or better
. OFFICE - . . ..