00060141 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS; PERM IT NO.
1,0307 VISTA KNOLL BLVD 00060141
OWNER'S NAME: APPLICATION SUB DATE
MA YANG M AND AMY C 06/21/2000
PIPUONE. SANITARY NO CONI Rol.N11,
OKE ARC]111'HCT/ENGINEER: • 11111 LDIN(I PIi1Uf1'1INI7u
¢ O❑O❑ III.[)(; ELECT, PI.UM11 MECH
auU 1_d CJ I-1 L_I
N¢n
FNj LICENM?DClicensdunOR'SDEionsof1lDN Job Description
QO�_O 1 hereby a1Bnn Iha 1 am licenced unlet provisions of C,ap¢r 9(unmmmming
v.Fw ,ri,h bill fin7tl(ad of Division 3unhe llusin=na unA l'mfmsioro Code,and my licence
x1= isinnCac,.ndefec,. ADDTN OF 75 SO. FT.
z Y S Dan Clms Cor M
0¢ antlor
nRCHnf e o S a DECLARATION
I unl r J ypl 11.11 be Public Illard, /
rc�p� Lae JI I � 'I
w
OW NI R HGII UI I..UI C1N
I ny B Into III II e L C aia, h.oa, l Law lo,
linty
L Ia b Section 7031.5.11 _ J I I L I e An,city e rc
4 x O which is issuance.fro a also re a Beraud,applicant
non w,do and sh,or noun od slmnurc
c. Par he I%ansedlprsu regoirc,the apprsolhit suchplanarUcca„ Us,(stutnncm
Ina,ns teenvd pursuant it)the prfDv,m nn,e he
llad WwOcnCode) Sq. Ft. Floor Area nation
or(coal thathe costing with Section our anof he basis 3,4 e a l Bede x and ion.Any%i Cade) $8000
or thatheis 31.5 b therefrom and or ,lora fonhe alleged exemption.Any l pennon
of Section thanfiehundreddo][fnr NdI.Lmhjeaathe applicanuoacivil penalty
arnnl more In.n five hundred deems a5IX11, APN Number Occupancy Type
I,as novae,if he pic,ny,co a,cn,l,lnyee,whh rages as their .Ic ccun,aaaana. 32613123. 00
will Jo the work,and the slmeture is not intended o,idened for sale Sec.7044.
B,Isinca,.ml P,ofca,mn,Cade:Tlnc C()I,tra.,nr,Lren.e Law does onto y ,tilt Required Inspections
orr f propuny who baud,or improve'11.creon,mm xIl()doe,all,work hi tit 101 — FOUNDATION
to ogb Ills own employee,.provided Ih:ll onah Ilnpruvcntcros um not into Ind(it
ollercd on rale.If howwcn the hulking n,iuTmvmncnt I,a Bold wfoo one you of � —
intplelinn.mc()wnc,balderxnlololitem...koArovm,Jmthc did notbwhlor 10L PIERS
inlfic,Hs,mnfIsle.). 1.03 — UFER,
01,as(most()I me property.a,n excm,i,el,contracting with licensed cnntmctm,I„ 1.04 — REBAR
onsaun the project(Sec 70,14.Buxiness and Professions Cad,)TIle Contmcmh
ii<enaeIaw does no apply no anwmmif no,NnywhnWild,nrnarrate,therenm. 105 — ANCHOR BOLTS
and whit contracts for such pmjccl,with a contmamlal licensed pursuant,o the
Contractor', Law.w. 106 — SEWER & WATER
Ell aid ,;in rand` z B&Pcbnorisrca.()n 202 — UNDERFLOOR PLUMBING
al _i
Dam ��Z;�O/
w (KER': .Oau•ENSAIIONDI A ATION 2Q13 — UNDERFLOOR MECHANICAL
I hereby alarm under penultyol perjatynie tit he following declarations: 204 — UNDERFLOOR FRAME
0 1 have ;,,td will Ittnml,n„ 1,cmanclntc 1 cnnscor to self-insure for Worker's 205 m _ UNDERFLOOR INSULATION -
Conqal.en, nn, provided o
III by Scetlon 3700 f the Lan,, C()de, lin IIlc
perforatunce of the work for which this p riait is issued. 301 ROUGH PLUMBING
°IInwe;,adwool atdntalnworker'sClaTenmdmlmsuraac.aarcwirmnySection 302 — TUB & OR SHOWER
370(1 of the honor Code.for the perforators-of the work for which this perinit is
i...ed.My W..kee,cnmpensadnn lnt,.mace care,and Policy nam()=,are: 303 — ROUGH MECHANICAL
carrie policy Ni : 304 — ROUGH ELECTRICAL
CERTIFICATION OF EKLMWION FROM WORKERS' 30S — FRAME
COMPENSATION INSURANCE
(chis section need not he coraplmed if the permit is for one hundred dollars 306 — HOLDOWNS
(sltxoorra,s.) , , 307 — INSULATION -
1 ssnily I,, the'do nm,oe if the work ort which this fiction is i%soled.1 308 — SHEETROCK
'hull not rnn,loy any parson In nor inmmcl'nu nx m be conte xt,bjc,l m the W..w,
C()npc ,atl1.1—Acalirmia.Dale 309 — EXTERIOR LATH-
nppllcmm
NOTICE ToAI'PIJCANT:lt:after utak ng l lois Cenilimne of Excmplion,you chluld 310 — INTERIOR LATH
hcavme eobjecuu the Worker's Cnmlrcmal len provisions on he"Nor CIA,,y()u must
O2 1on,wint ountp]rxithsuch pm kion,ort his pemtu shall W deemed nvoked. 311 — SCRATCH COAT.
E ^ CONSTRUCTION LENDING AGENCY 313 — ROOF NAIL
1 herchy aRrm that there i,a ennswetion lending agency for the rertormanle
'If the work for which this perm()is isarcJ(See.3097.Ci,C.) 501 —
FINAL ELECTRICAL ENERGY
y $ IsnddsNamc
.z Isndcr's hhaneAddic, 502 — FINAL PLUMBING ENERGY
U O I cenay flat l have read this apprc,m()n and ,at. bar he abase ator,nalion is 503 — FINAL MECHANICAL ENERGY
Car F., correct.I agree to comply with 011 lily and cunty nurdim nnncand slam laws%refuting — FINAL BUILDING ENERGY
OU mitirtg t fon tq1 by ors p tt or Irl , ,n 504 C%^� --
p (We)agree it)qkvc, isd,,nnil,IIl kill,hanrfl...a sty ICf tI g 505 FINRL ELECTRICAL.
F. m Cityiinca,pdgmunts,cans and nxhof do peaM1 n,y n.ter way ascme asst ,a x:Iie 506 — GAS TEST
U Z
City in anucqu ND of ore granting of WIl permll, �j
APPLICANT UNDERSTANDS AND WILL COMPLY WITH AI NON.I'OWr Issued'by: :;m7 — FTn1aI DI IIMA TNIF Date
$O..td GULATIO
Signature ,IA,,Iica 'nmmnor 10 3 Dm= Re-roots 508 — FINRL MECHANICRL
AZARI�US MAI'ERI. =DISCLOS RF:
Will the applicatit or future Wilding occupant snot,or handle runnelmaterial Type of Roof 509 — FINAL GRADE
as defined by the Capers.Municipal Code.Chapter 9AZ ad he Health and Safety 510 — FINAL PLANNING
Code,Section 1553:0.1? �
C Ye, /l No All roofs shall �3,jigspccteapN'pLto pW)ALo ftg qvp*8)eing installed.
Will the applicant or loran holding(1-opwtt use eylllpmcm or devices wtdc, If a roof is installed without first obtaining an inspection, I agree to remove
()nil bun.doua nl,'a,munnnum,, himcd,y the of,Arm Air Quality Management
ED Yes
�N all new materials for inspection. Applicant understands and will comply with
all non-point source regulations.
1 hoc read the hamrdous mmmlah rer,...emants under Chapter 6.95 of the
Cnlifomi.Health&Safety Gdc,Section,15505.35533 and 25534.1 understand Ism
if the building does not currently h:rve a tenant,that itis Iny m,rymaibility to no,iry the
occupant of the requirements which must tet prior to issuance of a Ceniticale of
o m
cegperey. Signature of Applicant Date -
��
0.at, nm medagent Dam All roof coverings to be Class `B” or better
CITY OF CUPERTINO
]BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BuIAIN.N6,iAxlRl_VISTA KNOLL BLVD PERMIT No. 00060141
ortMAs'YYTA/NGV M AND AMY C APID'esY221uJs2'0`00
•IONS: SANITARY NO. CONTROL NO.
R
O o ARCHITECT/ENGINEER: BUILDING PERMIT INFO
ce au- BLDG ELECT PLUMB MECH
,UC
5 v i LICENSED CONTRACTOR'S DECLARATION I es Crl tion
Z-o ,fi.b 7y aflinn that 1 stn licensed endo,pros-mm�s orm,C.r 9(commencing ADDTN OF 75
SQ. p
.m1_-u x'iN SrI Inner,
Bait;an3ofensdorerauismnd ,worm Cole (cmmencing
in full force and effect.
mAt License Class LIc.a
``y Date Commaar
plARCHITECr'5 DECLARATION
5 I understand my m,shall be used as public records /
fce
C O Licensed Pmt ,,mil /
o LL OWNER BUILDER DECLARATION
so1 hereby elfinn that l ten...onto from the Connarcon Lloeme Law for theQ sin ry0 0
F Z following reason.(Section)031.5.Business and Professions Coda Any city or county �J/p
E O which mi a tomtit in construct,alter,improve,dmnulisb,or repair any sma are
to 3°' pvar t°Ia ill uanct.alsomgWmsthe applic.mformchpermitao6l..,,medammmem _.
Nat he is license)pursuem to the pnivisions of the Convnmor'x Lirenae Lmw(Chain,,9 A" a all0❑
(commencing with St 70glof Division 3 b Business and Professions Code) ,
or mal he is escran tboad ma end the basis far the alleged c.emptian,Any vH,aiml
of Section 7031.5 by any applicant for a permit subjects the applicant to a cavil penalty
of not more than rive hmndred dollars($500), PX N Occupancy Type
❑I,as'bonofineprabvno,:"on,rmpmyee,smwall"a.then'cle mpensaaan. 102 - PIERS
-will do The work,and the structure is not intended or offered for sale(Sec:W". 103 —
Buaness and Pmursioni Coal,The Contractor's License Law does at,,apply car an Required Inspections
icaner of property Who builds or improves thereon,and who does such work himself 104 - REBAR
n through his own employee..provided that such improvements are not intended or -10 5 - ANCHOR- BOLTS-
offered for sale:If.bowesc the building.or improvement is sold within one year or
„nplrt;our the owner-builder ill have me burden of proving that he did not haild or 106 - SEWER & WATER
improve purpose of
.- _ .._ . _ _ 202 - .UNDERFLOOR PLUMBING__ _-
❑6 aa 111 til Ne pmpeny,ol.exclusively contracting with hcen.wd Contractor's
to 2 0 3 - UNDERFLOOR MECHANICAL ,
— cast the project(Sec.)west Business and Professions Code:)The Commctor's
cons
' License Law does not apply to as owner of property who builds o,improv,thereon.
' ._and who contracts for such projects with a contractor(s)licensed purs°ant.m the 2 04 - UNDERFLOOR FRAME
Cnnlo cmr's License Law. - - - '
❑1..exempt made,Set. ,Bate kPCfonhis reason 205 - UNDERFLOOR INSULATION
301 - ROUGH PLUMBING
Owner WORKER'S COMPENSATION DECLARATION 302 — TUB & OR SHOWER
1 hereby afron made, ,ray mpbrjory one of ter mnawing deenonim, 3 0 3 - ROUGH MECHANICAL
I have and wits ,.airman a Cen;ficalc of Coastal to self.imme for workers 304 - ROUGH ELECTRICAL
Compensation. as provided for by Section 3)(a of the Labor Code, for the 305 - FRAME
trrbumanoc of he work for spich his pants,is issued, 306 - HOLDOWNS
❑1 have arta wan maintain Workers Con;h.mation Insumnea.as renabce by Section 3 0 7 - INSULATION
3]W of the Labor Code,for the performance of the work for which this permit is
'
issued,MyWorker's Compensation Insurance carrier and Policy number are: 308 .-- SHEETROCK ,
carrltrt. pal;cyRa: 309" EXTERIOR LATH
' t', CERTIFICATION OF EXEMPTION FROM WORKERS'r'
COMPENSATION,INSURANCE,' - - .__._. ._...._,310.._=..—INTER TOR,-Li
. IThIs serum a,rcd nut be eom lined if the t is for one hundred doll.,
�• p perm; , 311' '- ' SCRATCH COAT
313 - ROOF NAIL
Icemrydistmmeperfonnmme.1lot work hi,which his permit isissued.1 501 - FINAL ELECTRICAL, ENERGY
tshell'no�employ any Person in any manner so as to become subject to the Wmkcrt
Comlrensallon Laws of C.Iffrnw.Date 502 - FINAL , PLUMBING ENERGY
Applicant
NOT ICE To APPLICANT..If.aer,makin6mi.Crn;acmeof& mption.you shamd 503 - FINAL MECHANICAL ENERGY
become subject to the W'orker's Compensation provisions of the Labor Code,you must 504 - FINAL BUILDING ENERGY
O O forthwith comply with such prov;siom.,,his permit shall he deemed revoked.
CONSTRUCTION LENDING AGENCY 505 FINAL ELECTRICAL
— '
' 1 hereby affirm that there is'a cunshuction lending agency for the rim ormance 506 - GAS TEST
car the work for which permit is issued(See.309),Civ,C.) —
LebdeI No. 507 FINAL PLUMBING
U,o ''`hdea'Address
_ 508 - FINAL MECHANICAL .
1 certify mar I h...read this atphcaaon and some thus the above information is 509 - FINAL GRADE
`correct.I agree to comply with all city and county ordinances and nate laws relating
O U tobuildingconstruction,:mdherebyauthofirerepresentativesofthiscitytoenterseem 510 - FINAL PLANNING
r-W he above-mentioned .,by for inspection purposes.,
C6 (We)agree tosavemdemnifyand keep harmlesstheCity ofcupenioaagainst 514 - FINAL PUBLIC WORKS
'r W liabilities,judgments,costs and expenses which may;n any way.cane against said
f.7. City inconsequence of the g,aa,ing of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINTIssued by: Date
SOURCE REGULATIONS. ' ' : R
Sign:nurc of Appli<anJCommgor Date Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building occupant store or handle baradous material Type of Roof ...
as defined by the Cupertino Municipal Code.Chapter 9.12 and the Health and Safety
Code,Section 25532(a). ,t;., , • . . ' ' ' ' I ' •
°Ycs �" _ All roofs shall be inspected.prior to any.roofing material being installed. ._. . .. ....
Will h c-apirfic.al or banare building p...I use ccIrmoncia or dices which If a roof is installed without first obtaining an inspection,I agree to remove
it harridan,a contaminant d fined by the Ba)Art Air Quality M nagement
sir t all new materials for inspection. Applicant understands and will comply with
0Y ONOall non-point source regulations.
I have read the hor. do.,ani cumberi is Linde Chapter 6.95 of the
California Hav hh&Snfny Code,Sections 25505,25533 and 25534.1 tinderstioadmat
if Ne building does not eurreatly have a tenant,that it is my responsibility to notify the -
necopern of the rayuiremems which imm,be met pm
ririr to issnce of a Cevure ificof
Clettinar.; - Signature of Applicant Date
Ox net or auNn,Ired a gem Date All roof coverings to be Class "B" or better
OFFICE