03020109 CITY OF CUPERTINO _* `'�.
BUILDING DIVISION PERMIT ,"CUNTRACTOR,T,LNP'ORMATIO1�V ,
BUILDING ADDRESS: PERMIT N0.
7530 WATERFORD DR 03020109
'S NAME: PERMIT ISSUE DATE
LOO WEI Z AND REIKO M TRUSTEE 02/26/2003
E: SANITARY NO, CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
' BLDG ELECT' PLUMB MECH
l� I� 0 0
4 o p LICENSED thatI.CONTRACnd r p DECLARATION Job Description
1 ion 7").f
relief that I am licensed i under provisions n(C ocia, 9(commencing P
b with Searcend1efe(Diviuon3 of de Business and Professions Code.and myliccnse is
Limnfomaanaerrea. ADD SHOW STALL/RELOCATE DOOR L-'NALED
DaunmClaa Convector ADD ATTIC FOR STROAGE IN GARA E
ARCHITECTSboosted DECLARATION FEB 0 5 2004
1 n
mWetsn nJ my plans used u public records
p r^ Licensed Proreniontl
OWNER-BUILDER DECLARATION , ^
E 1 Mrchy afOm tha I am exempt from Contractors Coors License Law for the BUILDING
p O following ren o.(Section 11131.5,Business and Processions Code:Any city or county
which requires a permit to construct,Sher,improve,demolish.or repair any Structure
I„ y' Prior N its Unarm.also requieeS the applicant for such Permit to rile a signed statement
< that he is licensed pursuant to the previsions of the Commodes License Law(Chapter 9 Sq.Ft.Floor Area Valuation
(commencing with Section 7")of Division 3 of the Business and Professions Cnde)or $850
.. Nat M u axempt therefrom and the bass for the alleged exemption.Any Sidledon of
Section 70313 by any applicant for a permit subjects the applicant to a civil penalty of 3 ApN N�Ifitber 0 0 - Occupancy Tr e
not mon than five hundred dollars($500). 6 66 6 3 P Y '7 P
❑I,as aws or the property,or my employs with wages as their sok compensation,
will do the work and theswaure is not intended or offered for sale(Sec.7044,Business �p,�
end Professions Code:The Connector's License Law ds not apply to an owner of 101 — FOUNDPpf2N5f6d Inspections
prepertywho builds or improves Nermn.and who doessah work himselfor through his 102 — PIERS .
own employs,provided that such Improvements are notinumdad confirmed formic.If,
however,the building or improvement is mid within one year ofmcipledon.the owner. 103 — UFER
builder will have the burden or proving that he did n°t build or Improve for purpose of
sale.). 104 - REBAR
0 1,a owner of the property,am exclusively contracting with licensed con"clon,to 105 - ANCHOR BOLTS
construct the project(Sec.7044,Business and Professions Code:)The Com actod U. -
momlawdsnotapplyheanownerof property who builds or improves Monaco.ad, 106 — SEWER & WATER
who contracts for mush projects wlN a conhacuens)licensed pursuant in the Commences 202 - UNDERFLOOR PLUMBING
Laoenm Law.
an emplirmhoSee. ,B&PC for this 203 - UNDERFLOOR MECHANICAL
Z — D. s6 a3 204 - UNDERFLOOR FRAME
WORKER'S COMPENSATION DECLA N 205 - UNDERFLOOR INSULATION
I hereby afire under penalty or perjury one of the following declarations: 301 — ROUGH PLUMBING "
have and will maintain a CeNficmoofCmdem m iel0laum for worker's Compen- SO2 TUB Sc OR SHOWER
mala.,u provided for by Smile.3700 of the 4bm Code.for the parformenm of tire _
work for which suPermit s peis issued. - 303 - ROUGH MECHANICAL
❑1 ban and will maintain Worker's Compensation Insurance,as required by Section 3 04 — ROUGH ELECTRICAL
3700 of the Labor Code,for to performance of One work for which this permlt is Inual.
My Workees Compensated"Insurance carrier mud Policy number are: 305 — FRAME
Caller. Policy No.: 306 - HOLDOWNS
CERTIFICATE
COMPENSATION INSURANCE WORKERS' 307 - INSULATION .
(This maim madna becomphund bobs permit lsforom hundred dollate($100) 308 — SHEETROCK
''less•) A 309 - EXTERIOR LATH
I uNn in Nin thashinmanco of the work for which this permit U issued,I NN nes 310 - INTERIOR LATH
L. any al"f59r4114nymannerp�a,l g�m°wbjecnotneworken'compeaaBon 311 — SCRATCH COAT
Laws of Celifo a.Da¢—f,i d
Apps ant 1n^ "��ln ' 313 - ROOF NAIL
CE TO PAUANT:Ir,after making this Cenifcase of Exemption,you should
e mesubject to the Worker'Compensation provisions ofthe Labor Code.you mum SO1 — FINAL ELECTRICAL ENERGY
z with comply with such previsions or this Permit Mall be emend revoked.
yo 502 - FINAL PLUMBING ENERGY
55 CONSTRUCTION LENDING AGENCY
I heathy annus Out Mom Is aconslrvction lending agcmy,for Nc performance of 503 - FINAL MECHANICAL ENERGY
C�. the work for which this permit is scum(Sm.3W7,Civ.C.) 504 - FINAL BUILDING ENERGY
{E7 Q Undoes Name
4ndee1 Anifyd 505 - FINAL ELECTRICAL
V P ittNe duo1haveread this lcitya1dcounand Send the 0.ndShoveinromalonis 506 - GAS TEST
Lu, eeerttt 1 gees to comply with all city and county ordinances Imo law misting to _
C) building convection,and hereby ambodmrepresentatives ofNischymantsyupon tho "FINALPLUMBING
ahovcmenlioced properly forinspection purposes. 0 ' C L(We)ag.t.save,indemnify ad keep Mrmleu the City or Cupertino AgainstVI IUbllities,judgmems.eas and expenses which may In my way accrue against mid City - a�in consequence of the granting of this permit. ///�/APPLICANT UNDERSTANDS AND WILL COMPLY WITH AL NON-POINT Issued by:5NG Date
�eupA�
CE g.EOULATIONS. Rf ES
y `/U L 2 `� ����7 Re-roofs
nature of ApplicIMOUOR actor Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant at=or handle hammou4 mamma]
fined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
.Scctie25532(a)1
C]Yea No All roofs shall be inspected prior to any roofing material being installed.
.Lure
Will the applicant future MIIOIng occupem use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
haamnus air comeminmis u defined by the Bay Arta Air Quality Management all new materials for inspection.
li.l'llca]Lb&SafctyC�,SwOons2M5.25333md25534.lundc.,L
n1
Dyes
-
Ihavemad the MnrNnsmauriah requiremcnuunder Cha6.93ordm Caliror.
FuilJignot currently haw a Nment.that h Ins my responsibility to mtily uPanl or the
4yf `"ts npg�xl °Troia°m"°rac`rlrreats° �pan pz6' Signature of Applicant Date
Owner a mmmi rad agent "D„e/3 AI I roof coverings to be Class"B”or better