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05070007CITY OF CUPERTINO ar','-" BUILDING DIVISION PERMIT CONTRACTOR INFO( IRMATFION BUILDING ADDRESS: ADMIRAL CONSTRUCTION PERMIT"005070007 79 WATERFORD OR ER'S NAME: PERMIT ISSUE DATE JAMES SHENCHU YEN 1711 BLOSSOM 5 PHONE: SANITARY NO. CONTROL NO. (408)309-5981 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description O I hereby of no Net w t 1 limmand under provisions of Chapter 9 lcommenein{ p withSection 7ar1o) of DlvWon 3 ofdm Bualneu ud Pmf,uam Code, aha my causes, infall to= aadeaees. 2 5 Z tie" REMODEL KITCHEN/2 BATHS & Dam Comranv — ITTE ADD RECESSED LITS./UPGR D ION ARCHnECi'S DEC � In sound my plans shall be used As public meords ri Licensed Pmfesdonal OWNER-BUILDER DECLARATION / m 1 am excmpl from the Consommes Ucca m Law far ft " 1 hereby affirmu 2005 fallowing more. (Secdun RD L5, B,ineu and Professiom Cade: My city ler county which requires a pori, to com ouch, alter Improve, dcmollh, or repair Any awcture prior to its iuu me.alau mqulres Lha applicant frsueh permit to file a signed Ramment that bel licensed pursuant W the provisions of the Conummri Uccr se law (Chapter 9 Sq. Ft. Floor Area 00 (commencing with Section 7000) of Division 3 of the Busineuand Professions Cade) or Ws M u exempt therefrom ted the tubs fm she alleged excempdu. My Aall'of APN Number Occupancy Tylx Section 7031.5 by any Applicant, fail peri t bj=, den applicant W a civil pemity of not mom dun five hundred doll.({500). 36617030.00 ❑ I. As owner of the property, or my employe, with wage, As their In compeumtan, Required Inspections will do the woW, ted the awctum Is not munnded or offered An, sale (Sec. 7044, Bmimsa and Pronasion, Cade: The Contractors Lkeme Law does no, apply to an owner ler prepeny who Wilds or improves lhemon. and who donauch work himselfor through his own employees. provided that Rush am not intended, offered for sale. if. however, the Wile log or improvement is sold within ohm year of completion. the ownef- Wllder will have dm burden of proving tis, he did nm build or improve for purpose of Role.). W 1, as owner of the Property am exclusively contracting, with licensed commitment in camwet the project (Sec. 70", Business and Profession Code:) The Coolness Li, eche Law does not apply W an mune of propeny.who Wilds or Improves Ihemon. and who comets for such projects with a eontracmr(s) Imosed pursuant W the Contractors Lice a Law. Clem e,e Iorder sea. .B$P rm'thiWs m/assn •gw..P.e S Dale WORKER'S COMPENSATIO5CL1RAT10 ((// I hereby aflirm under penalty of perju ane of tm following dechoatimur ❑ 1 have ted will malnuin a CWfteamaf Conserv W self-inum for Warmer's Compen- sation, u provided for by section 3700 of the lab, Code. far the performance of dm work for which this permil is issued. ❑ 1 hove end will maintain Workers Compensation Inurance. As acquired by Section 3700 of the Labor Cade, for she peRormanee of the work for which this permit is Issued. My Workers Compensation Insurenco cuter and Policy number are: Curter. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (7Tbssectan aced not W ca pteml If the permit is forommomm rut dollars ($100) or kat) I unify the, in the perfommue of the work fa which Its permit is Lou". I shall nm employ any penton in any manner m As W bocumc object to the Workers' Compensation Laws of California. Dau Applicant NOTICE TO APPLICANT: If, after making this CWfi,m of Excerption, you should become subject in the Workers Compenugan prevWom of rite Lahr Code, you an" forthwith comply wish such provision or this permit shall be darned meted. CONSrRUCDON LENDING AGENCY 1 hereby alarm that them is•.m tion lending agency rat to Performance of the work for which this permit II= (Sec. 3097, Civ. C.) ' Name , LmL•eadera Wer's Address I comfy that 1 Mw mad this Application and sum that de above informNm u coma I agree W comply with kr city and county antinuas and sum law rtltin{ he Wilding rohwuction, ted hereby uthon. aepmsenuuvcv of this city Is user, upon de, 71A,ve-mentioned property for inpection purposes. (We) agree W um, indemnify ted keep humkss the City of Cupcntno agunsl liabilities, judgmenu, core ted ecp roses which may In coy way ucom agalml said City in consequence or tie granting of this Permit. APPLICANT UNDERSTANDS A WIT. MP WITH ALL N 0� Issued by: Date SOU EREGUWTIONS. -Re-roofs Type of Roof um of ApplianVContrm Dam HAZARDOUS MATERIALS CLOSURE Will tmappliam or fnum building uccu team, handle hvsrdaos mamrial find by the Catamount Municipal Cade, Chapter 9.11. and the Health and Safety Section .[3Yrs ❑ All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will We applicant or ffug>fNo u'tture Wilding oecupam dm equipment or devices which emit hauadnu air conuminsnu As dirtied by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yea RN" 1 have mad the hamolons mamdalucquanmenu underompmr6.95 of the Califon no HmdM& SafetyCadc, Secumu 25505,15533 and25534.l understand thulrthe Wilding tats tit currently have a meant, that It ismy res nihility to nodry the occupant of the ,bureauswhichm,lbemet toiuu a h tiro r. /? Signature of Applicant Date All roof coverings to be Class "B" or better er or Authorizeds Agent _ -- •CUPERTINO I WTO I CITY OF CUPERTINO PERMIT APPLICATION FORM OS -D70" ", APN # _ o 3 62 d C7 Date: / -2-�S— I Building Address:r f-�-, q Mailing Ad ess (1T different from building address): BAPPLOTHER Owner's Name / h�� �N� Cyd �E�� �//7 Phone #: / �� u� Contractor: C car✓S ,PGrC.7 e9 License #: S'28 732 Contact:4�r /, Phone:(/4W; 9 -,fes Cupertino Business License#: I�E/( Fax: 8J -o MECHANICAL Building Permit Info: Bldg ❑ Elect K Plumb R Mech.❑ Job Description: /1&1 Residential E ` Commercial ❑ Sq.Ft. Floor Area: MECHANICAL Cost of Project: Occupancy Group: ype of Construction: �i� Please check this box if the project is a Construction Tax second -story addition: ❑ 1% &Z(.�rir hid/Off/Comm/Quasi Pro'ect Size: Standard ® Large ❑ Ma or ❑ 4e - Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiler > 500K to IM Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 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 <= 1000A ELECTRICAL BELEC1001 Elec 600V > j000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 #, �,,z0b �3W.36 CITY OF CUPERTINO t1, ini-nTul� PERMIT APPLICATION FORM %-UrcrN1nw uanti Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTRvIE Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING,. BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <=10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Mise Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl Switcb & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2of3 (War CUPER,TINO CITY OF CUPERTINO PERMIT APPLICATION. FORM Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs 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 Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/ Multi -Faro PLANNING PLLONGRNGR Planning Long Range Residential . PLANNING ZADDCHG Address Chane BUILDING 3 of 3 J • • CITY OF CUPERTINO Item 1 of 1 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36617030.00 DATE ISSUED.......: 07/01/2005 RECEIPT #.........: 30206 REFERENCE ID # ...: 05070007 SITE ADDRESS .....: 7579 WATERFORD DR SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ...... OPERATOR: conniew COPY # : 3 OWNER JAMES SHENCHU YEN ADDRESS ..........: CITY/STATE/ZIP ...: CUPERTINO CA, 95014-5233 RECEIVED FROM ....: JAMES YEN CONTRACTOR .......: DAM KIEU LIC #'22513 U COMPANY ..........: ADMIRAL CONSTRUCTION ADDRESS ..........: 1711 BLOSSOM HILL RD CITY/STATE/ZIP ...: SAN JOSE, CA 95124 • TELEPHONE ........: (408)309-5981 FEE ID ---------- UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL BENERGY ------------- PERMIT FEE ---------- 223.56 -------------------- 107.31 0.00 ---------- 107.31 ---------- 0.00 BPERMFEE VALUATION 15,000.00 223.56 0.00 223.56 0.00 BPLANCHK PERMIT FEE 223.56 298.34 0.00 298.34 0.00 BELEC200 METERS 1.00 29.43 0.00 29.43 0.00 BSEISMICRE VALUATION 15,000.00 1.50 0.00 1.50 0.00 PPLBG SQUARE FEET 628.00 50.24 0.00 50.24 0.00 ELECTRIC SQUARE FEET 628.00 50.24 0.00 50.24 0.00 EPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 TOTAL PERMIT ---------- ---------- 837.36 0.00 ---------- 837.36 ---------- 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- OTHER ------------ 837.36 ------------------ M/C TOTAL RECEIPT 837.36 U aCOF ,kEIIN0 C. Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 artment JOB ADDRESS: 7S -Z9 , /� ov I PERMTT # 06-0700,07 6-0%OQ,O7 1 OWNER'S NAME: �I PHONE # ((4a,?% S<S4h — Zh rI O CRNFRAT.CNTRACTOR: .4aAOi/?Al //rTi FAX# I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following, ormation: Owner/Contra r Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork X Cement Finishing Electrical i 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 I( Owner/Contra r Signature Date I _ I TA 4^0 s. f T —fit'. I �— cw L _. ...... .- �_Vy E. �;., .< b is o _- i \ � r;• .. i ,� - i Ch ar