06090015 CITY OFCUPERTINO
BUILDING DIVISION PERMIT zCONTRAC�"TQIi INFORMAI;IQN .
�'Rtfla,5ltids he '°tar al's =X A,+ml�a'- - - G".f.
BUILDING ADDRESS: WELKIN INTERNATIONAL INDf.4rr NO'06090015
7593 WATERFORD
OWNER'S NAME: PERMIT ISSUE DATE
YUH JIA SU 19925 S
E: SANITARY NO. CONTROL N0.
(408) 733-0188
ARCHIIECT/ENGINEFSt: BUDDING PERMIT INFO
BLDG ELECT PLUMB MECH
OO O
0, LICENSED CONTRACTOR'S DECLARATION Job Description
I d FI hereby affirm this I am licensed under Pmvilk n t of Chapmr 9(commencing
w10 Section 700sh ce'Divicars 3 of the Busiment Prafcaslam Codeand my license is
inmBfamaandeffen. RELOCATE THE DOOR BETWEEN GARAGE AND KITCHEN AD
t'qz Data an Contractor u`'" ADDITIONAL SUB PANEL 80 AMP
if
g
ARCH RECI'S DECLARATION
i S 1 mWcmmnd my plans shall bo uwd u public.cords
t
GLWenaed Professional
y OWNER-BUILDER DECLARATION
<� I Wrelay aITum dual I am cumpt form the Conuassofs Liccnu law for tW
,ese following renin.(Section IID 1.5,Business and Proposal Cade:My city in county
i$f which aul•Permit at conMmL slur,improve.demolish,err myon any sametum
-Zoo prior to its issuance,also requires the applicant for such pcmit in rule a signed sutemcntF[ Floor Area ValuaCip2OOO
—� that W is licensed pursuant m the provisions of tW Convectues License law(Chapter9 $q. .
I5F (commencing with Section 7008)M Division 3 of the Business and Professions Code)in
`c that he b exempt thereham and uses bub for the allged exemption,Any violation of
Section 7031.5 by airy applicant far a permit subjects the Applicant as A civil penalty Of APN Number Occupancy Type
not mom null five handled Callan(3300). 3 6 6 17 0 3 2 , 0 0
❑1,u owner of the ptopeny,in my moployco with wages as thefrwk emmpenandon,
will do the.&and thesnssum Unit lntendW m offered forsele(SO..70044,Business Required Inspections
and Profession,Code:The ContrecmrS Lt..Law doss not apply m an owner of q P
property who buildsorimprovea IWred,and whodoessuch walk himselfor through his
ownemployva,provided that such imprew:reanu art not intended moffemd fm Sale.If.
however,the Wilding or improvement U Said within arc year of caapleuon.the owau-
buildn will have tW Wrdan of proving that W Cid nut Wild or improve far purpose of
"U.).
1,as owner of the property,am exclusively convecting with licensed comrantan to
co and due project(Sec.7044.Business and Professions Cade:)The Contractor's Li.
cone law dam sal apply m an owner of property who Wilds or hnprovea IWrson,and
who Concob for such prejecla with a canuanwrb)Bcenaed purauam m the Conusctor'a
Licenm law.
❑l am exempt under Sec. ,B A P C for this rrasun
water t t n n 'T rl Data
O0.KER'S CSMP SA ON CLARATION
I hereby afllmm under penalty of Pefpuy ane of the following declarations:
i have and will mAinuln a Ce+ti0uw of Covent m utf-Insum fwworkeraComPen-
ution,u provided for by Session 3700 of the Labor Code,far the performance of the
work for which this permit is issued.
❑1 have and will maintain Worker's Compensation Inwrunce,as required by Section
3700 of this,Labor Code,("c performance of to walk for which this permit Is Waned.
My Worker's Compensation Insurance carrier and Policy number am:
Carer, Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This wmirn need mot W completed if leu pants U intone hundreddollaa($10()
or Co.)
1 mrtify amt in the pufomance of the work far which this permit U issued,I Dull not
employ any person in any maanarsu n in Wepm�'sr�.Wb ca 1plW workna'Canpenudw
laws of Califnno.Data
CC b
Applican!
NOTICE TO APPLICA :If.slur making this Ccr iRcam of Exemption,you should
become subject in the Worker's Campenastion provisions of the labor Coda you must
.,O forthwith comply with such provislana or Nb permit shall W doomed invoked.
Z CONSTRUCTION LENDING AGENCY
(•' IWinby 4111rm out thein is a Construction Was agency fm the Performance of
pa, the work fur which this permit is Wood(Sec.3097.Civ.C)
W� Q Lender's Name
z Lenders Add.
U I certify that I has read this application and mm Nu this above information W
W F correct.I agree to comply with all city and county ordinances and sou Ism lelaiag in
0 U building construction.and hereby amhoom lepresnutoo of this city to curer upon de
cd
or
purpo
es
W
above-memion...0.Costs
inspection which m.
f~ 0. (We)agree m save,indemnify and keep hmmiso the City of Cupertino against
C, incoseq Judgments,castsundof thisniah. mryln any way ucmc epalnat old City r
U'z A PLICANT of the granting of this D WILL
/7/ __,y.—aJ C
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULA ONS.
� E F—/_ Re-roofs
St nauf ofA lice^ amraeor Dem
g pp HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant Or future building occupant Blare rehandle haurdaua material
n defined by the Cupertino Municipal Cade.Chapter 9.12.and tW Health and Safely
40 ❑Yex
code,section xs53x(a) A+ Q No All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or-futtuure Wilding Occupant use equipment of devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hrardnus alt canmmina^u u defined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes �No
I have real the hnallous ma erialb mquirerantsundcr Chapter6.95 allies Califor.
niaHaalmhAs SafetyCo@,Sadao 25505,25533 am125534.1 understand thaifue building
dao on currently ham a tensa.that It is my responsibility to notify IW occupant of the
requirements which must be met prior m issuance of a CeniBcam of Occupancy. Signature Of Applicant Date
—(-66 All roof coverings to be Class"Bo or better
Owner mOofim gent 0 Dote'