03100039 r CITY OF CUPEWFINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION
BU ILDING ADDRESS: THE BEAUTY CREATION/YEE LI PERMIT NOO 3100039
OWNER'S NAME: PERMIT ISSUE DATE
NE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECFI
00 Lm lett LICENSEDCONTRACTORSDECLARATION Job Description
I I hereby E.r Nu I am licensed under ml limonts of Chopter 9(commencing s P
with Section]0(111).f Division 3.f Ne Ousineu and Prufcuinm Code,and my license Is
igZin Lmile
ien some and effect. METER SERVICE
Liccnu Class TSD
i Dau Contrutor
Iq- ARCHITECTS DECLARATION V
i$ I understand my plain shell M used as Public records ✓✓✓""/
.p
Licensed Professional
�3
OWNER-BUILDER exempt f DECLARATION
i O O 1 hereby affirm that 1 1. exempt Business An IM Contracted License Law for the
:OO which
followingo,rue..Permit
]onstrt,AR,imrProfessions Code:Any city or county
S$� which requires a pemlil ns nmabucl,since improve,Jcmnliah,Or upai(eny svucmre
.iy prior to its issuance,also requires the applicant for such permit to Ne a signed statement
m< that he is licensed pursuant]a the provisionsofthe Contractor's License Law(Chapter 9 Sq.Ft. Floor Area Valuation
2s-m (commencing with Section Rpo)of Division 7 of IM B Oiliness and Professions Coded or
that he is eacmpt therefrom and Ne bus for the,allcgcd exemption.Any violadoA of 31620037 . 00
Section 7051.5 by any applicant for a pmmll subjects the applicant to a civil penally of APN Number Occupancy Type
not more than Eve hundred dollar.($500).' P Y YP
Q L AS owner cribs property,or my employees with wages As their sole compensation,
will do the work,and the structure is not intended or offered forsale see.7044,Business _ ,�'j 7l(`�D Tjv enS
and Professions Cude:The Convectors Lt..raw dos not apply to an owner of ae[z(tHPo tl7t9t]
pmpeny who builds or improma thereon,and who doessuch work himself.,through his 501 - FINAL ELECTRICAL ENERGY
own employees,provided that such improvements are not intended oroffemd for caro.If. SOS — FINAL ELECTRICAL
however.the building or improvement is sold within one year of completion,Ne owner.
builder will lave the burden of proving Nal he did not Wild or improve for I uryox of
❑1.as owner of the property,am exclusively contacting with licensed contractors to
construct Ne project(Sec.7044,Business and Professions Cwm:)The Contractor's Li.
cense raw does not apply to an owner of property who Wilds or improma Neeson,and
Lw Wc.ntacus fm pchre sees withocantncmrp)licenxdpunuantto Ne C.nuxmri
L cox Law.
lam t o ,Sec, ,B A,P C for this..).
0 n Date
ORKER'S COMPENSAT.I�OANy CCLARATION
I heexbye under penally of perjuty6acuf the following declarati.m:
I ham and will maintain a Certificate of Conunno self-baure for Worker's ComTen.
cation,u provided for by Section 7]00 of Ne labor Code,for the performance of the
w.1 for which this permit is issued.
❑1 ham and will maintain Worked Compensation Insurance,m requited by Section
3700 of the labor Code.for Ne performance of Ne work for which this permit is issued. -
My Worker's Com pensasion Insurance carrier and Policy number aa:
Carrier. relics No.:
CERTIFICATE OF E)EMPI ION FROM WORK ERS'
COMPENSATION INSURANCE
(Thi.see inn need nos M completed if IM permit is foronc hundmd dollen(Sip))
of less.)
I certify Nat in the perfmmanee of the work for which this permit is Issued,I shall not
employ any penin in any manner an As An become subject o the Workers Compensation
Laws of C.Riandia.Dale
Applicant
NOTICE TO APPLICANT:If,error making this Cenificale of Exemption,you should
become&Object to the Worker's Compensation provisions of the labor Code,you must
�z forthwith comply with such provisions nr this permiuhall M deemed revoked.
OCONSTRUCTION LENDING AGENCY
1 hereby alrum Nal there its convection lending agency for the performance of
Y> the work fur which this permit b issued(Sec.3097,Civ.C.)
31 Q Lender's Name ,
Lender's Adducts
Z) z
;)Q 1 certify that 1 ham read Nis application and stats Nn the ahem information is
y correct.I ague to comply with all city and county ordinances and sue laws existing to
� Wilding convection,and hereby euthorm rcprencrufims of this city to enter upon the
Uabove-mentioned Property for inspection purposes.
(We)egme in tam,indemnify and keep harmless the City of Cupertino against
spy hadlides,j A dj;mcnuyTpstA and expenses which may in any way accrue againalcaid City
J z iAOPPLIC '41',0" E STANDStAhisND WILL COMPLY WITH ALL NON-POINT Issued by: Dale
SOURCES TI S
6_1Re-roofs
Si urc of Appli n C-mmemr Dale
rl ZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Ne appl I or future Wilding occupant store or handle huarxIms mauml
AS cleaned by Ne Cupertino Municipal Code.Chariot,9.12,and the Health and Safety
CWc. CYenon 25312(x)? �N. All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant an equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it havardous air contaminants As defined by the Bay AMA Air Quality Management all new materials for inspection.
evict?
❑Yes 1�Nu
1 have mad the havmdous materials requirements under Chapter 6.95.f the Califon
.in
HcalN�safe( Nuns 25505.25533 And 25534.1 emkistond that iflM building
docs not cum nlly have nem, at it is my responsibility,to stud I IM occupant of he
uyuiexmcnu which mus m nim to iuuanm or a certificate
or Oomancy. Signature of Applicant Date
fo=6 d 3
ownmm mirsdagenl Date All roof coverings to be Class "B" or better
I
� CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
qpkPN# 3 Date: I,n_ (o - 2p03
Building Address:
10 17---26 30r,-rH WoL-ff�-; rC # 2081 . Cw(t7 -Ttn10. CA- 0I501L'
Owner's Name: Phone #:
YGE LI THE 13C-AU-ry Cv2(FATk0r,1 qo8 -Eci3•-15-13
Contractor: License#:
OWne2
Contact: Cupertino Business License#:
J-DNrJ LI
Building Permit Info:
Bldg ❑ Elect Plumb ❑ Mech ❑
Job Description:
Residential Elr 6� GcC-/ 1 C(Ce:- " omm RI
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Project: / — Occupancy Group:
Type of Construction:
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/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 > 1000A ELECTRICAL
BELEC200 Elec Svcs 600V <=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
z337 �
1of3 ✓ / ' ZJ
' s7al CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPERTINO
Quantity Fee ID Fee Description Fee Group
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL
BNEWMULTI Multifamily Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BNUMULTI New Multi family Res PLUMBING
BNUSFD New Single Family Res BUILDING
BOVERTIME Inspection Overtime BUILDING
BP13ACKFLOW 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
BPREPIM Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinkler/Backflo 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 cfrn MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Fumace MECHANICAL
BREMFURNOV Relo Furnace> 1 OK btu MECHANICAL
BREWMAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
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atts
CITY OF CUPERTINO
CUC1PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BREMPOWER Power Device/Apparatus. ELECTRICAL
BRENIRECEPT Rc tl Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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
BSEISNUCOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
BTEW Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERNUTFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issuance PLUMBING
PPLBG Plumbing Fee s foot PLUMBING
ZADDCHG Address Chane BUILDING
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