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08050165 (2) CITY OF CUPERTINO _ /'x� ��, � r✓3vf" �%]��n'�,� (a'1�ii''' BUIIlJINCDIVFSION PEl�lYulVoi�ai l�[i�TQRfA'O�LYAvlh BUILDING DDRESS. PERMIT NO, 1075 BEARDON DR T & R MANAGEMENT & 08050165 .INER'S NAME: PERMIT LSUB DATE TZEKING ROCKY CHAN 6172 BOLLINGER RD STE 151 05/21/2008 ONE: SANITARY NO. CONTROL NO, (408) 329-2831 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION l Job Description At C 1 hetcby afRtm that i Am licensed under provisions of Chapter 9(mmmcneing P <U wiNs«uon]IXloy a(DiHsav3ofdc Busixu and Profeseam Cade.W mylacnmu TEMP POWER POLE in full forte and efface j M Z_ License Clan Lie.At F• Dam Contractor W ARCHITECTS DECLARATION 7 1 undersand my plans sIW I k used As public reemds JyU ICN Licensed Precessional nal DECLARATION 1 patchy alrim that 1 am exempt from Ne Como ttor's License Law for do COG fallowing Bacon(Section 7W 1.5.BLLSIMSs Ltd HarelLON Code:My city ar county which requisns A permit to cansruc4 arm,,improve,demolish•nr mPat,any sttoctum _zy poor m its issuance.Also,requires the applicant for such permit to rile asigncd statement < than paulicensed pursoantmthe provisions Ofthe Communes U..Law(Chapmr9 Sq.Ft.Floor Area $2000 • Valuation AA, $ (commencing with Section?ODO)of Division 3 of the Business and Pnefe¢ sions Code)or 2 0 0 0 _ And he u exempt them(mm and tic basis for Ik Alleged exmpdom My violation of Section 7MI.5 by Ary applicator for a permit subjects the applicant to A civil penalty OfNumber Occupancy Type ret ream Nan Bac hundred dollars(IM. 3 2 6 3 015 2 q� l,uowncroftk property,sur my employm with wag.tithes sole compcnudon, will inNewark andthe he C ms sLicentsurawdororxk(Sec.Id An B of are property wh W cadre The CantrxmfA L acts Law dao,rat apply lf rt owne sur Required Inspections property wk builds i ireprowsch i m r arm who arcssuch wort himself orNmAsk his awvner,th building improvement suchimpmvemmuartnot ear ofcmaRered for sale U, however,the building or dere of omr 4 halo within one year of mprove far the owner- builden will have Ik buNm of moving that k did ret atilo or improve for purpose of ole.). )9 I.As owner of the property.Am exclusively cunhL4ng with licensed mnuctms to - construct due project(Sec.7044,Business and Profession Code)M Contractor's V- time law docs not apply In an own.Of pmpeny who builds An improves thereon,std, who contracts for such projects with a mntmetos(s)licensed pursuant As tpa Contractor's Lie'.Law. I Am exempt under See .B&PJC far this rarer T� Dames TJX WQ$ AS COMPENSATION DECLARATION 1 hereby affirm under perWry of penjmy One of the following OeclLauans: ❑I ham and will maintain a Cersifleam of Consent to self-insure for WorkmesCompcn- ration,As presided for by Section 37M of the Labor Code,for the part. to of the work for which this Pit is banned. 0 1 have and will maintain Workels Campvuadon InsurLce.u required by Section 37ODofdm Latour Code,for the per(owmce of tk work for which this permit it issued. ' My Worker's Compensation lnsomen carrier and Policy number are: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thus secure need ret x cmnpkmd if do permit isfororc hun&eddaBan(SIOO) m ken) 1 unify than in the performance of the work for which this permit is issued.L shall nm employ any person in any mance r ohm becoa rambjenmNe Wo rkers'Compemation Laws Or Caufomia.Data ((�� Applieaot 71 _ /N W T NOTICE TO APPLICANT:If•after making this CeniEum of Exemption.you should. became subject or the Worker's Compensation provisions of the labor Cade,you most .J O forthwith comply with such provisions or this permit shall the doomed muted. Z" CONSTRUCTION LENDING AGENCY Ihemhyafftrm taw tpartits conswcunn lendinga forthe C > tate work for whim oris . allay perfamma sur �W 0 Lender's Name Permit u issued(Soo.JO9'1,Civ.C7 . G, z Lcmdm'A Address V 0 I cemly that 1 have read dtis Application And Anne,Nal dR above information is u,E cartel.I agree m sastye comply with all city and county oriices and b,"relating to l .O Cr^1 building camuuctian,and hereby Authorize nepresammots ofthu city to enmrupnn Ne r LIJ aWve-mentioned pmpeny for Wpecuan purposes f+6. (We)agree to save,indemnify and keeP hannhas tie City of Cupertino against pry liabilities,judgments.costs and expectses which may in any way accrue against said City fJ Z in consequence of the granting of this permit. ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date ,^ L— '(i r' SOURCE REGULATIONS. (/ Re-roofs — SignatureofApplimnsCoauact ' Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or run=Wilding occupant store or handle haurdous material u deftmd by 1pa Cupertino Municipal Cane.Chapter 9.13.and the Health and Safety Section 15532(a)? ❑Y. AN. All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit haartlnns air contaminants As defined by the Bay Arta Air Quality Management all new materials for inspection. District? Oyer I have resl the hxaalloue mamoals requimmenu undcrChapmr6.95 of the Callrar- niaHnslth&SafmyCodc,SccturATI 05,25533 and 25534.1 unMrsuntl th&if uc building does rat currently have A umc.L tau,it is my responsibility m notify the rccupxl or ac ampirtments which mus he met priorto issuance of a Cenifcatoof Occupancy. Signature of Applicant Dale 7y, 4 All roof coverings to be Class" Owner or soNOo>nd Agent � g j¢"or better CITY OF CUPERTINO • 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Elk: Lot: APN . . . . . . . .. 32630152 . 00 DATE ISSUED. . . . . . . : 05/21/2008 RECEIPT # . . . . . . . . . : BS000004857 REFERENCE ID # . . . : 08050165 SITE ADDRESS . . . . . : 10475 BEARDON DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : TZEKING ROCKY CHAN ADDRESS . . . . . . . . . . : 10475 BEARDON DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : TZEKING CHAN CONTRACTOR . . . . . . . : PAUL YANG LIC # 29369 COMPANY . . . . . . . . . . : T & R MANAGEMENT & CONSTRUCTIO ADDRESS . . . . . . . . . . : 6172 BOLLINGER RD STE 151 CITY/STATE/ZIP . . . : SAN JOSE, CA 95129 • TELEPHONE . . . . . . . . : (408) 329-2831 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---- ---------- ---------- ---------- ----------- 1BSEISMICR VALUATION 2, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 1ERT<200 UNITS 1 . 00 40 . 79 0 . 00 40 .79 0 . 00 1TRAVDOC FLAT RATE 1 . 00 40 .79 0 . 00 40 . 79 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 122 . 87 0 . 00 122 . 87 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER - --------- -------------------- CREDIT CARD 122 . 87 MC TOTAL RECEIPT 122 . 87 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 402 TEMPORARY POWER -� CITY OF CUPERTINO TEMP POWER CUPER,TINO PERMIT APPLICATION FORM APN # Date: 2a �3 0 �� too Building Address: e� %w Gil- x/5,0 /c/ Owner's Name: Phone #: `rz&Kinl67 CKAA1 q-o3K-o 0 Contractor: D-Qup Gorsfvu cam e Phone #: 4`0,F I°4 Fax #: q- 6 - 3 S8 Contact: P��. °"' Phone#: f �' 37q - 293 Contractor License #: Cupertino Business License #: Job Description: c �Sl Gtl'i(�1IJ f1 / r Dov Residential ® Commercial ❑ Valuation (cost of project): , 07)oo o Quantity Fee ID Fee Description Fee Group Permit Type IERT>1K Res. Temp Power>1K E 1REAP14 Amps /. IERT<200 Res. Temp Power<200 E Amps IERT2001K Res. Temp Power 200-1K E Amps IEPERMITFE Electric Permit Issuance E IELCPLNCK Electric Plan Check E / 1BSEISMICR Seismic Residential B r ITRAVDOC Travel & Documentation B Fee -� CITY OF CUPERTINO TEMP POWER CITY OF CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group Permit Type 1BSEISMICO Seismic Commercial B 10EAP14 IECT<200 Commercial Temp Power E <200 Amps IECT>1K Commercial Temp Power E >1K Amps IECT2001K Commercial Temp Power E 100-IK Am s 1TRAVDOC Travel & Documentation B Fee 1BUSLIC Business License B • Community Development r f J 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 SCUPEkTINO Building Department JOB ADDRESS: 10i -q5 ParcLen Dn'v2 PERMIT # O (Slo� O I o CA 15-01 (t- 6 OWNER'S NAME: Z& IN &-K1t1✓ PHONE # 40,t GENERAL CONTRACTOR: 7-i2 Com FAX # <,oS- I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information 21 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical 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 Ou-fer/Contractor Signature Date