S 0622 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE SALL POINT PEN ONLY '
CITY OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO. O
BUILDING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL S
BUILDING PROJECT IDENTIFICATION
BUILDINGADDRESS'. SANITARY NO. APPLICATION SUBMITTAL DATE
�SGIN32�(,
OWN"S AME PHONE: TRACTOR'S NAME: LIC NO:
NAC COONTTRROL#
�'HITE / EER: LIC NO: ADDRESS
CONTA P E' BUILDINGPERMIT INFO
G WAV[/ Consultant Fees Paidby Applicarit Unitlal) BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR' DECLARATION QTY. ELECTRIC PERMIT FEE
1 hereby affirm that I mo licensed under provisions or Chapter 9(commencing JOB DESCRIPTION _
X00P4Z with Saetioo]OW)of Division Sof the Business and Rnfessinrt Cale,and. I'enseis
0 0 PERMIns$unrvcE RESIDENTIAL
W r in full force and,Red. �/ c ❑SFDWL 0 KITCHEN REMODEL
�U$H License Clns Lich t o `Y+--rte APPLIANCES—RESIDENTIAL C:1 ADDITION 0PLUMBING RE-PIPE
y�at, Dan Ctmtm 4C
1„p>Cy> AR H ECT'S OECLARA O PANELS El MULTI-UNIT El STRUCTURAL
ZO p Iundersmnd my plansshall heusedaspablic records MODIFICATION
O'y-& UP TO 350 AMPS INTERIOR El CHIMNEY REPAIR
Fr3kW Licensed Proreseional 201-IMOAMPS MPROV ENT [3 SWIMMING POOLS
04..l OWNER-BUILDER m DECLARATION OVER Has)AMPS D ODEIJ PAIR El DEMOLITION
y C JW 1 hereby affirm that 1 t.5 exempt from the Contractor's eAnyLicense Law for the
)d 3� following reason. emit t ]ensu Rosiness roadimprove,
v,deli Code:Any city in county - SIGNS ELECi'RICAL OTHER
u1 which requires a permit re consumer,pl div improve,demolish,or repair any mmcmm
�ry� prior to its issuance,also requires the npplicvnt for such permit tofle aligned statement SPECIAL CIRCUIT/MISO
that he is licensed pursuant the provisions of the Contractor's License Law(Chapter 9
Ed (commencing with Section 7q))of Division 3 of the Rusiness and Pinfessime Coca)or TEMP.METER OR POLE INST. M R '
G y o 2� that he is exempt therefrom and the basis for the alleged exemption.Any violation of - ❑NEW BLDG/ADDITION 0 DEMOLITION
`m'm Section 703 15 by any applicant for v pemnit subjects the applicant to v civil penmlry of POWER DEVICES EI TENANT C FOOD SERVICE
q Oact mom than five hundred dollars($550).
L]I,vs owner of the property.nr my employees with wages us their sale cnmpensmina, SWIMMING POOL ELECTRIC IMPROVEMENT ,
02 will dothe work,end Obstructor,is not imendedorofferet truistic(See7044,Business OOTHER
da and Professions Code:The Contractor's License Law docs not apply to an owner of OUTLETS-SWITCHES—FIXTURES
property who builds or Improves thereon,and who does such work himselfmmugh
his own employees,provided that such improvements are not intended or offered for NEW RESIDENTIAL ELECTR SQ IT.
sale.If,however the building or improvement issold within oneyeandecomadon,the SQ.Fr.FLOOR AREA $/SQ.FT:
owner-builder will have the burden of p.,in,,h.1 he did not build or improve for put- 6r
Post dsale.).
0 I,as owner of the property,am exclusively contracting with licensed Contractors to _
construct the project(See.7044,Business and Professions Code;)The Contractors Li- • -
cense Law docs not apply to an owner of property who builds or improves thereon,and QTY PLUMBING PERMIT FEE
who contracts for such prom
projects with a contctor(s)licensed pummum to the Cotnractias
License Law. PERMITISSUANCE
❑ l am exempt under Sec ,R&P C for this reason
wner Date ALTER—DRAIN&VENT—WATER(IA) VALUATI
IOON
WORKER'S COMPENSATION DECLARATION BACK FLOW PROTECT.DEVICE
affirm �$1 A r
1 hereby under penalty of perjury one of the fallowing declarations: D p
'❑ I have and will maintain a Certificate ofConeent to seif-insure fnr Workers Compen- DRAINS—FLOOR,ROOF,AREA,CONESTORIES TYPE CONSTRUCTION
salion,as provided for by Section 37W of the Labor Code,for the performance of the
work for which this permit is issued FIXTURES—PER TRAP . .
0 1 have and will maintain Worker's Compensation Insurance,as required by Section
37Mofthe Labor Code,for the performance ofthe work for whicludia permit,,issued. GAS—EA.SYSTEM-1 INC.4 OUTLETS OCC:GROUP ANN
My Worker',Compensation Insurance carrier and Policy naular am
Corder 7 Policy N¢; GAS—P.A.SYSTEM-OVER 4(EA)
S 1'I OF EXEMPTION FRO WO KERS'
COMPENSATION INSURANCE REASFJINDUSTRL WASTE INTERCEPTOR BUIL NPa.'s
(This section neednot be completed ifide permit is fortune hundred dollars($I W) GREASETRAP
` 1,or less.) PLANCHECKF
I codify thatm the permarmaccefthe work for winchthis pe,.I,is issued,[shall SEWER—SANITARY—STORM EA.250 FT.
not,.ploy any person in any manner so as to become subject to the Worker,;Compen- ENERGY FEE r
I O O ssaationeLaws of California.Date WATER HEATER WNENT/ELECTR ant GRADING FEE1 all
y NOTICE TO APPLICANT.If,after making this Cenilicam of Exemption,you should WATER SYSTEMGREATING
a become subject to the Workers Compensation provisions of the Labor Code,you must SOILS FEE
forthwith comply with such provisions or this permit shall he deemed revoked. WATER SERVICE
a
CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMB. SQ.FT. PAID
I hereby action thauhem lsacoostmctioo lending agency for the perfortnunce ofW.
Dale Receipt
U the work fnr which this permit I,Issued(Sec 3)9],Civ.C.)
Lender's Name TOTAL:
l4L Lender's Address lap dc�
I certify that I have read this application and state that the shove infnrmmom is BUILDING FEE
V) correct.1 agree to comply withal]city and county ordinances and state laws relating to QTY. MECHANICAL PERMIT FEE
V z building construction,and hereby authorize representatives of this city to enter upon the - SEISMIC FEE
above-mentioned property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against PERMIT ISSUANCE ELECTRIC FEE
liabilities,judgments.costs and expenses which may in any way accrue against said City ATTER OR ADD TO MSCI I.
in consequence of the granting of this permit.in FEE
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO IBOW CFM)
SOURCE RESn l IONS, MECHANICAL FEE
I AIR HANDLING UNIT(OVER IgIXNI CPM) CONSTRUCTION TAX
Signature ofA eaducommetoc Date EXHAUST HOOD(W/DUCT7 HOUSING MITIGATION FF.F.
HAZARDOUS MATERIALS DISCLOSURE
W�applicant or future building occupant store or handle hazardous material HEATING UNIT(TO 100,00)BTU)
as defined by the Cupertim,Municipal Code,Chapter 9.12,and the Health and Safety
Cade,Section 25532(a)^. HEATING UNIT(OVER 10),)50 BTU)
El Yes ON. VENTILATION FAN(SINGLE RESID) PAID
Date Receipt#
-Will the applicant or future building occupant use equipment or devices which
mit hnzerdous air contaminants as defined by the Bay Area Air Quality Management BOILER—COME LIFE OR 100,000 BTU)
TOTAL:
•Okada'?
❑Yes 0 N BOILER-COME(OVER 100,0001311J)
') AIR have card the hazardous mmeriala requirement.under Chapter fi 95 of the Cali- AIR CONDITIONER ISSUANCE DATE
1, poria Hudlh&Safety Cade,Sections 25505,25533 and 25534.1 understand that fie, NEW RESIDENTIAL MECH. SQ.FT.
building does act carnally have a tenant,that it is my responsibility m notify the occupant
�y of the bequirreants which must he met prou to iiscance of a Certificate of Occupancy.
Owner or authorized agentDare - ISSUED BY:
OFFICE
. Ms. Lisa Lei Wang.
18818 Bellgrove Cir.,
April 6, 1998 . Saratoga , CA 95070 .
Cupertino National Bank & Trust,
Construction Lending Dept.,
20230 Stevens Creek Blvd. ,
Cupertino, California 95014 .
'
Subject : Change of General Contractor
Loan No. : 301065993 dated 10-27-1997
Permit No. : S 0622
Job-Location=--:-10171Camino Vista Dr. , Cupertino, CA 95014.
Use of'Structure- : SFR with attached garage
Dear Sir/ Madam ,
Due to unsatisfactory performance of the original General Contractor for the above project
Owner- Lisa Lei Wang decided to terminate the Building Contract dated 21, Oct.
_ 1997 with the orignal General Contractor -- Fran Lee Construction , Inc. ( State
✓!'��/� License No. 723438 ) on April 8 1998 -- 7:59 am .
• Starting from April 0,1998 -- 8:00 am
Sun Sun Enterprises, ( State Licence No. 744249 ) will be the new General
Contractor for the above project at 10171 Camino Vista Dr., Cupertino .
Kindly arrange necessary precedures for this change .
' Thank you for your kind assistance and coperation .
Sincere) Yours ,
APR E 1998
Owner : Ms. Lisa Lei Wang
SLOG CITY OF CUPERTINO MINT
r`
r' AIM SUN SUN ENTERPRISES,INC.
Q+New Construction,Remodeled Custom Home
Lie#74424
George C. K. But
Director
4300 Stevens Cnxk Blvd,#125
Sanlose,CA95030 USA AFT
Tel: (408)2462800 VM:(408)303d688
Res:(408)973-8013 Fax:(408)973-9103