06010057 (3) CITY OF CUPECONTRACTOR INF ILM YqN '"
BUILDING DIVISION
PERMIT
BUILDING ADDRESS: UNIQ ELECTRIC INC PERMIT NO.06010057
PERMIT ISSUE DATE
HER'S NAME:
SHUNG-FU SU 3248 MORRISDR 0 2006
SANITARY NO. CONTROL NO.
PHONE:
(650) 773-3734 BUILDING PERMIT INFO
ARCHTTECTIENGINEER: BLDG ELECT PLUMB MECH
apo LICENSED CONTRACTOR'S DECLARATION Job Description
1� Waby afnrm the l 1 em licensed under provisions of L'bapmr,9(commencing' with scedrn70P4))of Division 3 of line Business and Professions Code.and my license it
^� In full force andefrms. ADD RECESS LITE/REPLACE 6 CEILING LITE
3'z' Li==nm clans ucu ADD DEDICATED CIRCUIT FOR MICRO
I ppp Data Contractor
ARCHITECTS DECLARATION'
I undcratanJ my plans shall heated As Public mcnNs
It Licensed Professional
OWNER-BUILDER DECLARATION
1 mono .(Rare that 1 am exempt from the Cnnuacmh License Law for the
y o o following.axon.(Seation 702 I!,B"In"s and Pmfeatious Cade:Any airy Or county -- -- - —- ----- ---- --
$ which requires a permit m CO"Imct.¢Iter,Wpmve,demolish.or repair any suucmrc
'�'i^ priorm itsiatmacc.uhu.quit"the applicant far such Permitto file a signed statement Sq.Ft. Floor Area Valuati'�f 000
sC that he is licensed pursuant as the Provisions of thA Comracmi LLicense law(ChApar9
V $ (commencing with Section 7000)of Division 3 of the Business and Proressl^na Cod.)or
�.. dist he is exempt Ihcm(m a and Oa basis for the alleged exemption.Any violation of Occupancy Type
Section 7031.5 by airy applicant for a permit subjects da to applicant a civil penally Of APN Number
not mole Nan It.hundred dollars(SSW). 35617051 . 00
.
0 I,An owner of the property,Or my employees wish wag"As their sole compensation,
will do the work and the m"nua is net intended or offered for sale(Sea 7044,Business Required Inspections
and Professions Code:The Convectors License Lew da"not apply to an owner of
property who Wilds or Improves themon.and who doessuch work himselfor through his
..employ=,pmAded that such improvements arc not intended mortared frazzle.If.
however,the building or improvement is mid within one)ear of compledon,the owner.
builder will have Ute barrios of proving that he did not Wild or improve(or purpose Of
ufoJ.
0 1,as obner of the property,am exclusively convening with licensed convectors to
construct the project(Sec.7044,Basin.and Professions Code:)The Counsctor'z Li-
cause law does not apply to an owner of property who Wilds or improves themon,and
who contracts far such projects wiba convector4)licensed pursuant M the Contranrrf
Licenm Law, ,B&P C far this anon
0 1 Am exempt under Sec
Owner Data
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury a"Of the following declantio":
0 I ban and WII maintain acenvicaa Of Consent t^self-Insure for WmkehCompen-
"tlon,As provided far by Section 3700 of the Labor Cade,fm the Nor- --of the
work for which this permit is Issued.
0 1 have and will maintain Workces Compensation Insurance,As required by Section '
3700 of the Labor Cade,for the performance of the work for which this permit is issued.
My Workers Compensation Insumnce carrier and Policy number aa:
Cartier. Policy Nb.: '
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
r@ts section reed oar W completed]find permit Is faro"hundred dollars(SIM)
or loss.)
1 certify that In the performance of the work for which this permit is inucd,l shall nut
employanypermnin mymmncr As to ^me subject to Ne Workers Compensation
Laws ofo"ro"al"
Appli"nl
NOTICE TO APPLICANT:IL a0cr making thls Cenir. of Exemption,you should
become subject in she Workees Compensation previsions of the labor Code,you meet
�Z forthwith comply with such provisions or this Parmitshall be deemed mvoked.
.Z.aO CONSTRUCTION LENDING AGENCY
1 hereby aM m that thea is a construction lending agency for the Performance of
a> rite work(tar which Nis permit Is tat"d(Sea.3097.Civ.C.)
W Q Lenders Name
Ue&rh Addreu
V 0 I certify that I have read this application and sus deal the.LOVA inrannallu^is
W C'" canes I agree a comply with all city and county ordinances and some laws relating to
V buildin(we)suuctiao.aoriheabyauthodae apr"enales,tOfCitcity Corwin.Against
liabilities,
W aWvcme^liuned property for impaction Purp"es
py_6. .,mc And keep hay in my
City of Cupertinoagainst
liobilides,Judgmenla.cosu and aspenses which may In my way acerae against rid City
YJ z inconsequeneeof.hegaoingofthis permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: DBCC
SOURCEREGULAT ONS. ;+
1416 Re-roofs
Sigmas of Appli"elyCOmtrmarS R Dace Type of Roof
HAZARDOUS MATERIALS DISCLO
Will the applicant tar rutum building Occupant Store ter handle havardous material
az defined by the Cupeni^o Municipal Code,Chapter 9.12,and the Health and Safety
Code,Section 25532(a)? IgNa All roofs shall be inspected prior to any roofing material being installed.
0 y"
If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or future Wilding Occupant use equipment or devices which r
Amit hacardous air contaminants az defined by the Bay Area Air Quality Management all new materials for inspection.
D'uuict? �/-
DIGtycs Nu
I have mad the hazardous materials requirements under Chapter 6.95 ofthe Califor-
ninHealth&EAfnyCade,Sections 255505,25533 And 25534.1 understand dot lithe Wilding
dos not curendy have a to.sm,that it is my respoodulity Ir notify the ocupml of the
requlamcots which mutt ba mel poor u.menAAnr,Ce .cmoro, Y. Signature of Applicant Date
1 All roof coverings to be Class"B"or better
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• CCSY ` �tRESTD'ENTIAL PROJECZ ,COryvER'^kSHEE,I '_
r� a fr,cy �' J 1sxr^. r° -a,k }k Yr -�1�t ��iY w o t ' �'r£x T'4��'y °—i} yn��'. Tiw '`"}•.f:
CUPEkINO w x ¢ g F 2 r G T 6w ns " ;t .rv. ° 4 r _7•., rYlr_Y.dA} ic_.., v_a.:l
Assessor's Parcel Number:
Name of owner. 5({r t N G C( S Gl
Project address. Z 3 6 CO i ✓ SWO-1'(1 S f . L C( 2�r �,'0 c)
Contact-person.— '/CjZS4",LU L l �yG Phone. Z2 3 . 3 7 3
Fax.
APPROVED
}N ACCORijfe s4W,;j ejfTouge(cf lot.
CUPERTINO CODES AM ORDINANCES
)ATE n -0/ Existing Proposed
�-� S are o t" First floor: L+26
iIGNED 1j- Second floor: 9-00
This set of plans and specifications MUSTGarage:
De kept on the job at all times and it is u
lawful to make any changes or alteration�TOTAL: 2 G o c
on same without written permission fron.
•building DekeCtgfe' at4l-east++•two 10 foot by 20 foot clear spaces inside the garage? (Y3N
stamping of this plan and specifications
;HALL NOT be held to permit o to he ar,
oproval of thc4$iP,nBacy pr ciornplanting required for the project? Y N
onv City Ordinance or )tate Law
On what floor(s) is work being done? R rst d- 5ecorc( FL,D r .
Brief description of work. Q'Gfd 3D yeyf s L tt View (�ne t-er ivt crcwAuE (I-
Code
l Code editions: 2001 CBC (Y -N)2001 CFC (Y -N)2001 CMC (Y-N)
A01 CPC (Y - N)2001 NEC (Y -N)
Effective 11/1/02 add G �5 '
5" l lulus°ter ljecPrvo,vl.Cj /�
aedir"ol;'i
RECEIVED p i�Cdye) m # 3
JAN 1 0 2006 Z 5"
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0dc( 2 ZJ'Ah c Mic2cWALIE WA,tEr p}'s �kl eler ,
Plan Review Process Work Book Page-8-Revised 4/28/04
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