The URL can be used to link to this page

05080219 (2) CITY OF CUPERTINO , BulLolnc DlvisloN PERMIT O1I2ACTOIi TNF012MATI0Yi BUILDING ADDRESS: YOUNG' S CONSTRUCTION PERmr "°05080219 OWNER'S NAME: PERMIT ISSUE DATE CHING SHENG LIN 14839 CONWAY AVE 08/24/2005 NE: SANITARY NO. CONTROL NO. (408) 377-6839 ARCHIIECVENGINEER: BUILDING PERMIT INFO BOO PLU MEOCH .0e, LICENSED CONTRACTOR'S DECLARATION Job Description 4 I hereby eRirm that I am 1 nsrd under prov(daN of Chaper 9(commencing with Secti.3N)of Division eBasimanand tofesslonic AtITin Amnesia nZ1 �yo d5� Lcec anaercem. SRS/ UPGRADE ELECT. PANEL (200 AMP) Data Commissar ^1 HmicrS DECLARA �J 1 I understand my plans shall W died as public records a W 1.ICCnYd Pm(CS11aNI F/Ad. b0 OWNER-BUILDER DECLARATION Rf 1 hereby in.on 1 em exempt Imre the Contractors Licence Lew for ly rCti !' O O whichfollowingou mason.(Section 7 onL0.m amus and Profuctinm Cade:Any city or tcounty f �a 9�+ which requires a m.mo re unsruct alar improv,monolith,on repair end amerce _ n 1 Q 0 _Zi Prionmiss 4suence,ale requires tie appliumfonsechpemima Bleasigmdslatamenl ~v < NelbcbllronmdpursuantinMeprovisioNuftheConmrtmr'sLice= aw(Chapter9 Sq.Ft. Floor Area I yrs �,�., a anon $ (commencing with Section 70o0)of Division 3 of Ne Business and Prolamines Com)or p ed `fA f9& n that W 6 exempt M rmfrom and the basis for Me alleged exemption.Any violation of if// Fg (Ll Section 70313 by airy applicant her a permit subjects this applicant to a civil penalty of am notmdtanRKhanduaddallers(M). 5 IVr \J 17 ❑i,As Owner of de property.in my employed with was"As"it into Compensation. will do the work and the etmclum is at intended or offered for rom(Sec.7044,Business Required Inspections and Prof"siaN CodThm e: e Cu.erm's Lt..Law does not Apply a an owner of q - property who builds m Improwa Merton.and who docs ouch work himsel f m through M. own employees,provided that such improvements Are not Intended moffeed Admit,If. howevm,Me building or improvement is said within one you of completion,the owner- builder will have the burden of proving Mu he did not Wild or Improve for purpose of sale.), ❑1,As owner of Me property,am exclusively contracting with licensed rearm mors to construct the project(Sec.7044,BNin"s and Professions Code:)The Contractor's Li- cense law does not apply a An owner of property who Wilds or improv themon,and, who canuacts forsuch pmjem.with•conmractods)licensed pursuant an Me Commerce, License law. ❑14MCXCMPl under See. ,B&PCforthi.mason Owner Data 41 WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of Me following decleMioN: 1 haw and will maintain a Certificates of Consent to self-insure for Workers Coupon. Aides,as provided for by Section 3700 of the labor Cade,for the performance of the work fon which this Permit is iaues. ❑1 haw and will maintain Worlteri Compensation Insurance,As required by Section 3700of Me Labor Coulej Me perfo ear the wOrkfarwhieypuponnlNai"ued.- My Worm's COmpemmhm sago an "1 and Policy nu21pew2T —I Carrier. -I filmy No.: C.RTIFlCA OF K FnONFROM WORKE S' COMPENSATION INSURANCE CNb seNm reed mtbecompletrd limit permit is fm om hundred dollars(SIM) Or Is'..) I certify Mut In the performance,of to work for which Ole permit h,issued,)shall not employ any pctmn in any mantra As m become subject to the Warkess'COmpensstion Laws of California.Dam Applicant NOTICE TO APPLICANT.If,&Aar making this Certificate,of Exemption,you Mould bcoame subject in the Worker's Compensation provisions of On Labor Code,you must .,O forthwith comply with such proMilN Oter Mb Permit mull W docmcd mwkcd. wp:M CONSTRUCTION LENDING AGENCY 'rn I hereby affirm Met More is a construction lending agcoey for Me performance of C Me mass for which this permit is issued(Sec.3097,Civ.C.) Landers Name Z Leaden Address f>Q I unify,that I have read this application and mm that the aWve Information Is ts.!- correct.1 Agra to comply with all city and county ordinances and sus laws relating to C)SV' Wilding construction,and herebymmorier representatives,of Mb city a enter upon the Liz above-menuonW propeny for inspection purposes 6. (We).9.in save,indemnify and keep harnless the City of Cupertino Against rn liabilities judgmenta,costs saannnd expenses which may In my way stere against CityU in /7 (, APPLICANT UNDEof the R eOf thispandit. WILL COMPLY WIT ON-POINT Issued by: Date �- L, ( -0 SOURCE REGULATIO S. Re-roofs Signature of ApplicaDeanHAZARDO HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the a Cumn ire forum Wilding e.Chis m MIC9.1 m handle Health a material ldented io the 32(A)l m Municipal Code,Chapter 9.13,And the Health and Safety WC.Section 2553I(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes ON. Will the applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove It lumardous Air conmminanm u donned by the Bay Area Air Quality Management all new materials for inspection. mict7 ❑Yea ❑Nu 1hammW Me hua docs moviets requirements under Chapter 6.95 of the Califor. Health&SafetyCode,Sections 255(15,25533 uu125334.1 undcmmd that tribe Wilding e not cumntly have a enanL that it b my-ap�Nlbil ilik tie Occupant of theubemc h'hmum mmet prior toissuancenifmc.Mafu-cu Signature of Applicant Date own dr ambo l.d.gomDam All roof coverings to be Class"B"or better a Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 jUPEkTINO Building Department JOB ADDRESS: PERMIT# _ S'(I ,s-el CPO-Zr OWNER'S NAME: , PHONE # GENERAL CONTRACTOR FAX # I am not using any subcontractors: �' --C g S Signature Date Please check applicable subcontractors and complete the following information: 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 Owner/Contractor Signature Date CITY OF CUPERTINO 01F PERMIT APPLICATION FORM / CUPEIt,TINO APN# Date: Building Add ess: Mailing Address (if different from building address): Owner's Name: Phone 4- V � S-S-- - 22 Contractor: r Licen a #: S Contact: Phone: Cupertino Business Licenseg: Fax: Building Permit Info: C r„ ,� Bldg ❑ Elect Z�x Plumb ❑ Mech ❑ Job Descripti$� Residential EX Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: tt7e) DO Occupancy Group: D Type of Construction: Please check this box if the project is a AOL us) second-story addition: ❑ Pro•ect Size: Standard ❑ Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to IM Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILERS Boiler> 1.75MBtu 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 i3 ° F7Z- 1 of 3 -1 °a . 6 6 CITY OF CUPERTINO CUPEt�TINO PERMIT APPLICATION FORM uanti Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTWE Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING MIXTURE Pb1g 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 BPREPIPE Re i e Of Fixtures I PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING lop BPVENT Alt of Drain &Vent PLUMBING BPWATER InstalUAlter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Rein' ection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units<= 10,000 ctin MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Fumace MECHANICAL BREMFURNOV Relo Fumace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance . ELECTRICAL 2 of 3 CITY OF CUPERTINO CU CITY NO PERMIT APPLICATION FORM QuantityFee ID Fee Description Fee Group 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 BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inection BUILDING BSW1M Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM -- Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Chane BUILDING 3 of 3