06120028 (2) CITY OF CUPERTINO =w max' `�• °^" *` .x '� '
BUILDING DIVISION PERMIT CONTR'A.C,TTO,RhINk'QRMAT,IOl�[ x
BUILDING ADDRESS: VANNI BROTHERS CONSTRUCTI 2ERMIT N0.06120028
906 HYDE AVE V
OWNER'S NAME: PERMIT ISSUE DATE
CLEMENT, WANG 914 HYDE AVE 12/11/2006
14 NE:
SANITARY NO. CONTROL NO.
(408) 253-7028
ARCHITECT/ENGINEER: BUILDING PERMITINFO
BLDGELECT PLUMD MECH
L! (�
LICENSED CONTRACTOR'S DECLARATION Job Description
1 hexby affirm dost 1 anfvc licensed tread provisions of Chador 9(commencing P
;i� wish Savon]IXgl)of DiMsionJof Ne BndnessaM Pmfeuiom Code.mod mylicense u
>>N imfull mrteand effect. BATHROOM REMODEL-NON STRUCTURAL INCLUDES
License Class Le.N LIGHTING & PLUMBING FIXTURES
i F ca Dam Comarutm
ARCHITECTS DECLARATION
i < I vuorsund my plarm shall W used az Public meords
ayU
u.o Licensed Professional
OWNER-BUILDER DECLARATION
y I hereby affirm that I am exempt from the Contractor's License Law for she
C C following mason.(Section 71n I.S.Business and Professions Calc:Any city or county
res
e alv which rcgvix permit to construct.sitter,improve.demnl'sh,or repair any strac u e
u—w prior to its issuance.also requires the applicant rar such Permit o rile a signed statement
-�i Nat he is licensed pursuant to the provisions of de Contractor's Liccmc Law(Chapter 9 Sq.F[.Floor Area Val D lIDT5000
CFC (commencing wish Section 7000)of Division J of the Businev mM Pmfessims Cndc)tar
that he is eumpt therefrom and doe basis for doe alleged exemption.Any violadon of
Section 7031.5 by any applicant fa a permit subjects the applicant to a civil penalty of tqo EN Number Occupancy Type
not More done five hundred dollars($500). 3 7 5 39007 . 00
❑I.uowrcr of du propmy,amy employes wish wguaz does salt eompewtien,
will do tho work.xndth.meman is nor intended or offered formic(Sec.70". Required Inspections
and Pmfwiors Cale:The Cau
natons roers License Law dot apply to an owner of q P
property who Wilds orimprovee thereon,andwhodoessah wells him orf orthmugh his
awn employers,provided that uch imptovemens art not intended aro@red forsale.If.
however,the Wilding or improvement is sold within hie year of comp smon,the ownm-
builder will haw ft Widest of proving that he did not Wild or improve for purpose of
uM.).
1.u owner of the propcny,am exclusively conuuting wish lle mod comment.to
o mutt the project(Sec.70a4.Business and Professional Cade:)The Conuackrs U.
cense taw does ant apply to an owner of property,wW Wilds or improves thereon,and.
who contracts for such pojeeu wish a conuxtorts)licensed pursuant to she Convacsrri
License law.
❑ 1 ren cum tied"Sec .B&P C for Thu rtamn
Owner� / Dam I O
W .KERS CO�CLARATION
1 hereby aRm,under penalty of padury au of the fallowing declacuiom:
❑I ham and will maintain a Cenifieate of Consenua mlf-insumforWortcerCompere-
setion,uprovided for by Sectirn 3]00 of doe laWr Cade,far she peAormanceof dm
wodr for which this Permit is issued.
1 have and will maintain Workers Compensation Insurance,as squired by Section
3700 of the lather Code,for she perfarosance ofde wort for which this permit u issued. '
My Workers Compensation Insurance artier and Policy number art:
Cartier. Policy Na.:
CERTIFICATE OF EXEMPTION FROM WORKERS' '
COMPENSATION INSURANCE
(Thisseetion need not W cmerpleud if the permit is form.hundred dalton($100)
or leu.)
1 certify that in Me perfasnance of the wan for which this permit is ismed.1 shall not
employ any person many meso u to Wcome subjecuo doe Wartesi Compemation
Laws of California Dam 7��i5/v / / A
NOTICE TO APApplicant PLICANT.-II.after eking do�i u Certificate of Exemp'an,yhu should
become subject 0 she Worm is Compensation provisions of she labor Code,you most
.JO raMwido comply with such provision.a this permitshallM deemed revoked.
Z�y CONSTRUCTION LENDING AGENCY
(+ Ihereby affirm that dere is a construction lending agency for the Performance of
fY' Nr work for which this permit h;issued(Sec.3097,Civ.C.)
UJ Q Lendcr's Name
0.
0 z Lender's Address
V Q 1 certify that 1 ban mad this application and sum that the aWse information is
LL correct,l agree to comply with all city and county on inan es and sun laws relating in
O V Wilding construction.and hereby authorize reprucnutives of this city to enter upon the
En
above m,judgdproperty teriespenums purpowhich may
(•+6. (We)agrcc m save,indemnify and kap harmless de City of Cupertino against
Z 1.consequece of the grassing expcssesmit. may in anyway agmc against mid City
I)z AcPLICANec of doe UNDERSTANDS
this Permit.
^ APPLICANT UNDERSTANDS ANO WILL COMPLY WITH AL1.NON.POINf Issued by: Date
Sigink REG %NS. (�/'1/O /
/ // (� Re-roofs .
Sig rtof Appl' UCARDOr Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will she applicant or future Wilding e.Chapter
m handle Heasdons material
az dented by to Cupertino Municipal Code.Chapnr 9.12,roti she Health and Sa(cry
Cade,Section 35312(x)? All roofs shall be inspected prior to any roofing material being installed.
41 ❑Yoe )(7 No
Will the applicant orfuturebuilding oavpant ase equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
omit hazardous is,contaminants as dcfmd by Ne Bay Aura Ail Quality Management all new materials for inspection.
DistricR
0Ya No
I have mad the Wvardcros mamrialemquircmonal undo Chapur 6.95 o(Ne Califon
ria Healed&SafcryCade,Savour 25505.15573 sa125534.l uaermnd too ifte Wilding
does not c ty hash a le ZM Nat it is my MSWMibility to notify doe occupant of the
require hichmj=tpoor to issuance ofaccrufaZf d � Signature of Applicant Date
Owner or avdmr. gent Z Date All roof coverings to be Class°$°or better
CITY OF CUPERTINO
1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # : 1
Sec: Twp: Rng: Sub: Elk: Lot:
APN . . . . . . . . : 37539007.00
DATE ISSUED. . . . . . . : 12/11/2006
RECEIPT #. . . . . . . . . : 36992
REFERENCE ID # . . . : 06120028
SITE ADDRESS . . . . . : 906 HYDE AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : CLEMENT WANG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4663
RECEIVED FROM . . . . : CLEMENT WANG
CONTRACTOR . . . . . . . : VANNI, MICHAEL LIC # 18307
COMPANY . . . . . . . . . . : VANNI BROTHERS CONSTRUCTION
ADDRESS . . . . . . . . . . : 914 HYDE AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE' . . . . . . . . : (408) 253-7028
41E ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 15, 000.00 223.56 0.00 223 .56 0.00
BPFIXTURE UNITS 2 . 00 18.00 0.00 18.00 0.00
BPLANCHK PERMIT FEE 223 .56 298.34 0.00 298.34 0.00
BENERGY PERMIT FEE 223 .56 107.31 0.00 107.31 0.00
BREMFIXT NO. FIXTURES 1.00 1.20 0.00 1.20 0.00
PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00
BREMVENFAN NO UNITS 1. 00 45.39 0.00 45.39 0.00
BSEISMICRE VALUATION 15, 000.00 1.50 0.00 1.50 0. 00
EPERMITFEE FLAT RATE 1.00 38.37 0. 00 38.37 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 772 . 04 0.00 772. 04 0. 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 772.04 1450
TOTAL RECEIPT 772 .04
•
.b. Community Development
F 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
OUPEkTINO
Building De artment
JOB ADDRESS: PERMIT#
0 6 woe vE 0612 00
OWNER'S NAME: CCeMFN'r W4A& PHONE # — --o Z8
GENERAL CONTRACTOR Vjk OS C O 57R FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information
60 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
n Tile
• �i�-,� i 2 ► / z o o 6
er/Contractor Signature Date
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CITY OF CUPERTINO
cnvbr PERMIT APPLICATION FORM
CUPEkTINO C J
APN# Date:
3 - 00 - o C)
Building Address: AA Mailing Address (if different from building address):
9 \A Kqe__- ocl,vouak
Owner's Name: I Pho e#:
C- rn + W o.h _ 40 ;S
Contractor: �/ L'cense #:
Nom; V o.hv\' 171 ,604 2 31
Contat: h ne: 9,T3--)c2F Cupertino Business License#:
�e i vh t Fax: &3 b
Buildin Permit Info:
AY
�oo. 0- 1 I
g 14
� (NLI,JA—
Bld ❑ Elect ❑ Plumb ❑ Mech
Job Description:
Residential Commercial ❑
Sq.Ft. Floor Area: _ — Sq.Ft.:
Cost of Project: Occupancy Group:1
4J 1 5 Dp0
Type of Constructi n: Please check this box if the project is a
second-story addition: ❑
roject 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 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
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Gid CITY OF CUPERTINO
CFTMOF PERMIT APPLICATION FORM
CUPEkTiNO
Quantity 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
BOVERTIME Inspection Overtime BUILDING •
BPBACKFLOW 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
BPREPIPE 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 Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> 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
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CITE' OF CUPERTINO
"R
COPE TTINO PERMIT APPLICATION FORM
Quanti Fee ID Fee Descriptio n 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 Inspection BUILDING
BSWIM 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 Mechanical sq. 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 Change BUILDING
•
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