05100226 (2) CITY OF CUPERTINO '
BUILDING DIVISION PERMIT CONTRAGToR;INF0RMATION-nx
BUILDING ADDRESS: ALLBRAND WINDOWS PERMITNO. 05100226
10385 MELISSA CT
.R'S NAME: PERMIT ISSUE DATE
VIC SHUHAI ZHAO 551 INDUSTRIAL RD 10/28 /2005
PHONE:
SANITARY NO. CONTROL NO.
(650)622-0330
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
-BLDG ELECT PLUMB MECH
0 0 0 0
+O, LICENSED CONTRACTOR'S DECLARATION Job Description
o p
t�C I bm 0 a(Grm drat I am fth,lid mead provislons o(t Code. 9(commencing
LI vilb 5ccuon]Ol1U)of Division3of Ne BudncssaM Pm(ecriuni Code.ami mylzcnmu
±�„ in full forceandeffect I,, Lk.
R2�� S REPLACE 10 WINDOWS/2 SLID. DOORS,
7g' L1CL"mclaa 1 GAEDEN WINDOW
=„o Dam to—�Q-o.r Contractor ✓rN
W'i£',' ARCHITECTS DECLARATION
I N 1 urWaatud my plans shall b used as public retards
cwt
o G Licensed Professional
5 OWNER-BUILDER DECLARATION
if 1 hereby aRrm Nat 1 am exempt form the Contractor's License Law for the
a O following m6on.(Sc,tson 703I.S.Busim as and PmfCVmR Cods:Any city Or county
3 2?L' which requires a Permit to construes,aiun,improve,demolish.Or repair any structure
prior On its issuance.aim hal theapplicant for such permit to flux signed summent
< that he is licensed pursuant to the provisions of the Coneenum's License Law(Chapter9 Sq.Ft.Floor Area ValuaQdT0106
x�$ (commencing with Section 711M)of Division 3 of dre Business trod Professions Cods)or
et— Nat he u exempt therefrom tib the basis Its,the alleged exemption Any violation of
Section 7011.5 by arty applicant for a permit subjects the applicant to,a civil penalty of APN Number Oc cy Type.
not mom thm fee hundred dollars(ssmx 34245016 . 00
1,as owner of the yopmy,a my aoploym with wagp ss Heir role cmmpewtian, _
wrild0 thework.andthesmsctumisnotirnnded oro@roti formic(Scc.7W.Businw _ Re aired Inspections and Pmfesvass Cade The Ommscmr's Limrsen Law dorens
s t apply lo an owof q ns P
Property who Wilds mimpmves dmreon,and whodoesa sibwmkhimselfarlhmugh his
own employrc,provided that such improvements are not intended or offered faale.If.
however,the building or improvement is sold within oro year of campkum,the Owner-
builder will have the Wed.of pmving Oat he did ret Mid or improve for purpose of
sale.).
❑1.as Owrmr of the Property me exclusively cenoactiog vidt famand contractors m
cottstma the project(Sec.7014,Business aM Profusions Code:)The ContrmmYs U-
ewe Law does not apply m an owner orp apenywho Milds or improves thenen,and
who contracts far such project with a cormusu r(s)licensed pursuant In the Contractors
Lkemse Law.
I ore eacmp,under See .B&P C for this mason
Per Dao
WORKER'S COMPENSATION DECLARATION
1 breby affirm under penalty of perjury ate of dm following declerationc
❑1 ham and will maintain a CenifiwteofCaasent to self4asure fa Worker's Compen-
Wish.u provided for by Section 3700 of the Labor Cade,for the performarce,of the
work for which this permit is issued.
❑1 have mal will maintain Worker's Compc"ta kat Wuranrc,as required by Section
37(K)of the Labor Code,for Ne performance of the wok for which this permit is issued.
My Worker's Compemauon huurance n 'a and Policy number art: -
Cariee x e Pe icy No.. ir48257_0 4
CEKnFICA F XEMPIION FROM WORKERS'
COMPENSATION INSURANCE
(7Tis section,recd not b canplemd if We permit is forone hundred dollars(SIM)
or less)
I c utih that in dm performanac Of the work for which this permit is in and.I shall nm
arepioy any person in any manner an as an boom.subject to the Workeri Compurnem.n
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,a(mr making this Conine,of Exemption.you should
became subjm m the WmkerS Compc"andon Provisions of the Vbor Code.you must
.J z forthwith comply with such pmviilem Or Nu permit shall W deemed revoked.
z N CONSTRUCTION LENDING AGENCY
F 1 herby alfrm dist then is a eortsuueunn lending agcmy for the performance u(
a the work for which this permit u issued(Sec.3097,Civ.Q
6W. Q Lender's Name
z MetaMdma
C)Q I ec ory Nat 1 have rad this appliem..and stare dist dm above information is
Fcur I ath e to comply whh all city YM county Ordinances and state laws Resting In
QU
Wilding construction.no hereby autmoint tepmscnutives of Nis city m cnmr upon the
above-menudgm property for expenses puryoses
F y (We)agree to save.indemnify and keep hannlca the City of Cupertino against
czIZ inconsclucre Of the granting
sind expenses which may In my way accrue again aid City
C..3z Aconsequence of UNDERSTANDS
of A DWit. m
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date Z,f v y
SOURCE GUL��TTIIONS. (
(M- to-28-osRe-roofs �f
Signamm O(Applicam/Contramur Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Win the appIkent of future wilding occupant amm or handle hazardous material
defined by the Cupertino Municipal Code.Chapter 9.13,and the Health and Safety
O
Sc❑Yonsn 25537(a)? bN' All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining inspection,I
Will @e applicant or fuwr building occupant use equipment or devices which g anns agree to remove P
cook havardoes air camaminanu rfdefacd by tic Bay Area Air Quaky Management
Diatrkff LrY/ all new materials for inspection.
0y. Nu
1 have toad the M>ardass materials requimmenu undcrCMpmr6.95 Drum Califor-
nia Hcalth&Safety Ceuc.Saud,25M5,25533 and25534.I undcfsund th ddua,Wilding
docs not currently have a means,Oat it is my re poedbuity lo Dobry the occupant Of dm
mquimnmy�h.;hg.Vmet bronissuance ofaceNfexmofoccop' Signature of Applicant Date
d/- UDi s, - Tt l O-2g-O All roof coverings to be Class"B"or better
Owner nuNam<d agcm Dam-
CITY �o c DPERTvlSIONNO PERMIT • C�NTRAGTOR�INIVlS
FORMATI �
�l NEW�'
BUILDING ADDRESS: ALLBRAND WINDOWS PEnMRN0. 05100226
10385 MELISSA CT
OWNER'S NAME: PERMIT ISSUE DATE
Ah VIC SHUHAI ZHAO 551 INDUSTRIA
TARCHITECTMNGINEER:
NE: SANITARY NO. CONTROL NO.
(650)622-0330
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATIONIOb DOSCiIptlOn
I hereby affirm Jnr 1 am licensed under provisions of Chapter 9(commencingSexam 7")ofDlvisbnSof do Business and Professime Com.md my license is
Brmeeandeffect, l Le.a R27 REPLACE 10 WI LtZORS,
nmClas 1 GAEDEN WIND .� '0—'7$—Q,r_ Consracmr
ARCHITECTS OECLARATI N
f y s 1 understand my plans shall W used as public mcmdi
eCN Licensed Professional
ieA1 2 2006
3 OWNER-BUILDER DECLARATION
I hereby aRrm that 1 am exempt from Ne Contractors License Law for the
p o following mason.(Section 703 L5,Business and Priefessium Calc:Anycity o caumy
<m f which¢quirts a permit m cnnvucr,guar,improve,demolish.of¢pair ay swetum In rukla
°i< prior¢its issna.als�mquirs Ne applicant for such permiuo file asigadsutemcm
m 8that he is licensed pursuing to to provisions of the Comments's License law(charges 9 Sq.Ft. Floor e ValuaQdrp 10 6
xH (commencing with Sation70D0)of Division 3 of NC Business and Profession,Code)or
y that he is exempt thoefrom and as buffs for Ne alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type.
oat more this Eve hundred dollars(55001. 34245016 . 00
0 1,as owner of the property,or my emplayeu with wages as their sole campcnadon,
will da the weak.gad the structure Is act amended o,.fe.d in,sae(Sce.7014.Baines ns Required Inspections
-and professions Code:The Contractors Liaise Law does not apply to an owner or q p
property who builds orimproves thercon,and w ho dos such work himul r of through his
awn amplayeu.provided that men improvemens am.1 intended of oWrad for ale.IL
however,the building or improvement is mid within one year of completion.the owner
builder will have the burden of pmving that he did not build or improve for puryam or
.ale.).
0 h as,war of the propeny,am exclusively contracting with licensed con®atou to
cansuuct the project(Sec.7614.Business am pmfecsions Code:)The Contractor's Li.
come law does not apply as an owner of prapcny who Wilds or improves thereon,and.
who contracts for such project,with a contrasogs)Beamed pursuant to the Contractors
License Law.
0 lam sump,under See ,B&PC far da meson
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under pe®Iry of perjury ane of the following declarations:
0 I hire and will mainuina Cer riamof Canscnuaelf-insumforWarlecesCompen-
,adage,as provided far by Section 3700 of the Labor Code.far the pearmarmcc of to
work for which this permit is issued.
0 1 Wve and will maintain Workers Compensation Insurance,as required by Section
3700 of the Labor Code.to,the performance afthe work far which this pemtit is issued. '
My Workers Compesationlnsunnaca 'crand Policynumbcrve: /
Cartier. Polity Na.:
cliimrICA F EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section tined not be completed ifLm permit Is foranchundreG dollars($100)
ger 1¢54)
1 certify Ns in the performance of the work for which Nis rearm,It issued.I shell oat
employ any person in any manner m s to become subject to tW Warren'Compensation
iawa of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject in the Worker's Compensation provisions of the labor Cade,you mug
.JO ,oMwith comely with such provisions or this permit shall W merged revoked.
ZN CONSTRUCTION LENDING AGENCY
[-� I momy,Ram Nat them is a emsuucimi leading agency far the rerfwmana of
L4 the work for which this permit is cooed(Sec.3097,Civ.CJ
0. Lenders Name
z Lenders Addres
V 0 1 certify that I have read this application and sum that the above infamarim is
(y correct.l agree to comply with all city and county ordinances and sure laws miming to
O V Wilding construction,and hereby audmme representatives of Nis city to enter Upon the
�w move-mentioned property for inspection proposes,
F L1 (We)agree b ave,indemnify and kap harmless that City of Cupcnimo against
fA liabilities,judgments,casts and expenses which may in any way acruc against aid City
t)Z in consequence of the granting of this permit. ��
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date _)4/
SOURCE EGULgT'IONS. �
F11-11--1{( ;4— I0-2a -0:5 Re-roofs
Signature of Applicam(Contracmr Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or forum Wilding occupant atore or handle hvardous mnuinal
as do coed by the Cupenina Municipal Code.Chapter 9.13,and the Health and Safely
Cade,Section 15531(a)?
0y All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipmenrar devices which If a roof is installed without first obtaining an inspection,I agree to remove
craft hoaardma air contaminants ad defined by the Bay Area Air Quality Management all new materials for inspection.
Disaim?
OYcs Nu
I have mad the harardasa materials requirements under Chapter&95 of the Cilifor
ma Hcafth&Safety Code,Sections 15505.15533 and 25534.1 tmderauad tear ifthe Wilding
dons not currently haw a maim.that i,is my responsibility On tmory to acapam of the
requiremc hick mus Wmet 061 to issuance o(a CeNEcao:arcccupanq. Slgnatore of Applicant Date
owncr'Gr ambodxnd arum pate g
All f coverings to be Class"B"or better
' roocover
Y OF CUPERTINO
Cr of PERMI APPLICATION FOIA
CUPEkTINO / OS�crsZ Z
N# 3 Z �/S` L b Date: 1 ru — Z9— OS
Building Address- Mailing Address (if different from building address):
X0385 Melssa �+ c� QY+;�o cA 957011-1
Owner's Name: Phone #:
Vic 5kn ,1-,a; 2110.0 (6S/,D) 85 - 510
Contractor: License#:
Ai bv-Q,nX 927 75
Contact: Phone �: Z 40'3-0797 Cupertino Business License#:
RR)YQ�r\- wFax.650 622-0335
Building Permit Info:
Bldg V Elect ❑ Plumb ❑ Mech ❑
Job Description: w do. s Y+ Q�„ > 10 "N 0,,.,5 1 2 Al o.
Residential Y (S Commercial ❑
Sq.Ft. Floor Area: q.Ft.:
Cost of Project: 10 Occupancy Group:
IJ6 . ,0� _
Type of Construction: Please check this box if the project is a
secon -story addition:
ro'ect Size: Standard IV Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> IOOK.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/ uasi BUILDING
BCONSTAXB Con. Tax for B 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 Tnergy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
a > 17 ? 7
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