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03010019 (4) CITY OF CUPERTINO ? 's •�y.r ' BUILDING DIVISION PEWIT z C0Pd""eTORINFO TION., "TJazy* a 8dU - imicr BUILDING ADDRESS: YUANPENG ZHANG PERMITNO. 21837 MONTE CT 03010019 OWNER'S NAME: APPLICATION SUB DATE YUANPENG ZHANG 01/06/2003 PHONE: SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 xi00 LICENSEDCONTRACTORS underSDECLARATION tmuF 1ion7 affirmthat 1emftlicBu antlerpmvisionsofChapter sCode, 9(commencing Job Descriptiopf{ ;U with Section ande)ef Division Ne Business end Professions Code,end my license is / INALEC �„ mmBmmeanderm`s REMODEL KITCHEN/BATHRMS & Zpn?; License Class Lit.a Dale Contractor REPLACE GARAGE DR. /WINDOW. FEB 9 2004 ARCHITECTS DECLARATION I understand my plans shall he used as public meords dOWU w3wt- L¢cnscJ Professional £LLO OWNER-BUILDER DECLARATION BUILDING K uav'j a f 1 hereby affirm that I em exempt from the Comranma License Law for the w-00 fallowing reason.(Section 7031.5,Business and Professions Code:Any city or county e K m which requires a Permit to construct.alter,improve,demolish,or repair any structure toprior to its issuance,also vires the applicant for suchsigned s,i< req iii Permit lLienseLaw 7�0 that he is licensed pursuant to the provisions of the Contractor's License Lew(Chaptcr9 Sq. Ft. Floor Area Valuation s $ (commencing with Section 7")of Division or the Business and Professions Code)or �.. Nat he is exempt Nemfrom and Ne basis for the alleged exemption.Any violation of $30000 Section 7071.5 by any applicant for a permitsubjects the applicant o a civil Penalty of ApN Number not mom than five hundred dollars($500). Occupancy Type 1,Ma orths,property, 32619073 . 00 ❑ tur myempleyce&or offered axle compensation. will do fework,end : he Contisnotintendedorow do fs not sale See. Business and Pronasions Code:The es theme, License Law does not apply to an owner or 101 - FOUNDAff�ed Inspections ownproperty who builds or improves thereon,end who dos such work himmlredNmugh his howemPloyebuilding or thatsuch imprwmanaps sold ithin:not escroedoiplemod forrals.It,owner. ],02 — PIERS builder ,,the building or improvement is sold a within one year or completion,the owned builder will have Ne burden of proving Nat he did not build or improve for purpose of 103 - UFER tel`')' 104 - REBAR ❑1,as uct the owner of Ne(See,704. Bam usiness contesting licensed 105 - ANCHOR BOLTS construct the project(Sec.7044,Business and Professions Code:)The Contractors Li- cenmLawdoesnotapplytoanownerofpropenywhobuildsorimproveslhemon,and 106 - SEWER & WATER who contracts for such projects with a convanor(s)licensed pursuant to the Contractors License Law. 202 — UNDERFLOOR PLUMBING I am ex�mpt//nder Sec. ,B&P C for this reason 203 - UNDERFLOOR MECHANICAL 0 w //11G^� tat-6-© ; 204 - UNDERFLOOR FRAME - Wo E �dPENSATIONDECL ATION 205 - UNDERFLOOR INSULATION I hereby M.under penalty of perjury no of Ne following declarations: ❑I have and wil l maintain a ceni fiesta of Consent to self insure for Worker's Compcn- 301 — ROUGH PLUMBING sation.az provided for by Section 3700 of the Labor Code,for the performance of the 302 - TUB & OR SHOWER work for which his parmiti&issued,(10 303 - ROUGH MECHANICAL C]1 have and will maintain Worker's Compensation Insurance, required Section 3 04 - ROUGH ELECTRICAL 77of Ne Labor Code,far the penormance of Ne work for which Nperm itis peitt is issued. My Workers Compensation Insurance carrier and Policy oumher are: 305 — FRAME Carer: PolicyNo.: 306 - HOEDOWNS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE 307 - INSULATION (This seeionneeJ not M completedifthe Permit is foronc hundred dollars($100) 308 - SHEETROCK or less.) 309 - EXTERIOR LATH 1 certify Nat in the Performance of the work for which this permit is issued,I&hail not 310 - INTERIOR LATH employamyg man man so stoM®mea je So the Workers'Cnmpensadma Lawaprcalt m - 311 - SCRATCH COAT APPlicanu NOT C o A IC �F aByy +pg this Cenilicam of Exemption,you should 313 - ROOF NAIL he bjea to the Workads Cdtt n•Ylon provisions of the Ichor Code,yno must O0 I. hheomplywithsuchprevi&ionsorthisperrnitshallbedeemedmvnkod, 501 — FINAL ELECTRICAL ENERGY z CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY F a Iherebyoff.costthereisaconsWetionlendingagencyfortheperformanceof 503 - FINAL MECHANICAL ENERGY G the work for Namewhich Nisp mit isissucJ(Scc.3097,Civ.CJ Lenders Name 504 - FINAL BUILDING ENERGY W Ca � z Lander'sAddmss 505 - FINAL ELECTRICAL U O 1 certify that 1 have read this application and state Nal the above information is 5 0 6 - GAS TEST W correct.l agree to comply with all city and county oNinancus and state laws misting to - a OU building construction,and hereby audience representatives of this city m enter upon the 5 FINAL PLUMBING H 6above-mentioned property for inspection purposes. L i (We)agree to save,indemnify and keep harmless the City of Cupertino against 0 8 FIN pI liabilities,judgments,costs and expenses which may in any way see=against Said City 5 D U^+ in consequence of the granting of this permit. 7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL ON-POINT Issued by51 - NG Date [/— S RICER ULATIONS.` p� i 01 rQ y/� -w U Re-roofs Signature igna oMppbca our for Dam HAZA O IATERIALS DISCLOSURE Type Of Roof Will Ne epPliam or furore vilJing occupant store or handle Moluccas matenal az defined by the Cupertino Municipal CmIc,Chapter 9.12,and the Health and Safety Cock,Section 25532(a)? ❑yea -26b, All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit ha rdous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. P ❑Yes I have read Ne hxvardous mamrials mquirememe un der Cha mr6.95ofNcCalifor- niaHcalN&Seety Code,Swdons25M5,25533a d25534.lunders Na' Zine does not Carmody have a mount.that it is my mSommihility 11 notify t cupant of Nc ro,ommep, wlichmustMmet ria to{ssn of.Ccnirk I upancy. Signature of Applicant Date 1 - 6�r� ', ncr orauthodmd aEaV Date All roof coverings to be Class "B"Or better . • � 'OpRO VED M tA d' ACCORDANCE ING THE CITY OF D v CUPERTINO CODES NO 0 'INANCES N 0 6 2002 E ' scr��u Tf P3 set of plans d'n e f off kepi en the job d all times and Ica It MUST awfUt fo rttdke an) changes or alterations <` ------ on same *jfhoflt Written permission from the building Dept„ City of Cupertino. The stamping of this plan and specifications SHALL NOT be held to Prrmit or to be an S 10D'011 of the Violation 61 any provisions ^, nity 01dinonce or Stato t3tvy S LLI L/_ y' O L r SUBMITTAL #1 r &VVNER-BUILDER VERIFICWON 1. (Check one) I or my immediate family(parent,spouse or child) will perform: • A. All the work authorized by this permit B. _ A portion of the work C. _ None of the work If B or C is checked,complete 2 or 3 below. 4FJAN 2. A state licensed contractor will be hired to do: 0 s2002A. All of the work B. _ A portion of the work(complete section below) Contractor Address/City Phone# State License Type of work to be performed • 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or portions of the authorized work. I understand that I may be an employer(see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City.of Cupertino Building Department office., Person/Firm Address/City Phone Number Type of work to be performed ..................................................................................................................................................................................... I declare under penalty of perjury that the above is true and correct. I have read and understand the Owner-Builder Information(reverse side). Property Owners Signatur� Date l — 6 -- —03— job 3Job Addres • 8 3 Permit# Any changes to the information provided on this form shall be submitted to the City of Cupertino Build • Department. City of Cupertino Building Departmto CITY OF 10300 Torre Avenue CUPEk INO Phone: (408)777-3228 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. I For your protection you should be aware that as owner-builder you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself,you y may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required bylaw to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work,with the exception of various trades that you plan to subcontract,you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family,and the work (including materials and other costs)is$200 or more for the entire project,and such persons are,not licensed as contractors or subcontractors,then you may be an employer. If you are an employer,you must register with the state and federal goverrunent as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes,workers' compensation insurance,disability insurance costs, and unemployment compensa tic contributions. There may be financial risks for you if you do not carry out these obligations,and these risks are especially serious with respect to workers compensation insurance. For more specific information about your obligations under federal law,contact the Internal Revenue Service (and,if you wish,the U.S. Small Business Administration). For more specific information about your obligations under state law,contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale,property owners who are not licensed contractors are allowed to . perform their work personally or through their own employees,without a licensed contractor or subcontractor,only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder building permit,erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street,Sacramento,California 95814. Please complete and return the enclosed owner-builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, Building Department, • City of Cupertino Printed on Recycled Paper CITY OF CUPERTINO a3 o/ / J CITYOF PERMIT APPLICATION FORM l • CU PEkTINO APN# Date: Building Address: 37 Owner's Name- Phone#: �Lkaxo Contractor: License#: kp,t -ems G+ (lel Contact: Phone#: Applicant/Contractor: Fax #: Build ng rmit Info: Bld lect lamb Mech Job cription esidential: om ercia Sq.Ft. Floor Area: �/� S Architect/Engine : y� Valu tion: Type of Construction: Occupancy roup: Quantity Fee ID Fee Descri p tion Fee Group BAPPLOTHER Other Appliances 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 Elee 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BNEWMULTI New Multi-family Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM 10 New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING 2v7 1 of 3 �— ' r / (' 3 1 imgp,g CITY OF CUPERTINO CITY 40 COPE OF INO PERMIT APPLICATION FORM uanti Fee ID Fee Description Fee Group BNUMULTI New Multi-family Res PLUMBING BOVERTIME Ins2ection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum- PLUMBING BPCESSPOOL Cesspool 9P_ERMF'EE Bldg Permit Fees PLUMBING BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Pi in System Fe_e_ PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP -Plan Check Repeat Fee BUILDING BPREPIPE Repipe Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn Sprinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING 9P_VENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pipe PLUMBING BPWHEATER Water HeaterNent PLUMBING 13PWSVCS Main Water�Service PLUMBING EBREMBREINSPECT Reinspection Fee BUILDING 10 �EER A 13 REMACOVER A/C Unit> 10,000 cfhl MECHANICAL BREMAEU-JAN A/C Units<-- 10,000 MECHANICAL LI BREMAPPLI 'Annlinnnp Install MECHANICAL W y BUSWAY Remodel Busways ELECTRICAL BREMFIXT 11 ­16ting Fixtures ELECTRICAL BREMFURN I Relocation of Furnace MECHANICAL BREMFURNOV R�L 0 Furnace> 1 OK btu MECHANICAL BRENlHEAT Heater eatr� Installation MECHANICAL r BREMINHOO I Installation of Hood MECHANICAL BREMMISC MEA p2aratus ELECTRICAL BRENTNRAPP I RemNon-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Re tl Switch & Outlets ELECTRICA1, BREMRELOCA R c aiion of Hood' MECHANICAL HANffAL BRENIREPALT Relocation J_eafin2 MECHANICAL BRE7MRESAPP Remodel P.q A--I,*---- ELECTRICAL BREMSIGNAD Rmndl Q`-- AAA Branch ELECTRICAL S BREMSIGNS o Remodel Si- T-r--- ELECTRICAL B M E T Th TIT?PA/1'rf-TV A'M TH A R Theatrical I T ;alit;ng T7,, ELECTRICAL 2of3 4 CITY OF CUPERTINO `TMT TY OF PERMIT APPLICATION FORM CUPEpTINO Fee ID Fee Dpqcrintion Fee Group BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSF&2FAM Sin le &2 Family BUILDING BSFNA Sin le Famil New Add BUILDING BSPECIAL S ecial his ection BUILDING BSWIM Swimmin Pool BUILDING BTEMP Tem or Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Tem Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electricals foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE mechanical Rn font MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEEP!MI b' Permit Issue PLUMBING PPLBG binICanBUILDINGEee s foot PLUMBING ZADDCHG Address Chane MECHANICAL BBOILERI Boiler<-- 100.000 Btu BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILERS Boiler> 1.75 M Btu MECHANICAL • 3 of