02050049 (4) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS'. PERMIT NO.
8056 PARK VILLA CL CHEN ' S CONSTRUCTION CO 02050049
OWNER'S NAME: APPLICATION SUB DATE
MARIA CHAU 1271 WASHINGTON AVE 05/08/2002
PHONF-: SANITARY NO. CONTROL N0.
r (510) 639-0853
M77 O O ARCHmiGT/ENGINEER: BUILDING PERMIT INFO
U E 1 J LE PLUMB MECH
82
Ste= LICENSED COST'RACnS DECLARATION Job Description1 hctxhy affirm thatI am licensed under provisions of Chapter 9(commencing
„ 5
with Section 7")ofDivision3of,hcBuxinesswalPmlessions d angor I���C WINDOW/KITCHEN REMODEL/
tnmIIrarce and`f
o Lic,a �� CIRCUITS UPGRADE
Li«nu'
f 3 Dam Cry"."a'
oG ARCHITECT'S DECLARA cards Jug
0 rSQo�
g I dencid my plans shall he used as publi cL
,nye
t ts
1 i 3 O Licensed Pmessiowl
OWNER BUILDER DECLARATION
u 1 hereby affirm that 1 am exempt from the Contractor's license U.for the BUILDING
FZQ following reason.(Servion]0315,Business and Professions CAny city or county
5 5 M which requires a permit it,mnsme6 alter,improve,demolish,or repair any smatore
d3m prionnits issuance,also requiresthe upplicam for recti perminofileasigned nemmrnl - ---
i --- -that he Is II«nYd RYNt le tri[ f the Contravenes License Law Gna ter 9 _
pus pofDi Division
n ( p .,.t, ,Sq:Ft: FloorArea, 1 [r.• aluation
(commencing wish Sermon]fNp)of Division J of the Business arm Prorgsions Code) `{f,� r h:4 C" L 9.f s4 t.'s[ l!i� t.>
or that he is exempt Ncr=frnm and the basis loathe"IltgaU emmptii,b.Any violation
of Secuon 0031.5 by any appli.el for a Permit subjects the andionl m anvil penalty
of not more than five hundred dolllum($500). A um er Occupancy Type
OI,as owner of the properly,or my employees with wages as their sole compensation,
will do the work,and the simulate is not intended or'olfered'for sale(Sec.704A1.
Buamexs and Professions Code:The Contractors License Law does not apply to an 102 — PIERS Required Inspections' '
owner of property Who builds or improves,b=rcon,and who J«s such work himself
or through his own employees.Provided that such improvements are not intended or ----
':bffc-df I ILhm th buildln em is sold within one carol - - ' " -'- --"""
completion,to owner-balmy illhaveh hard.. fp vingthatbedidnotWildor 104 — REBAR
improve for purpose of sale.). 105 - ANCHOR BOLTS
OLasown=r of Ne properly,am Business a nonlraassmew liIThe omrayo,rsm 106" SEWER--&- WATER '"-- " 7, -" - ---
construct tire pro;ecl(S«.]aw.BasmexsartaProosamnsCade:)The Contractor 202 — UNDERFLOOR PLUMBING
License Law does not apply loan owner of properly who builds or improves thereon,
and who mmmn fnr.auch po.j.,will,munava,O).fiecmed.p—taunt m.dre .. ..- ---_— --
_
2 03 — UNDERFLOORMECHANICAL
conornmrs License law., .. .- .
❑lam exemp,under Sec. ,B&PC far his mason 204 — UNDERFLOOR FRAME '-
Owner Date205 — UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION
301 - ROUGH PLUMBING
I hereby amtm under Penalty or ar;ury one or the following declarations: 302 — TUB & OR SHOWER
❑ 1 nave and will maintain a Certificate of consent to self-insure for Workers 303 — ROUGH MECHANICAL
Compensation,-as provided for by Section 37W of the Labor Cade. for the
performancemf,mworlNrwhighthispwrytisissued. 304 - ROUGH ELECTRICAL
❑I have and will maintain Worker's Compensation Insurance,as required by Seclion 305 - FRAME
T!W the Labor Code.for the Niform e f thework f m ch Nis pert,;t is 306 — HOLDOWNS
Italics,My,Worke'x Comperm [n[us... dpof�cy be
can C✓Tb� PacrN fSOBIj—O/ 307-, --<INSULATION —
COMP_LNEXEMPfIONFROMWORKERS.- ( 4 ^•308 • `SHEETROCK' '
(IT s�umon need not h compin ON INSURANCE_s
_ CERTIFICATI OF E%E
_ _ . .-..._...309-, EXTERIOR....LATH----
I -
ed if the Pamir s for one hundred dollars :
alWwrless.) 310 — INTERIOR LATH
. _ 3Tl...e_..SCRATCH: COAT
certify man io the performance bl,he work for wM1ich Nei permit is isuid;I .s
Wali no,Employ any Pcr•an in any manner xa as la'come s�nj«,lathe workers. 313 — ROOF NAIL;
Compcosarion Uws of Cahfomia.Dam'
AppOcen, 501 ----FINAL- ELECTRICAL ENERGY — -
'NOTICE TO APPLICANT:Ir,after mawml,mi,cevNcme mf Exemp�ian,you snamC 502 — FINAL PLUMBING ENERGY
become sub;eer to the Work"s Campeomoun provisions of the Labor Code,you must
Obash..;Ncomplywith
sackpmvislars«"is
'mm,'hall
hedeemedreraked
_. . _ . .-503 . - FINAL_ MECHANICAL ENERGY -
0
7 - 411._,111 "CONSTRUCTION LENDING AGENCY 504 — FINAL BUILDING ENERGY
1 hereby affirm that Neto is a construction lending agency for the performance -
uf,hework for which this pem,itisixsumesee3W7.Gi,C.) _ 505 FINAL ELECTRICAL
Q Lender's Name'- - _. :,_ _S66"' -_
.._ .._. ..
a Under'sAddresx' - _.. 506 - GAS TEST
U-O . Isandy that l hartm.sidd,upsicalion and smmthm the.1ho,o nfunowion is507 - FINAL PLUMBING
W F 'wined.1 time to comply with all city and county ordinances and state laws relating 508 — FINAL MECHANICAL
Q V m Wilding constructiwand hereby authorize mpmscnmlives of this city to enter upon
F�
'he abu. tnenOmmdpropertyformspeceenpwiav,,. 509 - FINAL GRADE y' nharm
(We)agrcosave,indemnifyandkeeplessthriCity;I Cupertino against -
UV) liabilities 'udgmente,cosy and expenses which may in any way accrue against said S10 FINAL P N rp �/
.7� city' n' quenee of the glom: fhis LLCOL 5140— N R J t7 V
sA 'ICANTUNDERSTAN i'D WILL IP ON ALLNON- OINT'"
URCER. v. _ Issued by: D to
tc
Sis t A pl a 1 t D to Re-roofs
HA2IARDOU MATFRIAIS DISCLOSURE
mine pp team f m Wilding« pant am r n dl ba:atdo material
Type of Roof. -.. -. -
as d fnW by the 3201) n M b pal Cod Chapl 9 12 a d tit I{ hit d Sofay
Cod Sen on 25SR(el - = l (. . . '
oY ' .Q" _ All roofs shall be inspected.prior to any roofing-material being installed.
w'u N appf tart N;la g p t as=e9:i p n cels wM1icn - If a roof is installed without first obtaining an inspection;'llagree to remove
emit hazardous Ir cont m rants as defined by Ne Bay Ama A' Quality Management
Dist' t a all new materials for m ulati n Applicant understands,and'will comply
❑Y ❑No all non-point source regulations, ` . ;.
'I have .ad the h do i 'els requ ren is and Chapter 695 of he
California Health&Safety Code.'Sections 25505 25533 and 25534.1understand that .
'f theW gdoes not currentlyh - a tenant.Neldismy sponatDfyt ufy Nc "" - - �.`
occu t of Nc,requirements x must ba met poor to Iona
Or
°'"`y' _J`Z Signature of Applicant Dale
'sera, Nndz en. _ >at All roof coverings to be Class "B" or better-�•
.OFFICE — .. __.