06040138 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT CON+TRAOTORANFORMATI0N r
BUILDING ADDRESS: CALIFORNIA SKYLIGHTS PERMIT No.06040138
809 SEPTEMBER DR
OWNER'S NAME: PERMITLSSUEDATE
WU HWAI M AND BETTY M 18637 BUCKNAU RD. 04/24/2006
ONE: SANITARY NO. CONTROL NO.
(408) 866-6759
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG EISCT PLUMB MECH
0 0 0 0
+oro LICENSED CONTRACTOR'S DECLARATION
1 hemb form that 1 Am limned Manor mrimms of Cha 9 commencin Job Description
;� r a p Cham., ( g P
.Z with SarerAnd cfio Division3of Nc Business and Pmfcssions Cook,And mylicense u
a<, in fYli farce ands 00/��/
O.T T INSTALL SUNTUNNER SKYLI �_ NFRC 11607 . 81)
'�Z Licenm lac Lie.# h�sJp
FO Dete Con DECLARATION ee ARCHITECTS DECLARATION
l w� 1 understand my plans shall W used u public Toreros 'f■/ig__®
),U
A.t� Licensed Professional ���
OWNER-BUILDER DECLARATION
I 1 Wreby affirm Not I am caempt from the Commences License Law for On, ar L ay
00 following mason.(Section 70 L5,Business and Pretensions Coda:Any city or county CT Q
�,w which requires a permit m construct,alter,improve,demolish,or repair any structure oU $649
iy prior m its istuance.Alan requires the applicant for such permit m file aligned steteream
< NatheisliconsodpursuanttothepmvisionsoftheConmount'sLice=Law(Chapter9 Sq.Ft. Floor Area Valuation
e�FG (commencing with Section 7000)of Division 3 of the Business and Profeuiana Code)or
that he is exempt Nereftom and Ne bun for rhe alleged exemption.Any violation of
Semlon 7031.3 by any applicant far a Form,subjects me applicant m A civil penalty of
Am mort than fisc hundred callus(5500). c cy Type
❑1,u awnu of she poprmy,cur mY ooployaa with wagca u Ne'v mlccompensation,
will do the wart and the strtrmure is not intended or offered forsale(Sm.7(4/,Busimses Required Inspections
and Prefeviona Thrac
Code: e Commr ^ es ree
s L' "a Law dot apply m an a war of q P
property who builds m improve Norton,and who dms such wark himself or though his
Own employees,provided Nat such improvements are not Maxwell coffered for sale.IL
however.the building or impromment is old within arc year of completion,Ne owner.
builder will have Ne burden of proving that he did nut Wild o improve for purpose of
saky
❑1,as owner of the property.am exclusively contracting with licensed contractors In
construct the prejem(Sec.7014.Business and Pofcssions Cade:)no Contracmrs Li-
conse law don not apply to an owner of property who builda or impusws Nemo,And,
who contracts fro such p np.with A conuanor(s)licensed pursuant an rhe Canuactots
License Law.
❑lam¢cmpundarSee ,BAPCforlhiamAMm
Owner Data
WORKERS COMPENSATION DECLARATION
1 hereby An.under pommy of pojmy one of Ne fallowing docaruiou:
❑
[ham and will mainum a Certificate of Consent to auf-insure for WarkclsCompcn-
utian,u provided fro by Section 3700 of do lobo Code,fur Ne perfa bo ox of the
work for whim this permit is iuucd.
❑1 haw and will maintain Workefs Con emanon Iruunnce,As myuired by Section
3700 of NO labor Code,for on performance of dm work for which this permit is issued.
My Workers Compensation bavmnm canner and Policy number Am:
Carver.S'%ry-7t FLa^JC7 Policy Na.: ����63 �� '
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This amhan need not becomplesed Base permit is ferom hundred dollars($100) a
or lose)
1 certify Not in the Performance of the work for which this Permit B Wood.1 mAB not
employ any per on in any mannerso As In bawne subject to Ne Workers'Compensation
Laws of California.Date
Applicam
NOTICE TO APPLICANT:IL after making this Ccnificam of EaempOon,you should
became subject to the Warke's Cam usestion previsions or Ne Labor Cade.you man
.,OEforthwith comply with such pMw$iau or Nu Permit shall be dr<med rewired.
zy CONSTRUCTION LENDING AGENCY
l hereby alarm Nat Nem is a construction lending agency,tat Ne performance of
the wish for which this Permit is issued(Sec.3097,Civ,C)
F) Lenders Name -
Z:)z lenders Address
U C) I curtly Na I haw mad this application and state that Ne aWw information is
It, F co¢m.1 agree m comply with all city and county oNinamesand note laws relating to
0U Wilding construction,and herebyauthorine represenuimsar Niacity wea(MMpnn the
Wahovcmemiuncdpopcny ran iesacties which a
(We)agme to saw,indemnify and keep harmla s due City or Cup:nino against
tq inconseque dgm ats.of
cantruand or this
may in any way ecente agaiut said City
U z A consequence of Ne granting of Nis permit.
'—' APPLICANT UNDERSTANDS AND WIS..eOPM LY WITH ALL NON-POINT Issued by: Date G�—2- t't —V G
SOURCE�` 'IATIONS, f .a�
—:v 4 F�d� Y o Re-roofs
Srgwurt ofA IipHA or Dete
DD a MA AISDIaCLOSURE Type of Roof
WIIINeApplicant or(arum buildinge.Chapter
mo handle Health and
C d .Sed by de Cupertino Municipal Code.Chapter 9.13.and the HcaIN Ann Safety
code.Section 3ss33(a)? All roofs shall be inspected nor to an roofing material beim
❑Yea NM p p y g g installed.
Will thc applicant or future Wilding occupant use equipment or dI which If a roof is installed without first obtaining an inspection,I agree to remove
emit hums us air comaminansa aydcfiad by Ne Bay AMA Air Quality Management all new materials for inspection.
Courts'? r/
❑Yes ON.
1 haw man Ne huardras mamrialsrequimmenu unncr Chapter 6.95 of0e Califar.
nu Health&Safety G=M,SalICns 25505.25533uM1755 .IuMcrsurq thaif Ne Wilding
does not currently haw a tenant,that it is my m ility m badly the accupam of Ne
requirements which most be at pier to of a Catifcam of Patsy.
v Signature of Applicant Date
no,or mthomed.,v s Dan, All roof coverings to be Class"B"or better
CITY OF CUPERTINO
em 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36212003 . 00
DATE ISSUED. . . . . . . : 04/24/2006
RECEIPT # . . . . . . . . . : 34095
REFERENCE ID # . . . : 06040138
SITE ADDRESS . . . . . : 809 SEPTEMBER DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : WU HWAI M AND BETTY M
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ELK GROVE CA, CA 95758-
RECEIVED FROM . . . . : TERRY KIYAMA
CONTRACTOR . . . . . . . : TERRY KIYAMA LIC # 26844
COMPANY . . . . . . . . . . : CALIFORNIA SKYLIGHTS
ADDRESS . . . . . . . . . . : 18637 BUCKNAU RD.
CITY/STATE/ZIP . . . : SARATOGA, CA 95070
TELEPHONE . . . . . . . . : (408) 866-6759
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FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
------ ---- - ------------ ---------- ---------- ---------- ---------- ----------
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00
BPERMFEE VALUATION 649 . 00 83 . 16 0 . 00 83 . 16 0 . 00
BSEISMICRE VALUATION 649 . 00 0 . 50 0 . 00 0 . 50 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 118 . 52 0 . 00 118 . 52 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 118 . 52 VISA
TOTAL RECEIPT 118 . 52
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( - CITY OF CUPERTINO WD4013c�j
CITY OF PERMIT APPLICATION FORM
CUPERTINO
APN# 2rnn ^ �nDate:
Building Address: i- Mailing Address (if different from building address):
T
Owner's Name: Phone#:
/amu qGg-3a4 —moo
Contractor: License#:
2 —8
Contact: PCupertino Business License#:
seeFax:
Building Permit Info:
Bldg ❑ Elect ❑ Plumb ❑ Mech ❑
Job Description: /i)5TW 4_ sutiJTv �w Ec sk y c/G H--r Nf'er /�Eo7, e 1
Residential [ - ,� Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy Gro
u
p--5
Type of Construction Please check this box if.the project is a
second-story addition: ❑
roject Size: Standard B' Large ❑ Ma'or ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILER1 Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> IOOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to IM Btu MECHANICAL
BBOILER4 Boiler> IM 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
BELECI000 Elec 600V <= 1000A ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elee Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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S ; ; CITY OF CUPERTINO
CITYOF PERMIT APPLICATION FORM
CUPERTINO
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 IPLUMBING
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 rinklerBackflo 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 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 A liance ELECTRICAL
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Q`- CITY OF CUPERTINO
arroe PERMIT APPLICATION FORM
CUPEkTINO
kQuantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmd] 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 Insection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Ternp 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 Change BUILDING
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