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C[TY OF CUPERTINO
+BUILDI ld DIVISION PERMIT
CON'TRAGTO,R IAT.�ORMATION
BUILDING ADDRESS:
NA AL CONSTRUCTION REN
Ar ISTND-06090007
1352 S STELLING RD
OWNER'S NAME:
PERMIT MUEDAiE
DEUK JAE LEE
1355 FILIPE AVE
09/01/2006
NE:
SANITARY NO. CONTROL NO.
(818)221-6057
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED COMRACTOWS DECLARATION
Job Description
hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing
with Section 70M) of Division 3 of this Business and Profcuionu Code, and my license is
in full force and effect
INSTAL TEMPORARY POWER POLE
Licevc Class
ng
Date Co tracmr
ARCHITECTS DECLARATION
used
'I 1 understand my plans shall he used a public recordsIrecords�
/ /��
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby afrmr that I am c u rept from the Comaanor's License law far Ilk
i 703 Business professions Codc: Any city at county
O
following mason. (Section 1.5, and
f improse, demolish, or mpair any structure
$100
which requina a permit be construct. alter,
priors its iauaxe.slxurequires thcapplieant forsuch permitla file asignmisummem
Contractor's License Law (Chapter 9
Sq. Ft. Floor Area
aluation
e that he is licensed pursuant to the provisionsofthc
s (commencing with Sction 7001))of Division 3 of the Business and Professinm Coca)or
Nat he is exempt therefrom and the hasu for the alleged exemption. My violation of
er
Occupancy Type
Section 7031.5 by any appim m for a permit subjects the applicanua a civil penalty of
not mom than five hundred dollars (5500).
0 1, u owner of the property, or my employees with wages as their sole compensation,
Required Inspections
will do the work and Ne swctum is Wt intended or Offered for sate (See. 70U, Business
and Profestiasu Cade: T we Comembor's L.»" • law does not apply m an osvms of
property, who Wilds or i m proves d urcon, and who does such work himself or through his
awn employees, provided thmsuch imymvemau am not intended aro@red forsake. If.
however. the building., improwment is sold within ism year of cempletion. the owoer-
builder will have the burden of proving that he did not build or improve for purpose of
tile.).
I, as Owner of the property am aelusivcly contracting with Barad canteamms m
s mmi the project (Sec. 7044, Business and Prefafions Code:) The Conummu is Li.
se law dace not apply to an owner of property who builds or improw s thereon, and
o contracts for such projecs with a crntramer(s) liceved pursuant m rhe Comoa mes
ens law.
l am exempt un�d�SC/q . B,4 P C for this wan
/C/
ner Dake 6 0
;Mt,
WORT COMPENSATION DECLARATION
I hereby aR car pcnuby of perjury one of the following dechumBo c
Ilam and will mainuin aCertifom of
am as provided for by Section 37M of Ne Labor Cade, for the Performance of the
work for which this permit is issued.
0 1 have and will maimem Worker's O.mpcvation Insurance, as required by Section
3700 of the LAW, Code. for the performance of the work for which this permit u issued.
My Warkeis Compensation Wurentt carrier and Policy number art:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
-
(This section need not be Completed if the permit is foronc hundred dollars (SIM)
or less.)
1 certify that in One performance of the work for which this Permit Is issued. I shall not
_
Employ any person in any man mrso as at become subject to the Wortrrs' Compensation
Laws of California. D
Applicant l
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
become subject in the Worker? Compensation provisions of the labor Cadk% you most
r foMwith comply with such provisions or this permit shall he deemed mvokcd.
CON LENDING AGENCY
^ cm is a cION
hy thi that them is o C agency for the performance of
30
which 7, Cin,
the work for which this permit is issued (Sec. J09'f, Civ, CJ
k for d (So,.
Lis Name
AM
t<nem dcra Aaaw
I certify that 1 have brad this implication and sum that the above information It
^ COMCL I agree in comply with all city and county ordinances and sok laws relating to
building eomametion, and hemby authorive mpmsentatims or Nis city to enter upon the
U alm c-mcmiuncd property for impccdon purposes.
(We) agree to save, indemnify and trop harmless the City of Cupertino against
rfj Iiebilitics,judgmcnls,cMls and capers. which may in any way a.. against said City
r A eonaquNT of the granting of this permit.
' UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date /S
SOURC R
SOURCE REGU S.
Re -roofs
Type of Roof
—/'6=
�j
Signmum of A,dicars err Date
RDOUS MATERIALS DISCLOSURE
Will the appli Ior to,. building occupant scone Or baadle Ismardous material
as defined by the Cupertino Municipal Code, Chaim, 9.13. and the Heslth and Safety
Code, Schon 35533(a)?
All roofs shall be inspected to any roofing material being installed.
Oyes ON.
prior
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building occupant use equipment at devices which
emit hvardous air comamimuns as defined by the Bay Area Air Quality Management
all new materials for inspection.
District?
0Yes ❑Nu
Ihaw need hehat,adsurequirementsorder Chapter 95 of he Caifo
'^\
ra Hca &SeleCoccScecmns25505,25533 and 255understandthis ifthe building
does not emr.nJy haw a tenant, cut it u my responsibility m beefy the nempam of the
mquirtmcn m% to It prior misman.of. certifaamr orapc�p
Signature� of Applicant Date
-
All roof coverings to be Class "B" or better
Owner or mthon, em Dam "
am 1 of 1
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 36617099.00
DATE ISSUED.......: 09/01/2006
RECEIPT #.........: 35881
REFERENCE ID # ...: 06090007
SITE ADDRESS .....: 1352 S STELLING RD
SUBDIVISION ......
CITY .............: CUPERTINO
IMPACT AREA ......
OWNER ............: DEUK JAE LEE
ADDRESS ..........:
CITY/STATE/ZIP .... ,
RECEIVED FROM ....: DEUK J LEE
OPERATOR: amyw
COPY # : 1
•
CONTRACTOR .......:
NATIONAL CONSTRUCTION
RENTALS LIC
# 22537
COMPANY ..........:
NATIONAL CONSTRUCTION
RENTALS
ADDRESS ..........:
1355 FILIPE AVE
CITY/STATE/ZIP
...:
SAN JOSE, CA 95122
TELEPHONE ........:
(818)221-6057
•
FEE
----------
ID UNIT QUANTITY
-----------------------
AMOUNT PD -TO -DT
THIS REC
NEW BAL
BTEMP
FLAT RATE
1.00
----=---------------
62.10 0.00
--------------------
62.10
0.00
EPERMITFEE
FLAT RATE
1.00
38.37 0.00
38.37
0.00
TOTAL
PERMIT
---------- ----------
100.47 0.00
---------- ----------
100.47
0.00
METHOD
-----------------
OF PAYMENT AMOUNT
NUMBER
CHECK
------------
100.47
------------------
1143
TOTAL
RECEIPT 100.47
VOICE
ID DESCRIPTION
VOICE ID
DESCRIPTION
103
UFER
304 ROUGH
ELECTRICAL
•
kap`
CITY OF
*UPERTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building De artment
JOB ADDRESS: 3S Z S• S f wl"We /Zli .
C, . CA SDl
PERMIT #
OWNER'S NAME: KT LBS
PHONE #
GENERAL CONTRACTOR: N44T10u71
FAX #
I am not using any subcontractors: 2-1-4
ture Date
Please check applicable subcontractors and mplete the following information
• ntractor Signature
i
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
Tile
• ntractor Signature
i
i
IM -
CITY OF
OCU
CUPEkTINO
CITY OF CUPERTINO
TEMP POWER
PERMIT APPLICATION FORM
APN #
Date:
Building Address:
/ 3 5-. 5-1,11"
Gu �s i Ci 5 Di
Owner's Name: UPhone
#:
Contractor:
Phone:
License #:
Contact:
_uk
C,Z
Phone:
-�d�'1-8392
Cupertino Business License #:
Building Permit Info:
Elect ❑
Job Description:
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KlCrpu
Residential
Commercial ❑
Cost of Project
1 =�911L)
O OD
•
0
Qty. if
Applicable Fee ID
Fee Descrintion
Fee Clrnnn
- --r
BTEMP Temporary Power ELECTRICAL
EPERMITFEE Elect. Permit Issuance ELECTRICAL.
BUSLIC Business License BUILDING