06120007 (2) CITY Of CUPERTINOTV f�a« s - 77`77,
BNLIt�ING DIVISION PERMIT 'CONTRACTOR INFORMATION ,
:R. ¢m,RrR3+ �zYam'setdlk
OUILDINGAODRESS: ERIC ZHOU PERMIT NO.06120007
789 STENDHAT, TA
OWNER'S NAME: PERMIT LSSUE DATE
ERIC ZHOU 0
ONE:
SANITARY NO. CONTROL NO.
ARCHITECf/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
tap LICENSED CONTRACTOR'S DECLARATION Job Description
m F 1 hereby&(firm that I am licensed under provisions of Chapter 9(commencing P
in(oil fawiseSectionndof of Divisionlo(Uu Business and Pro(esiuv Code.aMmyliceraeu
r�dreeaWeffmC' &O q0 REPLACING EXISTING ELECTRICAL WIRING AT EXISTIN
License (..�� Lic.x '
it:u9 Dam sCmnmacC, O o ROOF
ARCHTIECTS DECLARATION
I
504' 1 undersand my plms Shall W used u public mmN I NQg IQAO FI.
a
'Oy Licensed Professional
5 OWNER-BUILDER DECLARATION
1 Wrchy wTmt Not I am exempt from the,Canlmm's License,taw far me
00 following mann.(Section 703 1.5,Business and Professions Code:Any city or county
f$tai which requires a permit m cnnstmct.a@e improve,demolish.car repair any smucome
-I< prior Or is issuance.atm require f applicant for such Permit o file a signed statement
Jut he isliccvcJ purvammtW proviaiov of the Conueur's Liarrm taw(Ch&par9 Sq.Ft. Floor Area Valuation .
`1$ (commencing with Sexuon700(3)of Division 3oftheBusinevandProfessionsCodc)or $.500
.. Nat W u exempt tMmfrom and the basis for the alleged exemption.Any violation of
Section 7831.5 by mry applicant fora permit mbjecm the applcat Ra a civil pemlty of ane O
b
APN Number Occupancy
,t mora road Bae hundred dollars(s5aq). P Y Type
❑1.as .or Ju import,or in,employee with wages a their sole camperuuon,
Will do the wark,md meawaue,mum intended oraRamd fonale(See.70x4,Business Re aired Inspections
and Prolmdoru Code:The Convaemes Licuse law does not apply a an mvrter of q P
Own enywho Wiids rimprarximprovements
doeauchwork hiroselforNrough hu
Own ver.m ruiprovided that suchent is id wit are naticar of
completion.
for Sala If,
howler.the building or improvement is sold within m¢year of completion.the Ower-
bailder will have the burden of proving that,he did rot Wild or improve for purpose Of
sale J.
❑ I,as Owner of Jon property,am exclusively contracting with licensed conuacmrs to
construct the prejud(Sec.7(k44,Business add Profeedmu Cade:)M Commerce.Li- _
cove law does not apply m an owner of property who Wild,or improve memos,and.
.ho,..m for such projects with a cantramortsl lirsved pursuant to tie Comanoes
License law.
❑1 am exempt order Sec .B A P C for this meson
Owner Dau
WORKER'S COMPEAT
NSION DECLARATION
1 hereby affirm under penalty of perjury arra^f the following declaramm-
❑Iham and will mmmisma Certif aro(Casemeoself-imme for Wormea Cmnpen.
ration,as provided for by Secum TKK)Of the User Code.for the perfomsanm Of the
work for which this permit is issued.
❑1 have azW will maintain Workers Compevatian I...as on d oOd by Section
3700 of the Lahr Code,fir the performance of the work for which this Permit is issued. '
My Workers Compensation Insurance carrier and Policy number am:
Cartier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section must not hceonrplacd if the permit is fore,hundred dollars(SIM)
carless.)
I,mfv that in she'ifosmaneqqqof da work for which this Permit is issued,I shall not
employ any'personinany p� /!{s/1Qh6eome sbbj�t w tW Worked'Compensation
laws of California.Dau LL/ --,•``''VV a&ss.. 113
Applicant
NOTICE TO APPLICANT.If,after making the Certificate of Exemption,you should
become subject in the Worker's Compensation provisions of the Labor Code,you must
.J z forthwith comply with such pmvisiov Or this permit shall W deemed svokcd.
zO CONSTRUCTION LENDING AGENCY
[-+ I Wreby affirm that there isoeovuucuon kmdimgagency for Ne peKurm...f
D: the work for which this permit 13 Issued(Sec.3097,Civ.C.)
ft1 0 lender's Namc
z Undue.Md.
U 0 1 certify that I have read this application and sate that rhe above or..uun is -
E' Correct.lagse to Comply with all city and county oacimances and suss laws slating to
V building consuvaion,and hemby authorise spcsenutivu of this city to enter uponf
nad
purposes
a aMvcmcnuuments,cry for dexpeses which m.
(We)acme m save,indemnify and keep harmless the City of Cupertino against
UZ in Criue.judgmcnh,corm and Of this fallen. may in anyway scone agaivssaid City
V z in cartsequancc of the greening Of this permit. _v`
^ APPLICANT NDERYfANDS AND WILL COMPLY WITH ALL N N PDINT Issued by: Date /2--
SOU) R U TIONS. I�� y��
4 1 Re-roofs
Stgnazus s.ApplscanmCanuemr Dau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will me applicant or future building occupantsmm Or"a hvallous material
as defined by Jon Cupertino Municipal Code,Chapter 9.12,and Ne Hcalth and Safety
cone,Section255324)?
40 ❑r Na All roofs shall be inspected prior to any roofing material being installed.
Will me applicant or fuwm building occupant taw equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove
emit hhavwdou air comm rem s as defined by the Bay Area Air Quality Management all new materials for inspection.
GYv CrN.
I have read!me trumm m materials squiremenm undcrCWpter 6.95 of the Califon
ria Hcalthik Salmy CoEc.Secums 25505.25533 and!25534.1 undcrsuM mmiftW Wilding
Jae out currently hate a mnanl mat it is my msinternality in notify Jm asOn.(of me
requirements wheh must be met prior w iutance,ora ecNfmate Of Occupancy, Signature Of Applicant Date
Dw,r or mahmocJ&cant Date I I All roof coverings to be Class "E"or better
,..e., Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPEkTINO
B Rdin De artment
JOB ADDRESS: PERMIT#
92I jcDHL4L n6 2 0007
OWNER'S NAME: Et/L\ c 2 H 9PHONE # koe 4b4 9170
GENERAL CONTRACTOR: (5 FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
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
C__!� F o�
Owner/Contractor Signature Date
CITY OF CUPERTINO
Om 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37542041 .00
DATE ISSUED. . . . . . . : 12/04/2006
RECEIPT # . . . . . . . . . : 36941
REFERENCE ID # . . . : 06120007
SITE ADDRESS . . . . . : 789 STENDHAL LA
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : ERIC ZHOU
ADDRESS
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : ERNO ORDASI
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY ERIC ZHOU'
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
TELEPHONE . . . . . . . . :
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- - - ------------ ------- --- - - - - - - - --- - - - -- -- - - - - - -- ------- - - -
BPERMFEE VALUATION 500 . 00 .83 . 16 0 . 00 83 . 16 0 . 00
BSEISMICRE VALUATION 500 . 00 0 . 50 0 . 00 0 . 50 0 . 00
EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
BUSLIC FLAT RATE 1 . 00 107 . 00 0 . 00 107 . 00 0 . 00
- - - - - - - - - - - - - - - - - - - - --- -- - - - - - ------- - - -
TOTAL PERMIT 229 . 03 0 . 00 229 . 03 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
- - - - - - - - - - - --- --- --- ----- -- --- - - - - -- - -
OTHER 229 . 03 VISA
TOTAL RECEIPT 229 . 03
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
----------
304 ROUGH ELECTRICAL 501 FINAL ' ELECTRICAL ENERGY
505 FINAL ELECTRICAL
•
CITY OF CUPERTINO ('(Q� 2, 0001
CUPEf OF PERMIT APPLICATION FORM
'RPAPN # Date:. I2- A I 0�
Building Address: q S• -rte Mailing Address (if different from building address):
Owner's Name: ZPhone#: koe k6k f'10
w �
Contractor: ' LA-Gln%0
#:
0� r� T- G1O 834450
Contact: n Phone: Cupertino Business License#:
EJ2utb Fax: Co(o ,797. Y13y
Building Permit Info:
Bldg ❑ Elect Plu b ❑ Vech ❑
Job Description: `-� -"( W LV-" CxAl XX• 'll° k- .
Residential ❑ ✓•901RW(%Ov q1tvflo Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: 6 o Occupancy Group:
3
Type of Constructio Please check this box if the project is a
second-story addition: ❑
*r-oiect Size: Standard ❑ Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to IM 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/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax - Resi/Mobile BUILDING
BELEC1000 Elec 600V <= IOOOA ELECTRICAL
BELEC1001 Elee 600V> IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
Iwo BINVESTIGA Investigation fee BUILDING
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°(�� CITY OF CUPERTINO
CITY bF PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee I 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 PLUMBING
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 rinkler/Backflo PLUMBING
BPSTORM Stomn/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain & Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water HeaterNent 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> IOK 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 I Remodel Res Appliance ELECTRICAL
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CITY OF CUPERTINO
dTYOF PERMIT APPLICATION FORM
CUPEkTI INO
AkQuantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl 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 Inspection BUILDING
BS WIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elee Permit Issuance ELECTRICAL
MPERMFEE Mechanical sq. 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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