03020109 (4) CITY OF CUPERTINO
BUILDING DIVISION PERMIT
a . 5zra',h ,.z,n)•O n and'tss ',i
BWIDINO ADDRESS: ` PERMIT NO.
7530 WATERFORD DR 03020109
OWNER'S NAME: PERMIT ISSUE DATE
LOO WEI Z AND REIKO M TRUSTEE 02/26/2003
E: SANITARY NO. CONTROL NO.
i
ARCHiTBCDBHGiNEER: BUILDING PERMIT INFO
BLDO EO Im PLUOMB MECH
-0p LICENSED CONTRACTOR'S DECLARATION
hereby.(Ilse wt 1 Am Ilcensnd under provisions of Chapter (commencing Job Description
xl
with Sec11on7010)ofDiv)eim 3ofmo Budneusnd PmeguonsCole,anl my HemousIt
InrullfaMandcrrem. ADD SHOW STALL/RELOCATE DOOR ww,, ,/�
ucenseClaa, Lk.N ADD ATTIC FOR STROAGE IN GAR ,YAL`E®
Contractor
Dau ARCHI'IF.CTS DECLARATION
1 mulmotand my pans.hall he used An public nan,de FEB 5 2004
30 Licensed professional
Oat I Am exempt form DECLARATION
Conor ON
0 1 hereby Arron
that 1 I.S.eaempt Oum Ne CminmoCode:A n c law for tM ��'�'�A
0 o whichfollowingre mean permit 7(131. Busloegs and Pro(esduns ,oMY city m tansy u
$Pi Width RgU1RJ, u.M.re cure.do Aper.ImpmN:,dtmalW.fi repair Od notation, BUILDING
F r rdarbits iesuenn.OURM tolsenheappUnnrfm such Courrarmitu file a Law sMamcnt
O (Comtethat me d,licewith
Somenunthcproviaions 3.fIW tamossALlmnselaw(Clupur9 Sq.Ft.Floor Area Valuation
$ that a is exempt
pt Cher fecomfiIn a d)th hunts I ,3.fIW Alleged
exempt.
m t.My W Code)At-
that
r $850
Nn k 4 eaempt meufrom and 0e hunts for the d1egW esrmpuon.My vloa0on of ppN N y
• Section 7031.5 by any Applicant for a permit anbjects ue Applicant m a civil penalty a 3 6 616��3G�0 0 Occupancy
not mase man ffw hmmmd dollars,(5500} pancy Type
D 1,As Owner of Ne property,or my employes with wages As their wk Compensation.
will do the wort and dmrwclum himIll ended Oroffeecd fmsAle(Sec.70,14,Budnw
and Pmfwion,Code:The Commences Linn law does Out apply in an owner of 101 - FOUNDPPjej16jqd Inspections
pmperty who builds mlmProves theman,andwho does,uch wart Munu(orlluougb his
Own mnploYes.providW,hnach lmprowmanu ammulmended moRereE(ecnle if. 102 — PIERS
however,the Wilding or improvement Is sold within one Sear ofnmpk)an,Its,awrcr. 103 — LTFER
Wilder will have the WNen of proving that he did set build or Improv for purpose of
44k•)• 104 - REBAR
D 1.As owner of the property,Am exclusively convecting with Ikmued eontraemA he 10 5 - ANCHOR BOLTS
Construct BC Pmfw(Sm 7044.Business And Prafegdam (
Cad]:)The Comets ,U.
censetaw des not apply man Owner of property who build,or lmproes thmoon.and, 106 - SEWER & WATER
who conmcu for Inch projects with a cmmemrD)licensed purwanl to List Contractor's
L 202 - UNDERFLOOR PLUMBING
icense law.
❑lam mptunder Sec. 38,PCImthismusm 203 - UNDERFLOOR MECHANICAL
�4 Z rJl� 0 a�,,-E6 03 204 - UNDERFLOOR FRAME
eWORKER'S COMPENSATION DECLAN 205 - UNDERFLOOR INSULATION
Ihereby Affirm under penalty ofperjury one ofthe following declarations, 301 - ROUGH PLUMBING
avovideldforbys ti07700ofthela�Code.fmtheperro�CceeoffOur 302 - TUB & OR SHOWER
forwMrhwspermnlsweed. 303 - ROUGH MECHANICAL
D I haw and will maintain Works Compensation Wnsnrance,As required by Section 304 - ROUGH ELECTRICAL
3700 of tho IaWf GOde,fm the pe femunce of Use work for which this permit to bound.
My WOrkefs Compangation ln,unnce canier and Policy number Are: 305 — FRAME
Comm: PolicyNa.: 306 - HOLDOWNS
CERT7FlCOMOF E]CEM PENSATIONiNSURRANCE ON FROM WORKERS 307 - INSULATION
trn4.etdanneed1heamp1mcdlnhnpermitI.weaWndreddnuan(slam 308 - SHEETROCK
ror kAs.) 309 - EXTERIOR LATH
I certify mat in thatArformaum of do,work for which this permit it Issued.I"I net Cati310 - INTERIOR LATH
Lawsoanyperw anymey�e 12Zb-o me,ebjec,rothewarktn'cmnpem.um, � 311 - SCRATCH COAT
employ nyK ADau J
Apps t �'�
CE TOAPPUC`ANT.ILa(ler making 444 CenlRnu of Eecmprion,you Mould 313 - ROOF NAIL
Ir
sub)ecru the Worker,Compewtim provisions of the labra Cntic,ya muss 501 - FINAL ELECTRICAL ENERGY
.J 7-, Mwithcomply with such provWons or 444 perch MAllMdcemW revoked.
z CONSTRUCT ON LENDING AGENCY 502 - FINAL PLUMBING ENERGY.
F�- 1hereby afnrm that them iuraAAmmCInn lendmgagency for me perrarmamaor 503 - FINAL MECHANICAL ENERGY
a the work for which this permit alvuedUlm.3w7,Cm.C.) 504 - FINAL BUILDING ENERGY
W C] Leadces Name
Z Lender's Add. 505 - FINAL ELECTRICAL
UO ICertify that Iha.road!do-ApplicNonAnd!euethat the Alan.Information 1, 506 - GAS TEST'
Ix, L conecL I gree,o,amply with All city and Gamy OrdinancesAnd assts laws mating to IPLUMBING
C building amwction.and hereby Authorize rep,esem matim of this city enter upon du
W AWw.mentionedpmpenyfmInspection purposes. %FINAL
MEC Cn L(We)aguerenuw,IMemnify andM Mmlw the CITY of Cupertino AgainstFNliabilities,judgments.costs and expenses which may in any wy Anroe 9111394 Said CITY IIn CO'c"Lemof drc gMling of this FCMILAPPLICANT UNDERSTANDS AND WILL COMPLY WITH A NON-POINrIssued by: NG Date
E'jEGULATIONS.
`r Re-roofs
rratuse or ApPlkanVCom DO Data
FIAT A to[=b MATERIALS DISCLOSURE Type of Roof
Will the a Cupertino
cur(mum Wilding a.Chapter
9.1"handle t hawth And Sural
C defined by the 32(a)?no Mun4lpal CO .Chapur 9.13,and the Health and Safety
caM, El et 35533(.)7 All roofs shall be inspected prior to any roofing material being installed.
El Yet No
will the applicantfuture Wilding Occupant um equipment A,bevies which If a roof is installed without first obtaining an inspection,I agree to remove
vardous it nnuminenu As defined by the Bay Arta Air Quality Management all new materials for inspection.
7
DVet 4:f�
Thew mW thehvaNasmaudW myvimmenuunder Chap r6.95of ire Califon
ataH l"Safety CoM.ScLd=25505,35533"M5N.1 thatlfue building
des trot cummly Mw A tern,that It 4 my responsibility u court upant of ue
my my any— 6-0etpnormaeumnOracmdBtAmn r� Signature of Applicant Date
Owneror amhorimdGgent ,Dam All roof coverings to be Class"B"or better
�3
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❑TY0
CUPERTINO ;
Assessors Parcel Number:
Name of owner. Wei' lee rk o Loa
Project address. 17530 ik)aP„ 74>,d b-r;116 D �'6�ClS7J/
Contact person. r/ii>2t L O fJ Phone.
Fax. -g240-,6 -3o gel-
r / /
Net square footage of lot., 6( >C (O ? = tO S2 7R Z
Existing Proposed
I Square footage: First floor: z53 lb 21r?.9-
Second floor: r7 6 w 7 6 rb
Garage: �-311
o TOTAL: 3369 rb 341 rb
SAre there at least two 10 foot by 20 foot clear spaces inside the garage? YJ N
On what floor(s) is work being done? C.,DVIC,,t- , S h
�� Gawe.- P�cfsf g c n (WC 4
Brief description of work.
Move, doa Cvc N -lo E ��1„
6") �ou/' cu
Code editions: 19 BC (Y- 19 8S � (Y _ 8 CMC (Y- U �v �l
� (IST k99�NEC ( -N) WCcC(d door C3L"�
App
IN ACCORD Rod
�'lIEC PLAN$ ANCE WITH THE CITY OtCIN AI CNO AESqt tiECKED BY UFFIrr N ORDINANCES
��ATE
SIGNED
This set of —
PLAM,X,, l '-s ' 1d S
be kept on the jab at `3jpeGhcabons MUST
lawful to make hmaS and i
ATE_ x D on same With ouTY changes tis un
5 The lamatio
ing Dept., City wittef permiss otnr from
2003 ping of this Cupertino.
1 >HALL NOT be b , plan end Specifications
DDroval of the a A to permit or to be ar,
=i ,r 'nv 10ation of any provisio❑,
City
e or State taw
Plan Review Process Work Book Page-7-Revised 5/17/00
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CITY OF CUPERTINO
I�1 1 of 1 PERMIT RECEIPT OPERATOR: conniew
COPY # 3
Sec : Twp : Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36616013 . 00
DATE ISSUED. . . . . . . : 02/26/2003
RECEIPT # . . . . . . . . . : 21204
REFERENCE ID # . . . : 03020109
SITE ADDRESS . . . . . : 7530 WATERFORD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LOO WEI Z AND REIKO M TRUSTEE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5234
RECEIVED FROM . . . . : WEI LOO
CONTRACTOR . . . . . . . : LIC #
COMPANY . . . . . . . . . . :
ADDRESS . . . . . . . . . . .
CITY/STATE/ZIP . . . : ,
TELEPHONE .
E ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
13PERMFEE VALUATION 850 . 00 77 . 00 0 . 00 77 . 00 0 . 00
BPFIXTURE UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00
BENERGY PERMIT FEE 77 . 00 23 . 10 0 . 00 23 . 10 0 . 00
BPLANCHK PERMIT FEE 1 . 00 62 . 25 0 . 00 62 . 25 0 . 00
PPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00
BPVENT UNITS 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00
BSEISMICRE VALUATION 850 . 00 0 . 50 0 . 00 0 . 50 0 . 00
EPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 250 . 55 0 . 00 250 . 55 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 250 . 55 VISA
TOTAL RECEIPT 250 . 55
9m
CITY OF City of Cupertino building Department
10300 Torre Avenue
CUPS TING 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.
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
may protect yoiisrself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law 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.
1'f you are an employer,you must register with the state and federal government 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 compensation
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 understate 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
ODWNER-BUILDER VERIFICO'ION
1. (Check one) I or my immediate family(parent,spouse or child) will perform:
A. _L 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.
2. A state licensed contractor will be hired to do:
A. _ 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
nsid/e).
Property Owner's Signature: �o (/l/� v Date: ��03
Job Add7s: /J�� ` G✓dd'� �Y _CT�� �1 Permit# U
An chant es to the information provided on this form shall be submitted to the City of Cu ertino Bu ld
Department.
ITY OF CUPERTINO • D 02 q
CITY Of CUPEkTINO PERMIT APPLICATION FORM
APN# 369 — Date:
Building Address:
Owner's Name: GPhone#:t/e� Lov 40do-/fK6-309s-
Contractor: License#:
Contact: Cupertino Business License#:
Building Permit Info:
Bldg ❑ Elect ❑ Plumb ❑ Mech ❑
Job Description: Add Shaw 5*a/i,to ,E'.e acs a Aoar
Residential 19 I�aYj' n win ow,A(W 4*y1 c Commercial ❑ &dy,4
Sq.Ft. Floor Area: /D Z $/Sq.Ft.: 8�/ Z
Cost of Project: R Occupancy Group.
Type of Construction:
0- Rem,adel
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits : foot BUILDING
BBOILER1 Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MEC ANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILERS Boiler> 1.75M Btu MECHANICAL
13CONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for 13Q Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V<= 1000A ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V <=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BDWESTIGA Investigation fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
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CITY OF CUPERTNO
awyo PERMIT APPLICATION;FORM
CUPEkTINO .
49 Quantity Fee ID "Fee Descri tion Fee Group"
BMITIGATR . Res. Housin Mit Fee . BUILDING
BMNEWMULTI New Multi-Famil Res MECHANICAL
BMNEWSF&2F New Sf&2F Res Bld s MECHANICAL
BNEWMULTI Multifamily Res .," ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm MechanicalMECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BNUMULTI New Multifamily Res PLUMBING
BNUSFD New Single Family Res BUILDING
BOVERTIME inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING.
BPFIXTURE Pblg Fixture PLUMBING
BPGAS" Gas Piping S stem Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
$PLANCHK. Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi: BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
13PREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK .
Lawn S rinkler
/Backflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Tra ' PLUMBING
BPVENT Alt of Drain&Vent PLUMBING
BPWATER Instal UAIter Water Pl e PLUMBING
BPWHEATER Water HeaterNent PLUMBING
BPWSVCS Main Water Service PLUMBING
a
SPECT Reins ection Fee BUILDING
COVER A/C Unit> 10,000 cfrn MECHANICAL
IRHAN A/C Units r- 10,000 cfm MECHANICAL
PPLI A liance Install MECHANICAL
SWAY Remodel Buswa s ELECTRICAL
FIXT Li htin Fixtures ELECTRICAL
FURN Relocation of Furnace MECHANICAL '
RNOV Relo Furnace> lOKbtu MECHANICAL
HEAT Heater Installation MECHANICAL
HOOD Installation of Hood MECHANICAL
MISC Misc A aratus ELECTRICAL
RAPP Rem Non-Res A liance ELECTRICAL
OLE Pole/Platform Fixture ELECTRICAL
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aCITY'OF'CUPERTINO
cl oro T PERMIAPPUCATIONTORM
uanti Fee ID Fee Descri tion Fee Group
BREMPOWER Power Device/A aratus' ` - ' ELECTRICAL
BREMRECEPT Rc tl,"Switch& Outlets ..; ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT. Re air/AlterHeatin MECHANICAL
BREMRESAPP Remodel Res Appliance : ELECTRICAL
13REMSIGNAD Rmdl Si s.Add Branch '' ELECTRICAL
BREMSIGNS Remodel Sims.Marquee ELECTRICAL
BREMTHEATR Theatrical T i tin Fix, . - ELECTRICAL
BREMVENFAN Vent Ean Sin le Duct MECHANICAL
BREMVENSYS Ventilation S stems MECHANICAL
BSCBLVD Scb S ecific 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 Temp 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
f PPERMITFEE Plumbing Permit Issuance'' PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
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