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07010101 CITY OF CUPERTINO T h BUILDING DIVISION PERMIT ��l`�T .��TC�R y ���Y����n• PERMIT NO. BUILDING ADDRESS: 1189 YORKSHIRE CT DOVE' S SE Nr pgRMITL55UEDATE OWNER'S NAME: 1695 SAG FWOOD AVE 01/18/2007 JASON YANG SANITARY NO, CONTROL NO. 'NE: (510) 376-6543 BUILDING PERMIT INFO ARCHITEC(ENGINEER: BLDG ELECT PLUMB MECH o p LICENSED CONTRACTOR'S DECLARATION Job Description U(- I hereby affirm that I am licensed under provisions of Chapter 9(commencing _Z'�'u with Section 7000)of Division 3 of the Business and Professions code.and my license is REPLACE FURNACE SAME LOCATION y in full force and�P j Z License 1 "TS &2C_ 2 C Lie. F Date P5,1 0Conlraclor ARCHITECTS DECLA T10N W I understand my plans shall be used as public records 4 L y Licensed Professional n H OWNER-BUILDER DECLARATION ga x I hereby affirm that 1 am exempt from the Contractor's License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to concoct,alter,improve,demolish,or repair any structure Z; prior to its issuance,also requires the applicant for such permit to file a signed statement S Ft.Floor Area Valuation =G that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q $3200 y l– (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3621100 7 Number not more than five hundred dollars($500). ❑I,as owner of the property,or my employees with wages as thew sole compensation, will do the work and the structure is not intended or offered for sale(Sec.70".Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If. however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. ❑1 am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Com rasa' n Insyrance carrier and Policy number am: Carrier a/C/ Polky No.: .3SL 7�3 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section meed not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued.1 shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date— Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must '.Z' forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Fes.,ter I hereby affirm that there is a concoction lending agency for the performance of a> the work for which this permit is issued(See.3097,Civ.C.) W Q Lender's Name Z Lendees Address U 0 I certify that I have read this application and state that the above information is w 0 correct-1 agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorise representatives of this city to enter upon the above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,toss and expenses whit may in anyway accrue against said City U Z in consequence of the granting of this per Date — —U 7 r--r APP(,ICANT NDERSTANDS AND ILL COMPLY WITWALL WN-POINT Issued by Re TIONS. . c l/ r �/ "7 Re-roofs Signature of Applicant/Comractor Date Type of Roof HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes ❑No Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new rr aterials for inspection. District? ❑Yes (3 No I have read the hazardous materials requirem is under Chapter 6.95 of the Califor- niaHcalth&SafctyCodc,Sections25505.25533 d 534.1understandthatifthe building does not currently have a tenant,that it is my sponsibility to notify the occupant of the requy�;nerrtywy�cIt must be met poor to i3) e a certificate Of� /a /d y Signature of Applicant Date / ti/ /C/ /Y All roof coverings to be Class"B"or better O r or authorized agent Community Development 10300 Torre Avenue Cupertino CA 95014 -.. Telephone(408)777-3228 Fax(408)777-3333 co OF t"UPERTINO Buildin Department JOB ADDRESS: PERMIT # gC Shlt t 070 OWNER'S NAME: Soni c PHONE # .510--J' .� GENERAL CONTRACTOR: Wgs C�CgvleJ FAX # �j� 5- - /6'pl I am not usingan subcontractors: -.���. r� S 8 0 y Sig lature Date Please check applicable subcontractors and com :ete the follow' 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 f. Owner/Contractor Signature Date CITY OF CUPERTINO t NACEA CUPS TING PERMIT APPLICATION FORM Date: APN# :3U2__ 1 Building Address: Ofd j�� Phone.#: Owner's Name: ��/� _ �5 _�(o ' Ll —gse C , License : SeK , Contracto : 't _ 1 bone: C J �S �Co n Z Contact, Phone: Cupertino Business License#: _.. Building Permit Info: Bldg [a Elect Plumb ©— Mech � Job Description: I.{ ri e e. . Residential JZ:L Commercial ❑ For Residential Installations: Attic W Is' floor F4 2°d floor❑ Adhere to min set back requirement❑ For Commercial Installations: ".eplacement same weight ❑ Additional weight (s ijctural calcs)❑ Structural Calculations required for new installation New installation Planning Approval Required ❑ Occupancy Cost of Project: of Construction: P Ycoup- Type �2 S Ft. loor Area: Strapped ❑ On Platform ff Bonded 0 J q New Location ❑ Replacement Qty. if Fee Description Fee Group EA licable Fee ID BUILDING BENERGY E�iergy BREMFURN Furnace MECHANICAL BREMACOVER A/,C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units<= 10, 000 cfm MECHANICAL BREMRECEPT R ec tl, Switch& Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE Flec Permit Issuance ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE P ld Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BPGAS Gas Piping System Fee PLUMBING PGASBusiness License BUILDING