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07080118 CITY OF CUPERTINO y��.��ff BUILDING D171SIGN PERMIT i PERMIT NO. BUILDIJVffES�S:RANBERRY DR. NICE & RIGHT CONSTRUCTION 07080118 - U[� - PERMIT ISSUE DATE OWNER'S NAME: WEI ALLAN WANG & HELEN C LIN P 0 BOX 2285 SANITARY NO. CONTROL NO. NE: (408) 861-0928 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH a o 0 0 z LICENSED CONTEtACTOR'S DECLARATION Job Description c F t I hereby affirm that I am licensed under provisions of Chapter 9(commencing U with section 7000)of Division3OftheBusinessandProfessionsCodc,andmylicenacis UPGRADE SERVICE PANEL AND REPLACE WATER HEATER in full.force and effect. z Licensc Class Lic.A Date Contractor Q ARCHITECTS DECLARATION F I understand my plans shall be used as public records :J N Licensed Professional OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the Soa following reason.(Section 7031.5,Business and Professions Code:Any city or county lz which requires a permit to construct,after,improve,demolish,or repair any structure Valuation H prior to its issuance,also requires the applicant for such permit to file a signed statement r'' Ft.Floor Area < that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q $2100 o (commencing with section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of pN Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3 6E04 5 0 Pb U. Number not more than five hundred dollars($500). ❑I,as owner of the property,or my employees with wages as their sole compensation, Required Inspections will do the work and the structure is not intended or offered for sale(Sec.7044,Business 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.). [gel,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 contractors)licensed pursuant to the Contractor's License Law' ,B&P C for this reason Q I am exempt under Sea Owner��y/��"• � �SAI=iN�DECLARAMONDale�g / `T WORRKE�'S CCOM E I hereby affirm under penalty of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for woftes compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the workCor which this permit is issued. I have and will maintain Workers Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workers Compensation Insurance carrier and Policy number are: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (this section need 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,I shall not employ any person in any manner so as ecomc ybjecl t Workers'Compensation Laws of Califo Dec 1 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 Qforthwith comply with such provisions or this permit shall be deemed revoked. ► CONSTRUCTION LENDING AGENCY 4.�-+ 1 hereby affirm that there is a construction lending agency for the performance of > the work for which this permit is issued(Sec.3097,Civ.C.) a Q Lender's Name 4 Z Leader's Address 1 certify that 1 have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorise representatives of this city to enter upon the Uabove-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against y liabilities,judgments,costs and expenses which may in any way accrue against said City Z in consequence of the granting of this permit. Date APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b,r' SOUJt�E REGULATIONS. - -roofs Stgnaturc of ApplicanNContract r Date HAZARDOUS MATERIALS DISCLOSURE Type of:Zoof Will the applicant or future building oceupantstorc or bandit hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roof:,shall be inspected prior to any roofing material being installed. 0YesANO If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new I naterials for inspection. District? Yes KNo 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the Date rcqui encs which must be met rior to is of a Certificate of Occupancy. Signature of Applicant ( 3 All roof coverings to be Class"B" or better D2u: wncr or authorized agent —T N CITY OF CCTPERTINO not PERMIT APPLICATION FORM CUPERTINO -� of I. _PN # Date: Building Address: r�iling Address (if different from building address): 1o4-2 Creanberr `Dr � ' Owner's Name: Phone#: NUTALAN NAN r- KELc?V C. L � - G r - v Contractor: License #: "/v/2T 9D_J� Contact: I Pho e: Cupertino Business License#: L. k � iA Fax: &)6(-,07.;-,- Building Pe it Info: CVq, rude seracp_ r-ep(ack wcT,� Gvec�ffr Bldg ❑ Mect oiih l P[umb Mech ❑ Job Description: Residential Commercial 1:1Sq.Ft. Floor Area: Sq.Ft.�� Cost of Project:J5 Q10o, Occupancy Group: Type of Consrtruction: Please check this box if t� project is a L second-story addition: 12 r—roject Size: Standard Large ❑ Maj:)r ❑ Quanti Fee ID ]Zee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler-> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX In(VOff/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax-Resi/Mobile BUILDING BELEC1000 Elix 600V <= 1000A ELECTRICAL BELEC1001 E(ec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA [nvestigation fee BUILDING t— I of 3 CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT' RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: B13:: Lot: APN 36204050.00 DATE ISSUED. . . . . . . : 08,'13/2007 RECEIPT #. . . . . . . . . . BS000002359 REFERENCE ID # . . . : 07080118 SITE ADDRESS . . . . . : 10,12 CRANBERRY DR SUBDIVISION . . . . . . . CITY CUERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : WE[ ALLAN WANG & HELEN C LIN ADDRESS . . . . . . . . . . : 1012 CRANBERRY DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2649 RECEIVED FROM HELEN C LIN CONTRACTOR JI.% HUO YU LIC # 23446 COMPANY N= & RIGHT CONSTRUCTION INC ADDRESS P 3 BOX 2285 CITY/STATE/ZIP . . . : CUPERTINO, CA 95015 TELEPHONE (438) 861-0928 FEE ID UNIT QUANTITY kMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- --------- BELEC200 METERS 1. 00 29 .43 0. 00 29 .43 0.00 BENERGY PERMIT FEE 1. 00 34 .86 0. 00 34 . 86 0. 00 BPWHEATER PER HEATER 1. 00 10.79 0. 00 10.79 0. 00 BSEISMICRE VALUATION 2, 100. 00 0.50 0. 00 0.50 0. 00 EPERMITFEE FLAT RATE 1.00 38 .37 0. 00 38.37 0.00 MPERMITFEE FLAT RATE 1. 00 38.37 0. 00 38.37 0. 00 PPERMITFEE FLAT RATE 1. 00 38.37 0. 00 38 .37 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 190. 69 0. 00 190. 69 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 190. 69 MC --------------- TOTAL RECEIPT 190. 69 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- -------- 103 UFER 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CITY OF -UPEkTINO Buildi:NO ar :' JOB ADDRESS: PE # �� 0 l : ?OWNER'SNAME: — PCTOR: /�/� F _ 4 I am not using any subcontractors: Si;;na Date Please check applicable subcontractors and complete e followin 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 Owner/Contractor Signature Date