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07080216
EBUILD11N8 Y OF CUPERTINO UILDING DTYISION PERMIT CNTAtATdR� EQRM `TI�N:; . PERMIT NO. ADDRESS:414 LOCKWOOD DR UNIT B OMEGA CONSTRUCTION 07080216 PERMIT ISSUE DATE 'S NAME: KENJI ARITA 451 FENLEY AVE SANITARY NO. CONTROL NO. NE: (408) 24:3-0404 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH adZ LICENSED CONTRACTOR'S DECLARATION Job Description 0 O I hereby affirm that I am licensed under provisions of Chapter 9(commencing EX PANE-- CHANGE (10 OA) with Section 7000)of Diviyelt 3 of the Business and Professi s Code, d my license is y in full force and effect Y� ) Licd OMEGA R�NEWED BL 8/24/07 ? License Clas p Date Contractor t ARC ITECTS DECLARATI i C< 1 understand my plans shall be used as public records idV toy Licensed Professional O< OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for the p O following reason.(Section 7031.5,Business and Professions Code:Any city or county $ which requires a permit to construct,alter,improve,demolish,or repair any structure Valuation "rn prior to its issuance,also requires the applicant for such permit to file a signed statement Sq.Ft.Floor Area z a that he is licensed pursuant to the provisions of the Conlractur's Liccnsc Law(Chapter 9 $1800 _ (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 ppOccupancy Type Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of 342290 4 0 Number not more than five hundred dollars(5500). 0 1,as owner of the property,of 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 10 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.). 0 I,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- ves reon.and cense Law does not apply to an owner of property who build oriptro o the Contractors who contracts for such projects with a contractor(s)licensed pursuant License Law. B&P C for this reason 0 f am exempt under Sea Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: J I have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 0 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 Worker's omp au o Insuran4FIXFTION 'r and Policy num er are: Cartier. Policy No.: CERTIFICA OF FRO RKERS' COMPENSATION INSURANCE (Phis 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,l 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. Z- CONSTRUCTION LENDING AGENCY [-r I hereby affirm that there is a construction lending agency for the performance of p; the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name G. Lenders Address U 0 I certify that I have read this application and state that the above inform is correct.1 agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City in consequence of the granting of this permit. Date 2 U Z JAPPLICANT UNDERSTANDS AND W LL COMPLY WITH ALL NON-POINT Issued try: SOU ATIONS. 4 2 Re-roofs Si ore of ontractor' Dam T of Roof HAZARDOUS MATERIALS DISCLOSURE Type 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 roo's shall be inspected prior to any roofing material being installed. 0Yes "° If a rocf 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 materials for inspection. District? 0 Yes 1 "° I 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 docs not currently have a tenant,that it is my responsibility to notify the occupant of HDate requirements which must be met prior to i uancc of a Certificate of Occupancy.nSignatt re of Applicant L All roof coverings to be Class"B' or better Own oriz cn Date Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 ClTlf Of Fax(408)777-3333 #7UPEkTINO Buildin De artment JOB ADDRESS- PERMIT # OWNER'S NAME: PHONE # GENERAL CONTRACTOR: FAX # I am not using any subcontractor 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 Date Owner/Contractor Signature CITY OF CUPERTIN ��naF PERMIT APPLICATION FORM CUPEk INO © C) ZC C.Q PN# `� Date: (�/ "7 �t0 o Z � 22 . / Buildin Address: :VIaili g Address (if different from building address): q. Owner's Name: ` _TA Phone# � c Contractor. License - © E ------ - --- -- Contact: rr ` Phone: ';j— upertino Business License#: DIE— Fax: Building Permit Info: . C CM Bldg ❑ Elect CR Plumb ❑ Mech ❑ Job Description: Residential Commercial El Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupancy Group: Q--� Type of Constructional Please check this box if the project is a second-story addition: El roject Size: Standard ❑ Large ❑ Ma or ❑ Qu—antity Fee ID Fee Descri tion Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERl Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to IM Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILERS E oiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind70ff7Comm/Quasi BUILDING BCONSTAXBQ Cc n. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Ccnstax—Resi/Mobile BUILDING BELEC 1000 E ec 600V <= l OOOA ELECTRICAL BELEC1001 Elec 600V> IOOOA ELECTRICAL BELEC200 Elei: Svcs 600V<= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BEWESTIGA Investigation fee BUILDING I of 3 CITY OF CUPERTINO 3 ITEMS OF 7 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 34229040. 02 DATE ISSUED. . . . . . . : 0E/24/2007 RECEIPT #. . . . . . . . . . BE000002467 REFERENCE ID # 0%080216 SITE ADDRESS 1C414 LOCKWOOD DR UNIT B SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER KENJI ARITA ADDRESS 10414 LOCKWOOD DR UNIT A CITY/STATE/ZIP CUPERTINO, CA 95014 RECEIVED FROM CHUNG HUR CONTRACTOR . . . . . . . : JUNG HUH LIC # 22317 COMPANY OIZEGA CONSTRUCTION ADDRESS 451 FENLEY AVE CITY/STATE/ZIP . . . : S'�N JOSE, CA 95117 TELEPHONE . . . . . . . . : (,108) 243-0404 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- - BELEC200 METERS 1. 00 29 .43 0. 00 29 .43 0. 00 BSEISMICRE VALUATION 1, 800. 00 0.50 0. 00 0.50 0. 00 EPERMITFEE FLAT RATE 1. 00 40 .79 0.00 -----40_79 ------0_00 ---------- ---------- TOTAL PERMIT 70.72 0. 00 70.72 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- ------- 103 UFER 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL