08110013 CITY OF CUPERTINO §+�&
BUILDING DIVISION PERMIT h,hCONTRAT�Oit INFU$�ATI ,;N
BUILDING ADDRESS: PERMR N0.
838 CAND A
OWNER'S NAME: PERMIT ISSUE DATE
0W90 KWOK Is T Ay. P9 BOX 24385
'N 1— 8 8 CONTROL NO.
408) 369-9570
ARCHITECT/ENGINEER:
BUILDING PERMITINFO
BLDG ELECTPLUMB MECH
0 0 0 0
O O LICENSED CONTRACTOR'S DECLARATION Ib Description
1 h,reby affirm that 1 am licensed under provisions O0SCT1 of Chapter 9(commencing / p
ith sectionandefmf Divison]of the Budnesa and Pr few Code. mylicense'
7w in fullfaseendefre0.� OPPER RE-PIPE
p 2� License CI Lld.Y
r p Dao: Contranar
ee 7W ARCNfrECI'S DEC ATI N
? U I uMerstanJ my plu r Nall he used sa p c rtcord
sun
o In Licuucd Rufcssional
i5 OWNER-BUILDER DECLARATION
V1 hereby aM.that I me eampt from the COntrac re.License Law for the
c:0 following mason.(Section](DIS,Business and Professions Cate:My city or county
e m which acquires a permit m comruq alar.improve,dere-ivh,or n:pub say stromuro
:4vo priorto its issuance.also,inquires the applicant fwach permit In file a signui statement
< Uat he is licensed purmsnt to the ptevisom of the Contnctrel License Law(Chapter 9 Sq.Ft.Floor Area Valuation
11--0 (commencing with Sectiou 7000)of Division]of the Butineu and Porfesiom Cods)or
that M is csampt therefrom and the basis for du:alleged caemption My violatio of
Suction 7031.5 by any,applicant for a Permit abjucu the applicnt m a civil Penalty Of APN Number Occupancy Type
not main dun Bw hundred dollars ISM
❑Latowner err the propmy,ater wplOYm wdth wager attheirakcmnpenswm, 36919029 . 00
windo Newark,and thestrucdum is reaienanded ooRered fmsale($ec.70th,Business
and Pmrawom code:The canttatorr Licatsse Law deal net.Mly to an Owner of Required Inspections
property who bis ilds or improver thereon.and who dos such work himsel f m through his
own employes,provided Nat such inque emet,tae not intended Or Offered for We.If.
however.the building or improvement is aid within am year of cempledon,the owner-
builder win have the,burden of proving that he did cat build or improve for purpose of
sale.).
❑I.to owner or the Propeny,am ealualvely contracting with licensed contractors to
constmct the pmjem(Sec.7014,Business and Professions;Cade:)The COnmaur's Li-
ce.Law dos not apply to an owor of peaeny who hands Or irepmves thercon,and
who contracts far such projects with.contrurneW Bonsed pumuant in We Cmnosser -
License Isw.
❑Iameaempturvie See .B&PCfmthismanm
Owner Date
WORKERS COMPENSATION DECLARATION
I hereby afBm under penalty of perjury One of the following decimations:
'.law and will maintain a Certificate fC..[to self-imam for WOrkefsCompen-
o.u provided for by Suction 3700 a the Labor Code,nor the performance of the
for which this Permit is issued.
❑1 have and will maintain Workafs COmperuation Insurance,an required by Seems
3700.f the Labor Code,for the performance of the work for which this permit is issued. '
My Worker's Compensation Insurance camier aed Policy number am:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
This it.need of be completed ITN,permit Is forme,hundred dollars(SIM)
or leu)
I modify Nat in the perform) of the Or Ire which this mated.1 shall not
employ anypc n dfnn r o abject k,n'Compensams.
Imwsaf Cali( i
AppReant
NOTICE TO C NT.If.&W nalicularis Cenifncam wnpden,yo should
becoe su m Nm
e Wmem,Compeatin provisions mof Lather Code,Code,you m
,J Om
forthwith comply with such provwom Or this pemhit Nall he domed tneked.
z'-" CONSTRUCTION LENDING AGENCY
Fn
-h.+ Ihereby hich thi UPe dxre uaconsistenciesd(Seclending agency for Uhe performs of
Ci du work lar which this permit 6 issued(Ser.1097,Civ.G)
0.Q Lundeen Name
D z 1<ndefs Address
U Q I candy that I haw and this application and sate that the above information Is
It, F correct.1 agree be comply with all city and county oNinnm and sum l.wsu misting in '
0U holding construction,and hereby audurine representatives of this city to enter upon cite
CI] alumna-menduned property for inspection purposes .
(We)agree m saw,indemnify and kucp haoml.die 'ty of Cupenino against
hF•i h liabilities,Judgments.costs and experience whic7/F
mayyammcagsislmid City
U z m cmnsegoae a granting Nia perch.
^v APP ANT ERST AND WIWITH ALL NON-PINT Issued by: Date 4w
s R un Re-roofs
M
ppb Husesur= US MATERIALSDISCL.OSURE ate Type of Roof
Will do sppficaret a futu,beading aaepsentaom orhndk hevatdom maseaial
as dcBned by the Calandra Municipal Code,Cbapter 9.13,arW the Health and Safety
Cade.Section u53z(.)7 /� All roofs shall be inspected prior to any roofing material being installed.
DYea [ .
Will Nc aFit.1 Or future building occupant use equipmem or devices which If a roof is installed without first obtaining an inspection,I agree to remove
iL hvndnm nil.munimnu ar de d by the Bay M.Air QualityMn.gcmcm all new materials for inspection.
bier?
❑Yo u
Thaw m1,the hvardnmmater5, 5533A..u . pterd.95mfth,CaIdingniaHeaIhavBarn nh sat usr7..DIa 5533d.95fthe 'IJingJamtmicurren hawatem duthuely notifydo ups fthe
reyui rata ichmun '.1 in ntea0, p Y. Signature of Applicant Date
err mari>rd.g, te All roof coverings to be Class'W'or better
CITY OF CUPERTINO
5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 36919029 . 00
DATE ISSUED. . . . . . . : 11/04/2008
RECEIPT # . . . . . . . . . : BS000006538
REFERENCE ID # . . . : 08110013
SITE ADDRESS . . . . . : 838 CANDLEWOOD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : WOO KWOK L ET AL
ADDRESS 838 CANDLEWOOD
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4653
RECEIVED FROM . . . . : JOHN JOSEPH WALLACE
CONTRACTOR . . . . . . . : JOHN J WALLACE LIC # 22457
COMPANY . . . . . . . . . . : MARANATHA PLUMBING COMPANY
ADDRESS . . . . . . . . . . : PO BOX 24385
CITY/STATE/ZIP . . . : SAN JOSE, CA 95154
TELEPHONE . . . . . . . . : (408) 369-9570
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- - ---------- ---------- -------
1BPWATER UNIT 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1BSEISMICR VALUATION 6, 200 . 00 0 . 70 0 . 00 0 . 70 0 . 00
1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1PRREPIPE NO OF FIXTURE 9. 00 91. 80 0 . 00 91 . 80 0 . 00
1TRAV60C FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 214 . 87 0 . 00 214 . 87 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- -----------------"---
CREDIT CARD 214 . 87 MC
---------------
TOTAL RECEIPT 214 . 87
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- - -------------------
301 ROUGH PLUMBING 507 FINAL PLUMBING
Ohl o
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
14':V
O CUPEkTINO PERMIT APPLICATION FORM
APN # 2) / v �� U 0 Date:
Building Addres s �C7
Owner's Name: / /Q� Phone #:
Contractor: vV / / Phone #: 441`,_/q S�
Fax #:
Contact:1414
G� Phone . G/q
Fax #:
Contractor License #: "7�c,If��Q
Cupertino Business License #:
Job Description:
4IResidential Commercial ❑
Valuation: / 2O0 c�0
Project Size: Express Standard Large 0 Major ❑
Green Building: Please complete relevant portion of the Green Building Checklist& attach it to the
application or if applicable, include in plan set & the sheet index. .
Green Building Points:
Quantity Fee ID Fee Description Fee Permit Type
Grou
1PCSEWER Commercial building P 1CPSS
sewer/sanitary sewer
1BPREPIPE Commercial re-pipe per fixture P 1CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial P
1BSEISMICR Seismic Residential P
1PRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERT_INO
Q` REPIPE/SEWERIMAIN SERVICE
C TV OF
CUPEkTiNO - FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
1PRREPIPE Residential re-pipe per fixture P 1RPRP
1BPWSVCS Water Service P 1CPWS or
1RPWS
1PPRSEWG Private Sewage Disposal System P
1PCESS Cesspool P
1BPWATER Install/alter Water Pipe P
IBPFIXTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
/ 1PPERMITFEE Plumbing Permit Fee Issuance P
/ 1PLMBLNCK Plumbing Plan Check P •
1PLMBINSP Other Plumbing/gas Insp. P
1TRAVDOC Travel & Documentation Fee B
1BUSLIC Business License B
Revised 6-16-08
•