08120022 CITY OF CUPERTINO
BUILDINGorvlslON PERMIT XONT, ?TtMA7CIO.N
BUILDING ADDRESS: PERMIT NO.
7569 KIRWIN LN SPEEDY ROOTER PLUMBING 0812on22
OWNER'S NAME: PERMIT ISSUE DATE
'ONE:
A O. CONTROL N0.
(408) 234-8134
ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG ELELT PLUMB MECH
uOc LICENSED CONTRACTORS DECLARATION Job Description
uZ I thereby affiw that 1 un Iheued under pmvW=of Chapter 9(commencing
a< with Section 7")of Division 3 ofdte Business and Professions Godo.aW my license is
❑<„ in fullfomsmajCitect Q i PROPERTY LINE CLEAN OUT .
j=ui Lieenm Clas IJc.I
n t-q Dau \2I Conuacwr
7W ARCHITECTS DECLARATION
U /1 noomm nl my plans shall be Canal a public recrrds
g LL Licensed Professional
503 OWNER-BUILDER DECLARATION
s� E I hecby alliin that 1 am uunpt(rein the COntramors Lissome Law for the
s o O following mann.(Section 701.5.Business and Pmfesdans Code:My city or County
S ff which implies a Permit t construct,alter.Improve,dCamuh.or-Petr any stmctum
i y prior to its issuance,also requires the applicant for such permit to file a signed swemcnt
E G
man heis licensed purssomto me provisions ofthe ComrxtrsLiccnsoLi.(Chapoer9 Sq.Ft.Floor Area Valuation
x�3 (commencing with Section 7000)of Division 3 of the Bonn. it Profeessums CHIC)or 1800
that be u exempt therefrom and ft mals for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
Nn mom Nan five hundred dollars(SM 35921004 . 00
❑1,uownerofdiepmpcny,ormycmploycawithwgeauNthmlccompe don,
wllldOdmw'o11r,NddxaWetu.knotimm�darOnemdfwta (Sec.7WpBpdem Required Inspections
and Professions Cual The Conuactrs Licence Law does Out appy t an move nser of q P
propertywW builds orimoseves tharnn,and wbudowimsts wmishimrelf or d oagh his
own employes.provided that such improvements art net intended"offhand for sale.If.
how...Ne Wilding or improvement is mid within one year of completion,the mmer-
buildc will have the burden of proving That be did Out bond or improve for purpose of
ale.). 7ARY
❑L u awdom Nf the ply in a wOf prop rty who ui with licensed Conaarors d.conswct the projec(See.70dd,Biouness and Profusions Code:)lie Conuumes U• SAN
cense law duea net e ts Deane of property coed Wilds or impmva Norton,and,
who cwuacu for,each projects with a conuactr(s)licensed pcaunt t Ne Conusors LimeLaw.❑I am acmptundeSee ,B&PCfeammecamn
Ownc Dau
WORKERS COMPENSATION DECLARATION
' 1 hereby affirm under penalty of perjury oro of the following declaations:
I ham vM will mainuio aCenifiutemf Consent-self-insure fa WorkehCompen-
on,u provided for by Section 3700 of the Labor code.for No wife..of the .
work for which this permit is issued.
❑I have and will maintain Workers Compcnuuan Ia m ne,as required by Section
3100of Ne Labor Code.for Ne perform.of the work for which this permit it issueC.
My Workers Comixammon yIwun carrier W Policy numbe
Cam'. 4WPolicy NO.: 6
mg
ChGTE'OIFMPTION
FROM WORKERS
COMPENSATION INSURANCE
(This salon need mtbecanpleud itthe pewit is formic hundreddallan($100)
o Less)
I catty thm in the Performance of Ne work for which Nis permit tissued,I shall ret
employ any person in any manner an as in become subject in the Workers Compensation -
Laws of Califomia.Date
Applicant
NOTICE TO APPLICANT:If,after mating Nis Ccnifiale of Exemption,you sWut
become subject N 1W Workers Compensation provisions of Ne labor Code,you const
.�z foMwith comply with such provisions or this permit shall W deemed revoked.
O CONsmucfIONLENDINGAGENCY
I-w.mow I hereby affirm that Nem is a construction lending agency for the performance of
C Nc work for which this permit is issued(Sec.3097,Civ.C.)
QLanders Name
z LerMeN Address
V0 I amity that 1 have mad this application and sum that Use above information u
LL E CorrecL I agree u comply with all city and county oNinancer and state laws mmung in
.0 building conswction.aW hereby sumorim-presentatives of this city in anter upon Ne
r t17 above-mmtimmd Property for inspection purposes
6. (We)agree m ave,indemnify and kap harmless Oe city of Cupertino against
rh liabilidu,judgmcnu,com;andeapcaea which may in coy accrvc agalnst said City
V z APPPLlCANr UNDER 0 N of AN IL 0 LY Wim ALL NON-POINT Issued by: Date 2
SOURCE REGUL
Re-roofs l�
Si DD run on Us MATERIALS DISCLOSURE Dau Type of Roof
Will Ne applicant or future building occupant store or handle haadoa metrial
as defined by tihe CupenioN Municipal Code.Chapter 9.13.and de Health and Safety '
Code,series 75531(a)±
❑Tea IVI1Na All roofs shall be inspected prior to any roofing material being installed.
Will Ne applicant orVfututo building occupant use emuipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
h h.ardoa air Common..a defined by the Bay A.Air Quality Management all new materials for inspection.
mT
❑Yn
I have-ail Ne haardoamauriaE mmuirenen der haper6.95NfNeCsifor-
nulica"Safay Cedc,Saiw 255p5.;d 133an Nm JNe building
daces not cimcntly have a ped rL r y tbilil mtiy Nc occupmt of du
toqulroments which mux be p' td ec f. 'Rat Nr«apaney. Signature of Applicant Date
L
Dat All roof coverings to be Class"R"or better
p pfyy
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 35921004 . 00
DATE ISSUED. . . . . . . : 12/02/2008
RECEIPT #. . . . . . . . . : BS000006730
REFERENCE ID # . . . : 08120022
SITE ADDRESS . . . . . : 7569 KIRWIN LN
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NIAN ZHOU
ADDRESS . . . . . . . . . . : 7569 KIRWIN LN
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : SPEEDY ROOTER
CONTRACTOR . . . . . . . : SPEEDY ROOTER PLUMBING LIC # 23086
COMPANY . . . . . . . . . . : SPEEDY ROOTER PLUMBING
ADDRESS . . . . . . . . . . : 701 ALDO AVE STE 43
CITY/STATE/ZIP . . . : SANTA CLARA, CA 95054
TELEPHONE . . . . . . . . : (408) 234-8134
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
------ --------- ------- ---- ---- ---------- ----------
1BSEISMICR VALUATION 1, 800. 00 0 . 50 0 . 00 0. 50 0 . 00
1PPERMITFE FLAT RATE 1 . 00, 40 . 79 0 . 00 40. 79 0 . 00
1PRSEWER UNITS 1 . 00 20 . 40 0 . 00 20 .40 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 .79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 102 . 48 0 . 00 102 . 48 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
-- --------------- --------------------
CASH 102 . 48
---------
TOTAL RECEIPT 102 . 48
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ------------ ----------
106 SEWER & WATER 202 UNDERFLOOR PLUMBING
301 ROUGH PLUMBING 400 SEWER/LATERAL
507 FINAL PLUMBING
s '
FROM :CUPERTINOSRNITRRYDISTRICT FAX NO. :4082535173 Dec. 08 2008 01:03PM P1
Sh
DISTRICT MANAGER�E GINEER BOARD OF DIRECTORS
MARK THOMAS d CON PANY,INC. 'SO ��" WILLIAM A.BOSWORTH
ATTO
RICHARD K.TANAKA JOHN M. ..YEAftS Op CURT19 B.HARRISONHAR
DISTRICT COUNSEL S F aVI JE WENDELL H.KERR,JR.
ATKINSON•FARAS .LLP. �ff'�B(ISNEo~9+ CHRISTOPHER C.LEE
HAROLD S.TOPPEL 20838 STEVENS CREEK BOULEVARD.SUITE i O4
CUPERTINO,CALIFORNIA 88014.21 SA
(408)2837071 PHONE • (408)2838173 FAX
www.ctip ertinosaitit8rydistrirt.coin
File: CuSD—MOP
Building Dept. —Cupertino
City of Cupertino
Attn.: Building Department
10300 Torre Ave.
Cupertino, CA 95014-3202
Subject: SFD In.stsi 11 Property Line Clean-Out
• Name: Nian Zhou Residence
Address: 7569 Kir win Lane
APN: 359-21-004 i2,2.68
Pemut No. 081200 22
• Videotape nd Property Line Cleanout inspected.
No additional conditions/requir y the District»
Inspector: George Santos/Roger Santos. .... . ..... ...........
Date:...1 -08-2008................... Sanitary Sewer Location:
20' JAPJ_
cc: Propert Owner 20' Long
5' Deep
S:\WORDS\CLJS \LN"I'TFRS\BUlI.,DtNG DEPT J..F.TTERS\CuSD 2008_TV
• lnpection,.08120a!2-7569 Kirwin Lane_)2-08-2008.doc
SUPPLYING SANITARY SEWERAGE SERVICES FOR:CITY OF CUPERTINO,PORTIONS OF THE CITIES OF SARATOGA,SUNNYVALE,LOS ALTOS AND
SURROUNDING UNINCORPORATED AREAS
CITY OF CUPERTINO 0 t 0,
REPIPE/SEWERIMAIN SERVICE
aF'C PERMIT APPLICATION FORM
APN # ) Date: 1 Z / Z U 0
1--9 59 1 U o(4. a
Building Address: 7 5 (o q V, ;
Owner's Name: Phone #: (%-1q) 255- 2290
1 �.1
Contractor: 15 -e P c1 y 1Z�o} R r Phone#: (Llo9)-I ul z - ob I f�Q
Fax #:
Contact: JU 5�I Phone #: C�(oe) rj(Oq� 61(Pn
Fax#:
Contractor License#: y 31,
Cupertino Business License #:
Job Description:
S�-x,11
Residential Commercial ❑
Valuation:
� , �OD,= _
Project Size: Express Standard Large 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
Group
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 CUPERTINO
�E" REPIPE/SEWERIMAIN SERVICE
CITY Or •
CUPERTINO 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
IPCESS Cesspool P
1BPWATER Install/alter Water Pipe P
1BPFIXTURE 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
I 1PLMBLNCK Plumbing Plan Check P .
1PLMBINSP Other Plumbing/gas Insp. P
1TRAVDOC Travel & Documentation Fee B
1BUSLIC Business License B
Revised 6-16-08
•
Community Development
MR
F
10300 Torre Avenue
'? «'-Ir` Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
UPEkTINO
Building Department
JOB ADDRESS: PERMIT # 0 O a
5 (oc1 wiv. L cam
OWNER'S NAME: b.Gv I PHONE # Oyu Z 55 224(o
GENERAL CONTRACTOR: S ,ee{ J?—c k-y-
I am not using any subcontractors: Z�z�oB
Si a,tdre Date
Please check applicable subcontractors and complete the following information:
21 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