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07060021 CITY OF CUPERTINO y��+7�7�,{�T�T f ` T BUILDING DIVISION rL`l�lvii1 � L" � �� f PERMIT NO. BUfLf�j1ffl'A1�,S_TE AV NICE & EIGHT CONSTRUCTION 07060021 �$ l� PERMIT ISSUE DATE OWNER'S NAME: WANG HSING J AND YEN C P 0 BOX 2285 06/04/2007 SANITARY NO. CONTROL NO. )NE: (408) 86'--0928 BUILDING PERMrr INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH pO LICENSED CONTRACTOR'S DECLARATION Job Description i 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing U with Section 7000)of Division 3 of the Business and Professions Code,and my license is TEMPORARY POWER y in full force and effect t ? License Class Lic.k t Dale Contractor ARCHITECTS DECLARATION i < I understand my plans shall be used as public records )WU LL y Licensed Professional OWNER-BUILDER DECLARATION > I hereby affirm that I am exempt from the Contractor's License Law for the 3 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 Z} prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 3q.Ft.Floor Area 2 0 0 2 f-- (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 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of Number Occupancy Type not more than five hundred dollars(S500). 36924051 ❑I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure isnotintendedorofferedforsale(Sec.7044,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.). I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044"Business and Professions Code:)The Contractors 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. ❑I am exempt under See. -7 B&P C for this reason 41L �7 Z Owner IA,6L]_-_Dam d _y WORKER'S CDMPENSAMON DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I]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 Worker's Compensation Insurance,is 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 riot be completed if the permit is foronc 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 to become subject to the Workers'Compensation Laws of Cahfom� r��Date Applicant OT,9L, L-CU.J 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 Oforthwith comply with such provisions or this permit shall be deemed revoked. Z" CONSTRUCTION LENDING AGENCY E~CA I hereby affirm that there is a concoction lending agency for the performance of fYi > the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name a z Lcndees Address U 0 1 certify that 1 have read this application and state that the above information is (7.►" correct.I agree to comply with all city and county ordinances and state laws relating to Ubuilding concoction,and hereby authorize representatives of this city to enter upon the W above-mentioned properly for inspection.purposes. CL (We)agree to save,indemnify and keep harmless the City of Cupertino against HIn liabilities,judgments,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. Date ►'� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by SOUR REGULATIONS . REGULATIONS �l� Re-roofs Si arurc of App icant/Con r DamT e of R 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 roofs shall be inspected prior to any roofing material being installed. 0 Yes t° If a roof i s installed without first obtaining an inspection,I agree to remove Will the applicant or uturc building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new rr aterials for inspection. District? Yesj�No 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 requiremen which must be mel prior to issuance of a Certificate of . parley- Signature of Applicant Date Y All roof coverings to be Class"B"or better Owner o t orizcd agent Datc CITY OF CUPERTINO 2 ITEMS OF 2 PERMI`[' RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Bl:c: Lot: APN . . . . . . . . . 36'324050. 00 DATE ISSUED. . . . . . . : 06 /04/2007 RECEIPT #. . . . . . . . . : BS)00001538 REFERENCE ID # . . . : 07 )60021 SITE ADDRESS . . . . . : 85.2 BETTE AV SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : WAJG HSING J AND YEN C ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4549 RECEIVED FROM . . . . : SHIRLEY NG CONTRACTOR . . . . . . . : JIA HUO YU LIC # 23446 COMPANY . . . . . . . . . . : NICE & RIGHT CONSTRUCTION INC ADDRESS P ) BOX 2285 CITY/STATE/ZIP . . . : CUPERTINO, CA 95015 TELEPHONE . . . . . . . . : (4)8) 861-0928 FEE ID UNIT QUANTITY .MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BTEMP FLAT RATE 1. 00 62 .10 0. 00 62 .10 0. 00 EPERMITFEE FLAT RATE 1. 00 38 .37 0. 00 38.37 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 100.47 0. 00 100.47 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 100 .47 MC --------------- TOTAL RECEIPT 100.47 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 103 UFER 304 ROUGH ELECTRICAL CITY OF CUPERTINO TEMP POWER CUPEkTINO PERMIT APPLICATION FORM Dia� APN# 2 ,L�D56 Date: T (� a Building Address: e-tc-� -v.o 0L Owner's Name: Phone#: Sin 9 ye ;I 4-- - ' o Contractor Ph ne: License#: Contact: Phone: fCupertino Business License#: v� " 0 Buil ing Permit I fo: Elect ❑ Job Description: Residential ❑ itonunercial ❑ Cost of Project: vd Qty. if Applicable Fee ID Fee Description Fee Group BTEMP Temporary Power ELECTRICAL / EPERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC B.isiness License BUILDING Community Development 10300 Torre Avenue Cupertino CA 95014 low Telephone(408)777-3228 CITU OF Fax(408)777-3333 7UPEVINO Building Department 0-70(p 11t)Z-1 JOB ADDRESS: PERMIT # L� vyt.o, G OWNER'S NAME: PHONE # –v GENERAL CONTRACTOR Q — FAX # I am not using any subcontractors: Siy = - €;nature 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 Tile er/Contractor ature Date