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07060089 CITY,OF CUPERTINO BUILDING DIVISION PERMIT �I ' IZ� C)R I� iMTI�N. i BUILT6ffit",S, GATE DR MR & MRS Y T. YAN PERMIT NO. LTJ 4 (j 07060089 . OWNER'S NAME: PERMIT ISSUE DATE MR & MRS Y. T. YAN 06/12/2007 ,ONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 00 LICENSED CONTRACTOR'S DECLARATION 'Z 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description ztLo with Section 7000)of Division 3 ofthe Business and Professions Code,and my license is CONVERT DETACHED GARAGE INTO A SHED !`4 y in full force and effect. �? License Class Lic.# INSPECTOR TO VERIFY LOCATION/PLANNING REQS 3 F a Date Contractor ARCHITECTS DECLARATION U1 understand my plans shall be used as public records ,a o y Licensed Professional a n OWNER-BUILDER DECLARATION j<I I hereby affirm that I am exempt from the Contractor's License Law for the .00 following reason.(Section 703 1.5,Business and Professions Code:Any city or county $!i which requires a permit to construct,alter,improve,demolish,or repair any structure y prior tar its issuance,also requires the applicant for such permit to file a signed statement e` that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 ;iq.Ft.Floor Area Valuation t-$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $100 .. 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 not more than rive hundred dollars(S5W). 3 2 6 3 0 0 3') PanC Y Type ❑1,as owner of the property,or my employees with wages as their sole compensation, 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 Required Inspections 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 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. ❑1 am exempt under Sed B&P C for this reason Owner Date (�-2 '/ty � CH COMPgI ON DECLARATION 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 Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's 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 am: Carrier. Polity No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for anc hundred dollars($100) or less.) I cenifv 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 California.Date Applicant NOTICE-TO A A :1f,after maki isertificate of Exemption,you should become subject to the Worker's( . k on provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. z CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of LY the work for which this permit is issued(Sec.3097,Civ.C.) WC1.A Lenders Name Z Lender's Address U C) I certify that I have read this application and state that the above information is U> "I correct.1 agree to comply with all city and county ordinances and state laws relating to 0 V building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. H a (We)agree to save,indemnify and keep harmless the City of Cupertino against ,.y fA liabilities,judgments,costs and expenses which may in any way accrue against said City V Z inconsequence of the granting ofS this permit. J 2— 7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date C/J— SOUR RE(kULA NS. �� a Re-roofs Signal of ApplicanUContract Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof 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)? C3 Yes All roofs sh 311 be inspected prior to any roofing material being installed. �iJo Will the applicant or future building occupant use equipment or devices which If a roof is i lstalled without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new maG;rials for inspection. District? ❑Yes ❑No 1 havc read the hazardous materials mquimmenis 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 requiremcnts which them t or to issuance ora certifica of Occgupancy. Signature of Applicant Date owi mra�mori,ed-t _� � ' All roof coverings to be Class"B"or better g Date CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN . . . . . . . . : 32630035 . 00 DATE ISSUED. . . . . . . : 06/12/2007 RECEIPT #. . . . . . . . . : BSC00001626 REFERENCE ID # . . . : 07C60089 SITE ADDRESS . . . . . : 20846 GARDEN GATE DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER MR & MRS Y. T. YAN ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : YI7ON YAN CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY MR & MRS Y. T. YAN ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 100 .00 83 . 16 0 .00 83 .16 0 . 00 BSEISMICRE VALUATION 100 .00 0.50 0 .00 0 .50 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 83 .66 0 .00 83 .66 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 83 . 66 1515 --------------- TOTAL RECEIPT 83 . 66 CITY OF C'UPERTINO CUPEI�TINO rr°F PERMIT APPLI[CATION FORM © 0(ot� CPN# on ��� _ � �O.�Jam, Date: 0/, /z--. Building Address: -2 C�F4 -K � �r :Mailing Address (if different from building address): Cwnker's Name .. Phone#: � j ` Cif l L ( o c�� — .� v o Contractor: jr License#: Contact: Phone: ,7>/­�&V Cupertino Business License#: Yra r, t in Fax: Buil ing Permit In o: Bldg ❑ Elect ❑ R umb ❑ Mech ❑ Job Description: ('.,III/ert -� 01d Jv-t<a � /V,w A?C14- c-, fU C4- Residential N r,4 14.Q S C 11 Qd ,. ?Sq.Ft.: cial F] ' a ,zO now Sq.Ft. Floor Area: -PAA -iy�r�4 �t7G��-Zjr1 �crr iYt ,rw�l' Cost of Project: D� Occupancy Group' Type of Construction: Please check this box if the project is a second-story addition: ❑ Project Size: Standard ❑ Large ❑ Major❑ Quantity Fee ID Foe Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to IM Btu MECHANICAL BBOILER4 Boiler > IM to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Cc nstruction Tax BUILDING BCONSTAX Ind/OfFComm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hartel and Motel BUILDING BCONSTAXR Constax –Resi/Mobile BUILDING BELEC 1000 Elec 600V<= l OOOA ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Secs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 acoFCITY OF C'UPERTINO CUEkTINO PERMIT APPLICATION FORM Quantity Fee ID :Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM Nevi Comm Mechanical MECHANICAL—— BNUCOMMP New Comm Plumb PLUMBING BOVERTIME In.>pection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE B Idg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK flan Check Fee BUILDING BPLANCKADD Pla:i Check Add Multi BUILDING BPLANCKREP Plait Check Repeat Fee BUILDING BPREPIPE Repipe Of Fixtures PLUMBING BPSEWAGE c ewa a Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn Sprinkler/Backflo PLUMBING BPSTORM S torm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS M yin Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C _Jnits<= 10,000 cfm MECHANICAL BREMAPPLI J�ppliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT bighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relc Furnace> I OK btu MECHANICAL BREMHEAT Beater Installation MECHANICAL BREMINHOOD Ing tallation of Hood MECHANICAL BREMMISC gisc Apparatus ELECTRICAL BRENINRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Re 3air/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 24 3 CITY OF C�UPERTINO CUPEk INO PERMIT APPL_[CATION FORM Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rindl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN— Vent Fan Sm le Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD S cb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE '.seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Ele,-- Permit Issuance ELECTRICAL MPERMFEE M.-chanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plunibing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Plannin :LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING 3 o1 3