The URL can be used to link to this page

07050076 CITY OF CUPERTINO BUILDING DIVISION PERMIT 259�" BUILD D ESS: PERMIT NO. 9Tf SCOFIELD DR D & D CONSTRUCTION 07050076 OWNER'S NAME: PERMIT ISSUE DATE ENDE WU 1447 HAMPTON DR. 05/09/2007 NE: SANITARY NO. CONTROL NO. BUILDING PERMIT INFO ARCHITECT/ENGINEER: TEMP POWER POLE BLDG ELECT PLUMB MECH 10 00 LICENSED CONTRACTOR'S DECLARATION Job Description m C 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing Z cu with Section 7000)of Division 3 of the Business and Professions Code,and my license is z y in full force and effect n? License Class Lic•M t- Date Contractor ARCHITECTS DECLARATION 1 C< 1 understand my plans shall be used as public records )yU U.H Licensed Professional H OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the Cp O following reason.(Section 7031.5,Business and Professions Code:Any city or county C .V which requires a permit to construct,alter,improve,demolish,or repair any structure prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 iq.Ft.Floor Area t-$ (commencing with Section 7000)of Division 3 of the Businessand Professions Code)or r 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 APN Number Occupancy Type not more than five hundred dollars(5500). ❑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 Required Inspections and Professions Code:Thnse Conuactor's License Law docs not apply to an owner of q p 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 contract 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 contractor(s)licensed pursuant to the Contractor's License Law. ❑1 am exempt under See B&P C for this reason f Owner Date r J WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑1 have and will maintain a Certificate of Consent to self-insure for Workces 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 Workefs Compensation Insurance carrier and Policy number are: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This 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,1 shall not employ any person in any manner!>A o as 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 O CONSTRUCTION LENDING AGENCY (~- ►�- I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097,Civ.C.) LUQ Lender's Name ] Z Lcndees Address U f] I certify that I have read this application and state that the above information is w►'" correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorise representatives of this city to enter upon the Uabove-mentioned properly for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against nE"y C*4) liabilities,judgments,costs and expenses which may in any way accrue against said City G U Z in consequence of the granting of this permit. Date ►'� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL N-POINT Issued by SOURCE REGULATIONS a� Re-roofs Signature of Applicant/Contractor Dare 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 roofs shall be inspected prior to any roofing material being installed. ❑yes ❑No If a roof i s 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? ❑Yes ❑Nu 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Cade,Sections 25505,25533 and 25534.1 understand that if thc building does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements which must met prior to issuance of a Ccrtificateofficcup3acy. Signature of Applicant Date All roof coverings to be Class"B"or better Owner or authorized agent D tc CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT' RECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: Bl}:: Lot: APN . . . . . . . . : 35909009.00 DATE ISSUED. . . . . . . : 05/09/2007 RECEIPT #. . . . . . . . . BS000001260 REFERENCE ID # 07050076 SITE ADDRESS . . . . . : 20641 SCOFIELD DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . . ENI)E WU ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR . . . . . . . ENDE WU LIC # 23939 COMPANY . . . . . . . . . . : D L D CONSTRUCTION ADDRESS 144:7 HAMPTON DR. CITY/STATE/ZIP . . . : SUNNYVALE, CA 94087 TELEPHONE . . . . . . . . : (408) 666-5298 FEE ID UNIT QUANTITY AMOUNT 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 ----------------- --------------- -------------------- CHECK 100.47 5988 --------------- TOTAL RECEIPT 100.47 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 103 UFER 304 ROUGH ELECTRICAL 07 p CITY OF (:UPERTINO TEMP POWER CITY OF .UPEkTiNO PERMIT APPLICATION FORM APN# -- pp — 007. Date: Building Address: / or Owner's Name: Phone#: Contractor: Phone: License#: Contact: Phone:�n�.� Cupertino Business License#: f/l/U �'�_ Building Permit Info: _ Elect (gl Job Description: Residential ® Commercial ❑ Cost of Project: Qty. if Applicable Fee ID Fee Description P Fee Group BTEMP Temporary Power ELECTRICAL EPERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC Business License BUILDING l 049- q1 1. Community Development m 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 "UPEt�TINO Building Department JOB ADDRESS: PERMIT# z 06 0 6,?0,S"0o,7 (� OWNER'S NAME: o-0- c— PHONE# �Q GENERAL CONTRACTOR: E /�) tiL v.,.— I FAX# I am not using any subcontractors: 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 Tile Owner/Contractor Signature Date