08070199 (3) CITY OF CUPERTINO
BUILDING DIVISION PER NIIT ,,, ONTRACTORINFORMATION :
BUILDING ADDRESS: - PERMIT NO.
20860 DUNBAR DR BEST HOME SUPPLY CORP 08070199
OWNER'S NAME: PERMIT Imtc DATE
CATHERINE LIU 7335, 'BOLLINGER RD STE D 08/05/2008
PHONE SANITARY N0, CONTROL NO.
(408) 255-4088
ARCHTTECITFNGINEEIC -- BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
o p LICENSED CONTRACTOR'S DECLARAnON lob Description
w 1 homily in.mat 1 w ler moed under pmvtiaes of Chapin 9(mmmmring'
with Seetion 70oo)or oiddon 3 of dm Bodo.mdPmfessmnseaee;wmylimtau 'REVISE HIP SIZES FM 12"DP TO10"DP SEE 2&CALC . S &
I.left LC1.vnurgr.
ic. Le.a REVS - SME FLR BMS FM 16"DP TO 11
Dam ARCHITECTS MRAMON 1/4"DP(ORG#07100207)BUT PLS—SEE CALC SHT 8 TO 14,
k< 1 undoimd my Plus shall be used a public moteds:
ryU
LL
U. d PNfCSS1nnBI
t0 OWNER-BUILDER DECI:ARAnON
1 hereby Nm,met 1 in mempt from the Crhm n a IJems Law fin me
O O following m'.on.(Seetion 701_5,Butiocst and Prolemom Code:Auy-CkY m county.
1$ which q.i.a permit m Marum Wes.imprmm,d.W W,Or impair my Momme
.Zr priwm ii,inuanu.alsore9uims the applium fwsuehpwmitulfilessilredmilemem
as< mat heit,licensed pm>vantmthe pmhs°morthe Commutes Lkm=Lw(aar=9 ' Sq.FL Floor Area Valuation
%1- (commendngwithSection70DO)ofDivision3oftheBusiwssandProfemvnsCode)w $0
.RE mat he iserompL thmrlsmu and me hem,for the alleged-empdon.;AOY Wolin of
Seen.7031.7 by airy eppImmt for a pomp Wbjem the app0unt WIN dVO pmalry ofNumber Occupancy Type
two mom than ftw hundred dNlis(SSW). 3 2 6 3 014 4 .'17'11'
❑L i vwmr°r the pupoty,m is o°ploym Nm avagu u tbebsvlammpewBw,
id dofimod.k and'hem"""'cis"°`intended°r--doter mot
a(Sre.701"•9"a°ea Required Inspections
-- and eny wh obu Cede The Cwouimr'a r^"+4w mh rm appy to rL awno os q P
owo employ m.pruorid me,M t,impoamormig penormho de hlmffered hrmgE his '
it on.meboprovidedtbiacre ML is semwitire nW BroodedoeoBered Wsale I.
hwwesa,in
ngwde,or erwuatb mldwlthbowyess of muomfor lbmpmea t
buildo velli haw me bardm of proving m.t be died not build w boprove for proposed
Zula).
1.a owriw of the Property.Me m e3w"ely metertaft with B®sed mmmms m. -
wwooet mm pmjm(Sec.7060.Business and Pralmai°m Cade)Tie Comrvom's Ur_
comm Law 6.vat Will to M owner of Property who bdma w hoprorei memo.'mg',
who conn ree such pojc=Nm a conaren°t(s)Harmed pins..,m the Conti emoo,
Liamom Law. �'•
QIin merypI.. See. `.B&Pecrorm4trea�lm
Ownv /lam/•LLA.Gr�_/7� 2 (A Die'931vL=
WORKER'S COMPENSATION DECLARATION
1 hereby afrum under penally of perjury me Of the following meet d
r °tac'
Ihs.e and w0i muntaiva Certificate ofCm¢"Ibeer(-ImipefaWw4YsCmnpem -
utim a provided for by Section 3700 of the Labor Code.fm the perfoimmme of the
work for which mis Permit k iiucG
❑1 hoe and will monomer,Wwbrfs CamPMW W Iomrsee.a mgtdmd by Smdm .
3700 of the Labor Code,for me pedarmavm of mm odic fwwhich this pomit Is's—,(
My W°rtr,.oonpematl°o lneormee unio and Pullry number
Crrrimr. P91ky No.:
CERTIFICATE OF E)(E2MP ION FROM WORKERS
COMPFNSAION INSURANCE
(This sed.rowd not be mmpkied tithe Permit Is fame h&Woul dollin(51010
or less)
I ClNofy mi in me Performmm pf the work for which rola permit u bleed l Wdl nm
CenPmy Ny'..in mY ma"nermi l°brrnme , lh Wwlvd.Compe.Wm
mo .
Ieim' , - Y
Applimnr
NOrICE7V n W the Wolt If,after making mil vWm of°r Fitbor Cod you Wmld
boomm subjm m me Mch Miow..Or
pmvlsi a b the labor Code you thou
�O foMwim comply with web prvvisiom w mu pemait khW be demoted!rernkr6
CONSTRUCDON LENDING AGENCY,
e+.. I hereby afrum dm mere u a conurutsim lending agony For the poforman¢of
p,'>
the work for which this pimp Is issued(sec.3097.Cb.e) .
WM Q I<ndels Name _
L
0.z cr dines Md. .
U 0 1 amdfy mat I haw rad Ws aPPHcadm and lino mi the above INwmdm b
gL P correct 1 Agee m comply with all miry and cooety mdinii es end ewe bn wring m
0 U building eonsuuction,and mreby aum°rum mpremtuhce;ofthk city In roto upon me
above-mmu°nd property for, m
inspeeuo"Purps
WM
(We)Aga ro ase,indemnor and kcP Imemlet the City of Cumnieto agAioss
,t Habili0ujdgmenu.cn^•and upeme which may in anyway Ante Agahw mid City
U z in conwgwau of me gcanung of roil pvmlt , •- 7
APPLICANT UNDERSTANDS AND Wnl:COMPLY.WITH ALL NON-POINT Issued by: Date —,f •—G/'
SOURS EG
jt:::� es?-'-&6" Re-roofs
Nisrumem of ApphuDau
HAZARDOUS
J
xAZARDOnOus MAMATERIALSNDISCLOSUREType of Roof
Win the'Pli.,err forum bulltlbg oet"psnt vorm w boodle hmmmor mravow
m defined by me Cupertino Mmiapal Code,Chapter 9.12.and the Health and Safety
Code.Seoion 25532(07 All roofs shall be inspected prior to any roofing material being installed.
❑Ye /6Na
Win rite Applicml or vending omrpanE use egUiPmett w�which If a roof is installed without fiat obtaining an inspection,I agree to remove
emir hwardnw air contamineeM a denied by me BsY Ase Ab QlwsirY.Mmagcment all new materials for inspection.
Disuia7
❑Ye r�Nu
1 have read me h%vrdousJTmiiia(smuimmwsmdofbaprv695of con Glifw-
nia Heolm&SafmyCcd-,Scnlam 75505,25533 a425534:ludriWnd miVmc building
duo net c dy hoc a rmmt thi it b my repwtsmilitY ro ddfY me s¢upant or me - - -
rcqu'ryrr which to met r:W .Codfeic of Occvitorey .Signature of Applicant Date
�6� All roof coverings to be Class'%W'or better
T
[�wrp ° err acv_ agem Date
o�o7 D/ 19
I am, CITY OF CUPERTINO
CITY OF
CUPERTINO REVISIONIDEFERRED
PERMIT APPLICATION FORM
APN # f^ Q yl I / i / 00 Date:
If/JV "� 7
Original Permit #:
Building Address:
as &-6o Dun , GA
Mailing Address (if different from building address):
Owner's Name: Phone #:
eATNTRJ;,VX 2- C
Contractor: Phone: r1
L' . O�, ri Fax: 7�/y
Contractor License
Cupertino Business License #: Z u o v 2 G _ 01'2—
Contact:
2Contact: Gds Phone:
` Fax:
Building Permit Info:
Bldg Er"""
Elect ❑ Plumb ❑ Mech ❑
Residential Commercial
Job Description:
4,� rs� -ter rs HIF sL2F-S �vll t2Z' I�7-�P -ro�� I�� �f fr 5tf,�
2. R�vlszr <ioM9 r4-ool2 R�6S pfwM 1E" Pa9r Iv I I44 pzar, V�f-r wIDEP- _
f �aSE 5 Z- 4. 5H�-Z-Tgro44- PEU- 2, r zoot7,,G
Isthe project in the Wildland- Urban Interface Fire Area? Yes ❑ No
Type of Construction (Usage Class): * Occupancy Type:
1-A, I-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B
Valuation (cost of project):
Project Size: Express Er Standard Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it
to the application or if applicable, include in plan set & the sheet index.
Points Achieved:
For help, contact Build it Green at ww•w.buildit reen.or
Revised 6/16/08
CITY OF CUPERTINO
ITEM 1 OF 1 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Tv A: Rng: Sub: Blk: Lot :
APN . .. . . : 32630144 . 00
DATE ISSUED: . . . . . . : 07/28/2008
RECEIPT #. . . . . . . . . : BS000005609
REFERENCE ID # . . . : 08070199
SITE• ADDRESS . . . . . : 20860 DUNBAR DR
SUBDIVISION,. . . . . . ..
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA` . . . . . . :
OWNER CATHERINE LIU
ADDRESS' . .- . : 20860 DUNBAR DR
CITY/STATE/ZIP ... . : CUPERTINO, CA 95014
RECEIVED-FROM . . . . : CATHERINE S LIU
CONTRACTOR REX C. LIU LIC # 27000
COMPANY . . . . . . . . . . : BEST HOME SUPPLY CORP
ADDRESS . . . . . . . . . . : 7335•'BOLLINGER RD STE D
CITY/STATE$ZIP �: . . : CUPERTINO, CA 95014
TELEPHONE ('408) 255-4088
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- -------=-- ---------- ---------- ---------- ----------
].REVSFDWL EACH 1 .00 734 . 00 0 . 00 734 . 00 0 . 00
TOTAL PERMIT 734 . 00 0 . 00 734 . 00 0 . 00
METHOD OF PAYMENT , AMOUNT REFERENCE NUMBER
----------------- --------------- -------- ----
CREDIT CARD 734 . 00 VISA
------------
TOTAL RECEIPT 734. 00