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09040026 CITY OF CUPERTINO BUILDING DIVISION PERMITdl' TR�► CTMtTIQiN' _.. PERMIT NO. BUILDING ADDRESS: 7534 RAINBOW DR ZHAO EL=ECTRIC CO 09040026 PERMIT ISSUE DATE OWNER'S NAME: PFT T TTAT'- rT4AT\TG S2899 A CONTROL NO. -ONE: (415) 867-9710 BUILDING PERMIT INFO ARCHITEC IENGINEER: BLDG ELECT PLUMB MECH u p p LICENSED CONTRACTOR'S DECLARATION Job Description C I hereby affirm that I am licensed under provisions of Chapter 9(commencing U Z m with Section 7000)of Division 3 of the Business and Professions Code.and my license is UPGRD E SEC SVC TO 200 AMP y in full force and effect i DMZ License Class Contractor Dale ARCHITECTS DECLARATION Cd< 1 understand my plans shall be used as public records D0. to yLicensed Professional n 0, , OWNER-BUILDER DECLARATION 1 hereby arm that 1 am exempt from the Contractor's License Law for the o o affirm following reason.(Section 7031.5,Business and Professions Code:Any city or county ,%g 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 Ft.Floor Area Valuation C that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 S(1 F $ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $1600 y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by airy applicant for a permit subjects the applicant to a civil penalty of APN Number not more than fire hundred dollars(M). 36611044 . 00 0 I,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:The Contractor's License Law docs 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 ksa J. I,as owner of the property,am exclusively contracting with licensed contractors to co ttuct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law docs not apply to an owner of property who builds or improves thereon,and. who contracts h projects with a contracto licensed pursuant to the Contractor's License 0 lain a empt nder .B&P C for this reason Owner Date v WORKER'SZCPENSADECLARATION I hereby affirm under penalty of perjury one of the following declarations: :have and will maintain a Certificate of Consent to self-insure for Workers Compen- -aon,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,as required by Section 3700 of the labor Code,for the performance of the work for which this permit is issued. My Workees Compensation Insurance carrier and Policy number arc: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not bo completed if the permit is for one hundred dollars($100) or less.) 1 certify that in the performance of the wor r which this permit is issued,1 shall not employ y person y manncrp as to me subject to the Workers'Compensation Laws oNalifornif Or. Applican NOTICE A LICANT:1 a is Certificate of Exemption,yo should become subj to the Worker's Compc provisions of the Labor Code you must ,J`j.., forthwith com ly with such provisions or s permit shall be deemed revoked. Z O CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of p;.7 the work for which this permit is issued(Sec.3097,Civ,C.) W A Lender's Name ►7 z L.endees Address U 0 1 certify that I have read this application and state that the above information is f7.►" correct I agree to comply with all city and county ordinances and stale laws relating to 0 V building construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. a (We)agree to saw,indemnify and keep harmless the City of Cupertino against HLo) liabilities,judgments,costs and expenses which may in any way accrue against said City (�z in co c of the granting of this Parini Date Pte! AP ICANT DERSTANDS AID W COMPLY WITH ALL NON-POINT Issued b;: SO RCE)!GU ATIONS. f Re-roofs Signat fApplicam/Contrac r Dare Type Of]ZOOf HAZARDOUS MATE L S DISCLOSURE 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(x)? All roofs shall be inspected prior to any roofing material being installed. OYes O If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which it hazardous air contaminants as defined by the Bay Area Air Quality Management all new r Taterials for inspection. ,trice? 0 Yes No 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia afcty Code,Sections 25505.255 25534.1 understand that if the building d not currcn aw a tenant at it is y ponsihility to notify the occupant of the yuircmen whit must be m prior to ante of a certificate of Occupan . V Signature Of Applicant Date All roof coverings to be Class'j!"or better O .r authorized agent Datc C)q0L4C�� CITY OF ..UPERTINO CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM Date: Building Address: ` ,� i N , C-- Mailing Address (if different from building address): Owner's Name: Tl- 21,,E C- ark Phone#: (4 t,j)) 1 t- - —6 n 9� HOA: (Exterior work only) Yes ❑ No If yes, provide letter from HOA Contractor: Phone: S - ZHAO -6:) r-C'TPtC Gtr, Fax: Contractor License#: 6 g t 6 g Ll Cupertino Business License#: Contact: , I Phone: 46 �') �� p cl 6 Fax: Residential Commercial ❑ Job Description: -o- (ed-rflc -<,erVl'CQ -/v Building Permit Info: Bldg ❑ Elect kr Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: I-A, 1-B ❑ II/III/V-A ❑ IVIII B, IV-HT, V-3 [- - '-3 Valuation: Square Footage: bD Project Size: Express [!r—Standard ❑ Large :1 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. 'loints Achieved: For help, contact Build it Green at www.builditgr�!en.or Revised 02/05/09 aRx CITY OF C-.UPERTINO CITY OF GENERAL BUILDING APPLICATION CUPEkTINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1STUCOAP Stucco A3plications (up to 400 sf) B additional stucco application 1 WINREP Replacement windows/sliding glass B door (ea 8 windows) 1WINMEWSTR New Window-structural shear B wall/mas-)nry (includes plan ck fee) 1 EPERMITFEE Electrical Permit Fee E 1 MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbing;Permit Fee P I ELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M 1 PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B when not over counter) hourly-st ind alone 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1 BSEISMICR Seismic 1Zesidential B 1BSEISMICO Seismic Commercial B 1TRAVDOC Travel & Documentation B i 1BUSLIC Business License B 5 of 5 Community Development 10300 Torre Avenue kj-' ,; Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 r,UPEkTINO Buildin Department JOB ADDRESS: �aGC pr�;� SQY t� ,� PERMIT # OYo0 2� OWNER'S NAME: PHONE # q-D - GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and corn_ lete the following information: SUBCONTRACTOR BUSI:vESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical z Hyo -E-L'C-cTR I C 61), 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 ' e Z� Owner/Contractor Si tore Date