The URL can be used to link to this page

10020144 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10640 FLORA VISTA AVE CONTRACTOR:CW BUILDERS PERMIT NO: 10020144 OWNER'S NAME: CHENG-YU LIN&STEPHANIE PENG P O.BOX 3206 DATE ISSUED:02/25/2010 qE 'S PHONE: 5103645098 S.IRATOGA,CA 95070 PHONE NO:(408)378-4323 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F_ ELECT PLUMB r License Class t Lie.# R2_63 0 � MECH r— RESIDENTIAL r COMMERCIAL� Contractor CL„ ) D6(1Ae),S Date L� JOB DESCRIPTION:TEMP POWER POLE;**CW BUILDERS RNWD BUS LIC** I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$250 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:32608039.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Z 2.1--r 0 with all non-point so ce regulations per the Cupertino Municipal Code,Section Issued bye 'T �— Date: 9.18. Signature Date RE-ROOFS: [3 OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is nstalled without first obtaining an inspection,I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of nspection. the following two reasons: 1,as owner of the property,or my employees with wages as their sole compensation, signature of Applicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A”OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Sections 25505,25533,and 25534. 1 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 Worker's Owner ed a t: Compensation laws of California. If,after making this certificate of exemption,I Date: become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save mify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. Lwilthnon-point regu ons per the Cupertino Municipal Code,Section Licensed Professional e Com- Date Z f V CITY OF C'UPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32608039 . 00 DATE ISSUED. . . . . . . : 02/25/2010 RECEIPT #. . . . . . . . . BS000009831 REFERENCE ID # . . . : 10020144 SITE ADDRESS 106.10 FLORA VISTA AVE SUBDIVISION . . . . . . CITY CUP:73RTINO IMPACT AREA . . . . . . OWNER CHR\TG-YU LIN & STEPHANIE PENG ADDRESS 10610 FLORA VISTA AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM CHARLIE WU CONTRACTOR CHARLIE WU LIC # 25285 COMPANY CW BUILDERS ADDRESS P.O.BOX 3206 CITY/STATE/ZIP SARATOGA, CA 95070 TELEPHONE (408) 378-4323 FEE ID UNIT QUANTITY PMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- 1BCBSC VALUATION 250 .00 1. 00 0 .00 1 . 00 0 . 00 1BSEISMICR VALUATION 250 .00 0 .50 0 . 00 0 .50 0 . 00 1EPERMITFE FLAT RATE 1 .00 42 . 00 0 . 00 42 . 00 0. 00 1ERT<200 UNITS 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1 . 00 42 . 00 0 .00 -----42_00 ------0_00 -- -------- ---------- TOTAL PERMIT 127 .50 0 . 00 127 . 50 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ----- CREDIT CARD 127 .50 VISA --------------- TOTAL RECEIPT 127.50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -- 402 TEMPORARY POWER CITY OF CUPERTINO RECEIPT NUMBER: BS000009832 RECEIVED BY: PATRICIAG PAYOR: CHARLIE WU TODAY' S DATE: 02/25/10 REGISTER DATE: 02/25/10 TIME: 16 : 00 1 BUSINESS LICENSE TAX RNW CW BUILEERS $114 .00 ---------------- TOTAL DUE: $114 .00 CREDIT CARD: $114 . 00 REF NUM: VISA TENDERED CHANGE $114 . 00 $ .00 4 If CITY OF CUPERTINO TEMP' POWER CUPEIkTINO PERMIT APPLICATION FORM APN # Z � F1 7 a � Date: Building Address: o/_�0 F10 V( S h 11 r Owner's Name: Phone #• 51 06�-5- e>t Contractor: Phone #:(q_08),3go Fax #: Contact: I Phone #: / r Contractor License #: 82-63e! Cupertino Business License#: Job Description: ��iL�� (-� `r �ti J.� �'1 Residential Commercial Valuation(cost of project): Z S-.� Type of Constructio . N/X Quantity Fee ID Fee Description Fee Group Permit Type I ERT>1 K Res. Temp Power>I K E IREAPI4 Amps / I ERT<200 Res. Temp.Power<200 E Amps 1 ERT2001 K Res. Temp Power 200-1 K E Amps IEPERMITFE Electric Permit Issuance E 1 ELCPLNCK Electric Plan (;heck E 1BCBSC Cal Bldg Stan iards B ALL PERMIT Commission Fee TYPES 113SEISMICR Seismic Residential B 1TRAVDOC Travel & Doc-imentation B Fee Revised 01/07/09 Community Development 10300 Torre Avenue a „, Cupertino CA 95014 7' go Telephone(408)777-3228 CITY OF Fax(408)777-3333 :UPEkTINO Buildiia Deartment JOB ADDRESS: PERMIT # OWNER'S NAME: G eh L� ^ PHONE # �� 310 --3 8 0 GENERAL CONTRACTOR: Ci,,,) U r/cl:1-1 FAX # $ 3 &-Lf3.i I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSIrfESS 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 2-12 jj/ Owner/Contractor Signature Date