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04070084 - PUB�039� r ` `JJiilr>>i ! rive} - = LJi'=;' FJj ll� file Edit Actions Details Links Favorites Help .0. Permit Information Permit Number' 04070084 Status' L *✓J Master Number ! C�! Notes 0 Project Apply Date 07/16/2004 Operator 'suem Permit Issue Date 09/10/2004 Operator suem Certificate Issued 06/14/2006- Operator _ Certificate Type CO - CERTIFICATE OF OCCUP Certificate Number Permit' Property Zoning Applicant y ContractorDefined-Fields Location Information Address' 10398 PALO VISTA RD City/State/Zip CU PE R T I N O APN 35702049.00 Unit Oa%-ner Entity Ir-ifom-lation Owner Name' DANNYWONG— — Use Default 0 --- ------- Address Home -10398 PALO VISTA RD City/State/Zip CUPERTINO:CA 95014 Permit Details Permit Type' SFDWL-ADD1 (]! 'DO NOT USE Usage Class' iDWL-WHEWJ', DWELLING TYPE 5 WOODNEW Applied Value' 180000 SQUARE FT. 9441 Calculated Value 109277 US C-404 Type 434 ADD: RESIDENTIAL Permit Form' A( UTOPERM - PERMIT Ownership 1 -Private Project Size 'ermit issued 0911012004 nter permit status Purpose/Special Conditions 95014 _ ADDITION/REMODEL(BATH/ENTRY) 944' MATERBEDRM/BATH 08/24/04 ADDRESS CHANGED FROM 10394 TO 10398 FILMED 2011 10Add Default T Y [U.4 0 K 4a Back 49r;1 Contractors Fees Plan R eviews Inspections Print Permit aAdjustments lA Holds Cam] Copy Permit 0 Close Permit Overrides f !�" Supplemental Fields 1 h!l N otes l Iti, Attachments yyAJ�oo <VZU n�Z 3yU SOS anyt zCoOpE� X2 WrN L CITY OF CUPERTINO * a ��lXi BUILDING DIVISION PE qfi BUILDING ADDRESS: PERMfr NO 04070084 103 OWNER'S NAME: PERMIT ISSUE DATE DANNY WONG PHONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70(I)) of Division 3 of the Business and Professions Code, and my license is in full force and effect- ADD I T I ON /REMODEL BATH License ClassLic. N Date Contractor ( / ENTRY ) 944 ' MATERBEDRM/BATH ARCHITECTS DECLARATION 1 understand my plans shall be used as records 0 8/ 2 4/ 0 4 ADDRESS CHANGED FROM 10394 TO 10398 Licensed Professional OWNER -BUILDER DECLARATION ' I hereby affirm that 1 am exempt from the Contractors License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county 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 that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of 1 8 0 0 0 0 APN Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than rive hundred dollars (S500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, . Required ired Inspections will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Conuactor's License Law does not apply to an owner of q p property who builds or improves thereon, and who does such work himself or through his own employers, provided that such improvement 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 k). as owner of the property, am exclusively contracting with licensed contractors to truct the project (Sec. 7044, Business and Professions Code:) The Contractor's Li- cense Law does not apply to an owner of property wh9q,�6urIds or improves thereon, and who acts for such projects with a contractor(s) IicAsed pursuant to the Contractor's Licen w. ❑ I am exem rider Sec , B & P/C fthis reon ~o O v Owner r Date ` ORKER'S CO EN9ATION DEC - RA I hereby affirm under pen ly of perjury one oLUnt fo owing declarations: ❑ 1 have and will maintain a.Certificate of Consent t Olf-insure for WorkcesCompen- sation, as provided for by Section 3700 of the Lab r Code, for the performance of the work for which this perm if is issued. ❑ 1 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 Worker's Compensation Insurance carrier and Policy number are: Cartier: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Crhis 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, I shall not employ any person in any manner so at to become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT:If, after making this Cenificate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Codc, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 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.) Lender's Name . Lender's Address 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 slate laws relating to b ding con,wc ion, and hereby authorize representatives of this city toenter upon the oho -mentioned property for inspection purposes. e) agree to save, indemnify and keep h ess the City of Cupertino against liabilitl ,J gments, costs and expenses which ma rn any way accrue against said City / in conseq trice of the granting of thi permit. v APPLI UNDERSTANDS A D WILL OMPLY WITH A L NON- INT (/ Issued by: Date " SOUR E t38LATIONS. n a p C' / /C Li ' /(` Re -roofs r V 7 Si lure of Applicant/Conlract6r � -"�D HA2ARDe0US MATERIALS DISCLOSURE Type of Roof Will the applicant or Ilrturc building occupant store or handle hazardous material as defined by the Cupertin6 Municipal Code, Chapter 9.12, and the Health and Safety Code, Section 25532(a)7jn �J. All roofs shall be inspected to any roofing material being installed. prior If a roof is installed without first obtaining an inspection, I agree to remove Will the appli�ant or future building occupant use equipment or devices which emit hazardous air cone smin nts az cfrned by the Bay Area Air Quality Management all new materials for inspection. District? 0, es o I have read the hazardous materials requiremAs under Chapter 6.95 of the Califor. nia Ith&SafetyCode, Sections25505,25533 d2,5534.1understand that ifthe building d no currently have a tenant, t it is my ponsihility to notify the occupant of the re sire nts which must be met p 'or w issu ce offtancy. Signature of Applicant Date �f,cateo I/ All roof coverings to be Class "B" or better .AWncrorauthorixcdagcnt ,' D te an-P., CITY OF CUPEkTINO WITY OF CUPERTINO* PERMIT APPLICATION FORM 6�iD�f�O$Y APN # 3 y7 , 0 2 O Date:q- Building Address: Mailing Address (if different from building address): toad 1o3�(q- �a(o 11�s�'a, Owner's Name: Phone #: -1,+1 -- 193 2 aOu otJ 408- Contractor: License #: Contact: G , T A5606 i.a.7'E S Phone: t) -21c,3 Too Cupertino Business Licenset CMAIIPI1 r-_S ?. Fax: .210 o Building Permit Info: Bldg C91"' Elect QK Plumb CsY Mech C� Job Description: cr-i44. 562 rzT. Apo lT►ow Tc �`l Residential [� S 1 PJk�E 3To ►Z u Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: 6i4+ sQ Cost of Project: i 8a, o00 - Occupancy Group: 4+ g. 3 Type of Construction: v Please check this box if the project is a second -story addition: ❑ Project Size: Standard QK Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax - Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3