The URL can be used to link to this page

09030223 - PUB)223 4001 . 2y�t =ile Edit Actions Details Links Favorites Help �� is � ,�, �► ��' :'•'� �? Permit Information Permit Number" 09030223 Status " Closed' Master Number Z Notes 0 Project CCU Apply Date" 03/30/2009 �, Operator patg Permit Issue Date 03/30/2009 Operator patg Certificate Issued 10/20/2009 Operator PALM-� Certificate Type Certificate Number Permit " Property Zoning Ii Applicant I, Contractor " l� Defined Fields Permit Details Location Information A Address " ! 1173 CRESTLINE DR - - CitylState/Zip,CUPERTINO I ® 95014 APN 36229041.00 Unit Ok-wier Entity Information Owner Name " SU-ER SYANG Use Default ❑ Address Home 1173 CRESTLINE DR City/State/Zip `CUPERTINO CA 95014.5034 —1 Permit Type" 11R3SFDREM R SINGLE FAMILY DWELLING REMODEL Usage Class " II/lll B, [ ,IIIIII B, IV-HT,V-B NEW 1 Applied Value % L- 3000] SQUARE FT. 430 Calculated Value Q US C-404 Type 434 ALT: RESIDENTIAL Permit Form " JAUTOPERM - PERMIT v� Ownership 11 - Private Project Size EXPRESS - EXPRESS Purpose/Special Conditions RMDL(E)KTCHN(200SQ),CONVRT PRT FAMRH TO 4TH BDRH&P,LOCT LAUNDRY(230SQ) STRUCTURL FILMED- 20111 Add Default T v V OK @ Back In Contractors lW Fees �,, Plan Reviews ly Inspections Print Permit IFIAdjustments �f Holds l Copy Permit l0 Close Permit (Overrides Supplemental Fields j Notes 1 [EgAttachments 'ermit issued 0313012009 'f Inter the purpose or any special conditions for this permit CITY OF CUPER'11NO x BUILDING DIVISION PERMIT i BUILDING ADDRESS: 1173 CRESTLINE DR TBD - OWNER'S NAME: .TTN-M N SYAT`TC PHONE: ARCHITECT/ENGINEER: u O ZO LICENSED CONTRACTOR'S DECLARATION i; I hereby affirm that I am licensed under provisions of Chapter 9 (commencing With Section 7000) of Division 3 of the Business and Professions Code. and my license is y in full force and effect 2 r+R' ? License Class Llc. N nF Date_ Contractor y ARCHrIEcTS DECLARATION 1 understand my plans shall be used as public records �a. u. y Licensed Professional O < OWNER -BUILDER DECLARATION yr �t � !hereby affirm drat 1 am exempt from the Contractor's License Law for the O O following reason. (Section 7031.5, Business and Professions Code: Any city or county K m which requires a permit to construct, alto, improve, demolish, or tepair any structure u Z r prior to its issuance, also requires the applicant for such permit to file a signed statement = C that he is licensed pursuant to the previsions of the Contractor's License Law (Chapter 9 h (commencing with Section 7000) of Division 3 of the Business and Professions Code) or y 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 Lo a civil penalty of not more than five hundred dollar (M). ❑ I, as owner of the property, or my employees with wages as their sale compensation, will do the work. and the structure is not intended or offered for We (Sec. 7044, Business and Professions Code The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his awn 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 salQ ). aP ', as owner of the property, am exclusively contracting with licensed contractors to concoct the project (Sec. 7044. Business and Professions Code:) The Contractor's Li- cense taw does no ly to an owner of proy who builds or improves thereon, and who contracts for su¢ projects with a contrac s) licensed pursuant to the Contractor's License Law. ' ❑ 1 am exempt tan r Sec , B & P C fo) th' rcuo owner _ Date ) d I hereby affirm under penalty of perjugone following dec(arado-/ ❑ I have and will maintain a Certificate of Consent self -insure for Worker's Compen- sation, as provided for by Section 3700 of the Labor Code, far the performance of thci 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 Worker's Compensation Insurance carrier and Policy number am: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu section need not be completed if the permit is for one hundred dollars (S100) or less) I certify that (n the formaRce f th c for which this permit is issued. I shall not employ any pennon i ray mach m ccomc subjec the Workers' Compensation Laws of California. ate 777 Applicant NOTICE TO AP � .ale lhta Ce '*arc of Exemption, you should become s, c Workers Compe n prov io of the Labor Code, you must .J O forthwith comply with such provisions or peon t s 1 be deemed revoked. z 0 CONSTRUCTION LENDIN AGENCY H .-r I hereby affirnn that there is a construction lending agency for the performance of tY. the work for which this permit is issued (Sec. 3097, Civ. C) QLenders Name 0. z Lenders Address U O 1 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 to 0 n CF.) building cocoction, and hemby authorize representatives of this city to enter upon the W shove-memoned property for inspection purposes. CL (We) agree to save, indemnify and keep harmless the City of Cupertino against nF,.t rn liabilities,judgmen costs and expenses hich may in any way accrue against said City U Z in consequence of granting or this it ►� APPLICANT U STANDS AND ILL COMPLY WITH ALL 1,17 I SOURCE REGU TIONS, 11 ` D Signature of pl t/contractor Lmic HAZARDOUS] DIS OSURE Will the applicant or future build occupant sto or handle hazardous material as defined by the Cupertino Mum pal ode. Chapter .12, and the Health and Safety Code, Section 25532(a)? ` ❑ Yes 1Q no Will the applicant or future building occupant use equipment or devices which emit havardous air con tamin anis defined by the Bay Ama Air Quality Managcmcni District? ❑ Yes No BE DETERM PERMIT NO. PERMIT ISSUE DATE Job Description CONTROL NO, BURRING PERMIT INFO BLDG ELECT PLUMB - MECH RMDL(E)KTCHN(200SQ),CONVRT PRT FAMRM TQ 4TH BDRM&RLOCT LAUNDRY(230SQ);NO RE-RF;DO HAVE STRUCTURL Sq. Ft. Floor Area Valuation 30000 APN Number Occupancy Type 36229041.00 Required Inspections Issued by: Re -roofs Type of Roof Date �= All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. I have read the by ors materials mqui cots emdcrChapler6.95 of the Califor- niaHealth&SafetyCade, 'ors 25505, 23533 25534. I understand that dthe building does not currently have almani.. that It is my reonsibilfty to notify the occupan ' f th requirements which inmet prior to issu of a certifies pf Occvpan . Signature of Applicant . M— it / Date Owner or All roof coverings to be Class "_ ' or better