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05040069Permit , ,CUPERTINO File Edit Actions Details Links Favorites Help Permit information Permit Number " 05040069- Status" jE-Expired Master Number Notes Project -- Apply Date" `04/12/2005 Operator Permit Issue Date 06/23/2005 Operator Certificate Issued Operator Certificate Type Certificate Number 0 l4I conniew conniew Permit " Property 11 Zoning ` Applicant Contractor ' Defined Fields Permit Details Permit Type x Usage Class , Applied Value SQUARE FT - Calculated Value US C-404 Type Permit Form 0 wnership Project Size SFDWL-ADD1 FDO NOT USE DWL WNEW [CQI DWELLING TYPE 5 WOODNEW 140000, 616 71308 (1 1434 ALT: RESIDENTIAL AUTOPERM -PERMIT j 1 - Private .410 Permit issued 06/2312005 Enter the purpose or any special conditions for this permit v Location Information Address " 6432 MYRTLEWO0D DR City/State/Zip CUPERTINO - —� ® 950 44 APN 36920023.00 Unit C k,wier Entity Information Owner Name " JAMES LIN Use Default Address Home - City/State/Zip CUPERTINO CA 95014-4626 v Purpose/Special Conditions ADD 616' (MS BEDRM/RELOCATE GARAGE) REROOF EXPIRED FILMED-2011 Add Default Text rV7 O K ) [ Back In Contractors Ir.4 Fees 14 Plan Reviews 1,01 Inspections Print Permit lAdjustments J Holds Copy Permit 10 Close Permit Overrides Supplemental Fields 1 Notes ICirJ Attachments DVP r1 sh UXOO !UZ nQy j y�Z o: � 9WL i u, f— O N� CC km�+ y"v -2a z*=`C CITY OF CUPERTINO a s xC�T�tACTbt1t3 lTI�1... BUILDING DIVISION PERMIT BUILDING ADDRESS: COLOA CONSTRUCTION, INC PERMIT NQ,U 5 0 4 0069 6432 MY OWNER'S NAME: PERMIT ISSUE DATE JAMES LIN 1671 CANYON VIEW DR_ 0612-1/2005 PHONE: SANITARY NO. CONTROL NO. (408) 891-2449 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Dlv' on 3 of the Business and Professions Codc, and m license is in ran rote and effect- '7 License Class Lle. A f ADD 6161 (MS BEDRM/RELOCATE GARAGE) Date Contractor REROOF ARCHITECTS DECLARATION I understand my plans shall be used as public records 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 V"*D 0 0 0 (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 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 ($500). 36920023.00 ❑ I, as owner or the property, or my employees with wages as their sole compensation, Required Inspections will do the work and the structure is not intended or offered for sale (Sec. 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of properly 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 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractor's Li. cense Law does not apply to an owner of properly -who builds or improves thereon, and who contracts for such projects with a contracior(s) licensed pursuant to the Contractor's License Law. C]1 am exempt under Sec. , B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a Certificate of Consent to self -insure for Workers Compen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain Workers Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers Compensation Insurance carrier �Policy number am. raand Carrie5 pSZ� �S"Poli"cy'No.: G I CER71FICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (f 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 as to become subject to the Workers Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. I CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a concoction lending agency for the performance of i the work for which this permit Is issued (Sec. 3097, Civ. C.) ' Lenders Name - Lender's Address j 1 certify that 1 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 building construction, and hereby authorize representatives of this city to enter upon the zj above -mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against p,�.—�,a• liabilities, judgments, costs and expenses which may in any way accrue against said City v ' in consequence of the granting of this permit. �4J ' APPLICANT UNDERSTANDS AND WI COMPLY WITH ALL NON -POINT SOURCE RE TIONS. / Issued by: Date �� 4/ aJ 1 Re-roofs SignatuK.of`Applicant/Conuactor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof 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(a)? All roofs shall be inspected prior to any roofing material being installed. C] Yes C] No If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use pp g p equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District, ❑Yes ❑No 1 have read the hazardous maicrials requirements under Chapter 6.95 of the Califor- nia Health & Safety Code. Seedons 25505, 25533 and 25534.1 understand that if the building does not cu rely have a tenant, that it is my responsibility to notify the occupant of the requirements hich m be me 'or to issuan f a Ccrlifrcate of Occupancy. Signature of Applicant Date All roof coverings to be Class "B" or better Owncrorauthoriztdagcny� Date CITY of CUPERTINO i 0 CITY OF CUPERTINO PERMIT APPLICATION FORM 0S'D�- 0 o 6' APN # 3 / . 2 0 ' 0 �3 Date: '+/ / � /o' Building Address- �r, Mailing Address (if different from building address): 2 rte W o�Gf Q, vtoCA q ©� - Owner's Nam - Contractor, e �v► • I c . License #: > 5 �3 Contact: (� f^ f Phone: GUGUti 2 Wt-p9%/ Cupertino B iness License#: 0 n o Fax: 1 - Building Permit Info: Bldg dIX Elect Plumb Mech� Job Description: 1W 61b 5'tV 77 To TKE-(t-7) �, -) 94 SQ, �r- l- Sib-P-r HCX S1=- . tWUW4& CO — Residential [4""/(4A " P�oV aH . 6ATAk.V 4 Commercial ❑ t�Woa Sq.Ft. Floor Area: (.,I� S- P; 2Z CtS $/Sq.Ft.: Cost of Project: Occupancy Group: i 4c, coo Type of Construction: Please check this box if the project is a second -story addition: ❑ Project Size: Standard Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL 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 BELEC 1000 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 Iof, CITY OF UPEP\TINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: 6 z M (-ewo o6k 1�)r PERMIT # vto D 67 OWNER'S NAME: GENERAL CONTRACTOR: FAX # 4 o e.- z _ o 3 I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork D [ o �. L F 7S"�6S--b o3 Cement Finishing a � .� 3 0 4 Electrical Gv�oo� '' Excavation C U 170�, Z +k- Fencing /l%l Flooring: Carpeting Linoleum / Wood f Glass / Glazing r. Heating Gd�oa Co�s�rK�-f;b� ;2,5 - Insulation Landscaping 0" V)w Lathing 2S Masonry e - 5`2�zy Ornamental Sheet Metal WA U:22 Painting / Wallpaper Paving Plastering Plumbing p� n Cfln s� r c� i b Roofing Septic Tank /v 1 Sheet Metal N/A Sheet Rock P 6? Tile EE Owner/ Contractor Signature Date b b