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06110037 - PUB
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OL a`r a� a� mar y 2 C q cn U Z) d o 0. ;, e>_ v J CL [L (n 16- < CL U t U 0 •�. - f _ u q CITE'OF CUPERTINO x y BUILDING DIVISION PEt R BUILDING ADDRESS: PERMIT NO. 0600 JOHANSEN DR TU NGUYEN 06110037 OWNER'S R'S NAME: PERMIT ISSUE DATE LIN RESIDENCE 5309 ASILOMAR CT 02/27/2007 PHONE: SANITARY NO. CONTROL NO. (510) 487-6170 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH p LICENSED CONTRACTOR'S DECLARA71ON Job Description t_ 1 hereby&(firm that 1 am licensed under provisions of Chapter 9(commencing with Section Toto)of Division 3 of the Btrsiness and Profession Code, mylicense is NEW SFDWL-19 9 3 ' ,COVERED PORCH 28 ' , GARAGE 437 ' w in full force and effect. z License Class Lic.N SANITARY IS SUNNYVALE' S JURISDICTION Dale Contractor ARCHITECTS DECLARATION PORCH 28 ' X 38 . 51 = 1078 . 28 --SEE BELOW R 1 understand my plans shall be used as public records "t Licensed Professional a OWNER-BUILDER DECLARATION � 1 hereby affirm that I am exempt from the Contractors License Law for the 0pC following reason.(Section 7031.5.Business and Professions Code:Any city or county fi which requires a permit to construct,alter,improve,demolish,or repair any structure .y prior w 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 Businessand Professions Code)or $452956 ._ 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 to a civil penalty ofNumber Occupancy Type not more than five hundred dollars(5500). 3 7 5 3 6 0 0 7 . ❑i,as owner of the property,or my employers with wages as their sole compensation, will do thework-and thestructure is not intended or offered forsale(Sec.7044.Business Required Inspections and Professions Code:The Contractor'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 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.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contactors Li. cense Law dors not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law. C3 1 am exempt der Sec . B&P C for this reason Owner ! Date WORK MPENSATIO RATION f h y affirm un penalty of perjury one of the following declarations: ❑1 hsve and will maintain a Certificate of Consent to self-insum 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. ❑1 have and will maintain Workers Compensation Insurance,as required by Section 3700 M 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. Pofncy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the Permit is for one hundred dedlars($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 m bcCpm objet orkcrs'Compensation Laws of Caliromia.Data 4 Applicant NOTICE TO APPLI :If,aftc ling this Certificate of Exemption,you should become subject to orkees C nation provisions of the Labor Coda you must z forthwith comply - such profin or this permit shall be deemed revoked. OCONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a convection lending agency for the performance of n>-e the work for which this permit Is issued(Sec.3097,Civ.C.) 0 Lenders Name z Lender's Address Q I certify that I have read this application and stare that the above information is correct 1 agree to comply with all city and county ordinances and stare laws relating to C> building construction,and hereby authorise representatives of this city no enter upon the W above-mentioned property for inspection purposes. GL (We)agree to save,indemnify and keep harmless the City of Cupertino against v) liabilities,judgments,costs and expenses which may in any way accrue against said City Z in consequence of the granting of this permit — APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date _ 2� •� SOURCE REG TT �� Signature of licant/Con Re-roofs HAZAR US MATERIALS DISCLOSURE i Type of Roof Will applicant or building occupant store or handle ha-zardousmaterial as defined by the Cupertind- unicipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(x)? ❑Yes ❑No All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes ❑No I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&SafetyCotk,Sections 25505,25533 and 25534.I understand that if the building does not currently have a lenant that It is my responsibility io notify the occupant of Inc rcquircmen h)cl,must be rn, prior to issuance of a Certificate of Occupancy. Signature of Applicant Date �f -7 All roof coverings to be Class "B" or better Owner or.`thorirsd agent Date CM OF CUPERTINO BUILDING DIVISION PERMIT BUILDING ADDRESS: PEILM r Ma 10600 JOHANSEN DR TU NGUYEN 06110037 OW t4ER'S NAME. PERMIT LRIE 0 A LIN RESIDENCE 5309 ASILOMAR CT 02/27/2007 ONE SANTGIRY NO- COKMQL No. ARcrlrrecr1ENGINEM PHONE: NEW SFDWL-19 9 3 BUHDUIG PERMUINFU ' , COVERED Q ELECT MECH °c PORCH 28 ' GARAGE a ' 'TO AftRAN`UL'RYSPECPION' JOB DESCRU`nON le Call 777-3228 between 7:30 a.m.and 3:30 p.m., RESIDENTIAL: C3 i Monday through Friday,at least 24 hours before 71 SFDWL ❑ Krr0IENREM ODEL FOUNDATIOWPIFRS/H_D.S. required inspection. Job address and Permit Number ❑ADDRYON ❑ PLUMISING RE-PIPE '� Je UFER GROUND are needed when requesting an inspection. ❑ b Lnm-UNrr ❑TMUCRJRAL w F ON PADISET BACK-CERT RESroENTLA2COMMERCIAL OTHER NTEIOR C3UW4EY R E PA IR GARAGE SLAB_S/PPEGUNITE IMPROVEMENT ❑ SwAdMavG POOLS � •>> § uA7ARDOUS FIRE AREA C3 BATH REMODELiRFFPAIR❑ DEMOLM()N Inca x m UNDERGROUNDlSLABC]OTHER w Z y ❑YES If yes-I understood Wu a Class A mof uwnbly is required. �_`a UNDERGROUND PLUMS ING a` � UNDERGROUND ELECTRICAL ❑ NO Innial t.c�.o.o COMMERCIAL: F,ayn dG ROOF COVERING ❑ NEW BIDG/ADDR•ION ❑ DEMOLITION UNDERFLOOR PLUMBING ❑ TENANT ❑ FOOD SERVICE UNDERFLOOR MECHANICAL Number of existing cn—inP IMPROVEMENT UNDERFLOOR ELECTRICAL To be removed To be retaitted ❑OTHER UNDERFLOOR FRAMING VENTS UNDERFLOOR INSULATION a F, , w ti.•e g ,:a� xva r s% r Ty? F ROOF CO G EXISTING: RO O ` ROOF SHEATH/DIAPHRAG1vI M \ PLUMBING C) Built-up Roar C� ❑ Built- RoofTUBS A SHOWER PAN ❑ Asphalt Shinel el' C] Asphalt Shingles MECHANICAL " l—/�7 ❑ Wood Shaka /U� `� 1 ❑ Wood Shakes ELECTRICAL/POOL BOND —0 ❑ Wood Shingle ❑ Wood Shingle FRAMING/STAIF{WE.EGRESS — Cl Other(Specify) ❑ Other(5peafy) ENSU ATION/VENT13-ATION 7 NO FINAL INSPECTIONS . Provide LC-B.O.Report Na UNTIL ALL REQUIRED BUSINESS Provide mfg'-(nsmlladao Spec. EX'I7ERIOR SHEAR/HOLD DOWN INTERIOR SHEAR/HOLD DOWN /110-7 _AA "GENGS ME 013NNEE) SHEETROCKISSEETROCKSHEAR . iNSPErnON SPECIAL--INSPECTION REQUIRED ❑ DATE INSP EXTERIOR LATH/W-SCRE I'V J SHOWER LATH tki,, + hhusl o, SCRATCH COATS 5 EWER1WLjQt / J> (- V� TEMPORARY APP OVALS OCCUPANCY Y Q e O� 4. w ., . . � . � ... z CUPERTINO SANITARY DISTRICT. PLANNING 777 33as GAS TEST Closed circuit video inspection of property line cleanout,point of connection GAS=� and street lateral required prior to passing FINAL CITY PLUMI NNG GRADE(P.W.777-3354) / , 7 ty' INSPECTION. Call the District(405-253-7071)for an appointment. J O FIRE-CALL(408)3781010 HANDICAP Z� & Z(, 1/fZ w ELECTRICAL IMPORTANT r G. PLUMBING J Z MECHANICAL -� Z When a permit has expired,a charge totaling o ENERGY obtain a new�ermit must be paid to reactivate the ermit: i 7 VISUAL FINAL ONLY -3� of'r'` e7r;.: BUILDING /�?Lrj If a permit has been expired for more than one year,a charge totaling r A' ' . _ ..K .•, the full fees to obtain a new permit must beto reactivate the O permit. ' CERTIFCATE OF OCCUPANCY PRE-INSPECTION. PLYWOOD-. IN-PROGRESS: (NSP DATE _ INSP. DATE _ INSP. DATE TEAR OFF INSPECTION: BATTEPIS. FINAL: INSP. DATE INSP. DATE INSP. DATE NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION *CITY OF CUPERTINA ov'�'l 0�3� a10 NEW SINGLE FAMILY DWELLING CUPEI�TINO PERMIT APPLICATION FORM APN# Date: Building Addr • Mailing Address (if different from building address): Owner's Name:. Phone#: Contractor: License#: Contact: Phone: (4,�Z- -3 Cupertino Business License#: r>c�,Y rr�) f 3F_> Fax: 6aq6)q 4.6-7 s ocy Building Permit Info: C'oo 5c+ 1—S (orY ti� oo s e Single Story Two-Story ❑ Three-Story ❑ Basement ❑ Sq.Ft. Floor Ares-- $/Sq.Ft.: 1 � R 3 -+ g C F`� Cost of Project: Type of Construction: �9—Ki Project Size: Standard Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group 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 BMITIGATR Res. Housing Mit Fee BUILDING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING 1 of 3 Community Development S71-11 O' 10300 Torre Avenue mLCupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPERTINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: PHONE # - -- GENERAL CONTRACTOR v FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork U Cement Finishing A Electrical To.- '0 60 0 ST y ihp-Y, 3 Excavation -T j - (?©w '71-Y"4 et,(2 Fencing N Flooring.Carpeting N fA Linoleum/ Wood L -Al Glass / Glazing Heating T L VVIC Z X93 Insulation T, - t� (9 V\4 � Landscaping1014 Lathing Masonry N A Ornamental Sheet Metal IJ Painting/ Wallpaper Paving Plastering M67 H Trvv3qq Plumbing - VXSA YLJ16y, Roofing hio4tA i7fl y: 1! '7 9 Septic Tank N �A Sheet Metal U n 5 V>)JL oV) �S 3 3 Sheet Rock M G I V\ T r 1 5 Tile U - K ci -v4 m L. r. U Owner/Co trac r Signature Date