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06020041 CITY OF CUPERTINO �+ ^' I'` •'° BUILDING DIVISION pEItjKIT CONTRACTOR INT+' ,XTION -n.,...a ny .,....W . F.s aH°r syr BUILDING ADDRESS PERMR N0.o6020041 1896 BARNHART AVE MIT 65 EWS NAME: PERMIT DATE ZHIHONG LIU 02/08/2006 NE SANITARY NO.' CONTROL NO. ARCHITER/P.NGINEER: BUILDING PERMITINFO BIRO F1E.CT PLUMB MECH zZ .Op LICENSED CONIitACIDRS DECLARATION Job Description rd 1 ea mby Lupton than I en licensed codeso.ium ps a Chu nes 9(tunmcMnt p N Senbn]O]0)of DlrUbn 3.f the Builnrr and Prafessiiw Code,and my He.u n� infWIforce.ndeBctt TEMPORARY POWER POLE Licemc Class L.ic.I NA �, DateConlruarARCHrrECI'S DECLARATION I mderm.M my pYM sant be used u pudic reads `. J�N �. u Limntd Pmfavow OWNER-BUILDER c. DER Dt the Contractors nT10N .z a f I herthY a( that 1 am e.emp tram the pose.. c :Any Law o far IK /© p O which ag reason(SrcBon]8513,Business and w.do u Code:Any oily IX manly W a,e ty c $ which us I.. .ad.re ansrthe.alan.knpoo.e,h p.Ith,a a anti ed nm.nt q/{. $10 0 -iy priamis issuartc.alwnquvn thcapplcam for such pmmltm Ole.ugnedswcrant `e shat he Is lfeaNed pmw.n1.the l.a.i,;a�.,ar me C. .°m°;I�aLIw(Chapan9 Sq.F[.Floor Area �'�� Valuation�$ $ (canmencint with Sec ien]IXIO)of Divtaim3 athe Business"Pmfcuimu Codc)a �j�sibigd _ that he H eaemp therefran and We basis for We alleged eacurplU n Any=a tl V b fd�A sees"703U by any applicant fora pefmlt atbJew tN.pplicw b a eMl penallya � Occupancy +T7Wr mare naw not hawed draw.(ssoo). ❑Las owner of Bt PMPmy,a my=Ploro with wags u Web wk canpenn0on. MB do Ih week,areal We structure 6 nor ntund"A a dfraW fm sok(Sar.]f111,Busing arm Provaiom Cone:The Coetracta z L{aax Law dais cot apply man owner of Required Inspections property who bunds or lmposear thereon,and who does such west hidelf a through he, aro empbyw,provided that such uoprmmmu ase era uuerded a oQcred for sale-B, hwmer.We WWI,or hapo.t Is sold within one year a complelim,the,.- ddWa wiB barer IK piths a pmving Wu tr did cam bdW a import fa pvpot a 7y{L,u owrc a the pooPcny,arm uauiwnd carufaNeg with IS¢uN mnuactors n cbavruct We es jot it,7W.an owner as and Pnotficany.whuw Code)The CmuanaY and,Genre Law dais not apply e s,owner a poWenYwln Wilds or impwsts thereon,and. Lica mnvuu for such pm)ew with•mnuacta(a)licensed pumaN b the CmuxtNs Law. 0 fsortarm uemp wdN See .BkPC faW taDareDL WORKERS COMPENSATION DECLARATION 1 hreby.Buu udrr,panalsy of perjury,arc a We following dee sou lame I Nae and WlmdNale.Cmif teaCaermtoselr-lanae for Walrls Campem station,u provided for by Sttthm T/r10 a the Mbar Code,for We Pe+famutm a the west far which this permit u issued. ❑I hart and will mumun Waters Compensation Insurance as m]dn,d by section 3]00 ar the Mbar Code for,the perfIXmatne of Ne wart for which this perms i.I—an! My Wohcla Co npnsation Invm�aeric,and Policy comber arc Carrels: Polley Ha.: CERTIFICATE OF EXEMPTION PROM WORKERS' COMPENSATION INSURANCE (Thu sedlon need aIX becanplerd B We permu Is rorone huMeddullia(SIW) a less.) 1 ceNfv thou In the perfamanre of the wak for which this permit u'„.„n,I still out maplvy,any person In any mmrcrsnVyYtr me wbOtlp NCWmtrrs'Campvwtim Laws of Califumi..Disc Ln Y! E Application G NOTICE TO APPLICANT:IL supper mating this Certificate of Exemption,you sbauld become wbiect to the Wa s Campcmuion p W oat of the Latin Code you muss .Jz forthwith comply wish such pr°virom IX this penult swl be deeaed resakcd. Z O CO.NSIRUCTION LENDING AGENCY F� I hereby affrn that Nen,Iscnnunuct5na lending.pmcy for the pcfamatat of [�> the w,urk fa which War ptemit Is I".”(See-Wt.Ci,C) V4Q Lcode,a Name 7 Z lenders Aden" U O 1 cendry dist 1 Nn,rad this appicas.and stat that We.pure iWamube Is U. '-' caws 1 agree to comply with all city and county owwwes tad state laws vaturz to p F" building mnsuuNon,and ocreby southern rtprtunuui 4 of this city to entre upon to U .M.e.mvloned proltny for inspection Purpaua (We)agree m uvc,In scmnify and kept harmkas the Cly a Cupertino against F'N HadlWca.jdgmems,cosu ude.pcnsu which may u any way acrnc.gaWt said City U In cohq.a thc granmg ef this permis APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGIILAnONS. ' f �• � Jv/ORe-roofs HAZARD Slgnuurt'djAPWIc• a HAZARDGUB MATERIALS DISCLOSURE Type of Roof Will let o Cupertino a fortuneni Wilipal Co emvpant sso 1 a h.Mk h icafdpsc!uvial SI as trlutd by tht Cupenhn MuasifW Code.Chapter 9.12 and she Fio1N tad Sdmy e Scc8m23 ')] All roofs shall be inspected prior to any roofing material being installed. ❑Y 9No Win the applcatu«future building oaupaN use equipment or Imics which If a roof is installed without first obtaining an inspection,I agree to remove W-11 harrurEtveI ear emtaminanu as ticOn of by the Bay Area Air Qwity Management all new materials for inspection. Oisukt] ❑Yes 0 N 1 haze read the Nasebus mueru4 mpri.unlet'Chapter 6.95 attic C.lifar. sob Iblth k Safcty Code,Sadao 25505,25533 W 25534.1 unhrMrd nut lithe building does not mmemly Nan a tenant this It c my responsibility b aadfy the omupant of tic requiterneres whKhnum the=1prl°ras°°aoceaaCotk f Signature of Applicant Date All roof coverings to be Class"B"or better Owner,i wthorirtd apnt Disc ' CITY OF CUPERTINO 1 of 1 PERMIT RECEIPT OPERATOR: Buem COPY # 3 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37509027.00 DATE ISSUED. . . . . . . : 02/08/2006 RECEIPT #. . . . . . . . . : 33134 REFERENCE ID # . . . : 06020041 SITE ADDRESS . . . . . : 18969 BARNHART AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : ZHIHONG LIU ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JING LI CONTRACTOR . . . . . . . : LIC # COMPANY . . . . . . . . . . : ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . .O . , TELEPHONE . E ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW HAL __________ _____________ __________ __________ __________ __________ __________ BTEMP FLAT RATE 1.00 62.10 0.00 62.10 0.00 EPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 TOTAL PERMIT 100.47 0.00 100.47 0.00 METHOD OF PAYMENT AMOUNT NUMBER OTHER 100.47 VISA TOTAL RECEIPT 100.47 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- -----------_---------------- _________________ 103 UFER 304 ,, ROUGH ELECTRICAL ' CITY OF CUPERTINO t -OF TEMP POWER // UPERTINO PERMIT APPLICATION FORM Old/ Oc2 Uc/)7 / APN# i Date: 75� C)— oY/�sr Building Address: i �°r6 Owner's Name: Phone #: ZIP; ton v 62 1 — 3?l -Z- Contractor: Contractor: Phone: License #: 0/,Y Contact: Phone: G Z f _ 3 / Z Cupertino Business License#: 3L� Building Permit Info: Elect U Job Description: Residential Commercial ❑ Cost of Project: o 0 Qty. if Applicable Fee ID Fee Description Fee Group BTEMP Temporary Power ELECTRICAL EPERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC Business License BUILDING