06060234 CITY OF CUPERTINO g
BUILDING DIVISION PERMIT CONTRACTQR,1INI�O
RMA'IION`"':
BUILDING ADDRESS: STEVE NAN CONSTRUCTION PP Mrr ND.06060234
10148 BRET AV
OWNER'S NAME: PERNUT SUE DATE
SHIAO MEI NAN LLC 919 LORNE WAY 06/28/2006
NE: SANITARY NO. CONTROL NO.
(408) 203-3933
ARCHITEC PENCINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0
uoo LICENSED CavrnACOERS DECLARATION lob Description
1 hcscby afr Oat I w Ikenac5 under pz v..of Chap-9(mnmc«+TIG
with Satim7MMI)of Dinaum 3 a(ihe Btud c ud Pratev4m.Code.utl my licma4
2M mrLloa maurm $ ��2��J� TEMPORARY POWER DURING NEW CONSTRUCTION
o,k � �c0"Baamr I
EC oa,"I EC1-S DFLI.SRATION ry p qqq
tt 1un4ma«I mY PI•^r alWl hu uadu PuEtic read. AL�
JU
a.4- Liaenad PmfeasianW
Oat I=BUILDERDECORATION
I hcmby rfBrm Nu I I exempt from Nc Cams C :My
law for the 1j/ _
O O faftw i%,ruw1L(Satlan IUJ IR,Batineu W Prauai0a Code:Any ety a mwty J
2 rhim mquirn.Pvmht b carauhtot Wta,hpptvw,dcadu4«mpah any amnmc2flng $200
_iy Prwr bili itsaartn:,a4a mahn tic aPPlvatt f«such Pmmit to Bk a algtW aamnan
< toi W atliccroad'ocauw b Uc pmviyatu of the Coon &t U..Laa(CE+pter9 Sq.FL Floor Valuation
i� (mmmatcingwith Swd.7000)d Diviwbn3of We BudnevWPmfealatu Codd«
e5? that he u exempt hhvcf W the,buu f«dr alkgcd u=Pdoa.Any%Chtlo l of
S"d.ymIS by uy.pplivm fa.pu h abjccu ft aVpllcmt W.civil Paany of Cf Occupancy Type
eat more thot the hwdmd tblWa ISM '
D l,ua
wl0 do hw.ik,o%j ijba m ,amuyrmetiot-,dad w«itohRwaagu fmuaaah,(Sc
c N.Butd
W roataptortwtadn,
Required lnspections
pmprnY who WOdaatrpprahcs thaeao,W rho d«sa«b vert Mim:elr«Nmugh hat
ow cmployen,P"r'Idcd Wu aab imPravcmau ate oat 41Cad]I'«aQerd fa ale U,
bowe,c.Ne ddldiag«'vnposemw V aaa within me yer acomp4doa,the owar-
W naa wm n.re w badah a pmWng IhW ee ma na baW«improve r«pmpoa a
ak.)
❑1.u aunt a the'.pcm.am ecWusely coavacting rMh II®tca mmaw,icas to
cmurvn the pmjea(Sx 7011,Bmorc .nd Pmreal«u Codc:)The conaaebra U.
tr»Law cion rtot apply m u. (prvpary vba buiWa u u^pmre•Nereaa.acid.
who u,xcu ra sack projccm vim.awtuclom)hernia Pa•^•m to tW caauc '
L a c Law.
❑lam exwptvMV Set, .BkPCtoo Au naaa
OverWm
EN
WORKERS COMPSATION DECLARATION
1 bcrcby v .muter Peoalsy of KIM arc of We foBowing aecla.wWnt
,J Ihs.e.pa w0l rnnnuipa CenifiaeaCvvut to air-Inca f«watrfa campem
saslon,u pwidcd for by Sectao J9(MI a the Mbar Cock,fa hhe performuhts a We
wart f«rhkh Nis pvmu a iif«Q
0 1 base asW will amain,w« 'Caapcsmton Blvtruac a tryutmd by Seaton
3]W of the LahwCode.I.Oc,peR«manrs orthe work(«wlaieh that permit J.tuucd
My warkera Copt�°°1 nna WPolicy numba.m:
Carrier. S�'/`C /I Policy No:/M.X1'�j`
CERnFIC TE OFEX PTIONFROMWORKERS
COMPENSATION INSURANCE
(Tbisaecdm ad as W C.P4md I(Oa;cnaah u f«ane httW loll.(2100)
«lora)
1 cstfr W t ld hx pa(tvaanee a the rah fa rhich that Permh 41.vued.I shall oa
emplaq urypersan Ncity muucrmubbe9me subjea to Ne Watr Compem•'c.,
laws of Califo Dam
Appllom
NOTICE TO APPLICANT.I.afmr making this Ccn f¢uc of Ecmptim.you ahooW
baw subjrn tithe WOrkcfs Canpcuatan poa ivu athe Law coot,yar t•'•^
.�Z fcrOwiO comply with such praNriona a this permit shall be dmtud mhu4d.
zCONSTRUCTION LENDING AGENCY
[–t I hucby aRrm that there u a mnuruc oo lmdin'ageay f«the perfoaame a
tYa 7 the wak f«which hhu parch U imw (Sec.309'1,Civ.C.)
W Q lr0dcrs N.am
Z)Z �M.ra Aea�
U O 1 cc,"'tat I las,,tud 1Wa ap04wion and aiatc"the aWr<laaaatl�n u
I,, F ct .I agrc to coraply with all city sad county adin $and swc Ira Nakingb
C U Wilding coesuuction.W hemby.uth0rire mpresenmti of that city to enter upon Na
r W abort-mc dti fuopcny fa itupccdon puryors
(Wt)agmc to fart,indcmni fy and trop harm)ess the city a Cyher itro.gaiut
E"f4j1 Iiahilitka,jWj; c 'cousWUPc aaoatwhichwyIn., Y..galtwudCity
U z u1
APPLICANT UND STANDS AND WIL COMPLY WITH All.NON-POINT Issued by: Date
SOURCE REG ONS. .
ti 6'-"�""'1�5 Re-roofs
SltaWum aAPPI+
HAZARDOUS DOUS MATERIALS DISCLOSURE Type of Roof
Witt to appllmpt«futatc Wilding a cupaatuoa a hulk h.vsdam mrtc o]
u dcB«.tl by the Cupcnino Mh.kW Coda,Chapw 9.13,and the FbIN W Safra
Calc.SaZao 25533(.)7 All roofs shall be inspected prior to any roofing material being installed.
0y.
Win h>,.'plk.m«fora,,Wilding asap u w,,wul,.«aeriar which If a roof is installed without firs[obtaining an inspection,I agree to remove
emit ba,Ardtwn air==Inwu u dcfuud by ft Bay Arc.A'v QWIhy Maw =M all new materials for inspection.
L�H.1"
Yn � No
art mad the bausdmomare hmwbctr.M•io. cta Q95 amt Calif.
Safay Coo.Sasiaa 25505.25533 W 25531.1and+mami uwi(the Wil�nga.rcmly haw a'• 4 that hum to'cadNlity b miry th om9•m err the w - bnuwbe a.Cmtr¢aWerr Signature of Applicant Date
All roof coverings to be Class "B"or better
authavcd a'. D.m
CITY OF CUPERTINO
•m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37511038 . 00
DATE ISSUED. . . . . . . : 06/28/2006
RECEIPT # . . . . . . . . . : 35051
REFERENCE ID # . . . : 06060234
SITE ADDRESS 10148 BRET AVE
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : SHIAO MEI NAN LLC
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : LIN HAI NAN
CONTRACTOR . . . . . . . : LINHAI NAN LIC # 24450
COMPANY STEVE NAN CONSTRUCTION
ADDRESS . . . . . . . . . . : 919 LORNE WAY
CITY/STATE/ZIP . . . : SUNNYVALE, CA 94087
TELEPHONE . . . . . . . . : (408) 203-3933
WE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- ----- ------- ----- - - --- -- -------- -------- - --- ------ ----
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
-------- ---------------------------- -------- ----------------------------
304 ROUGH ELECTRICAL
•
Community Development
10300 Torre Avenue
!. ✓' Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
*UPEI�TINO
Building Department
JOB ADDRESS: PERMIT
ab d6
OWNER'S NAME: o.' PHONE #
GENERAL CONTRACTOR: FAX # off
I am not using any subcontractors: �—
Signature Date
Please check applicable subcontractors and complete the following information
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
CITY OF CT TPLRTINOEn
TEMP POWER
CITY OF
SLUPERTINO PERMIT APPLICATION FORM
APN # 3-75—) )— Date:
Building Address: 6
�i Ave .
Owner's Name: Phone #:
Contractor: Phone: License #:
Contact Phone: Cupertino Business License#:
Building Permit Info:
Elect ❑
Job Description: �/ r
Residential Commercial 10
Cost of Project:
•
Qty. if
Applicable Fee ID Fee Description Fee Group
BTEMP Temporary Power ELECTRICAL
EPERMITFEE Elect. Permit Issuance ELECTRICAL
BUSLIC Business License BUILDING
r•