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03040006-FPo'( z Ft W' LL U� LT. j 0 Fi ►-r I U; CITY OF CUPERTINO ; DIVISION BUIL IN PERMIT rtN'•��CU]Eiit�2V1(Tz(�3 BUlLLgF411PR EVENS CREEK BLVD PERMIT NO. 03040006 0` 19ffRTENCE3' HAIR & NAILS • PERMITISSUEDA 04/25/2003 PHONE: SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO HLDO ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description 1 hereby affirm that 1 am licen under provislons of Chapter 9 (commencing with Scct n 7000) of Division 3 of th'ncss fc i Co"",IiccMSc fore e L TENANT IMPROVEMENT License an Lk. N en Date nlrector CONTRACTOR: THANH HA CONSTRUCTION AR R 1 un d my plans shall be as public records Licensed Prufcssiona�l' 9Wr OWNER-BUILDER DECLARATION i I hereby affirm that 1 am exempt from the Contractors License Law for the > follnwing reason. (Section 7W", Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure Sq. Ft. Floor Area Valuation t prior to its Issuance, also requires the applicant forsuch permit to rile a signed statement ' Contractor's License Law 9 that he Is licensed pursuant to the provisions of the (Chapter (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 five hundred dollars (S500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, 3162 1029.0O Required Inspections fl P will do the work and the structure isnot Intended oroffered forsale(Sec.7044.Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon• and who does such work himself or through his 101 - FOUNDATION own employees, provided that such improvements are not intended or offered for sale. If, 102 — PIERS 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 103 - UFER °III`•)• 104 - REBAR ❑ 1, as owner of the property am exclusively contracting with licensed contractors to concoct the project (Sec. 7044. Business and Professions Code:) The Contractors Li- 105 — ANCHOR BOLTS cense Law does not apply to an owner of property who builds or improves thereon, and 106 - SEWER & WATER who contracts for such projects with a contractor(s) licensed pursuant to the Contractor', License Law. 202 - UNDERFLOOR PLUMBING ❑ I am exempt under Sea , B & P C for this reasa^-. 203 - UNDERFLOOR MECHANICAL °`"n`rDate204 WORKER'S COMPENSATION DECLARATION - UNDERFLOOR FRAME I hereby affirm under penalty of perjury one of the following declarations: 205 - UNDERFLOOR INSULATION 0 1 have and will maintain a Certificate of Consent to self-Insum for Worker's Compen- 301 - ROUGH PLUMBING cation, as provided for by Section 3700 of the Labor Code, for the performance of the 302 - TUB & OR SHOWER work for which this permit is issued. 303 — ROUGH MECHANICAL ❑ 1 have and will maintain Workers Compensation Insurance, as required by Section tai 3700 of thc.Labor;Coda for the performance of the work for which this permit Is Issued. 304 — ROUGH ELECTRICAL My w�rkedresCper,sau su nes u are 305 - FRAME YOM� ��,� 0 x MPTTow0RI S' ✓ 306 - HOLDOWNS ' COMPENSATION INSURANCE 307 - INSULATION ' CrhIs section need not he completed If the permit Is for one hundred dollars (S 100) 308 - SHEETROCK or less.) 1 certify that In the fro anec of the work for which this permit is issued. I shall not 309 - EXTERIOR LATH employ any y manner so as to become subject to the Workers' Compensation 310 — INTERIOR LATH Laws 311 — 313 - SCRATCH COAT ROOF NAIL App ca V APPLICANT: If. after making this Certificate of Exemption• you should been subject to the Worker's Compensation provisions of the Lahor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 501 — FINAL ELECTRICAL ENERGY j CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY I hereby affirm that there is a construction lending agency for the performance of_ 5 0 3 FINAL MECHANICAL ENERGY y tine work for which this permit Is issued (sec. 3097, Civ. C.) Lender's Name 504 - FINAL BUILDING ENERGY Lender'cAddress 505 - FINAL ELECTRICAL D I certify that I have rad this application and state that the above information is 506 - GAS TEST correct. I agree to comply with all city and county ordinances and state laws relating to building construction. and hereby authorim representatives of this city to enter upon the FIN PLUMB G above-mentioned property for inspection purposes (We) agree to save, Indemnify and keep harmless the City of Cupertino against O 8 FIN L n liabilities, judgments, costs and expenses which may In any way accrue against said City 5 in consequence of the gmnling of this permit. APPLICANT UNDERSTANDS �N/fF/W�ILL COMPLY WITH LL NON•POINT Issued bY:S ING Date U SOURCE 14 NAL PUBLIC WORKS Re-roofs Type of Roof gnatuie of Applicant/ContractorDalc HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future bulIding occupant store or handle hazardous material as defined by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety Code, Scction 25532(a)7 , All roofs shall be inspected prior to any roofing material being installed. ❑ Yes No If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or u/ton: building occupant use equipment or devices which emit hazardous air contnminan as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Ya No 1 have mad the hazardous matcrisismquiremcnts under Chapter 6.95 of Linc Califor. nia Health& Safety Code. Sections 25505.25533 and 25534.1 understand that if the building docs not currently have a tenant, Pstjt Is my responsibility to notify the occupant of the requirpmen hie MgWancof a Ccn ifieste of Occu Signature of Applicant Date All roof coverings to be Class "B" or better tnerorauthorizcdagcnt ,le CITY OF CUPEkTINO Ci ff OF CUPERTINO PERMIT APPLICATION FORM 2- APN # % ,,. � � Date: f Fee Group BAPPLOTHER Building AcYdr6ss. { .STV O LSA Name: FR TCS KA -1V HAILS' Phone' , Contractor: `TL0+� 4 H p e_0 Ns'T(z Ql Oo License #: Contact: RO-H 14 MN --H , (409) Wo_? 06 Cupertino Business License#: Building Permit Info: Bldg Elect Plumb ISD Mech Job D scription: Residential ❑ Commercial Sq.Ft. Floor Are : $/Sq.F Cost of Project: r Occupancy Group: Type of Construction: MECHANICAL Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING 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 BELEC 1001 Elec 600V > l OOOA ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit: Fee BUILDING I of 3 UTY OF CUPERTINO CUPEkTINo PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi -Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifan-ffly Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn SprinklerBackflo PLUMBING BPSTORM StomVRain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <=10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREM 3USWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > I OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL u 2 of 3 CITY OF CUPEkTINO CITY OF CUPERTIN%j PERMIT APPLICATION FORM Quantjty, Fee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Lkppliance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Sips, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING " ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3 AdEr CITY OF CUPEliTINO City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: (408) 777-3228 FAX: (408) 777-3333 BUILDING DEPARTMENT OFFICIAL NOTIFICATION OF ADDRESS CHANGE TO: County Assessor, Fire, Sanitary District & Health Dept. FROM: City of Cupertino DATE: June 03, 2003 RE: Address Change Please note the following address changes. The plans and plan check information for the following permit numbers had the incorrect addresses on them: Permit # Control # Incorrect address Correct address 03020027 11940 19929 Stevens Creek 19959 Stevens Creek (Quiznos) 03040006 12056 19979 Stevens Creek 19969 Stevens Creek (Hair/nails) Please change your records to reflect the correct addresses. If you have any questions, please call me at (408) 777-3246. Sincerely, Susan Winslow Administrative clerk I'noted on Nocycled Papp;