06050023 (2) CITY OFCUPERTINO ""M�l�(/�
BUILDING DIVISION PERMIT EVOL�'�- �� '•'`^O-""-" � �
BUILDING ADDRESS: CALIFORNIA SKYLIGHTS PERMTr N0.06050023
7474 DF FOP, DR
OwNER'S NAME: PERMIT SUE DATE
CONRAD TSAO 18637 BUCKNAU RD
ONE: SANITARY NO. CONTROL NO.
408) 866-6759
ARCHnECVENGINEER: BUILDING PERMIT INFO
. BO EO PLUMS MEOCH
o p LICENSED CONnsed under previsions DECLARATION pf' [J ®
1 Iherebyaffirmthat NS1AmONTRdundoSDECLATIONChapter 9(rommendng JobDescriptionLY L
tth Section 70011)of Division 3 of Ne Badness W Professions Cade.and my Imes,U ser I■1
+�gq NmnramAndeffect. INSTALL SUN TUNNEL SKYLIGHT
Lic.,e�W Oa0, lass ARCNfiECI-SO m RATI N
i 7 MAY Z%-- 2006
L 1 understand my plats shall be used u public mor s
>R!U
yGr^ Liccmcd Pofcssianal �[� p�� (d
3 OWNER-BUILDER DECLARATION aV■ ep lllp((t���\t■g
aF I hereby alRm that i 1. exempt from the Conuuorl License Law for Ne a�5'
D O following moon. aeon 1 71D 1.5,Badmas and ad.dermw Code;Any city m roomy CCG771
391Vi1 which requires s permit re cathe dW.kernt fmvc,h permit fie a sig and awcturc 5
_ A ch are m its l issuance-alto requirestoe Novisio nm(or amh permit Utensc Law
swcmcm
thnbeuliceoedpunuammlbeprovisiomafthaConuacmriLiasclaw(Chapmr9 Sq.Ft. Floor Area Valuation
E%5$ (commencing with Section 7000)of Division 3 of the Business And Profession,Code)or
L' .. that ha Is exempt theefom and the basis far the alleged exemption.Any vbiadoa of
Section 7031.5 by any Applicant for a Permit subjects the applkut in a civil penalty of Armr Occupancy Type
not marc than five hundred dollen(SM.
❑I,uawnu ofthe property,or my employca with wages as their sole eompemation,
will do the wort.and the souaure B not intended maffaed fmWe(Sec.7044.Badness Required Inspections
And Profeasiam Coda The Contruc m's License law data e not apply m an cannot or 9 P
property who bui Ida or improves timmon,and who data such wart himself or through his
awn employees,pnrvmed that such Improvements are mtlmand oroRetadfmaxle IL
however,the building or Improvement issold within am)ear of completion,the owner-
builder will have that hurdca of moving Na he did ret build a Improve for purpose or
sak.).
❑1,as mum,of site property,am exchnively connecting with licensed omumn to
commct the pmjea(Sec.7064.Business and Profculans Code:)The Comrumr's U.
Geese law does not apply to an owns of property who bulbs or Improves theme.and,
wM emwnta for such pmjc=with amnua.7or(a)licensed panant eathe Conu stem's
Limem Law.
❑lam esempl undo Esc .Bd•.PCfarthmmuon
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury arc of one,follewing dalantimn:
1 ham and will maintain aCaaOam of Con¢at to coif-insure fa WartrrsCompen-
salon.As provided far by Section 3700 of the Labor Cade,far Am penfarmcoce of the
work for which this permit is issmd.
❑1 have and will maintain Worker's Compensation Insurance,as required by Section
3700m`the labor Cade.far de,performance often work fa which Nis Permit is Issued.
My Workers Compenudm lmunenec canis and Policy number are:
Carder. Polley No.: y77g KC3^Df
CERfIFlCATEO EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
e
(This serum reed notbe compkmd if the pcmit Is roam hundred dollars($100)
or less.)
I certify that In the Performance of the wort fm which this pewit Is Issued,I shall ret _
employ any person in any mmmrso As m became object in tia WorkaYCompamation
Law,of Califomia.Dam
Asp
NOTICE TO APPLICANT:If,after making this CenlOom of Exemption,you should
became subject m the Worker's Campenaadon prevision of the labor Cods,you mum
.J O forthwith comply with such provisions or this permit shall he doomed revoked.
zpn CONSTRUCTION LENDING AGENCY
PI hereby aRrm that Nem is a eonsmurunn lending agency for the perfamame of
C4 the wor
> k far which this peon k island(sea.3x97.Civ.C.)
Oleaders Name
7 2 Lenders Addreas
U0 1 certify that 1 have mad this application W sum that the above infom ul.Is
LU F coram I Ague to comply with all city and county ordinances atm cam laws miming to
OO building consuuction,and hemby Authorize representatives of this city to enter upon the
U shove-mcndoncd property for irepcction purposes.
CL (We)ague to taw.indemnify W keep harmless the City of Cope no atainst
vn fA llabilitia,judgmenu.comisW expenses which may as any way Account against said City
I.conazatuchV APP CANTeof the g
UNDEgQSTANDS ANDof WILLWILL COMP TH ALL NON-POINT Issued by: Date —i�
SOURCE EU BIONS.
kfll�- 3-71 /' Re-roofs
Sigmturc of Appli—UCoy mor OAm *
N A0.DOUSMA T
ALS DISCLOSURE of Raaf
Will the applicant or future building aceupatsame or handle hazardous material
As earned by the Cupertino Municipal Code.Chapter 9.13,and the Health and Safety
Cala Section 337330)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes Fir 41
Will the applicant a future building oceupant use equipment are devices which If a roof is installed without firs[obtaining an inspection,I agree to remove
emit lwamnes Air crenarrim ms As dcrined by the Bay Am Air Quality Mmagcment all new materials for inspection.
Diauict?
Cl You Nu
I have mad the basammm materials requimmanu under Daman 6.95 ofthe Calif c.
malimits&Safety Cme.Seams335OS,25533W25534.1undcnmulthat iftiebuilding -
dom not manot]y how a mnen4 that Itis my mspaesihility m ratify the accupmt a(the
require w m.IWIpriorIm �Ccrdfm,mafocaxecY. Signature of Applicant Date
• t
b4crorauth.rizedIZAL crew L All roof coverings to be Class °B°or better
CITY OF CUPERTINO
1 of 1 PERMIT RECEIPT OPERATOR: quem
COPY # 3
Sec: Twp: Rng: Sub: Elk: Lot:
APN . . . . . . . . : 35924036.00
DATE ISSUED. . . . . . . : 05/03/2006
RECEIPT #. . . . . . . . . : 34222
REFERENCE ID # . . . : 06050023
SITE ADDRESS . . . . . : 7474 DE FOE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CONRAD TSAO
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : TERRY KIYAMA
CONTRACTOR . . . . . . . : TERRY KIYAMA LIC # 26844
COMPANY . . . . . . . . . . : CALIFORNIA SKYLIGHTS
ADDRESS . . . . . . . . . . : 18637 BUCKNAU RD.
CITY/STATE/ZIP . . . : SARATOGA, CA 95070
TELEPHONE . . . . . . . . : (408) 866-6759
4EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
______ _____________ __________ __________ __________ __________ __________
BENERGY PERMIT FEE 83.16 39.92 0.00 39.92 0.00 '
BPERMFEE VALUATION 599.00 83.16 0.00 83.16 0.00
BSEISMICRE VALUATION 599.00 0.50 0.00 0.50 0.00
__________ __________ __________ ----------
TOTAL PERMIT 123.58 0.00 123.58 0.00
METHOD OF PAYMENT AMOUNT NUMBER
_________________ ------------ __________________
OTHER 123.58 VISA
TOTAL RECEIPT 123 .58
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Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
OCUPERTINO
Building De artment
JOB ADDRESS: PERMIT #
OWNER'S NAME: <2c, S pz� PHONE # d �r-/b
GENERAL CONTRACTOR: c , FAX #
I am not using any subcontractors: r
Si ature Da e
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
Owri�r/Conactor Signature Date
CITY OF CUPERTINO
CUPEI�TINO PERMIT APPLICATION FORM Q�pQ�rQj�.3
APN# 35c? � //O3 / Date: N � / R'c)6'
Building Address: / 7 1p Mailing Address (if different from building address):
"7 �F
Owner's Name: Phone#:
Contractor: License#:
Gt9 C / F99,014 S L
Contact: S co-r-r IPhone:N08P/.1-7.314 Cupertino Business Lice se#:
Fax:
Building Permit Info:
Bldg B/ Elect ❑ Plumb ❑ Mech ❑
Job Description: A)FRG—//6a,2.0 /
Residential L i Ai ommercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy Group:
S�9 — 14Z-3
Type of Construction: N Please check this box if the project is a
1,7,� S:4' i �' 'L AiA.C-L second-sto addition: ❑
ro•ect Size: Standard ❑ Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERl Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> IOOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to IM 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
BELEC1000 Elec 600V <= IOOOA ELECTRICAL
BELEC1001 Elec 600V> IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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ZAP- CITY OF CUPERTINO
CUPEf PERMIT APPLICATION FORM
uanti Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
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
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinklerBackflo PLUMBING
BPSTORM Storm/Rain 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
BRENCU IAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> l 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
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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:(+ CITY OF CUPERTINO
CUPER,TINO PERMIT APPLICATION FORM
uantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, 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 Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Change BUILDING
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