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07080277 CITY OF CUPERTINO �� CTQR ZjQATIDN* BUiLDINGD:ViSiON PERMIT PERMIT NO. BUILDING ADDRESS: NICE & RLGHT CONSTRUCTION 07080277 10170 LEBANON DR PERMIT ISSUE DATE OWNER'S NAME: 0 8/3 1/2 0 0 7 MING, XIE & CHEN, XIAOLI P 0 BOX ?285 SANITARY NO. CONTROL NO. 'NE: (408) 86.1-0928 BUILDING PERMIT INFO ARCHITELTfENGINEER: BLDG ELECT PLUMB MECH Z o Z LICENSED CONTRACTOR'S DECLARATION Job Description e v l- I hereby affirm that I am licensed under provisions oC Chapter 9(commencing TEMP POV�ER PERMIT =z U with Section 7000)of Division 3 of the Business and Pr cssions Code,an my license is n=y in full force and effect{ Lic.# sn Z License Class 1155_R Contractor 3 t-� Dam ARCHITECTS DEC LA Tl0 f.11 a U I understand in plans shall be used as public records a � i C y Licensed Professional OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the p Op� following reason.(Section 7031.5,Business and Professions Code:Any city or county {z which requires a permit to construct,alter,improve,dcmolLah,or repair any swcture Valuation 4'rA prior ID ifs issuance,also requires the applicant for such permit to file a signed statementr2l S Ft.Floor Area $200 2 O O =?>. that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9fl $ s t-e (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y.y 9 that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of ��ppN Number not more than eve hundred dollars($500). 3 .UU 0 1,as owner of the property.or my employees with wages as their sole compensation, Required Inspections will do the work.and the structure is not intended or offered for sale(Sec.7041,Business and Professions Code:The Contractor's License Law docs not apply to an owner of 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.). 0 1,as owner of the property.am exclusively contracting with licensed contractors toconstruct the project(Sec.7044.Business and Professions Code:)The Contractoes Li- cense Law does 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. B&P C for this mason 0 I am exempt under Sec. Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: �]I have and will maintain a Certificate of Conscnt to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 0 1 have and will maintain Worker's Compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's C mpensation insurance carrier and Policy number 0 Carrier. Policy No.: Z CE TiFI TE OF EMPTION FROM WORKERS COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the perfornance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Dam Applicant NOTICE TO APPLICANT.If,after making this Certificate oxemption,you should f E become subject to the Worker's Compensation provisions of the Labor Code,you must Z forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of Q!> the work for which this permit is issued(Sec.3097,Civ.C.) W A Lender's Nun CIO L.endees Address i certify that I have read this application and state that the above information is LUL 0 correct.l agree to comply with all city and county ordinances and state laws relating to C V building construction,and hemby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. >4 (we)agree to save,indemnify and keep harmless the City of Cupertino against Hliabilities,judgments,cosu and expenses which may in any way accrue against said City Date — U Z in consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued )y: SOURCE REGULATION 41 Re-roo.'s Viete ' Signal Applicant/Contraclor J_ T o:Roof HAZARDOUS MATERIALS DISCLOSURE Type Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? � All roc fs shall be inspected prior to any roofing material being installed. 0Yea o If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which all new materials for inspection. emit hazardous air contaminants as defined by the Bay Area Air Quality Management District? Yes o I have mad the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building docs not currently have a tenant,that it is my responsibility to notify the occupant of the Date require m ich must be ml prior to issuance of a Cenifrcam o ancy S ignat ire of Applicant All roof coverings to be Class"B"or better Owner 6ifutharized agent Date CITY OF CUPERTINO PERMIT RECEIPT OPERATOR: CathyS 2 ITEMS OF 2 Copy # 1 Sec: Twp: Rng: Sub: Blk Lot: APN 342:_4018 .00 DATE ISSUED. . • • • • ' : 08030000035 RECEIPT #. • " • 07080277 REFERENCE ID # • • • SITE ADDRESS 10170 LEBANON DR SUBDIVISION . . . . . . CUPERTINO CITY . . . . . . . . . . . . . IMPACT AREA . . . . . . ' OWNER MING, XIE & CHEN, XIAOLI ADDRESS CUPERTINO CA, 95014-2646 CITY/STATE/ZIP . • • RECEIVED FROM • ' SHIRLEY K NG LIC # 23446 CONTRACTOR • • • . . JIA HUO YU NICE & RIGHT CONSTRUCTION INC COMPANY • " " • P O BOX 2285 ADDRESS . CUPERTINO, CA 95015 CITY/STATE/ZIP (908) 861-0928 TELEPHONE . • • • • • • NEW BAL UNIT QUANTITY AMOUNT PD-TO--- THIS REC ---------- FEE ID ------ 0.00 ------ ---- 62 .10 -- ------------- ---- 62 .10 0.00 0.00 ------ 1.00 40..79 BTEMP FLAT RATE 1.00 40.79 0. 00 _____ EPERMITFEE FLAT RATE ------- 0.00 102 .89 0. 00 102 .89 TOTAL PERMIT : AMOUNT REFERENCE NUMBER-_ METHOD OF PAYMENT ------ ----------------- ---102 .8S MC CREDIT CARD --------------- 102 . 8`' TOTAL RECEIPT VOICE ID DESCRIPTION ________ VOICE ID DESCRIPTION _____ -------------------- ------------ -- ____ -------------- 304 ROUGH ELECTRICAL 103 UFER CITY OF CUPERTINO CUPCITY OF ERTINO PERMIT APPLICATION FORM 40 G �v � oZ r1PN# Date: 3LIZr �i �l s . uv 0 Building Address: i v7o Zeba4()'-L Ownq"s Name: Phone#: e 4747 ---- - Corntractoi Phone: License -cj rrS -bg_ 261 -- 0 Contact: Phone: Cupertino BusinesLicense#: Building Pe it Info: Elect ❑ Job Description:�Q Ly Residential Commercial ❑ Cost of Project: N, Qty. if Ap licabl Fee ID Fee Description Fee Group BTEMP T:m orary Power ELECTRICAL EPERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC Business License BUILDING CITE'OF CUPERTINO BUILDINC DIVISION PERMIT PERMIT NO. BUILDING ADDRESS: TBD — TO BE DETERMINED 07080006 21952 L I NDY LA PERMIT ISSUE DATE OWNER'S NAME: 08 01 2 0 0 7 TAY S I MEHMET U AND CANDAN SANITARY NO. CONTROL NO. PHONE: BUILDING PERMIT INFO BL HITECT/ENGINEER: CD j ELECT PL� MG� o Z LICENSED CONTRACTOR'S DECLARATION Job Description V I hereby affirm that I am licensed under provisions of Chapter 9(commencing RE-PIPE (COPPER) FROM GARUI z U with Section 7000)of Division 3 of the Business and Professions and my license is a. in full force and c Lie# l�-� /� PAID FOR, BL - RCV PLUMBING AND SEWER 8/01/07 ? License Class�—Contractor t— Dam pRCHITECCS DECLARATION < 1 understand my plans shall be used as public records t0.0 OH Licensed Professional < OWNER-BUILDER DECLARATION 3 a I hereby affirm that 1 am exempt from the Contractor's License Law for the q O following reason.(Section 7031.5,Business and Professions Codc:Any city or county which requires a permit to construct.alter,improve,demolish,or repair any structure Valuation i H prior m its issuance,also requires the applicant for such permit to file s signed statement =Floor ea $5 0 0 0 ?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 t=— (commencing with section 70D0)of Division 3 of the Business and Professions Codc)ur Occupancy Type I that he is exempt therefrom and the basis for the alleged exemption.Any violation of N Number Section 7031.5 by airy applicant for a permit subjects the applicant to a civil penalty of 3562401;3 . not more than five hundred dollars(5500). 0 1,as owner of the property,or my employees with wages as their sole compensation, Required Inspections will do the work.and the structure is not intended or offered for sale(Sec.7044,Business and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intendedm offered fiheor owner- however,the building or improvement is sold within one year P builder will have the burden of proving that he did not build or improve for purpose of sale.). 0 1,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds orimp o the thereon. and who contracts for such projects with a contractors)licensed pursuant oes License law. B&P C for this reason 0 1 am exempt under Sec Date Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a Certificate of Consent to self-insure forworkres Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the -k for which this permit is issued. SANITARY I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Codc,for the performance of the work for which this permit is issued• My Work s C in ensauon Insurance carrier and Policy number are: Cartier. Policy No..: CERTIFI COMPENSATION FEMIOFROM WORKERS INSURANCE ('this section need Rothe completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued.I shall not employ any personin any manner so as to been su .1 to Workers'Compensation Laws of Cal' is C7 Applicant NOTICE TO APPLICANT: , fuer makin s Ccrti(icau of Exemption,you should become subject to the Worke ompensad provisions of the Labor C. you must �Z forthwith comply with such provisions or this permit shall be deemed revoked. Z- CONSTRUCTION LENDING AGENCY CA I hereby affirm that there is a construction lending agency for the performance of p;> the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name 0 z Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and slate laws relating to V Ubuilding construction,and hereby authorise representatives of this city to enter upon the above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against Yy liabilities,judgments,costs and pxpcnsea which may in any way accrue against said City Date a- U Z in conseqce of the grantin of this permit. APPLIC U E A DS ND WILL COMPLY WITH ALL NON-POINT Issued by: SOURC t R GUL O S. I I U Re-roc fs Signature of A Iicant/Contr r Dam e c f Roof g PP HAZARD U MATERIALS D S OSURE TYP Will the applicant or fut building occupant s ore or handle hazardous material as defined by the Cupertino Munici aI Code,Chapter 9.12,and the Health and Safety Code.Secuon25532(a)? All rot)fs shall be inspected prior to any roofing material being installed. 0Yes ° If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as d ,nod by the Bay Area Air Quality Management all net v materials for inspection. District? �,( Yes !�J'ryO I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building docs t cu ntly ha a tc nt,that it is my responsibility to notify the occupant of due Date req encs I st ,net riorJ91an r reamoroe Icy. igna'ureofApplicant (j G ~� All roof coverings to be Class'B" or better I Da Owner or authorize g t N`TOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE I CITY OF CUPERTINO PERMIT INVOICE OPERATOR: CathyS Sec: Twp: Rng: Sub: Blk: Lot: APN 35624013 .00 INVOICE DATE. . . . . . : 08/01/2007 REFERENCE ID # . . . : 07C80006 SITE ADDRESS . . . . . : 21c-,52 LINDY LA SUBDIVISION • . . . . . : CU]'ERTINO CITY . . . . . . . . . . . . IMPACT AREA . . . . . • • OWNER TA7(SI MEHMET U AND CANDAN ADDRESS . 95014-4813 CITY/STATE/ZIP CU_ERTINO CA, CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP TELEPHONE . . . . . . . . DUE FOR ------ AMOUNT DUE PAID BALANCE------ --- FEE DESCRIPTION ---------- ---------- - --------------------------- PRINTING PERMIT 9 . 00 9..00 0 .00 MAIN WATER SERVICE PRINTING PERMIT 38 .37 38.37 0.00 PLUMBNG PERMIT ISSUE ---------- ---------- -----47 .37 47 . 37 0 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION V __________________ __------ ---------- ----------------- - -- --------- 502 FINAL PLUMBING ENERGY 301 ROUGH PLUMBING 507 FINAL PLUMBING CITY OF (:UPERTINO ' . 1 S AIN SERVICEREPIPE/SI `� l , CUP EkTINO PERMIT APPLICATION FO U -7 APN# Date:�� O Buildin�ddress: ' S j /I }r� p ) Ow e• - -- i Phon ) � I G 1 lLl.) Contrast o License#: Q Q + Cupertino Business License #: Building Permit o: Bldg ❑ Elect ❑ Plumb Job DescriptionW 1-0 Residential Commercial Cost of Proje ,O Qty' if Fee Descri tion Fee Group A licable Fee ID PLUMBING PPERMITFEE PlumbingPermit Issuance BPREPIPE -Repipe of Fixtures PLUMBING BPERMFEE Bldg.Permit Fees BUILDING BPFIXTURE Pbl .Fixture PLUMBING BPFIXTU Main Water Service PLUMBING BPSEWER Sewers PLUMBING BPSEWAGE Sewage Disposal PLUMBING BUSLIC Business License BUILDING