04120135 Y •
CITY OF CUPERTINO
BUILDING DIVISION PERMIT 'CONTRACTOR INNeFORMATION':
t'a�s3f .^.� •ihKb Y
BUILDING ADDRESS: PERMIT NO.
YOUNG KIM 04120135
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S NAME: PERMIT ISSUE DATE
KIM 00771A AT (`AT.r—Y SANITARY OL NO
PHONE .
ARCHITECrYENGINEER: BUILDING PERMrr INTO
BLDG ELECT PLUMB MECH
30o LICENSED CON'TRACTOR'S DECLARATION Job Description
1 hmcby.Rrm Net 1 w Ikcnxd muter piorio«u or Ch.pmr 9(commcminl
with Section 7")of Division 3 of dm Buri.sod Profevone Code.+od my Iku.ec t,
v
mfullr«a.w6Den
Lf.11ilie.. SFDWL-2 STORY (5 , 224 ' LIVING)
j
No, ABCHTTECT S DECLARATION GARAGE-6 2 0 ' /STAIR 121 '
5 I n&.d any Ill."I be used n ludic sec«d.
` U
t� Lcrmcd Prafesdovl
O.11 so, DILDER OE ft coon ON
sc
1 Femby afRrm th.1 1 1 eumpl fmm Ne Gmlmoos :Any C Iyw,for Nc /
nLy
KS 0 following,,rOo,s, rcr«17011 S,Btuimv W Psafvd«n Code:Any cry« uoc
K$ which regdra.permit or enrutraet-ppilc tnymc,dvnalh4«mads any nrumum
prior n iB issuance,aBu mqu'uu Ihe+ppll"..,for arch pmmir to Ble.,igswd Balemem
Ih.tbel,Ilccnmdpumo•oton�prov'Id«uaW,Camr.curr's li¢n¢Liw(Ch.Ple,9 Sq. Ft. Floor Area Yallld eb
(communingwish 5cmim7()(o0 Division 3 of Ne Budne,aM P,afew«u Cnde)«
.. IhN be is euaopt sheet.and the but,for,Ne dirled eaempdm.Any vioHtion of
Se Won 7MI.5 by ir,."lcant for.permil nbjccu W, PPllcnt no at lPcoshY of APN Number Occupancy Ty rl
.or mart dun fire bundrtd"W,,(55083 ll
I,u ovov of Ne proputy.«my wpMrm wish wag,u Ne'u ink compcmuim. 34244039 . 00
.IRmurcwnn.+mneva ami+oo,m"dodor remdfarweIS".7a.,Busdss . Required Inspections
and Pcofe ..Cade The m
Cosic of.Lkso law does,rd.ppiy 0 so owner of
perry who b'yld+orlmP°`T+ ^••sod who dou.uch wort hlau Jfor Nmulh his
owe unNrYm.p ided N+Inch jo,, ncnu m nm inlmdcd uralferW f«aak U. +pw
Yavere,,346 ddldiol m hopn.t I.sold within ane you of c«npliclion.lbe vww-
hviWer wB1 bare on,WrOc,,of Parini Nat Ic did n«Wild«Improve f«puryoa of
❑I,u owner of Ne property un a usiw,corur.mi,with Ikw¢d mno.clors W
ccosv the sl(Sec.7061,B..a Rofevbrs Code:)The Conk 'U.
cove Us.dos n«.Pply to n omr or propmy wbo Wilds or impco n Neuron,and.
who cont,,,foraoipmjc.w o.cmu,schr(,)lireved p nr WNe Cbo wes
Lice.law.
l weaempt un�dto BI-
4
c
r f' /
W 5 COMPENSAIIUN DECLARATION
I booby arMn under pmW 1y of PUFOY ane of she fallowing dcclmsi«u:
1n,upod win for by .CcNnam of Com cm W Codk.furt o Wrfbsos co Of ho r'
vdmi.v pmvidcd for by Sevum]Af0 of do LaW«Code.r«Ne puf«muia of Ibe
woe fm which this pcmit t,ivied.
❑1 have sod will nuinutin W«tef,Onm,,boo a Ineiusoc%n .qW d by SeWon
3700 of Nc Isbm Calc,f«Ne Pco(ann.mm of Ne wort for welch mi1 puma is Wv
My Wart M,CompcmWoo Wursoa catdv pod Pdicy numbv art:
Cartier: Pdky No.:
CERTIFICATE OF MEMPr10N FROM WORKERS
COMPENSATION INSURANCE
midi,¢vim,rd ort be c«opkcd UNe pc+,ou u f,arc bun6ed doom 12100)
«kis)
1 c fy Not in the perio—,neo of Ile wort for which �permi/t1�'s pIs1�uCcS0.�o1 NN not
unpby+ny,cm^n in soy msoncrsoubbecome,ubj / N" l uno
NOTICm n^
NOTICE bj a Wffio N�L a( TIG thi,Cw of Libor oo,yin rbmld
hcc«ne sobj.m m Ili Winter`.Cmofcor this Pmnil 00 M Ne Libor Cade,yvu much
OronhwiNromplywlusoch pro.isionsm NupumitNJl be drsmcd rtwtoA. '
Z CONSTRUCTION LENDING AGENCY
(..r Ilurch,aR,m Nat Ncrt Us coostrvnim Wdinl+FocY f«Nc Pcrfosol of
(Y> dm•wort for which Nis pcmih u issued(Sc]f A7,Civ,C.)
W Q IrMrYs N.
a,z Irndcr',Addrev
t..)O 1 an fy thd I rare road Nu aWlkadan aM win mu Ne+bore Woron.uun t,
W rurrecl-I agree W canPlY with dl ciy W county ONin roil vise I+ws m Winl or
GtilElnl cm ido. of Nuoily U)-=Opus Ih
W shore-menu«N Rop.nY for impecvon pbp /
fWc)+gmeo sore,iMcmmryuWkeep Wrmlr+e wily
of M,iotq city
IZ U+birlosf ualmenicSrsung of his ca which vuylo soyw.y acorW ag.inu s.ld Cry Q J
V zorrnil-
APJ.ePPLICCANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULA ONS.
Re-roofs
Sigeatvm ofAppl HAZABDOU ATRRIAI S DISCLOSURE Type of Roof
W, , ,PIjcsol«muco Wilding ocarpam a.or O lldk Wndou,ahl
derlmd by do Cupenlm Moroi")Coe,Chapter 9.11 sold do Hu1N Old Wcly
e.Senior 15532(.)7 All roofs shall be inspected prior to any roofing material being installed.
DYu ❑No,
Will the appiicenl or mWm building a vWi a¢equipment«dcv which If a roof is installed without first obtaining an inspection,I agree to remove
cmlt Wsrdo,sir conuminams,&fund by Nc Bay Am Air Qudity M Vosnet all new materials for inspection.
D nrinT
❑Yes ON.
1 hmc m.d Ne baxud«u mden.H mquincmcma unhr Chapter 6.95 of No C.Ilfw-
nullcnlNh SduyCodc,S.255M,25533.nd 25534.1 undcrosvd Nat I(&building
dm Doi cursorily hoc.mnam,Jut Ir u my rupowbilu,W miry,he ocl of ds
mg who au m 1prio W m anr.CuuOo�r Signature of Applicant Date
D,m All roof coverings to be Class"B" or better