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08010078 CITY OF CUPERTINO /v*'��?y1n.^yy3.. 4�*^�"� ' y�ra3 "gg'�iys 'p�rkya�♦ r �} BUILDING DIVISION PERMIT n 1.��Y'U. 4TQA\�1ilA.'�1�kClt? QLA PERMIT NO. BUILf3{rvG AGpgEsy DE ANZA BLVD TBD - TO BE DETERMINED 08010078 l2'SVNLAUMEI J PERMIT ISSUE DATE RANK LIANG & SUCHIN LI 03/06/2008 PHONE: SANITARY NO. CONTROL N0, ARCHITECT/ENGINEER: BUILDING PERMIT INFO -BLDG ELECT PLUMBMECH a 0 0 0 wLICENSED CONTRACTOR'S DECLARATION AIOb DCSCiIptlOn 1 hereby affirm Nal 1 am licensed under provisions of Chapter 9(Commencing '� with Seen..7")of Division 3Ofthe Box.and Professions Codc.and my Income is COMM t L T.I . , STRCTL INCLDG ELECT, MECH & PLMBING A in full r.rec and effect. Lu,nm Class Lie.d Fn Dam Contractor ARCHITECTS DECLARATION rZ Q I understand my pians shall he.4 As public records iy u H Licensed Pndusionel tcts OWNER-BUILDERexemptDE DECLARATION I hcechy.(Sec nd 11. exempt(mm the Comas Co License C Law for the p O following An.. orris in RDLS B.men. and Profusion h,Or Any city or County m tBi which mquiru a permit m lutm the a alcor,improve.de Permit t of e a sig any stmaUned ummerc 3iy that M is sliensed p.alwm to the thovisioso for such Contractor's icessLaw( ha:mem STI (hasheiscingwitpurswnttodwprovisionsofIhoComsinessLicenselaw(Code)9 Sq.FC Floor Area Valuation j t-$ (cat he is(commencingwithdiection rom and theof basis f r he al eged ev and Professon.Anynvi Code)or 2 0 0 0 0 that o u exempt thalefrom and Bar buns far be alleged eBempnCo.Any violation of SeNon 7031.5 five airy applicant far a permit subjects the applicant ro a civil puulty of 3 5 910 0 4 4��Number Occupancy Type not more Nan five hundred dalton(5300). l,u Owarofthepmpwy.mmyemploycuwithwapsuA irmkcmpcvdo., will do thcwurk.and the swctum Is eminknded oroRertd foracle(Sec.7044,Bamsem Required Inspections and Pmfeui.ns m Code:The Conuw/s Liaisens w law denal apply an Owner a q p property who builds w improves dtermn,and who does such work himself w through his awn employees,provided that such improvements are oat intended woffered for uta U. however.the building or improvemenl'u mid within ane year of c.mpled-m.due wvtty- builderwill have the burden of proving that he did not build or improve for purpose of uk,. 1,u owner of Ne property,am.1.6vely convecting with ficctued Contracrors w construct the pmicct(Sec.70,1 Business and Professions Code:)The Contraaofs i cone law does not apply or an owner of property who builds or improve;Merton,and, who contracts for such projects with a conuacmr(s)licensed pursuant to the Contaacwrs License Law. ❑lam ,B d P C for this myon Dau J b-JI a6 WORKER' E ATION DECLARATION 1 hercbY elfin under Am" perjury One of du fallOwinB dalemdons - ❑IhareandwillmainulnaCe late of Consent to self-Iammfar Warkef;Compm- satian,uprovided(ea by Secs n"'0(the labor Cade.for the porformance of the work for wM1ieh Nis permit is used. ❑t have and will mainuin Worker'.Compensation Insurance,As required by Section 3700 Of the labor Code,for the Performance of the weak for which this Permit is issued. My Worker's Compeuati.a lose..artier and Policy number ase: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu scall..need wt hecomplcud if the Permit is for.hundtrA doliam(5100) or lcm.) 1 comfy that in the performance of the work for which this permit ts bound,l Adult not employ anypesmn in any.AnAn.r 1,become mbjpy�o Neworken'Compewdon LawA of Caiifolpja _ Applicant r NOTICE To APP f,After makings Cenificate of Esempdan,you should ., become subject m the W.hch COmpcnsado provisions of the labor Code,you mtm .JO rOMwidte.mply withsuchpmvisions or Nilnrmit shall be deemed revoked. zCONSTRUCTION LENDING AGENCY F1 hereby aRren that then is a construction lending agency ror the Performance of g>;> one work for which this Permit Is issued(Sec.3097,Civ.C.) W Q Lender's Name z Landers Addreu [,) p 1 certify that I have mad this application and state that thc above information is g� F torten.1 agree to comply with all city and county ordinances and sou laws relating or C) building c.nswec n.soave hercemnily fy d keep han.l.te cats city menwfUpon the above-oteromyed property to,ormiccti.......s. (We)agme to save,indemnifyadharmless the city of against id City U N liabilities.judgmentseeosuand expenses whim may in any way acerae against aid City U z in consequence of the grambRSTA DSNisD rniWILL Date '-� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOUR S. _4 L Re-roofs Signature tanUCondacwr Dadeu HAZARDOUS MATE DISCLOSURE Type of Roof Will Ne applicant arfutumbuildin upum Atom or handle hautdoes material fined by the Cupertino Muni,Pat ode,Chapter 9.12,and Ne Hata and Safety section 25532(.)9 All roofs shall be inspected prior to any roofing material being installed. 0yes Will the applicant or future building Occupant use equipment or dcviaA which If a roof is installed without firs[obtaining an inspection,I agree to remove emit hal rd.us air contaminants as defined by On,Bay A.Air Quality Management all new materials for inspection. District? / ❑Yu 1 have read the havardsms materials requimments unser Chepters.95 of the Califor- nia Health Sa Safety Cede,11etiau25505,25533 and 25534.1 undersu d Ihm Rthc building J .maul Natit u my mspowihility w notify the wm'.1 of the mgnimmentswnk .Athmtpd.rwiAsuanann team aapan Signature of Applicant Dale ownweaa.th.rf,a,genl D,w All roof coverings to be Class "B"or better CITY OF CUPERTINO /v*'��?y1n.^yy3.. 4�*^�"� ' y�ra3 "gg'�iys 'p�rkya�♦ r �} BUILDING DIVISION PERMIT n 1.��Y'U. 4TQA\�1ilA.'�1�kClt? QLA PERMIT NO. BUILf3{rvG AGpgEsy DE ANZA BLVD TBD - TO BE DETERMINED 08010078 l2'SVNLAUMEI J PERMIT ISSUE DATE RANK LIANG & SUCHIN LI 03/06/2008 PHONE: SANITARY NO. CONTROL N0, ARCHITECT/ENGINEER: BUILDING PERMIT INFO -BLDG ELECT PLUMBMECH a 0 0 0 wLICENSED CONTRACTOR'S DECLARATION AIOb DCSCiIptlOn 1 hereby affirm Nal 1 am licensed under provisions of Chapter 9(Commencing '� with Seen..7")of Division 3Ofthe Box.and Professions Codc.and my Income is COMM t L T.I . , STRCTL INCLDG ELECT, MECH & PLMBING A in full r.rec and effect. Lu,nm Class Lie.d Fn Dam Contractor ARCHITECTS DECLARATION rZ Q I understand my pians shall he.4 As public records iy u H Licensed Pndusionel tcts OWNER-BUILDERexemptDE DECLARATION I hcechy.(Sec nd 11. exempt(mm the Comas Co License C Law for the p O following An.. orris in RDLS B.men. and Profusion h,Or Any city or County m tBi which mquiru a permit m lutm the a alcor,improve.de Permit t of e a sig any stmaUned ummerc 3iy that M is sliensed p.alwm to the thovisioso for such Contractor's icessLaw( ha:mem STI (hasheiscingwitpurswnttodwprovisionsofIhoComsinessLicenselaw(Code)9 Sq.FC Floor Area Valuation j t-$ (cat he is(commencingwithdiection rom and theof basis f r he al eged ev and Professon.Anynvi Code)or 2 0 0 0 0 that o u exempt thalefrom and Bar buns far be alleged eBempnCo.Any violation of SeNon 7031.5 five airy applicant far a permit subjects the applicant ro a civil puulty of 3 5 910 0 4 4��Number Occupancy Type not more Nan five hundred dalton(5300). l,u Owarofthepmpwy.mmyemploycuwithwapsuA irmkcmpcvdo., will do thcwurk.and the swctum Is eminknded oroRertd foracle(Sec.7044,Bamsem Required Inspections and Pmfeui.ns m Code:The Conuw/s Liaisens w law denal apply an Owner a q p property who builds w improves dtermn,and who does such work himself w through his awn employees,provided that such improvements are oat intended woffered for uta U. however.the building or improvemenl'u mid within ane year of c.mpled-m.due wvtty- builderwill have the burden of proving that he did not build or improve for purpose of uk,. 1,u owner of Ne property,am.1.6vely convecting with ficctued Contracrors w construct the pmicct(Sec.70,1 Business and Professions Code:)The Contraaofs i cone law does not apply or an owner of property who builds or improve;Merton,and, who contracts for such projects with a conuacmr(s)licensed pursuant to the Contaacwrs License Law. ❑lam ,B d P C for this myon Dau J b-JI a6 WORKER' E ATION DECLARATION 1 hercbY elfin under Am" perjury One of du fallOwinB dalemdons - ❑IhareandwillmainulnaCe late of Consent to self-Iammfar Warkef;Compm- satian,uprovided(ea by Secs n"'0(the labor Cade.for the porformance of the work for wM1ieh Nis permit is used. ❑t have and will mainuin Worker'.Compensation Insurance,As required by Section 3700 Of the labor Code,for the Performance of the weak for which this Permit is issued. My Worker's Compeuati.a lose..artier and Policy number ase: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu scall..need wt hecomplcud if the Permit is for.hundtrA doliam(5100) or lcm.) 1 comfy that in the performance of the work for which this permit ts bound,l Adult not employ anypesmn in any.AnAn.r 1,become mbjpy�o Neworken'Compewdon LawA of Caiifolpja _ Applicant r NOTICE To APP f,After makings Cenificate of Esempdan,you should ., become subject m the W.hch COmpcnsado provisions of the labor Code,you mtm .JO rOMwidte.mply withsuchpmvisions or Nilnrmit shall be deemed revoked. zCONSTRUCTION LENDING AGENCY F1 hereby aRren that then is a construction lending agency ror the Performance of g>;> one work for which this Permit Is issued(Sec.3097,Civ.C.) W Q Lender's Name z Landers Addreu [,) p 1 certify that I have mad this application and state that thc above information is g� F torten.1 agree to comply with all city and county ordinances and sou laws relating or C) building c.nswec n.soave hercemnily fy d keep han.l.te cats city menwfUpon the above-oteromyed property to,ormiccti.......s. (We)agme to save,indemnifyadharmless the city of against id City U N liabilities.judgmentseeosuand expenses whim may in any way acerae against aid City U z in consequence of the grambRSTA DSNisD rniWILL Date '-� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOUR S. _4 L Re-roofs Signature tanUCondacwr Dadeu HAZARDOUS MATE DISCLOSURE Type of Roof Will Ne applicant arfutumbuildin upum Atom or handle hautdoes material fined by the Cupertino Muni,Pat ode,Chapter 9.12,and Ne Hata and Safety section 25532(.)9 All roofs shall be inspected prior to any roofing material being installed. 0yes Will the applicant or future building Occupant use equipment or dcviaA which If a roof is installed without firs[obtaining an inspection,I agree to remove emit hal rd.us air contaminants as defined by On,Bay A.Air Quality Management all new materials for inspection. District? / ❑Yu 1 have read the havardsms materials requimments unser Chepters.95 of the Califor- nia Health Sa Safety Cede,11etiau25505,25533 and 25534.1 undersu d Ihm Rthc building J .maul Natit u my mspowihility w notify the wm'.1 of the mgnimmentswnk .Athmtpd.rwiAsuanann team aapan Signature of Applicant Dale ownweaa.th.rf,a,genl D,w All roof coverings to be Class "B"or better