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06070131 CITY OFCUPERTINOx -3k; .T �n -� ^'"• " - `"` �UILDI NG'DIVISION PERMIT *COsN,T"QTOR`INFORMr�.TION .. BUILDING ADDRESS: WONG ELECTRIC INC """"ITN006070131 20955 STEVENS CREEK OWNER'S NAME: PERMIT ISSUE DATE WEISS PAUL E AND BARBARA H TRU4067 TRANSPORT 20 2006 NE: SANITARY NO. CONTROL N0. (650) 813-9999 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH p G LICENSED CONTRACTOR'S DECLARATION U t 1 I Mmby affirm Nal 1 am EmvW under provisions of Chapter 9(commencing Job Description u� wins Section IIKlR of Didmcm 3af Ne Business and Professions Code.and my license is e.e, in lullmmemrinfem- TEMPORARY POWER ,q? ueen,ea m - sere.« o, ConlracWr 44 ARCHITECTS DECLARATION i W 1 understand my plans shall M used se public records r6u Licensed Pmfcssianal ''aZ OWNER-BUILDER DECLARATION C E I'mh' mmo a(Sect Nor 1 1. eumpi from the Cssions o License taw for 0e -:CC O fallowing reason.(Section 7G3 L5,Business and Pu.demob Calc:Any oily or county •,a which requires a permit a cnvwm,aMr,improve,demolish,or repair any ssmcsum $500 9i priorMay cenedpalso mquira tub appin o the larmch Law(Chapter p (ffou he commcsliconudpumuon70YRofDivision ivionso of ft Business ni¢muMw(Code)w Sq.Ft. Floor Area Valuation e� ch.As t exempth Section and the basis for of the Business and I'mon.A.,ovi laton of s�9 mat M u exempt thme(rom and the baso for me alegW eumpaam Any violation of Section 7031.5 by any applicant for a permit subjccu the applicants o a civil penalty of 3 OR Mznper U Occupancy Type out mart than five hundred dollars(SSW). 0 1,As owner of t e propeny,or my employees with wages as thew sole eompmelman, will do the work and Nesuvewre is rwr intended Mraaored Tarsale(See.704,1,Ba.ua and Profevi.ns Code:The Commences Limine Law doex WI apply a an mwnm of Required Inspections progeny who buildsorimprovss therms.and wM doessuchwork himulfor through his own employers,provided that such improvemenu are nor Amended er.fin ml for sale.If. however,me building or improvement is sold within oro year of completion.the owner. builder will Mae the burden of proving that M did Out build or improve per purpose of sale.). 0 1.as owner of time proPenY•am exclusively c mso ning with licensed mnuusors As construct the pmjem(Sec.7044.Business and Professions Cade:)The Conhacmr's Li. n ccnseLaw doar suchapply ean ownmmfpr Cony wea wild rimprows themMn,and who . �U� es as rte..,.® Limine"Lace for such projecu with aeanuamm(sl limned punuam tithe Cantrxtoh ((y�l" ";a/aft+}=�gsFTg g/fi'{{�QtTt�rtty`_-"'r f.icxrsse law. ❑lamexemptunderSee .B&PCfwdasmason Owner Date WORKER'S COMPENSATION DECLARATION Alt;© L a)oO 1 hereby a10ne under povity of perjury ane of the t fallowing declarmona, (- ! r'6 I M+e m o mill maintain a Cerufuae of Covens to self insure for WMrteYSCompen- sada.,u provided for by Section 37M of thmamm e labor Cade,for the peAmof the 1y}{ 'i IT work for which this permit is issued. 1 have and will maintain Workers Compevaaon huurmm,as rtyuimd by Section 3700af the labor Codc,for the performance offt Aunts for which this permit is issued. My W. /M1 1 e�r'/s�Cso/mJpen 'o Ins mlicy num Carrier try NM.: I S OOHS U5 CERTI ICATEO EXTIONI SUROMW KER 1 COMPENSATION INSURANCE - - (This uctiun need net bucanpleted Rnse permit is formic hundred dollars($1 00) nr leu) 1 verify that in use performance of the work for which this permit is issued.1 shell not employ anyponun in any mamerso as At become subject to the Workers'Compevaion Law s of c3hromia.Dam Applicant NOTICE TO APPLICANT:IL aper matting this Ceniflate of Exemption,you should become subject 0 the Workeri Compensation provisions of the labor Code,you must .J O fonhwith comply with such provisions or this permit shall be doomed r okcd. z y CONSTRUCTION LENDING AGENCY E. 1 hereby alEres that mem is a consorted.ending agency for the porporm.sir C > don work for which mix p<m,il is Wood(See.309'f,Cm.C.) wM q^ Lender's Name z Lender's Address U Q 1 codify that I have mad this application anal sue door the above information is UL H conn.1 agree a wmply with all city and county odlinames and sou laws miming w O U building consvuction,and hereby authom<¢pmsenurives ofthis city to enter upon the FW abuve-m.j.d, dpmpeny foninspection purpowhich ms. C (we)agree to save,indemnify and keep harmless the City of Cupertino against 42 4 t/lZ inmormsice .ofth,comaand ea pensoswhich may in any way accsu agavtsaid City U z A PLICA T of de RSTAN of mint permit 7 'eD� / APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date i O SOURCER NAAL A� I /W/U/^ Re-roofs Signme.01 AppllcanVC career De V HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding emumm snort orhasalle havaNnus materia u de0ncd by the Cupertino Municipal Code,Chapter 9.13,and the Health and Safety Code.Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes AK. Will mea Errant or Wilding em,u t see If a roof is installed without first obtainingan inspection,I agree to remove pp g Pan ea Ai,Qnt hl denims which lye g it hvvdnv air conuminmu u defined by IM Bay Area Air Quality Management all new materials for inspection. District? ❑Yes 'Al. - I have mal me Mvasd.materials myviremcnu under Chapter 6.95 of the Califon nu Health&Safety code.Secvau 25505.25533 and 25534.1 undmaxand drat ifine building r Jars not currendY Mae a enact.that it u my MaNdsibility W notify the Occupant Of the regmmmM which be metpriaeiaamanceofaCertifeae.(Oc.P..y Signature of Applicant Date OwnerormdMr cdagcm All roof coverings to be Class 'B"or better o3JUL. 19. 2006• 1 :49PMgx 85o 8139884 WONG ELECTRIC, INC. NO. 0860 P. 3 ®o03 Commuuity Development 10300 Torre Av=uc C perdria CA 95P14 Telephone(408)777-3228 &COF Fox(408)777-3333 OCUPERTINO Building De artment JOB ADDRESS: PEMWIT# 20 o S4'p v?,ws Lek B LJd D6 oa 000 8 OWNER'S NAME: 591Qr> !Y/L-L PR-076P, Y"RMVY PHONE# GENERAL CONTRACTOR: TAr, FAX # 40?—.p K _?6qk l,,l,�+ UoFlsrRt-t.sto� I am not using any subcontractors: �, _ -1 (S p Sig ature Efate Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Woti(* F-LE (C Tt3L 2o3(oS C_—( 0 Excavation Fencing Flooring; Carpeting Linoleum/ Wood • Glass / Glazing Heating Lnsulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Pltunbing Roofing Septic Tank Sheet Metal Sheet Rock Tile • Owne /Contractor Signature Date CITY OF CUPERTINO 1 of 1 PERMIT RECEIPT OPERATOR: bethe COPY # 3 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32631020.00 DATE ISSUED. . . . . . . : 07/20/2006 RECEIPT #. . . . . . . . . : 35321 REFERENCE ID # . . . : 06070131 SITE ADDRESS . . . . . : 20955 STEVENS CREEK BLVD SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : WEISS PAUL E AND BARBARA H TRU ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : LOS ALTOS HILLS CA, 94022-3211 RECEIVED FROM . . . . : STEVEN WONG CONTRACTOR . . . . . . . : WONG, STEVEN L LIC # 20368 COMPANY . . . . . . . . . . : WONG ELECTRIC INC ADDRESS . . . . . . . . . . : 4067 TRANSPORT ST CITY/STATE/ZIP . . . : PALO ALTO, CA 94303 TELEPHONE (650) 813-9999 IRE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ______ _____________ __________ __________ __________ __________ __________ BTEMP FLAT RATE 1.00 62 .10 0.00 62.10 0.00 EPERMITFEE FLAT RATE 1.00 38.37 0.00 . 38.37 0.00 __________ __________ __________ ---------- TOTAL PERMIT 100.47 0.00 100.47 0.00 METHOD OF PAYMENT AMOUNT NUMBER _________________ ------------ _______-____-_____ OTHER 100.47 MASTERCARD TOTAL RECEIPT 100.47 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY 505 FINAL ELECTRICAL • _o_JUL. 19. 2006) 1 :49PWAX 650 6139se4 WONG ELECTRIC. INC. NO. 0860 P. 2 ®002 CITY OF C UPERTINO TEMP POWER • CUPEI�TINO PERMIT APPLICATION FORM 0( 070131 APN# Date: 31- 0a0 , Building Address: 2-09S5 S I _ r / .p V 1 e.v� t s rhe, D �k Owner's N me: Phone#: _ stub Contractor: WalgL ...LL�-C-W.1 L Phos 50���3-q�l� x1 C-t156 3(0;�l O Contact: I Phone: Cupertino Business License#: MCLViti KANl& l50 813-9�z^y ((� ) x'2 q BuildinggPermit info: 001? Elect I!Q Job Description: � aoA -l�I�It'o2r�fZY �owER Residcniial ❑ Commercial Cost of Project: O S • Qty. if Apyl.Ica 10 Fee IA Fee Description Fee Group BTEMP Temporary Power ELECTRICAL EPERMITF'EE Elect. Perrnil Issuance ELECTRICAL BUSLIC Business License BUILDING -L-7� •