06060235 CITY OF CUPERTINO a' 3KhxX..� - a`°
BUILDING DIVISION PERMIT �COI�TTRAG"TQRI1�FOR ATI^N,-
fR+�A ,.4*...
BUILDING ADDRESS: DRAIN DOCTOR Pfi"MITNO06060235
18841
OWNER'S NAME: PERMIT ISSUE DATE
HO YU 1775 WINCHESTER RT.vn 09/28 /2006
NE:
SANITARY NO. CONTROL NO.
(408) 370-3082
ARCHITECT/ENGINEER: - BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
u a p LICENSED CONTRACTOR'S DECLARATION Ib Description
d w C 1 hereby aRrm Nal l am licensed umkr provisions O05CO of Chapter 9(mmmcncing p
'Zw with Section 70W)of Division 3 of Me Business and Noressions Code.and my licemc is
<a infullforceanBe K:5 C/ PIPE BURSTING TRENCHLESS ADD PROPERTY LINE CLEA
5,'I�= umnseCiaa �4Z
t Dale Coatralwr OUT
ARCHr1ECTS DECLAR ION
?w U 1 unders nod my plans shall be used u public records
0
k�H
Licensed Professional
5 OWNER BUILDER DECLARATION
I hereby alum Hot 1 1. exempt fate Ne Canto Code:
IJecnw Law for the
o O following muon. emit t ]031.5.Business and improve,
dcoou Calc:My city as County
structure$� which rtquima a permit w consumer,alter,wpmw,dcmtlish.or repair any swcwm
—zY priormits sensed c.alsamtoima thavisianant the
Contractor's
file aaLaw(rnemcm
<
(that commencing
incingwJpurwannoNcpmviviamafofMeBusiness
uxwr'sndProl l�w(CTapus9 Sq.F[. Floor Area Valuatf�ytl200
(hot he is exempt Sectionrn and f Division for niche ng a cramni Professions Cain of
Q�— that he u exempt thmermm and the buss for ctr allegetl exemption.Any violation of
Smith 7031.5 by arty appii som far a perp it subjects the applicant o a civil penalty of APN Number Occupancy Type
not more than five hundred dollars fss(o). 37533057 . 00
❑I,an owner ofthe property.or my employer with wages u Hcir sole compensation,
will darework.andthe he c mieaces Liens Lawdoforsale(Sec.](N4,Bmin of
ani ertywhobu Code ort.datum.,Lieu Law dam rot apply lf an owne or Required Inspections
propsoywhobuitis i impmvm Hereon,anderho saessuchwork himself alHaugh his
Own cmplaym,pmrlorri that such imPmwmmtt are not intendedaofd oroBered for ale IL
build.,,thebuildingorhnpmvemmt usaid within at year of mproefor He owned
sale). will have the burden of proving Net w did not wild or improve for purpose of
ale.).
❑1,as owner of tho property,am exclusively contracting with licensed contractors m
comlrltel the es nor
(Sec.7044.nweerBioOf Pandroperty
rty who
Cade:)The,Comacmr's fid
Lo
chow Law does oat apply m an owner of property who builds r improves thereon.and
Whonse Law.far each pmjdeL4 with amnVXm!(a)IIUMed pu13Wa1 m 11M f.'anVK10Ya
License Law.
❑cote exempt under5,. .Bk PC far His recon 1 �IVI—
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby aBlrin Under penlltY Or pel]Ny aIle of HC following deelYddam:
1 haw and will maintain a cmrt remw of Consent to wl(--imam far workers Campen-
subm,as innovated far by Section 37013 of He labor Code,for He performance of the
woh for which His permit is issued.
❑1 have and will maintain Worker's Compensation I..as required by Section
3700 of the Labor Cade,for He Furtherance of He work for which this permit is lsswH '
My Worker's Compensation Insurance Cartier and policy number are:
Comer.m! K yy�Kyolicy No.IS ISI_ /SO3 S3
CERTIF
ICATE OF EXEMPTION ION FROM WORKERS'
COMPENSATION INSURANCE
(ITu wnim teed not w Completed iflK permit Is f,one hundmddoBma(g 10))
ar less)
employ certify Hal er He n my manme of Um woh for which His prem,rk issued.I amid nm
Lawsaany raid.. any manrmrw um wromc wbjea to HC Workers'Compematitn
Laws of California.DataAppl
NOTICE,
"Orr s lTD APPLICANT:If,army making n p Cerins o of Exemption,you should
b,owi abject m the Wortcro Compensation provisions the Mental
Code,you mum
.J Z forthwith comply with such provisions or Hu pchmit shall be domed rewkes.
zO CONSTRUCTION LENDING AGENCY
'ra I wmby&IBrm Hxc there is a Conswction lending agency for He performance of
rG > He work for which this permit in issued(Sec.3097,Civ.C.)
W�Q Lenders Name
.7.Z L.cnder's Address
V 0 1 muff,that I have mad His application W mute Hal He&bow information is
u.H correct I agree to comply with all city and county ordinances and saw laws nearing to
OU building consruction.and hereby awhurim ripmwntalives afthis city to enter upon the
r W above-mentioned properly for inspection pugwws.
1Fi raj] limiliduWludgmenls,catsmldexpemcs Whiich may.myy waylaycctuc a,wastaid City
V Z in consequence or He gratting of this permit.SOU / ,L�Ql
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
CE REGU TIONS.
Z Re-roofs �-�
lgnimmou fi onaacmr Da
dAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will He applicant or future Wilding aceuput mare or handle ha'raNam nu mriil
u defined by tie Cupertino Municipal Code,Chapter 9.12,and Me Banks and Safety
Coca.Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
0Ym you
41 Will Hca applicant or future building oma nt ail If a roof is installed without first obtainingan inspection,I agree to remove
PP g e Wuipr Qu or sevum which g
emit bvardom air cuntamimnu u dcfinc0 by He Bay Area Air Quality Managcmcnc all new materials for inspection.
District?
Ym u
I have mad the ba candummamrials requirements under Chapmr6.95 ofthecalifor.
ma Hal"S9ctycade.Saxiomn5)5,25333 and 25534.1 uweaand Hsu Rthc wilding
it=Inst currently have a moan,Hal it u my responsibility It notify He Occupant of He
requirmcntswhic uBbrmapnorwiauanmofaccmflrateoraro cy. Signature of Applicant Date
wncr or au ."at DOW
- D All roof coverings to be Class "B"Or better
CITY OF CUPERTINO
em 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37533057 . 00
DATE ISSUED. . . . . . . : 06/28/2006
RECEIPT # . . . . . . . . . : 35052
REFERENCE ID # . . . : 06060235
SITE ADDRESS . . . . . : 18841 TUGGLE AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HO YU
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : DRAIN DOCTOR
CONTRACTOR . . . . . . . : JOHN H. LIM LIC # 24784
COMPANY . . . . . . . . . . : DRAIN DOCTOR
ADDRESS . . . . . . . . . . : 1775 WINCHESTER BLVD
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (408) 370-3082
�EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--------- - ------------- ---------- - - - ------- ---------- --------- - ----------
BPSEWER SEWER SYSTEM 1 . 00 21 . 58 0 . 00 21 . 58 0 . 00
PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
------- --- - - ---- -- -- ---------- ----------
TOTAL PERMIT 59 . 95 0 . 00 59 . 95 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
---- -------- - ---- ------------ ------------------
CHECK 59 . 95 10643
TOTAL RECEIPT S9 . 95
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
106 SEWER & WATER 202 UNDERFLOOR PLUMBING
301 ROUGH PLUMBING 507 FINAL PLUMBING
•
,.. Community Development
{1 10300 Torre Avenue
i� Cupertino CA 95014
' Telephone(408)777-3228
CITY OF Fax(408) 777-3333
�UPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
�8aw 'ry 6-&i 14ue-- 06 o e6-L-Is"
OWNER'S NAME: O 60PHONE # yoS $5 7 /(0 3
GENERAL CONTRACTOR: 17oC<Ia2- FAX # Uo!5r -) -7o 38 3
I am not using any subcontractors: z D
ature Date
Please check applicable subcontractors and complete the following information:
60 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
•
Owner/Contractor Signature Date
_ o(oowa35
-� CITY OF CUPERTINO
REPIPE/SEWERS/MAIN SERVICE
CITY OF
• CUPERTINO PERMIT APPLICATION FORM
APN# 315 -3-3 -01 Date: �� D
Building Address:
88V1 T011-61,4 40e-
Owner's
veOwner's Name: Phone#:
D VO zlD y $'.S7 ilo 3�
Contractor: Phone: License#:.
ra, 4-a2 1-580 �,� � �I S � b L) 3 USa
Contact: Phone: Cupertino Business License
INr of - l �r J o -ecz -/ #:
3
Building Permit Info:
Bldg ❑ Elect ❑ Plumb
Job Description:
3ucs�<< u1s T� e,i�c: -- L —ado( e
Residential Commercial ❑
Cost of Project:
�3�C7C7
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg. Permit Fees BUILDING
BPGAS Gas Piping System Fee PLUMBING
PPERMITFEE Plumbing Permit Issuance PLUMBING
BPREPIPE Re i e of Fixtures PLUMBING
BPFIXTURE Pblg. Fixture PLUMBING
BPWSVCS Main Water Service PLUMBING
/ BPSEWER Sewers PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BUSLIC L Business License BUILDING
•