01080098 CITY OF CUPERTINO s3 ° % > ' '"cYa'` `a '-' ✓ T���
I
BUILDING DIVISION PERMIT 3CONTRACT.OR+ NF I TIQN
a, OR �5ORMA.�e
BUILDING ADDRESS: - CHUNG & SOLIN YEH PERMIT NO.01080098
'S NAME: PERMIT ISSUE DATE
PRONE: SANITARYNO. CONTROL NO.
ARCHITECryENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
I00 LICENSED CONTRACTOR'S DECLARATION O O O O
£u 1 Wreby affirm the,I am licensed under provisions of Chapter 9(commencing Job Description
m with Section 7pX11of Division S or the Business and Professions Code,and my license is
in full rade anderfem.
;Sz
License Class
Lk.0 SFDWL LIVING 3782/GARAGE 634 SQ FT
Dem Contractor
` ARCHITECTS DECLARATION
e Iunderstand myplans shallncused aspublic.cards PERMIT .APPL EXTENDED TILL 6/20/03 PER GREG 1/29
IQ Licensed Profeaionel
9OWNER-BUILDER DECLARATION
2�m I hereby affirm Net 1 am exempt ham the Contractors License law for the
00 rollowing reason.(Section 7131.5.Business and Professions Cade:Any city at county
$ which requires a tentative connotes,alter.improve,demolish.or repair any gtructum
-iy poor to is intunce,also.quires she applicant rorsuch Permit no file aigmd.laemem
(5FF< that he is licensed pursuant In the Provisions of the Contmcmr'sLianse Law(Chapter 9 Sq. Ft. Floor Area Valuation
Cys (commencing with Session TOM)at Division 3 ofthe Business and Professions Crac)ter
Net he is exempt the.from and IN,bub far the alleged exemption.Any viohdon of $750000
Section 703 LS by any applicant for a permit ubjects the applicant to a civil penalty of APN Number Occas anc �I e
not marc Nan five hundred delta.($51)(f. P •Jp
El 1.as owner of the property.or my employees with wages u their sole compensation, 36603061 . 00
will do the work and the structure b nos intended Or offered far sale(Sec.704,Budn.s Required Inspections and Professions Code:The Communes Licence e Law does not apply b an owner or q p
property who builds or Improves thereon,and who dmuuch work himself or through his
awn.mploycea,provided that each improvement ora hatinarted or offered frank.It. 101 — FOUNDATION
however,Ne Wilding or improvement is sold whom am Sear of completion.Ne owner- f
builder will have the burden of paving that be mPose did not Wild or improve for pof 10 2 — PIERS
ex"1. 103 — UFER
1.as owner of the property,am exclusively contacting with licensed conwaon m j
c .wet the pmjccl(Sec.7044,Business and F.feaaans Cade:)The Contractor's Li. 104 - REBAR
who onwdo.naupplyman itleawner omactortywassedpurlth rimprovatheman,and
or', 105 - ANCHOR BOLTS
who cantata far such project with a conwnor(31lcensed pursuant m tite Comrenor's
Clef Law. 106 — SEWER & WATER
I un exempt under Sec. B&P Cfpr V,re n
��7,�,f� b 202 — UNDERFLOOR PLUMBING
r WORK OM NSATIONDECLAJ:"AITON 203 — UNDERFLOOR MECHANICAL
Ine.by,&in=under penalty ofprryryamofON,following declarations: 204 — UNDERFLOOR FRAME
❑Ihaw and will mainuinaCenihrneof connnua 4lFinsum fmwohers Compeo- 205 — UNDERFLOOR INSULATION
cation,as provided for by Section 3700 of the IwWrCode,for tite performance of the 301 — ROUGH PLUMBING
work for which this permit is issued.
a 1 haves and will maintain Workers Compensation Insurance.as required by Section 302 — TUB & OR SHOWER
37MofheLaborCode.forthePerformanceoftheworkforwhichthispewlt1tissued. 303 — ROUGH MECHANICAL
My Workers Compensation losonme,carrier and Policy number am: 304 - ROUGH ELECTRICAL
Carrier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS' 305 - FRAME
COMPENSATION INSURANCE 306 - HOLDOWNS .
or lea)(This, I.namino,Wcompleted ifch,Permitisfroomhundred doll.(SIM) 307 — INSULATION
1 certify Nos in the performance of tint work oar which this Pewit is same.l snail no, 308 — SHEETROCK
employ any person in any mnncr an a as become subject in ti.Workmi Compensation 309 — EXTERIOR LATH
Laws of C41ifornia.Dem
Applicant 310 — INTERIOR LATH
NOTICE TO APPLICANT:If.after making thb Certificate of Exemption,you should 311 - SCRATCH COAT
become subject to the Worker's Compensation previsions of the InWr Code,you must
.Jz forthwith comply with such provisions or Nis Permit shall W deemed revoked. 313 - ROOF NAIL
Eo CONSTRUCTION LENDING AGENCY 501 — FINAL ELECTRICAL ENERGY
�-+ � Ihereby.Rum that Nem ill constuninn lending agency for tiro perrurmance of _
E
IMwuhf. Permit 502 FINAL PLUMBING ENERGY
too
Undies Name 503 — FINAL MECHANICAL ENERGY
D z LendersAAdmss 504 — FINAL BUILDING ENERGY _
r,0 1Caldlydust Ihave mad thiuptelicatilm"sum that the aWveinfomutiunb 505 — FINAL ELECTRICAL
pyo cancer.1 agom to Comply With all City and County aNinam.and state laws relating m
0U building conswction.and hereby authod.representatives OfNisCity toenter upon the - GAS TEST
w shove-mentioned property for inspection purposes. -
d (We)agme to save,irmmoi ry and keep harmless the City of Cupertino against O - F I
M liabilities,judgm.nu,cost and..pens.which may to any way acne trl said City D///
U in consequence of the granting of this Permit. - ICAL
�7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NO -POI Issued by: — Dat
SOURC ULATIONS. /�,
vI Re-roofs510
NAL PLANNING
;d.i.cd
amafApptienUCan D.m 5,14 — FINAL PUBLIC:WORKS
W111 Neappl,H ter fD USbuMdAnT- .D`S Lor handle hared..material Type of Rob"02 — ROOF PLYWOODNAIL
by Ibe Cupenino Municipal Cade.Chapter 9.11,and fie Hales and Safety 603 - ROOF BATTENS
Section 155314)7 All roofs sl�llll�e inspFSri� �aR��lterial being installed.
❑Tres �Ma
Will the applicant or future Wilding occupant un equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emir hoeardnus air contaminant as defined by the Bay Area Air Quality Management all new materials for inspection.
District? �.J
❑Yea 9 Na
I have read the hoo rdea.materials rpryi.mmru under Chapter 6.95 of the Califor-
nia Heef"Safety Code,Sections,25505,15533 and 25534,1 undcnuvd that if the Wilding
does not currently have a tenant Nat it a my responsibility m notify IW aetro nt of the
qm mcnawnanmanbemetPoortoinaanearace0,te
ara.�nry/Rra.�nry/R 6 Signature of Applicant Date
Owner or mthmimd agent Data All roof coverings to be Class"B"or better C-