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06050086 CITY OF CUPERTINO BUILDING DIVISION PERMIT '�`� � ' BUILDING ADDRESS: HERITAGE CONSTRUCTION AND PERMIT NO' 06050086 10280 TULA LN PERMIT ISSUE DATE OWNER'S NAME: ANGELA SHU 13622 SARAVIEW DR 05/10/2006 SANITARY NO. CONTROL NO. NE: (408) 867-6881 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH 100 LICENSED CONTRACTOR'S DECLARATION Job Description LU p 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing ?z with Section 7000 of Division 3 of the Business and Professions Code,and my license is TEMPORARY POWER POLE .D H in full force and effect j v�Z License Class Lle•# p Date Contractor F m ARCHITECTS DECLARATION U l understand my plans shall be used as public records H Licensed Professional y OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors License law for the p O following reason.(Section 7031.5•Business and Professions Code:Any city or county $500 m which requires a permit to construct alter,improve,demolish•or repair any structure "0 prior to its issuance,also requires the applicant for such permit to file a signed statement SFt.Floor Area Valuation -Z< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q RF- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 4 5 S that he is exempt therefrom and the basis for the alleged exemption.Any violation of5. Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of r not more than five hundred dollars(5500). ❑I,as owner of the property.or my employees with wages as their sole compensation, will do the work and Ute structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(See.7044.Business and Professions Code:)The Contractors Li. cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractar(s)licensed pursuant W the Conq Ictoes License Law. B& for this C:]I am ezemp ndu S � reanit"' Owner Date WOR COM SATIO LARATION l I hereby__litre un r penalty of perjury the following declarations: ❑1 have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workers Compensation Insurance carrier and Policy number are: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less) I certify that in the performance of the work for which this permit is issued.1 shall not employ any person in any manner so Inne t to the Workcre Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after mala ificatc of u should become subject to the Workces Compcnsauon provisions of theUbbrCode.you must 2 forthwith comply with such provisions or this permit shall be deemed revoked. z CONSTRUCTION LENDING AGENCY I hereby alum that there is a construction lending agency for the performance of ai> the work for which this permit is issued(Sec.3097,Civ.C.) , W Q Lender's Name z Lenders Address I certify that I have read this application and state that the above information is LUL correct.I agree to comply with all city and county ordinances and state laws relating to ❑Vbuilding construction,and hereby authorise representatives of this city to enter upon the W ahovc-mentioned property for inspection purposes. L1. (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City V z in consequence of the granting of this permit. Date S((J--I L ►- APPLICANT UNDERSTAND AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE REGU ONS. b6 Re-roofs Signature ofApplican ontractor Dare T Of Roof HAZARDO ATERIAL OSURE Type Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12•and the Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes ❑No Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes ❑No I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505.25533 and 25534.1 understand that if the building docs not currently have a tenant.that it is my responsibility to notify the occupant of the requirements ich rens met pt9orto iss ance of a Certificate of Occupancy. Signature of Applicant Date All roof coverings to be Class"B"or better Owner or authorized agcn Date CITY OF CUPERTINO m 2 of 2 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35913102 . 00 DATE ISSUED. . . . . . . : 05/10/2006 RECEIPT # . . • • • • • . . : 34334 REFERENCE ID # . . . : 06050086 SITE ADDRESS . . . . . : 10280 TULA LN SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER ANGELA SHU ADDRESS . . . . . . . . . CITY/STATE/ZIP . . . : RECEIVED FROM . . . . : CAROLINE HUANG CONTRACTOR . . . . . . . : HUNG VAN TRAN LIC # 25516 COMPANY . . . . . . . . . . : HERITAGE CONSTRUCTION AND ADDRESS . . . . . . . . . . : 13622 SARAVIEW DR CITY/STATE/ZIP . . . : SARATOGA; CA 95070 TELEPHONE . . . . . . . . : (408) 867-6881 FEE 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 200 . 94 AMEX TOTAL RECEIPT 200 . 94 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ---- 103 UFER 304 ROUGH ELECTRICAL Community Development 10300 Torre Avenue "1,. Cupertino CA 95014 '..-a Telephone(408)777-3228 CITY OF Fax(408)777-3333 -UPEkTINO Building Department JOB ADDRESS: PERMIT # t �N- 7'Q.,,le-,e- Ly? X60--s-0 0 S- 6-� OWNER'S NAME: (-,, PHONE # 7t GENERAL CONTRACTOR: r' Ci . FAX # I am not using any subcontractors: - - v Si tore Date Please check applicable subcontractors and complete the fo in information: 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 Owne ontracto gnature Date c�o5 CITY OF CUPERTINO Er .i. 1 i� --UPEkT]NO PERMIT APPLICATION FORM APN# 35"1 - ' S— ' ?)n Date: 6 Building Address: Owner's Name: n � �p(n ��U Phone #: C�aa� t"1 T� O �r Contractor: Tr-01 ��, License I �JQ n Contact: I n,n no� Phone:/� .3�5 a��. Cupertino Business License#: tC� ' q�e 1. �"v C Building Permit Info: Elect Ek---- Job Description: Residential Commercial ❑ Cost of Project: 5wpp Qty. if Applicable Fee ID Fee Description Fee Group 1 BTEMP Temporary Power ELECTRICAL 1 EPERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC Business License BUILDING