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07090118 CITY OF CUPERTINO BUILDING DIVISION PERMIT PERMIT NO. BUILCaII��/ ��'ShORTHVIEW SQ ADVANCED PLUMBING & 07090118 l I f. PERMIT ISSUE DATE OWNER'S NAME: WEIJUN ZHANG 18780 TUGGIE AVE 09/19/2007 SANITARY NO. CONTROL NO. 'NE: (408) 77"-0651 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH 0 0 p p LICENSED CONTRACTOR'S DECLARATION 10b Description mI 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 FURNACE REPLACEMENT =y in full force and effecL t�? License Class Lie.# • p Date Contractor F ARCHITECTS DECLARATION i < I understand my plans shall be used as public records .a. ' U.H Licensed Professional OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the jC O following reason.(Section 7031.5,Business and Professions Code:Any city or county $ which requires a permit to construct,alter,improve,demolish,or repair any structure a'N prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Ft.Floor Area $1850 e IS (commencing with Section 7000)of Division 3 of the Business and Professions Code)or L 5 that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3 16 3 600 7 �Number 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 the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's 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 be did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such pmjects with a contractor(s)licensed pursuant to the Contractofs License Law. ❑1 am exempt under Sec .B&PtrC for this reason Owner �_Date WORKER'S COMPENSA ON DECLARATION I hereby affirm under penalty of perjury one of 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 Workees 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 as to b�coln=syhicct Ip the Workers'Compensation Laws of Califomia.Date LA�r11n''44 /it U 1 Applicant NOTICE TO APPLICANT:if,3 r mikfng u Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code.you must ,J O forthwith comply with such provisions or this permit shall be deemed revoked. Z, CONSTRUCTION LENDING AGENCY F~.r I hereby affirm that there is a construction lending agency for the performance of fl: the work for which this permit is issued(See.3097,Civ.C.) W A Lenders Name =Z Lender's Address U 0 1 certify that 1 have read this application and state that the above information is Lt. correct.I agree to comply with all city and county ordinances and state laws relating to U building construction,and hereby authorize representatives of this city to enter upon the U above-mentioned property for inspection purposes. GL (We)agree to save,indemnify and keep harmless the City of Cupertino against Hliabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. �. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE RE ULAnO S. r, (� Re-roofs Signature of Applican on r D Type of F;oof HAZARDOUS MATERIALS DISCLOSURE yP 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 s 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 ❑Nu 1 have read the hazardous materials requirements under Chapter 6.95 of Use Califor- nia Health&Safcty Codc,Sections 25505,25533 and 25534.1 understand Utas if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the requircmcns hich must be met prior to issuance of a Certificate of Occupancy. $ignatur(,of ApplicantAg ilki 1,/ Date All roof coverings to be Class"B"or better Owner 4r aulh razed agent are CITY OF CUPERTINO CUPEkTINO PERMIT APPLICATION FORM APN# �1 (v 3(, 0 0-7 , Date: Building Address: 1097 Owner's Name: Wa j uN 21IM6- Phone #: Contractor: C M V11(tk(-Q-J jlv_ License #: 794 397 Contact: KE-k cl-M Cupertino Business License #: Building Permit Info: Bldg ❑ Elect C�-� Plumb C Mech Lzf' Job Description: T,7ur AA Ca Q„ , (a CQ UAae,-U Residential Corninercial ❑ For Residential Inst llations: Attic ❑ 1st floor 2nd floor ❑ Adhere to min set back requirement❑ For Commercial Installations: Replacement same weight ❑ Additional weight (structural cales) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required Cost of Project: L S U Type onstruotion: OccupancyV_— Strapped group: _ V Strapped ❑ On Platform Bonded Imo- Sq.Ft. Floor Area: New Location ❑ Replacement Qty. if Applicable Fee ID -,J Fee Description Fee Group BENERGY _ __ _ I F_.ner�,v BUILDING BREMFU_RN Relocation of Furnace _ MECHANICAL BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRFIAN _ �A/C Units <= 10, 000 cfm MECHANICAL BREMRECEPT I Recptl, Switch & Outlets ELECTRICAL BSEISMICRE t Seismic Fee Res BUILDING EPERMITFEE --��_— Elec Permit Issuance ELECTRICAL MPERMITFEE _ _,/tech Permit Issuance MECHANICAL PPERMITFEt Fliumbing Pen-nit Issue PLUMBING BPERMI=EE_ _ _P..Idg Pen-nit Fees BUILDING BPLANCHK .'ian Check Fee BUILDING BUSLIC :3us ness License BUILDING CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN . . . . . . . . . 31E36007 . 00 DATE ISSUED. . . . . . . : 09/19/2007 RECEIPT #. . . . . . . . . : BSC00002681 REFERENCE ID # . . . : 07C90118 SITE ADDRESS . . . . . : 10E75 NORTHVIEW SQ SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . . WEIJUN ZHANG ADDRESS . . . . . . . . . . : lOE75 NORTHVIEW SQ CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : XIF.OJIE YAO CONTRACTOR . . . . . . . : XIINSHANG LI LIC # 24013 COMPANY . . . . . . . . . . : ADVANCED PLUMBING & ELECTRIC ADDRESS . . . . . . . . . . : 18-/80 TUGGIE AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : (4C8)777-0651 FEE ID UNIT QUANTITY TMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 1. 00 34.86 0. 00 34 .86 0. 00 BREMFURN NO UNIT 1. 00 14.31 0. 00 14 .31 0. 00 BSEISMICRE VALUATION 1, 850. 00 0.50 0. 00 0 .50 0. 00 EPERMITFEE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00 MPERMITFEE FLAT RATE 1. 00 40.79 0. 00 40 .79 0. 00 PPERMITFEE FLAT RATE 1. 00 40.79 0. 00 40 .79 0. 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 172 . 04 0. 00 172 . 04 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 172 . 04 MC --------------- TOTAL RECEIPT 172 . 04 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- - -------- ---------------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 ';UPEI�TINO Building Department JOB Sl D RESS: PERMIT # u r . .ev k tU C j1�1 L-2`"7 040t�d� OWNER'S NAME: I Z s �L^ 2 HONE # — G GENERAL CONTRACTOR: C FAX # I am not using any subcontractors: < { Ll - - Signature Date Please check applicable subcontractors and complete the following 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 Owner/Contra+ r Signature Dat