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03040106 CITY OF CUPERTINO a& „C'.t Bmt rwc mvlslon PERMIT • CONTRACTOR,, N" ORMATIO,� BLI WINb"X ftER LA PERMITND'03040106 IffyAIZHANG PE"M"-`047P 2/2003 NE, SANITARY NO. CONTROL NO. ARCHITECTIENOINIl BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 ioo LICENSED CONTRACTOR'S DECORATION Job Description O I bacby affirm Nu 1 am liad ruunder pmrisiont of mope,9(wmmendng p 1 wid,Scction70rq.f DiWron Ba the Busineu W Profudom Codc,oaf my Ec.1, ' In full forte ard'nect gi Lk cC a x.. ADD 413 SQ. FT. /UPGRADE e ^J ARCH(fECI-S DECORATION e 1 undrmanJ or plalu mail lc used as public mmrd. r�U ,.o Lfcev¢J Rvfcumnd OWNFam cu pt form DECORATION iy I naso .so,that 1 am easmpt from tro Contramots Licmuc Law for tro O O which mason.(Sadao]BJI.1.Buslwr. and Naessiom Code: piscityan a county $ which narylru•pctmit m cotaruc4 aisr,improve.Jcmolbh,a rtrylr any wwurt -Zi prohealiuwrcc.alsorc to thc'c.pplkanl for wchpccmitb Rcroo Law(Chamcnt F< commcoice�Jt� tionb0Mpmvi,inna 3aftHn'b„L�nscssions pl'r9 Sq. Ft, Floor Area $, Ion . C$ (cam'caingwibSortfru and!tfDasisfratro Budncaslidon- uiorYCah)Lar ”{ 3 SOmLec o b uwb Jsrtfmn,M Its Wab far We cts be pplica ora Any vidaaan of ll .roomQ]m byamf,ppbantfor,permit subjects da applkatm.civilpwlry of oatmom banns•banana daw(gsaoL 39r3$19f94ef 00 OccupahGy Type t]1,u owns a tro pmpnty,a my cmpluyca with wag•as thew Wk compsuadon, MR]doth'work.ad the.p,sto.b rot inkMcd or ofkrtA rd for,ale(Scc./ ,Bu,ieeu 101 - FOUND�[P , Pmftviva code Tro Conunols LJcwe Law door not apply b an owls,or 'Ke d Inspections Isopeny wTO Wild,or imr,o ,lerwn.ad who doassucir week himself or bmugb bb 102 - PIERS own employ.,pmvidcd that.o'h impms.t.;ee not lmerded or offend fa We If. 103 — UFER he ,cthe rcr, e Wildint or imprdt1.and within arm yorr of cornpledon,the owner IWildcr. 11boas be baden of moving bat he did not Wild«ImproK for pulp°¢of 104 - REBAR sole) L.own a th WpWtr•un uclud,cJr canuaming with licvucd cmmnm to 105 - ANCHOR BOLTS e traettro pmjm lSa.]0.4,Bwirsn and Paafadata cme:)Tro Contm'wr,la 106 - SEWER & WATER Law dao nor apply b o an ars ro of property,wWilds or Imp ,u b meleun,and wm,e ho,ontacu for wee pmjcm aim a comoacbr(a)lkaaed puwanl to roe Comr e.' 202 - UNDERFLOOR PLUMBING Lk.Law. 203 - UNDERFLOOR MECHANICAL ❑I.an Lac ptu Sec ,BkPCf tN,rorsm ,r¢ �y 204 - UNDERFLOOR FRAME W RKER3 COMPENSAOONDECLARATION 205 - UNDERFLOOR INSULATION Ikmbyaffirm unxrpewtyofperjury oncofd,efauawingdw.a aa: 301 - ROUGH PLUMBING ❑IW.s.mwulmainwn.eemr.atease•N'mbrlr-la<urtro<work'racampert. 302 - TUB & OR SHOWER ado n,a ponbld for by Sadao B]Bda ds Labor ends.far tro performalta ads 303 - ROUGH MECHANICAL wart ra whim Ub permit b i.aea ❑1 have and will maintain Worsen Compvtudon Iluu .u rtgairtd by,Senior 304 - ROUGH ELECTRICAL 3]W.(ft Labor cmc for dK p"f.of me wan for which w,armh b wKd. My,Wbrtd � a Coml 'awo aand tion urannicr Policy namb305 - FRAME cr am: 305 - HOLDOFRAME NS Grt1a CERTIFICATE OFEXEMMON FROM WORKERS 307 - INSULATION COMPENSATION INSURANCE 308 - SHEETROCK or Icas.(TL'aacNm nxd ods c nPLced iftro lcmh Is for crc huMrtd doB.r.($IDB) 309 - EXTERIOR LATH I ccrdry Lodi W perf once orbs wan ra whKh d,b pemtlt 4laued.1 mall ora 310 - INTERIOR LATH empby.ny In n marsrwa ,new 'atpbe wonas'Compcnudon 311 - SCRATCH COAT Lan of :IU App — 313 - ROOF NAIL NOTO AP CA If,aBc mating aid,Ccniftsam a Eacmplon,you mm1J Iscumc wbfcct b f W 's compem,timt pla.;,ions of m'Labor code.ya ro 501 - FINAL ELECTRICAL ENERGY D rnnhwideeompyww,ampro.i,ins.thia aritshall bok nmm,okd. 502 - FINAL PLUMBING ENERGY Z CONSTRUCTION LENDING AGFNCY 503 - FINAL MECHANICAL ENERGY z > mcwort Ilfor which tmhikIWPetmBielrtba,accmdw . ,cm ca.gl fro 504 - FINAL BUILDING ENERGY e� ° iNa 505 - FINAL ELECTRICAL z LaMcfa Addmu . ;) p l cenlfy dw I ha,e mW bl.application and anb dw Inc abuv'lnromuutat is 506 - GAS TEST C.L.I,.to.,I,aibdltit,andrnumt,ordilursea.ndwmUwsrtbJngb 507 - FINAL PLUMBING minding cnw tion and romby wmosire mpmsemel.a of bb chy,to But,upon tin - FIN MEC ICAL N LLj ,row-mentioned proPeny for bra cdon propo¢t fy (We)agm b a,e,indemnify and lacp hdomka the City or Cupmim.gain V) Ibtilida,JdgnsnLLco,v and upcn,a which may In any way acauc.,ma,a id City �OUFI 'NGr2 �- Ic 'Z in con...occ of do granting a oil permit APPLICANT U ERSTANDS AND WILL COMPLY WITHALL NON-POINT Issued by: C WORKSDat SOURCE GU TIO ` ' Re-roofs rt of ApplicanuComnnaDate HAZARDOUS MA ALS DISCLOSU Type of Roof Will ds app"n"m a futac Wilding acupant Loom a handle hvaot,a makfid u defined by do Cursom.Municipal Code.Ch.ptcr 9.12,aM b'11.1h],and Safely Coda.se y.lssau.r �]Ho ❑Yor . All roofs shall be inspected prior to any roofing material being installed. Will dm,pp]iCMLor fumm Wilding occupant oac cgoipmem or d'v.--,which If a roof is installed without first obtaining an inspection,I agree to remove It hmardma air conamlana u dcdnd by ds Bay Arca Air Qualhy Mnugcrocn all new materials for inspection. DiarkR ❑Yu A;4�{'" . 1 dw<mW tro lendwsmakrial,rcquimrcm,maks CTupv 697 olds Cdifa� nbHorhh@SafmYha, Sadao all Iti myrud177J..1 to soupy bendsbuilding Jou' nm oily N,cauear¢m4ltb my,T•.bilitYbawfY datmTant of Nc on! mm wok morn mmpdorblaueccorri ficasar Signature of Applicant Date All roof coverings to be Class "B" or better a,aholvd agcm Date g CITY OF CUPERTINO Oem 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp: Rng: Sub : Blk: Lot : APN . . . . . . . . : 36616037 . 00 DATE ISSUED. . . . . . . : 04/22/2003 RECEIPT # . . . . . . . . . 21674 REFERENCE ID # . . . : 03040106 SITE ADDRESS . . . . . : 1630 ASTER LA SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : NEIL CHANG ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5207 RECEIVED FROM . . . . : NEIL CHANG CONTRACTOR . . . . . . . : LIC # COMPANY . . . . . . . . . . : ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . , • TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - - - - ------ - - - ------- - -- - - -- ---- - - ---- - - ----- --- - --- ------ BPERMFEE . VALUATION 45, 000 . 00 460 . 00 0 . 00 460 . 00 0 . 00 BPLANCHK PERMIT FEE 460 . 00 391 . 00 391 . 00 0 . 00 0 . 00 BSEISMICRE VALUATION 45, 000 . 00 4 . 50 0 . 00 4 . 50 0 . 00 BENERGY PERMIT FEE 460 . 00 138 . 00 138 . 00 0 . 00 0 . 00 ELECTRIC SQUARE FEET 413 . 00 28 . 91 0 . 00 28 . 91 0 . 00 PPLBG SQUARE FEET 413 . 00 .28 . 91 0 . 00 28 . 91 0 . 00 EPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 MPERMFEE SQUARE FEET 413 . 00 28 . 91 0 . 00 28 . 91 0 . 00 MPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 PPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 TOTAL PERMIT 1186 . 79 529 . 00 657 . 79 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER -- - - - - - - - - ----- - - - - --- ------- - ------- CHECK 657 . 79 1055 TOTAL RECEIPT 657 . 79 • Cupertino Union School DistrlLrt • 6916 10301 Vista Drive (408)252-3000 • Cupertino, CA 95014 Developer Impact Foo Compliance The Cupertino Union School District'has adopted Resolution Nos. 1403 and 1404, imposing developer impact fee pursuant to Government Crr��od^1e 530r1y'8.0.... Building Permit Req t (.� AP Z The City of has received a requ st for ildiit ribed as follows: Reside tial De elopment Project Comme Project Name of Developer: �J_�C t C-4& Project Address: ofx A ST.a o Description: / Square Footage: Lot/Parcel#: Permit#:Q • Date: By:- 1 1 City oriz 171, epresentative Square footage will be verified by the city prior to iss nce of a building permit; fees may be adjusted accordingly. SCHOOL DISTRICT DEVELOPER IMPACT FEE CERTIFICATE OF COMPLIANCE The authorized representative of the Cupertino Union School District has reviewed the City of Cl/PC2-r7"D Building Permit Request described above and hereby certifies that the developer or authorized representative has met the requirements of the District's Developer Impact Fee requir encs. Dated: 2 2-10 3 By. Authoriz epresentative Cupertino Onion School District EXEMPTED ! r ,t. Certificate not valid without '.l District Seal,Initial,and Date - Fee$�. FaGldias Planning White �'Cny Yellow" - Re uestor PrnkL�" ~ A union Gold} ` L-.e .,.._ � .....�... ._.. . . ./ . . .:C.'� +.r: ._ Q_ ?' - ...t _a.!"�. .._ _... >+f. 9_t.n, 0` FREMONONION HIGH SCHOOL DISTIC D ITO d 589 WEST FREMONT AVENUE t SUNNYVALE, CALIFORNIA 94087 APR 2 00 408-522-2200 By r e f . Developer Impact Fee Compliance e Building permits will not be issued without a compieted Certificate of Compliance f. Building Permit Application d The City of has received a request for a Building Permit described as follows: I; t, ___ New Residential Development ___ Residential Addition (501 sq. ft. or more) ___Commercial Development I Name of Owner/ DeveloperE l L- CA4a�l6-t(: Project Address: ` v3C) Lot/Pa el # Square Footage: `t I S Description: Permit /Pan eck # 0ILL �a Dat e: By: • Qty Building Inspector Square footage verified by the city prior tn issuance of a building permit; fees may be adjusted accordingly. — ' Feeder Elementary District SCHOOL DISTRICT DEVELOPER IMPACT FEE CERTIFICATE OF COMPLIANCE The authorized representative of th •remont Union High School District has reviewed the City of V Building Permit Request described above and hereby certi les that the developer or authorized representative has met the requirements of the District's veloper Impact F equirements. Dated: a 0-2, By: Fremont Union High School District Authorized Representative t Certificate not valid without=' District Seal, Initial,and•�Date,`,` Fee Rev. 11/02 Facilities P(atinih$...tY}iim City-- Yellow Requester--Pink Accounting--Gold (11/02- 1,0001 ATY OF CUPERTINO • 0 j �� ( ° 6 CITY OF PERMIT APPLICATION FORM • CUPEkTINO APN # Date: Building Address: l 0 /l , mEV- L � � ZTF�{O ��(+ Owner's Name.--;,d ' 1 !L� , „ [ 1� Phone#: 4V Q —76tZ—Z7 Contractor: License #: Contact: Cupertino Business License#: BrdSN'�6 ing Perm't Info: BEl ct Plu b Me Jo criptio��: _ Residential [ / Co mercial Sq.Ft. Floor Area: $/ q.Ft.: Cost of Project: D -Occupancy Group: Type of Construction: Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu. MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax-Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investi ation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of 3 (� �Q CqrY OF CUPERTINO CUPEIZTINO PERMIT APPLICATION FORM QuantityAi Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BN-UCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTHAE Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING • BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Stoim/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units<= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFIJRN Relocation of Fumace MECHANICAL BREMFURNOV Relo Fumace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL 101 BREMPOLE Pole/Platform Fixture ELECTRICAL 2of3 b , CITY OF CUPERTI O CITY OF PERMIT APPLICATION FORM CUPERTINO Ouantity Fee ID Fee Description Fee Group BREMPOWER Power DevicyApparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inection BUILDING BSWIM SwimmingPool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING • 3 of n � • • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CM OF Fax(408)777-3333 OUPEkTINO Building Department JOB ADDRESS: loTc- z LPA, jc- 030q-010(a OWNER'S NAME: N C—I t_ Q4A0,16F PHONE# 40 —7- Z- z7 GENERAL CONTRACTOR FAX# I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork V Cement Finishing c-ouCr i 1. � t9r, C',t-e, 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 � 03 Owner/Contractor Signtlure Date