00040144 CITY OF CUPERTINO IT/NO
BUILDING DIVISION CONTRACTOR INFORMATION: " [,� 6
BUILDING ADDRESS: / ` 6 -1 `(
Of3 /f/f &j,4 �y(/ /lam/L/ /�y /LC�IC�C, SAMTARYNO. APPLICATION SUBMITTAL DATE
OWNER'S N.1ME: - - /TN 4t2t —0
NICCONTROL#
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s z ARCHITECT/LM1"ID ' / �0 /s��
qqqq (J BULDING PERMIT INFO
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Wu
i y i LICENSED CONTRACTOR'S DECLARATION ,
bneby aRw stir 1 w Ecrosed uMar provisions of Chapter 9(comrrcaisg Job Description
�arc�SF5.uy9J
with Satin]Opp)ofDivision3°/the Businasuq Pmfeuiom Code,aM my license is
LicNil
sNice
und.Hat.G/U
3�O� Date-�1'IELT•S DEC TION `/A// J�
�<a mdnadmypWaWibudaspbic«Ods f/-�� � /{/(�
C p Uceu.Pmfo....
o, OWNER-BUI DM DECLARAnON -
3< 1 bereby aRrm that I w camps from the Contractors License Law for the
D following reason.(Section 7031.5.Bmina.and Rofasioes Code:My city m county
i3$ wWchitsnuapennhcpores shewee,improve,h pmeit t ort spired summit
Sq. FC Floor Area
that he its nm,also don to she applicant for such pemm m Ne a signed tammrnt Valuation
Area-
that heencifinvd preuanuo Ne Of Divisiion I thea Stlwora Ucrose law(Clupter9 U '
!commencing with5«tion]000)of Division 3 of the Butinur and Rofeuio r Cnde)m
that he's exempt thacfmm and um basis forthe alkg eleumpuon.Any violation of APN Number Occ panty Type
Section]031.5 by any epp0cent fm a pnnit mbjecu Ne applicant to a civil Penalty of /� 316 ,- -56
-_ o � V"
m moa thin Eve hurMd dollw(25(101.
wiwil
Lasnwmrnftnepec,orm mmy`N:endedwimwadIns Insulin
I`70". aananas Required Inspections
and Pathe ion.aM theaue c onummimendcd tiro&red fors apply
a,1,Busima -
W Property
who
Code:The timuheme Littera law Poo nam appty to ir thoo of
his--who Wade a itnprovp thsuch i end who dues such woh ded o rof through
Wa own employeee provided that row impros sold wish,w not,d m oame.for _
we.ILhowev wthe Widingmion a piwhi is sol heiOrcywounloose far the
owrcr-builds will haus the buNm of proving than he did trot Wild m improve for pr-
p«orala.l.
❑I,u owner of the propny,w exclusively contracting with littnsed ounnanma to
.ansnuct the project(Sec.]OSA,Business and Frde oro Code:)Tfr Cornerstones contractors,
in
came law done nm apply to v owner of property who builds or improvas Nems.and
who conuats for ouch proj«N with.m.ancons)licensed pursuant an IN,caurmiors '
Liana law.
son exempt under Sm. ,B@PCfor this on �•+�•7
Owner Dam
WORKER'S COMPENSATION DECLARATION
I hereby afore under Penalty of Perjury orae Orate fallO,vug declensions:0Ihaaand will maintain a Cartri moofConc,ro m,f-insa, nWorkers Cone,
cation,as provided for by Smuts,3700 of the IaWr Code,for the pMomsae of the
, mth for which this peis issued
jhave and will contain Waters Comperessu m luunvice,u empa ral by Section
Kofthe labor Cade,for the pe mosom ache wank for which this parent is issued.
MYW°rk Cj avian rimier and Pow
policy number :
Carrier.57•!J ,ra�a Policy No.:
CERTIFICATE OF EXEMPnON FROM WORKERS'
COMPENSATION INSURANCE
alas.)!lids section needmr becompleta s ifthe Kronor from ohundred ddlus(SIM)
I cmify thatin the Performsoceofm work forwhich thispeut is issued,l shall
and employ any Person a say manner eco u to hecom subject to the Worken Compen-
ution is ve.f Caliromia.Data
Applicant
NOTICE ID APPUCANT:If,after making N.C urdlW,of Exemption,you sl euld '
become whims to the Workres Cromem iou provisions of the Labor Code,gam man
forthwith comply with Inch provisions or this Inank.hall W domed savokW.
CONSTRUCTION LENDING AGENCY
Z p Ihereby ulfion thu there is a moloncaon lending agency forth. atiom om of
Z the work fm which this permit isis.md(Sm.NA],Civ.C.)
[.. UndeM1 Name ,
p; } IaMer.Addae..
Wa Q 1 ttnily tha I Cao read the application and irate that to above iNormasim is
corral 1 agro to comply wob all dry aM county ordiuncce and ewe laws slating e.
building consu coon,all herebya dentim mpmanwives of this city toenur upon the
U OeWvo-mmarsiored D."y for iupecuw purposes.
QF (Wo eSmn in save,indemnify and kap harmhss tee City of Copeman,against
V liabilities,judgments,contaand expenses which may in any way accrue against aid City
} Li7 in mnsegmuce of the grand,of this pined, ' - -
E APPLICANT. DERSTANOS AND WILL COMPLY WITH ALL NON-POI!{f�
Sigaummof AppheannlConhectm a DOR
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or fuau,Wilding acapwstate Or undlc examen,matins,
u Re-roofs
defined! the Cupertino Municipal Code,Chapter 9.12,end the HCIth rent Seday
Code,Section 25532(a)? ']gape of Roof
❑Yes -Tyr-\a�''
on Will the applicant Or Ktruildingmespent use equipment or devices which All roofs shall be inspected prior to any roofing material being
nsuic.?hatouswconumiunuasdeapdpaysaeBayAruAvQuJltyMuug[mel installed. If a roof is installed without first obtaining an inspection
oar,H❑Yca I a ree to remove all new materials for inspection. Applicant
I n
have od don haauK xd-resotTraner under Claier695°lNe Cali undg
erstands and will comply with all non point source regulations.
romie ealth A safety Code,Secuous 25505,25533 and 2553,1.I t aani nuad thd if the
Wfaiu �gh��heto
tning�fa4 in is my�144'maiwnn
°/my atihc.m w(x.apay.
Owmror euthnneW agentSignature of Applicant
Dao Date
All roof coverings to be Class"B"or better
OFFICE
Ory. it Applicable Fee 10 Fee Description 'Fee Group
cl �B?ER�IFcE BLDG PERMIT FE=S IBUILD6VG
IBCONSTAX 1CONSTRUCTION TAX BUILDING
IBENERGY JENERGY IBUILDIING
1BENERGYAOD JENERGY ADD MULTI 1BUiLDING
1SOVERTIME JINSPECTION OVERTIME BUILDING
BTEtvIPPERM TEMPORARY BLDG PEERMIT IBUILDING
BNIITIGAT HOUSING MITIGATION FEE BUILDING
ISPLANCHK PLAN CHECK FEE BUILDING '
SPLANCKADO PLAN CHECK ADO MULTI BUILDING
BPLANCKREP PLAN CHECK REPEAT FEE BUILDING
BREINSPECT REINSPECTION FEE BUILDING
BSC8LVD SCS SPECIFIC PLAN BUILDING
BSEISMICOM SEISMIC COMMERCIAL BUILDING
BSEISMICRE SEISMIC FEE RES BUILDING
BSPECIAL SPECIAL INSPECTION BUILDING
BSWIM SWIMMING POOL BUILDING
ZADOCHG ADDRESS CHANGE BUILDING
EPERMITFEE JELEC PERMIT ISSUANCE ELECTRICAL
BELEC1000 ELEC 600V =1000A ELECTRICAL
BELEC1001 ELEC 600V>1000A ELECTRICAL
BEI EC200 ELECT SVCS 600V c=200A ELECTRICAL
SNEWMULTI MULTIFAMILY RES ELECTRICAL
BREMBUSWAY REMODEL BUSWAYS ELECTRICAL
• BREMFIXT LIGHTING FIXTURES ELECTRICAL
BREMMISC MISC APPARATUS ELECTRICAL
BREMNRAPP REM NON-RES APPLIANCE ELECTRICAL
BREMPOLE POLE/PLATFORM FIXTURE ELECTRICAL
BREMPOWER POWER OEVICE/APPARATUS ELECTRICAL
SREMRECEPT . RCPTL, SWITCH &OUTLETS ELECTRICAL
SREMRESAPP REMODEL RES APPLIANCE ELECTRICAL
BREMSIGNAD RMOL•SIGNS ADD BRANCH ELECTRICAL
BREMSIGNS IREMODEL SIGNS, MARQUEE ELECTRICAL
BREMTHEATR THEATRICAL LGHTNG FIX ELECTRICAL
BSF&2FAM SINGLE&2 FAMILY ELECTRICAL
BTEMP TEMPORARY POWER ELECTRICAL
BTEMPSVCS . TEMP DIST SVCS ELECTRICAL
MPERMITFEE MECH PERMIT ISSUANCE MECHANICAL
BAPPLOTHER OTHER APPLIANCES IMECHANICAL
BBOILERI BOILER c= 100,000 BTU MECHANICAL
BBOILER2 BOILER>t00KTO500K BTU MECHANICAL
BBOILER3 BOILER>500K TO IM BTU MECHANICAL
BBOILER4 BOILER>1M TO 1.75M BTU MECHANICAL
SBOILERS BOILER> 1.75M BTU MECHANICAL
BREMAPPLI APPLIANCE INSTALL MECHANICAL
BREMHEAT HEATER INSTALLATION MECHANICAL
BREMVENFAN VENT FAN SINGLE DUCT MECHANICAL
BMNEWMULTI NEW MULTI AMILY RES MECHANICAL
BMNEWSF&2F NEW SF&2F RES SLOGS MECHANICAL
IoL2
F� ixa mass
9R�ibIAC0VCO QAC UN IT >IGOOG1�1=ri.NIC%.LI
<= 10;OGCCFNI IMECr1ANICALI
JBREMAIRHAN JA/C UNITS MECHANICAL I. t
�BREtiIFURN RELOCATION I FURNACE
�BREMFURNOV
!: ::,LO i:FURNACE > 1CK BTU jNIECH NIC L
BREMINHOOD INSTALLATION OF HOOD MECHANICAL
BRENIRELOCA RELOCATION OF HOOO MECHANICAL
BREMREPALT REPAIR/ALTER HEATING MECHANICAL
BREMVENSYS (VENTILATION SYSTEMS (MECHANICAL
11 P 11 PERMIT11 F 11 E 11 E PLUMBNG PERMIT ISSUE PLUMBING
BNUMULTI NEW MUUFAMILY RES IPLUMBING
BNUSFD NEW SINGLEFAMILY RES PLUMBING
BPBACKFLOW ATMOSPHERIC VACUUM PLUMBING
BPCESSPOOL CESSPOOL PLUMBING
BPFIXTURE PBLG FIXTURE PLUMBING
BPGAS GAS PIPING SYSTEM FEE PLUMBING
BPINTERCEP IND WASTE INTERCEPTOR PLUMBING
SPREPIPE REPIPE OF FIXTURES PLUMBING
BPSEWAGE SEWAGE DISPOSAL PLUMBING
BPSEWER SEWERS PLUMBING
BPSPRINK LAWN SPRINKLER/BACKFLO PLUMBING
BPSTORM STORM/RAIN WATER PLUMBING
BPTRAP KITCHEN TRAP PLUMBING
BPVENT ALT OF DRAIN 6 VENT PLUMBING
BPWATER INSTALUALTER WATERPIP PLUMBING
BPWHEATER WATER HEATER/VENT PLUMBING
BPWSVCS MAIN WATER SERVICE PLUMBING
ZDEVAGREE DEVELOPMENTAGREEMENT PLANNING
ZDIRTM DIR TENT MAP PLANNING
ZFULLHR FULLAPPLBASE+HR PLANNING
ZFULLTM FULLADPL TENT MAP PLANNING
ZFULLUP FULL ADPL USE PERMIT PLANNING
PLANNING
ZFULLZONE FULLAPPLZONING PLANNING
ZGPAMEND GENERAL PIAN AMEND PLANNING
ZLIMAMENO LIMITED AMEND PLANNING
ZLIMTM LIMITED TENT MAP PLANNING
z.UMUP LIMITED ADPL USE PERMI
ZMA PUP MIN AMEND TEMP US ERM PLANNING
ZMINHILLEX MINOR APPL HILL EXC PLANNING
ZMINSIGNEX MISC SIGN EXCEPTION PLANNING
ZMINTM MINOR APP TENT MAP PLANNING
ZMINUP MINOR APPL USE PERMIT PLANNING
MISC ARCH SITE PLANNING
ZMISCASA PLANNING
ZMISC MISC TM AND UP EXT PLANNING
ZMISCFENCE MISC FENCE EXCEPTION PLANNING
ZMISCGEN MISCELLAPPL GEN ERAL PLANNING
ZMISCPCINT MISC PC INTERPRETATION PLANNING
ZSIGN SIGN PERMI PLANNING
ZTE►APSIGN TEMPORARY SIGN PLANNING
ZVARIANCE DIRECTOR VARIANCE
2 oft
µerica 311W"
INVOICE INVOICE -INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE ,INVOICE
T CITY OF CUPERTINO
BUILDING PERMIT INVOICE OPERATOR: karenb n
Sec: Twp: Rng: Sub: Blk: Lot:31630073.00
INVOICE DATE......: 04/24/2000
REFERENCE ID # ... : 00040144
SITE ADDRESS .....: 10534 N BLANEY AV
SUBDIVISION .......
CITY ......... ....: CUPERTINO
IMPACT AREA .......
OWNER CHANG YUNG TEH AND HUA YU
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-2455
CONTRACTOR .......: MA, STEVE OOONG LIC # 19882
COMPANY ..........: ISAIAH ELECTRIC CO ,.
ADDRESS ..........: 2555 HOMESTEAD RD
CITY/STATE/ZIP ...: SANTA CLARA, CA 95051
TELEPHONE ........: (408)406-9725
FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE
--------------- --- --------- ------------ ---- -____
BREMPOWER P 44.40 0.00 44.40
EPERMITFEE P 35.52 0.00 35.52
_________ ____________ ___________
79.92 0.00 79.92
�ID DESSCIPPTION ---- VOICE IO OCO9 .... SCRIPTIO.�
... .................... ...... ......
305 FRAME 307 INSULATION
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
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