02080076 CITY IUILD NG DIVISSIONN� PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS PERMIT NO.
18725 LOREE AVE GIANG CHI TAT & DUONG TUN O 020$800076
o"Wff':CHI TAT & DUONG TU NGO 18725 LOREE AVE APPLICATION
08/ 14Aj 2002
PHONE: SANITARY NO. CONTROL NO.
O O ARCHITECTIENGINEER: I BUILDING PERMIT INFO
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BLDG ELELT PLUMB MECH
M O I"-1 LJ t:--D
Z 8 y LICENSED CONTRACTOR'S DECLARATION ] CR SIO
of 1hereby affumdoor Iamlicensedunder provisions ofChapter 9(commencing WINDOW REPLACEMEpT�fvtr'�n $r�(�g 75LIDER
with Section 700(1 Division 3 of Ne Business and Professions Cade.said my license �w��y���®
a Y is in full forte and effect.si r 'V
yesy m g 6 License Class Li,M
n7 3 u✓n Date- Connector
ARCHITECT'S DECLARATION
C ta I understand my plans shall be used ea public rtcoNs AUG 2 9 2002
w
nr p o Licensed Professional
R� OWNER-BUILDER DECLARATION BUILDIN
I hereby effort Out I sexempt from the Contmm
er's License Law for On
Z a following reama,(Section 7031.5.Business and Professions Code:My city or county Q Q Q
f F a whichrequiresa permit to construct,alter,improve demolish or re,sr tiny structure
u13 a� poorto its issuance.also requiresthe applicant for such Permit to file a signed statement-
th the alttnud¢ohswtl ts5lu pons siom of to Contractors License Law(Chepter9 f ♦t .�'Xtr.'l�N31�f,g�pg.a y. ,x.ryyFv, Valuation
(cdmmemi g ith Secuon1000)of Division Softhe Bustnessand ProfessionsCade) `,?;�I \ t iv://�s� t�Aa al.' t! .\.l,ag a l\:
or that he Is exempt therefrom and the basis for the ollsged 4tmption.Any violation
-of Section 7031:5 by any applicant fora permit subjects the eppiicam to a civil penalry�
,of no[maim than five hundred do11ars(E500). 101AP-N Csf® WIDATION _ Occupancy Type
❑1,as snarler of the properly,ur my employees with wagesaztheir sole rnmpenmtion, 102 - PIERS
-will Ju the we k:'..d the structure is not inmnded'nr offered for said(Sm.70,kL
103 3 - UFER Required Inspections" ''' •' '- /
'Business add'Professions Code:The Contrecor's License law does not apply to an
owner of properly Who Wilda or impmves turtun.and who does such work himself 104 - REBAR
or through his own employees.provided Nm such improvements art not intended or
corredi rale Ifni n lhavet en fprovt a1dwm -eyeador '105- _ ANCHOR BOLTS"' „
improve for then fsu ie.) nail the the burden of proving that he did not Wild or 106 - SEWER & WATER
improv purpose
UNDERFLOOR---PLUMBING _-._..._..,..__..__
4 h m owner of tM Properly am exclusively contracting with licensed contractors to --
construct the project(Sec.901 Business and Profassioru Code:)The Control 203 - UNDERFLOOR MECHANI CALL-,-.
La -
c- License w does not apply to an owner of properly who builds or improves thereon. '
_... :. _.aard.who.comrau.for such projeco-wim.n coneammfsl.homenG.pursuant to.he ___.. _.. 2.04_-- ...UNDERFLOOR—FRAME -.- . . -_.._..._......_..._______....__ ...-. ..._.
romosion's License le
Pk1 pians " ' BSPCrnrmismpxnn 205 - UNDERFLOORl''INSULATION
1� Da /J 7,/y3-2 301 - ROUGH PLUMBING
SCOMPEN (CATION 302 - TUB & OR SHOWER
I he by of rot under penalty of pe0ury one of the following dalarmmini 303 - ROUGH MECHANICAL
it ave and will maintain'e'Cenircals of Conseni to self-inxum for Workers 304 - ROUGH ELECTRICAL
ompensation,-aa-p....ded for by Section 3]W'of-the Labor Code, for the 305 - FRAME
_ 'performance of the work forwhich this pnmit is issued.
❑I basement v
will mmain WorkerslComp boxion lnsemnce,airmailed by Station 306 - HOEDOWNS
3700 of the hbor Cade,for the performance of the work for which this permit is
307 - INSULATION
iss d My Wo kers C mpenmupn Irtsd c comer end Pol cnumber
„z. _ 308' SHEETROCK . ..
Pol cy N n _[`11; 1l �yy-,
S 1 CERTIFICATION OF EXEMPTION FROM.WORKE] - f t.��xA X3.0.?� ,. EAT8k1,OR:IrLATHL';
r' COMPENSATION INSURANCE ew " s-
..: — „• - .. .,-•_. ... -- --37 0 -:---INTERI'OR--LATH-- ._.._.-..—.. — .._...------------- —
lnh,'seca nend nestbecompletedifthe Permit isfor onehundred dollars 311 - ' SCRATCH COAT
(b1001 I I
I try(bat. yk p I mqn an t kiro P i x.issuekers 501 - FINAL ELECT'RICAli"ENERGY''"'
which
'sh II t cmPl,Y,any pc n In any an 'e b��o suhlcct the Wnrken'
camp n tai Jpwx fcpl mm D9 `1Yf�vo 502 - FINAL PLUMBING ENERGY
lice TDAttpucANTlf nrpen gthis c rlficale fE pas you should 503 - FINAL MECHANICAL ENERGY
o Z bcc M1len to @e Worker's C'tdp2ncat provisions of lie Labor Code,you must'
0 C fort iM1 comply with suchProvisions o tb pe 't hall be demJ ked. 504 - FINAL BUILDING ENERGY
_ __ _ _
CONSTRLC`FIOK LENDING AGENCY - 505 - - FINAL ELECTRICAL
1 he by admin that theis a ciummactionndirl agency for Performance506 - GAS TEST '•' ' `
of rh k for which thispemut issued(Sec.3091 Ci C)
96, --Leneerarvame-:__. s•. _ ._ . __:.. .. - -- '507-.._-_-FINAL-._PLUMBING.
;.Z Lender:nddrass ..... ---
= ,:p 50 - FINAL MECHANICAL'
I certify the I have read this application end ordinances
and
state
minn is 5 9 - INAL GRADE
tr,U inbuilt.1 acme to comply,w he ell au and enemy;pncruse pend stnte lows misting
O.V 'the aboingconatmnioaandhertrospection rep'esen[asivcx of ttiia city to upon 5 0 - INA ANN NG
�,,, 4>a Jhe bons et ned property fo 'nspanon purposs -.
L.O.
Ib)
agetoaeindemmfyandkeep hmmlss the C'ryofCpeninoagaimn 5 - INAL B RKS
tar)L, Z liabilities.1 dgmems,ensu nJ u` f Ili nom may.many navy I . gainxt said /��
C.). City in c r req f N g f rhrs peCO .,
APPLICANT UN A ANO WILL COMPLY�4'ITN ALL vP NT
s ukccR loNtU�'�,,, Issued by; Date
AA ". "; "�
mure of n nor , Date Re-roofs
a. H US MATERIALS DISCLOSURE
I WII Ne appli
cat Future budding ac pant mare handle hilarious matenel Type of Roof
as defined by the Cupertino Municipal Cod Chapter 9 12 and the Health and Safety
_ 1 - -
.Cad El yes 255�i2(� 1(I o" 1 t 'Ae ;4 vee t rf� Is at'r� v �:j:f
�" .All roofs shall be,inspected.prior.to any roofing.material being.mstalled
W lltu ppio.I, fum bolding occupant eq ipmmt or devices which If a roof is installed without first obtainingan inspection';I it ree to remove
em r haurd tai o t J fond by theBay Asea Ail Quality Management P g
District? all new materials for inspection. Applicant understands and will comply with .
ores :; Nn - all non-point source regulations.
a
Lc.lif.�nt
have eadvhe h x J n'meicii equirements Ender Chepmr'6.95 of she
Health&Safety Code,Sections 25505,M533 and 25534.1 understand tut
4
leigds not currently have a tenant,that it is my usWnsibilirytonmify theLurementficme ofolic `Y 6aq� Signature of Applicant Date
11
Ar t Date All roof coverings to be Class B or better
.OFFICE ._ __ _.__. .. . _. .. ... . . . . . . . _