06010060 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION
FaUILDINGADORES& WEI JAO & JIEN MEEI CHYU PERMITNO.06010060
20
OWNER'S NAME: PERMIT ISSUE DATE
WEI JAO & JIEN MEEI CHYU 01/11/2006
NE: SANITARY NO. CONTROL NO.
ARCHITECrfiENGINEER: BUILDING PERMIT INFO
BLDG EIECT PLUMB MECH
Z O o LICENSED CONTRACTOR'S DECLARATION Job Description O O O
9 u C 1 hereby affirm that I am IittM1Bo under And
Pisioro of s Codc.r Y my he...is I3 t�k A �
ata with Section 70(IU)ofDivisisn 3ofdp BuslrcssaM Profcuiom Cadc.antl myliccnm is \�iiJyl
„ mmnmm .ndercn NEW SEWER LINE/MAINLINE & C/,O
5 z uccnx class sec.a
n� Dale Contmcpr
££ ARCHITECTS DECLARATION
a C 1 understand my plans shall be used as public rtcerds JAN / 2006
DyV
;QIn Licensed Professional
5 OWNER-BUILDER DECLARATION �II t?�.5 sates. yr �
I hominy affirm root I am exempt from the Co ureides License Law(a,the 'sg(Ivtp'S rn7a LF[[I{IIJ'Jk/]JI'Mt 1(gl
p O following roamn.(Section 71131.5,Business and Pe.derin l Code:Any city s county
e
'rd m which rtyuispe n Permit to ares the alter,improve,demolish,or repair any statement
prior At its issuaneaaru requires thovisio sof for such pcmrinoiense Lactlsmmmcm
< that he(commislicensed cingwitpuntion7 r )ofDiviomofoftheBthe lrumrinirenxlsw(Chaprer9 Sq.FL Floor Area Valuation
x�$
(commencing is exempt Section md)of Division of the Business And Profcu vi Code)of
Q that o u exempt therefrom and dm aper for the subjects
th d ewcant to Any violation of
Section thatin five
any applicant(ora permit subjects rhe appimam m a civil penally of
not mare rlun Rw Wnarea dollars(ssoo). -3 AN er Occupancy Type
❑1,pe owner of Ne property,or my employees with wages As their Aute compensation,
will do the work end Nesweru ,is not Intended or offered for sale(Sec.7044.Busmen
and ProRuions Code:The Conuactofs Liam Law does not apply m in owner of Required Inspections
property who builds or im proms Nermn,and who does such work himself or through his
own employes,provided that such improvements art not intended ormfr.d for sale.if,
however,the building or improvement is said within one year of completion.Ne owner-
builder will have the burden of proving that he did not build or improve far purpose of
sak.I.
❑I,As owner of toe property am exclusively contracting with licensed ronvacpr b
comrroct rbe project(Sec.7614.Bsinets and Profession Code:)The Combaclots Li.
came Law dors not apply in an owner of propcny.who Wilds or improves themon,and,
who contracts for such projects with a canuactoKs)licensed pursuant to rhe Conmctofs
License 4w.
I..a empt under Sec B k P C for thio
lcz
et 7 Dem
WOR rPENSATION RATION I I .
I hereby affirm under penahy of perjury ane of rbe following tlxtaratiom:
haw and will maintain a Certifiam of Cansenr m self-insure for Workers Compere
n,pe provided for by Section 37W of dm Labor Code,for the performamc of the
k for which this permit is issued.
have and will maintain Workers Compensation Insuruta,as required by Section
of the Labor Code,fa the pciformana of Ne work ism which this pemtit is issued.
Workers Compensation Insumna aria and Policy number art:
ier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
rlhrseclion need notbe completed dobe Permit is f rronchundred dollars(SIM)
or less.)
1 emdfv Nat in Oc Performance of the work for which this Permit is issued.I shall nm
employ any nerwnin any manner o rob am subject in
the Workers'Compemadon
Laws Of California.Data
Applicant—S IT A t
NOTICE TO a (CANT: after making Nis i rEca or Exemption.you should
become subject to the Worker's Compensation provisions of the Labor Code,you most
.J O foMwith comply with such provisions Or this Permit shall be mimed rooked.
Z r` CONSTRUCTION LENDING AGENCY
by
[-+ k for which thi Nat there isamn(See. W7.Cing agenry for rhe perrurmana of
l� rhe work for which this permit is issued(Sec.309],Civ.C.)
aA Lenders Name
Z)z 1<ndcr's Address
U Q I certify that I have read this application and state that the above information is
I, F correct.I agree to comply with all city and county ordinances and stare laws relating to
0 Wilding construction,and hereby authome MPwwnmiw of Nis city to enter upon the
W above-mentioned propeny for inspection p rpmes.
F
C. (We)agree to save,indemnify and kap hartnkss the City of Cupertino against
fq liabilities,judgments,costs and expenses which may in any way acerae against said City
A APPLICANT
of the granting of this permit. /�
U z APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date /
�SOURCE REGULATIONS. `
r�cNw Re-roofs nr
S eofAppltcanOConuactor am
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tip applicant Or future building accupam store orhandie harardom material
u defined by the open no Municipal Cade.Chapter 9.12,and the Health and Safety
Cade.Section 255324)?
El yes ON. All roofs shall be inspected prior to any roofing material being installed.
Will thea applicant or future building Occupant tis, If a roof is installed without first obtainingan inspection,I agree to remove
PP d p Wuipr Qu or Marta which p g
nit haraNnus air mnraminants ss dcfncJ by de Bay Arta Air Quality Management all new materials for inspection.
Disvict?
QYa ON.
1 hove read Ne Warah us mamrialamqu imaAMA under Chapter 6.95 of the Cubic,
ni,tIlcahli Safcty Code.Sodom 25585,25533 And 25534.1 undemmM thorifthe Wilding
does rpt currently have•moan,door it r my ma miihiliry m notify rte occupant or the
scyui Ittbemrpriorwiuvanc TpaparOccupan Signature of Applicant Date
J) D
own authorivcdagenr V Dare All roof coverings to be Class"B" or better
Community Development
c 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY 0, Fax(408) 777-3333
�PEI�TINO
Building De artment
JOB ADDRESS: PERMIT #
206-5-11-
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR FAX # /
I am not using any subcontractors:
61 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 _
ontractor Signature Date
Community Development
Ms 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
� CITY OF Fax(408)777-3333
PERTINO
Building Department
JOB ADDRESS: PERMIT#
06-'7L- SC e cl DY. f' , 666� ooGa
OWNER'S NAME: i �t D 1) 1 JA - i Ill w PHONE
GENERAL CONTRACTOR: " FAX #
I am not using any subcontractors:
. / Signature Date
Please check applicable subcontractors and complete the followinginformation
SUBCONTRACTOR BUSINESS NAME , $USINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry r
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering >
Plumbing i
Roofings r
I
Septic Tank f
Sheet Metal
Sheet Rock
Tile
a7Z-mac-� _
Owner-Contractor Signature ; Date
��~`1*OCC
SANlrgq`o f
s
DISTRICT MANAGER-ENGINEER JO BOARD OF DIRECTORS
MARK THOMAS&COMPANY,INC. c.a �' WILLIAM A.BOSWORTH
DAVID E.ROSS JOSEPH BROWN
DISTRICT COUNSEL F.j` y JOHN M.GAT-TO
ATKINSON•FARASYN,LLP
r�BL CURTIS B.HARRISON
HAROLD S.TOPPEL 20833 STEVENS CREEK BOULEVARD,SUITE 104 WENDELL H.KERR,JR.
CUPERTINO,CALIFORNIA 95014-2154
(408)253-7071 PHONE • (408)253.5173 FAX
January 6, 2006 File: CSD—MOP
Building Dept. —Cupertino
City of Cupertino Approved For Issuing
Attn: Building Department
10300 Torre Ave. Building/ Plumbing Permits
Cupertino,CA 95014-3202
Subject: To abandon existing Septic System and connect to Sanitary Sewer
Name: Wei Jao &Jien Meei Chyu
Address: 20654 Scofield Drive
APN: _ 359-10-007C
Cupertino Connection Permit No.: 17170 J4N 1FjvF�;
0006
The Cupertino Sanitary District has reviewed the plans for the subject project:
■ Sanitary sewer is available, see conditions/requirements listed below.
The following Conditions/Requirements are made:
• Install new Property Line cleanout or locate and raise to grade an exiting
property line cleanout(Property Line Cleanout must be within 5 feet of the
property line). Cleanout shall be the same diameter as the street portion of the
service lateral (gravity lateral is 4" diameter minimum).
• Videotape Inspection of the existing/new Property Line Cleanout,Point of
Connection and Street Lateral is required prior to passing The City of
Cupertino Final Inspection. Owner to call District 48 hours prior to video
inspection to schedule a District Inspector. District to provide Building
Department with written notification upon completion of inspection.
All conditions, requirements and recommendations are to be completed at the
(Owner/Developer)'s expense.
SUPPLYING SANITARY SEWERAGE SEAVICES FOR: CITY OF CUPERTINO, PORTIONS OF THE CITIES OF SARATOGA, SUNNYVALE, LOS ALTS AND SURROUNDING UNINCORPORATEIIT AREAS
w w w.cup 8 1 fin os o n ifo r y dis frit r.cm
Page Z
Subject: To abandon existing Septic System and connect to Sanitary Sewer
Name: Wei Jao&Jien Meei Chyu
Address: 20654 Scofield Drive
APN; 359-10-007
Cupertino Connection Permit No.: 17170
Storm water from surface or roof drains, other general surface runoff water or condensate
from any residential HVAC equipment shall not be discharged to the sanitary sewer.
. Yours very truly,
MARK THOMAS & COMPANY, INC.
District Manager-Engineer
�QY By David E. Ross
CHB:cvv
If you have any questions or need additional information, please call Nichol
Bowersox or Chien Vu at 408-253-7071.
cc: Home Owner
OWNER-BU1LDEK VEK1k1L:A11UN
1. (Check one) I or my immediate family (parent, spouse or child) will perform
A V All the work authorized by this permit
B. = A portion of the work
C. None of the work
If B or C is checked,complete 2 or 3 below.
2. A state licensed contractor will be hired to do:
A _ All of the work
B. A portion of the work (complete section below)
Contractor Address/City, Phone # State License # Type of work to
b2 —r�t is:uacd
3. _ I will utilize unlicensed person(s) other than my immediate family to perform an or
portions of the authorized work I understand that I may be an employer(see reverse side). A
. Certificate of Insurance covering workers compensation must be on file at the City of
Cupertino Building Department office.
Person/F= Address/City Phone Number Type of work to be
performed
.....................................................................................................................................................................................
I declare under penalty of perjury that the above is true and correct I have read and understand the
Owner-Builder Information(reverse side).
Property Owner's Signaturre: 1 J` p� Date:
Job Address: 20��f �l C 1 1J r Permit#
Any changes to the information provided on this form shall be submitted to the City of Cupertino Build
Department.
City of Cupertino Building Department
10300 Torre Avenu
CITY OF Phone (409)77
CU PERTINO7-3z�
Dear Property Owner.
An application for a building permit has been submitted in your name listing yourself as the budder of
the property improvements specified.
For your protection you should be aware that as owner4x alder you are the responsible party of record
on such a permit Building permits are not required to be signed by property owners unless they are
personally performing their own work. If your work is being performed by someone other than yourself,you
may protect yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all
permits for which they apply.
If you plan to do your own work,with the exception of various trades that you plan to subcontract,you
should be aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family,and the work
(including materials and other costs) is$200 or more for the entire project,and such persons are not licensed as
contractors or subcontractors,then you may be an employer.
If you are an employer,you must register with the state and federal government as an employer and
you are subject to several obligations including state and federal income tax withholding,federal social
security taxes,workers' compensation insurance,disability insurance costs,and unemployment compensation
contributions.
40
There may be financial risks for you if you do not carry out these obligations, and these risks are
ess
especi
ally serious with respect to workers' compensation insurance.
For more specific information about your obligations under federal law,contact the Internal Revenue
Service (and,if you wish,the US.Small Business Administration). For more specific information about your
obligations under state law,contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale,property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees,without a licensed contractor or
subcontractor,only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder
building permit,erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing
their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors State License
Board in your community or at 1020 N Street,Sacramento,California 95814.
Please complete and return the enclosed owner-builder verification form so that we can confirm that
you are aware of these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
Building Department,
City of Cupertino
prkiod M Aecyded Pape,
CITY OF CUPERTINO
REPIPE/SEWERS/MAIN SERVICE S a 6 �
UPEkTINO PERMIT APPLICATION FORM
APN # 3S 7 Date: / /
BnAddress:
Own 'sNPhone#: U
i am �e YIe i �� * � 6 - 3
Contractor: Phone: pff License#:
3
Contact: — Phone (! Cupertino Business License#:
S D�
Building Permit Info: (r�stQ l /fir � ��n `�ye��tp yz—�:, �
Bldg ❑ Elect ❑ Plumb
Job Description:
Residential 8 Commercial ❑
Cost of Project: o
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg. Permit Fees BUILDING
BPGAS Gas Piping System Fee PLUMBING
PPERMITFEE Plumbing Permit Issuance PLUMBING
BPREPIPE Repipe of Fixtures PLUMBING
BPFIXTURE Pblg. Fixture PLUMBING
BPWSVCS Main Water Service PLUMBING
BPSEWER Sewers PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BUSLIC Business License BUILDING
32777
�Q�`�o SANITgq�,o r
s
DISTRICT MANAGER-ENGINEER g� BOARD OF DIRECTORS
MARKTHOMAS&COMPANY,INC. WILLIAM A.BOSWORTH
• DAVID E.ROSS DR.JOSEPH F.BROWN
DISTRICT COUNSEL JOHN M.GATTO
ATKINSON a FARASYN,LLP
I�BLIsNEl) CURTIS B.HARRISON
HAROLD S.TOPPEL 20833 STEVENS CREEK BOULEVARD,SUITE 104 WENDELL H.KERR,JR.
CUPERTINO,CALIFORNIA 95014-2154
(408)2530071 PHONE • (408)253.5173 FAX
January 6, 2006 File: CSD—MOP
Building Dept. —Cupertino
City of Cupertino Approved For Issuing
Attn: Building Department
10300 Torre Ave. Building/ Plumbing Permits
Cupertino, CA 95014-3202
Subject: To abandon existing Septic System and connect to Sanitary Sewer
Name: Wei Jao &Jien Meei Chyu
Address: 20654 Scofield Drive
APN: 359-10-007
Cupertino Connection Permit No.: 17170
The Cupertino Sanitary District has reviewed the plans for the subject project:
Sanitary sewer is available, see conditions/requirements listed below.
The following Conditions/Requirements are made:
• Install new Property Line cleanout or locate and raise to grade an exiting
property line cleanout(Property Line Cleanout must be within 5 feet of the
property line). Cleanout shall be the same diameter as the street portion of the
service lateral (gravity lateral is 4" diameter minimum).
• Videotape Inspection of the existing/new Property Line Cleanout,Point of
Connection and Street Lateral is required prior to passing The City of
Cupertino Final Inspection. Owner to call District 48 hours prior to video
inspection to schedule a District Inspector. District to provide Building
Department with written notification upon completion of inspection.
All conditions, requirements and recommendations are to be completed at the
(Owner/Developer)'s expense.
SUPPLYING SANITARY SEWERAGE SERVICES FOR: CITY OF CUPERTINO, PORTIONS OF THE CITIES OF SARATOGA, SUNNYVALE, LDS AITOs AND SURROUNDING UNINCORPORATED AREAS
www.cup e r lin oson iforydis lrir f.com
. Page 2
Subject: To abandon existing Septic System and connect to Sanitary Sewer
Name: Wei Jao &Jien Meei Chyu
Address: 20654 Scofield Drive
APN: 359-10-007
Cupertino Connection Permit No.: 17170
Stone water from surface or roof drains, other general surface runoff water or condensate
from any residential HVAC equipment shall not be discharged to the sanitary sewer.
• Yours very truly,
MARK THOMAS & COMPANY, INC.
District Manager-Engineer
LU W
�\( By David E. Ross
CHB:cvv
If you have any questions or need additional information, please call Nichol
Bowersox or Chien Vu at 408-253-7071.
cc: Home Owner
��~`�O SANligq�,o/f
-DISTRICT MANAGER-ENGINEER � � �_ BOARD OF DIRECTORS
MARK THOMAS&COMPANY,INC. " —"' WILLIAM A.BOSWORTH
• DAVID E.ROSS DR.JOSEPH F.BROWN
DISTRICTCOUNSELJOHN M.B(1SHEO CURTISB.ATTOHARRISON
ATKINSON■FARASYN,LLP
HAROLD S.TOPPEL 20833 STEVENS CREEK BOULEVARD,SUITE 104 WENDELL H.KERR,JR.
CUPERTINO,CALIFORNIA 95014.2154
(408)253-7071 PHONE 0 (408)2535173 FAX /
File: CuSD—MOP
Building Dept. —Cupertino
City of Cupertino
Attn.: Building Department
10300 Torre Ave.
Cupertino, CA 95014-3202
Subject: To abandon existing Septic System and connect to Sanitary Sewer
• Name: Wei jao & Jien Meei Chyu
Address: 20654 Scofield Drive
APN: 359-10-007
Cu SD Connection Permit No. 17170
■ Videotape and Property Line Cleanout inspected.
No additional conditions/requirements by tDistrict.
Inspector: George Santos/Tony Soares...................(/,�.e
Date:...1-19-2006................... Sanitary Sewer Location:
cc: Property owner
SUPPLYING SANITARY SEWERAGE SERVI(ES FOR: CITY OF(UPERTINO, PORTIONS OF THE GFIES OF SARATOGA, SUNNYVAEF, LOS ALTOS AND SURROUNDING UNINCORPORATED AREAS
www.r up a r tin os a n ito r y dis tri U.rom