020301330C
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CITY OF ERT
DWGDIVISION
PERM14
CONTRACTORINFORMATI
BUILDING ADDRESS:
PERMIT N0,
7408 STANFORD PL
JOSEPH J CHEN
02030133
OWNER'S NAME:
APPLICATION SUB DATE
JOSEPH J CHEN
03/25/2002
'PHONE:
SANITARY NO. CONTROL NO.
ARCHITECiENGINEER:
pp� X'V BUILDINGPERMITINFO
4'BLDG 'ELECT- PLUMB MECH
L-=) I_. 1"t, L=—
. uLICENSED
LICENSEDCONTRACTOR'S DECLARATION
1 hereby aRmn that 1 em licensed of Chapter 9 (co
ILO
Job Descri '� -
p pT f�
under Provisions a erming
with Section 7000 of Division 3 of the Business and Professions Code. and my license
fT O LU U(
CHIMNEY REPAIR .
is in full force and effect.
License Clns Lic. e
Data Contractor
ARCHITECT'S DECLARATION
gUILD�+VG
1 understand my plans shall be used as public records
Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby dorm Nat 1 em exempt from the Conmctor's Licarwe Law for the
following reason. (Section 703 1.5. Business and Professions Code: Any city or county
$15000
construct, requires a permit to consct, alter, improve, demolish, or repair a'mu'much",ny 'much",
. poor to its Issuance. also requires dC applicants the such permit to file a signed minimums.
_
$,f3�sk �.J�a� t�rBa; -, •
Valuation
that he is licensed pursuant to the provisions ofthe Convenor's License Law (Chapter 9
(commencing with Se Non 7")of Division 3 of the Business and Professions Code)
or that he is exempt thertfmrd and the basis for IM alleged uemgimi. My violation
l ) 1379'B L'U �2iC.
'
of Smtion ]031.5 by any opplicem for a pcmdt subjens the applicom to a civil penury
'err not m°re than ave hundred dollars SSW).
l 0 3APN N�AT I ON
,
Occupancy Type
O I, as owner of the property, or my employees with wages as their sole compensation,
will do the work; And the swcturc is hot intended or offered for sale (Sec. 7044,
Business and Professions Code: The Comorw m'a License Law does not apply so an
514 — FINAL P1 24lg7r& Iu'If IRXii8ns
owner of property, Who builds or improves torcon. and who does such work himself
or Through his own employees, provided that such improvements we not intended or
offered four sald. IC however, the Wilding or improvamem is sold within care year of
-
completion, the owner -Wilder will have the burden of proving that he did not Wild or
improve for part of tale.).
❑ I, es owner of the property. am exclusively contracting with licensed eonvacmrs to
- -
conswct the project (Sec. 70 . Business and Professions Code:) The Contractor's
License Law does not apply to an owner of property who Wilds or impmvas thns,on,
and who contracts for such projems with • comm"ot(s) licensed pursuCnt to the
-
--
Conunctor'a License Law.
❑IemexemptunderSec. ,B&P C for this reason
-
FONALE®
Owner Date
WORKER'S COMPENSATION DECLARATION
a
r� a] 3 q Q
APR O 20OZ
Iheraby.!firmunderpenaltyofperjuryoneofthefollowingdalentions:
1 have ind will mainaln a Certificate of Consent to self -inure for Worker's
Compensation, u provided for by Section 3700 of the Labor Code, for Lha
BUILDIi��
performance of the work for which this permit is issued.
❑ 1 have and will maintain Worker's Compewtian Insurance. as required by Senion
37W or the labor Code, for be performance of tha work for which this peter
issued. My Wort Compcmation Insurance carrier tad Policy number sac:
:r
Carries: : �� . .,, .!: :.. 'Policy No.:
CERTIFICATION OF EXEMPTION FROM WORYERS'
• ). ...,. _: COMPENSATIONINSURANCE'; - ....
.... _... ....__.. .
f (This section need not W maple'.toll if the permit is for one hundred dollars
-
(1100) m less.)
t 1 cenploy an in the performance of e work for eh this permit is issued, 1
e con
Coll nes employ any Forest in any manncr se, u to baotnc wbjett to the Worked
'
Compensation Laws of CJifomie. Date
,
Applicant
NOTICE TO APPLICANT, If, after malting Cenifi of Exemption, you should
'
provisions of the Labor Code, you mus
become subject the Work n p s o
Colons
such pr in runs
forthwith comply with such provisions or this permit shall W deemed revoked.
y
.1
CONSTRUCTIONLENDINGAGENCY
'
1 hcteby af(Inh that there is a construction lending agency for the performance
-
of the work for which this .it is issued (Sec. 3097. Civ. C.
.Lant Name
Lendm.a Address"
1 certify that 1 base rend this application and cute that the above information is
�maea. I agree t° comply with it[] city and county ordinances and state laws mising
to Wilding constmetion, and hereby awronee representatives of thus city to enter upon
to above-mentioned pmperty for inspection purpose.
(We) ogres, on save, indemnify and keep humless the City of Cupesinc against
liabilities, judgments, cont, and espemes which may in any way acerae against said
''.
City in consequenoe of the granting of thus pennis.
APPLICANT UNDERSTANDS AND, WILL COMPLY WITH ALL NON -POINT"
"'
Issued Date
Y'
SOURCE REGULATIONS:
sigmmmofAppIicwwCmwxctor '.• '. ..-Date'
Re roofs
. ' HAZARDOUS MATERIALS DISCLOSURE
-
" W Ito appBcant m future buiklbiY occupant sae m handle hal dress mnerial
Type of Roof .. .. .
defined by the Cupwrw Mwtcipd ode, Chapter 9.11, and Ne Hulth and Sdery
_
Cade. `D SJ1(g7:
C
� "
.
.:'
Yu a. �° ��'
'
,,.,.All roofs shall be inspected prior.[o.any roofing material being installed.
'gWill the applicant or future 9u,ilding occurpaint use equipment or devices which
'1
If a roof is installed without first obtaining an inspection; I agree to remove
emir li ardous air contamiaunu u defuirA by the Bay Area Au Quality Management
Diaysct7
all new materials for inspection. Applicant understands and will comply with
ore,;,;0No: ,„
'
all non -point source regulations.
t'hive read the ha>iAous materials require... under Chapter 6.95 of the
Califomia Health & Safety Code, Section 15505, 25533 and 25534. 1 understand that
if the Wilding does not currently have a sawn, that it is my tesponsibiliry to notify the
occupant of the requirements which must W act point o issuance of is CutiOate of
'
°G•`uw�`y. --
of Applicant Date
-
_Signature
All roof coverings to be Class "B" or better '
owner n, anthodaca.gent .. Data .
OFFICE
0
CITY OF CUPERTINO
I1• 1 of 1 PERMIT RECEIPT OPERATOR: conniew
COPY # : 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 35932028.00
DATE ISSUED.......: 03/25/2002
RECEIPT #...••••••: 17732
REFERENCE ID # ...: 02030133
•
SITE ADDRESS .....:
7408 STANFORD PL
SUBDIVISION .......
CITY .............:
CUPERTINO
IMPACT AREA .......
OWNER ............:
JOSEPH J
CHEN
ADDRESS ..........:
CITY/STATE/ZIP ...:
,
RECEIVED FROM ....:
JOSEPH CHEN
CONTRACTOR .......:
LIC #
*OWNER*
COMPANY ..........:
JOSEPH J
CHEN
ADDRESS ..........:
CITY/STATE/ZIP ....
,
TELEPHONE ........:
0E
PD
THIS REC
NEW
BAL
ID
UNIT QUANTITY
AMOUNT
-TO
-DT
----------
---------
BPERMFEE
-------- ----------
VALUATION 3,750.00
----------
97.00
----------
0.00
----------
97.00
0.00
BPFIXTURE
UNITS 1.00
8.33
0.00
8.33
0.00
BENERGY
PERMIT FEE 97.00
29.10
0.00
29.10
0.00
BPGAS
OULETS 1.00
4.44
0.00
4.44
0.00
PPERMITFEE
FLAT RATE 1.00
35.52
0.00
35.52
0.00
BREMRECEPT
NO. OUTLETS 1.00
1.11
0.00
1.11
0.00
BSEISMICRE
VALUATION 3,750.00
0.50
0.00
0.50
0.00
EPERMITFEE
FLAT RATE 1.00
35.52
0.00
35.52
----------
0.00
TOTAL PERMIT
----------•----------
211.52
0.00
----------
211.52
0.00
METHOD OF
PAYMENT AMOUNT
NUMBER
-----------------
OTHER
------------
211.52
------------
AMEX
TOTAL RECEIPT
211.52
VOICE ID
DESCRIPTION
VOICE ID
DESCRIPTION
101 FOUNDATION
312
________-_------------------
CHIMNEY
REBAR
& STRAPS
514 FINAL
PUBLIC WORKS
•
CITY o
CUPEkTINO
CITY OF CUPERTINO • b Z
PERMIT APPLICATION FORM
APN # F51 3 2 D 2 p
Date: 3 2S D
Fee Group
o
Building Address: 70 057�s1j kOwner's
Oih—erAppliances
MECHANICAL
I
Name: Ion
V ✓ �
Phone #:
00
BUILDING
Contractor: //
License #:
`U51
A
Contact:
Phone #:
MECHANICAL
Applicant/Contractor:
Fax #:
MECHANICAL
Building Permit Info:
Bldg lect Plumb
Mech
MECHANICAL
Job Descript
Residential: Commercial:
Boiler> 1.75M Btu
Sq.Ft. Floor Area:
$/Sq.Ft.: � 3 7rD
Construction Tax
Architect/Engineer:
Valuation:
Ind/Off/Comm/Quasi,
Type of Construction:
Occupancy Group:
Con. Tax for BQ Zone
Quantity Fee ID
Fee Description
Fee Group
BAPPLOTHER
Oih—erAppliances
MECHANICAL
BBLDGFEE
Bldg Permits . foot
BUILDING
BBOILERI
Boiler <= 100,000 Btu
MECHANICAL
BBOILER2
Boiler> 100K to 500K Btu
MECHANICAL
BBOILER3
Boiler > 500K to IM 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
BCONSTA)MQ
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
Investigation fee
I BUILDING
BMITIGATC
Comm. Housing Mit. Fee
I BUILDING
1 of
-# ( 773 ?-
E
•
V%•
11W8ns
N
I_
Ei �Lj
I
i
I l Zoo? c z avw
j APPROVED
Ili ACCORDANCE WITHDTHE CITY OV
DRD NANCES I `�
CI�P. CODES
MAN
SI IED c;E:cations MUST j
TI set of plans
b sept on t'r,: } i c c ; hn:'s and it at un
doo
Mao
or alteration ul to ia
c Cc.mssion
c same cj.lE, Cupertino. ' _ -- 1 ( i
It. builtlit�C.-w
�14AIU QUD4as w;e . d. p . n , n; specto
e to blit
at,
t, po,m.il 1
rovlsron'
pl¢wail ¢l the vada[: n of any p j a; --
,�aaw C• . n:�tr..rlr•'r or, Stata
I
'I r1I
Al
E
0
0
N
YI
++__ I o
! :• 00
l_J Q
Ica
}
M's4a0VIED
W ACCORDANCE WITH T'icc—GIIY Ofi I .4
C JPERTINO CODES AND ORDINANCES
I; a pcc hcations MUST i -lop
�
1 Lres and it is onIN ON
! i ��I Y �y �i t. lll���✓✓✓
t. RILL RCMA
.s or alterations ! I`HIS PLAN SH
f: r-- :mission from I ITHf ,^gt�_T ALL TiMSS DURING
"_,oerfino. i ' — o INSTRUCTION.
spzdf
.Val ai :c t.^. f c"Y grmiaioas
f.ih� 0"3i:}:�aa yr St�a L=
AR 2 5 2002 �U
M
5
' SUBMITTAL
z
z�
E;
WW's
a
t4z
v -o
U _z
CITY DIVIOF
CONTRACTOR INFORMATION:
SION
PERMIT
BUILDING ADDRESS:
PERMIT NO.
7408 STANFORD PL
JOSEPH J CHEN
02030133
OWNER'S NAME:
APPLICATION SUR DA'I'S
JOSEPH J CHEN
03/25/2002
PONE:
SANITARY NO. CONTROL NO.
ARCHITECDENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR 'S DECLARATION
Job Description
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing
with Seaion]OW7of Division3of the tlusincss and Professions Codc, end my licence
CHIMNEY REPAIR.
in fun force and effect.
License Class Lic. a
Dae Contractor
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records
Licensed Professional
OWNER -BUILDER DECLARATION
I hercby .!firm the, 1 am exempt fro the Commnor's License Law for the
follow ing maser. (Section 7031.5. Business and Professions Code: Any city or County
$15000
which requires a permit In cou,nect, cher. improve, demolish, nr repair any orucwre
-prion. ill iuoawe.alm mr,drestheepplicam forsucM1 permit m filevalgnedsmmmem,
,....31�5�'rd�t'®a 1� &�.-:,..a,.
("1,J 5 1 i \.e{,
Valuation
that he,i: �icena(d pursuant tothp provisions of the Conuactors License Law ICh.Ner 9
fc ingwdh sectionfninc7")of ansCwe)
ert the
leged midi ba. An
End the basis far the alleged demdhoto Any violation
that the basis
or Sect he Is ekempt any
1,
applicant
P.5 vi any applicant for v permit subjects the applicant m °civil Penalty -
of Section 703 than
wlmlm"re man TL -e hundred dollars ($500).
10 IAPB ��iR1P1�DATION
"ll, � � Occupancy Type
01, as owner of the property, or my employees with wages as their sole compensation,
-will do the work, and 'the .amcmre'is not intended offered for smr(sac.-tow:..
•Business and Professions Code : The Contractor's License Law does not apply lo an
-
514 — FINAL PIRB4I II I6igRKSns
owner of pr"peny Who builds or improves thereon, and who does such work himself
or through his own employees. provided That such nproveme I t intended or
"-offered for siiiII however, the Wilding onmpro.xmem is sold with!. one ycv oY
'' ' s •' 1
completion, the owneobulWer will have The burden of proving that he did not build or
improve for purpose of sale.).
.as owner .Rio
the p(Sec.
Business CodIaTh
704th
and Professions onti
(Sec. ]B14, Business and Professions Code:) The to
consumer the wjeContractors
no
propemy who builds improves thereon,
does improves thereon,
License Law data of apply to an owner
with se
fLasuch pmjats with ..comracmrtx) licensed personal to.thc.
,add who m License
Centimeter's License Law,
A
❑late exempt under Sec. ` 1 n II this reason
�
� � A'®�®P,`
I
��'' //B&PCfor
Owner, O ER'Sam
COMPENSATIONIOECLAR°Dr
■
APR p 2 2002
1 hemby affirm under penalty of perjury one of the following dalantions:
-
17 I hese °rad'will"moimnn v CeAfirde of Consent to self -insure for Worker's
Compensation, as for by Section 37W of the Labor Code, far the
BVIL✓'gag
BUILDING
performance of the work fee which this permit s issued.
❑ 1 have and will maintain Worker's Compen:a;on Insurance, as requited by Section
37W of the '"We Code. for the performance of the work for which this pcmvt is
issued. My Worker's Compensation Insurance carrier and Policy number arc:
hiPolicY
t. ( ac ��
,:..;CERTIFICATION OF E%EMFIION PROM'WORRERS':I --,,.,
;,I r-•
Art! .'. s_ s,.,. .�, .. ,...
COMPENSATION INSURANCE' -"'IO ''"
_ _ _
(1nd"action reed not be complemA if the permit is for one hundred dollars
s 1 - -
SIM., lnsa) ,
1 i'eri fy th I n the f a (th k f i s nmed T
,
o become
shall not employ any Person any c s w become subject (th Wnrkcrs
on Laws of California. Dam
.'
Applicant „�fl, •... ...
Applicant.
L IL e C of io Yen
NOTICE TO APPLhe
•'
youshould
Compensation sio de, st
hi of theLaborCode, must
Work isiohi o Labor
bechwithcsubjectpto the Worker's Cions is
or Perm
forthwith comply with such provisions or his Permit shall be dimmed revoked.
•
,CONSTRUCTION [.ENDING AGENCY ""
' "
• " I hercby affirm that there ea'a communion lending agency for the peffoonmtce
of Ne work for which this Permit is issued (See 7097, Civ. C.)
Lenders Name •... ,_....- _ ..
_._. __. _._. ... ..._ _.... _.. _._... _.._.. ..
•
I certify that 1 have mad this application and state that above information is
carnal: I agree 10 empty with III city and counlY ordinances and state laws relating
m building conswai.n, and hereby duthmiu represematives of this city to enter upon
the ebuvWc)emiomed property for inspection purposes. -,_
I gra to save , indemnify and keep harmlen the City of Cupenina against
liabilities, judgments. costs and expenses which may in any way acaue against said
vel
City in consequence of the granting of this p.I,. : ' "' ..
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT,
..
Issuedb : r Date —�
Y
SOURCE bLATfO s.
w
s;gnalure Iiea Cmt ,m' ..".' "', ".--,d,' .,'."Dae
'
Re -roofs
' HAZARDOUS MATERIAL$ DISCLORE
d applicant fru b Iilog tic p Il or handl hamrd material
_ ._
.Type of Roof. .. - - -_ ..• .
"•
as deflmu by the Cupertino Municipal cod Chapter9.12. and theHealth d Safety
Codc S❑ctior 255n2(a)
;. -
_ , l I'..,.
1 .� -.r 1 r ".'.• ter ".�•,
f]N .!•. )', 4`. „Ifl i 1 t ,.,
:., ... '_
\. -9-
All roofs shall be inspected prior to.any roofing material being installed.
_
th pplicam.r future hu Idmg c pard use equipment devices which
If a roof is installed without first obtaining an inspection;d agree to remove
mit hazardous 'r contaminantsas defined by the Bay Area A Qua! y M gement
Is6let?
,
all new materials for inspection. Applicant understands and will comply with
.1
all non -point source regulations.
I' 1 have mad the bazard.us'materials req. remenes unde Chapin 6.95 of the
Califemia Health & Safety Code, Sections 25505, 2553] and 8534. 1 undsremnd ilia
ifthe building does not Current ly heveorenanl, that it is my msp.nsibilirymnolify the
_
"" '" "'- , - "
pcea, i t of the requirements which must h tact pnor to tss6am'e of a Certificate of
°""p°"`y • :. - -
Signature of Applicant Date
All roof coverings to be Class "B" or better
g
Ownc uthorizeda t' Dam
OFFICE .. .. _ ... .... ..... _ _ .-.