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06090258 (2) CITY OF CUPERTINO �,� �* & gsnq* '" BUILDING DIVISION PERMIT � ONT—RACTOR INFO,rl�"jTU BUILDING ADDRESS: ALBERT CHOU PERMIT ND.O IJO9OZS8 7488 DE LA F OWNER'S NAME: PERMIT ISSUE DATE ALBERT CHOU 09/27/2006 NE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BLDG BUILDING PERMIT INFO MECH ELECT PLUMB l� 0 tela LICENSED CONTRACTOR'S DECLARATION Job Description u 1 hncby affirm that 1 arello mel under provisinm of Chapeu 9(coamerting with Sea.70nB of DivWOO 3ofthe Business and Pnefesemm Code,and MY license is +� in full(am am offices. INSTALL (1)NEW FURNACES (2)NEW A/C' S j 2 License Class Lk,a -�, Date Contractor ARCHITECTS DECLARATION I i I understand my plana shall M used as public records )dU cat< Licensed Pmfcled.mil s OWN -BUILDER DECLARATION 7ve ER I hereby affirm that 1 am asempt from the CommetaYs License Law For the ?C c following mason.(Sudan 703 1.5,Business and Prefo,iom Cade:My City at county f$Pi which requires a permit to conune4 Wer,Marvin.demulleh,or repair any su ustoo $10000 -2 r prior m its hasuancei.a4u requires the applicant for such Permit to 0leasigned su¢mm e 0 thin M s,licensed pureaanto the e pmm visioof the Contractors umene,Law(Chapter 9 Sq.Ft. Floor Area Valuation 55 $ (cammeming with Section 70)0)of Division 3 OF the Budaeta and Profeadona Cede)a Nat M is exempt diemfmm and the bass,(m do alleged memptiwm MY violation of Suctlan 7031.5 by am applicant fu a permit subjects the applicant M a Civil penalty of r Occupancy Type mol more than fin hundred dWlan(5300). 0 1,u awwr of the pmpMy,m my emploYM wIN vngex u thCbank compere dOR. will do the work and the nuuctum s,notimtendcdoraRend foraala(Sec.7044,Bual"-•• Required Inspections and Profession Cade:This Communities Lica^-Law den tot apply to an owner or q P property who build,orimprovm thcrcon,and wbod..swhworthimsolfor Waugh his own emplayou,provided that such improvements sure mot Intended or offered(orale.IL however,the building or impmnmant la sold within one year of completion,the owner. Wilda will haw the burden of proving Nat he did hat Wild or improve for purpose of ale.). 1.as pwwr of the amp ty,w oclusively contracting with licensed mnuacmn to mnatruct the projem(See.70".Business and Prefesdona Code:)The Courthouses U- wine law dace am,Wy o an ounces of propcny who builds or improves tioreon,and, who contracts(m such projects with aco trwoM1d Iicemed pom uant In de Cantnctah Licen slaw. ❑lam oem --� R&PC(or is mase Ow- Dau ORKBR'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury and of the following deciamiam: 1 ham and will maintain a CatiBate ofCowem in self-Imum far Wor4er'sCompen- sation,as provided far by Section 3700 of sire Labor Code.per the performmm of Ne wort for which this permit is issued. 0 1 Mare and will mdaain WasCes CompenaWo Imunnce,as required by Section 37110 of the labor Code.for the performance of tha work for which this permit 4loved. My Walan.Compensation bssu ane anise and Policy number am: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thissection wed routine completed if Ne Pont,Is forum hundred drdara(5100) alcaa.) 1 ceNfy that In the performance of No work for which this permit is isswd.I shall not employ any nafnon in my Contra me WartenCnm nwohm Laws ofCliomiA% ;2W"&b v - Applirnt � NOTICE TO APPLICANT:If,after malting this Ca tincate of Escalation,you should become subjest to the Wortdes Compemetion provisions of the Labor Code,you muse OfoMwith comply with such proirim.or this permit Wall M domed rewhit. 'Z„'� CONSTRUCTION LENDING AGENCY (ti I heirchy aff.Nal Vert s,4 assumed..lendingagency for the perfarmanceuf �i the work for which this permit Is issued(Sec.3097,Civ.C.) 9412 Lcndefs Name r7 12 Lancer Address U C 1 certify that 1 haw read this application and scale that the above Information is !7.r correct.I agree to comply with all city and county ordinances end sue laws relating I- L) U building consouction,and hereby authorize representatives of this city to enter upon the fad shove-mcnii anal property,for inspection purposes. pY (We)agree to save.indemnity and top harmless me City of Cupertino against fpr Iiabilitiex,judgmenn,amu and We.which may in any way.199.1 Wit City U Z, in conacgwae of the grading of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date ,'L.7-G SOUR ONS. Re-roofs ^ ' �rt orA lianl/Cor HAZADOUS MATERIALS DISCLOSURE D Type of Roof C '� Will do applicant or future building occupant atom a Iundle haandous mala d as dcl by he CuperOno Municipal Cade.Chapter 9.13-and the Health ad Safety Cock,Section 35533(a)? All roofs shall be inspected prior to any roofing material being installed. OYes Na Will the applicant or future building Occupant use cyuipmcnt or devices which If a roof is installed without first obtaining an inspection,I agree to remove emlt harudnus air centsfi ante as do d by the Bay Am,Air Quality MAMIAMC'nt all new materials for inspection. District? I--]You Nu I have mad the buardousmatesias,mguimmcrosundarClupwrd.95of L e C,lifar- niaHwlth&Safety Cade,Sactimo25505.35533and2553d.funder thulfde building dace ion carmn0y have a scream.than it is my respamiMlity m notify me occupant of de re beOce , ,Motu Signature of Applicant Date Z7 .19 ' All roof coverings to be Class"B"or better wrier unuthnrind agent rDa CITY OF CUPERTINO •m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . 1 : 35926036 . 00 DATE ISSUED. . . . . . . : 09/27/2006 RECEIPT # . . . . . . . . . : 36228 REFERENCE ID # . . . : 06090258 SITE ADDRESS . . . . . : 7488 ,DE LA FARGE DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ALBERT CHOU ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : LISA CHAU CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : ALBERT CHOU ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ------ ---- ------------- ---------- ---------- ---------- ---------- ---------- BREMAIRHAN NO.UNITS 2 . 00 20 . 52 0 . 00 20 . 52 0 . 00 BREMFURN NO UNIT 1 . 00 14 . 31 0 . 00 14 . 31 0 . 00 BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BREMRECEPT NO. OUTLETS 3 . 00 3 . 60 0 . 00 3 . 60 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 BSEISMICRE VALUATION 10, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00 EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 MPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 ---------- ---------- ---------- ---- ------ TOTAL PERMIT 189 .40 0 . 00 189 .40 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 189 . 40 413 TOTAL RECEIPT 189 . 40 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ---------------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL • Community Development 10300 Torre Avenue `/' Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 �UPEkTINO Building Department JOB ADDRESS � De� Or- # Q(-Qcq00-5e) OWNER'S NAME: LIS)LI AjMrj=QhaLU PHONE # - GENERAL CONTRACTOR O 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 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 Owner/Contractor Signature �te CITY OF CUPERTI °a58 - p` NO O(��FURNACE/AC UPEkTINO PERMIT APPLICATION FORM APN 36# n Date: Building Address: "� c L r r Ow er's Name: rhone#: f - d 3 Contractor: D Phone: license#: Contact: Phone: Cupertino Business License#: Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Job Description: :77 &r2r4 — Residential Commercial ❑ For RWes Installations: Attic I" floor ❑ 2nd floor❑ Adhere to min set back requirement[] or Commercial Installations: eplacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation New installation Planning Approval Required Cost of Project: Type of Construction:l� Occu oup: L �_anc Strapped On Platform Bonded Sq.Ft. Floor Area: New Location Replacement ❑ Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Furnace MECHANICAL BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units<= 10, 000 cfm MECHANICAL BREMRECEPT Rec tl, Switch & Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE Elec Permit Issuance ELECTRICAL I MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BPGAS Gas Piping System Fee PLUMBING BUSLIC Business License BUILDING Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 AJPERTINO Building De artment JOB ADDRESS: C .So r PERMIT# D i 0 ZS` OWNER'S NAME: r-- — PHONE # GENERAL CONTRACTOR . FAX# zr I am not using any subcontractors: ?� G�.1711� CJ CCM1 a0 Signature Date Please check applicable subcontractors and complete the followinginformation: 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 Owner/Contractor Signature Date