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06100049 CITE'OF CUPERTINO BUILIDING DIVISION PERMIT C�1 RA Te1R IN t RMATI� I: BUILDING ADDRESS: TCL CONSTRUCTION INC PERMIT NO.06100049 20960 GARDEN GATE DR OWNER'S NAME: PERMIT ISSUE DATE CK WONG & TIM LUI 1010 MORSE AVE STE 23 10/09/2006 NE: SANITARY NO. CONTROL NO. D 9> n (408) .400-0100 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB IAECH 0 0 0 a 10 p LICENSED CONTRACTOR'S DECLARATION Job Description U p I hereby affirm that I am licensed under provisions of Chapter 9(commencing 2 Z w with Section 7000)of Division 3 ofthg LAsiness and Professions Code,and my license is ?=,a„ in full force and fe TEMPORARY POWER POLE > ^ License lass tY 3 t„a Date Contractor h�' ARCHITECTS DECLARA N ,a U 1 u crs a d my plans shall be used as public records U.y Licensed Professional y OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county <m ff which requires a permit to construct,alter,improve,demolish,or repair any structure $200 Z y prior u)its issuance,also requires the applicant for such permit to file a signed statement F x`e that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation uI- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or L that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of r Occupancy Type not more than five hundred dollars(5500). ❑I,as owner of the property,or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of q p property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If. however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense law does not apply to an owner of property who builds or improves thereon,and, who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. ❑I am exempt under Sec B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: VI haoe and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workermp nsation surance carrier and Policy number are,:, 10- ��Cartier. �� Policy No: CERTIFI TE OF EXEMPTION FRO WORK S' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:if,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,z forthwith comply with such provisions or this permit shall be deemed revoked. z O CONSTRUCTION LENDING AGENCY F~t►Cn+ I hereby affirm that there is a construction lending agency for the performance of a+> the work for which this permit is issued(Sec.3097.Civ.C.) W A Lender's Name az Lcndees Address U 0 I certify that I have read this application and state that the above information is f3.O- correct.I agree to comply with all city and county ordinances and state laws relating to O 1-4 U building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. >_4 a (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City V z in conseque of the granting of this permit. Date ► APPLI UNDERSTVDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOU E REGU ONS. l�� to/ Re-roofs Signature of Applicant/Contractor Type of Roof HAZARDOUS MATERI S DISCLOS E Will the applicant of future building upant store or handle hazardous material as defined by the Cupertino Municipal Co ,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes ❑No Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? _ C3 Yes ❑No I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building docs not currently have a tenant,that it is my responsibility to notify the occupant of the requircmc -v hich mu be met prior to issuance of a C rtific or apan Y. Signature of Appl icant Date GG v All roof coverings to be Class"B"or better Owne or authorized agent I I Date CITY OF CUPERTINO 2m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32630015 . 00 DATE ISSUED. . . . . . . : 10/09/2006 RECEIPT # . . . . . . . . . : 36349 . REFERENCE ID # . . . : 06100049 SITE ADDRESS . . . . . : 20960 GARDEN GATE DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER CK WONG & TIM LUI ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , RECEIVED FROM TCL CONSTRUCTION CONTRACTOR . . . . . . . : CHUNKIT WONG LIC # 28132 COMPANY . . . . . . . . . . : TCL CONSTRUCTION INC ADDRESS 1010 MORSE AVE STE 23 CITY/STATE/ZIP . . . : SUNNYVALE, CA 94089 TELEPHONE . . . . . . . . : (408) 400-0100 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL -- ---- ---- ------------- -- -------- ---------- ------- --- ---------- ---------- BTEMP FLAT RATE 1 . 00 62 . 10 0 . 00 62 . 10 0 . 00 EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 ---------- ---------- ---------- ---- ------ TOTAL PERMIT 100 . 47 0 . 00 100 . 47 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER -- --- ------------ ------------- --------- --------- CHECK 100 . 47 369 TOTAL RECEIPT 100 . 47 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 103 UFER 304 ROUGH ELECTRICAL Community Development 10300 Torre Avenue r Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPEkTINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME:-rf r'Y) LL1 j PHONE # -C0I GENERAL CONTRACTOR:?-GL, 0, Oh FAX # -4-"7(,o- i '2-- 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 KaH ona I Orjr) 2.V5;E?> 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 M7 CITY OF CUPERTINO r E P POWER CUPEkTINO PERMIT APPLICATION FORM APN # 81:2(�,,_ 13U 0 Date: / o/ �� Building Address: Owner's Nama• Phone #: Keg c 176 ._ ;e8 </ % Contractor: Phone: �7(� -��/ License #: Contact: Phone: Cupertino Business License#: Building Permit Info: Elect ❑ Job Description: Residential Commercial ❑ Cost of sect: Qty. if Applicable Fee ID Fee Description Fee Group I BTEMP Temporary Power ELECTRICAL 1 EPERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC Business License BUILDING