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10100182 CITY OF CUPERTINO LUILDING PERMIT BUILDING ADDRESS: 10129 MELLO PL CON TRACTOR:WATER QUALITY PERMIT NO: 10100182 PLUMBING 'NER'S NAME: WEI WEI&ICING WAH YEUNG 1860 4,LMADEN RD DATE ISSUED: 10/25/2010 OWNER'S PHONE: 5308480739 SAN JOSE,CA 95123 PHONE NO:(408)267-9330 Ix LICENSED CONTRACTOR'S DECLARATION BUI DING PERMIT INFO: BLDG r ELECT r PLUMB r License Class G Lic.# �� MECH RESIDENTIAL COMMERCIAL Contractor V. Date �V 10 JOB DESCRIPTION:COPPER WATER REPIPE&WATER HEATER I hereby affirm that I am licensed under the provisions of Chapter 9 REP[ACEMENT (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,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 provided for by Sq,Ft Floor Area: Valuation:$6000 Section 3700 of the Labor Code,for the performance of the work for which s permit is issued. ' API` Number:36905029.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. ditionally,the applicant understands and will comply with all non-point s rc regula' per the Cupertino Municipal Code,Section 9.18. ` Isst ed by: Date: /j�` Z�_ 1G nature Date OWNER-BUILDER DECLARATION RE-ROOFS: All •oofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of inst filled without first obtaining an inspection,I agree to remove all new materials for the following two reasons: ins f ection. 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, Sigi nature of Applicant: Date: Business&Professions Code) — I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I h:.ve read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. con rpliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Sal ety Code,Section 25532(a)should I store or handle hazardous material. Ad Jitionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this cor taminants as defined by the Bay Area Air Quality Management District I will permit is issued. ma[ntain comppjitynce with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall He ilth&S e Code tions 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's !' Compensation laws of California. If,after making this certificate of exemption,I OV au d agent: U become subject to the Worker's Compensation provisions of the Labor Code,I must Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I h,xeby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Le ider's Name to building construction,and hereby authorize representatives of this city to enter i the above mentioned property for inspection purposes.(We)agree to save Le nder's Address mnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I u iderstand my plans shall be used as public records. 9.18. Li sensed Professional Signature Date CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: HATE: REVIEWED BY: AI N: BP#: *VALUATION: Iso *PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex ``, PENTAMATION 1 RPDP USE. < �' �.zr_.€. PERMIT TYPE: WORK SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Piping, Area 1 PREPPIPE 1 # $42 Water Heater 1 PRWHEATR 1 # $25 TOTALS: $67.00 h '/.J°�Ch(,k Plumb.Plan Check 0.0 hrs $0.00 Plumb.Permit Fee: IPPERMIT Other Plumb Insp. 0.0 hrs $42.00 Li�xiz �,. 1;,•f, r'' NOTE. Thesefees are based on the preliminary information availal le and are only an estimate. Contact the De t or addn'I info, FEE ITEMS [Fee Resolution 09-051 Eff 7,1%101 FEE QTY/FEE MISC ITEMS 'Ctt1 C'ht'c:n _.e C, PME Plan Check: $0.00 1'crrnit f °c Supp/. Irt4j F'c t> PME Unit Fee: $67.00 PME Permit Fee: $42.00 (_onsli-11clion y-ax Work Without Permit? 0 Yes E) No $0.00 Plcrrtra ttr�7 l��°<' Travel Documentation Fee: ITRA VDOC $42.00 i Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $15.1.001 $0.00 TOTAL FEE: 1 $151.00 Revised: 10/17/2010 .indoor Air Quality and Finishes 1 IA(VHealth pts y--yes; 0 2.Use Low VOC,Water-Based Wood Fishes 2 IA(VHsalth pts y--yes 0 3,uni1 3 IA(VHealth pts yeses 0 4.Use Salvaged Materials for Interior Finishes 3 Re Source pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 6IA(VHealth pts y=yes D 6.Use Exterior Grade Plywood.for Interior Uses 1 IA(VHealth pts y--yes 0 41A(l/Health. pts y=yes 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y--yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3[An ealth pts y--yes D 1 i 1 N.Flooring 1.Select FSC Certified Wood Flooring __ - --B Resource pts Y=yes -- D -— ---- — 21ilaalR 4 Res:)urce pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Res:)urce pts y--yes 0 4.Install Natural Linoleum in Place of Vinyl .5 IAC/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yes 0 Total Points Available: 401 1301 57 Total Points Project Received:1 01 01 0 G:datalprogsrnbWld'i rggwd Ines/remodelers/greenp6intsfina1212D4protectedxis Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: /06Z /Wec C'C- - PERMIT OWNER'S NAME: /yl1-$ PHONE# c7 2�- 073 e( GENERAL CONTRACTOR: f�ccw BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: $15— *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY IN-SPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCO TRAC FORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 1 am not using any subcontractors: Signature Date Please check applicable subcontractors and complete .he 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 Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO REPIPE/SEWERJMAIN SERVICE CUPEkT1NO PERMIT APPLICATION FORM APN # -' Date: Building Address: Owner's Name: Phone#: 07 3`r Contractor: !! r Phone -.9-6 7- 9'33 �i2" -t �I�w.�► Fax #: -�Po a fjy!� C,. 3 Contact: Phone#:,f0L X67 ?,F- a Fax #: Contractor License#: SC:15 7't7- Cupertino 7-Cu ertino Business License#: Job Description: �I Residential C)mmercial ❑ Valuation: Project Size: Express Standard 0 Large-0— arge Major Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. - Green BuildingPoints: Quantity Fee ID Fee Description Fee Permit Type Group 1PCSEWER Commercial building P 1CPSS sewer/sanitary sew,-,r 1BPREPIPE Commercial re-pip.;per fixture P 1CPRP 1 PGASCOM Commercial Gas R ping System P 1-4 Outlets 1BCBSC Cal Bldg Standards Commission.. B ALL PERMIT Fee TYPES 1 BSEISMICOM Seismic Commerci?Ll P Revised 01/07/09