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07070010i �J IJJP J11J?1111['r17JJ �_ i -ii L11 711 1! 1 File Edit Actions Details Links Favorites Help P rr71i� 11 "Orfi, I L_.ca` _n in'ormaor, Permit Number 07070010 Status x C - Closed Master Number APN 31620087.01 Project (4I U nit Apply Date 0710212007 Permit Issue Date 0710212007 Certificate Issued Use Default ❑ Certificate Type Address Home -19501 STEVENS CREEK BLVD # Certificate Number 0 Permit x Property L_.ca` _n in'ormaor, Contractor " Defined Fields Address' I 19501 STEVENS CREEK BLVD #103 City/State/Zip CUPERTINO 141 Notes 0 APN 31620087.01 141 (4I U nit Operator suety 10 ner Errtii, Lii�rn.��r_n Operator suety I Owner Name xl VU & BAOTRAM TRUONG Operator Use Default ❑ STORES V N R Address Home -19501 STEVENS CREEK BLVD # Permit x Property Zoning Applicant Contractor " Defined Fields Permit Details Permit Type COMML-TI 141 DO NOT USE Usage Class" ST V N R X41 STORES V N R Applied Value % 0 SQUARE FT. 0 Calculated Value 0 Ij US C-404 Type 437 14I ALT: NON -RES, NON-HSKPG Permit Form' AUTOPERM -PERMIT City/State/Zip CUPERTINO CA 95014 CA 95014 Purpose/Special Conditions TEMPORARY PERMIT -T -I EYECARE STORE E/M/P ORIG PERMIT 07050169 -NO FINALS ON THIS PERMIT- NO MORE INSPECTIONS ON THIS PERMIT- ORIG PERMIT 07050169 ISSUED 7/18/07 - FILMED 6/20111 Ownership 1 Private_ ---__-_-- Project Size I[QAdd Default Tera You have chosen to bypass the holds for this permitjparcel Enter the purpose or any special conditions for this permit W CITE' OF CUPERTINO BUILDING DIVISION PEAT ra BUILDING ADDRESS: PERMIT NO, 19501 STEVENS CREEK BLVD #103 ARCANA CONSTRUCTION, INC 07070010 OWNER'S NAME: PERMIT ISSUE DATE VU & BAOTRAM TRUONG 292 BARNARD AVE 07/02/2007 PHONE: SANITARY NO. CONTROL NO. (408) 288-6961 ARCHTFECf/ENGiNEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job DESCiIptlOn I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 701M) of Division 3 of the Business and Professions Code, and my license is TEMPORARY PERMIT-T.I EYECARE STORE E/M/P ORIG in full force and effect. License Class Lic. ri PERMIT 07050169 -NO FINALS ON THIS PERMIT. Date Contractor ARCHITECTS DECLARATION I understand my plans shall he used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Lew for the following reason. (Section 703 1.5. Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation that he is licensed pursuant to the provisions of the Section 7000) Division 3 of the Business and Professions Code) or $ Q (commencing with of 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 ,VN Number Occupancy Type not more than five hundred dollars (5500). 31620087 V 1 ❑ 1, 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. ❑ 1 am exempt a , B& P C f r tui reason Owner Dale %i 0 WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a Certificate of Consent to self -insure for Workers 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 Workers Compensation Insurance carrier and Policy number are: . Carrier: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' 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, 1 shall not em to an person in an manner so as to become subject t e•�'✓orf ��jf{ ensation y t Laws of Califo — L r v. 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 ' forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY a I hereby affirm that there is a construction lending agency for the performance of y the work fur which this permit is issued (See. 3097, Civ. C.) ' Lenders Name , Lender's Address 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 upon the above-mentioned property for inspection purposes. " (We) agree to save, indemnify and keep harmless the City of Cupertino against 7 liabilities. judgments, costs and expenses which may in any way accrue against said City in consequence of the granting of this permit. " APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date j —7 SOIJ� TI IS- : Z � 11 Re -roofs Signature olApplicant/Conuactm" Dale HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Code, Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. C] Yes ❑No If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? [3 Yes F-1 No 1 have mad 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 requirem st be met prior to issuance of a Certificate o ori:,, ty. Signature of Applicant Date 2 All roof coverings to be Class "B" or better Owner or autfrorized agent Date CITY OF CUPERTINOclt� '7�o CG CITY OF CUPE��INCI PERMIT APPLICATION F'® _ 0 7a1aD/0 APN # 316 �� / Date: .7 Building Address: Mailing CUPLA,A,0 Address (if diff e f m building address): C(50 I k,vAA 134--4e- --m 103 ev, Owner's Name: "i-vwo r\ Z— Phone #: 4-6 $ . �y Contractor: �-,'w. 10�fQ?Aga r � � � �� License 3 2 7 6n w,,uv►4 . ~Phone: Boiler > 1M to 1.75 M Btu Contact: Se "t S"," _l _a 1409 r6g �_ 6 46I Cupertino Business License#: MECHANICAL Fax: Building Permit Info:—,, p, �t (�gm ��-- Bldg Elect Plumb Mech Job Description: BUILDING BCONSTAXH Residential ❑ BUILDING Commercial t4'� Sq.Ft. Floor Area: BUILDING Sq.Ft.: Cost of Project: S T�%�� Occupancy Group: Elec 600V > IOOOA 7, BELEC200 Type of Construction: ELECTRICAL Please check this box if the project is a Energy 1lU second -story addition: ❑ Energy Add Multi BUILDING BINVESTIGA Project Size: Standard Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > l OOK to 500K Btu MECHANICAL BBOILER3 Boiler > 500K to 1M 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 BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax – Resi/Mobile BUILDING BELEC 1000 Elec 600V <= 1 OOOA ELECTRICAL BELEC1001 Elec 600V > IOOOA ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3