08080035 CITY OF CUPERTINO ,ypL,m r�7r� `� R •�^ :�� '.r.
BUILDING DIVISION •• PERMIT y:i �1`,; �Oa`IdtF�QTIQtI
BUILDING ADDRESS: PERMIT NO.
9 /4 CANDLrEWOOD DR BAY AREA HAULING & BOBCAT 08080035
OWNER'S NAME: PERMrf ISSUE DATE
!tORER'1' LEE P 0 BOX 36143 08/05/2008
NE: (408) 592-9755 SANITARY NO. CONTROL NO.
ARCHTfECDENGINEER: BUILDING PERMIT INFO
-BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'S DECLARATION
m I bemby a(rrm that I un ilconseud under provisions of Chapter 9(commencing Job Description
with ScetionVia))of Division 3 ofthe Business and Professions Code,and my license is p00L DEMO, RESIDENTIAL
^ in full force and effect
'M� License Class tic.N
Dale come"nr
ARCHITECTS DECLARATION
1 understand my plans shall he med as public records
D.0
g G to Lkmsed Professional
c OWNER-BUILDER DECLARATION
p 1 teeny,Rem that I am rscmpt from the COnlranaYs Liccnx law for de
COO following m•.^n.(S ction 2(130,Boniness and Profesdom Code:Any city m county
rd$ which requiresa permit m comment.alley.impraro,demolish,or rtpalr my s rom m
_ice pnab.fiamncc,auurtgoima lrorisiicantforechposteltofskasigrcdstaumnnt
F o dwn ;:reamadpntan,nlmw pm :a^aorm canna mrauQ s ,w(eb,pta 9 Sq.FC Floor Area Valuation
Ogg (ctIne3 amlatSeNonn and of Dhosins n3 OftheBminea aMPfaressi vi COEe)w $2900
IML k u exrmq ihemfmm and the bus for the allege...mans to Any l Pena^n of
Section]0316 by any applicant fa a permit subjects the applicant to a evil penalty ofNumber OT
men dram Ave hundred dollars ISM3 6 919 015 . Occupancy P Y YPe
1,an owner of IM property,a my employees with wages as their sole eompens idon,
will do the wart and the structure Is not Intended or offered for sale(Sec.20a,Business
and Professions Code:The Commences License Law dam not apply to an Owner of Required Inspections
property who Wilds or im proves Herman,and who does such work himself or through his
Own employes,provided that such improvements;arc notintanded or offered foranle.If,
however,the building or improvement is sold within One year of compkuon,the awner-
builder will have the burden of proving that k did not build or improve fmr purpaa of
;t-u owner of the property am exclusively contracting with licensed contraadors to
construct IM project(Sec.]WC.Boniness and Pmfmsiou Code:)The caaaemes Li-
ave Law dope nm apply man owna of property who Wilds or improv thereon,and
who....for such projects with a corlsaemrts)licatsed punmm in the Contravenes
L iceve Taw.
O l not escmpt under
/gee ,B&PC fair this reason
Owner 't /'l--1 Date
WORKERS COMPENSATION DECLARATION�f`
1 hmeby anon under pmmy of perjmy oro of dte following dndmit one
I his wind will munuin a Certificate of Covent m xlf-imam for Wal Compen-
antler,as provided for by Section 3700 of the labor Code,fm the performance of the
work for which this permit is issued.
❑I have and will maintain WMI COmpensadon Insurance,u required by Section
37W of the,Labor Code,for the performance of the west for which this permit u issued.
My Workcn's Compensation Inaunue ce ca mor and Policy mete,art:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Tbuseedm need an be completed if the permit is(a=hundred dollars(SIM)
ar kis)
1 catty that in the performance of IM work for which this permit u Was.1 shall an
employ anyperson in any a..,.u W in 7mill
Tec rode Wastes'Conpcnfdm
laws o(Catifomia Da x/4 ill
Appliant �(��
NOTICE TO APPLICANT:If,After making this Ccnilicme of Eumption.you should
baome sabjca M dte WOdLi Campewuan pmvisiov of the Later Code,jou most
.J O foMvti
with comply with such Prau be a this permit shall draind stro
eked,
Z E 'r CONSTRUCTION LENDING AGENCY
om I hemby aRml that them is.commucdnn lomingagceq for to perfamanceof
the work for which this permit Is issued(Sec.X19],Civ,C.)
W� A undefs Name
z Lenders Address
U Q I certify that 1 have mad this application and suite than the above information is -
Ll, E+ cone I agree in comply with,11 city sed county,oNinances and scam laws mining m
0U building construction,and hereby mthorim rtpmuntauvv of this city m tour upon the
F 4 above-mentioned temperty for inspection purposes
(We)agree to uvea indemnify and keep haneless the City of Cupertino against
H Ifidlities,judgci costs and aspeves which may in any way oma against said City
U,Z in consequence of the granting of this MMiL
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGU ` ONS. 5
SS/ o$ Re-roofs /
Signs=of ApplscanVConuacmr pate
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applianm m futurebuilding actupum oro m hasblc hmaintains material
U&f ood by the Cupertino Me I Code.Chapter 9.12.and de Hdth and Safety
cork.sealer 2s3l21,r.
❑Yes All roofs shall be inspected prior to any roofing material being installed.
e
ppIf a roof is installed without first obtaining P an inspection,I agree to remove
the alicant or forum (ding Occupant sec equipment a devices which
.n namWille a;,conumiM. efined by the Bay Arta Air Quality Management all new mate gIals for inspection.
❑Yes Nu
I have mad the hasudousmamnab nequimmenu underChapterS.95ofthe Califar- II
ria HeaM&Sdcty COde.Scnimas 155(15.25333 and 25534.1 understand thatif the building
doer not currently have a tenant dal it IS my resp enjulity m noul'y the mupwo Of Nc
m,moor'nu which mmtbc Ipnor uuyee ofa Ccnifime nice] anry. Signature of Applicant Date
Owner Onmhomcd qct paoisw
� s�rsAll roof coverings to be Class'W'or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36919015 . 00
DATE ISSUED. . . . . . . : 08/05/2008
RECEIPT #. . . . . . . . . : BS000005690
REFERENCE ID # . . . : 08080035
SITE ADDRESS . . . . . : 974 CANDLEWOOD DR
SUBDIVISION . . . . . . . '
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . .. ROBERT LEI
ADDRESS . . . . . . . . . . : 974 CANDLEWOOD DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4653
RECEIVED FROM . . . . : ROBERT S LEI
CONTRACTOR ROBERT ARRIGHI LIC # 24175
COMPANY . . . . . . . . . . : BAY AREA HAULING & BOBCAT SERV
ADDRESS . . . . . . . . . . : P 0 BOX 36143
CITY/STATE/ZIP . . . : SAN JOSE, CA 95158
TELEPHONE . . . . . . . . : (408) 592-9755
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- --------- --------- ------- -------- -- -- ----------
1.13SEISMICR VALUATION 2, 900 . 00 0 . 50 0 . 00 0 . 50 0 . 00
IDEMOPRE SQUARE FEET 1, 621 . 00 490 . 00 0 . 00 490 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 490 . 50 0 . 00 490 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 490. 50 MC
---------------
TOTAL RECEIPT 490 . 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
704 DEMO
•
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CITY OF CUPERTINO
�� ' DEMO
CITY O
CUPEkTINO PERMIT APPLICATION FORM
APN# Date:
3Co `� ( 9 01 �� U v
Building Address:
9-14 Cotv�dlewoi)A D,n\je CeApw4c�,o c4 9501'-{
Mailing Address (if different from buil ing address):
Owner's Name: Phone:
�a1XC+ Le-'(
Contractor: /J,� , / , 4- Phone : (gDg)S92 -i37
Fax:
Contractor License #: q 3 3 v
Cupertino Business License #: o?
Contact: Phone: 6LOS) 64z_937
��be,✓'I- A r r � 5 hi
rFax:
Residential Nr Sq Footage I (0 Z Commercial ❑ Sq Footage
Job Description:
ODI pPimJ peS:d�,�{gl
Valuation: $ Z, q o v
Project Size: Express [a' Standard ❑ Large ❑ Major ❑
Please complete relevant portions of the Green Building Checklist & attach it to the application
or if applicable, include on the plan set & the sheet index.
Quantity Fee ID Fee Description Fee Group Permit Type
IDEMORES Demo-Residential B 1SFDWL-DEM
1 1DEMOPRES Pool Demo Residential B 1SFPOOL-DEM
IBSEISMICRE Seismic Residential B
Revised 6/16/08
CITY OF CUPERTINO
Zal*
DEMO
CUPINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group Permit Type
1DEMOCOM Demo-Commercial B 1COMML-DEM
IDEMOPCOM Pool Demo Commercial B 1CPOOL-DEM
1BSEISMICOM Seismic Commercial B
1BUSLIC Business License B
•
•
Revised 6/16/08
Community Development
10300 Torre Avenue
1 'Y Cupertino CA 95014
a�b Telephone(408)777-3228
CITY OF Fax(408)777-3333
4fUPEI�TINO
Building Department
JOB ADDRESS: `l7t4 +dlewvod PERMIT #
OWNER'S NAME: PHONE # o, ZS 7--LoV4
GENERAL CONTRACTOR: o c 4 1+ FAX #
I am not using any subcontractors: `Z/ � J%
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