The URL can be used to link to this page

0608025621 CITY OF CUPERTINOYs°*_ ,� • BUILONG DIVISION PERMIT tCONTRACTIOR INFOT.tMATI BUILDING ADDRESS: MATTHEW LAWRENCE PERMIT NO. 06080256 20674 CELESTE OWNER'S NAME: PERMIT USUEDATE MATTHEW LAWRENCE 08/30/2006 NE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG0 PLO MECH LICENSED CONTRACTOR'S DECLARA71ON Job Description hereby affirm Nu I am liamcd under provisions of Chapter 9 (commending With Section 7") ofDlvWon 3 oftho Businwand prormalua Code, and my license Is infull to. and effeel. FRAME IN NON -LOAD BEARING ALL AT LOFT License Clan L.le. g Date Contractor ARCHITECTS DECLARATION I understand my plans shall he used as public records Licensed Pro@mortal OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors Leena Law far the following meson. (Section 7031.5. Business and PmMsioss Code: Any city at county $100 which requires a permit to convect, alum. Improve, demallah, or mpoir any structure isdorto its inuancc. Wu requires IW applicant for mch permit to ilk a signed statement Contmcter'aliamclaw(clamUr9 Sq. Ft. Floor Area Valuation thathcrlkeneedputmanttatheprovisbeofthe (commencing with Section 700)) of Division 3 a(thc Butanes eM Profcuinm Cade) or that be is exempt therefrom and th< beer for the alleged exemption. Any Halation of Section 7031.5 by any applicant fm a permit Objects the applicant to a civil Penalty of j APR NVIAber U U Occupancy Type nut more than five hundred dallans (5500). 0 1, u move of the emptily, or my employes with wages as their sole compensation, Required Inspections q P wif do the work, and Namracum r not intended m offered for sale(Sec. 7044. Busircsa and Profuuona Cada: 77e ContracmYs License Law does Out apply 0 an owner of property who build, or improve thercon, and who docs such work himsel r or through his ownemployces. provided thotench improvements am not Intended moRered (ors 1e. if. however, the Wilding or Improvement i sold within one year a(wmPletice. the owner builder MB lave the burden of proving deal W did not Wild or improve for purpose of sale.). jrl. as owner of the property, am exclusively contracting with Ikeesed contractors m LI- coetmct the Protea (Sec. 7064, Business and profuuone Code:) The ConLl- cm.es ply an owner, of property who Wilds or improv Uemm, and. cmLe Lw doam apm who contracts fes such pojcets withaantraMrts)Ikertsedpuraunttothe Gum etors License Law. 0 lamnem tun ci B@PC for this moon Owner / Dau KEN'S COMPENSATION DECLARATION I hemby afftno uM r pen4ty of perjury aro of the following declaratioe: of Consentmsede,for Ter Iham onowill morinmuts, 3iau rimmtCompem moan, provided for 7700 0( the labor Code, far the pcAormana of the Ss a Issued. work for which this permit is ivued. r 0 I have and will maintain Workers Compensation Insurance, as required by Section 3700 of the Labor Code, for the Performance of the work for which this permit Is imued. My Worker's Compensation Wu once arricr and Policy number sm: Cartier'. Policy NO.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Otr section ..door he completed if the permit is for. h ani ed dollen ($100) or Ices) 1 certify that in the perfomuna of the work Or which this Permit r issued, I shelf net employ any peon in my m P(/o a to became Object to de Workenr Compensation Lewy of Celifomi of NOTICE Af. atom mating this CertificatensOf of Exemption, NTO dyou u must becomehcomp to the Warhera Compensation previsions of Out Isbm Cade, you cores subject W me _ farthWlth comply with such provisiane or Nr permit Nall W domed revolted. CONSTRUCTION LENDING AGENCY 1 hereby Ulu Nem is a co agency for the performance of inn30 which Nr permit r iuocd (Sec. 709'1. Civ. C.) a the work which (Sec. 7, CN, ` Rome, Lemi.es Nese ' � Lendeh Address 1 certify that I heves tend this application and aside then tie above inforromon is correct. I agree to comply with all city and county cognomens and sum laws mlating to building conmuction, and hereby authodm mprucmutives of this city to enter upon the ahovc-memiuned for impaction pmperty purposes Cupertino tie City of ame (We) agme to save, indemnify and keep hardensg '� n expensesthiswhich may in any wyaaroc against Old Gty inconsequence of the granting of this permit. inconseque consequence or me sterling 7J. -rid APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date 50 O Re -roofs Type of Roof Signernfire dIrApplictuoXommemir Dau HAZARDOUS MATERIALS DISCLOSURE Will the applicant or futum building oaup tare orc orbartdle haardoe maeriu u defiocd by de Cupertino Municipal Code. Chapter 9.12 and the Health and Safety Code. Section 25532(07 All roofs shall be inspected prior to any roofing material being installed. CYu BNa If a roof is installed without first obtaining an inspection, I agree to remove Will ft applicant or future building Occupant use component of dules which nth hwnNnu sir contuninm s as dcfncd by the Bay Ates Air Quality Managcm..L all new materials for inspection. District? 0Yes BNo 1 have mad the haardsmr maurialsmquimmems underChapW 6.95 of theCalifor. nit Heahh&SafctyCodc, Sectiom25505,25533 arm25534. 1 undcmwd thatifthe building haa tenant tNt h is my mspaaiMlity to nodfY the ocapant oT tie dna nal cormnU ve require ma W 'jjtpoor toluuanaafaCertificateofOea eney Signature of Applicant Date (' )o -Data. All roof coverings to be Class "B" or better owner of authancd agent cl of 16UPEkTINO • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: PERMIT # o o d 6 OWNER'S NAME: dt �f PHONE # FAX # GENERAL CONTRACTOR: I am not using any subcontractors: J�i�Kd' 49" 3a - G� Signature Date Please check avvlicable subcontractors and complete the following information Owner/ Contractor Signature Date 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 OWNER -BUILDER VERIFICATION 1. (Check one) I or my immediate family (parent, spouse or child) will perform: • A. All the work authorized by this permit B. _ A portion of the work C. _ None of the work If B or C is checked, complete 2 or 3 below. 2. A state licensed contractor will be hired to do: A. _ All of the work B. _ A portion of the work (complete section below) Contractor Address/City, Phone # State License # Type of work to VC C11 V1L11CLL • 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or portions of the authorized work. I understand that I may be an employer (see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. Person/Firm Address/City. Phone Number Type of work to be erformed I declare under penalty of perjury that the above is true and correct. I have read and understand the Owner -Builder Information (reverse side).. Property Owner's Signature: //�" ' ! Date: Job Address: ��^%Y� V_ e 4; 49ZA1 a C9 Permit # 000 g"5,r� Any changes to the information provided on this form shall be submitted to the City of Cupertino Build • Department. City of Cupertino Building Department CITY OF 10300 Torre Avenue* C U P S [2' j' I N O Phone: (408) 777-3228 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as owner -builder you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation* contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an owner -builder building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners uinless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, Building Department, City of Cupertino • Printed on Recycled Paper �a lea Ia Coe ti— ;)o 6 741 Ce%5fe c, �^, Cape✓f,',tio ca 9501y r'17%11Ae ri "rcAce u„a'- .20S -,Z9/4/ if 1/e i A ..01 p -- —fie-- rT -- N � -- savvy ici°� '� r7/—F/ vo—s��jvrs -- --- -2- N am 1 of 1' CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 32658073.00 DATE ISSUED.......: 08/30/2006 RECEIPT #••.......: 35848 REFERENCE ID # ...: 06080256 SITE ADDRESS .....: 20674 CELESTE CL SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: MATTHEW LAWRENCE ADDRESS ..........: CITY/STATE/ZIP ...: , RECEIVED FROM ....: MATTHEW LAWRENCE CONTRACTOR .......: LIC # *OWNER* COMPANY ..........: MATTHEW LAWRENCE ADDRESS ..........: CITY/STATE/ZIP ...: , TELEPHONE ........: •FEE ID UNIT QUANTITY AMOUNT BENERGY PERMIT FEE 1.00 34.86 BPERMFEE VALUATION 100.00 83.16 BSEISMICRE VALUATION 100.00 0.50 METHOD OF PAYMENT ----------------- CASH TOTAL RECEIPT • AMOUNT ------------ 118.52 118.52 OPERATOR: amyw COPY # : 2 PD -TO -DT THIS REC NEW BAL 0.00 34.86 0.00 0.00 83.16 0.00 0.00 0.50 0.00 ---------- ---------- 0.00 ---------- 118.52 0.00 r L 4 CUPERTINO CITY OF CUPERTINO rr�nn� PERMIT APPLICATION FORM W QU 9W N # Fee Description Fee Group BAPPLOTHER Date: MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL / y b Building Address: MECHANICAL Mailing Address (if different from building address): O -no CA Xo& Boiler > 1M to 1.75 M Btu Owner's Name: BBOILER5 Boiler> 1.75M Btu MECHANICAL Phone #: Contractor: Oln BUILDING BCONSTAX Incl/Off/Comm/Quasi License #: Contact: Qom- Phone: BUILDING BCONSTAXH Cupertino Business License#: BUILDING Fax: Constax - Resi/Mobile BUILDING BELEC1000 Building Permit Info: AAA -e ,n AoAR Loa (e/M vt11&V 1,p BldgV Elect F-1 Plumb Elv Mech ❑ Job Description: BENERGY Energy BUILDING Residential G( Ener .Add Multi BUILDING Commercial ❑ Sq.Ft. Floor Area: BUILDING Sq.Ft.: Cost of Project: Occupancy Group: OZ!, 1- 3 Type of Construction: Please check this box if the project is a IIt/ /' second -story addition: ❑ ro'ect Size: Standard Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > I 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 Incl/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax - Resi/Mobile BUILDING BELEC1000 Elec 600V <= IOOOA ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Ener .Add Multi BUILDING BINVESTIGA Investigation fee BUILDING • 1 of Z CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM Ouantitv Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING. BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER' Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BRENLkU HAN A/C Units <= 10,000 cfin MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREM 3USWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > I OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2of3 CUPERTINO 4C OF CITY OF CUPERTINO PERMIT APPLICATION FORM ,Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/ Multi-Fam PLANNING di PLLONGRNGR Planning ong Range Residential PLANNING ZADDCHG Address Change BUILDING • Riy&