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06050007 CITY OF CUPERTINO BUILDING DIVISION prt,RMIT CUN" RCQI2II '. `(.1R�'It1tTIQ1 ad�4y�r5-Lis#'o{a+b avEfa'. BUIL DING ADDRESS: AAAA—DRAIN PATROL PERMIT"0'06050007 10440 S DE ANZA BLV ERS NAME: PERMRLSUEDATE CENTURY 21 2400 LINDBERGH ST 006 PHONE: SANITARY NO. CONTROL NO. (408) 989-6005 ARCHREC(ENGINEER: - BUILDING PERMIT INFO BLDG ELECT IS O PLUMB MECH O O jp LICENSED CONTRACTOR'S DECLARATION Job Description i 1 haeby am Nm affirm 1 licensed under pruvismos of Chapter 9(ammkncing P Zj`yf with Section 7080 of Diviaon3ofine Businstand Pmfeuiom Cade.and my licensed t --n mfall(..andeffuL /�ZZINSTALL CLEANOUT FOR EXTERIOR j Lkcttse Clanslgmt., Dam Gndumr 1� As shall use DECLARATION (FAXED PERMIT TO SANITARY 5/1/06) l I understand my plans shall he Teti u public CLARamm l c ted Lkcnsed Profrstional ZUER aON 1 Oat I am calfr m the Commoner 2 0 0 1 hereby.(Sect mel i am exempt from tete Gain Ca License Law for the 0 0 which muoa Permit h 7101.5,Business and Pmrkuium Cale:Any dry or county S3 Psi whkh requia•permit m cnnaeec4 almc.nt peeve,dpemil t m repair any uremeee z 8 priotut to hes dNaM0.shot mart to Ott ma applicant rhefect Cwtora lnit m cle ense w Chaps enl ceapp (coheircingwitpSewentmciteprevisionsoftheCmuacmr'aLkcnarlaw(tCode)9 Sq.Ft.Floor Area Valuation Z F 9 'ham a is ext ept hadma 70nd the DlaWm J arum Buaneasand Prmfixodon.My vi Code)of $1200 c�— that k d esempl thert(eem and the Oud for me alleged,••^puon MY MolaUm of Semon 7031.5 by any appiou t for a permit subject;the applicant to a civil penalty of APN Number Occupancy Type not mart than five hundred dallm($500). ❑L"owner of tee property,or my employees with wages,u tlemmleeanpvuauon, will do Liewark,and the mom m d notinmnded woffeed mrula(Sec.7044,Business Required Inspections and Professions,Code:the Gntraemis Lioe nsnm Law date not apply m an owner of q P property who Eullds er tmprows Names,and who dao such work himself or through his own employees,provided that such impmvemend tee rat Intended ornUcred forsala U. however.that buiMiogor Impeevemem is mid within am year afcomplman,the awner- builder ,will have the burden of peeving that he did ret holm or Improve far purpose of rale.), ❑1,u awmr of the property w swousively mmeacting with licensed tmmteamon to ennatnct the project(Sec.7044.Business and Professions Code:)The Cmuaemts,LI- cove Law dean not apply to an sumer of property who builds,at improver thereon.and. who emuacta far such pmjcm wire a com mear(G Howard pernmt m the confuumes license Law. f]]ma exempt under Sec ,B d P C for dtia reonn SANITARY vee Dam WORKER'S COMPENSATION OECLARAT10N n 1 hereby same under penalty of perjury am of we following mclanuorm ❑ihim,dwlllmainuina Ceninmmofcomntmulf-Insure,for Warkcescompen- sauon,as provided for by Sad.3700 of the labor Cade.far the perfoaano of me work for which this permit is issued, ❑1 have and will maintain Waitees Compensation lanunna,as required by Semon n 3700of the Labor Cos's Contrade.far the performance,of the work fm which this permit a Wood. rC..w{/ My Wo STcQ'L�on lmmance carrier and t!0 n Policy Nl'try n r O 61L) �� �7sw M' Gmkr. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE s or kaa) MAY L U find section need ret be completed little perch d for one hundredm don (S 10n) te1AV 07-2066 ' 1 anify mot in the performance of rho work for which this permit is Issued.l shall aot r employ any person in my mumerm u to became subject to the Woeken'Cmpemadon {{{ y Laws,of Califamd.Dow ,i+➢11�■ -lt1 Applicant NOTICE TO APPLICANT.If,aMr making this Certificate of Exemption,you should become subpar to the Worker's Compensation provisions of the labor Cade you must wJO forthwith comply with such peeviaau a mu permit shall nd duxual evoked. z► CONSTRUCTION LENDING AGENCY (ti I hetchydlia the them is a conamsedu im ingaaney Aortic urfermanattf IX we wart far which oda permit isissued(Ss,.3097,Civ.C.) ' WW 0 Lemke:Num o-O z Landees Ad was U Q I family that I have:mad this application arta sus,dw the above informadun is py H comm I ago to comply with aR city and aunty erdimncea and rete law relating to 0U Wilding convection.and hereby authorise representatives or this city to enter upon de a above-mentioned pmpeny for inspection purposes. (We)agree to arm,indemnify and lop harmks,s the City of Cupenim against vFw rA liabilities,judgmewu.cam and cap.which may in my way monk agaimt said City (�z in consequenck of the ting of this permit APPLICAM UND ANDS AND L COMPLY WITH ALL NON-POINT Issued by: .Date SOURCE REG5AIbNs. / Signature of enoolut Applican enunctar Dam (' Re-roofs 14AZARDOUS MXrERUALS DISCLOSURE Type of Roof Will the applicant or future Wilding mcupanlnon or handle hummer materiat a:dkOmd by we Cupertino Municipal Code.Chapter 9.12,and the Health and Safety —aJa. 0 es 2.5532(x)? �/� All roofs shall be inspected prior to any roofing material being installed. ❑Yu t.(�Nu Will the applicant or future building mcupant um equipment or devise which If a roof is installed without first obtaining an inspection,I agree to remove emit Incom nm air contaminants of Jefimd by we Bay Area Air Quality Management all new materials for inspection. District? y�`n ❑Yes !� I hive nod the Wastak usmamriab mqubamenu undcrchapmr6.95 brute Collier. maHealtit&Safetycode,Seeuam 25305.25533 and 25534.I understand thmifde building Joel ret currently ha ane was.It k my amenability on mdfy the occupant or the mquimmc: w metpim oma xCerunow ar�pnpmry. / Signature of Applicant Date 5 // C� Owner a sumari7eA age OamAll roof coverings to be Class"B"or better ' Community Development 10300 Torre Avenue to Cupertino CA 95014 " Telephone(408)777-3228 CITY OF Fax(408)777-3333 ecu INO Building Department JOBDURESS: PERMIT # p /� q o .5�.' ZFtVi✓2'4 &o D 1 0 60-5 2ZV 7 OWNER'S NAME: C� p rJ-P' 2 1 PHONE # Z S— Cb O GENERAL CONTRACTOR: ,1 FAX# h I am not using any subcontractors: C Signature Date Please check applicable subcontractors and complete the 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 Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing AAAA C©i2A u PgrRaL Roofing Septic Tank Sheet Metal Sheet Rock • Tile Owner/Contractor Signature Date CITY OF CUPERTINO em 1 of 1 PERMIT RECEIPT _ OPERATOR: suem COPY # 2 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36940015.00 DATE ISSUED. . . . . . . : 05/01/2006 RECEIPT #. . . . . . . . . : 34201 REFERENCE ID # . . . : 06050007 SITE ADDRESS . . . . . : 10440 S DE ANZA BLV SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : CENTURY 21 ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . RECEIVED FROM . . . . : AAAA DRAIN PATROL CONTRACTOR . . . . . . . : ECCLES, CHET LIC # 10745 COMPANY . . . . . . . . . . : AAAA-DRAIN PATROL ADDRESS . . . . . . . . . . : 2400 LINDBERGH ST CITY/STATE/ZIP . . . : AUBURN, CA 95602 TELEPHONE . . . . . . . . : (408) 989-6005 OEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPSEWER SEWER SYSTEM 1.00 21.58 0.00 21.58 0.00 PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 59.95 0.00 59.95 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CASH 59.95 TOTAL RECEIPT 59.95 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 507 FINAL PLUMBING D CITY OF CUPERTINO REPIPE/SEWERS/MAIN SERVICE CUPEkTINO PERMIT APPLICATION FORM 6 APN# 36 4(2 D/S Date: —� Building Address: � ��� L)/D/D y0 Dry A61-Owner's Name: CEH'lv2Y 2 / I I Phone#�,72, S L100 0 Contractor: Phone: D n v License#: z 2 3 A i2A•i� P4T2o c.. -279- Contact: Phone: Cupertino Business License #: � s Building Permit Info: C Bldg ❑ Elect ❑ Plumb Job Description: 2 cdAy r Residential n Commercial Alai Cost of Project: •� O Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg. Permit Fees BUILDING BPGAS Gas Piping System Fee PLUMBING PPERMITFEE Plumbing Permit Issuance PLUMBING BPREPIPE Re i e of Fixtures PLUMBING BPFIXTURE Pbl . Fixture PLUMBING BPWSVCS Main Water Service PLUMBING BPSEWER Sewers PLUMBING BPSEWAGE Sewage Disposal PLUMBING BUSLIC Business License BUILDING • MAY-04-2006 08:43 MARK THOMAS CUP 4082535173 P.01i01 Spnl14,PP Nr DISTRICT MANAGER-ENGINEER ? BOARD OF DIRECTORS MARK THOMAS&COMPANY,INC. V r WILLIAM A.BOSWORTH �\ DAVID E.ROSS 4 DR.JOSEPH F.BROWN JOHN M.GATTO DISTRICT COUNSEL CURTIS B.HARRISON •�.r c,°o ATKINSON•FARASYN,LLP r4eR I S H by ��' HAROLD S.TOPPEL 20833 STEVENS CREEK BOULEVARD,SUITE 104 WENDELL H.KERR,JR, CUPERTINO,CALIFORNIA 950142154 (408)2537071 PHONE 0 (408)2535173 FAX �/I l: File: CuSD—MOP Building Dept. —Cupertino Community.Development Department—Building City of Cupertino 10300 Torre Ave. Cupertino,CA 95014-3202 Subject: Install cleanout for exterior • Name: Century 21 Address: 10440 S De Anza Blvd APN: 36940-015 Permit No. 06050007 No additional conditions/requirements by the District. Inspector: Tony Soares/George Santos......................................... �... Date: 5-03-2006...................... Sanitary Sewer Location: I cc: !-tome owner SUPPOING SANITARY SEN(FRAGF SERVICES FOR: CITY OF (UNRIINO, PORTIONS OF)NE CITIES OF SARATOGA, SUNNTVALE, Los AUOS AND SURROUNDING ONINCORPONAIEO ARSAS WWW,(U(1e ll)1105001 RUCydISIY)C L COVN TOTAL P.01