The URL can be used to link to this page

04030210CITY OF CUPERTINO N;ras>w NTRACrTOR INFORMATION:, BUILDING DIVISION PERMIT'"COO BUILDING ADDRESS: DON WADE ELECTRIC CO PERMITN004030210 7558 HEATHERWOOD DR - OWNER'S NAME: PERMIT ISSUE DATE ELIZABETH BUCKEL 16120 HARWOOD ED /94./?nn4 ONE: SANITARY NO. CONTROL NO. (408)377-2323 ARCHITECTAINGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description p 1 wreb effr Nal I am licensed under provisions or Chapter 9 (commencing with Sec ,ofgivlmon3aftk Buv Pmfessiaru CD�ryylkenxc is FWAILE® in full to der a,. �f/ /"�(�/y—"�/Y I Lice. Itis !/ L' N ELECT UPGRADE-200AMP . Da Contractor ` A ITECI'SON MAR 3 12004 w d P ds BUILDING u Licensed Pru eumnal OWNER-BUILDER DECLARATION pt fir n Law for tw 1 hcmby arum n 11. cBusin from Ne Cont.mors L: A c following recon. (Saturn and Calc: Any city or county ate, dcaudi n, alma improve, Fi mash any swemre .I71131.5. t..1m,t which reyuims a pcmtit h Permit to primmireissmmc. also mquims tw i.m. of for We Cohrector'mfileasignedchavmem muco, he Sq. Ft. Floor Area Valuation (War commiscmncapuation7)ofDivinnsnoftheBmnesaum.fmionshamm9 (commencing with Section 7000) sur Division 3 of she Business and Professions Cmc) or Cars he is attempt therefrom and the baso for the alcgrf eaemptim. My violation of 5tYN841"er0 0 Occupancy Type Sccdo s 7031.5 by may applicant for • permit subjects she epplicanua a Civil pwlly of not mom Nen five hundred della. ($5001. ❑ L a( propmy, m my unplayes with wags u thele sok compB Ones, Required Inspections q p andstructure Is not Intended a ed (SaJON, ss will o mewo d thewons Lilose w does Owner of roil Pmreuiobu code: The Connector's License Law dem nal apply lf an owner sur Pr C e: pmpem whowiidsorimprovsu thereon, and who aresamhwmk himue his edforWe Own employes,provided Nn such improvements are not intended or for sale. If. _ llered however. the building or improwmenl is sold within on year of completion. the ower( builder will Mw the burden of proving that w did not build m improve for purpose of 04.). 1.0 owner of the pmpery. am exclusively contracting with licensed mnt.cm. to Cocoanut the project (SCC. 70:4. Business and PmfeSVOns Com:) The ChamuCbra LI. cense law does not apply lean owonf of property who builds or improves thereon. and who contracts for such projects wish scontracmr(s) licensed pursuant to the Contractors License raw. O l am exempt under Sec. ,B&PC for this mann ghvoer Date WORKERS COMPENSATION DECLARATION 1 hereby drion under penalty of perjury am of she following declarations: 1 have and will maintain a Cenifcate of Consent to self-kaum for Worker'sCompcn- 0tion, as provided for by Section 37M of the labor Code. for the penomm.oe of the work for which this permit is issued. 1 have and will maintain Workers Compensation Insurance, a requited by Section 37W of We labor co,. for the performance of she work for which this p emit is issued. My M rkjrJf., minnparsatmo In �a C.Onsran/d,�palirynumberam:'74 n �wa�a, f gQtWNOMWOR�MT -- C IFlC OFEXE. NFROM WORKERS' COMPENSATION INSURANCE COMPENSATION ' (Tnu sectim recd notwcmnpleed of Permit Is (mane hundred dollars (SIM) sur leu.) 1 Certify that in the performance of We work for which this permit is issued, I shall not employ any peun. in any manner an as an West., subject,. the Workers Compensation Laws of California. Dam Applicant NOTICE TO APPLICANT: IL after making shis Certificate of Exemption, you should become aubjcct m Ne Workeh Compcmeum provisions of tw lab,. Cook. yes mon roMwup comply with such provisions or this Permit shall w decreed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that Were is a construction lending agency for the, performance or ' the work for which thu permit is Lcsmd (Sec. 3097. Civ. C.) Lender's Name underi Address 1 ceniry that 1 have read this application and sum that she shove inrmmtiun ki conecL I agree to comply with all city and county ominanen and slue laws muting to aushonm a pnemnm as t of Nis city theater ino .&..aL abow-mentioned prepeny for Inspect.. purpOY1 building co) a,.. to rand saw, indemnify (We) 0gmt to YVC, and expen and keep bayin m w y &c o against Cold ld City expenses which may in my way ¢trot apunslseid City (� in Consequence of gratsmd ing of this Permit.WIDate a A APPLICANT sur UNDERSTANDS � APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE Z Re.roofs Type of Roof Bi1omL.cC.fA,hCMMmnemu.1 HAZARDOUS MATERIALS DISCLOSURE , am Will the applicant or fumm wilding occupant more or handle havardous matenal a defined by We Cupertino Municipal Code. Chapter 9.11, and the Health and Safety Code, Section 25531(a)7��''"" ❑ Yon l . All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove will the applicmt or future Wilding Occupant mm equipment or devices which dous air contaminants defined by On Day Area Air Quality Management mit ha erma all new materials for inspection. District? Ym I have mad she hmatdous materialsrequimmcmts under Chapmr6.95 Crum Califor. nia Health&SafctyCode.Senio.t73505.25577 and 25530.1 undmodual position:wilding does rot currently haw a scant that it H my respomihility 0 notify We occupmt of We reyuimmenL ma mop' laaaneeoheertifimmoracapmcr. Signature ofApplieant Date z All roof coverings to be Class "B" or better ncr car auihorived ogcnt Da¢ crfy ye CUPERTINO CITY OF CUPERTINO 63 J 2 / 6 PERMIT APPLICATION FORM AP #' Date: /a3 -N L5: Buildiness: %✓l ZYi'I,� Owner's Name: Phone #: 611x? . &IeCke/ `ia - 89/- X3/9 Ce - Contractor: License #: T�vvrt GUzee ¢ . E%e'fy� C L'orri C/o - V 703 i Contact: Doi-- 7'Is/1 iYl06,P-6LI .- Phone #: -�oS - 5? -7 x3-'33 Applicant/Contractor: Fax #: Building Permit Info: Bldg Elect Plumb Mech Job Description: Residential: VICE TZJ 2LY>A?rCommercial: Sq.Ft. Floor Area: $/Sq.Ft.: Architect/Engineer: Valuation: I Type of Construction: Occupancy Group: BELEC1001 Elec 600V > 1000A lei Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances 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 BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. ousing Mit Fee BUILDING BMNEWMULTI New Multi -Family Res MECHANICAL BNEWMULTI New Multi -family Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb t P UMBING F--21 1 of3� S� �/ 1 M, xI5' g t. CITY OF CUPEfkT �TINO CITY OF CUPERTINO PERMIT APPLICATION FORM uanti Fee ID Fee Descri tion Fee Group BNUMULTI New MII1fl_fnM;Ix,Res PLUMBING BOVERTIME Ins ection Overtime BUILDING BPBACKFLOW Atmos heric Vacuum PLUMBING BPCESSPOOL Cess ool PLUMBING BPERMFEE Bld Permit Fees BUILDING BPFIXTURE Pbl Fixture PLUMBING BPGAS Gas Pining S stem Fee PLUMBING BPINTERCEP Ind Waste T-+-----. Or 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 rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT -Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > 1 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 HeatingMECHANICAL BREMRESAPP Remodel Res A liance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL 2of3 UO3-1- CITY OF CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSF&2FAM Single & 2 Family BUILDING BSFNA Single Family New Add BUILDING BSPECIAL Special Insection 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 Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler > 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler > 1.75 M Btu MECHANICAL •L • KI l] i J r