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06070164 CITY OF CUPERTINO rvUILDING DIVISION PERMIT BUILDING ADDRESS: JOYCE EHRHARDT PERMITNO06070164 20631 MC CLELLAN RD OWNER'S NAME: PERMIT ISUEDATE JOYCE EHRHARDT 07/25/2006 NE: SANITARY NO. CONTROL NO. ARCHrTECT/ENGINEER: BUILDING PERMIT INFO BO ELECT PLO 0 o0 LICENSED CONTRACT'OR'S DECLARATION .106 Description i 1 tareby affirm Thu I w licensed under provisions of Clupter 9(..mg .. P M Section 70(IU)of Division 7 ofd,Business and Pmreaabw Coda,and my Ikeae,is in Pull fares and eneet. _ INSTALLING VINYL SIDING OVER EXISTING SIDING License Cl s - — Lt..#_F Data, Co.. ARCHTIEC3 DE LLA ATION AMERICA' S VINYL/EXTERIORS PAID FOR BL 7/25/06 i 1 understand my plow shall he used u public records i U Local Professional a OWNER.BUILDER DECLARATION l 1 hereby affirm that I am attempt from the Conwnoh Iiecnm law for Lk :40 following mason.(Bordon 1031.5,Business and Profession,Code:Any city or county j§9 which requires a permit to construct,alma improv,demolish,or repatr my structure -�Sw prior to its issuance.also requimatite.pplicmt for each permit to Ole a signed stammmt ,�< tharhetalicettsed Pureaantsodm provialow a(Ua Cantrmmra Licens law lCMPter9 Sq.Ft.Floor Area Valuation B (commeneing with SeNon 7000)of Dividon]of site Budttm and Fafosions Code)or $15000 51 that he u exempt therefrom and the basis far dm alleged exampliw.Any violNon of Section 7071.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type rot mart Nan five hundred dollars(S500). 0I.uowner offie property,or my uoploym witheral u theirmleeompendadon, will da rose work.end thesbuetum ism,intended waffered tarsals(Sm.7tlM,Business Required Inspections and Preparatory Code:The Commemes License Law dao not apply m in owner of q P property who kildsorlmp anotherea,and who dwa suchwarkhimselfar Waugh his ...play=,praNded tkteach Improvements ase trot dunked araneved forest,U, however.the Wilding or imp avammt he sold within one year of completion.Ae owner- 7 sed.j. will Mw sire hurdan of proving that k did rot build ar Improve far purpose of j[ N/O ❑1,re owner of the property.B eseess and Pro usetint witht)Th eCconuumn .came,La tite projm(See.to an wneir of and rtywho w ds ori The Coauum.LI-whoc law darn rot apply e an owner of property who kills or improves therew,and Linc. racufor amh prokma wINaconuanorO)Ikattxd punwntmthe Contractors Lkenm Law. ❑Tem uempt under Be, .BlPC fm dda reuoo Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under pmulPy of perjury,atm of the following declanfimu: I bete and will mmmin a Cctdfim uof Consent to self-insure for Workers Counter. sal u provided for by Section 3700 of the Labor Code,far the performance of the work for which Nie permit Is issued. 0 1 have and will maintain Workes Compensation Imtrmce,as mquimd by Section 3700 of the labor Coda.for due:performance of the words far which this yarn,H lumA My Workh Compensation Inummaxw rPrtiv and Policy number are: Canter.5•33,71 'a A'O PoIIry No.: /A3 G y� CERTIFICATE OF EXEMP ION FROM WORRERS' COMPENSATION INSURANCE (Thmsech.need net k completed line,Permit Is(atone Itundrtddallan({101) or Ida) 1 emtlfy that in the perfmmance of the work far which this permit is bound,l"I rat employ any person in my manneuran u at become subject to the Workers!Co%pewation Laws o1 Cali(umm.Data Applicant NOTICE TO APPLICANT:If,after malting this Certificate of Exemption,you should become subject ut the Workers Counteraction provisions of the labor Code.you mm .JO forthwith comply with each provision,or this permit shall W deemed avakd. CONSTRUCTION LENDING AGENCY [.r 1 hereby affirm that dam is a commucdnn lending agency for the performance of pt; the work for which this permit is issued(See.3097,Civ.C) W Q Lenders Name :0 z Lenders Addrcu U Q I coolly thea I have read Wa application and state d u the above information is lf. coronet.I agree m comply with all city and county ordinances and rate law relating to OV building consuvction,and hereby mthone rtpclatfiiver of this city to enter upon the W shove-mcnduncd property rm inspection purposes. (We)agree to ave,indcmni fy and keep harmless the City of Cupertino against y liabilitiu,judgmenu,cow and expenses which may in my only socnm galwt said City V z In cowequenee of dm granting of th It. i 2 — 6 APPLICANT UNDERSTAND D WIL Y WITH ALL NON-POINT Issued by: Date —t C- SOURCE R• OLATIONS. y ZS'0& Re-roofs �_ {mart of AppliwnVCo nor Dam H RDOUSMA 'A'SDISCLOSURE Type of Roof Willmeapplie tmfuturtklld ng occupml done arkndlc hucal nuarted as deRwd by fie Cupertino Municipal Code.Chapter 9.11,and the Health and Safety Cam,Section 25531(.)7 All roofs shall be inspected prior to any roofing material being installed. Oyu bRfNo Will the appllCant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit haeardnw air contaminants we defined by the Bay Area Air Quality Management all new materials for inspection. Dieuiet7 ❑Yw Nu gow Secnusme qulrcmcntsunderChapmrd.95iftheWildin- nScebow25311 ray am12533a.1 wdereay ft assum lot or the daa L W bray pomihilllY m notify the occupant of the att arm's «oracutikamoroccupatap Signature of Applicant Date -e -o& ownerorauthadred.gm Dote All roof coverings to be Class"B"or better CITY OF CUPERTINO 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35916004 . 00 DATE ISSUED. . . . . . . : 07/25/2006 RECEIPT # . . . . . . . . . : 35364 REFERENCE ID # . . . : 06070164 SITE ADDRESS . . . . . : 20631 MC CLELLAN RD SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : JOYCE EHRHARDT ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : VLAD CHERNIOGLO CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : JOYCE EHRHARDT ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : •EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---- ------ ------------- ------ ---- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BPERMFEE VALUATION 15, 000 . 00 223 . 56 0 . 00 223 . 56 0 . 00 BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00 BSEISMICRE VALUATION 15, 000 . 00 1 . 50 0 . 00 1 . 50 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 364 . 92 0 . 00 364 . 92 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ OTHER 364 . 92 VISA TOTAL RECEIPT 364 . 92 • M-0 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 #UPEI�TINO // Building De artment JOB 2O63IRESS-�� �e1�Av✓ (� ER /NO PERMIT O 76l' 6- �y OWNER'S NAME: Ehrhhra-C I PHONE # / - O GENERAL CONTRACTOR Pq S N ,e.I FAX # ?tip 6 6- 3 I am not using any subcontractors: Si tune 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 Roofing Septic Tank Sheet Metal Sheet Rock Tile ZS- 06 Owner/Contracto Signature Date CITY OF CUPERTINO 0(.(0-70 (Qq- CUPEf�F PERMIT APPLICATION FORM WKPN# 3 91— I Le 00 Date: juh/ 2-5, a0O (, Building Addre s: Mailing Address (if different from building address): 7-0631 G Ell /✓ ROI CLC EILT/n/O CA O Owner's Name: Phone#: o m 644 t y08- 257- Abby Contractor: License #: meer. c Uivt LY/ 5Y-fEf40leS - SS-//:7 Contact: M42,4c Phone: 47/b -826 OV,7c Cupertino Business License#: 9/&- 26-0 Fax: Building Permit Info: Iyls f�lis?� //1v1yt SIAIA/6 011E4 Bldg M Elect ❑ Plumb ❑ Mech ❑ V Job Description: Residential ® Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: /S OO Occupancy Group: 0 i Type of Construction- Please check this ox if the project is a 0444-40/`) second-story addition: ❑ Coi—ectsize: StandardW Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL 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> 1.75M 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 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 I of 3 CITY OF CUPERTINO CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNOCOMMM 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 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> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Mise 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 Q CITY OF CUPERTINO CUPC wo PERMIT APPLICATION FORM uantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Sips, 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 Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING Ah PLLONGRNGC anning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Change BUILDING • 3 of 3