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
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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
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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
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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
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