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06090243 CITY OF CUPERTINO ���'! BUILDING DIVISION PER c� RAkcca ., R I1V'k'ORMATIU +. rs=✓d a a ,....�,r I;�w1 n,9,,4rj s3,:NA°.v0riera , BUILDING ADDRESS: DOVE I S SERVICES INC pERMRN0.06O90243 21852 MONT OWNER'S NAME; PERMIT ISSIIH DATE KUMAR GANAPATHY 1695 SAGEWOOD AVE ng/26/200e NE: SANITARY NO. CONTROL NO. (510) 376-6543 ARCHI'fECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECr PLUMB MECH loo LICENSED CONTRACTOR'S DECLARATION Job Description FF 1 hereby affirm dui I am licensed under provision of CMpwm r 9(comencing ;Z`y wide Section 70nU)of Division 3ofate Business and Professions Code.aM my]loan=is in full fo=at REPLACE 1 FURNACE AND 2 A/C' S Data V, 7 Canuanor'��(�3LLgK's ARCHITECTS DECLARATION i� I understand my plans shall he used u public records )yV e jtt7, Licensed Pmfessia..I OWNER-BUILDER DECLARATION 0 c I hemhy.(Sens that 1 1. esemps from dee Cssions Co License c taw for dee p o following rises.. (anis i 71m L5,Business and Professions Code:Any city or county 39� which requires•permit w ennslruct alcor,Impmro.mmnitsiu or repair any awnure $7000 •DHy pdor to its Issuance.also requires he applicant for such permit m file a signed sawmenl Valuation f that he is licensed pursuant to the provislonsofthc Conte we.litamm Law(Chap¢r9 3q.FC.Floor Area $ (commencing with Section 7000)of Division 3 of dee Business and Profession 5 Code)or— that he is therefrom and the basis for the alleged exemption.Any vlotsdan of Section 7031.7 by any applicant for s permit subjects dee applicant m a civil penally of Occupancy Type not mote than five hundred dollars($500). 0 1.as water of tko propmay.Or my employees with wages a their wk compensadan, will do theworkmd the suuclum is.1InwMedarartered for We(Sec.7044,11esiness Required Inspections and PmfessCode:The CoThe Conncwh Licrmm m "Ons,law dal apply In an of q P property who builds or i m provesBuemn.and who does such work Mmelf or through his own employees.provided thaterch Improvements am not intended oraRcred for sale If. however,dee building or improvement is sold within ane Year of completion,the ownr- builder will have the burden of proving that he did cot Mdid OF improve for purpose of sale.). D I.m owlur of the property am exclusively mnvacdng with limed com rens w Construct dor projem(Sec.7044.Business am Profession Cade)The CLanemra U. ense claw does nos apply m m amen of property who holder or improves thereon,and, who contacts for such pmjecu with a mnuacm(s)Ilanmd pvrawm m dor Conuxcmh License taw. D lanceempvunder See .BBpCfmlhismuan Owner Data WORKERS COMPENSATION DECLARATION I hcroby darm under pensity of perjury arc of the following dedmatmor I hero aM wtll melanin a Cerdnesw of Cameos to self-luurc fee Wa keelCampen- sutm,as provimd for by Section 3700 of dor tabor Cade.for dee perfarmence of dor work for which this permit Is issued. 0 1 have and will maintain Wortrts Compensation Insurance,as required by Section 3700 of the labor Coda,far the pmformawe of W work for which this permit is issued. My Workers raps meal uunnmanterand Pellry num cr am: Cartier.-L1/ /� 1rL-�Nt Ol Policy No.: CERTIFICATE OF EXEMPTION FROM ORXERS, COMPENSATION INSURANCE ' (This section need not he completed lithe permit Is(crow hundreddallma($100) ar lea.) 1 certify that in the performance of deo work for which this Permit is issued.I shell not employ any person in any manners as In became subject to the WorkersCompensation Laws of Califoma.Data Applicant NOTICE TO APPLICANT:If,after making this Cmincem of Exemption,you should become subject to the Worker's Compensation provisions of the labor Code.you mum mJ Q forthwith comply with such provision or this permit shall m deemed mmked. „zy 41`7CONSTRUCTION LENDING AGENCY [-� I bemby affirm that Nem ts a construction lending agency for dor performance of y' dor work fur which deo permit ts!used(Sec.3097,Civ.CJ Qlanmr's Name z Lenders Address U Q I certify that I have read the applkation and mw dor the above in(armNun is W t•' carr..l agree to comply with all city and county ordinances and sum laws miming m 0U building construction,and hereby authorim mpmamunim of this city 10 saw'upon the r W move-mantioocdpmpertyss fond expenses whichpurposes. (We)agree m save,indemnify and keep haralea dee City of Cupertino again) r� liabilides.judgmenu,ecru andexpe-•-•which may in any way acrnwagmnslaid Cly U z m c of the granting of Nis pc APP RCE ANT UNDERSTANDS AND ILL COMPLY WITH ALL NON-POINT Issued by: Date S RCER ULATIONS. 0� Re-roofs Silgigime of AppliesnVComacmr Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applwael or future Wilding aecupanlsmre,or handle ha mmawtid as defined by dor Cupertino Municipal Code,Chapmr 9.13.and dor Health and Safety Code.Section 25732(a)? All roofs shall be inspected prior to any roofing material being installed. C]Y" 0N Will the applicant or future building Occupant rte equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emir hazardous air conuminnta as de0ned by the Bay Area Air Quality Management all new materials for inspection. District? DYes CNu 1 have mad Ne hmandous materials requirements under Chapter 6.95 Lithe Califary nice Heal 8:Safety Com,Seeman 3551 5533 and 25534,1 understand that ifllc building does n niV�a/Y h /'wnant,the t Is y rcspansihllity.ra l notify the occupant of Ne myu' me hwhmuInv`mM Ip rte' umwcOr.Ccrtifi afOcpupan Signature of Applicant Date ZG All roof coverings to be Class 'B"or better Own or autharizedagent Date' CITY OF CUPERTINO om 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32619081 . 00 DATE ISSUED. . . . . . . : 09/26/2006 RECEIPT # . . . . . . . . . : 36206 REFERENCE ID # . . . : 06090243 SITE ADDRESS . . . . . : 21852 MONTE CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : KUMAR GANAPATHY ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : DOVE' S SERVICES CONTRACTOR . . . . . . . : DONALD DOVE SR LIC # 27990 COMPANY . . . . . . . . . . : DOVE' S SERVICES INC ADDRESS . . . . . . . . . . : 1695 SAGEWOOD AVE CITY/STATE/ZIP . . . : SAN LEANDRO, CA 94579 TELEPHONE . . . . . . . . : (510) 376-6543 •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---- - -- -- - ---------- ---------- BREMAIRHAN NO.UNITS 2 . 00 20 . 52 0 . 00 20 . 52 0 . 00 BREMFURN NO UNIT 1 . 00 14 . 31 0 . 00 14 . 31 0 . 00 BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BSEISMICRE VALUATION 7, 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 MPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 185 . 50 0 . 00 185 . 50 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ---- ------------- ------------ --------------- - - - CHECK 185 . 50 1502 TOTAL RECEIPT 185 . 50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING '508 FINAL MECHANICAL • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 #UPEI�TINO Building Department JOB ADDRESSZ)?YL /-r vin' CT PERMIT#0hQ ©Z OWNER'S NAME: IPHONE # GENERAL CONTRACTOR _ FAX # _I I am not using any subcontractors: lK (gni Z 6 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 Roofing Septic Tank Sheet Metal Sheet Rock A—Tile 2�-y6 Owner/Contractor Signature Date CITY OF CUPERTINO aAg0,;2A3 FURNACE/AC �UPERTINO PERMIT APPLICATION FORM APN# Date: Building Address: 219,52— M0 le, G+. Ownis Name: Phone#: &ana A Con etor: Phone: Licen e#: ,S See 1 s �• 510 -376 - 65 C13 650 2 CoPhone: Cupertino Business License#: M"4 /,J - 3 7G - 6 3 2 Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech 25-- Jo escripplon: IQC e t(A' e c �R�C , ' c-azc�s. l move- o IJ F"t.u. v a.1c in s,*11 xl Resi ential Ja Commercial ❑ For Residential Installations: Attic ❑ 1" floor ❑ 2"d floor❑ Adhere to min set back requirement❑ or Commercial Installations: eplacement same weight ❑ Additional weight (structural talcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: Type of Construction: Occupancy group: Strapped 0 On Platform EJ Bonded El Sq.Ft. Floor Area: New Location ❑ Replacement QL Qty. if Applicable Fee ID Fee Description Fee Group ( BENERGY Energy BUILDING BREMFURN Furnace MECHANICAL BREMACOVER A/C Unit> 10,000 cfm MECHANICAL 2 BREMAIRHAN A/C Units <= 10, 000 cfm MECHANICAL BREMRECEPT Rec tl, Switch& Outlets ELECTRICAL I BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BPGAS Gas Piping System Fee PLUMBING BUSLIC Business License BUILDING