06050150 CITY OF CUPERTINO ''�^^y°' �" '�•" "`
IIUILDiNGbIVISION PERMIx a , . ' 0' "
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BUILDING ADDRESS: NOBLE,• CONSTPERMIT ND.O 6 O S O 15 O
7567 NORMANDY WY
OWNER'S NAME: PERMrr LSSUEDATE
MUSIL LEONARD M AND MARY A 259 N CAPITOL AVE06
NE: SANITARY NO. CONTROL NO.
(408) 205-3692
ARCHrfECrtENGINEER: BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
i 0 o LICENSED I s CONTAACndo,Provision
- lob Description ���® �®
i 1 hereby )of that 1 am fft Bu under providom of Chapter 9(commencing L
With Section 7M) the Business end PrOrcaaiana CoM.and myliccnse is
M3H hmBforcemd.rT REBUILD CHIMNEY FROM SHOULDE
j M Z License CI
dDeNsCSnI lnEcmF
°'
I drsphos shall b sa � — — MAYZo 2006
,L; Licensed Pmfcsstan.I /y 6 �B l�pa fpr
y5 OWNER-BUILDER DE ft Co TION ���■ 5 /y '
� I hereby orfirm Not I em exempt from Jen ConvactorY License law for the L �t��i*r
p O following reason.(Section 7001.7,Business and Professional Code:Any city or county
which
re9ulms a permit W CWHINCL alar,Improv,demolish,or repair any mucmro
_Zy prior to its issuance,also raquins the applicant for such permit to file a signed maremem
€0 Net he is licensed pursuant m the provisions of the Conuacmr's License Law(Chamer 9 Sq.Ft.Floor Area Valuation
$ (commencing with Section 7000)of Division 3 afthe Businial Pmfeseiona Cade)or
.. that he is exempt donarorn and the bads far the alleged exempdon.Any violation of
Section 7031.3 by any applicant for a permit subjects the applicant o a civil penalty of r Occupancy Type
not more than Rw hundred dollars($700}
❑I,U owner of die property,or my employcaa with wagon U their soh compensation,
will do the warkand the nuucture is not mended or offend for w e(Sm.]044,Bud. - Required Inspections
and Professions Cade:The Contractoh License Law dean ret e apply m an more,of 9 -
property who builds orimpmves thereon,and whodoessuch warkhimselror Wough his
Own employees,provided thatsueh Improwmenla arc trot intended oroffered for We.If.
however,the building or Improvement is sold within ane year of cempletion.the owner.
builder will have has burden of proving that Ire did not build or improsc for purpose of
oak.).
❑1,as Owner of she property,am exclusumly eonuuvng with licensed contractors to
convict the project(Sec.70",Business and Prefectures Code:)The ContracmrY Li-
cense law dam not apply to an Owner of property who builds or impmvns become.and,
who contracts for such projects with a c.neractor(s)licensed purawnt to the Contractors '
License Law.
❑Iamexemptundm See .B&PCror Niamaon
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury aro of the following declmatiam:
1 Mw and will maintain a Certificates of Consent m self-imam for WO r'sCampcn-
Milan,ss provided for by Section 3700 of the labor Code,for the performance of ire
work for which this permit is issued.
❑1 haw and will mdnum Warkeh Compensation Insurance.an required by section
3700 of the Labor Cada,far the performance of the work for which this permit Is issued. '
MY Workers madon Insurance r and Policy number are:
Carder. Policy No.:
C T E7( Pr10N FROM WORKERS'
CO SA"ON INSURANCE ,
(Tbhacmiannredom complcmdirthe p.rmitisfaronchundreddollan(SIM)
or less.)
1 eeNh that in th performance c walk for which to perrpft Is .1 shall oat
employ any Pen manymmtrigogauttal mbjed W Wptl Mgt
lawso(CaB le
APPIic t
NGnC APPLItoldems
; ,a0er meld nCeniO• IpWO,yOu should
become In m therl Compen do provhi.na of the labor Cad�yus meet
.J z forthwith comply wipmvhiom ar permit shill be dxmed rowkcd.
„'�,.�► STRUCTION LENDING AGENCY
1xrobyrink ac.wroctinn lending agency for the performance of
a' tiMe work for which this permit is issued(Sec.3097.Civ.C.)
6Wi Q Lenders Name
]z Lunettes Address
U Q 1 certify that 1 haw read this application and stsk that be show infOmadon Is
If.P correct.1 agree in comply with all city and county ordinances and state laws raising to
0 building conviction,and hereby authorize rcpresenutiws ofthis city to enter upnn the
>"0. ahovc.mcntiuncd rape for InspeC9 ITOM
(We) a to leave,indemnify and keep harmless the City or Cupcnino against
rFs rA IiebilWeaJ gotten,costs and expensm which may in any way accrue agdnaCmid City
U z APPIL NTeUNth RSTA S AMNO WILL COMPLY WITH ALL NON-POI Issued by: Date l7
SO REGU AT10
Re-roofs
store A HAz ous RIAL CLOSURE °a Type of Roof
WIII pplkactor furereb II grecupentat.re rhendle haysNons mnmrial
m defined by Cupertino Music ode,Chapter 9.12,and the Health and Safety
Cade.Seed. 532(x)? All roofs shall be inspected prior to any roofing material being installed.
❑Y 0 N ,
WIII the applicant or future building occupant use equipment or dcvivs which If a roof is installed without first obtaining an inspection,I agree to remove
:mit hamtdaus dr contaminants as JcOncd by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yen ONO
Irk ad the am materialsmluimments under Chapter 6.95 ofthe Califor.
nig Hol S myceed.Saktiorel.27733sndi5534.1undersundthatlfdn building
docs no cuncn(I ant.That It h my responsibility to many the Occupant Of the
ro cru.which apriorml ancearacertirmalearacupaney. Signature of Applicant Date
ner.r oat ,hes agent Dare All roof coverings to be Class'B"or better
CITY OF CUPERTINO O 10,0 To k o
CUPEI�r PERMIT APPLICATION FORM
N# 36e - I/. I 5,5, 0 oo Date:
Building Address: Mailing Address (if different from building address):
Owner's Name: Phone#:
44-
C tractor:_ License#:
Contact: Phone: 7,'f a� Cupertino Businesfc ss e e#:
Fax: n y
Building Permit fo:
Bldg Elect ❑ Plumb ❑ Mech ❑
Job Description:
Residential ❑ ❑
Sq.Ft. Floor Area: / Sq.Ft.:
Cost of Project: �oe Occupancy Group:
Type of Construction:,/ Please check this box if the project is a
(yv second-story addition: ❑
ro'ect Size: Standard 2"' Lar ie ❑ 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 Investi ation fee BUILDING
lof3 2Z " ^ � �
CITY OF CUPERTINO
CUPERTINO PERMIT APPLICATION FORM
QuantityFee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM 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 Pblg 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 Stom1/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 clip MECHANICAL
BREAUUiAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BRENUI RN Relocation of Fumace MECHANICAL
BREMFURNOV Relo Furnace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res App liance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rcpt], Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
2 of 3
CITY OF CUPERTINO
CUPEf�TINO PERMIT APPLICATION FORM
uantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, 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 Electical 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
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Chane BUILDING
•
3 of 3
CITY OF CUPERTINO
!m 1 of 1 PERMIT RECEIPT OPERATOR: christya
COPY # 3
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36611155 . 00
DATE ISSUED. . . . . . . : 05/17/2006
RECEIPT # . . . . . . . . . : 34438
REFERENCE ID # . . . : 06050150
SITE ADDRESS . . . . . : 7567 NORMANDY WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER • MUSIL LEONARD M AND MARY A
ADDRESS . . . . . . . . .
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5222
RECEIVED FROM . . . . : LARRY BARRAGAN
CONTRACTOR . . . . . . . : LARRY BARRAGAN LIC # 24654
COMPANY . . . . . . . . . . : NOBLE CONST
ADDRESS . . . . . . . . . . : 259 N CAPITOL AVE #152
CITY/STATE/ZIP . . . : SAN JOSE, CA 95127
TELEPHONE . . . . . . . . : (408) 205-3692
�EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BENERGY PERMIT FEE 83 . 16 39 . 92 0 . 00 39 . 92 0 . 00
BPERMFEE VALUATION 2, 550 . 00 83 . 16 0 . 00 83 . 16 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
BSEISMICRE VALUATION 2 , 550 . 00 0 . 50 0 . 00 0 . 50 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 228 . 58 0 . 00 228 . 58 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CASH 228 . 58 $
TOTAL RECEIPT 228 . 58
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
• PERMIT INVOICE OPERATOR: christya
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36611155 . 00
INVOICE DATE. . . . . . : 05/17/2006
REFERENCE ID # . . . : 06050150
SITE ADDRESS . . . . . : 7567 NORMANDY WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MUSIL LEONARD M AND MARY A
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5222
CONTRACTOR . . . . . . . : LARRY BARRAGAN LIC # 24654
COMPANY . . . . . . . . . . : NOBLE CONST
ADDRESS . . . . . . . . . . : 259 N CAPITOL AVE #152
CITY/STATE/ZIP . . . : SAN JOSE, CA 95127
TELEPHONE . . . . . . . . : (408) 205-3692
•
FEE DESCRIPTION ACCT NUM CHK TOTAL FEE PD TO DATE BAL DUE
------------------------ ------------ --- ---------- ---------- ----------
ENERGY 4119 A 39 . 92 0 . 00 39 . 92
BLDG PERMIT FEES 4116 P 83 . 16 0 . 00 83 . 16
SEISMIC FEE RES 2013 P 0 . 50 0 . 00 0 . 50
BUSINESS LICENSE 4063 A 105 . 00 0 . 00 105 . 00
------------ ------------ ------------
228 . 58 0 . 00 228 . 58
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
-------- ---------------------------- -------- ----------------------------
101 FOUNDATION 102 PIERS
103 UFER 104 REBAR
105 ANCHOR BOLTS 106 SEWER & WATER
202° UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL
204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION
301 ROUGH PLUMBING 302 TUB & OR SHOWER
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
305 FRAME 306 HOLDOWNS
307 INSULATION 308 SHEETROCK
309 EXTERIOR LATH 310 INTERIOR LATH
311 SCRATCH COAT 313 ROOF NAIL
501 FINAL ELECTRICAL ENERGY 502 FINAL PLUMBING ENERGY
503• FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERGY
005 FINAL ELECTRICAL 506 GAS TEST
507 FINAL PLUMBING 508 FINAL MECHANICAL
509 FINAL GRADE 510 FINAL PLANNING
514 FINAL PUBLIC WORKS
Community Development
10300 Torre Avenue
Cupertino CA 95014
t Telephone(408)777-3228
Cl OF Fax(408)777-3333
WUPERTINO
Building Department
JOB ADDRESS: 7 /1 o,P.ir (�/� PERMIT #
oSo / s'D
OWNER'S NAME: / PHONE #
GENERAL CONTRACTOR: Z4 FAX #
I am not using any subcon cto s. / 7 p�
lgnature Date
Please check applicable subcontractors complete the f information:
SUBCONTRACTOR USIN SS N E BUSINESS LICENSE #
Cabinets &Millwork 44
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
S et Rock
it
Vc�ntrdct(27ature ate