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06030114 CITY OF CUPERTINO BUILDING DIVISIONp)Ci jt 11T CONPR .CTOR NFOR IATIUN .,e A^•cx- 35Y11L''+s ° fi x:1- xx ., 7,k BUILDING ADDRESS: PERmrrNo.0 6 V3 U114- 10317 NORWICH AV NER'S NAME: FERNUT ISSUE DATE JOSHI, SHILPA AND SATICH 383 HANS WAY 03/21/2006 HONE: SANITARY NO. CONTROL NO. (877) 929-5524 ARCHYIECr7ENGINEER: BUILDING PERMIT INFO BLDG � ELO P !! MEOCH 3066 LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I am licensed under provisions of ChAfur 9(commencing IN Section 7np)of DlHdon 3af dm Budev,ab Professions Cade.&nd my lissom u 4 Ci in tall farce ane et. REPLACE GALVANIZED WATER PIPES WITH COPPER Ice Z Llcenm Ian Lic.N J Dem Cmonau-r ARCHITECrS CLARATION TI 1 understand my plans shall he used as public records F'NA,LE J J !!� l� a Licensed Pm(csdonal OWNER-BUILDER DECLARATION APR /* 2006 I hereby a(fum Nn 1 L!exempt from the Camraemo Llcenm Law for IM E p o following moon.(S.1.1 Bossu construct. Land Re,c1co li Cod,:My mity ar county $6500 5$♦<i which its a permit re quires b t,alms,improve,demolish,ore pair ed structure pat am its issuatm0.also requires thprovisions of toe sock m n's Uce ac Law nammem S�n< (commba enlicensed pSectio7000)ursuant to the ofDvof the Comsinessnd Prof Law(C odc)apter 9 Sq.PI. VaIURIIOn (cammendng with Section 7000)of Division)of the Business and Profnsinm Csale)or that he ts exempt therefrom and the basis for the alleged exemption.Any vloladon of fiulwl 14L Section 7031.5 by any applicant for a permit subjects the applicant In a civil penalty ofumber Occupancy Type not mart Nan live hundred dollus($300). APN ❑1,as owner of the property,or my employees with wagm As their sole compensation. will do the work and themucture H not intended m.ffined fee Asia(Sec.70th.BusinessRaired Inspections and Profemicas Cade:The Conuumra n e ns License Law donot apply m an owner of tl p propenywho buildsur Improves thereocandwho doessuchwork himselfor through his , awn employcea,provided that such improvements am notimended oroaered formic IL however,the building or Improvement is old within one year of compledon,the owner- builder will he"the burden of proving that he did not build or Improve for purpose of rete.). ❑1,As owner of the property,am exclusively contracting with Ikraud contracting b construct the project(Sec.7044.Businw and Prafesdons Code:)M Cmtmanors U. nen Law don not apply m an cannot of property who Isuilds or improves tlmman,and, who contracts for such projects with a contnemr(s)licensed pursuant to the conuacmra License Law. ❑Iamexempluader Sm. ,B&PCforthtsmaaon 13700 wner Data WORKERS COMPENSATION DECLARATION I hereby of on under Penally of perjury one of the following declarations: I hart and will maintain aCutlfmte ofConsent toself-insure forWoekersCompen- don,u provided for by Section 3700 of the labor Cade,far the performance of the ork far which this permit is issued. 1 have and will maintain Workers Compemation Insurance.u required by Scotian of the labor Coen,for the Performance of Ne work for which this permit Is Issued. y Warker's�Clapremadon Insuranceartier And Polity number are: Gofer. Polley Na: CLRTI•CA7 F E3 EMFTION FROM WORKERS' COh PENSATION INSURANCE Missccfw mW not he completed lfthe Permit Is two=hundmddollos(31M) or tesc) 1 sonify that in the perfowance or the work for which this Permit is issued.I A.11 not employ any person in my mn evlp omesubl'scI re the Workers'Compensation Laws f Celifo ie.ralean Applicant �^�wV�� r� NOTICE in APPMAM-((,etiertih n t o mpuoca n.you dmuId become object In the Worker's Compenmtan providom of the Labor Code,you muss 3z forthwith comply with such provisions"is Permit shall be domed revoked. zvy CONSTRUCTION LENDING AGENCY PPa ll site worI hereby affirm that them its consi=dnn lending agency far the Performance of k for which this permit is issued(See.3097,Civ.C.) GQ Lender's Name z Lender'sAddrw V O I cenify that I lase read this application and sum that the&bow:informadon is - Its F coronet.I apse to comply with all city anal county mo manses and state tsw missing in 0V building construction,and hercbyauthodm nmth rc,meatims of this city to enter upon e t17 show-mentiondi properly for inspection purposes. (We)agnce m save,indemnify and keep homing,the City of Cupertino against rA Eabllhosjudgments.costs and expenses which may in any way accrue against old city C.>7 t7- grantingof this Permit APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SO CER ULATIONS. Re-roofs Si{nuum of A/Z" _(:7 pplicandifComancior Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant sort or handle hamokous material As denned by the Cupertino Municipal Code,Chapter 9.11.and the Health and Safety code,5cedan i5s31(a)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes Wi11 dm aPPlkanl or future building occupam use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hamrdnns air contaminants As defined by the Bay Arta Air Quality Management all new materials for inspection. DlslnclT ❑Yes 0.11- 1 have mad the homohms materials requirements under Chapter S95 ofthe Cali(or. rola Health&Safety Codd,Sam an 25505,15533 anI25534.1 understand twtlfthe building does not comardy hem a mnan,this It is my mspenualby m Amory the ucupant or tm reqmen�/h�chjAnn b�m tpnarmiuuance GenifmmorOccupan Signature of Applicant Date Owner ae,trmanrea.gent T 6 All roof coverings to be Class"B"or better CITY OF CUPERTINO •in 1 of 1 PERMIT RECEIPT OPERATOR: bethe COPY # 2 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31629084 .00 DATE ISSUED. . . . . . . : 03/21/2006 RECEIPT #. . . . . . . . . : 33656 REFERENCE ID # . . . : 06030114 SITE ADDRESS . . . . . : 10317 NORWICH AV SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : JOSHI, SHILPA AND SATICH ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2445 RECEIVED FROM . . . . : A PLUS CONTRACTING CONTRACTOR . . . . . . . : EDWARD L MULLINS LIC # 25457 COMPANY . . . . . . . . . . : A PLUS CONTRACTING ADDRESS . . . . . . . . . . : 383 HANS WAY CITY/STATE/ZIP . . . : SAN JOSE, CA 95133 TELEPHONE . . . . . . . . : (877) 929-5524 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BALL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPWSVCS WATER SERVICE 1.00 9.00 0.00 9.00 0.00 PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 47.37 0.00 47.37 0.00 METHOD OF PAYMENT AMOUNT NUMBER _________________ ------------ _--------__-__---_ OTHER 47.37 VISA TOTAL RECEIPT 47.37 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING • Community Development t 10300 Torre Avenue .' ✓' ` Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 SCUPEKTINO Building Department JOB ADDRESS: PERMIT # L O/ 0(003011 k OWNER'S NAME: PHONE # $77— GENERAL CONTRACTOR: / q ' FAX # a9 5-5'a I am not using any subcontractors: Ed&VzA bL 9,w, / 'k V zllDz� 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 Tile Owner/Contractor Signature Date CITY OF CUPERTINO • 10-1 REPIPE/SEWERS/MAIN SERVICE CUPEkTINO PERMIT APPLICATION FORM ow3oo4 APN# Date: 3/4 'a9 -004 Building Address: !03/-7 10,yrwl�;A AK Owner's Name: Phone#: ash ' Contractor: Phone: License#: A -gW Contact: Phone: Cupertino Business License #: 77y�%55 aa�Y57 Building Permit Info: Bldg ❑ Elect ❑ Plumb 0' Job Description: Rep14,ce, e_X J,5ttny pa lvatn;red werplpes NYS-M Copps^ Residential Rr Commercial ❑ Cost of Project: Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg. Permit Fees BUILDING BPGAS Gas Piping System Fee PLUMBING PPERMITFEE Plumbing Permit Issuance PLUMBING BPREPIPE Re i e of Fixtures PLUMBING BPFIXTURE Pbl . Fixture PLUMBING BPWSVCS Main Water Service PLUMBING BPSEWER Sewers PLUMBING BPSEWAGE Sewage Disposal PLUMBING BUSLIC Business License BUILDING •