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08060099 CITY OF CUPERTINO BUILDING-DIVISION- PERMIT lsV�;day ll['1� �R�j'A'Q�fS' l�l� BUILDING ADDRESS: PERMIT NO. 1.047 PENNINGTON LN TBD — TO BE DETERMINED 08060099 OWNER'S NAME: PERMIT ISSUE DATE KAMAKSHI KODUR 06/12/2008 NE: SANITARY NO. CONTROL NO. ARCHRECYrENGINEER: BUILDING PERMR INFO 'BLDG ELECT PLUMB MECH 0 0 0 0 �o o LICENSED CONfRACIOR'S DECLARATION Job Description w C 1 Mreby affirm Wt 1 am liccmnd under Pmnsions of Chapter 9(commencing P 'DTw NthSation7gK0afDividon3oftheBuainrasaMPrafesuamCode.andmyliccnsu TEMP POWER POLE FOR SFDWL CONSTR. R J HAAS CONST. run force and 5222 LicenseClum L .g y CORP. PD BUS LIC 6/12/08 Dow Contras" ail ARCHITECT'S DECIAR ON e w U 1 uMersund my plants mall W used as Public records _ .. 6 hyo I Licensed Professional OWNER-BUILDER mDECLARATION ZOOthereby.(sect than 1 1. exempt from a C etime;Co :Menu law for IW COO following mean.(Srmit t 703 1.5.Business and Pmfations Code:Any city or countyoma $ which mqussu a permit m cnnumct.der,WPmse,h Permitdcro.Koh,t or repair ed muctum z< prior mits cenence,also nt M ft the applicant for suchpunnet lairkalignedsutemem xx That heelittnseJpunuenrmtimpmvidonsofthe,Conurcmrsl3aueLaw(CMpmr9 Sq.Ft. Floor Area Valuation xl-° (commencing withSeeuan70W)ofDivuianSoftheBusineaaerdPmfeaiouCade)or $250 y $ that W is exempt therefrom and the buts for the alleged exemption.Any violation of Section 7031.5 by any applies for a sound,subjccu the applicant to a civil Penalty of ppm Number Occupancy amt mare than Ove hundred doll.(SM. .36204031 .'VV' P Y Type 0 I,u owner often Property.or my employees with wage u ftir sole compensation. will do Ne wart and thesuuctme Is notintended or offered formate(Sec.70/4,Business and Professions Code:The Contactors License Law docs set apply m an owner of Required Inspections property who builds or imprm es Ihercon,andwho doessuch work himselforthrough his one employees,Provided that such impmvermenu are not intended trellised Passaic.V. hwew,the building or improvement is sold within one Sean of completion.due owner- Wilder will ave to burden of proving that W did not build or improve for purport of talo.). 0 1.as was of the Property,am adusively encountering wits licensed cea tranm he consttact the project(Sec.7014.Business and Proftesslou Code)M Cneusctors U. cense law does not apply m an owner of Property who Wilds or Improves Norton,and who contacts for such projects with a ctntractar(m)lireved pursuant on the Contnetorm License law. 0 Ianusexemptunder Seu ,BAPCforthisuaa n Owner Data WORKER'S COMPENSATION DECLARATION 1 hereby s u r peuhty of perjury oro of tie folld Pts decuntionc 0 1 hem and will maintain.Ceeifacae of Couam he self-insure for Workers Campen- udon,as providW fm by Section 3700 of she labor Code,for 0e peRarmane of to wart for which this Permit is issued. 0 1 have and will maintain Workers Competuuion Imuran¢,at required by Section 37W of the Labor Code.for the performance of the wart for which this Permit is issued My Workers trope rano artier and Palley number am: - Cartier. Polity ROWOMERS' - CERTIFl ATIE OF COMPENSATION EXEMPTIONFROMERS' COMPENSATION INSURANCE ' (Thu section tuned set W completed if the return is for ane hundred Moan(SIOM or las.) I certify tar in the perforreanec of Lou,wart rte which this Permit is issued.l shall not employ anypetsen in any manrcrse an to become subject no the Wmken Compenadon U.,of California,Dam Applicam NOTICE TO APPLICANT:If.after making this Ccnincam of Eecmpdan,you should become subject as the Workers Compensation provisions of the Labor Cade,you most .,O forthwith etmP1Y with such Provisions u this Permit mall W domed revoked. z4 CONSTRUCTION LENDING AGENCY :14 I amity anion dist Nem is s ed(Sccunn lending agency for the performasee of > the work for whim Nu permit a issued(Ser.3097,Cir.C.) W�q lenders Name �z Lenders Address V Q I certify that I have read this application and stats that the above information is 1, F correct.1 agree m comply wish all it,and county oWinancrs and scam laws relating to 1 .C)U Wilding construction,am!hembym0son.rtpmunwives of Nu city m cora noun do Lk7 anme-mentioned ent.cents for inspection which may (We)ogee m taw,indemnify and keep harmleu the City of Cupcnise against Z in equence of gratsing expenses which may in.ny way accrue against City t.)z A consequence of the granting of the permit. ^ APPLICANT UND STANDSAND WILL COMPLY WITH ALL NON-POINT Issued by: Dale IV—ti� WMATIP14S. d$ Re-roofs Signuum ofX03carMoureaccor Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the appiicamor forum Wilding occupant some or andlc hunches material as defined by to CuPcnino Municipal Code.Chapter 9.11.and the Health and Safe,, code.section 25332(s)?❑Yes ff/ All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove DirmW�nua air conumirunu u defined by the Bay Asea Air Quality Managemcm all new materials for inspection. 0Yes I have revel the harallom materiae reWi emcm umler Cheaper 6.95afthe Califon- n13 Heslth k Safety Cade,Sections 25505.15533 tad 25534.1 undersand thus ifthe Wilding does not cunemlY hem a taark that it is my respectability to notify the reentrant of the n masuW00,pderdiamummooracc'u" trOa Signature of Applicant Date I All roof coverings to be Class's!'or better Ownua N mdagem pat' CITY OF CUPERTINO • 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN I . . . . . . . .. 36204031 . 00 DATE ISSUED. . . . . . . : 06/12/2008 RECEIPT # . . . . . . . . . : BS000005108 REFERENCE ID # . . . : 08060099 SITE ADDRESS . . . . . : 1047 PENNINGTON LN SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : KAMAKSHI KODUR ADDRESS . . . . . . . . . . : 1047 PENNINGTON CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : RICK SANGETTA CONTRACTOR TBD. -, TO`BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . , TELEPHONE . . . . . . . . : • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---- ------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 250 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00 1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 1ERT<200 UNITS 1 . 00 40 . 79 0 . 00 40 .79 0 . 00 1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 TOTAL PERMIT 232 . 87 0 , 00 232 . 87 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 232 . 87 AMEX --------------- TOTAL RECEIPT 232 . 87 VOICE ID DESCRIPTION -VOICE ID DESCRIPTION --- ------------------------- --- - - -------- ---------------------------- 402 TEMPORARY POWER • 0�?D & 0099 CITY OF CUPERTINO TEMP POWER CUPEfkTINO PERMIT APPLICATION FORM APN # Date: �toz 0-,04 ®3i , DD 0 -/Z .08 Building Address: 104717 Owner's Name: Phone #: Contractor: S Phone #lfp� 7ZS (5300 Fax #: (c? Contact: Phone # Q 23 g2Z Contractor License #: (ro cJ3 Cupertino Business License #: Job Description: Residential Commercial ❑ Valuation (cost of project): Quantity Fee ID Fee Description Fee Group Permit Type 1 ERT>1 K Res. Temp Power>-1K E 1REAP14 Amps l IERT<200 . Res. Temp Power<200 E Amps 1 ERT2001 K Res. Temp Power 200-1 K E Amps i IEPERMITFE Electric Permit Issuance E r 1 ELCPLNCK Electric Plan Check E IBSEISMICR Seismic Residential B 1TRAVDOC Travel & Documentation B Fee CITY OF CUPERTINO e � TEMP POWER CITY Of CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group Permit Type 1BSEISMICO Seismic Commercial B 10EAP14 IECT<200 Commercial Temp Power E <200 Amps IECT>1K Commercial Temp Power E >lK Amps IECT2001K Commercial Temp.Power E 100-1K Amps ITRAVDOC Travel & Documentation B Fee ` 1BUSLIC Business License B • ' R3.�11 puEDl R�� Y Community Development `I 1'�(UUY�J 1 J r 10300 Tone Avenue Cupertino CA 95014 TCITY OF Telephone(408)777-3228 UPEkTINO Fax(408) 777-3333 Building Department All Cupertino building permits must meet certain conditions related to maintaining environmental quality and public peace and safety. The two most common conditions are described below. STORMWATER POLLUTION CONTROL State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and the Santa Clara Valley Water District control stormwater pollution. Educating local residents and businesses and enforcing stormwater pollution control laws are key parts of the City's compliance efforts. Stormwater pollution prevention: It's up to us In northern Santa Clara Valley, storm drains flow directly to local creeks and San Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife dependent on our waterways, for people living near streams and baylands, and for the local water supply. Common sources of stormwater.pollution include: • Dripped oil, fuel, and antifreeze from vehicles and heavy equipment; • • Construction debris, including dirt, concrete and paint; Landscaping runoff containing pesticides or weed killers; and • Any material dumped or spilled into streets or storm drains The property owner and the contractor share ultimate responsibility for activities occurring at a construction site and will be held responsible for any environmental damage caused by subcontractors or employees. For more information on construction-related stormwater requirements, see the Stormwater Quality Regulations section of the City of Cupertino web site at: htto://www.cupertino.org/city government/departments and offices/ environmental services COMMUNITY NOISE CONTROL The basic noise control requirements for construction sites are as follows: • Typical construction work hours are: - Weekdays - 7 a.m. to 8 p.m. - Weekends - 9 a.m. to 6 p.m. • Construction other than street construction is prohibited on holidays. • Residential daytime noise levels from complaint site - 60 dBA • Nonresidential daytime noise levels from complaint site - 65 dBA For more information on noise control, please see Chapter 10.48 of the Cupertino Municipal Code, which can be accessed at htto://www amlegal com/cuoertino ca/ • Greg Casteel Building Official Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY Of Fax(408)777-3333 41CUPEkTINO Building Department JOBADDRESS: I PERMIT # O/ OWNER'S NAME: C7 u PHONE C) 97. O GENERAL CONTRACTOR: % FAX # �j3( I am not using any subcontractors%` -- 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 Ow� CD•/�'oo /Contractor Signature Date r -