06080014 CITY OF CUPERTINO r`'
.BUILDIo>'S DIVISION PERMIT tiCONTRACTOR INFORMAT,ION
=?a`r`" 1 r-r iti�b.
BUILDING ADDRESS: a PERMITNO.06080014
8051 PRESID10 DR
OWNER'S NAME: PERMIT ISSUE DATE
MC MILLAN WILLIAM A ET AL 006
E:
SANITARY NO. CONTROL NO.
ARCHI'fEC1ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
O j LICENSED CONTRACTOR'S DECLARATION
<� I lob Description
H af
1 hereby firm that 1 am Ra mud under provisions of Chapsu 9(mmt
mem ng P
wmt Section 7")of Divan 3 ofthm Brs
uaintand Prof uppa.a my licence is
nm
in full foedef(act GU CHIMNEY REPAIR INSTALL CLASS A F U
rya? License Class L.
y Dale - Contractor
ARCHITECTS DECLARATION
I undersand my plans shall he used u public mcnrN
)yU {
't In Chemed Pmfcssional Y
j03 OWNER-BUILDER DECLARATION
10I 1 natio alliin on 1 1. exempt from the C scion;CoLicense: c Law for the �•I\
:0 o following nation.(Section 1(131.5.s5.Business and Professions Code:Any dry,or county O
f$ which rtquirta a permit d construct alcor,improve.h permit t nr repair any swctum $6000
pd.uits issuance.
ensed pursunto resthe thovisiosof far sohpermitta Renesle ae Lawdaumment
< (that he commeccgwith Section
Nc provisions 3 omComdctorsniceuc loons Cecil or Sq.Ft. Floor Area Valuation
2�� (cat No I.(commencing Seuua]odd of basis f r th the Business and Proon.Any vi Code)of
Nat he u exempt therefrom and the buss(w Ne illcgcf exemption.Any violation of
Section 7031.5 by cry applicator put permit subjects he applicant to a civil penalty of r Occupancy Type
moo mart Nan five hundred dollars(SM.
❑1,u owner of die prolan;,ar my eroployca with wages u Ne'v sole compensation.
will do the wart.and thesuuctse is act hounded orartered for wds IS..11144.Beat. Required Inspections
and Professions Cade:The Cantrscmrs License law does not apply m an e owner of q P
property who Wildsmimpmvn thereon,and who doesawh work him elf.,through his
own employees,provided dal such improvements are not in',Med oroufeeed for sale It. -
however.the building or improvement is sold within one year ofcomplerion,the owner.
builder will have the burden of proving that he did rot build w improve for puspue of
sok.).
❑1,as owner of rhe property,am aaelusively contracting with licensed coma urn to
construct the project(Sec 7014.Business and Profession Cade:)The Chemises U.
Mance law does not apply as an owner of progeny who Wilds or improv thereon.and.
who contracts for such projeaf with a condiments)licensed promised ad the Contactors
Licence law.
❑1 me axempwnder Sec .B&P C for this reome
Owner Dare
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of t e following federations:
hs and will maintain a Certificate ofComsenttoself-insunfwwarkerscmmpen-
mom.as provided fo by Schon 3700 of the labor Cade,far the pertormmuce of the
wart for which this permit is isued.
1 have and will maintain Workers Compevation Introduce,as required by Secure
dm lobo COM For do pent. of the wart far which NU pemriruusned
My Worker amp sauonl unnce 'cr and Policy no
art: � ao ,
Cartier. e, V Policy No.:
CERTIFICATED EK PILON FROM WORKER '
COMPENSATION INSURANCE .
(Thu account heed not W completed if be Permit is foro e,hurWrtddollan(SIW)
or Icss.)
I cenifv Nat in the Performance of the wort for which this permit Is issued.I shall not
Conlin;any person in any manner m as to become subject to the Workers Campmnauan
Laws of California Dae
Applicant
NOTICE TO APPLICANT:If,after making this Cenificam of Exemption,you should
become subject an the Workers Compensation provisions of the tabor Code,you muss "
,JO faMwirh comply with such provisions or Nu permit Oil]W deemed mucked.Z� CONSTRUCTION LENDING AGENCY
[•+ Iherehy M.Nat Vert is a convection lending agency,for the peffsnmance of -
lY dm wok for which this permit is issued(Sec.3097,Co.Q
UAQ Lenders Name
Z lenders Address
U 0 1 certify that I have read this application and sum the the above information is
cancer.1 agree to comply with all city and county ordinances and anti laws mlaing m
p V Wilding construction,and hereby ambonre mpmmnariws of this city to moor upon the
FW above mentioned Progeny for impccuon purposes.
y (We)agree to save,indemnify and Ihep harmless the City of Cupertino against
fA liabilities,judgments,costs and expenses which may in way acame against mid city
V z A consequence of the granting of Nis Fermi
^ A UNDERSTANDS A LL COMPLY WITH ALL NON POINT Issued by: Dale
SOURCE
gJY` L
SOURCE GULA N
Sign rear AicaDam Re-roofs
P HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or(tun Wilding a.Chapter
rare w handle h eardousd Serail
u defined io the Cupertino Municipal Code.Chapter 9.12,and the HeaIN roti Sa&ty
Matic.Section 25532(.)?
cYca All roofs shall be inspected prior to any roofing material being installed.
Will the
dapplicant or future Wilding occupant use equipment or dnwhich If a roof is installed without first obtainingan inspection,ection,I agree to remove
.haardnu it autonomous,u Ufncd by Ne Bay Ana Air Quality Management
all new materials for inspection.
.restrict? .
l/— I ❑Yes
16m—
I have read Nehvallousmamriau requimmentsu rChapter6.95 ofthe Califon
nia Hcahh&S cry Code,Sced.255u5,255JJ J4.l unfcrsund Natif the Wilding
does rot cu tly haw a coram.Nat i, responsibility as notify the oMmmr of fe
osmirtmen whichto be met ' r m issuance ofa Conircam of 9;c Signature of Applicant Date
Gamer sir sumer cd agcnr �f" Data All roof coverings to be Class "B"or better
o qU
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APPROVE U
IN ACCORDANCE WITH T E CITY I
CUPERTINO CODES AND 0 DINANC S
D TE 2-0 6 yov
S NEU
T is set of pans and specific tions M S
kept on the job at all time and it i un
la dul to make any changes 9 Its m
nn same without written per fission f
n building Dept., City of Cup rtino.
ih stamping of this plan and s ctficati n
iH LL NOT be tied to pe,mit r to be ' r
i
or roval of the viola,ion of an prov,sl' . l�o�bls p Papaq
i
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MW Community Development
Y f 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
�1PEkTINO
♦♦
Building Department
JOB ADDRESS: PERMIT #
cdb-�5- e s c Oc/ 06 0<f 0.D( 1-r
OWNER'S NAME: G ,` PHONE #
GENERAL CONTRACTOR 2� �L� /� FAX
I am not using any subcontractors: !i1/ .� O
Signature ate
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
- 94114
;OwZner//C ntractor Signature Date
CITY OF CUPERTINO
I� 1 of 1 PERMIT RECEIPT OPERATOR: bethe
COPY # 3
Sec: Twp: Rng: Sub: Elk: Lot:
APN . . . . . . . . : 35611072.00
DATE ISSUED. . . . . . . : 08/02/2006
RECEIPT #. . . . . . . . . : 35487
REFERENCE ID # . . . : 06080014
SITE ADDRESS . . . . . : 8051 PRESIDIO DR
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : MC MILLAN WILLIAM A ET AL
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4026
RECEIVED FROM . . . . : ABA SERVICES
CONTRACTOR . . . . . . . : LIC #
COMPANY . . . . . . . . . . :
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
TELEPHONE . . . . . . . . :
ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW HAL
_____ __________ __________
BPERMFEE VALUATION 6,000.00 126.36 0.00 126.36 0. 00
BENERGY PERMIT FEE 126.36 60.65 0.00 60.65 0.00
BSEISMICRE VALUATION 6, 000.00 0.60 0.00 0.60 ' 0.00
MPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00
BUSLIC FLAT RATE 1.00 105.00 0.00 105.00 0.00
TOTAL PERMIT 330.98 0. 00 330.98 0.00
METHOD OF PAYMENT AMOUNT NUMBER
_________________ __________________
CHECK 330.98 11230
TOTAL RECEIPT 330.98
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
101 FOUNDATION 312 CHIMNEY REBAR & STRAPS
514 FINAL PUBLIC WORKS
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CITY OF CUPERTINO
CUPE�Tnvo PERMIT APPLICATION FORM QwbDdl`1'
N# - // _O '74? Date: qf--) � (0
Building Address: ,p Mailing Address (if /different from building address):
Owner's Name: Phone#: �-j(� '
it I� t16laV1
Contractor: L-D SG V cG2 ^r� License#: rD
11,04
Contact: II Phone:46-0 gds Cupertino Business License#:
G lre �ffb 1yf5 Fax
X21
Building Permit-Info:
Bldg-®, Elect ❑ Plumb ❑ Mech
Job Description: rc `5.X1-1 ]n C a-a
- v
Residential ❑ G 4MR e t t'— Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy roup:
,OD
Type of Construction Please check this box if the project is a
second-story addition: ❑
oject Size: Standard 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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a—bw�m'_, CITY OF CUPERTINO
clwF PERMIT APPLICATION FORM
CUPERTINO
Quantity Fee 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
BOVERTWE 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 Re eat 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 elm 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> IOK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc 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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CITY OF CUPERTINO
CITY F PERMIT APPLICATION FORM
CUPEI�TINO
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 Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanical sq. 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 Change BUILDING
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