06070081 CITY OF CUPERTINO � 07 _, 1. t 1nMem" " 1171-TAX
BUILbING DIVISION PERMIT 4 , RA.CTQRt1MRMATIQN ;-
n 4,, a,n . Ia.
BUILDING ADDRESS: SOUTHWEST ELECTRIC PERMIT NO.O6O70081
10134 S TANTAU AVE
OWNER'S NAME: PERMIT L4IJE DATE
RAMAN MUMIVIVARPU 14510 BIG BASIN WAY 07/13/2006
E:
SANITARY NO. CONTROL NO.
(408) 999-8721
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
loo LICENSED CONTRACTOR'S DECLARATION Job DOSCrIpUOO
MF❑ I Mob,affirm rhes 1 am licensed under po rwamul of Chapter 9(ammencing
IiW with Senion7IXXJ)of DivisionJof the Business and Professions Code,and my license is
in full forte and cff t, SERVICE CHANGE TO 100 AMP
]pi LiMd 'I Cic.K _
t„o Dam COnmazmr
ARCHr1 SDECJX ATION
aI urWersanJ my plans shall be used u pub m Mends
xyU
Licensed Professional
.,y
OWNER-exempt
RDthe ComTION
<C I mare
alum on 1 em exempt from the fiasimer C a License Law for the
p o following anion.(Section]B3 d Business and an.da ori Coale:My city err county
e m which requites a permit m cnnstroeL slur,impove,dcmalIsh.err repair,any structure
$1500
prior it itsissuance.also requires the applicant for Such permil to rile a signed sammenl
€o thatheislicerwdpersonalasthepmvism.oftheConuactor'sLice.Law(Chap=9 Sq.Ft. Floor Area Valuation
[ (commencing with Section 7000)of Division]of NC Business and Professions Code)or
that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 70313 by airy applicant for a permit subjects the ir,lloam to s mil Penalty of A1PN mittlerOccupancy Type
net mou Nan five hundred dollars(350(1).
Q 1,u owns of uhe pmpmy.err my mopiayea with wages u theh sok campenution, As a3 Pl/Y Il
will do the work.and the structure is not Intended oroffared lursale(Sec.7044,Business tl f a
and Pmfessians Cade:The Comearcmr's License Law does not apply m an owner of IR glist Ed QI3SpeCU_
Property who builds or harpoons s therein,and who dos such work himself or though her
own employers,provided Nat such imprmemens she not intended moffeop for We.If. !'(v aS006
however,the Wilding at improvementm:is sold within ayear ofcompletions the owner- AIG QL
1-
builder will have the burden of proving that he did tet build or impoa fa purpose of
sok.). � �rrlyyy��s ��K111
❑1,a Owner of to property.am exclusively contracting with licensed contractors to /ate t1
do.Lla the es a., (Sec.7 ad Business and Professions Cade:)The COnmmers Vit I IIILLL"'llJlJl (at\,'•✓_/
ecus Law does r such to a an owner of poapeny who Milds err improv Comanu and 11
whocontractsU far such gajecte with a contracwr(s)licensed pursuant m the Gaduacmis
License Law.
❑lam czem oder Sea ,a&PC far this o n
Ownu Dau
ORKFA'S COMPENSATION DECLARATION
herebY
aRnv under pvarsity of perjury arc ofthe following daleretions:
I ban and will maintain aCerdfswte of Cmmm to ulf-inure for Workces Compen.
sation,as provided fa by Section 37()0 of the lobar Code.for the performarra of the
work for which this permit is issued.
9I bare aad will mainuin WortrYs Compensation Insurance,u required by Smion
x]00 of the Labor Code,fm Ne pdifiarmocc of Ne wide for which this permit is ivaed.
My Workers Com notion Insu c amici end Policyrnu�mb�c�mc: -T
Cartier. , e Policy No.1SCJ_G(I `
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not he completed if the permit is foredo hundred doRvs(SI W)
Or less.)
1 certify test in tic performance of t e work for which this permit is issued,I shall not
employ any Wotan in any manner so as o became subject to the WorkesCOmpeoation
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
became subject m dte Workers Compensation provision of the Labor Cada you mou
.,QM
foWith comply with such Provuo N
inm u mdenied.permit shall he deeed wked.
ZUj CONSTRUCTION LENDING AGENCY
[-+ 1 hereby affirm that then 4.construction lending agency far de performance of
the work fur which this permit Is Issued(Sec.3097,Civ.C.)
aLancets Name
z Lender's Address
U Q 1 certify dial f lave frac this appliemion W stem that the allow infonnadun is
u. H correct.I agree to comply with all city and county ordinances and suis laws relating he
0 building construction,and hereby suthmis opresenlaliws of this city to enter uprm the
r W alrovc-mcmioned propc sit Tadd a pe expenses
purposes.
(we)agree to save,indemnify and kap harmless the City or Cupertino against
fq liabilities.judgments. end ezpeslms which may in any way accrue agalut said Cly
U Z is eo na of the&.1mg of this permit.
^ APPLI[A NDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
3001/ LATI S. 7r' D / Re-roofs
t of "pplican/COMraclor (,/ x B Date
r HA2ARDOUSMATERIALS DISCLOSURE Type of Roof
Will de applicant Or rulum Wilding occupant state or handle haaardous material
as denncd by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety
Cade,Sermon 25533(a)T All roofs shall be inspected prior to an roofing material being
❑yes P P Y g g installed.
If a roof is installed without first obtainingan inspection,I agree to remove
Will the applicant u f u 'Wilding Occupant tau equipment err M...which P
emit horsrdnus air conuminanu u defined by the Bay Arta Air Quality Managcmcnl all new materials for inspection.
District?
❑Yrs No
I he.rcvuNl the haateriaH rcquimments unAcr Chapter6.95 aided Calif.
iia HN
.SxdouMM5.75577 and 25534.I tmMrsuM lMirate Wilding
does moan,Natitismymspomibiliyonotifytheascnupantofthe
radairhemet pnormissuance Ora Cemficate 1a/OC Signature of Applicant Date
Owner ora tharbmd agent Date All roof coverings to be Class "B"or better
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37507038 . 00
DATE ISSUED. . . . . . . : 07/13/2006
RECEIPT # • • • . . . . . . : 35246
REFERENCE ID # . . . : 06070081
SITE ADDRESS . . . . . : 10134 S TANTAU AVE
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : RAMAN MUMIVIVARPU
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : SOUTHWEST ELECTRIC
CONTRACTOR . . . . . . . : LA RITA A WILKENS LIC # 21488
COMPANY . . . . . . . . . . : SOUTHWEST ELECTRIC
ADDRESS . . . . . . . . . . : 14510 BIG BASIN WAY
CITY/STATE/ZIP . . . : SARATOGA, CA 95070
TELEPHONE . . . . . . . . : (408) 999-8721
*EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------- ----- ------- --- ---------- ---------- ------- --- ----------
BELEC200 METERS 1 . 00 29 .43 0 . 00 29 . 43 0 . 00
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
BSEISMICRE VALUATION 1, 500 . 00 0 . 50 0 . 00 0 . 50 0 . 00
--- - ------ ---------- --- - ------ - - --------
TOTAL PERMIT 169 . 79 0 . 00 169 . 79 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 169 . 79 1011
TOTAL RECEIPT 169 . 79
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
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Community Development
10300 Torre Avenue
sFs Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
GVUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
10134 S.TaNvU
OWNER'S NA.ME:ge=nW IviVarM PHONE # - 25—
GENERAL CONTRACTOR:
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
60 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
r- CITY OF CUPERTINO � �
(�
C T'W PERMIT APPLICATION FORM
CUPEkTINO
Ad 1k
N # 16
� ��� Date
Building Address: Mailing Ad re (if different from building address):
01 5 , to
Owner's Name: Phone#:
Kn I V CA 1,- Z S mac/ ZSR
Con ctor: License #:
o�c 53 r1- er vl lfi1 V
Co ct: Phone: 5� — 6 K 7 1 Cupertino Busine s License :
l,U K PK4 Fax: ct 7f- / 1/a
Building Permit Info:
Bldg ❑ Elec Plumb ❑ Mech ❑
Job Description:
Residential ❑ Commercial ❑
Sq.Ft. Door Area: Sq.Ft.:
Cost f Protect: Occupancy Group:
Type of Construction: Please check this box if the project is a
/ 00 second-story addition: ❑
roject Size: Standard ❑ Laze ❑ 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 1 M Btu MECHANICAL
BBOILER4 Boiler> 1 M 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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CF CITY OF CUPERTINO
CUPEf� PERMIT APPLICATION FORM
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
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 rinkler/Backflo PLUMBING
BPSTORM Storm/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 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREEMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> I OK 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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apla CITY OF CUPERTINO
°TMOF PERMIT APPLICATION FORM
CUPERTINO
kQuantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Sips Add Branch ELECTRICAL
BREMSIGNS Remodel Sips, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Sob 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 Eleeffical 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 Plannin Lon Range Residential PLANNING
ZADDCHG Address Change BUILDING
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