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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 • 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 ] of3 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 2of3 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 • 3of3 • ����''s ����13 � 7z� S� �� I � •