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06090050CITY OF CUPERTINO �' '^� '^ '�" "``'''""``•"''�" CONTRACTnR INFOLtMATI. l lel`. BUILDING DIVISION PERMIT Ha=$.i3k'rS`%a"e�`•.in-,k:.K,.."•�P'&- "�'XsYr :z'wY BUILDING ADDRESS: CUPERTINO ELECTRIC INC PERMIT NO. 06090050 20650 VALLEY GREEN DR OWNER'S NAME: PERMIT ISUEDATE SOBRATO VALLEY GREEN ASSOC ATE1132 NORTH 7TH 6 NE: TR SANITARY NO. CONOL NO. (408)991-1000 ARCHflEC IENOINEER: BUILDING PERMIT INFO ISELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Suction 7010) ofDivislan 7 of No Business and Professions Cod., and my kicense is in full forte and often. COMMERCIAL ELECTRICAL GROUNDING FOR TEMPORARY Clue Lm.d OFFICE TRAILERS De¢ Contractor Dam ARCHITECT'S DECLARATION 1 uhhMrmand my plana shall he used as public records Licensed Professional OWNER -BUILDER DECLARATION 1 hereby 4Mm Thal I am esempt fmm to Com acmh License Law for the following rental. (Section 711713, Business and Professions Code: Any city or county which req.t. a Permit in ---net. aimr, improve. demolish, nr repair any smunum pilar to i%isuance. alw requires Ole applicvnl forsuch permit o Ole asigned statementValuatiQd IJcensc law 9 Sq. Ft. Floor Area 0 0 0 That be is licensed pmwanuo the provisions of the Con metoes (Chapter (commencing with Sad..70D0) of Dwisian 3 of the Business and PinfcsNnns Cade) or that he Is exempt thmefrmo and de basis fu the dleged acculadom Any via'ohn" of Seldom 7031.5 by any applicant Ise a permit Objects die apir icanl m a Clod Pointy ofppN Number Occupancy Type oat mom Than five hundred dollua500). (S 3 2 610053.00 ❑ 1, u owns of the pmpwy, in my mmployees with wage as their Ole mmpewdon, Required Inspections q P will do the work. ad the atwnum I. at immnded or offered fur ago (Sm. 7044, Business and Professional Code: The Canonical License Law does ant apply m an owner of property who hui Ids or im proves thereon, and who does such work himself err through his own employ=. provided that such Improwmenu are not intended uranehed forsake. if. however. the building or Improvement is mid within ane year of completion. da mums - builder will know the burden of proving that he did not bund .r Improve far purpose of mm.). 1, u owmr of the PropenY• am esciunely counseling with licensed canuanon m noun the projen (Ser. 7044, Business and Proreseons Code:) The Contractors Li - In. law does out apply In an owoer of propeny who builds or improves dermn, and . who contracts for such projects with a contractions) licensed pumuam to the CamrscmYs License I.W. lw ❑ 1 am testees Se , B k P C r Ni reuon owner Ducts D ORKER'S 1/.gp NSATION DECLARATION it1 hereby eRum under penity of perjury oro of the following daltuadam: I haw am will mainuin a Cmaittcom of Cammrt ua self -ilium for WoduYs Compen- cWoe, as provided far by Secdm 7700 of use Labor Cade, for the peritoneum, of to work, for which this permit is owed. ❑ 1 haw and will maintain Worker Compensation Iowans., as required by Section 7700 of the labor Code, for Ne performance of the work for which this permit is heated. My Workees Compensation Insurance canis and Policy number art: Cartier: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu sMlm need m, becomplem l If the Permit is imam hundred doll= ($100) or less) 1 nrdfy that in me performance of the work for which this Permit 4lswed. I Shall not , employ any per;yo'Ql�neVaome Object to dm Warkon'ComPeuadon Iawa ofC ADPIice /dL�fd NOTIC P CANT; If mu Cenincso of E on, you shauW emaking Labor baome aubj t m the Wark repatriation provlaiam of to Labra Cade, you must [ forthwith comply with such pravisime or this permit 0.11 be dammed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm this them Is a,muxtim lending agency far to Iertomana of > the work for which dos permit Is issued (Ser. 7097. Civ. C.) " Lender's Name ' 1<ndeh Add. I certify thin P haw reed this application and sue that the above information Is cored. I agron m comply With all City and county ordinances and state laws relating,. building construction. and hereby autharim mprescr udves of Nis city to enter upon the !'a ahove.mcnumm property for i,upection purposes. kh (We) agree to saw. indemnify and keep hamless de City of CuNam, against q liabilities. Judgments, coats and expenses which may in my Way ,nue,gales, said City in eonaequmco of the of this prmiL granting APPLIC U DER ANDS AND WILL COMPLY WITH A N9�'-POINT Issued by: Date - L& so E /� 7/06 Re -roofs Type of Roof 'sign PAPP scan rotor DAM r 1 H RDOUS MATERIALS DISCLOSURE Will the apPlicam m future building accupectstom m handle hav4rd000 material as deBmd by the Cuperma Municipal Code. Chapmr 9.11. and the Health and Safety Cade, Semon 2.55324)1 / El Yes <Na All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without firs[ obtaining an inspection, I agree to remove What de uplicum orr form building accupant use wulpantat or davl= Watch emit hu strap u air conuminanu u defined by the Bay Area Air Goodly Management all new materials for inspection. District] OYsa p",a I have mad the bauNous mamdals requirements under Chapmr6.95 of he Califon dariffic building naHcal"Safcty Calc, Sad 15505,25533moI25534.1undcamnth Jan mt ct rensly haw • sen L at Pt u my responsibility m nadfy occoydral of the Date rtyulrt higjo rmivaamear,cenilkamgrea Signature of Applicant All roof coverings to be Class "B" or better owner ori>ad stem Dam om 1 of 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ... ..... : 32610053.00 DATE ISSUED.......: 09/07/2006 RECEIPT #.........: 35956 REFERENCE ID # ... 06090050 OPERATOR: amyw COPY # : 2 SITE ADDRESS .....: 20650 VALLEY GREEN DR SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: SOBRATO VALLEY GREEN ASSOCIATE ADDRESS ..........:' CITY/STATE/ZIP ...: , RECEIVED FROM ....: RICHARD PEDLEY CONTRACTOR .......: RAVIZZA, EUGENE A LIC # 697 COMPANY ..........: CUPERTINO ELECTRIC INC ADDRESS ..........: 1132 NORTH 7TH ST CITY/STATE/ZIP ...: SAN JOSE, CA 95112 TELEPHONE ........: (408)991-1000 •FEE BAL ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW --------------------------------- BSEISMICOM VALUATION 1,000.00 -------------------- 0.63 0.00 -------------------- 0.63 0.00 EPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 TOTAL PERMIT ---------- ---------- 39.00 0.00 ---------- ---------- 39.00 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ CHECK 39.00 ------------------ 5410 TOTAL RECEIPT 39.00 VOICE ID DESCRIPTION VOICE -------- ID ---------------------------- DESCRIPTION -------- ---------------------------- ------------------------------------ 304 ROUGH ELECTRICAL -------- 501 ---------------------------- FINAL ELECTRICAL ENERGY 505 FINAL ELECTRICAL • is Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 Building Department JOB ADDRESS: 204e5U U•�� knewt P4L, PERMIT # 06 d gpos6 OWNER'S NAME: t PHONE # GENERAL CONTRACTOR gj tip FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 0 IrI7106 O r/Contractor Signature I Date 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 0 IrI7106 O r/Contractor Signature I Date CITY OF CUPERTINO aC10F PERMIT APPLICATION FORM CUPERTINO # I O_O53 Date: of 7 0 6 7N ldinAddress: Mailing Address (if different from building address): ` C-Trtert 2 1 50 V,a L -Le Oz, O�rPor mer �N 'e uvie, J Phone #: Contractor: License #: Contact: Phone: 40fw " upertino Business License#: 1c1^{- lam- Fax: MECHANICAL Building Permit Info: Bldg Elect Plumb ❑ Mech ❑ Job escription: Co M. e.ic4 i eLeeA ttAl /Cerau"�—A.i.not i:frn4O / r Residential ❑ r 5-,CvJL( VZAI t-8« Commercial Sq.Ft. Floor Area: Sq.Ft.: Cost of Prcje Occupancy Group: Type of Construction: t i% BCONSTAX please check this Fox if the project is a BUILDING nd-storyaddition: ❑ Ind/Off/Comm/Quasi BUILDING ro'ect Size: Standard ❑ Large ❑ Ma or ❑ Con. Tax for BQ Zone 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 L-1 1 of 3 i CI OF CUPEI,TINO CITY OF CUPERTINO 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 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 BREWSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREM 3USWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > I OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Mise 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 2 of 3 J 1 CITY OF CUPERTINO CUPEkF PERMIT APPLICATION FORM uanti 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 PlanningLR Comme/ Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Change BUILDING 0 • 3 of 3