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CITYBUILDING
INF,ORMATIO
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DrERONNo PERMITCOTN
,"".TOR
as
BUILDING ADDRESS:
CONSOLIDATED PLUMBING INC
PERMIT No.
1.20875 VALLEY GREEN DR
Y W NER'S NAME:
PERMITfSSUEDATE
WOODMONT PROPERTIES
3732 D CHARTER PARK DR
08/23/2006
E:
SANITARY NO. CONTROL NO.
(408)978-3093
ARCHrTER7ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION
Job Description
p
1 hereby affirm Ilial 1 am licensed under provisions of Chapter 9 (commencing
with Section 7") ofDivision 3ofUm Business and Protrusions Code, and my cons,
g:t'�05.
INS W,'ER
inmBforce andcffa} P
��!
INE: CLEAN OUT - RECREATION CENTS
Locare Clea L Lk.g
,ryf�ap
`
Date Conumtor
/'
ARCHf1ECP5
1 understand my puns shall he d v�pubhc hoards
/
A
1= �I n
imJ •�'+A
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby .(Saco Not 11. exempt from Ne Canvas License law for the
Co
following reason. (Seeds' t Business and Cade: Any city or county
,
o ab W,. chnoos
which mquiros a permit m cnnswc4 alcor. improve, demolish, or repair my structure
' prirrto its inuance.alm requiresthc applicant formch Permiva rik asignol statomcm
oorArea Valuation
t Ilialhoislicensedpursuant1.theprovisi..Ofthecontrarmr''sLicose aw(Chirac,
q.
(commencing with Sauon 7000) of Division 3 of the Business and Proresiou Code) or
$4000
Nat he is exempt therefrom and the basis for the alleged exemption. Any violation of
APN Number
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than lim hundred dollars (8500).
i.uowrrer of the yopvry. car my wployeu with wagesuUreu cote eonpeuasion,
'
Required Inspections
will do the work. and the structure is not intended or cliched for We (Sao . 7014, Business
and Profestires Code: The Contractors Liatue Law does cot apply to an Owner or
property who Wilds or improves thereon, and who does such work himself or through his
awn employees. provided thatsuch improvements me not intended oroRerd for We. If.
however. the building or improvemas is mid within one year of c hoPICUan. die owner -
builder will have the human of proving Nn he did rut build or improve for purpose of
sale.).
❑ I, as owner of the property. am aclmively contracting with licensed contractors to
consuact the project (Sec. 7014. Baines and Professions Code:) The Contactors U.
room Law does not apply to an owner or property who builds or improves thereon, and
who contracts for such pmjeets with a cormactoh(s) littnxd Panamint to the Contactors
License Law.
❑ l amaemptunder See .B&PCr.Oia..
Owner Due
WORKER'S COMPENSATION DECLARATION
L hereby affirm under peUnity of perjury, one of the (allowing clacho mus:
I have and will maintain a Canilleate of Cmtscnt m self -insure for Worked Compeer-
salon, u provided for by Section 3700 of Ute labor Code, for the performance of the
work for which this Pamir is issued.
SANITARY.
❑ I have and will maintain Workers Compersat an Insurance, u requited by Section
3700 of the Labor Code. far the performance of the work fa which this permit is issued.
My Workers namemon Insurance artier and Policy number arc:
Carrier. PoliN 6 33 iI
O CERS'
CERTIFl ATEPE
NERAN
COMPENSATIONE
COMPENSATION INSURANCE
-
(Thu section need not becomplemU if the Permit is for one hundred dollars ($IM)
or less)
1 certify Nat in We performance of the work for which Nis permit is issad. I shall not
c.9ploy any p[raan in any.Maim as an became subject m the WodmrS Gompensamm
Laws of California. Date
Q
Applicant
D
NOTICE TO APPLICANT: If, after making this CcniOcate of Exemption, you should
became $Object b Ne WorkerS Compensation previsions of the Lather Code, YOU muse
' frMwub comply with such provianns or this permit shall he lamed mvokcd.
i CONSTRUCTION LENDINGAGENCY
1 hereby Nat there iss construction I lending agency for the performance of
cfhm
the wort (o which thio permit u seemed (Set 7097, Civ. C.)
cci
Undoes N
Lenddiders Address
'
I cunity that 1 have read Nis application and cute that the above information is
' torten. l agree m comply with all city and county ordinances and sore laws ¢lasing m
building construction, and hereby armhorim representatives of Nis city to enter upon the
0 ahovc-mcmioncd pmpc for ie ecdonPenics purposes.
(we) agree to save, iademni fy and kccp harmicea the City Of Cupertino against
accata d rt and expcnsea may in anyway attmc against acid City
e.(thegran
in c. match
m a(the Buntingof this permit.
APPLICANT
' APPLICANT UNDEgSTANDS AND WILL MPLY WITH ALL NON -POINT
Issued by: Date U
Od`
SOURCEREGU T10
Re -roofs
Type of Roof
=A 52A
gnat „ Applian✓Con r d
H) ZARDO MATERIA 1SCLOSURE
WIIl the aPpii nEorfutum Wilding p.n,st.merhandichva ommawriaI
as delmed by the Cupertino Municipal C . Chapter 9.12, and the Health and Safety
J
Cole. Semon T5531(a)? ft�a�
pre
All roofs shall be inspected prior to any roofing material being installed.
i
If a roof is installed without first obtaining an inspection, I agree to
Wit] irk applicant or future building Occupant use equipment or devices which
remove
.. it havaair canumihu da u &rad men
by the, Bay Area Air Quality Management
all new materials for inspection.
District?Nou
0 Yes
I have mal the huh duuslr mamrialsrtquiumcnn umkr Chapur6.95ofthc Califao-
iia Heslth&Safety Codc,Scnian ZM5.M33am 534. lundcrsundthuifthc building
does not currently hoc a mamL that U u my meboodbuity to Unity On occupant err the
mvuiremrnuw tog met poor toissU rracchdrka.Warucupmcy.
Signature of Applicant Date
UG
All roof coverings to be Class "B" or better
'Obner car authohbod age '
to'
F
CITY OF
OJPEkTINO
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS:
2c 7,S- a!t G
ec A
(tom.
PERMIT
OWNER'S NAME: acc J
riolp
Cabinets & Millwork
PHONE # 2 396 p
GENERAL CONTRACTOR:
6-,vso(.. 6 6rc(2-oc
Cement Finishing
FAX # qe,�- '25 3 c 9
I am not using any subcontr� -- 016
Signatur Da
Please check applicable subcontractors and complete e following information
ba
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
om 1 of 2
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 32609064.00
DATE ISSUED.......: 08/23/2006
RECEIPT #.........: 35745
REFERENCE ID # ...: 06080192
SITE ADDRESS .....: 20875 VALLEY GREEN DR
SUBDIVISION ......
CITY .............: CUPERTINO
IMPACT AREA ......
OWNER ............:
ADDRESS ..........:
CITY/STATE/ZIP ...
WOODMONT PROPERTIES
0
OPERATOR: amyw.
COPY # : 2
RECEIVED FROM ....: CONSOLIDATED PLUMB
CONTRACTOR .......: D DOUGLASS LIC # 22941
COMPANY ..........: CONSOLIDATED PLUMBING INC
ADDRESS ..........: 3732 D CHARTER PARK DR
CITY/STATE/ZIP ...: SAN JOSE, CA 95136
TELEPHONE ........: (408)978-3093
kE ID UNIT
BPSEWER SEWER SYSTEM
BUSLIC FLAT RATE
PPERMITFEE FLAT RATE
TOTAL PERMIT
QUANTITY AMOUNT 'PD -TO -DT THIS REC
VOICE ID DESCRIPTION
106 SEWER & WATER
301 ROUGH PLUMBING
•
1.00 21.58 0.00 21.58
1.00 105.00 0.00 105.00
1.00 38.37 0.00 38.37
---------- ---------- ----------
164.95 0.00 164.95
VOICE ID DESCRIPTION
202 UNDERFLOOR PLUMBING
507 FINAL PLUMBING
NEW BAL
0.00
0.00
0.00
0.00
Sea -
CIN OF
�UPEkTINO
CITY OF CUPERTINO
REPIPE/SEVERS/MAIN SERVICE
PERMIT APPLICATION FORM
APN #
32Lo-09 -CWH
Bldg. Permit Fees
BUILDING
Date:
Gas Piping System Fee
PLUMBING
PPERMITFEE
o
Building Address:
BPREPIPE
Re i e of Fixtures
PLUMBING
BPFLYTURE
Pbl . Fixture
PLUMBING
BPWSVCS
Owner's Name:
PLUMBING
BPSEWER
Phone #:
o cc4tr;4t � o
BPSEWAGE
Sewage Disposal
us 2S 3 02 G o
Contractor:
Phone:
License #:
Business License
490W
Qi7ir3a 3
-Pos-(62 G -.7L
Contact:
Phone:
c�K kzz c l l g
Cupertino Business License #:
4
9?bgo53
Building Permit Info:
Bldg ❑ Elect ❑
Plumb (C -
Job Description: V �-ti <Al
c Gl
Residential Commercial ❑
Cost of Project:
L'
is
Qty. if
Applicable Fee ID
Fee Description
Fee Groun
BPERMFEE
Bldg. Permit Fees
BUILDING
BPGAS
Gas Piping System Fee
PLUMBING
PPERMITFEE
Plumbing Permit Issuance
PLUMBING
BPREPIPE
Re i e of Fixtures
PLUMBING
BPFLYTURE
Pbl . Fixture
PLUMBING
BPWSVCS
Main Water Service
PLUMBING
BPSEWER
Sewers
PLUMBING
BPSEWAGE
Sewage Disposal
PLUMBING
BUSLIC
Business License
BUILDING
0
DEC -13-2006 13:10 MARK THOMAS CUP 4082535173 P.02i02
•
DISTRICT MANAGER -ENGINEER
MARK THOMAS 0 COMPANY, INC
DAVID E. ROSS
DISTRICT COUNSEL
ATKINSON • FARASYN, LLP,
HAROLD S. TOPPEL
City of Cupertino
Attn.: Building Department
10300 Torre Ave.
Cupertino, CA 95014-3202
1`!p SANIT4#rA
w w
YEAU QF
��l'�BLISHEO ti�b�
20833 STEVENS CREEK BOULEVARD, SUITE 104
CUPERTINO, CALIFORNIA 9501 &2154
(408) 253707/ PHONE (408) 2535173 FAX
www. cuperiinosanifarydistri cI. c o m
BOARD OF DIRECTORS
STEPHEN C. ANDREWS
WILLIAM A. BOSWORTH
JOHN M. GATTO
CURTIS B. HARRISON
VVENDELL H. KERR, JR.
File: CuSD–Mon
Building Dept. – Cupertino
Subject: Tenant Improvement—Install Sewer Cleanout
Name: Recreation Center
Address: 20875 Valley Green Drive
APN: 326-09-064
Permit No, 06080192
• Videotape and Property Line Cicanout inspected.
No additional conditions/requirements by the Distr'
Inspector: George Santos/ Tony Soares ............................... .............
Date --12-13-2006 ................... Sanitary Sewer Location:
SUPPLYING SANITARY SEWERAGE SERVICES FOR: CITY OF CUPERTINO, PORTIONS OF THE CITIES OF SARATOGA, SUNNYVALE, LOS ALTOS AND
SURROUNDING UNINGORPORATED AREAS
TOTAL P.02
0 2
Z C
a>
a�
�2
UC
OF
t -
Fa
�z
CITY OF CUPERTINO
.� +� •'
INFORMATION =,
BUILDINds DIVISION PERMIT
rCONTRACTOR
BUILDING ADDRESS:
WEST POINT SOLUTIONS
pcRtomrblo.06090231
20875 VALLEY GREEN DR
OWNER'S NAME:
PERMIT ISSUE DATE
WOODMONT PROPERTIES
2292 16TH AVE
09/25/2006
NE:
SANITARY NO, CONTROL NO.
(415)643-5200
ARCHITECT(ENGINEER:
BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Jpl]DCSCiI Description
1 hereby affirm that l am licensed under provisions of Chapter 9 (commencing
P
wi0SmWm70M)of Divia efthe Bush. and Professions Code.and my licensee
in rallfeme.nd,f b
INSTALL SEWER LINE CLEAN OUT - RECREATION CENTE
_ o
Liana Clux Lk. g
Dem Conoacmr
ARCHITECTS DECLARATION
1 understand my plans shall W used u public record
Limited Professional
OWNER -BUILDER DECLARATION
I hcoby affirm that 1 am exempt from the Contractor's License law for the
following reason. (Section 703 1.5, Business and Professions Cale: Any city or county
which requires a permit to construct, alter. improve, demnliah, or repair any structure
$2000
! prior W its issuance. also requires We applicall for such permit to Glc a signed smtemenl
that he is licensed n IN of We Conoamr's Lich,, Law (Chapter 9
Sq. Ft. Floor Area
Valuation
pursuant provisions
(commencing with Section 7") of Division 3 of We Business and Peo"amooa Code).
War he u exempt therefrom and the buss for We alleged exemption. Any violation of
APNeT
Occupancy Type
Section 7031.5 by any applieam for a permit subjects We applicant to a civil penalty of
not more don I. hundred dollars ($500).
❑ I.uowmraf the prapctty.amy employm with wagsuthe'v xk eampensatien,
Required Inspections
will do We work. and theaWchtm is notimmu ed.r.Mmd (Oracle (See. %W, Business
and Profession code: The Conuacmr's License law does ant apply m u owner or
_
property who Wildsorimpraves Wermn, and who doassuch work himxifor through his
own employees, provided War such improvements ate not intended oroRered formic. If.
however. We building or improvement is sold within one year ofcompletion. the owner-
,
builder will have the burden of proving Nat M did net Wild or improve for porins, of
t
Sale.).
❑ 1. as owrcr of the property, .m exclusively Contracting with licensed rnnvaams to
consumer the project (SCC. 7W, Business and Poefesslons Coda:) The Contractors U.
,
cense law door not apply in in owner of property who Wilds or improves thereon, ad.
who contracts for such projects with a convxmr(s) licensed pursuant on We Contractor's
License taw.
0 l am ...or under See. , B & P C for this moon
Owner Data
WORKER'S COMPENSATION DECLARATION
I hereby alGfm under pmady of perjury ate of the following declarations:
I have and will maintain a CeniBnte of Consent to self -insure for Worker's C.,. -
much. as provided for by Section 3700 of the tabor Cade, for Was performance of the
work for whim this permo is issued.
1 have and will maintain Worker's Compensation Insurance• as required by Secourt
-
37W of We labor Code. for the performance of the work for which this permit as issued.
My Worke�r',s/ �Co1m_penudon In^surance, artier sed Policy number am:
Cartier. LI ".sd[ Policy No.: oOIA
D
CERTIFICATEOF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu xnlat nccdnotWcompleted i(We permit is faronchundred dollen (EIIX)
or kss)
I cenify Not in We performance of the work for which this Permit is issued. 1 shall oat
employ any person in any manrcr su as m become subject to the Workers' Compensation
Laws of California. Date
Applicant
NOTICE TO APPLICANT: If. after making this Ccnific sec of Exemption, you should
become subject ho We Worker's Compnwtion provisions of Ne, tabor Code, you muss
forthwith comply with such provisions or this Permit Shall W Wormed mvkcd.
CONSTRUCTION LENDING AGENCY
I hereby alrnm that Were is a construction lending agency for We Performance of
!
We work for which Ude permit Is itseedi (Be,. 3011• Civ. C.)
Lender's Name
'•
Lender's Address
I I molly that 1 have read this ... licaumm and mate Wet the above hummsdon IS
coven. 1 agrec to comply with all city and county ordinaocu and state laws relating m
building eonsuunion, and hereby authorim represcnutives of this city to enter upon We
alwve-mentioned property for inspection purposes.
(We,) agree I. save, indemnify and keep harmless We City of Cupertino against
liabilidu•judgmems•cosu and expenses which may in any way accrue agaimtsaid City
in consequence or We grantermit.
APPLICANT UN RILL COMPLY WITH ALL N N -POI
SOURCE
Issued by: Date
R 0
Re -roofs
Signature o li tractor Dem
HA7ARDOOS MATERIALS DISCLOSURE
Type of Roof
1 applicant of future Wilding mcupantsmre or handle hmamou mamdal
as &Bne dce Cupertino Municipal Code. Chapter 9.13, sed the Health and Safety
Code .Spvu 35.33(.)± No
All roofs shall be inspected prior to any roofing material being installed.
Will me applicant o fist re, building occupant use equipment or devices which
If a roof is installed without first obtainingan inspection, I agree to remove
P g
emit harardom air c°nmmirwu as dcfned by the Bay Arta Ail Quality M ... g.mem
all new materials for inspection.
DinricR
❑ Yes EQNu
1 have maJ the Waa,dnus m_amriab reyuirements under Chapterh.95 of Ibe Glifor.
niceHealth&Safety Cade,S.6.MW5.35533and35534.1undersund Wxtifthe Wilding
dasmfau nil a t i my responsibility to Wity We nompanrnrthe
'
requirem nts hen p
..of.C.mr...rfO
Signature of Applicant Date
All roof coverings to be Class "B" or better
Owner Oras nrinda nt D
!m 1 of 1
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub:
Blk: Lot:
APN ........:
32609064.00
DATE ISSUED.......:
09/25/2006
RECEIPT #.........:
36190
REFERENCE ID # ...:
06090231
SITE ADDRESS .....
SUBDIVISION ......
CITY .............:
IMPACT AREA ......
20875 VALLEY GREEN DR
CUPERTINO
OWNER WOODMONT PROPERTIES
ADDRESS ..........:
CITY/STATE/ZIP ...: ,
OPERATOR: amyw
COPY # : 2
RECEIVED FROM ....:
WEST POINT SOLUTIONS
CONTRACTOR .......:
JOHN SHEEHAN LIC # 25128
COMPANY ..........:
WEST POINT SOLUTIONS
ADDRESS ..........:
2292 16TH AVE
CITY/STATE/ZIP ...:
SAN FRANCISCO, CA 94116
TELEPHONE ........:
(415)643-5200
•FEE ID UNIT QUANTITY
AMOUNT PD -TO -DT THIS REC NEW BAL
BPERMFEE VALUATION
2,000.00
83.16
0.00 83.16
0.00
BPSEWER SEWER SYSTEM
1.00
21.58
0.00 21.58
0.00
PPERMITFEE FLAT RATE
1.00
38.37
0.00 38.37
0.00
TOTAL PERMIT
---------- ----------
143.11
--- ----------------
0.00 143.11
0.00
METHOD OF PAYMENT
-----------------
AMOUNT
NUMBER
------------
CHECK
143.11
------------------
2838
TOTAL RECEIPT
143.11
VOICE ID DESCRIPTION
-----------
VOICE ID
DESCRIPTION
--------------
106 SEWER & WATER
202
UNDERFLOOR PLUMBING
301 ROUGH PLUMBING
507
FINAL PLUMBING
fi.'
i.
CITY OF
*UPEkTINO
1]
C
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDRESS:
-mss--, s v0.11 C -,,IQ
PERMIT #
C o l o
OWNER'S NAME: l&ock,,Aot a Se�/� t[�
PHONE # S -O Q
GENERAL CONTRACTOR: �j o
FAX #
I am not using any subcontractors: -195-� 1 O
i e Dat
Please check applicable subcontractors d co plete the following information:
69
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
(I apc�A �,
dffY ciF
41 CUPERTINO
CITY OF CUPERTINO
REPIPE/SEWERS/MAIN SERVICE
PERMIT APPLICATION FORM
APN # 32W— l.y�'� �- — 231 ��7 I
Bldg. Permit Fees
Date:
-G
Gas Piping System Fee
D
Building Address: A 1 r
Plumbing Permit Issuance
PLUMBING
208% a
S
P .
PLUMBING
Owner's Name: % o C
J
Phone #: n
Contractor: C\ Phone:
7�
License
Contact: Phone:
Sewers
Cupertino Busin,es�jLicense #:
a � —
Sewage Disposal
PLUMBING
Building Permit Info:
Bldg ❑ Elect ❑
Plumb
BUILDING
Job Description:
loC, :L
Residential Commercial [:J
Cost of Project:
•
Qty. if
Applicable Fee ID
Fee Descrintion
Fre C;rnnn
C BPERMFEE
Bldg. Permit Fees
BUILDING
BPGAS
Gas Piping System Fee
PLUMBING
PPERMITFEE
Plumbing Permit Issuance
PLUMBING
BPREPIPE
Re i e of Fixtures
PLUMBING
BPFIXTURE
Pbl . Fixture
PLUMBING
BPWSVCS
Main Water Service
PLUMBING
/ BPSEWER
Sewers
PLUMBING
BPSEWAGE
Sewage Disposal
PLUMBING
BUSLIC
Business License
BUILDING
Is