06060108 (2) CITY OF CUPERTINO hnxn�utya.+fieri '^'it nr''§ "^ ' *a �"
BUILDING DIVISION PERMIT �N.v�k\Tl[k14TV� ,ixy ".
BUILDING ADDRESS: WI OW GLEN ELECTRIC INC PERMIT NO.06060108
10533 CEDAR TREE CT
WS NAME: PERMIT ISSUE DATE
CARL MAYEDA 1085 WARREN AVE 2006
PHONE: SANITARY NO. CONTROL NO.
(408) 289-9725
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
3CFp LICENSED CONTRACTORS under
DECons ofCON Job DCSCrIpII
1 hcroby affirm NS 1 am under DEC A A ION 9(commcndng IN �'`/B/
_z wbut Section 7O(X))Of Dirlalon Satellite Budnas and Prefeadmis Cola,and my lleemca
< in fell f.andeffect. S5� $_ Cf0 PANEL UPGRADE TO 200AMP
z Lineman Clue Lk.g
p— Dam F� Contractor JUN 2006
ARCHITECTS DECLARATION 4 c a p
1 understand my plans mall M used u public records
pyU
jCx Licensed Professional BUIL DIN
OW NER-BUILDER DECLARATION BUIL
1 thereby affirm that 1eampt s an the Contractors License Law for the
loo which ny mason.permit
7031.5.Buainss and vis.dedom Code:Any rimy Or county
S 9 which requires*permit re cores ft aloe m(wsuch
u,de permit
m or repair any twcture 2 7 Q
—iy pat heir anded p.aha requires thovisio ant for sochpnrme toicese Law(Charter
€C ihathcencinjwJpunhantmthe proviviamoftheComramisndProruaonsCepte9 Sq.Ft. Floor Area Valuation
that a is exempt
pt homfSection s and i f buil p r of the Businessand
on.My
Cade)of
— that he b aumpt therefrom and the bub for the alleged exemption.My vmladan of
Section 70713 by any appllam for a permit aubjeeu the applicant m a civil penalty of r Occupancy Type
imt mart than five hundred dollars(3300).
❑1,as Owneroftha pmPeny,or my employes with wages as their sole ampemu0on,
willdothework and the structure a rmtamndcd orancmd fonale(Sce.MM.Business Required Inspections
and Professions Codc:The Contracmra Llcm Law did not apply m an moor of 9 P
property who builds a improve Nerean,and who dos such work hi mself or though his
awnemplayess,provided that such Improvements an nmintended oroRered for sale IL
however,the building or Improvement is acid within ane year ofcompledon.the ownery
builder will have the burden of proving,that he did not build or improve for purpose of
sea.).
❑1.w owner of site property am exclusively contracting with Ocemed conu$mon m
construct the pmjm(Sac.7044.Bwaao and Professions Cade:)The Conuaeur4 LI.
came Law dos not apply to an Owner of Property who builds or improves Iherean,and
who convects for such pmjcm with a conuadar(s)licensed pursuant to the Canuactors '
License Law.
0 lamuemptunder See .B&PCfarthis.
Data
WORKER'S COMPENSATION DECLARATION
1 hereby aBim under penally of perjury mm of the fallowing daluationr:
❑IhawandwBlmalnWns CeNOmmof Cmtsentmself4..forwor .Cm .
nation,an provided for by Section 3700 of the Labor code.for the performam>:of the
work for which this permit is bound.
❑1 have and will maintain Worimes confirmation fimation Im$mate,as required by Section
3700 of the labor Cod..for the performance of the were for which this permit is iuuN.
My Warker's Compeauti so insurance artier and Policy numbs are:
Cartier. USC{ Ca PoliryNa.: DZI.21JO 1)
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Cinb section need net be completed Ifdte Permit Is forabe hundred do0an(SIM)
or las.)
I certify that In the performance of the work for which this permit is issued,)WII not
employ any person in any number an as to become subject an the Worken'CompemNan
laws of Califamia.Data
Applicant
NOTICE TO APPLICANT:If,aper making this Certificate of Exemption,you should
become subject m the Workefs Compemation previsions of the labor Cock.you must
.,O forthwith comply with such provisions or this permit$hall M deemed rerouted.„
z.ry., CONSPRUC ION LENDING AGENCY
(-. 1 hereby afftm that them is a corahuNnn lending agency for the Performance Of
ori the work for which the permit is issued(Sec 4457,CN.C.)
W�Q Lenders Name
z Lender's Address
U O 1 certify that 1 haw read this application and sum Nat the above information is
U, P cortin.l grce in comply with all city and county ordinances add sole laws relating be
OU building construction,and hereby authorwa representatives of this city to enter upon the
6Wi shove-mentioned pmperty for inspection purpoaes.
(We)slim m an,Mentally sed kap harmless the City of Cupertino agaimm
liabilidesjudgmems.caats and expema which may in any way sora against said Cay
in
U s permit.
APPLICANT UNDEuence of the RSTANDS Aranting of ND WILL COMP(,Y-WITH ALL NON-POINT Issued by: Date [
SOURC EGULATIONS. `
O Re-roofs
Sign ofA lino n le
AR UB TERIAISDISCLOSURE Type of Roof
Will the appliesetor or=building occupant Nom orhandla haurdous mamrial
wdllmd by 0u Cupertino Mu,lcip,l Codc,Chapter 9.13,and the Health sed Safety
r.section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Ya eloq No
Will did applicant or future building occupant use equipment or dMocei which
If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air conuminsets as defined by that Bay Are.Air Quality Management all new materials for inspection.
District?
❑Ya No
Ihaveradthehva owmalcrabmqubemenuunder Chopmr6.93oftheCalifor-
his Health&SafctyCode,Sec0om25505,23533 and 25534.Inflectional thatif site building
dos not cumody have a unset dot it' mapondhility m nodi the occupant of the
mquirtmen hlenmuRmmel wnaanc Signature of Applicant Date
Owner r arizcd$gem pP 0 All roof coverings to be Class "B”or better
• CITY OF CUPERTINO
Item 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31634022 . 00
DATE ISSUED. . . . . . . : 06/13/2006
RECEIPT # • . . . . . . . . : 34836
REFERENCE ID # . . . : 06060108
SITE ADDRESS . . . . . : 10533 CEDAR TREE CT
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : CARL MAYEDA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : WILLOW GLEN ELECTRIC
CONTRACTOR . . . . . . . : LONDRE, MARK T LIC # 15897
COMPANY . . . . . . . . . . : WILLOW GLEN ELECTRIC INC
ADDRESS . . . . . . . . . . : 1085 WARREN AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
• TELEPHONE . . . . . . . . : (408) 289-9725
FEE 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
EPERMITFEE FLAT RATE 1. 00 38 . 37 0 . 00 38 . 37 0 . 00
BSEISMICRE VALUATION 2, 750 . 00 0 . 50 0 . 00 0 . 50 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 103 . 16 0 . 00 103 . 16 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 103 . 16 11642
TOTAL RECEIPT 103 . 16
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
-------- ---------------------------- -------- ----------------------------
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
•
Community Development
*C10F
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408) 777-3333
�UPEI,TINO
Building De artment
JOB ADDRESS: PERMIT #
X533
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR GGA lei e G FAX # C/
I am not using any subcontractors: C //
Si a Date
Please check applicable subcontract s Com 1 the llowing information
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets'&Millwork
Cement Finishing
ectrical c c
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
' D
r on ctor Signature Date
G(C)U106 cto1--,30seA,
(� CITY OF CUPERTINO 36 weckHr a
• CUPEfa;TINO PERMIT APPLICATION FORM g_ L SQ se.
APN# Date:
Building Address: `J CJO
/OS33 Ce do,(- Tree COOS-
Owner's Name: Phone#:
Gaal m c eLk -q?2 20
-
Contractor: e n _ nG• License#:
Contact: V v Cupertino Business /License#: C/
m ce, (o)m0-003Z
Building Permit Info: (x�t q ( Q 2
+0 C)0"fN
BldgEl Elect \ �J Plumb ❑ Mech ❑
Job Description:
Residential Commercial ❑
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Project: 0 Occupanc Group:
Type of C)nstruction:
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL
BBOILER3 Boiler>500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOMER5 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<= IOOOA ELECTRICAL
BELEC1001 Elec 600V> IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
B IGATC Comm.Housing Mit. Fee BUILDING
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CITY OF CUPERTINO
CUPEfZTINO PERMIT APPLICATION FORM
uantity 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 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 Mechanicals . 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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