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06080182 (2) CITY OF CUPERTINOMA V-. BUILDING DIVISION PERMIT ° CON'T'RACTOR TNF',UR .TIUi` , •. ,�C.� .v'v:e.h,.�Tnr a o- s`�S:A,^. s a..ru. VT BUILDING ADDRESS: AAAA—DRAIN PATROL PEaMITNo.06080182 7467 DE FOE DR OWNER'S NAME: PERMIT ISSUE DATE MATSUDAIRA TAKEO AND KEIKO 2400 LINDBERGH 91 08/22/2006 E: SANITARY NO. CONTROL Na (408) 989-6005 ARCHITECUENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MEOCH loo LICENSED CONTRACIDR'S DECLARATION lob Description 1 hereby afRrm dent 1 am Imsmad under provisions of Chapter 9(commencing ZE with Section 7")or Division 5 of den Businwas and Professional Code.and my licenmu 1.fullItms&adeffet. REPLACE 50 GALLON WATER HEATER. EXTEND EXISTING L+censc Clsss enc.Is 'l 2 t 3 � Dae�ContranWr ��ai�htre>t GAS LINE 3 FEET AT DRYER LOCATION AND REPLACE Rc crsDEcuaAnSF" HOT & COLD VALVE AT LAUNDRY LOCATION. i I understand my plans hill M used w public records °end Licensed Pnttcssional ly OWNER-BUILDER DECLARATION i M C I Mmhy alarm that 11. ummpt from the Cornerstones o :A License Law at for the :MC o fallowing moon.(Section 7(11.1 Bualmr. and Pre.denull Code:Any city lir county $� which requirca A permit w tmwuct alter.Mpmw.demnl W,lir repair any umcturc ty prior m its issuance.also require the applicant for such permit o file a signed AAWmem < that he is licensed Ferment to the proviswm of ft Canuacmrs Lia.Law(Chapter 9 Sq.Ft.Floor Area Valuation C (commencing with Section 70001 of Division m of tha Business and Profession.Cou)ar $2250$ that he u summit therefrom and the basis fen the alleged compt+on.Any violation of Section 7013 by my,applicant for a permit subjects the applicant W a civil penalty of APN Number Occupancy Type sent mom den fmw hundred dollars ISM ❑I,an owner of the propmsy,lir my employees with wegu a their sale comPenadM. willdothc"kasdthegtmctumlana,inw h .roBeredfwd (Sw.70a,Busiess Required Inspections and Professions Code:The ContrwlW e nsor's License Law doss m'apply an owner of fi P pmpenywMbuild.wimpmwa1Maron,andwhodorsouchworkhm fmdumghha own employers,provided that such improvements artsat ina,ded aroaered fmsdk.If. R� app{{{ s builders,throw obi Weeks ed did not year ofcamove rarurawer- �� /f{L huskier will Wen i.Mrdcn Improvement mI that wdid ml build lir improve fen purpose of r- jl�I g sak. ❑1,As owner of the propenY,am eumuducly,contracting with Became cantrcetars W ronsuuct the project(Sec 7044,Business And Profusions Cane:)net Cmuac7nrs U. ) �jf3n�t ounce Law data nolapply in owfpsapeny who bnildaarlmprovesdtemon,and ��/ W mro FI,It14 who contracts fat such projects with a mnwemr(s)Rented purAmM m the Contrumh r (s 1sV Lice.law. ❑lam uemp'uMa See .BkPCfor Wsmason ji st sll� ({ ,eSs>. Owner Dam tJ4]t{tN"fq r'®{+ Fs17�i�',"S®Ja�l"9 WORKERS COMPENSATION DECLARATION I hereby affirm under penally of perjury one of(M following declantimtc ❑I have and will maintain aCaNOcamof Cnsuem to elf-Ineum for Workees Campen. sat+on,an provided fen by Scum 5700 of tM labor Code,for the performance or the work for which this permit is issued. ❑1 have and will maintain Workers Compensation Insurance,As required by Section 5700 of de tabor Code,fen den performance of site wont for which this pored,is tssuW. My WarterPA CompenAuan Insurance:cartiv and Policynumber a2: Carrier. /S U Polley No.:'7'1 14-7M CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sealon need an,be completed Been Permit is forme hundrcddallan GIg) or tut) I certify the,In the part....of the.,it far which this permit IA issued 1 shell ret employ any person in any manerso As W become mbjut a den Workers Compensation Loss of Cnifum+a.Dow Applicant NOTICE TO APPLICANT:If.after making this Certificate of Exemption.you should Incomes subjet W the Weaker's Compensation provisions of the labor Cade,you menu .JO forthwith comply with such provisions lir this permit shall be demand newild. Z► CONSTRUCTION LENDING AGENCY (-m IMrcby alBnn dentdenm lalronutucum kndingagcey rm laperfwmuxeuf CG> the wart for which this permit is issued(sec 3097.Cl,,e.) QLaMar's Name a z Leaders Address V I cdnify thin I haw sad this appliadan aM sure that the Above+nfoanadun is U, F correct.I agree to comply with all city and county oNinawes and state laws mining W OV Wilding construction,and hereby authorize mpretruntives ofthis city to tenor upon the [41 aMw-mcmiuned prepcny for Inspection purposes. (We)agree W saw,indemnify and keep harmless den City of Cupertino!guns' ti y Iabilides.judgmenW costs and expenses which may in anyway accrue against said Ctty t)Z in consequence of the Swung of We permit. •" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOU ONS. ~ --PIZ-ZIW Signature a(Aps+ uR00Deft MZZA0S MATERIALS DISCLOSURE Type of Roof Will tM applicants,Or futum Wilding occupant more w handle hazeAous maarid As defined by the Cupertino Municipal Code.Chaser 9.11.and We Health and Safety Cole,Stood.15531(!)7 All roofs shall be inspected prior to any roofing material being installed. ❑Ya Will the applicant or forum building occupant sea equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit board...air cormorms us As Bond by the Bay Arca Air Quality M AZMAnt all new materials for inspection. Mulct? lct7 ❑Yen Nu I haw mad the hoandun materials requirements under Chapter 6.95 of the Califar. me WAIN k Safety Cade,Secoon 15505.25533 and 75534.1 undersand In Bthe building data not currently haw a¢sant,that It is my responsibility W notify one accurate,of the mtg,i"mew h� hambemetp�aCertificamor Signature of Applicant Date owner.'a.marivm agtn —� 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 . . . . . . . . : 35924015 . 00 DATE ISSUED. . . . . . . : 08/22/2006 RECEIPT # . . . . . . . . . : 35719 REFERENCE ID # . . . : 06080182 SITE ADDRESS . . . . . : 7467 DE FOE DR SUBDIVISION . . . . . . : CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : MATSUDAIRA TAKEO AND KEIKO ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : AAAA DRAIN PATROL CONTRACTOR . . . . . . . : ECCLES, CHET LIC # 10745 COMPANY . . . . . . . . . . : AAAA-DRAIN PATROL ADDRESS . . . . . . . . . . : 2400 LINDBERGH ST CITY/STATE/ZIP . . . : AUBURN, CA 95602 TELEPHONE . . . . . . . . : (408) 989-6005 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------ - ---------- ---------- ---------- ---------- ---------- BPGAS OULETS 1 . 00 5 .40 0 . 00 5 .40 0 . 00 BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BPWHEATER PER HEATER 1 . 00 10 . 79 0 . 00 10 . 79 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 BSEISMICRE VALUATION 2, 250 . 00 0 . 50 0 . 00 0 . 50 0 . 00 MPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 128 . 29 0 . 00 128 . 29 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 128 . 29 40837 TOTAL RECEIPT 128 . 29 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 502 FINAL PLUMBING ENERGY 506 GAS TEST 507 FINAL PLUMBING • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 6UPERTINO Building Department JOB ADDRESS: PERMIT # "74 l0 7 T71; P 1?—, 6 6 O —L OWNER'S NAME: —M-(c�Ev M a-TFv cx�-+ � PHONE #(A-V g 2 78 _c)17 GENERAL CONTRACTOR 1og4�t rl FAX# I am not using any subcontractors: .C�V.P-r2 T2�,.e�- Signature Date Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Ile 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 d � CITY OF CUPERTINO p AOCaD1182 ITMOr PERMIT APPLICATION FORM CUPEkTINO N# Date: -2� C Building Address: Mailing Address (if different from building address): '<t-ro7 v3E:-;7- DL-- ggr>l�t- Owner's Name: Phone#: `T,L<1Cy a 1.n Contractor: License #: , A-2 2 11, C, Contact: Phone: C4-687> Cupertino Business License#: Fax: ry70 017 " I o 7 45 Building Permit Info: 1Pt14Ct So qAt LbNsTE Q6FFIFTF$ X`rENDED lcfg C7V 2— Li►� 3 T el:A D fctt� C�vtJ ND 4MVIO ,t Bldg ❑ Elect ❑ Plumb JR Mech X & Job Description: Residential ❑ Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: 4F tE Occupancy G oup: 2tz5o, _ Type of Construction: Please check this box if the project is a second-story addition: ❑ ro'ect Size: Standard SI Large ❑ 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 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 Investi ation fee BUILDING 1 of 3 ��� CITY OF CUPERTINO - CUPEf�F PERMIT APPLICATION FORM QuantityFee 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 BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> 10K btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNR APP 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 BREMREPALTRepair/Alter HeatingMECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 I CITY OF CUPERTINO CUPEf�F PERMIT APPLICATION FORM uantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL g 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 Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temp6rary 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 Chan e BUILDING • 3 of 3