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06060239 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT �N,=CRACTORINFURMATION ,;; BUILDING ADDRESS: NATIONAL CONSTRUCTION REN rSTNO06060239 7610 HOLLANDERRY PL OWNER'S NAME: PERMITISUEDATE RAJEEV PASADS 1355 FILIPE ME 06/28/2006 Eu SANITARY NO. CONTROL NO. (818) 221-6057 ARCHrMCT/ENGINEER: BUILDING PERMIT INFO B PLUMB - MECH xW 0 0 �8'z LICENSED CONTRACTOR'S DECLARATION " i 1 hemby affirm that I am hemmed under previsions of Chapter 9(mmmencing Job DCSCCAIpVQ �vs. with Section 7")of Division 3 of the Beat..atd Professor.Com,and my he.=is �s^ s rp �5.•:e.x th Lice WC11 MesrrmL R INSTALL TEMPORARY POW\�R- POLE' �0�6 n�Z Data Cl honed p,p Date — — Conlrenar l 700 ARCHITECTS DECLARATION }lg I rwon shall nd my piII sed s public rermcn ✓ unde -G Licenced Professional vt� Oat I rem cmp(frILDER un the C DECLARATION i 1 Meshy affirm that I em esempt from the C.vutafs License law for Mm } G a o fallowing Mason.(Section 7031.3.Business and Profemirnd Cade:My city or county YYY which requires a permit m convect,tier Improve,mmallsh.or repair any sweture $350 prior to its issuance,also requires the aappplicat for such permit to flit a signed sutemem �< Nat he la licensed Power,to Me pmvlil is of the C.uamur's limos Law(Chapter 9 Sq.Ft. Floor Area Valuation 3 (commencing with Scotian 7W)of Division]of the Business orb Pmfusiand Cade)ter that he Is aampl therefrom and Me basis for the alleged eaareption.Any violation of Seed.7031.3 by arty applicant for a Permit subjects the applicant to s civil smoggy of h u WE Type not mom due live ha Bred dollars(88004 0 1,as m.of the property,or my employees with wag.as Met,tale mmpe.ation, will do the work,and the structure u not intended or offered for We(S..70x,Business Re uired Ins ections and Profession,Code:TM ContmcmYs Liam¢Law dos rem t apply to an orer of q P property who buildsorimpmvs Mmrmn,and whadoessuchwarkhlmaelfm through his JULown emplayme,provided tMtsumesu ch irepneveare or not intended olfernd fm sale ff, 1006 however.Ne building or improvement is said within am your of eamplation.the awrcr• U builder will have the bunders of proving that M did not build or imprse for purpose of akJ' 0 1,as mer of the property am exclusively contracting with licensed cnnuamnra to camsLa IM does (Sec.in aA,wner of and property who Cadei The C.tnnufs LI- '�/CCCIII eros law does rotchply a an Owner of property who build at improves Mmmms.and whocontractsLacs for such projeN with a contracurDl licensed punwnl ro the Gnuacnnh L'ecae law. ❑lore esempt under See .fid PCfm Nis rrss. Owner Dau WORKERS COMPENSATION DECLARATION I Mreby affirm under penalty o(pcqury am of the following declarations: 1 ham and ode for by echoes 3 u of C e Labor Code,for fmWmaeYa Camp de, wtion,a provided for by Suction 3700 of the labor Code,far Mm pertermenm a(Mm work for which this permit is issued. , 0 1 have and will maintain Workces Compensation Insurance,s required by Sachem 3700 of the Labor Cade,for the pertmmance of the work res which situ permit is I"'1 My Wartime.Campemstion{1n�kurenga carior and PoBry number art: Cartier.��!1C OV tidy- Policy No.: CERTIFICA OFEXEMPTIONMOMWORKERS' COMPENSATION INSURANCE Cnaisstemion mad solid completed BMan permit is froom hundred dollars($100) or lea) I certify thus in the perfoon V of a work r whip Nis permit u Wood.l shall cat employ any pchum in ay marc u m 'emu the Workeri Compensation Laws of CallfomlL Dau Appal m 4449 NOTICE TO APP ,afy making this Cedifrc rte of Exemption,you should bmome abjml MOW! ompendation provisions of the labor Code you most .J 0 mW forthwith comply with such provisions or this Permit shall be deerevoked. Z CONSTRUCTION LENDING AGENCY 'f+ Ihereby M.don there u a condensed..lending agency fm Me pesformarce of a.�. Mm work fm which this permit is issued(Sec.3097.Civ.C.) W Leadch Name 0 Z lenders Address V O I gangly that 1 have rod this application and sum the Me above information is W F CormcL 1 agree to comply with all city and county oNinaacei md,ate laws elating m 0 Ubuildingconswcrion,and hereby authome mpreemutives ofthis city to enter upon hate W shove-mcmirned property for impaction purposes. 6, (We)agree to arc,indemnify and lamp harmless the City.(Cupertino against v<fA liabilitkajudgmenu,cmu adespenaes which mayin.ywayamoo againslsid City U,Z in eo.egucme of the i, do of this permit " APPLICANT UNDER A D WILL COMPLY WITH ALL N-POINT Issued by: Date SOURCEREGU NS. / � ai� C ' 6I z Re-roofs Signatuteof Apply�t110 tractor Date ( HAZARDOUSMATERIAISDISCLOSURE Type of Roof Will Ne applicant or future building occupaleam or handle haamos material as defined by Me Cupertino Municipal Code,Chapter 9.13,and hate Health and Safety Cam,Sem.y533Z(g7 All roofs shall be inspected prior to any roofing material being installed. 41 0Yes yNo If a roof is installed without first obtaining an inspection,I agree to remove Will the applia.t.r fJJwm building Occupant arc eq.ipmesl Of.rims Which ' emit haardnus air c.tuoi.nts s defined by the Bay Area Air Quality Management all new materials for inspection. District Oyu u I have read lid hux metedels mquiromenu unmr Gapter6.93.(the Gli(om nu Hcelth&Safety Code,$, m7]303.213ll am12533a.l undcmaM dWl(Me building does not curmnM u L tl t h 6 my rupomibilitY m notify Mm occuPa of M/s myuirtmcn mhmu c • o issuarccofaCenilkateaf0 ucY of7 Signature of Applicant Date owner .it ori rad egcnl Dam All roof coverings to be Class"B"or better Community Development 10300 Torre Avenue . j + Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 WUPEkTINO Building Department JOB ADDREy��Srr: PERMIT # v H `cznc�� Cbt Fj o 6a Z� y OWNER'S NAME: a Ca4PHONE # ( o Z8'p o GENERAL CONTRA OR: mng 1 4s Yu FAX # I am not using any subcontractors: o y� t tune Date Please check app licable subcontractor d com"lete the following information 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 CITY OF CUPERTINO �m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36229005 . 00 DATE ISSUED. . . . . . . : 06/28/2006 RECEIPT # • • • • • . . . . : 35061 REFERENCE ID # . . . : 06060239 SITE ADDRESS . . . . . : 7610 HOLLANDERRY PL SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : RAJEEV PASADS ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : FANG MING SONG CONTRACTOR . . . . . . . : NATIONAL CONSTRUCTION RENTALS LIC # 22537 COMPANY . . . . . . . . . . : NATIONAL CONSTRUCTION RENTALS ADDRESS . . . . . . . . . . : 1355 FILIPE AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95122 TELEPHONE . . . . . . . . : (818) 221-6057 *EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ------- --- ---------- ---------- ---------- BTEMP FLAT RATE 1 . 00 62 . 10 0 . 00 62 . 10 0 . 00 EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 --- ------ ---------- ---------- ---------- TOTAL PERMIT 100 .'47 0 . 00 100 .47 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ OTHER 100 . 47 MASTERCARD TOTAL RECEIPT 100 . 47 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 103 UFER 304 ROUGH ELECTRICAL • CITY OF CUPERTINO-1(7� TMP .POWER �UPERTINO PERMIT APPLICATION FORINT APN# �2- '2-9 _ 00D Date: G Building Address: -7 /o v-y Owner's Name: RA J 0, FOS f Phone AFD S Contractor: NcuTi a Not 1 cetis 1 Y td. Phone(/i p8)2 2-7&-vg-p_ �o-v License#: ,: Pv� lT Contact: .51Phone: Cupertino Business License#: Building Permit Info: Elect, Job Description: Residential Commercial ❑ Cost of Project: n f Qty. if Applicable Fee ID Fee Description Fee Group BTEMP Temporary Power ELECTRICAL EPERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC Business License BUILDING •