05070063 (2) CITY OF CUPERTINOx3mxr�mg*''< ,
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION ,,,
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DING ADDRESS: CRAFTSMENS GUILD INC PERMIT TN%5070063
10913 LEAVESLE
NY PL NAME: PERMIT ISSUE DATE
MOHAN MAHESWARAN 10566 S DE
ONE: SANITARY NO, CONTROL NO.
(408) 366-1000
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG 0 ELS PLUMB MECH 0 0 0
x00 LICENSED CONTRACTOR'S DECLARATION Job Description
C I lercby afford that I am licensed under provisions of Chapter 9(rnmmeno
cing
U with SmJan tgMB of DivixionJoftM Buvrs�and Profcsiom Code.and myliccnu is
rtj2d infullfa ati UPGRADE SERVICE PANEL TO 200 AMPS
j Z Liccnu Claso.Clmx Lic.s
n=� Dam Contractor
FF ARCHITECTS DECLARATION
?W 1 understand my Pins shall W used as public records
u
;off Licensed P oicssional
3 OWNER-BUILDER DECLARATION �O
<x I hereby a1Lnn that I Om exempt from the Contractor's License law for the �y
O o fallowing mason.(Seedun 7031.5.Business and Professions Code:Any city or county �.
x m which mquires s permit to constium,a1mr.improve,demolish,or repair any structure J
w�'^ prior In its issuance.also mquirm the applicant for such Permit to file a signed stamidid
Nat he is licenced pursuant to the provisions of the Commetari license law(Chapter 9 Sq.Ft. Floor Area Valuation
a (commencing with Section 70R)of Division 3 of the Business and Professions CnJc)ur
y Nat he is exempt therefrom and the basis for the alleged exemption.Any violation of n
Section 7031.5 by any applicant for a permit subjects the applicant to a Civil penahy of e10 0 Occupancy Type -
not more Nan five hundmd dollars 1150M,
0 I,n owner of the property,or my employees with wages as their sole compensation,
t will do the work.and theslnYwre u not intended or offered TorsabT044,Business Required Inspections
and Professions Code:The Comramofs License Law does not apply to an owner of e q ns P
property who builds or impmod.thereon,and who doess.1i work himulf Orthrough his
own employes,provided thm such improvements arc not intended oroffered forsele.If,
however,the building or improvement is old within one year of mmplcum,the owner-
builder will have the burden of proving that he did rot build or improve far purpose of
s ld I.
0 1,as owner of the property,am exclusively contracting with licensed convacros,to
convect the pmjcct(Sec.7004,Business and Profcumns Code:)The Comment'Li
come taw dos not apply w an owner of property who builds or improves themon,and
who contracts for such projects wish a contnemr(s)licensed pursuanuo the Consacwrx
Lkenu law.
0 l am cacmpt under Sec. ,B&PC fee Nis on
nor 1[f'/xA/IXla_N-,`4 Dam
Z.W.
K R' COMPENSATION DECLARATION
I hereby a?rte under p nalry of perjury We of the fallowing decimations; - -
❑I have and will maintain a Certificate of Consent m self inure for Workers Compete
mien,ss provided for by Section 3700 of the labor Code,for he performance of the
work for which suis permit is issued.
0 I have and will maintain Worker's Compensation Insurance,as required by Section
37M of the Labor Code,for Ne performance of the work for which Nis Flood,is issued.
My Workers Compensation huunnce artier and Policy number ave:
Cartier. Policy No.:
CERTIFICATE OF EXEM MON MOM WORKERS'
COMPENSATION INSURANCE
(Thu sesirn sed not be completed if the permit is foronc hundred dollars(SIM)
or less.)
I arufy that in the Performance of do work for which this Permit is issued.1 shall not
employ any person in any manner ed as w become subject in the Workers Compensation
Laws of Califop Da A '
APPlicant F
NOTICE T�PLICA v:IL after making this Cemifcate of Exemption,you should
become subject to the Worker's Compensation provision of the Labor Code.you most
.,z faMwith comply with such provisions Or this Permit mall be deemed mekad.
z� CONSTRUCTION LENDING AGENCY
[-. 1 hereby affirm that there is a constmaion lending agency lot the Performance of
0Y> Ne work fur which Nu permit is issued(Sec,3097,Civ C.)
W 7� Lenders Name
01
= z lenders Address
V Q 1 certify that 1 have mad this application and amw Nat the shout information is
P correct.1 agree to comply with all city and county eminences and sou laws relating to
�U building convection,and hereby moorim mpromm,ives of this city to enter upon the
r ly ahovcmer iuned pmpefty for inspection purposes.
(~C. (We)agree to sive,indemnify and loop hafmloss the City dCupcmdO against
h liabilities.judgments,costs and"Nome which may in any way acm,&glmlaid City
in comcrof the
U Z his Permit.
APPLIC Ni UNDERSTANDSradding of IAND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOyyaaEgg REGULATIONS.
loot frill or, ��IJQ� Re-roofs ✓ ;z C
gnazurt ofAp mHA]7aRD0Us MATERIALS DISCLOSUREType of Roof
Will the applicant or future building occupant stem or handle h ramous material
as defined by the Cupenino Municipal Code,Chapter 9.12,and the Heads and Safety
roleen 25532(a)9r1tinsAll roofs shall be inspected nor to any roofingmaterial being installed.
Will thc applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit haramous air conventions ss as acfncd by the Bay Area Air Quality Management all new materials for inspection.
Di Aria?
0Yet
I have reel rhe hnxamrms materials uquiremcns under Chapter 695 of the Califor-
niceHealth&Safety Code,Savour 25505,25533 and 25534.1 undersand thutrue,building
docs Out ewrtntly hate a woad,that i,u my responsibility w notify the occupant of Ne,
m ns which most he me,prior toioiante ora CCmfeaw of occupancy. Signature of Applicant Date
d
owner set aWhnca agent am All roof coverings to be Class"B"or better
CITY OF CUPERTINO
I� 1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Elk: Lot:
APN . . . . . . . . : 35615027.00
DATE ISSUED. . . . . . . : 07/12/2005
RECEIPT #. . . . . . . . . : 30314
REFERENCE ID # . . . : 05070063
SITE. ADDRESS . . . . . : 10913 LEAVESLEY PL
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MOHAN MAHESWARAN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4747
RECEIVED FROM . . . . : MODERN CONST DESIGN
CONTRACTOR . . . . . . . : FEIHMANN, GARY LIC # 17526
COMPANY . . . . . . . . . . : CRAFTSMENS GUILD INC
ADDRESS . . . . . . . . . . : 10566 S DE ANZA BLV
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 _
TELEPHONE . . . . . . . . : (408) 366-1000
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 8, 000.00 0.80 0.00 0.80 0.00
I __________ __________ __________ ----------
TOTAL PERMIT 103 .46 0.00 103 .46 0.00
(METHOD OF PAYMENT AMOUNT NUMBER
____ ------------ __________________
CHECK 103 .46 4001
------------
TOTAL RECEIPT 103 .46
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
- Community Development
( ' Cu0 Torre Avenue
pOertinoC 9 014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
OUPEkTINO
Building De artment
JOB ADDRESS: PERMIT#
lOgl3 LEA/ESLE�' �L v �—O-�6
OWNER'S NAME: MO HAM PHONE i1.08 3 6 6- —1000
GENERAL CONTRACTOR: C2AF rsMev 5 401,D FAX #
I am not using any subcontractors: ,�o�hi// avi i t Z Ot5—
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
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
er/Contractor Signature Date
CITY OF CUPERTINO
CUP TYOF O PERMIT APPLICATION FORM
050 �ODIo�
APN# 3� (a /S oa Date: 7
Building Address: Mailing Address (if different from building address):
/0913 I..EAYSLE;r 1"L /Q5-66 5 .D ANZA �IVJ7•
Owner's Name: MOHAN- /� � � /'YI,G O Scor Phone#:
r[7.GsF rC4i/7 9t eOX6 J
Contractor: License#:
CRAFT5MEnr-5 CU/tp CO•
Contact: Phone:.¢o8*489.7667 Cupertino Business License#:
MATT AMIn11 oR PEaRy Fax:
Building Permit Info: dPG,eRpr= S,--,eviC& F,9NAlErz 70 200 f)M PS
Bldg ❑ Elect P� Plumb ❑ Mech ❑
Job Description:
Residential El Commercial ❑
Sq.Ft. Floor Area: _ $/Sq.Ft.:
Cost of Project: Ly� 8 �— Occupancy Group:
Type of Construction: Viv Please check this box if the project is a
second-story addition: ❑
Pro•ect:Size: Standard 21 Large ❑ Major ❑ — — —
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
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
BBOILERS 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> IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V <=200A ELECTRICAL
/ BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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CITY OF CUPERTINO
CITY°F PERMIT APPLICATION FORM
CUPEkTINO
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
BOVERTR E 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 Stonn/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
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfin MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc 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
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CITY OF CUPERTINO
CITY INO
F
CUPE TPERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Signs 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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