06040019 (2) CSTYOFrUPERTINO
BUILDING DIVISIONPERMIT ��.CQNTR"AGTQR I1 FORMATION �.
BUILDING ADDRESS: PERMIT N0.
10680 MINETTE DR
OWNER'S NAME: PERM7f ISSUE DATE
0IMICHELLE ARMSTRONG 3710 YALE WAY 04/05/2006
NE: (408) 279-8824 SANITARY NO. CONTROL NO.
ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
I,+Op LICENSED CONTRACTOR'S DECLARATION lob Description
f 1 hereby affirm Nei 1 Am located under provisions of Chapter 9(commencing
with Section 7M)of Division 3 of the Business all Profess!..Code.urdmylkenats SEWER LINE REPLACEMENT FROM FRONT OF HOSE TO PR
°p in full force and tet. /7a 4,42
�y�z ueenm I r— Lica Q LINE.
9q` De¢
Contractor
ECL
ARCHITECTS DECLARATION
1.dr—mmond my Pmn+shell he=J a pull.mcnrda
5
yam] Licensed Professional
OatNEm exempt
DECLARATION
1 hereby.(Se that 1 em exempt from the Comoro Cc License law for the
Ii o fallowing trona.(Scion 7101.5. sines and improve,
durum Cole:My city s county
$ which in issuance,
a permit re Co...[.,shat improve,demolish Permit t fi repair ed onamCM
uraclum
PNar m its i eased p also inquires the applicator for Contractor',
Liile a cense
signed 0temenr ValUatl
< that be 485
�$ (commelicgwithS uantmthe ofDiviomafrhaContameass Llcensclaw(Chaplor9 Sq.Ft. Floor.Area
that he s ithomfiroe.70nd thDrvlison3 of theeged exampt Professions Cam)ur
Nat a 7exempt1.5 btherefrom And or bats for Ne alleged exemption.Any violation of
Settlor 7031.5 five
any for a permit subjects the applicant m a cavil pemlry of y Is� p y'I�rpe
Our mac than eve dundrtd dollars(5500). 3��O�'S� 0 0 _Occupancy
0I,acornuoftheproperty,mmyemployeeswhhwgmmti irrolemmpe=don,
will do the work and thestrsdue,is not mint An offered forsam(SmJUC4,Business Required Inspections
and Professtuna Cade:The Contractor's Loa= m Law danot apply m a e owner of q p
property who build,or imprrwna thereon,and who doesauc h work himself or through his
own employees,provided thatsuch Improvements Are not Intended unframed you Sale.U,
however•the building w improvement is said within one yea of completion,the owner.
builder will have the hands.of proving Nat he did am build or impmve for pulp.of
Asia.).
0 1,m Owner of da Property.am exclusively contracting with licensed contractors an
...sooner the projea(Sec.70x4.Business end Profesuom Code:)The Contractor'.LF
came Law does not apply In an owner of property who builds or improves thereon,and
who contacts for such projects with a contracmr(s)licensed pursuant As the Contomme,
Lia=Law.
O l am exempt under See. ,B k P C for this reason
Owner Dam
WORKERS COMPENSATION DECLARATION
I hereby of on under penalty of perjury am of flue following decluarionm
1 haw and will maintain a Certificate of Consent An selfdmum for Worker'sCampe.-
anon•As provided fa by Section 3700 of the labor Code.for the performance of the
work for which this permit is Wood.
0 1 have and will mainmin Worker's Compensation Insurance,As rtquortd by Section
3700 of the Labor Code.for the performance of the work for which this permit Is lssud.
My Worker'.Cn pensulon 1=Ana aria and Poliry numMr Am:
Geier. t2_Poliry No.: I :34C{
CERTIFI ATEOFEAnONTON FROM WORKERS ATA COMPENSATION INSUMNCE CDrisuctlo.need notbecompleted If rhe permit Is foram hundmddollan(SLOT)
a IessJ
RY.
I ardfy that In the performance of the work for which this Permit is issued.I Ahall not SAN
employ anypamn in any manner an As in become subject to the Wmkear CnmPc=tion
law+of Califoo..Data
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should
become subject in the Worker's Compensation provisions of mm Labor Code,you mum
.$ forthwith comply with such provisions m this Permit shall be dcmad raveled.
'ZOCONSTRUCTION LENDING AGENCY
[r I hereby alRrm that dmrt is a construction lending agency for due,perfwmAue of
a> the were for which this permit Is mused(Sc.3091.Co.C.)
QUndoes None
P lander'Addams
fJ C I unify that 1 have read this application and slam that the above information is
It, correct.I agree to comply with all city and county ordinances and slate[am relating to
1)O building construction,and hereby authorim arprerentarive+of this city to color upon the
tf) above-meadmu d property for impaction purposen.
(We)agree to ave,indemnify and kap harmless the City of Cupertino Against
pajy liabilities.judgments,emu and expenses which may in any my acme against said City
()7 in c mequenee of the gn Im of NIs permla
r1- AP ICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date ( T/
50 CE4 LATIONS,
1 \ - 415 le,f. Re-roofs �—
Signuurt of ApplianUC.Mmeler Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will theappliantwfuuuebuildingaecuputsWmmhgndleha ousmaloriai
As defined by the Cuporma Municipal Code.Chapter 9.13,and the Health and Safety
Code,Section 35532(a)7 All roofs shall be inspected prior to any roofing material being installed.
-1 Y. )9ru
41 Will the applicant or future building occupant ua eyuipmcal at dcvi=which If a roof is installed without first obtaining an inspection,I agree to remove
emit huudnus air cantsminau As defined by the Bay Am.Air Quality Management all new materials for inspection.
District
0 Yes []Nu
I have mad the named...materials requirements under Chapter 6.95 arrive Castor.
A u 111th@Safty Code,Sections 25505,2553e3 and 25534.1 understood!dust iftle building
d or current) haw a lenan4 Nu II is my mspamlbility m notify the a�cupat of the
at menq�nhmam4met nmmiaaanccanCcnina nr cu ry. Signature of Applicant Date
\t \J 4��°�0
't ' All roof coverings to be Class"B"or better
Owner or authorized Agent Data
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 37531045 . 00
DATE ISSUED. . . . . . . : 04/05/2006
RECEIPT # . . . . . . • . . : 33850
REFERENCE ID # . . . : 06040019
SITE ADDRESS . . . . . : 10680 MINETTE DR
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : MICHELLE ARMSTRONG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : JUAN DIAZ
CONTRACTOR . . . . . . . : PETER DUMLAO LIC # 26329
COMPANY . . . . . . . . . . : BELL PLUMBING SOUTH BAY
ADDRESS . . . . . . . . . . : 3710 YALE WAY
CITY/STATE/ZIP . . . : FREMONT, CA 94538
TELEPHONE . . . . . . . . : (408) 279-8824
OEE ID UNIT . QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPSEWER SEWER SYSTEM 1 . 00 21 . 58 0 . 00 21 . 58 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 164 . 95 0 . 00 164 . 95 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 164 . 95 3068
TOTAL RECEIPT 164 . 95
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
-------- ---------------------------- -------- ----------------------------
301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY
507 FINAL PLUMBING
•
' s Community Development
10300 Torre Avenue
Cupertino CA 95014
CITY OF Telephone(408)777-3228
Fax(408)777-3333
4VU P E IST 1 NO
Building Department
All Cupertino building permits must meet certain conditions related to maintaining
environmental quality and public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District control stormwater pollution. Educating local
residents and businesses and enforcing stormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains flow directly to local creeks and San
Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
• Construction debris, including dirt, concrete and paint;
• Landscaping runoff containing pesticides or weed killers; and
• • Any material dumped or spilled into streets or storm drains
The property owner and the contractor share ultimate responsibility for activities
occurring at a construction site and will be held responsible for any environmental
damage caused by subcontractors or employees. .
For more information on construction-related stormwater requirements, see the
Stormwater Quality Regulations section of the City of Cupertino web site at:
htto://www.cupertino.org/city government/departments and offices/
environmental services
COMMUNITY NOISE CONTROL ARRILOPYThe basic noise control requirements for construction sites Ffs`Po
CE
• Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street construction is prohibited on holidays.
• Residential daytime noise levels from complaint site - 60 dBA
• Nonresidential daytime noise levels from complaint site - 65 dBA
For more information on noise control, please see Chapter 10.48 of the Cupertino
Municipal Code, which can be accessed at htti)://www.amlegal.com/cugertino ca/
• Greg Casteel / R 0 D
AP 5 2606
Building Official !�.
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
4CUPER,TINO
Building Department
JOB ADDRESS: PERMIT#
10 .
OWNER'S NAME: PHONE # b 1p- /4-6 R_ c(ooc'-Y
GENERAL CONTRACTOR ro FAX #
I am not using any subcontractors:
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
•
Owner/Contractor Signature Date
-� CITY OF CUPERTINO
REPIPE/SEW.E RS/MAIN SERVICE
CUPEkTINO PERMIT APPLICATION FORM
APN# 3 5'3 O q13 Dao 8 6
Building Address:
Owner's Name: Phone #:
40 -
Contractor: Phone: License#:
111 1 -7 4
Contact Phone: ��b 3a b 6 Cupertino Business License#:
J- ` 14 6`b
Building Permit Info: f
BldgEl Elect El Plumb LSU
Job Description:
1 0
Residential Commercial ❑
o .
Cost of Project: o
-9
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg. Permit Fees BUILDING
BPGAS Gas Piping System Fee PLUMBING
PPERMITFEE Plumbing Permit Issuance PLUMBING
BPREPIPE Re i e of Fixtures PLUMBING
BPFIXTURE Pblg. Fixture PLUMBING
BPWSVCS Main Water Service PLUMBING
BPSEWER Sewers PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BUSLIC Business License BUILDING