06070190 (2) CITY OF CUPERTINO �
BUILDII:C DIVISION PERMIT MCONTRACTnR lNITRMATION
8 :
BUILDING ADDRESS: • KALMANGE KRISHNAKUNAR PERMRNO.06070190
10510 PINEVILLE AV
OWNER'S NAME: PERMIT ISSUE DATE
KALMANGE KRISHNAKUNAR 07/27/2006
E: SANITARY NO. CONTROL NO.
ARCHITECf/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
lop LICENSED CONTRACTOR'S DECLARATION
C 1 hereby aRrtn INP 1 me licensed under provisions of Chaptcr 9(commencing Job Description
w with Section 7")or Division 3 ofthe Business and Profession Colk.md my license is
„ inmBforocame ab �- 200 AMP ELECTRICAL UPGRADE
)LIE Llccmc Cl a Lic.a
jFw
Data As shalt used asCunnTION DOLLENS ELECTRICAL CORP . PAID FOR BL 7/27/06
iU 1 undersand my plans shall be used ss public rtarrB
CG Licensed Pofcssio..I
OWNER-BUILDER DECLARATION
2 I hereby alTires that 1 am exempt Wm the Concocs.r's License Law for Ne
00 following muoa.(Sued..713 1.5,Business and Profam..Code:Any city m county
which requires a Permit to construct,alcor.improve.dcm.Iish,Or roped,any manure
to
prim to its issuance,also requires Ne applicant for such permit o rile a signed statement
< NathcislicenxdPursuanstodsprovisionsoftheContractor'LicenseLaw(Chapter9 Sq.Ft. Floor Area Valuation
i O (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $2000
$ Nat he u exempt therefrom and the basis fm the allegro eswpd.Any violation of
Section 7031.5 by arty applicant for a permit subjects the applicanuo a civil penalty of APN Number Occupancy Type
not more Nan five hundred dollars(S500).
I,ss owner of Ne Proprmy,mmy employe=with wag=ss Ne'v role compenmden,
will do On work.and On structure is notimmnded mafrerod for.We(Sec.7041.Business -- Re aired Inspections
and Profession Chain:The Commoners Lt..Law don not apply b an owrmr of q p
property who builds.,i.p.Barron,and who does such work himself or though his
Own employees,provided that
pr such improsemenuasem eser dcdmonered for sok.R.
however.the building unimpro having said diin.ney=r of completion,the ower'
Wilder will have Ute busd=of posing Nat he did rot build or improve far purpose,of
sale).
0 1.u owner of On property.am=elusively concocting with licensed contractors m
ecouse a the es jea(Sec.toad,Basinofs am property
who ns Code:)The Cmuacon.and
whoa nor does not appy a an Owner.(psclany who builds or improves thereon.and
who concocts for such projects wiNaconuacor(s)Remained purawntw Be C.nvacoYs /
Lice.Law.
❑lam=crept under Sea .BBPCfor Nis mason
Owner Dam Gi 1
WORKERS COMPENSATION DECLARANo
1 hereby M.under penalty of perjury ane of Ne following declarations: D/
I him and will maintain a Cenifi=m o(Comcm m self-inwa far Wmkae Compere (/7
cation,as provided for by Section 37M of the Labor Cade.for the Performance.f the
work for which this permit is issued.
0 1 have and will maintain Worker's Compensation Insurance,as ryuirm by Section
37W.f Ne Inbar Code,for do performance.(the work for which this permit is issued.
My Worker's Compemation herurunce=nim and Policy number are:
Curie' h� Policy No.:
CEeTIFICA OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu sectors need not becomplcmd if the Permit is future hundred dollars(SIM)
or Ices.)
I emicv Nat in Ne performance of Nc-ark fm which this emit H issued,1 tha1P oat
employ any person in any mannersessobecomemb'ecU Wo Cmpcnsatlon
Laws
of'
Appli tit
WemCE TO ag i c.ifcare of Exemption,you should
become s o the Warkcrs Compensation provisions of the Lebur Cmc.you muse
.J O forthwith comply with such frovido s or Nis permit thall he accused revoked.
d.
CONSTRUCTION LENDING AGENCY
(~ I bureby aRrm But Ncre is a contended.lending agency for Um Perfomtanx of
C Ne work for which this permit is wood(Sec.3097,Civ.C.)
GQ Lendces Name
z Lcmer's Address
C) I certify Nn 1 Pave mad this application nm sum that the above information is
W F' correct.I agree to comply with all tiny and county ordinances and soon laws relating to
pU building contration and herab,..O.dre represcnutivvof this citym cow.pnnthc
yabove-mentioned Property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cope him,against
I,, liabilities,judgments.casts and expenses which may in my way acerin against saidCity
U 2LiCANT Us Permit.NcR
D WIL Y WITH ALL NON-POINT Issued by: Date
RCE REGULAT
Re-roofs
A ARD
Sin f PPI'caMrlclal
HcOUS MATERIALS DISCLOSURE Type of Roof
Will Ocapplicantofuturebuilding mchina, ore.handle hanNous mamdil
as dcrined by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety
Cade.Section Vi532(a)7 111y11aaa�aa�� All roofs shall be inspected prior to any roofing material being installed.
❑Yrs No
Will Ne applicant or future building occupant use equipment m devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit ha>eNnas air c.nami s az defined by the Bay Area Air Quality Management all new materials for inspection.
District'
❑Yas
1have real thehuaM mamrialsmquimmentsunder .Chapmr6.95ofthe Califon
nice ct Codc.Scctiaas]550 ndcrsando ildmg
ms roteFa" vren itis my retpo.....o ratify the tor'ole
royunemenswhieIs be mel pd. oraCeNrma mor. Signature of Applicant Date
Owrror or mNamcd agent D,m- All roof coverings to be Class "B"or better
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF
4UPEI�TINO
BuildingDe artment Fax(408)777-3333
JOB ADDRESS: io,to P(N fV(LL.d AV& PERMIT #
Cl 501 Li I 070( q-6
OWNER'S NAME: I<AL ,t/G-d {L(Z1 PHONE # 'Qr-cl Zq-b(Q
GENERAL CONTRACTOR PC2LL.EA,5 &= M V- (yRA FAX #
I am not using any subcontractors: ZZ
Date
Please check applicable subcontracto s and com Tete the followin information:
66 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 . . . . . . . . : 36913031 . 00
DATE ISSUED. . . . . . . : 07/27/2006
RECEIPT # . . . . . . . . . : 35406
REFERENCE ID # . . . : 06070190
SITE ADDRESS . . . . . : 10510 PINEVILLE AV
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : KALMANGE KRISHNAKUNAR
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : DOLLENS ELECTRIC
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY . . . . . . . . . . : KALMANGE KRISHNAKUNAR
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . ,
TELEPHONE . . . . . . . . :
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- --- ---------- ----- - ---- ---- - - - --- ---------- ----- - - --- ----------
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00
BELEC200 METERS 1 . 00 29 . 43 0 . 00 29 . 43 0 . 00
BSEISMICRE VALUATION 2 , 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
- --------- ---------- ---------- ---- ------
TOTAL PERMIT 208 . 16 0 . 00 208 . 16 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
-- - --- -- - - - -- ---- ------ ------ ------------------
OTHER 208 . 16 MASTERCARD
TOTAL RECEIPT 208 . 16
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
•
,t Suiv CITY OF CUPERTINO
arror PERMIT APPLICATION FORM
CUPERTINO N # ,/,
�7k'`�1— Date:
3 V�I 'A
z
Building Address: Mailing Address (if different from building address):
•p 5 Q t v
Owner's Name: Phone#:
v 3 1 q-q z Li s e"Yge-
Contractor: License #:
pou.t9.u'5 Cn '367376
Contact: Phone: 31 y—LiZ-L( Cupertino Business License#:
Fax:
Building Permit Info:
Bldg ❑ Elect A Plumb ❑ Mech ❑
Job Description:
Residential 2txm,,-4Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy Group:
z sly
Type of Construction: Please check this box if the project is a
second-story addition: ❑
ro•ect Size: StandardR 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> I OOOA ELECTRICAL
BELEC200 Elec Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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�p� CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPERTINO
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
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 rinklerBackflo PLUMBING
BPSTORM Storm/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
BRENINRAPP 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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R ( Q CITY OF CUPERTINO
• CITY OF PERMIT APPLICATION FORM
CUPEkTINO
1puantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, 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 Mechanical sq. 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 Plannine Lon2 Range Residential PLANNING
ZADDCHG Address Change BUILDING
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