05060025 (2) CITY OF CUPERTINO '
BUILDING DIVISION PERMITCUlVTRA.CTQR=INZ<'URMA.'CIO.,fN
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BUILDING ADDRESS: DAN & ROSSANA GRANERA PER ""05060025
119 PAP, T11J
OWNER'S NAME: PERMIT ISSUE DATE
ONE: SANITARY NO. CONTROL NO.
ARCHITEC IENGiNEER: BUILDING PERMIT INFO
BLDG EIJ:CT PLUMB MECH
p
+1GOZ LICENSED CONTRACTOR'S DECLARATION JobDescription
Id 1 hereby affirm that I am licensed umler provisions of Chapter 9(commencing
,� with Section 7000)of Division 3 of the Business and Profession;Code.and my licence is
5giicemucorcesnd effect. 71 FENCE (SIDE ONLY)
? Lfullfrcea Lle.g
Z Dam Contractor
DECLDECL
9 ARCHI7F.CrSARATION
ll I understand my plum shall bo onad u public record+
3
t�
Licensed Professional
OWNER-BUILDER DECLARATION
0 1 hereby affirm that 1 1. exempt from tiro Gmmracmrs e:A License Law for the
00 which following resume.(Saito 7 construct.Alter.
and ve demli Code:Any oily or county
9 which requires a permit re ares dic alter,improve,dPermit,lirto e a sig any tatement
HZ>
prior mits iensedpatwmgoima Nto de, ovisiappoe of for such Cormmi',LiceseLaw(ned ummcnt
ggzF< thnheincingudpSectio 7")ofviiomofNeConuiness LkcnmlaonsCodar9 Sq.Ft. Floor Area Valuanon
ID$ (est he
(commencing Section7")ofDivisionbasir th alleged
euandon.My vi Code)or
3 Nat he h exempt R¢mtmm and Use buts for the aim{cd esempnon.My vloh0on of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of five hundred doll3 r &bCTO Q
not mart I I I n Occupancy Type
Nan en(55001.
❑1,uawnermfaepmperty,ormyemploymwiNmrAnftkwlecmnpemdon,
will do the work and the swctum isnot intended ora@red forsale(Sec.704/,Business Rtai ed actions
and Profeulon Code:The Comrsctnts License Law does rot apply m An roamer ns ar of q p
property who builds or impuves Hers n,andwho daweuch work himanifor(hrough his
own employees.provided that such improvements Are notlmtemded or offered forsala it. G. •s
however.the building or improvement issold within oa)car of completion,Ne owner.
builder will ltave the burden of proving that M did tent Wild or improve for purpose of
rale.). r /r
❑1,as owner of the properly,am exclusively contracting with licensed contractors to t. K�r�7
convect the project(Sec.7040,Business and Professions Code:)The Contractor's Li.
cern law dorm not pply to an mama of property who Wilds or improves Neuron,and,
who contracts for such pmkeu with a emuacmr(s)licensed pursuant m the Contractor.
License Law.
®lam tae ands Sec. B&PCfm an naso
Owner Date
WORKER'S COMPENSATION DECLARATION
lb by affnm under penalty of perjury one of the following dalamions:
I have and will maintain aCeNOcate of Consent to self-Insure far Worker's Conifer.
131M
tion,As provided for by Section 3100 of the labor Cade.for the peRormaae of tite
rk for which this permit is issued.
1 have and will maintain Worker's Compemtion Imrance.u required by SeNon
ofNe labor Cede,fur Ne pexinmmance of Ne work for which Nu permit is When.
y Worktrs Compensation thwart carrier end Policy number art:
rtier. Polity No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu it.need not W completed if tk permit ts foronc hembed dellan(5100)
lir less.)
I certify Nat in the perfomnana of the work for which this permit is issued.I shall not
employanypereoninanyman rsgvASwMtnme subjatto Ne Workeri Compemtian
Laws of Calif D D
Applicant a"'a
NOTICE 713&PPUCANr.If.after making Nu Cenifiam of Eaemption,you shald
become subject an the Workers Compensation provisions of the IaWu Cemc.you must
0 0 forthwith comply with such provision or this permR shall W darned revoked.
Z'--' CONSTRUCTION LENDING AGENCY
[-s4 I hereby affmm that Nem Is a conwNan lendinpgency Jar led performance of
a> the ,it for which this permit I.issued(Sec.3091.Civ.C.) '
OW.Q Lenders Name
z Landers Addnsss
U O 1 certify that 1 have mad Nis Applicant.and sum than the above Jet.Nun is '
W cctrett 1 agree to comply with W city and county ordinances And rota laws relating in
0 building construction.and hereby authadrn representatives of Nis city to enter upon Ne _
W above-mentioned property for Inspection purposed.
gy (We)Agree m an.indemnify and kap harmless the City of Cupertino against
ter V) Ilatellides,judgments,ensu and experts which may in any way acme against aid City
In consequence of the granting of this permit.
F7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURR�EGULTIONS.
S' �
, G Re-roofs
nayfic of AppliantMon—tor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant m forum building acupumm
uor handle hsexrduomamdal
CudcOned by Ne Cupertino Municipal Code,Chapter 9.11,and the Health and Safety
Cale,Section 33532(;)1
❑Yos �'Nu All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
:mit he'urdaua air conumironu As defined by the Bay Arca Air Quality Management all new materials for inspection.
Dhhict7
❑Yea )6No
I heve mal the hunthwa naukdals"uimments underCWpser6.95 orde Califor-
.is HcaithBSsfetyCade,Secdmu 15505.25533and 25531.1undcntand Nuilate Wilding
dues not currently have a tenant,that it is my responsibility he notify the occupant of Ne
requirements which must bc met Prieto,iuumccara Certincam of OccuPane>y. Signature of Applicant Date
n taunorirsdagnat Dom All roof coverings to be Class "B"or better
April 6, 2005
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014
To Whom It May Concern:
I, Chris Cheng owner of the property located at 10750 Rae Lane,
Cupertino, am giving Dan & Rossana Granera, owner of 22119 Rae Lane, .
Cupertino, to replace and build 7 feet high with lattice fence between the
two properties.
• Sincerely,
JUN 0 3 2005
Chris Cheng
(510) 390-0766 —''`
Community Development
a10F
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
�UPEI�TINO.
Building De artment
JOB ADDRESS: PERMIT #
OWNER'S NAME: PHONEQ� ZS3- Z23
GENERAL CONTRACTOR FAX#
I am not using any subcontractors: 9t,& li4.� 11� •
l Signa e 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/pIntractor Signature Date
CITY OF CUPERTINO
CIT °F PERMIT.APPLICATION FORM
CUPERTINO
APN# 3S�D el Date: G _ -3
Building Address: Mailing Address (if different from building address):
RIFE Gam✓
Owner's Name: Phone #:
e� ;, ,eaA �,e�vEx�t
Contractor: License #:
6/IZ,DE
Contact: Phone: Cupertino Business License#:
Fax:
Building Permit Info:
Bldg ❑ Elect ❑ Plumb ❑ Mech ❑
Job Description: dFg
,jfavrOHO 6'
Residential ❑ Commercial ❑
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Project: Occupancy Group:
Type of Construction: Please check this box if the project is a
second-sto addition: ❑
Project Size: Standard ❑ 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 IM 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 <_ IOOOA ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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t-arm CITY OF CUPERTINO
CITY OF 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
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pb1g 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 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 cfm 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
Ak BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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I CITY OF CUPERTINO
CUP PERMIT APPLICATION FORM
Quantity 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 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 Ran! e Residential PLANNING
ZADDCHG Address Change BUILDING
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