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06050227 (2)
CITY OF CUPEC� `L`-, ,0 ��ISRMA.T N' BUILsDINC DIVISION 10N PERMIT � BUILDING ADDRESS: AMERICAN RESIDENTAIL SERV C TNO06050227 729 STENDHAL LA OWNER'S NAME: PERMIT ISSUE DATE BURNETT DONALD R AND NANCY H T1479 BERGER DR 05/26/2006 E: SANITARY NO. CONTROL NO. (408) 287-2165 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECN +oz LICENSED CONTRACTOR'S DECLARATION t�j� y .. 0 0 0 0 us 1 Wi reby affren that I am lived m ed ukr provisions of Chapteroa 9(e mning I�F SE O pr jiCi��t{ t< v,WSeetion 7") I'M'asm 3 ofthe Business and profession Code,and my license is ��"" in Tall fare aM INSTALL A PROPERTY LIN SEW EANOUT License s Ly.N Fo Dare DOalmemr ARCHITECTS DECLAARKY JUN o /nDC I¢< 1Prole tamJ my plain shall he used as public records •V tJ G Licensed Profcstional 1 3f I OUILDER DECLARATION hereby tha, I am exempt Wm the Conmctah ■I■ ��� License!caw for We ❑O fallowing mason.(Scwma"ID L5,Biomass and Profwsiou Code:Any city or County <m which rephest a permit w construct.alter,improve,demolish.or repair any structure $3900 ?iy pdorm itsimmCa.a4orequiresdcapplicanl forsuch permit m fileasignedsi emenl < that he is licensed purmanOoWeprovisionsofWeContractor's 1-ianscLaw(Chapter 9 Sq.Ft. Floor Area Valuation YFG (commencing wit Sudan 7")of Division 3 of the Business and Professions Cade)or i tat he is eumpl Wumfoom and the basis far the alleged eumption.Any violation of Section 7031.5 by any applicant for a permit subjects We applicant m a civil penalty of r Occupancy Type not mart Was five hundred dollus IS300). ❑I,nowmrofthepmpay,wmyemploycuwildw,gumU 4mlecomK=Uon. and datewart.and We he C.mrsnots Lt wawde tarsale(Sec.y044,Business and arty who a Code:The C sthmem4 and ho Law dao Out apply lf an owner is Required Inspections property who b,provi imphateach i m r and who daessmh work Mediated Waugh his two employees,provided that such rat is are not arofintended araRued We rule If. however.One building or improvement u sold whin one year or completion.to ownsn builder will hese the burden of paving that he did not Wild or improve for puryose of sok.). ❑1,as awns,of We propeny,am exclusively contracting wit Ikensed comtrxWs is construct the project(Sec.7044,Raciness and Professions Code)The Com,cmis U. came law does not apply to an owner of property who builds or improve Jamon.and. who contracts far such pmjeets wit a com acmr(s)licensed pursuant m the Cattmeme. License Law. ❑Iamexempundcr Sec ,B&PCfo,Numamn Owner Data WORKERS COMPENSATION DECLARATION 1 hereby aRmt under penalty al perjury am of the following declarations: 1 have and will maintain a CeniOcem of Demand m xlyiwum for WorYM.Compere salion,as provided for by Section 3700 of We Labor Code,far to performance of We work for which this permit is Issued ❑1 have and will maintain Worker's Compensation 1..."0 required by Section 3'100 of Um Labor Code,far We ,to..of We work far which this permit u issued. ' My Workeh Compens�firmg�In.m nacc JJaa�ni.,and Fail,number ma: C M OFOMPE SATION10NPRAN WORKERS' COMPENSATION INSURANCE , (Thu scrim=it not becomplemJ If to permit is form hunteddollan(SIW) less.) 1 certify Wm in We performance of We work far which this permit is issued.I shall not employ any person in any mannsr so as to became subject m the Wohen'Commusation Laws of califomia.Date Applicant NOTICE TO APPLICANT:If,after making Wu Certificate of Exemption,you should become subject no the Workces Compcmation precisions of the tabor Code you must .,z forthwith comply with such provisions or this permit shall W deemed revoked. zC7 CONSTRUCTION LENDING AGENCY f•' 1 harsh .M.that Wert is a connn¢tion Icndin Y g agency far We performancecar fY We were fm which Ws permit u iuuW(Sec.3(19'(,Civ.C.) Iandee's Name z Lentlers Address O Q 1..if,that I have read this application and sum Wu We above information u Ly E correct.I agree to comply with all city and county ordinances and rule laws relating in U building Construction.and hereby auth Wim mpresentmives of this city to enter upon We rU above-mentioned propeny ser inspecuoa purposes. (We)agree to save,indcmuily and k<cp harmless to City of Cupertino against H('q liabilities,judgments,ewes and expenses which may in any way accrue against said City I. of We ding Of L)z APPLCA nscUNDEgMANDS WIs crunit. ND WILL COMPLY WITH ALL NONPOINT Issued by: Dale .TiL•P.GG SO E LA NS. T124 Sib at a(Applic VCanlrscmr ae '- Re-roofs AZARDOUS MATERIALS DISCLOSURE Type of Roof dl the applicant car forum Wilding occupamncre car handle hnrd aous material as dcOm.d by We Cupertino Municipal C ,chapter 9.12,and We Health and Santry Code,Seed..25532(x)? All roofs shall be inspected prior to any roofing material being installed. ❑Yu If a roof is installed without first obtainingan inspection,I agree to remove Will m ircontapplicant car future Wilding occupant taw Area Air Qu car dMana which P g In hayardans air contaminants v defined by We Bay Arta Air Quality Management all new materials for inspection. District, ❑Yes u 1 have read W havasWmsmuerials requirements umkrCTupter 6.95.r&Cali(or. .is Rea lthhSalCly ode,Scc6.25M5.25533.d25534.1.&.Mdthuiff Wilding dais mly ve.rename N It u my res bility m ratify W e occupant or We Met m nti is sen ..af.cmileamaroZ6ry. � Signature of Applicant Date Owner a,m a ized agent Date All roof coverings to be Class "B"or better Community Development 10300 Torre Avenue JCupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 IOUPEkTINO Building Department OB ADDRESS: l PERMIT# ZQ � /1 60 S6 2�-7 OWNER'S N (� PHONE #yd GENERAL CONTRACTOR FAX # I am not using any subcontractors: 5/a ignature 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 OL-z Til Owner/Contractor Signature Date CITY OF CUPERTINO !m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 37542032 . 00 DATE ISSUED. . . . . . . : 05/26/2006 RECEIPT # • . . . . . . . . : 34572 REFERENCE ID # . . . : 06050227 SITE ADDRESS . . . . . : 729 STENDHAL LA SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : BURNETT DONALD R AND NANCY H T ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : RESCUE ROOTER CONTRACTOR . . . . . . . : BUREL, MARK T LIC # 21504 COMPANY . . . . . . . . . . : AMERICAN RESIDENTAIL SERVICES ADDRESS . . . . . . . . . . : 1479 BERGER DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95112-0845 TELEPHONE . . . . . . . . : (408) 287-2165 WE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---- ------------ - ---------- ---------- ---------- ---------- ---------- BPSEWER SEWER SYSTEM 1 . 00 21 . 58 0 . 00 21 . 58 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 59 . 95 0 . 00 59 . 95 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ------- ---------- ------------ ------------------ CHECK 59 . 95 003834 TOTAL RECEIPT 59 . 95 VOICE ID DESCRIPTION VOICE ID DESCRIPTION-- ------------ 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 507 FINAL PLUMBING • �, CITY OF CUPERTINO ic" 0.: REPIPE/SEWERS/MAIN SERVICE •CUPEkTINO PERMIT APPLICATION FORM APN# Building Aidre `� L r s N e: Phone#: o tr ctor: Phone: License#: I/Ug Z�Z--/D/�j z tact: 2 Phone: C pertino Business License #: /09 2r ZL/Z Building Permit Info: Bldg ❑ Elect ❑ Plumb Job Description: ,v l � (Z�PU©vT Residentiaf Commercial ❑ Cost of Project: 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 •