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07020054 CITY OF,CUPERTINO n 7�7 j BUILDING DIVISION PERMIT � R BUIL t�TG DR PERMIT NO. 6 bRKSHIRE CT WILLOW GLEN ELECTRIC INC 07020054 OWNER'S NAME: PERMIT ISSUE DATE SARAH AND ANDY FEIT 1085 WARREN AVE 02/09/2007 )NE: SANITARY NO. CONTROL NO. (408) 2E9-9725 BUILDING PERMIT INFO ARCHITELT/ENGiNEER: BLDG ELECT PLUMB MECH 0 0 �Z � O LICENSED CONTRACTOR'S DECLARATION Job Description e U P I hereby affirm that I am licensed under provisions of Chapter 9(commencing =UZ U with Section 7000)of Division 3 of the Business and Pro'rns Code,and my license is 2 0 DAMP PANEL UPGRADE H in full force and eftec r_ Jf 9 Z License CtI atj t> Lic.If p Date Contractor Motrig "i­%_y_", rr ARCHITECTS DECLARATION cz ELI U I understand my plans shall be used as public records a C H Licensed Professional y OWNER-BUILDER DECLARATION +�<X 1 hereby affirm that 1 am exempt from the Contractor's License Law for the %C o following reason.(Section 7031.5,Business and Professions Code:Any city or county K which requires a permit to construct,alter,improve,demolish,or repair any structure zi Z} prior to its issuance,also requires the applicant for such permit to file a signed statement $ Ft. Floor Area Valuation =0 that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 9 3 O O 0 n— (commencingwith Section 7000 of Division 3 of the Business and Professions Code)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of Number Occupancy Type not more than five hundred dollars($500). 3 6 2 11 0 C 5 . V V ❑I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of 9 P property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. ❑1 am exempt under Sec. B&P C for this reason OwnerDate WORKER'S COMPENSATION DECD ARATION I hereby affirm under penalty of perjury one of the following declarations: I]I have and will maintain a Certificate of Consent to self-insure for Worker's Compcn- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. thave and will maintain Worker's Compensation Insurance,as required by Section of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation Insurance ca cr and Policy number are: Cartier. O Woicy No.: Wf Nv e rg Syy Ccs,V1 I CERTIFICATE OF EXEMPTION FROM WORKERS' �) COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:if,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. z►r CONSTRUCTION LENDING AGENCY [---r 1 hereby affirm that there is a constructian lending agency for the performance of <Yi> the work for which this permit is issued(Sec.3097,Civ.C.) W QL.endces Name Z Lender's Address U 0 1 certify that I have read this application and state that the above information is LL►� correct.I agree to comply with all city and county ordinances and state laws relating to 0 V building construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against CA liabilities,judgments,costs and nscs which may in any way accrue against said City L ()z in co e f th grantin this permit. --t APPLICA RSTA AND WILL OMPLY WITH A�7*7 OINT Issued by: Date �2, SOURC UL S Re-roofs Signature of Applicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code.Section 25532(a)? ❑Yes VNo All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove :mit hazardous air contaminants as defined by the Bay Area Air Quality Management all new rr aterials for inspection. District? ❑Yes *No I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505.25533 and 25534.1 understand that if the gilding does no rre Ely ha a tenan that it is my responsibility to notify the occupant of the raqui nts hich t be 'or lu issuance of a Certificate of Occup ey Signature of Applicant Date 9 1f p•7 owner art aathari.d agent Dare All roof coverings to be Class"B"or better CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec: Twp: Rng: Sub: Bl.c: Lot: APN . . . . . . . . . 36211005. 00 DATE ISSUED. . . . . . . : 02 /09/2007 RECEIPT #. . . . . . . . . : BS )00000432 REFERENCE ID # . . . : 07)20054 SITE ADDRESS . . . . . : 1131 YORKSHIRE CT SUBDIVISION . . . . . . : CITY . . . . . . . . . . . . . . CU:?ERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . . SKZAH AND ANDY FEIT ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : CU:?ERTINO CA, CA 95014-4967 RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR . . . . . . . : LONDRE, MARK T LIC # 15897 COMPANY . . . . . . . . . . : WI:,LOW GLEN ELECTRIC INC ADDRESS . . . . . . . . . . : 1035 WARREN AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95125 TELEPHONE . . . . . . . . : (408)289-9725 FEE ID UNIT QUANTITY ;\ MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- ---------- BELEC200 METERS 1. 00 29 .43 0. 00 29 .43 0. 00 BSEISMICRE VALUATION 3, 000. 00 0 .50 0. 00 0.50 0. 00 EPERMITFEE FLAT RATE 1. 00 38.37 0. 00 38.37 0. 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 68 .30 0. 00 68.30 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 68 .30 VISA --------------- TOTAL RECEIPT 68 .30 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 103 UFER 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL x § CITY OF CUPERTINO b'j�2bo5t� CITY OF PERMIT APPLICATION FORM CUPEkTINO _CPN# Date: � 2-- 11 -n o :a- l Building Address: Mailing Address (if different from building address): ► 1 It i Owner's Name: Phone#: Contractor: License#: W J r1t,"--.5 C�, i 5,1/11/(? Li © Contact: Phone: q vS 0cA? Cupertino Business License#: Building Permit Info: Bldg ❑ Elect :dumb ❑ Mech ❑ Job Description: Residential L�' � �' o d< k C.x 5 z a 7 N,�_ a�le,l . Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: dp--3C c-o Occupancy Group: Type of Construction: Please check this box if the project is a V, C+ " second-story addition: ❑ jeroject Size: Standard 7 Large ❑ Major E] Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other A liances 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 B oiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX In,I/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Co istax—Resi/Mobile BUILDING BELEC 1000 El-c 600V<= l OOOA ELECTRICAL BELEC1001 Elec 600V> 1000 ELECTRICAL BELEC200 Elec Svcs 600V<— OOA ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 *CFCITY OF CUPERTINO CUPEkTINO PERMIT APPLICATION FORM Quanti Fee ID Fee Description Fee Group BREMSIGNAD Rindl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BR EMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM S Ismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL S eciallnspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM TemporaKy Bldg Permit BUILDING BTEMPSVCS Ternp Dist Svcs ELECTRICAL BUSLIC :Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL l EPERMITFEE EL.-c Permit Issuance ELECTRICAL MPERMFEE N[echanical sq. foot MECHANICAL MPERMITFEE Me.,h Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Plannin Long Range Residential PLANNING ZADDCHG Address Change BUILDING 3 of 3