06060089 ITY OF CUPERTINO
BUILDING DIVISION PERMITS I } Mt `IIi�'
BUILDING ADDRESS: t DAN ALFORD PLBG PERMIT NO-06060089
7614 BARNHART PL
PERMIT ISSUE DATE
OWNER'S NAME:
ENID LEUNG 813 CEDAR AVE 12/2006
SANITARY NO. CONTROL NO.
JE:
(408) 393-6383
BUILDING PERMIT INFO
ARCHITEC(ENGINEER: BLDG ELECT PLUMB MECH
p p LICENSED CONTRACTOR'S DECLARATION Job Description
V 5 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing
Z with Section 7000)of Division 3 of the Business and Professions Code?and my license is WATER HEATER SAME LOCATION
y in full force and e t l
License Class Lic• DAN ALFORD RENEWED BL 6/12/06
y Date Contractor
CHiTECTS DECLARATION
i a< I understand my plans shall be used as public records
1aV
tL F' Licensed Professional
'O<
OWNER-BUILDER DECLARATION
a1 hereby affirm that I am exempt from the Contractor's License Law for the
:2 O following reason.(Section 7031.5,Business and Professions Code:Any city or county
e.ff which requires a permit to construct,alter,improve,demolish,or repair any structure
Z r prior to its issuance,also requires the applicant for such permit to file a signed statement Ft.Floor Area Valuati d 3 0 0
2 that he is licensed pursuant to the provisions of the Contractor's Liccnsc Law(Chapter 9 Sq
t, (commencing with 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 ofAM�1u der 0 0 Occupancy Type
not more than five hundred dollars(5500) 3 062
O 1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is notintended or offered for sale(Sec.7044,Business Required Inspections
and Professions Code:The Contractor's License Law does not apply to an owner of
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.).
O 1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044.Business and Professions Code:)The Contractors Li-
ccnse 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.
OI
am exempt under Sec. B&P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
1 hereby affum under penalty of perjury one of the following declarations:
U I have and will maintain a Certificate of Consent to self-insure for Worker's Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the -
work for which this permit is issued. w
O 1 have and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
My Workers Compegc • n Insurance carrier and Policy number are:
Carrier: M`� Policy No.: x
CERTIFICATE OF EXEMPTION FROM WORKERS' v
COMPENSATION INSURANCE
(chis 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,1 shall not
employ any person in any mapnor as o betiotrUbject to the Workers'Compensation
Laws of Califrleni_a.Date stn�S.l�ss'
Applicant 41:31
f lT lam/f
NOTICE TOA PLI NT:f1k ifteV making this Certificate of Exemption,you should
become subject to the Workers Compensation provisions of the Labor Code,you must
Z forthwith comply with such provisions or this permit shall be deemed revoked.
O CONSTRUCTION LENDING AGENCY
(~-t rte. 1 hereby affirm that there is a construction lending agency for the performance of
p;> the work for which this permit is issued(Sec.3097,Civ.C.)
W A Lenders Name
=2 Lenders Address
1 certify that I have read this application and state that the above information is
LUL O correct.I agree to comply with all city and county ordinances and state laws relating to
0 U building construction,and hereby authorise representatives of this city to enter upon the
Uabove-mentioned properly for inspection purposes.
4 WGL (We)agree to save,indemnify and keep harmless the City of Cupertino against
„Fy to liabilities,judgments,costs and expenses which may in any way accrue against said City
V Z in consequence of the granting of this permit- Date
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:
SOURCE REG TIONS.
^t 2— Re-roofs
Signature of Appliar UContractor�AALSDao Type Of Roof
HAZARDOULOSURE
Will the applicant or future building occupant sore or handle hazardous material
as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Cale,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
O Yes O No
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
emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
O Yes O Nu
1 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 building
does Trot currently a tenant. at It is my responsibility o notify the occupant of the
requirements wh' m be me nonce of a C ficatc oroceupancy. Signature of Applicant Date
All roof coverings to be Class"B"or better
Owner or authorized agent Datc
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
"MkTINO
Building Department
JOB ADDRESS: PERMIT #
U
OWNER'S NAME: " ` ,,, PHONE #
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: c►,,C - I) �t t Z_
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
m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36624020 . 00
DATE ISSUED. . . . . . . : 06/12/2006
RECEIPT # . . . . . . . . . : 34804
REFERENCE ID # . . . : 06060089
SITE ADDRESS . . . . . : 7614 BARNHART PL
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER ENID LEUNG
ADDRESS . . . . . . . . .
CITY/STATE/ZIP . . . :
RECEIVED FROM . . . . : DAN ALFORD
CONTRACTOR . . . . . . . : DANIEL AFLORD LIC # 26363
COMPANY . . . . . . . . . . : DAN ALFORD PLBG
ADDRESS : 813 .CEDAR AVE
CITY/STATE/ZIP . . . : SUNNYVALE CA 94086
TELEPHONE . . . . . . . . : (408) 393-6383
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
___
-------------
---------- ----------
---------- ------
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 0
BPWHEATER PER HEATER 1 . 00 10 . 79 0 . 00 10 . 79 0 . 00
PPERMITFEE FLAT RATE 1. 00 38 . 37 0 . 00 38 . 37 ------0_00
---------- ---------- -------- - --
TOTAL PERMIT 84 . 02 0 . 00 84 . 02 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 84 . 02 VISA
TOTAL RECEIPT 84 . 02
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
502 FINAL PLUMBING ENERGY 506 GAS TEST
507 FINAL PLUMBING
CITY OF CUPERTINO OC��ab
WATER HEATER
CUPEt�TiNO PERMIT APPLICATION FORM
APN# � n f „ n ^, n Date.
Building Address:
Owner's Nam : Phone#:
Contractor: Phone: License#:
Contact: Phone: Cupertino Business License#:
Building Permit Info:
Bldg ❑ Elect ❑ Plumb Mech ❑
Job Description:
Residential F=[L Commercial ❑
Cost of Project: Cw,,
Strapped—El_ On Platform-0— Bonded New Location ElReplacement-G—
Qty. if
Applicable Fee ID Fee Description Fee Group
BPWHEATER Water Heater/Vent BUILDING
PPERMITFEE Plumbing Permit Issuance PLUMBING
BENERGY Energy BUILDING
BUSLIC Business License BUILDING