Loading...
07010148 CITY OF CUPERTINO BUILDING DIVISION PERMIT �C� R� T+CiR IQRMTIDN' BUILDING ADDRESS: PERMIT NO. OWNER'S NAME: UE TE MURRAY W S AND SUSAN H 01/24/2007 ZONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH J0p LICENSED CONTRACTOR'S DECLARATION Job DBSCTIptlOn e V p I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z'UJJ with Section 7000)of Division 3 of the Business and Professions Code,and my license is REPLACING 4 1/4 WINDOW WITH 6 X 6 WINDOW. y in full force and effect. j ? License Class Lic.# F Date Contractor ,,,t ARCHITECTS DECLARATION a< I understand my plans shall be used as public records 7WU aH Licensed Professional n 0, OWNER-BUILDER DECLARATION `>3e 1 hereby affirm that I am exempt from the Contractors License Law for the L p O following reason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure y Z y prior to its issuance,also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft. Floor Area $3500 Valuation J4 t–$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y 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 3163010 L.�!$N Number Occupancy Type not more than five hundred dollars(5500). ❑1,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 docs not apply to an owner of q 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.). ❑I,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 der Sea I� B&P C for this reason Owner `5�'*I "``'`{� Date /.`z a WORKER'S COMPEN ON DECLARATION I hereby affirm under penally of perjury one of the following declarations: ❑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. ❑I 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 Workei s Compensation insurance carrier and Policy number am: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is foronc 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�aybecome bject to the Workcrs'Compensation Laws of California Dale Applicant /� NOTICE TO APPLICANT:If,after making this iflcatc of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J O forthwith comply with such provisions or this permit shall be deemed revoked. z " CONSTRUCTION LENDING AGENCY F-t rte. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097,Civ.C.) aA Lender's Name a Lender's Address U 0 I certify that 1 have read this application and state that the above information is V. ►" correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorize representatives of this city to enter upon the LIa above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against 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 �`� t'(— [i� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE REGULATIONS. 4), S e Z e-t.o7 Re-roofs Signatureof Applicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of F.00f 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)? �� All roofs shall be inspected prior to any roofing material being installed. 13 Yes p tvo 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 rr aterials for inspection. District? ❑Yes 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 not currently have a tenant,that it is my responsibility to notify the occupant of the require encs Nch must be et prior to issuance of a certificate of Occupancy. Signature of Applicant Date �` ��of'� /r Z-(`U7 All roof coverings to be Class"B"or better Owner or authorized agent Date MACCU pppRo lv CUPERTINO WITH THE CITY 0' DATE CODES AND ORDINANCES _ " , --- SIGIVED sE —a 7 This + t of Rept on t'. 'N'ecific ,q �f c u; ations MUS; 6 lawrt,�l to ` a.7 tiines TUU "e t3:y chap and it is ur, �n :�me bviih..W -, .i+ ILM 86" LANDINO IDS changes or alter he uu,�r, r;«,7 pA;mis ation• IX ,MAX STEP DN I"- scam S Citv cf C sion fror, or`this upertino. 777�� hf,. ,�1,: ; ROMOVE(W 6040 KNDOW AND Ri•PLACC WITH 6066 HORIZ SLOB PATIO DOOR w/ Tow OL �--u�—I � �'� L--j ( M. BIMROOM 121-6 X 18'-0 WINDOW ROPLAORMEXT IN M.BEDROOM MURRAY ROSIVENaR 1050 1 N.PORTAL CUPERTINO,GA 1/11/01 SCALL'- 1/4"s V-0-- STOVE -0"STOVE BONZING-ARCHITECT SARAT00A,0Aop Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 -UPEkTINO Building Department JOB ADDRESS: PERMIT # L LG)S'0 f "1/. ���s' l�„� / OWNER'S NAME: PHONE # 40 Z 011.1f- GENERAL CONTRACTOR: 00 FAX # I am not using any subcontractors: Si;;nature 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 CITY, F PERMIT APPLICATION FORM CUPEkTINO CPN# Date: 3% 30 f�f Building Address: Mailing Address (if different from building address): l©5i1 N. �1,�JJ IJie Owner's Name: Phone#: 4 M Contractor: License#: 1 Contact: Phone: L105' 7_0Z-2,6,0 Cupertino Business License#: �c�, l v.r✓c Fax: 44oS- Building Permit Info: Bldg ®" Elect ❑ Plumb ❑ Mech ❑ Job Description: Residential 3'_ �� ���. 4,; c�,l, CJ oma �- Commercial ❑ Sq.Ft. Floor Area: joSq.Ft.: Cost of Project: Occupancy Gro u : Type of Construction Please check this box if the project is a second-story addition: El .'roject Size: Standard ❑ Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Bo:ler<= 100,000 Btu MECHANICAL BBOILER2 Boile-> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 B3iler> 1.75M Btu MECHANICAL BCONSTAX (construction Tax BUILDING BCONSTAX Incl/Off/Comm/Quasi BUILDING BCONSTAXBQ Co i. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC 1000 El,;c 600V <= l OOOA ELECTRICAL BELEC1001 E(ec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA [nvestigation fee BUILDING 1 of 3 an CITY OF (:UPERTINO 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 Yew Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW At-nospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE J;1d2 Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Ga:;Piping System Fee PLUMBING BPINTERCEP Incl Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plai Check Repeat Fee BUILDING BPREPIPE R,,-pipe Of Fixtures PLUMBING BPSEWAGE 'sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lavin Sprinkler/Backflo PLUMBING BPSTORM S torm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT A:t of Drain & Vent PLUMBING BPWATER Insti.II/Alter Water Pipe 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 Jnits <= 10,000 cfm MECHANICAL BREMAPPLI E�_ppliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT bighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relc Furnace> l OK btu MECHANICAL BREMHEAT Beater Installation MECHANICAL BREMINHOOD Ing tallation of Hood MECHANICAL BREMMISC vlisc 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 BREMREPALT Re-)air/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 m CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmc 1 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 c cb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE ',seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP T,,-mporary Power ELECTRICAL BTEMPPERM Tem?orary Bldg Permit BUILDING BTEMPSVCS remp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC I?lectrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Meeh Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Lone Range Residential PLANNING ZADDCHG Address Change BUILDING 3 of 3