The URL can be used to link to this page

07080010 CITY OF CUPERTINO ` BUILDING DIVISION PERMIT {��I,:. C �N PERMIT NO. BUILD��tj p1 "96TTON PARK PL TBD TO BE DETERMINED 07080010 PERMIT ISSUE DATE OWNER'S NAME: IKEMOTO HIROYUKI AND SHERYL E 08/02/2007 SANITARY NO. CONTROL NO. NE: BUILDING PERMIT INFO ARCHITECTIENG)NEER: BLDG ELECT PLUMB MECH 00 LICENSED CONTRACTOR'S DECLARATION - Job Description W p 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing z8 with Section 70M)of Division 3 of the Business and Professions Code,and my license is REPLACE WATER LINE FROMMETER TO HOUSE MAIN y in full force and effect. ? License Class Lic•g t- Date Contractor ARCHITECTS DECLARATION i a a I understand my plans shall be used as public records tyU U.t"' Licensed Professional I y OWNER-BUILDER DECLARATION > I hereby affirm that 1 am exempt from the Contractor's License Law for the I p o following reason.(Section 7031.5,Business and Professions Code:Any city or county 120 `� which requires a permit to construct,alter,improve,demolish,or repair any structure r"n prior to its issuance,also requires the applicant for such permit to file a signed statement c that he is licensed pursuant to the provisions oC the Contractor's Liccnsc Law(Chapter 9 Sq.Ft. Floor Area Valuation 8 7 S l-$ (commencing with Section 7000)of Division 3 of the Business and Professions Codc)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 ofNumber Occupancy Type not more than five hundred dollars(5500). 3 7 5 3 5 0--;6 .q�1 ❑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 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.). RI,as owner of the property,am exclusively contracting with licensed contractors to struct the project(Sec.7044.Business and Professions Code:)The Contractors Li- cense Law does not a ply to an owner of property (ho builds or improves thereon,and who contracts for su projects with a contractors)icensed pursuant to the contractors License Law. ❑I uemp der Sec ,B&P C f r th' n Owner Date Z WORKERS COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑1 have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑1 have and will maintain Workers Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation insurance carrier and Polity number are: Carrier: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE S) N Ry (ibis section need not be completed if the permit is for one hundred dollars($100) or less.) I certify tha�in the pc ormancc of th work for which this permit is issued,I shall not TAemploy anyon i ny o bject to the Workers'Compensation Laws of Caa a Applicant0,2 NOTICE TO P A :If,after ma ng 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' CONSTRUCTION LENDING AGENCY [-�� I 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.) aQ Lender's Name a z Lender's Address U 0 I certify that 1 have read this application and state that the above information is correct.1 agree to comply with all city and county ordinances and state laws relating to U U building construction.and hereby authorize representatives of this city to enter upon the W ahove-mentioned property for inspection purposes. CL (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 U Z in consequence of the granting of thi permit. Date �. APPLICANT UNDERSTANDS D WI COMPLY ITH AL N N-POINT Issued b-i: SOURCE REGULATIO S. l 6 Re-roofs Signature of Applicant/Codtractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Zoof 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 roof::shall be inspected prior to any roofing material being installed. ❑Yes JAN. 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 1 naterials for inspection. District? ��/// ❑Yes pg No 1 have read hazardws`materials requirements under Chapter 6.95 of the Califor- niaHealth&Safety ode, ons 25505.25533 and 25534.[understand thatiCthc building does t currentl�avea t. attt' myresponsibilitytonotifythe •cup t of the a rcyui t p once of a Certificate of tx p Signator of Ag�ltcanr :" Date Da All roof coverings t^e Class"B"or better Owner o authorized agent -' CITY OF CUPERTINO 2 ITEMS OF 2 PERMI`7 RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Bl-,r,: Lot: APN 37 335036 . 00 DATE ISSUED. . . . . . . : 08 /02/2007 RECEIPT #. . . . . . . . . . BS)00002233 REFERENCE ID # . . . : 07 )80010 SITE ADDRESS . . . . . : 59L5 SUTTON PARK PL SUBDIVISION CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . ... : IKEMOTO HIROYUKI AND SHERYL E ADDRESS . . . . . . . . . . : 5915 SUTTON PARK PL CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-3530 RECEIVED FROM . . . . : H IKEMOTO CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : TELEPHONE . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPWSVCS WATER SERVICE 1 . 00 9 . 00 0. 00 9 . 00 0. 00 PPERMITFEE FLAT RATE 1. 00 38.37 0. 00 38 .37 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 47 .37 0. 00 47 .37 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 47.. 37 VS --------------- TOTAL RECEIPT 47 .37 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- --------------------------- 301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING CITY OF CUPERTINO REPIPE/SEWERS/MAIN SERVICE CUPEKTINO PERMIT APPLICATION FORM j-� ,;�UU k b APN# 0 v Date Building Address: 6 I G s tJ U`T•Ta f,(- Owner's ,t-Owner's Name: Phone#: u1" � 1�&6_4 b To Zy3 • SOO (l3u-019% Contractor: License #: 77q (.,(nS Contact: Cupertino Business License #: Building Permit Info: Bldg ❑ Elect ❑ Plumb Job Description: Residential )9 Commercial ❑ Cost of Project: e" Qty. if Applicable Fee ID Fee Description Fee Group PPERMITFEE Plumbing Permit Issuance PLUMBING BPREPIPE Repipe of Fixtures PLUMBING BPERMFEE Bldg. Permit Fees BUILDING BPFIXTURE Pblg. Fixture PLUMBING BPWSVCS Main Water Service PLUMBING BPSEWER Sewers PLUMBING BPSEWAGE Sewage Disposal PLUMBING BUSLIC Business License BUILDING