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07080048
CITY OF CUPERTINO BUILDING DIVISION PERMIT 0.0 PERMIT NO. BUiLDiit(G,.(tU 9Rl2F,SlS:N PORTAL AV RUNNING ELECTRIC 07080048 l lJ PER ISSUE DATE OWNER'S NAME: MURRAY W S AND SUSAN H 935 HILLCREST DR SANITARY NO. CONTROL NO. NE: (831) 335-9024 BUILDING PERMIT INFO ^HITECT/ENGINEER: BLDG ELECT PLUMB MECH Z LICENSED CONTRACTOR'S DECLARATION Job Description O F I hereby afore that I am licensed under provisions of Chapter 9(commences SERVICE UPGRADE 200 AMPS ,U,t with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect ? License Class QLic.» o Date Contrac-, fAqf omkC4. �{ A CHI TECTSDECLARATION a< I understand my plans shall be used as public records U F Licensed Professional OWNER-BUILDER DECLARATION 1 hereby alTirm that I am exempt from the Contractor's License Law for the oe� following reason.(Section 7031.5,Business and Professions Code:Any city or county fi which requires a permit to construct,alter,improve•demolish,or repair any structure 'rn prior tt)its issuance,also requires the applicant for such permit to file a signed statement 3q,Ft. Floor Area Valuation that he is licensed pursuant to the previsions of the Contractor's License Law(Chapter 9 m (commencing with Section 70DO)of Division 3 of the Business and Professions Code)or 3 "41that he is exempt therefrom and the basis for the alleged exemption.Any violation of A 1�Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3 1 6 3 01 C 1 . V not more than five hundred dollars(S500)• ❑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 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.). ❑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 Contractofs License Law. ❑I am exempt under Sec .B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 17 I have and will maintain a Certificate of Consent to self-insure for WOrkees Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the irk for which this permit is issued. have and will maintain Worker's Compensation Insurance,as required by Section JO of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number arc: p^ - Cartier. Ile 15 � Policy No2a� (y3�o J 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. r--t CONSTRUCTION LENDING AGENCY 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.) a Q Lender's Name Z Lender's Address 0 I certify that i have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to C..1 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 y liabilities,judgments,costs and expenses which may in any way accrue against said City (1 ,Z in consequence of the granting of this permit. Date 0-0 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b": SOURC GULATIONS. Re-roofs Si lure o7Applican onttactorDamT of:Zoof AZARDOUS MATERIALS DISCLOSURE YPeWillant 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 AN. If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new l naterials for inspection. District? ❑yes o 1 have read the hvardous materials requirements under Chapter 6.95 of the Califor- nia Hcalth&Safety Code;sections 25505.25533 and 25534.1 understand that if the building docs not currently have a tenant,that it is my responsibility to notify the occupant of the Date reyuircmcns which must be mt pri to issance o a Ccrtific euatc of S ignatur✓of Applicant All roof coverings to be Class"B" or better Ow r or authorized agent Liam Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 (.-,UPEkTIN0 Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: o �� y PHONE # �' 3 / ,5' GENERAL CONTRACTOR: .,Y- AX # I am not using any subcontractors: �/ S gnature Date Please check applicable subcontrctors 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 3 ITEMS OF 3 PERMIP RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 31630101- 00 DATE ISSUED. . . . . . . : 08/06/2007 RECEIPT #. . . . . . . . . . BS000002274 REFERENCE ID # 07080048 SITE ADDRESS . . . . . : 10501 N PORTAL AV SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER MURRAY W S AND SUSAN H ADDRESS 10501 N PORTAL AV CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : RUNNING ELECTRIC CONTRACTOR . . . . . . . : JCHN C FASOLAS LIC # 28994 COMPANY . . . . . . . . . . : RUNNING ELECTRIC ADDRESS . . . . . . . . . . : 935 HILLCREST DR CITY/STATE/ZIP . . . : FELTON, CA 95018 TELEPHONE . . . . . . . . : (831) 335-9024 FEE ID UNIT QUANTITY AMOUNT 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 ----------------- --------------- -------------------- CHECK 68.30 7218 --------------- TOTAL RECEIPT 68.30 VOICE ID DESCRIPTION VOICE ID DESCRIPTION `------- ---------------------------- -------- ---------------------------- -103 UFER 304 ROUGH ELECTRICAL 505 ., FINAL ELECTRICAL CITY OF C UPERTINO CITY OF P� IT APPLICATION CUPEkTINO Date: wilding Address: Mailing Address (if differe t from building address): Owner's Name: Phone#: , License # (`o,itractor: Contact: Phone: Cupertino Business License#: ,Tv S D 5 Fax: Building Permit Info: ��. Bldg ❑ Elect Plumb ❑ Mech ❑ Job Description: Residential� Commercial ElSq.Ft. Floor Area: Sq.Ft.: Cost of Proj t: Occupancy Group: j©©G Type of Construction: Please check this box if the project is a second-story addition: El 'roject Size: Standard ❑ Large ❑ Major ❑ Quantity Fee ID ]Tee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boil(-,r> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boller> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX In(VOff/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 <= 1 OOOA ELECTRICAL BELEC1001 E lec 600V> I OOOA ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3