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07080060 77777777777�—I CITY OF CUPERTINO yNF BUILDING DIVISION PER1v1117�+ i � t P.,.R 1. PERMIT NO. POWNER'SNAMP DDRESS: 54 NORMANDY WAY CHEROKEE CONTRACTING CO. 07080060 PERMrF ISSUE DATE ENE MON-REN 356 MAr1HEW ST SAARY N M CONTROL NO. E: (408) 727-9850 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I am licensed under provisions of Chapter 9(commencing With Scction7000)ofDivision3ofthcBusin=andProfessionsCode.andmyliccascis INSTALL 4 IN LATERAL C.O. ?- in full force and eff L .°S J W�,s 1 License Cl _� 5 Lic.8 Date I `1 t'1 l Contractor s ARCHITECTS DECLARATION I understand my plans shall he used as public records U Licensed Professional OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the ofollowing reason.(Section 7031.5,Business and Professions Code.Any city or county 9 which requires a permit to construct,alter,improve,demolish,or repair any structure N prior to its issuance,also requires the applicant for such permit to file a signed statement S Ft.Floor Area Valuation a that he is licensed pursuant to the provisions of the Contractors License Law(Chapter 9 q' $4500 m (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 Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). 3 6 6 17 0 E 5 . U 0 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.lf, 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.). 0 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)Mie Contractors Li- cense Law does not apply to an owner of property who builds or improves thereon.and. who contracts for such projects with a contractors)licensed pursuant to the Contractors License Law. B&P C for this reason 0 1 am exempt under Sea Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: U I have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of dee Labor Code,for the performance of the work for which this permit is issued. 0 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 WorkeCr'�Coq pensat}pu Insuce carrier and Policy number Carrier.—J'r'' ev r1 Policy No.: _ I G b(1-1 CERTIFICATE OF EXEMPrION FROM WORKERS' COMPENSATION 114SURANCE (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. �— CONSTRUCTION LENDING AGENCY 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.) 7 Q Lender's Name Z Lender's Address p 1 certify that 1 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 U building construction,and hereby authorize representatives of this city to enter upon the w ahove-mentioned property for inspection purposes. y L1. (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way acauc against said City Z in consequence of the granting of this permit. Date ►- APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b is S CE REG TIONS. V.4 0 & I 1 " Re-roofs Signature of Applicant/Contract Date Type of Zoof HAZARDO MATERIALS DISCLOSURE 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)? j/ All roof;shall be inspected prior to any roofing material being installed. OYes e If a roof is installed without first obtaining an inspection,I agree to remove Will the zaapplicant or future building occupant use equipment or devices which all new;materials for inspection. emit hardous air contaminants as defined by the Bay Area Air Quality Management 0 Ycs 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 building does not currently have a tenant,that it is my responsibility to notify the occupant of the Date requi m is hich ust be met prio+y issuance o Certificate of Occupant.? S ignatui e of Applicant \t — g b� All roof coverings to be Class"B' or better Owner or authorized agent Datc CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36617065 .00 DATE ISSUED. . . . . . . : 08/07/2007 RECEIPT #. . . . . . . . . : BS000002289 REFERENCE ID # . . . : 07080060 SITE ADDRESS . . . . . : 7554 NORMANDY WAY SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER CHENE MON-REN ADDRESS 7554 NORMANDY WAY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : RCBERT RUIZ CONTRACTOR . . . . . . . : YATES, JAMES H LIC # 702 COMPANY CHEROKEE CONTRACTING CO. ADDRESS . . . . . . . . . . : 356 MATHEW ST CITY/STATE/ZIP . . . : SANTA CLARA, CA 95050 TELEPHONE . . . . . . . . : (408)727-9850 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPSEWER SEWER SYSTEM 1. 00 21.58 0. 00 21 .58 0. 00 PPERMITFEE FLAT RATE 1. 00 38.37 0. 00 38.37 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 59 .95 0. 00 59 .95 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 59 .95 MC --------------- TOTAL RECEIPT 59 . 95 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING • CITY OF ,CUPERTINO REPIPE/ ' ` ��.1�/MA1�I SERVE CUPEkTINO PERMIT APPLICATION FORM c3 �bg O b Cs�-CS APN# . 3b (P f.-7p 6f Gv Dg. 1-7 l 7 Build' A dress: +7. NO IZ_ IM Qwner's Name- Phone#: Cti-actor: Plione: T\6-P-0 7 -7 C nt ct: � PI}one: �, _��S 9 Cupertino Business License#: Building Permit Info: Bldg ❑ Elect ❑ Plumb Job Desc�ion: 1�� Residential Commercial ❑ Cost of Proje saw Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg. Permit Fees BUILDING BPGAS Gas Piping System Fee PLUMBING PPERMITFEE P.umbing Permit Issuance PLUMBING BPREPIPE Repipe of Fixtures PLUMBING BPFIXTURE P-Ag. Fixture PLUMBING BPWSVCS 1Vain Water Service PLUMBING BPSEWER S.;wers PLUMBING BPSEWAGE S,.-wage Disposal PLUMBING BUSLIC B isiness License BUILDING Community Development 10300 Torre Avenue { Cupertino CA 95014 N Telephone(408)777-3228 C1TY OF Fax(408)777-3333 "WEkTINO Buildi[n De artment JOB ADDRESS: PERMIT # OWNER'S NAME: i 1 j___ PHONE # GENERAL CONTRACTOR: rAl) eb FAX # I am not using any subcontractors: C��(JLh �( 7 l 7 S ignaa e Date Please check applicable subcontractors and coni lete 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