Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
07080197
-777777777777---7777777 CITY OF CUPERTINO BUILDING DIVISION PERMIT 4MTION� PERMIT NO. BUILDING ADDRESS: 10798 BROOKWELL DR STERLINC GENERAL 07080197 OWNER'S NAME: CONSTRUCT= PERMIT ISSUE DATE MERCER SHERRYL E 1566 SAE,INA WAY 7 SANITARY NO. CONTROL NO. NE: (408) 26E -2036 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH Z LICENSED CONTRACTOR'S DECLARATION o Job Description ul- I 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 FIRE DAMAGE REPAIR INC. STRUCTURAL LIKE FOR LIKE ; z Licenscfull f Classdc(t Lica 7 ( � MAST BEI) 2 ROOFS FRAMING F pale Contractor x ARCHITECTS DECLARATION 1a< I understand my plans shall be used as public records y tU U.y Licensed Professional I OWNER-BUILDER DECLARATION } 1 hereby affirm that 1 am exempt from the Contractor's License Law for the p o following reason.(Section 7031.5,Business and Professions Code:Any city or county 94 which requires a permit to construct,alter,improve,demolish,or repair any structure t Z r prior to its issuance,also requires the applicant for such permit to file a signed siatement Ft.Floor Area Valuation that he is licensed pursuant to the provisions of the Contractors Lit.-cnse Law(Chapter 9 :;q. $218562 F= (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 ofNumber Occupancy Type not more than five hundred dollars(5500). 3692103- .q( ❑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 t ontractars to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law docs 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 Contractors License Law. ❑1 am exempt under Sec. B&P C for this reason Owner Dam WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: L]I 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 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 Work rs Compensation Insurance carrier and Policy number ale: r Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM ORKERS' 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. Z' CONSTRUCTION LENDING AGENCY H*--r I hereby affirm that there is a construction lending agency for the performance of C4 > the work for which this permit is issued(Sec.3097,Civ.C.) W A Lender's Name az Lcndees Address Q 0 I certify that 1 have read this application and state that the above information is U H correct.I agree to comply with all city and county ordinances and state laws relating to J U building construction,and hereby authorize representatives of this city to enter upon the above-menuoned property for inspection purposes. W (We)agree to save,indemnify and keep harmless the City of Cupertino against a rn liabilities,judgments,costs and expenses which may in any way accrue a ainst said City _ � U Z in consequence of the granting of this permit. Date `' 1 �—+ APPLI UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by. SOUR RE TIONS. Re-roofs Signature 6iMpplicWContractor Dare HAZARDOUS MATERIALS DISCLOSURE Type of Roof l 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. ❑Yes / 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 materials for inspection. District? ❑Yes [�No 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 d�quircmts ly have a tenant,that it is my responsibility to notify the occupant of the rich msvQc�netpt;ortuisananccoraccrtificarcofomrpancy. Signature of Applicant Date �w"— �' t �-- All roof coverings to be Class"B"or better Owner or autborixcd agent Dam — CITY OF CUPERTINO 10 ITEMS OF 12 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN 36921033 . 00 DATE ISSUED. . . . . . . : 08/21/2007 RECEIPT #. . . . . . . . . : BSC00002444 REFERENCE ID # . . . : 07C80197 SITE ADDRESS 10-198 BROOKWELL DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER MERCER SHERRYL E ADDRESS 10; 98 BROOKWELL DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4609 RECEIVED FROM . . . . : STE,RLING GENERAL CONTRACTOR PA"RICK WEHNER LIC # 22979 COMPANY STIRLING GENERAL CONSTRUCTION ADDRESS 1566 SABINA WAY CITY/STATE/ZIP . . . : SAN JOSE, CA 95118 TELEPHONE (408)266-2036 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ----- BENERGY PERMIT FEE 1, 365.12 655 .26 0. 00 655.26 0. 00 BPERMFEE VALUATION 218, 562 . 00 1365 .12 0. 00 1365 .12 0. 00 BPFIXTURE UNITS 7 . 00 63 .00 0. 00 63 . 00 0. 00 BREMHEAT NO OF HEATERS 1 . 00 7 . 02 0. 00 7 . 02 0. 00 BSEISMICRE VALUATION 218, 562 . 00 21.90 0. 00 21 .90 0. 00 ELECTRIC SQUARE FEET 1,200. 00 96 . 00 0. 00 96 . 00 0. 00 EPERMITFEE FLAT RATE 1. 00 38.37 0. 00 38.37 0. 00 MPERMFEE SQUARE FEET 1,200. 00 96 .00 0. 00 96 .00 0. 00 MPERMITFEE FLAT RATE 1. 00 38.37 0. 00 38 .37 0. 00 PPERMITFEE FLAT RATE 1. 00 38.37 0. 00 38.37 0. 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 2419 .41 0. 00 2419 .41 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 2, 519 . 88 17970 --------------- TOTAL RECEIPT 2, 519 . 88 -x a CITY OF CUPERTINO My or PERMIT APPLICATION FORM cuPE�iNo CPN# '726 Date: Building Address: Mailing Address (if different from building address): cl Owner's Name: Phone#: C ntractor: License#: -tef iN &1J COMA. TOC . 7612- � Contct: Phone:4v ��1 312- Cupertino Business License#: WeIxNeR, Fax: Z— Building Permit Info: Bldg Elect Plumb J8 Mech& Job Description: 5iWO we Residential "� \ w.czS � '`, u iv'r Commercial ❑ VW,0�rbqA Sq.Ft.Floor Area: Sq.Ft.: Cost of ect: Occupancy Group: 21�i b < or T e of Construe 'on: Please check this box if the project is a second-story addition: ❑ Project Size: Standard Large ❑ Maior❑ Quantity Fee ED Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILER1 Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler>500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 P oiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX In i/Off/Comm/Quasi BUILDING BCONSTAXBQ Can. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC 1000 El ec 600V<= 1000A ELECTRICAL BELEC1001 E lec 600V> 1000A ELECTRICAL BELEC200 Eler. Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD 3nergy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �UPEkTINO Buildin De artment JOB ADDRESS: PERMIT # L OWNER'S NAME: , � _��`� PHONE # +-e; GENERAL CONTRACTOR: � -e,-r FAX # �t, I am not using any subcontractors: 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 jLi © T sir CITY OF CUPER,TINO Assessor's Parcel Number: Name of owner. 13roject address. �� Cl,b �'�- l__�-,(,�_—�•_ ------- ct erson. Fax.Phone. ' ' Conta p <" n ( � � Net square footage of lot. Existin ; ELoposed Square footage: First floor: Second floor: �---- Garage: TOTAL: �— Are there at least two 10 foot by 20 foot clear spaceE inside the garage? Is privacy protection planting required for the project? y zl-< On what floor(s) is work being done? Brief description of work. ..{ �tvz- �'r r, J;�c ,L Code editions:2001 CBC N)2001 CFC N)2001 CMC 2001 NEC '�N)2001 CPC € 'F� f e Effective 11/1/02 ,r Plan Review Process Work Book Page-B-Revised 8'22/05 f f � I z� am f . a� z I i! 1 t I � _ t . I 4i II �.'QllQ�gl �, $'�FY3 Iii 3 y E. ie�s cm is cm Fry - ' F l i s i LainK rlasQerEcd T, t s .f LTi % •," I.2..4.. 3 i r { �ji �{ I in i. IAS.1.0 --- -— ---------- -` °3"---_---------- ---- -� fi•I iw DRAWING IS NX TO SCALE, Please see attached job scope for the cdentt of the fir.We will be doing a fire damage rem-as-lett I F?,mlic'L4'._..._._._..__. wc ._.. El s m y r • kllAMiq Ali ...- _..,_. � in�.]! �Y'Po➢k�r uSyt � i ` 7 Chil�xu ._._. t .Tee•.._._.__ lank�af J y �- � be � . G��wnUore•Rr Tyra kA Uses Vii: U 3 xaa fa 97 �k1U�J ode- Ili dull! STINW?uR� eR�N a% l : Ji } 13Y OFFICE CO 14 CO rj,�TJ\110 9 i� 1 07 � OWNER "�' �C NERCER,SHERRYL 10 799 BROOKWELL DRIVE Lti v4®� �� CUI�TINO,CA 95008 CONTRACTOR any Q: S7 ElI[i1.1G GENERAL CONST.INC �► 17?7 DELL AVE !�� 0�p be h•o\at�eb CAMPBELL,CA 95008 408-871.1372 o�a�Cry prd�va I?11rA.'VIL11G 1S NOT TO SCALE n :v