Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
07090106
7777.7777777 CITY OF CUPERTINO BUILDING DIVISION PERMIT of"aQ f}R ATI�N�. PERMIT NO. BUILOTS r�DpRF„S,S�RNHART PL SPEEDY FOOTER PLUMBING 07090106 / /� j$ PERMIT ISSUE DATE OWNER'S NAME: HARRISON WESLEY E AND JUDY M 701 ALDO AVE 09/18/2007 SANITARY NO. CONTROL NO. NE: BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 1:4Z LICENSED CONTRACTOR'S DECLARATION Job Description MI V C I hereby affirm that I am licensed under provisions of Chapter 9(commencing u� with Section 7000)of Division 3 of the Business and Professiuns Code.and my I'�rise is CITY CLEAN OUT. a in full force and effect >�j? License ClassLic.S M Date LTi -Contractor < ARCHITECTS DECLARAT N i a< 1 understand my plans shall be used as public records >yU 'wti Licensed Professional a OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law ter the jo O following reason.(Section 7031.5,Business and Professions Code:Any city or county e which requires a permit to construct,alter,improve,demolish,or repair any structure "y prior to its issuance,also requires the applicant for such permit to file a signed statement e Valuation Z a that he is licensed pursuant to the provisions of the Centractur's Licettsc Law(Chapter 9 .q.Ft.Floor Area $1700 L F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or L 9 that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 36624024 . �Number not more than five hundred dollars(5500). ❑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.70",Business Required Inspections and Professions Code:The Conuactoes 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.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to bANITARY construct the project(Sec.7044,Business and Professions Code:)The ContrataoeS Li- ccrse Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a conu=or(s)licensed purstiant to the Contractor's License Law. [31 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: ❑1 have and will maintain a Certificate of Consent to self-insure for workces 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 3700of the La ode.for the performance of the work for which this permit is issued. My Worker's nsation Insuran carrier d Policy number am: �[ i Carri er: C"' ''/�'t ,liry Na.:V 1/ we'dgOF EX ON FROM WORKERS' COMPENSATION INSURANCE not be completed if the permit is for one hundred dollars(E 100) or less.) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Workeri Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Workers Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. z CONSTRUCTION LENDING AGENCY HI hereby affirm that there is a construction lending agency for the performance of (Y> the work for which this permit is issued(Sec.3097,Civ.C.) Ila ALender's Name az Lendei s Address U C) I 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 Ubuilding construction,and hereby authorise representatives of this city to enter upon the Uabove-mentioned property for inspection Purposes. f]r (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,toss and expenses which may in any way accrue against said City U Z in consequence of the granting of is perms r Date APPLICANT UNDE STAND AND L Co1�4PLY WITH ALL NON-POINT Issued by'. SOURCE RyULbNS. ' '�` _�,•-- Re-roofs SigadiodofApplicant/Con actor Dam Type Of Roof H DOUS MATERIALS DISCLOSURE yP Will the applicant or future building oceupant store or handle hazardous material as r fined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety 96de,Section 25532(a)? All roofs ihall be inspected prior to any roofing material being installed. ❑Yes '[yNo Will the applicant or future building occupant use equipment or devices which If a roof i;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 materials for inspection. District? ❑Yes ©Mo I have read the hazardous materials reQuiremcros under C haptc 6.95 of the Califor- ma Health&Safcty Cede,$actions 25505,25533 and 255341 under id that if the building docs not currency ve//.tenant,that it'u my responsigifity to rn�e ify the occupant of the requircmensw y5t'bcmetprior toissuance#fffltcrtifidk ofOccupancy. Signature of Applicant Date ' `" All roof coverings to be Class"B or better Owner or Y,prized agent i Dam TI Q7oy of �� CITY OF CUPER NO -_R`/MAIN�. SFR ICE REPIPE/S �� CUPEkTINO PERMIT APPLICATION FORM APN# O a �' Date: F,-U -7 Building Address:? Owner's Name: Phone#: Contractor: Phone: � - License Contact: Phone: Q a4 r Cupertino Business License#: 2 Building Permit Info: ,,/ Bldg El Elect ElPlumbs LJ Job Description: L Residential Commercial ❑ Cost of Project: Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg. Permit Fees BUILDING BPGAS Gas Piping System Fee PLUMBING PPERMITFEE Plumbing Permit Issuance PLUMBING BPREPIPE Ro ipe of Fixtures PLUMBING BPFIXTURE Pblg. Fixture PLUMBING BPWSVCS Main Water Service PLUMBING BPSEWER Sewers PLUMBING BPSEWAGE Sewage Disposal PLUMBING BUSLIC Business License BUILDING CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36624024 . 00 DATE ISSUED. . . . . . . : 09/18/2007 RECEIPT #. . . . . . . . . : BS000002670 REFERENCE ID # 07090106 SITE ADDRESS 7564 BARNHART PL SUBDIVISION . . . . . . CITY CUFERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : HAFRISON WESLEY E AND JUDY M ADDRESS . . . . . . . . . . : 75E4 BARNHART PL CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5239 RECEIVED FROM . . . . : SPEEDY ROOTER CONTRACTOR . . . . . . . : SPEEDY ROOTER PLUMBING LIC # 23086 COMPANY . . . . . . . . . . : SPEEDY ROOTER PLUMBING ADDRESS . . . . . . . . . . : 701 ALDO AVE CITY/STATE/ZIP . . . : SANTA CLARA, CA 95054 TELEPHONE . . . . . . . . . FEE ID UNIT QUANTITY 1,MOUNT 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 40.79 0. 00 40 .79 0. 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 62 .37 0. 00 62 .37 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CASH 62 .37 --------------- TOTAL RECEIPT 62 .37 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- --------------------- 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 302 TUB & OR SHOWER 502 FINAL PLUMBING ENERGY 506 GAS TEST 507 FINAL PLUMBING Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 -UPEI�TINO Building Department JOB ADDRESS: PERMIT# 7t-5 l I <!!�> -? 06° OWNER'S NAME:(„)(LSS k U/ PHONE # 74- g— ? 1 8 GENERAL CONTRACTOR: � e FAX# 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