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07090151
CITY OF CUPERTINO BUILDING DIVISION PERMIT 1.� l�TRM7tTI© • BUILD{N§AT'TZANBERRY CL EAGLE P[LUMBING INC P07090151 OWNER/'S NAME: PERMIT ISSUE DATE MURTHY CHANDRASEKHAR AND GITA 544 HASSINGER RD 09/21/2007 )NE: (408) 281-0583 SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 p 0 LICENSED CONTRACTOR'S DECLARATION Job Description %m I hereby affirm that I am licensed under provisions of Chapter 9(commencing U5 with Section 7000)of Division3oftheBusinessandProfessionsCode,andmylicenseis REPIPE :ALV TO COPPER WTR SVC CHANGEOUT y in full force and effect. t v�z License Class C- t%n Lic.S t w Date - j-0:4 Contractor ARCHITECTS DECLARATI N i a< I understand my plans shall be used as public records CJ .0. U.In Licensed Professional y OWNER-BUILDER DECLARATION '> I hereby affirm that 1am exempt from the Contractors License Law for the j 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county rZ which requires a permit to construct,alter,improve,demolish,or repair any structure Zprior to its issuance.also requires the applicant for such permit to file a signed statement x o that he is licensed pursuant to the provisions of the Contractor's License law(Chapter 9 c,.q.Ft.Floor Area $6200 Valuation t- (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 of 3620300 9A kJ Number Occupancy Type not more than five hundred dollars($500). 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 docs not apply to an owner of q P 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.). 0 L as owner of the property,am exclusively contracting with licensed conttactars 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 Wereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractoes License Law. 0 1 am exempt under Sea B&P C for this reason Owner Date WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1]I 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. 0 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 Wor;qiiii; r and Policy numbber are: Carrier. Policy No.: A o 5114 t S XTION FROM WORKERS' COMN 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 Workces Compensation provisions of the Labor Coda you must Oforthwith comply with such provisions or this permit shall be deemed revoked. Z ' CONSTRUCTION LENDING AGENCY E r►�-r 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.) W A Lendcr's Name z Lender's Address U 0 1 certify that I have read this application and state that the above information is LL r--r correct.I agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorize representatives of this city to enter upon the nWr above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against Co) liabilities,judgments.toss and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. r. APPLIC. £RSTXNQS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REG TI ---- c - Re-roofs Signature of pp ican tractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof 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,Section25532(a)? All roofs shall be inspected prior to any roofing material being installed. C:]Yes � 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 maerials for inspection. District? 0 Yes �14t�i 1 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 h ant,that it is my responsibility to notify the occupant of the requircments which'(nust Jme or to issuance of a Certificate of Occupancy. Signature of Applicant Date Owner or aulhorizcd agent Date- All roof coverings to be Class"B" or better CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . . 36203009 . 00 DATE ISSUED. . . . . . . : 09/21/2007 RECEIPT #. . . . . . . . . : BS000002724 REFERENCE ID # 07090151 SITE ADDRESS . . . . . : 7945 CRANBERRY CL SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER MURTHY CHANDRASEKHAR AND GITA ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4923 RECEIVED FROM . . . . : EAGLE PLUMBING CONTRACTOR . . . . . . . : RODRIGO ARZATE LIC # 25400 COMPANY . . . . . . . . . . : EAGLE PLUMBING INC ADDRESS 544 HASSINGER RD CITY/STATE/ZIP . . . : SAN JOSE, CA 95111 TELEPHONE . . . . . . . . : (408) 281-0583 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 40.79 0. 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 49 .79 0. 00 49 .79 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 49 .79 MC --------------- TOTAL RECEIPT 49 .79 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING CITY OF C.UPERTINO REPIPE/S N`E s�_ '�/MAN SERVICE CUPEkTiNO PERMIT APPLICATION FORM APN# �3 (o Q �, Date: C - a 1 - o �7 Building Address: Owner's Name: Phone#: -l T (� U ►CZ-y qoD q 3 3 -� 8(6 Contractor: Phone: License #: g 1 \ boy I ieAb�E ,� �0S 3fsi - 0S-63 Contact: Phone: Cupertino Business License #: R X108 5q3 00 Building Permit Info: Bldg ❑ Elect ❑ Job Description: CANCn T- Residential,j;�]- V vCommercial ❑ Cost of Project: v 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 RE; i e of Fixtures PLUMBING BPFIXTURE Pt,lg. Fixture PLUMBING BPWSVCS Main Water Service PLUMBING BPSEWER Sewers PLUMBING BPSEWAGE Sewage Disposal PLUMBING BUSLIC Business License BUILDING Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 -,UPEkTINO Building Department JOB ADDRESS: PERMIT # 3g95 LF, egg C 0-70 �d� rr OWNER'S NAME: I 1 )3v M QR -OAyA PHONE # q 3 - 86 -)l GENERAL CONTRACTOR: \ ' = FAX# I am not using any subcontract:— _ S , tore Date Please check applicable subcontractors and co m ►fete 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/Contraetor Signature Date