The URL can be used to link to this page

07090168 CITE'OF CUPERTINO � BUILDING DIVISION PERMIT PERMIT NO. BUILQ(NG�¢pRFss INBOW DR DOVE' S SERVICES INC 07090168 OWNER'S NA�Mj E: PERMIT ISSUE DATE MESZAROS ALEX S 1695 SAGEWOOD AVE 09/25/2007 tNE: SANITARY NO. CONTROL NO. (510) 376-6543 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH o Z LICENSED CONTRACTOR'S DECLARATION m 1 hereby arm that I am licensed under provisions of Chapter 9(commencing Job Description z Lu affirm Section 7000)of Division 3 of the Business d Professions Code,and my license is REPLACE 750, 000 BUT FURNACE y in full force and CL r Z License 1 s Lic.# _ F,tp Dam Contractor SeRvIf ARCHITECT S DECLARATION i a< I understand my plans shall be used as public records 1yU 'u.h Licensed Professional y OWNER-BUILDER DECLARATION j a 1 hereby affirm that 1 am exempt from the Contractor's License Law for the "00 following reason.(Section 7031.5,Business and ProfessionsCalc:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure z yy prior to its issuance,also requires the applicant for such permit to file a signed statement =o that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area $2200 Valuation e.t- (commencing with Section 7000)of Division 3 of the Business and Professions Codc)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 �p�Number Occupancy Type not more than five hundred dollars($500} 3 6611041 :tt l�` ❑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 fired Ins ections and Professions Code:The Contractor's License Law does 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 sal.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.7144,Business and Professions Code:)The Contractors Li- cense law does not apply to an owner of property who builds or improves tihereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law. ❑1 am exempt under Sea ,B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION - - I hereby affirm under penalty of perjury one of the following declarations: ❑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. I 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 Workers Compensation Insurance carrier and Policy n ber are: Carrier:s 541qfk PiLA6 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,1 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 Cafe,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. z"" CONSTRUCTION LENDING AGENCY E'"►�� 1 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.) QLender's Name z Lender's Address U 0 1 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 Ubuilding construction,and hereby authorize representatives of this city to enter upon the Uabove-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against E"1) liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. r-t APPLIC UNDERSTANDS WILL COMPLY WITH ALL NON-POINT Issued by: Date — ",� SOURREG CATIONS. l �l .=U '`�-- q '01) Re-roofs k Signature of Applicant/Contractor 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 Cole,Chapter 9.12,and the Health and Safety Cade,Section 25532(a)? All roofs:;hall be inspected prior to any roofing material being installed. ❑Ycs 6—N. 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 �J No 1 have read the ha72rltws materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.I understand that if the building docs t currently have a tenant, is my responsibility to notify the occupant of the reqs me hick must be met 'or to issuance of a Certificate of cupan Signature of Applicant Date I a v Owner or authorized agent o te All roof coverings to be Class"B"or better CIPTY OF CUPERTINO 0 9 FURNACE/AC CUCFTT OF kTINO PERMIT APPLICATION FORM ?N# � Date: 0 , �C�! / �f 11 o 0 Building Address: Owner's Name- Phone#: Plione: License#: C�`ontract . p -&C/ Contact: Phone: Cu ertino Business License #: Building Permit Info: Bldg ❑ Elect Plumb [ Mech Job Description: _ 4E. Ctre � OL� fZC iCl/�71c' urY� /G /� /o}z_ Residential Commercial ❑ For Residential Installations: Attic ❑ 1" floor ❑ 2nd floor❑ Adhere to min set back requirement❑ For Commercial Installations: ''_eplacement same weight ❑ Additional weight(strictural calcs)❑ ,tructural Calculations required for new installation El New installation Planning Approval Required ❑ Cost of Project: Type of nstruction: Occupancy group:up: Strapped ❑ On Platform ❑ Bonded Sq.Ft. Floor Area: New Location ❑ Replacement'Ei-- Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Furnace MECHANICAL BREMACOVER A/�Unit> 10,000 cfin MECHANICAL BREMAIRHAN A/�—Units <= 10, 000 cfin MECHANICAL BREMRECEPT Rt cptl, Switch & Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE El-,c Permit Issuance ELECTRICAL MPERMITFEE Mach Permit Issuance MECHANICAL PPERMITFEE Pbambing Permit Issue PLUMBING BPERMFEE Bl ig Permit Fees BUILDING BPLANCHK Pl,m Check Fee BUILDING BPGAS Gas Piping System Fee PLUMBING BUSLIC Business License BUILDING CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: B1}:: Lot: APN 36611041. 00 DATE ISSUED. . . . . . . : 09,'25/2007 RECEIPT #. . . . . . . . . : BS000002756 REFERENCE ID # . . . : 07090168 SITE ADDRESS . . . . . : 7558 RAINBOW DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MESZAROS ALEX S ADDRESS . . . . . . . . . . : 7558 RAINBOW DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5237 RECEIVED FROM . . . . : DOVE'S CONTRACTOR DONALD DOVE SR LIC # 27990 COMPANY DOVE'S SERVICES INC ADDRESS 16: 5 SAGEWOOD AVE CITY/STATE/ZIP . . . : SAN LEANDRO, CA 94579 TELEPHONE (510) 376-6543 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- ---------- BENERGY PERMIT FEE 1. 00 34 .86 0. 00 34 .86 0. 00 BREMFURN NO UNIT 1. 00 14 .31 0. 00 14 .31 0. 00 BSEISMICRE VALUATION 2, 200. 00 0.50 0. 00 0.50 0. 00 EPERMITFEE FLAT RATE 1. 00 40 .79 0. 00 40 .79 0. 00 MPERMITFEE FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00 PPERMITFEE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 172 .04 0. 00 172 . 04 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 172 . 04 #2090 --------------- TOTAL RECEIPT 172 . 04 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ----------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: B11:: Lot: APN 36( 11041. 00 DATE ISSUED. . . . . . . : 09/ 25/2007 RECEIPT #. . . . . . . . . : BS(100002756 REFERENCE ID # . . . : 07090168 SITE ADDRESS . . . . . : 75-,8 RAINBOW DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA OWNER ME:)ZAROS ALEX S ADDRESS 7558 RAINBOW DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5237 RECEIVED FROM D017E'S CONTRACTOR DONALD DOVE SR LIC # 27990 COMPANY DOITE'S SERVICES INC ADDRESS 16`_>5 SAGEWOOD AVE CITY/STATE/ZIP . . . : SAN LEANDRO, CA 94579 TELEPHONE (5:_0) 376-6543 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- --------- BENERGY PERMIT FEE 1. 00 34 . 86 0. 00 34 . 86 0. 00 BREMFURN NO UNIT 1. 00 14 .31 0. 00 14 .31 0. 00 BSEISMICRE VALUATION 2, 200. 00 0.50 0. 00 0.50 0. 00 EPERMITFEE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00 MPERMITFEE FLAT RATE 1. 00 40.79 0. 00 40 .79 0. 00 PPERMITFEE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 172 .04 0. 00 172 . 04 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 172 . 04 #2090 --------------- TOTAL RECEIPT 172 . 04 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ------------------------ 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 f.",M TINO Building Department JOB ADDRESS:/J PERMIT # c�l�h�tz� D,-"v`" 0 ? 0 OWNER'S NAME:/�/P n PHONE # GENERAL CONTRACTOR: ,Uo vt-s FAX I am not using any subcontractors: yc Z Signature Date Please check applicable subcontractors and com Clete 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