08100207 CTfYOFCUPERTINO ay �'�
BUILDING DIVISION PERMITCO�NTRAGTORIATI< nATION
BUILDING ADDRESS:_ PERMIT NO.
6658 CLIFFORD THE SHED SHOP INC
OWNER'S NAME: PERMIT ISSUE DATE
p SA CONTROL NO.
ARCHr1ECf/ENGINEER:
BUILDING PERMIT INFO
BUILD 8X5 (120 SQ FT) O O PLUMB O
'x'oo LICENSED CONTRACIOWSDECLARATION STORAGE SHED W/ ELEC
rJ 1 hoeby affirm Out.I me licensed under provisions of Chapter 9(commenting r�lli�seription
e==h{ with Section 70C10)ofDivd.on 7 of dc Business and professions C .W my lkenmu '^•"""' '"' "�"""""
n=m in full forte am t.
pz LmmmCl Gyle
- wan l0 1 Cr
e ARCHnELTSDECDECLARATION
y << I unde=ad my plans andl he used u public RcoNs '
3yU
�at; Licensed PmfcNanal
OWNEon exempt
DECLARATION -
ggqy I moo .Ran that 11. exempt from um Cunians Co license Law o far tie
L
no following Rnsmn.(Section]fD 1.5,Business and Professions h.or Any oily m county
3$ which in issu a panni,recons the der,iffnt rmw.dcmoliN,fie a sig any cornu u n
z r prior b its issuance.pursuant
roquiRe the applicant the Con permit b file a Law mammem
££ G dwheineittnmdPmction7 )ofDimdo.3NeConua.suniceNetawsCo,c)r9 Sq.F[. Floor Area Valuation
Y�B tammenc uxuriNSerefrom and
Divisionr of ma al Busimuaudon,AnsioNCade)ser
— Nat IR u exempt therefrom and Ne baso for res alleged eumpti..Any violation of
Section 7071.5 by any applicators for a permit subjects the applicant b a civil penalty of APN Number Occupancy Type
not.ort than ftw hundred dollars(&500}
❑I.uawrcr of th<pmpvty,wmy eraPloyw wins wagauUe"tr role compensation,
MB do Newark,Cd :TheCratemtimm�dedorawda m not CSee.7014,Bmar Of
and ery,who W Cade:mpe Cosmara Y and
ocu does not apply b rd m.gh is Requited Inspections
property,who n.proIX ed thatex ob imp,Ltd wlb ar exlnellwart hlnlmff W Irk r sale his
somm.lthe Wilding
Numch imprmemmu am mot ear ore mplenoroffoe.for ale.If
however.the arm the wimprowmmt amu within arc year of i m row fur the owmu-
builder will love tiro burden of proving that k did set build a improv(or purpose of
1,as amort of Ne property,am exclusively contracting with SoNm.nuctws to
caNlNel the project see.7W.Business old Professions Godes)The Gan4mb/a U.
RnY Law does not apply b in Owner of property who Wilds or improve,NtRon.and
who mnvuts for such projects wins.colt acmr(s)recnsed pursuant to the Contractors
License law.
❑I un crosept under Sec ,B B PC for thin rtums
Owner Data
WORKERS COMPENSATION DECGRATION
I thereby dorm timer pealty of perjury one of tsar following restorations:
I haw oro will maintain a Certifienc or Consent m self-insert far Workers Comperl-
don,as providm for by Section 3700 of the IAbor Code,for the performance of t e
were fee which this permit is wood.
❑I haw am will maintain Workers Compensation Insurance.u required by Scctbn
7700 cruse Labour Code.fa the peRortnaree cruse weak for which this permit is ints". '
My Wory1er�s vCory}pe on has; m and Policy number art:
Cartier. v� `l \ Policy No.: a'3032
RTIFIGTE OF EKEMP ION FROM WORKERS
COMPENSATION INSURANCE
CTh6meaan need mals:completed if the pemitis(want hundred dawn(LIOU)
or leu)
1 certify out in the Performance of the work for which this Permit Is issued.I shill not
employ any person in my manmrm u m become subject to use:Workm'Compensauon
Laws of C.1iform..Data
Applicant
NOTICE TO APPLICANT:If.&flet making this Cenffiau of Eumptiun.you should
become subject to the Workers Compensation provisions of the Labor Code you am
.J O farNwith comply with such provisions or Nu permit mail be domed revoked.
z'--' CONMUCT10N LENDING AGENCY
[-..N. I hemby d0.thu frt use summed.lending a ffne,for the performance of
Ri r>-, the wort for which Nu Permit a issued(See.3097,Civ.C.)
0 Lenders Name
.7 z Lenders Address
V O t certify that 1 have Rad this applicmim and arm dor tie show information i,
comma 1 agree b comply with all city and county ordinances and sum laws misting to
.O building couumtion.am hereby authorize representatives of this city to inter upon re
0. ahow-menuonm property for inspection purpuet.
(We)agree to saw.indemnify and keep harmless the City of Cupertino against
vF,l rA
liabilities.Judgments.cots and eapeNes which may in any wry sol.against said City
fJ z in con wore Ne LranIt Nis permit.
APP ANT DERSTAND ANO WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU E TIO
L'7( 0Re-roofs /
Si curt afA antrComrsctor Dau
IIAZAADOUS MATERIALS tmon,oDISCLOSURE Type of Roof
Will tiro applicant.(otitic bullring e.Chapter 9.1wandl Health and Safety a dcfi�by tate Cupenim M mctpal Code.Chapter 9.17,am Ne Health end Suety
Code.seed.sss77(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yo a
Will the applicant.forum Willing owupam um cyuipmmt or skvices which If a roof is installed without first obtaining an inspection,I agree to remove
it IO7,ml a air contaminants as Jefimul by the Bay Am,Air Quality Management all new materials for inspection.
mrictT
❑Yns Nu
I hmm and baud bmwimmew.derChgmr6.95ufumCalifw-
nuHa kga@ty 'w25505.25577 anu35534.1 umursmm th.if the building
duet t urrtnJy .mNn4 Nu it u my responsibility m maty Ne occupant of We
Ryes' en.w 'h Nt iana.eaf.Certificate afOc: / Signature of Applicant Date
mer or anNamc s., I Onto- All roof coverings to be Class'%?."or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36924054 . 00
DATE ISSUED. . . . . . . : 10/31/2008
RECEIPT # . . . . . . . . . : BS000006519
REFERENCE ID # . . . : 08100207
SITE ADDRESS . . . . . : , 6658 CLIFFORD CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . . MARK MUEGGE
ADDRESS . . . . . . . . . . : 6658 CLIFFORD CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2347
RECEIVED FROM . . . . : THE SHED SHOP
CONTRACTOR . . . . . . . : PAUL JOHNSTON LIC # 24190
COMPANY . . . . . . . . . . : THE SHED SHOP INC
ADDRESS . . . . . . . . . . : 37341 BLACOW RD
CITY/STATE/ZIP . . . : FREMONT, CA 94536
TELEPHONE . . . . . . . . : (510) 623-9100
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------- ---------- ------- ---
1BREMRECEP NO. OUTLETS 1 . 00 40 . 79 0 . 00 40 . 79 0 .00
1BSEISMICR VALUATION 600 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40 .79 0 . 00 40 . 79 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 .79 0 . 00 40 . 79 0 . 00
---------- ---- ---- ----------
TOTAL PERMIT 122 . 87 0 . 00 122 . 87 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 122 . 87 master card
---------------
TOTAL RECEIPT 122 . 87
•
3 rl.NS� '� -rr�Far `Sta'
ems, .
Y•� � fi '+ �� : . 1. 1 x.s4Ly ti� wd '�'t'a w:"5..�. t P. e" V � .
Assessor's Parcel N�umgber3 U ?,2—
Name of owner. 10. ` VV 41e-
W4
1 - L
Project address.
Contactperson. �f' ��� � �� Phone. oto` i�11"x`133
Fax.
Net square footage of lot.��,
Existing Proposed
Square footage: First floor:
Second floor:
Garage: \
TOTAL:
�e there at least two 10 foot by 20 foot clear spaces inside the garage? N
Is privacy protection planting required for the project?-----X-------1T
On what floor(s) is work being done? t--� A,
Brief description of work. , 79� '�` rcuif ruh ` Zo s sk i S��i ,
Code editions:2008 CBC (Y-N)2008;CFC,=L,(Y -N)2008 CMC (1-N)
2008 CPC „(YC��2008 IN.EQH .. y
0PERTINO CODES AND ORXI-1.+CES
Effective 1/1/08 tATE_�G_
31GNEU_
This set ct v ations MUS
be kept on L i nd it is un
lawful to m,' i alteration
on same M01 m ssion iron
the building 1,4 .. tmo.
The stamping ci I. f^cdication o
SHALL NOT be he v , ii,; ;r to be a,
approval of the violalicn ct any provismr
• it any City Ordinance at Stata i qw
Cry
s
Plan Review Process Work Book Page-8-Revised 1/I/08
Q CITY OF CUPERTINO
• CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
t
APN# Dae:
iq 0 31 �
Building Address:
w5s
Mailing Address (if different from building address):
Ow ne 's Name: Pho
4ek a#:
Contractor: Phone:
_T�Q. �QJi <:EAAo Fax: 510 . 1`�Z. ld51C
Contractor License#: $lel WELf
Cupertino Business License#:
Contact:. Phone: 510.1`11 .'I }33
Fax: 510.-1.4z.N�to
• Residentia Commercial ❑
Job Description:
�7:0
Building Permit Info:
Bldg ❑ Elect Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type: 1
I-A, 1-B [_111/111/V-A E] II/III B, IV-HT, -B V- � 1""L"�11�b'��bl�
Valuation: Square Footage:
Project Size: Ex ress Standard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it
to the application or if applicable, include in plan set& the sheet index.
Points Achieved:
For help,contact Build it Green at www.builditgreen.oLrg
• Revised 10/20/08