The URL can be used to link to this page

07060254 CITE'OF CUPERTINO BUILD INGDIVISION PERMIT -� PERMIT NO. BUILDING ADDRESS: 19111 PRUNERIDGE AV PRESTON PIPELINES INC 07060254 PERMIT ISSUE DATE OWNER'S NAME: HEWLETT—PACKARD 133 BO'IHELO AVE 06/27/2007 SANITARY NO. CONTROL NO. VE: (408) 26 -1418 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLLD_G, ELS PLS MCECHH p LICENSED CONTRACTOR'S DECLARATION Job Description VP I hereby affirm that I am licensed under provisions of Chapter 9(commencing z U, with Section 7000)of Division 3 of the Business and Professions Code,and my license is INSTALL 1" TEMPORARY WATER SERVICE TO MODULAR yin full force and effect [�j 6 V License Lass Lam•# - HOME. p Da tc Contractor F ARCHITECTS DECLARATION i a e 1 understand my plans shall be used as public records .0. U.y Licensed Professional a OWNER-BUILDER DECLARATION 3< 1 hereby affirm that I am exempt from the Contractor's License Law for the a O following reason.(Section 7031.5,Business and Professions Cade:Any city or county which requires a permit to construct.alter,improve,demolish,or repair any structure -y prior w its issuance,also requires the applicant for such permit to file a signed statement Ft. Floor Area Valuation ?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 9 $35000 I-� (commencing with Section 7000)of Division 3 of the Business and Professions Code)or '3 r3., that he is exempt therefrom and the basis for the alleged exemption.Any violation of Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of A� not more than five hundred dollars($500). 3160704 V 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 Contractors 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.). 0 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractors Li- cense Law does 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. 0 I 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: tJ 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. 0 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 Workei s Com enation Ins nee ca je//ryyand Polity nJr are, Cartier. U'Policy No.. C RTIFICATE OF EXEMPTfON FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is foronc hundred dollars($1170) 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 Workcrs'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 E r co) 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.) W Q Lenders Name aLender's Address U O 1 certify that I have read this application and state that the above information is 0-1 correct.I agree to comply with all city and county ordinances and state laws relating to Q Ubuilding construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City oC Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City U z Ala e granting of thi rmit. Date �+ UNDER DS ILL CO P Y WITH ALL NON-POINT Issued by: IO �� Re-roofs nt/Con o DateT e Of F.00f HAZARDOUS MATERIALS DISCLOSURE yPteappicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety Cede.section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. 0Yes VN. If a roof:s 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? 0 Yes AN. I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Section 25505,2 3 and 25534.1 understand that if the building r does no emly have a tenan ata' sponth'ity to notify the occupant of the 11 Date requir nts which must prio c rificau: "cug3QC�'3 Signature of Applicant �r�/ All roof coverings to be Class"B or better ner or authorixcd agent Date CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN 31E07042 . 00 DATE ISSUED. . . . . . . : 06/27/2007 RECEIPT #. . . . . . . . . . BSC00001827 REFERENCE ID # . . . : 07C60254 SITE ADDRESS 19311 PRUNERIDGE AV SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER HEWLETT-PACKARD ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : RECEIVED FROM . . . . : PRESTON PIPELINES CONTRACTOR . . . . . . . : PRESTON, MICHAEL LIC # 10661 COMPANY . . . . . . . . . . : PRESTON PIPELINES INC ADDRESS . . . . . . . . . . : 13'� BOTHELO AVE CITY/STATE/ZIP . . . : MILPITAS, CA 95035 TELEPHONE . . . . . . . . : (4()8)262-1418 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 38.37 0. 00 38.37 0. 00 - ------ ---------- ---------- ---------- TOTAL PERMIT 47 .37 0. 00 47 .37 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 47 .37 #13296 --------------- TOTAL RECEIPT 47 .37 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ------------ 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 302 TUB & OR SHOWER 506 GAS TEST 507 FINAL PLUMBING CITY OF CUPER TING 0.70(o d� REPIPE/ Y,., ` - : /MAIN SERVICE CUPEkTINO PERMIT APPLICATION FORM APN # Q 0 Date:6- Building Address: Ower's N e: P one#: ontactL-ea: Pone: Cupertino Business iy onA- � y ense#: 2 - 1 Building Permit Info: Bldg ❑ Elect ❑ Plumb Job Description: �ns4n / -1- l ± 1� -P�2 P— home, Residential ❑ Corhmercial ❑ Cost of Project: Qty. if Applicable Fee ID Fee Description. Fee Group BPERMFEE Bldg. Permit Fees BUILDING BPGAS Geis Piping System Fee PLUMBING PPERMITFEE I'L mbing Permit Issuance PLUMBING BPREPIPE R(-pipe of Fixtures PLUMBING BPFIXTURE P14g. Fixture PLUMBING BPWSVCS . EqMain Water Service PLUMBING BPSEWER SE wers PLUMBING BPSEWAGE Sfwage Disposal PLUMBING BUSLIC Business License BUILDING Community Development 10300 Torre Avenue a Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 UPEIQTIN0 Building Department JOB ADDRESS: PERMIT# ICY// I AU\- ' l CQ)DR. 00 - OWNER'S NAME: PHONE # �4 2 - Wry GENERAL CONTRACTOR; A^ FAX # I am not using any subcontractors: -2-7-67vlz� Si;, ature Date Please check apphcable subcontractors and complete the following information: 60 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