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07060226 CITY OF CUPERTINO BUILDING DIVISION PERMITV. TPR Tf�lY PERMIT NO. BUILDING ADDRESS: 11085 CATALANO CT LOT 2 GREATEF- BAY CONSTRUCTION 07060226 PERMIT ISSUE DATE OWNER'S NAME: PANCAL CATALANO 4125 BI,ACKFORD AVE 06/26/2007 SANITARY NO. CONTROL NO. )NE: BUILDING PERMIT INFO ARCHITECT/ENGINEER: TEMP POWER POLE. P_W ELECT PLUMB MECH 0 0 0 i 00 LICENSED CONTRACTOR'S DECLARATION Job Description w P I hereby affirm that I am licensed under provisions of Chapter 9(commencing 2 Z UW with Section 7000)of Division 3 of the Business and Pr fcssions Code and qty license is t y in full force and effec j v�2 License CI s Lic.# g pate Contractor F A CHITECI'S DECLARA ION 2 d< I understand my plans shall he used as public records )yU 'u.� Licensed Professional a OWNER-BUILDER DECLARATION a1 hereby affirm that 1 am exempt from the Contractor's License Law for the y p o following reason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to concoct,alter,improve,demolish,or repair any structure prior to its issuance,also requires the applicant for such permit to file a signed statement $q.Ft.Floor Area Valuation -z< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 t=-C (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y 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 PN Number not more than five hundred dollars(5500). 0 I,as owner of the property,or my employees with wages as their sale compensation, will do die work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's 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 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's 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 Contractor's License Law. 0 1 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: J I have and will maintain a Certificate of Consent to self-insure for Worker's 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 37W of the Labor Code,for the performance of the work for which this permit is issued. My Worker' Com nsa Insurance mer and Policy� � number a:: CarrierG' Ydt14-kPolicy No.:(A `S�� CERTIFICATE OF EXEMPTION FROM WORKERS' 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,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 Worker's Compensation provisions of the Labor Code,you must ,J O forthwith comply with such provisions or this permit shall be deemed revoked. z" CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of > the work for which this permit is issued(Sec.3097,Civ.C.) Lia Q Lender's Name �Z Lender's Address I certify that I have read this application and state that the above information is U cared.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorim representatives of this city to enter upon the a above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date �+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b": SOURCE GULATIO . �l 40, e (a o 216*7 Re-roofs Signature of Applicant/Contractor Date Type of Roof MATERIALS DISCLOSURE yP 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,Section 25532(a)? All roof: shall be inspected prior to any roofing material being installed. 0Yes � 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 Arca Air Quality Management all new i naterials for inspection. District? 0 Yes A Y- I have read the hazardous materials requirements under Chapter6.95 of the Califor- nia Health&Safety Code,Sections 25505, 533 and 25534.1 understand that if the building docs not currently have a tenant.that it' my responsibility to notify die occupant of the require me hie issuance of aeenificateofOccupancy. Signatur'ofApplicant Date — — All roof coverings to be Class"B"or better Owner or authorized agent Date CITY OF CUPERTINO 2 ITEMS OF 67 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Bl}:: Lot: APN 36� 18066 .2 DATE ISSUED. . . . . . . : 0626/2007 RECEIPT #. . . . . . . . . : BS000001795 REFERENCE ID # . . . : 07060226 SITE ADDRESS . . . . . : 11085 CATALANO CT LOT 2 SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PANCAL CATALANO ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : RECEIVED FROM . . . . : GREATER BAY CONST. CONTRACTOR . . . . . . . : PETER CHUI LIC # 22292 COMPANY . . . . . . . . . . : GR]!ATER BAY CONSTRUCTION ADDRESS 4125 BLACKFORD AVE CITY/STATE/ZIP . . . : SAN JOSE, -CA 95117 TELEPHONE (408)248-6600 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- ---------- BTEMP FLAT RATE 1.00 62 .10 0. 00 62 .10 0. 00 EPERMITFEE FLAT RATE 1. 00 38 .37 0. 00 38.37 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 100.47 0. 00 100.47 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 103 UFER 304 ROUGH ELECTRICAL .-) Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 ''UPEkTINO Buildi:n Deartment JOB ADDRESS: PERMIT# C OWNER'S NAME: '°,p�. C° PHONE # GENERAL CONTRACTOR: GFAX# 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 V Electrical j 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 _ /,?- lc7 Ckv�er/Contra'c'tor Signature Date ' Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 C1TY Of Fax(408)777-3333 *TPERTINO Buildin De artment JOB ADDRESS: PERMIT# 1 OWNER'S NAME: ; �,` �. ( r�*jf jt,''1;1 PHONE # <'L GENERAL CONTRACTOR: C 1, 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 CITE'OF CUPERTINO BUILDING DIVISION PERMITS GTS IEQMAT�ON' PERMIT N0. ""'I' iff9"tATALANO CT LOT 4 GREATER BAY CONSTRUCTION 07030075 PERMIT ISSUE DATE OWNER'S NAME: AVE 06/27/2007 PANCE: CATALANO 4125 BLACKFORD SANITARY NO. CONTROL NO. NE: (408) 243-6600 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH p LICENSED CONTRACTOR'S DECLARATION JOU DOSCTIptlOn U i= I hereby arm that I am licensed under provisions of Chapter 9(commencing Zw with Section 7000)of Division 3 of the Business and Professions Code,and my license is S FDWL 2 -STORY3 4 7 0 ' GARAGE 4 9 0 ' affirm a a in full force and effect. j ? License CI ss Lic.# p Dat, Contractor 2 m RCH)TEC1 S DELLRATION j a a I understand my plans shall be used as public records JyU U.H Licensed Professional a OWNER-BUILDER DECLARATION <� I hereby affirm that 1 am exempt from the Contractors License Law for the p O following reason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure - prior tai its issuance,also requires the applicant for such permit to file a signed statement 3 .Ft. Floor Area Valuation -?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q $771489 F$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or I- 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 3 6 218 0 6 8 Number not more than five hundred dollars(5500). ❑1,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 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.). ❑1,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's u- 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 Contractor's License Law. ❑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: ❑1 have and will maintain a Certificate of Consent to self-insure for Worker's compen- sation provided for by Section 3700 of the Labor Code,for the performance of the wo or 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 Wort s Compe1pps_a. Insurance cTarticr and Policy number are: Cartier. f fin< 1 _ S Polity No> � �13 lb CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (ibis 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 Workers Compensation provisions of the Labor Code,you must ,'Z forthwith comply with such provisions or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY V) I hereby affirm that there is a construction lending agency for the performance of fYr> the work for which this permit is issued(Sec.3097,Civ.C.) (Zl A Lender's Name Lenders Address U 0 I certify that I have read this application and state that the above information is L> E- correct.I agree to comply with all city and county ordinances and state laws relating to U building construction,and hereby authorise representatives of this city to enter upon the W above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City U 2 in consequence of the granting of this permit. Date ►� APPLICA UNDERSTAN D WILL COMPLY WITH ALL NON-POINT Issued b". SOUR _ULA ONS. y._ Re-roofs Signal: of Applican ontractor Da T of Roof HAZARDOUS MATERIALS DISCLOSURE Type Will the applicant or future be occupant store or handle hazardous material as defined by the Cupertino Muni pal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roof! shall be inspected prior to any roofing material being installed. C]Yes No If a roof is 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 defined by the Bay Area Air Quality Management all new I naterials for inspection. District? ❑Yes Nu 1 have read the hazardous materials requirements under Chapter 6.95 offt Califor- nia Health&Safety Code,Sections 25505.25533 and 25534.1 understand that if the building does not currc Iy have a tenant, at it is my responsibility to notify the occupant of the 11 Date requiremen ich must be m p or to issuance of a Certificate of Occupancy. Signator of Applicant All roof coverings to be Class "B"or better Owner or authorized tgp6l Dat,