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,