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07060251CITY OF CUPEKY NU BUILDING DIVISION PERMIT r DING ADDRESS: 7938 CRANBERRY CL ER'S NAME: YOSHINAKA KIYOSHI NE: ARCHITECT/ENGINEER: ce Q LICENSED CONTRACTOR'S DECLARATION m 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 y in full force and effect. ? License Cla s L".N o Date Contractor ARHIT CECTS DECLARATI J a < I understand my plans shall be used as public records a.0 U. ti Licensed Professional a OWNER -BUILDER DECLARATION 3 < I hereby affirm that I am exempt from the Contractor's License Law for the ,no following reason. (Section 7031.5, Business and Professions Code: Any city or county e 0_ P which requires a permit to construct, alter, improve, demolish, or repair any structure " y prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 4 a=LZ (commencing with Section 7000) of Division 3 of the Business and Professions Code) 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 not more than five hundred dollars ($500). 0 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 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 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 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: L] 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. ] 1 have and will maintain Workers Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. wy Workers Compensation .Insurance carrier and Policy number are: Carrier. t�/ �I C / 0 Policy No.: CERTIFICATE OF EXEMPTION FROM WORKER COMPENSATION INSURANCE (This- action need not be completed if the permit is for ane 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 forthwith comply with such provisions or this permit shall be deemed revoked. 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.) Lender's Name Lenders Address 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 building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (Ws-) 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 in consequence of the granting of this permit. APPLIC UNDERSTAND WILLf OMPLY WITH ALL NON -PO NT 4 Signatur6 of AFrNit/c:ontractor - r �• HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino M;p al Code. Chapter 9.12, and the Health and Safety Code, Section 25532(a)? 0 Yes Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants defined by the Bay Area Air Quality Management District? 0 Yes u 1 have mad the hazardous materials requirements under Chapter 6.95 of the Califor nia Health & Safety C , Sections 25505, 25533 and 25534.1 understand that if the building does not cu7�tl a tenant, ,�yJ.�t a res n to fy the occupant of da rcauimmerV4'w y mrrdl be mClDr n7 iss CC a CrCrufjf Oecupan9y. / Owner or thorizcd a cqv v Date .,.. - PERMIT NO. CHASE ELECTRIC 07060251 PERMIT ISSUE DATE 35574 GARRONE PL 06/27/2007 SANITARY NO. CONTROL NO. (510)713-8661 BUILDING PERMIT INFO BLDG ELECT PLUMB Job Description UPGRADE ELECTRICAL SERIVCE TO 200 AMPS. sq. Ft. Floor Area $2100 valuation 3 6 2 0 3 015. � Number Occupancy Type Issued b; Re -roofs Type of Roof Required Inspections All roof: shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new inaterials for inspection. Signatur -, of Applicant All roof coverings to be Class "B" or better Date 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Bl -r,: Lot: APN 36:303015.00 DATE ISSUED.......: 06/27/2007 RECEIPT #.........: BS)00001824 REFERENCE ID # ...: 07)60251 SITE ADDRESS 7938 CRANBERRY CL SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OWNER ............: Y03HINAKA KIYOSHI ADDRESS ........... CITY/STATE/ZIP ...: OPERATOR: patg COPY # : 1 RECEIVED FROM ....: CRICKET HENNINGS CONTRACTOR .......: PAJL HENNINGS LIC # 23222 COMPANY ..........: CHASE ELECTRIC ADDRESS ..........: 35574 GARRONE PL CITY/STATE/ZIP ...: NENARK, CA 94560 TELEPHONE ........: (510)713-8661 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC ---------- NEW BAL ---------- ----------------------- BELEC200 METERS ---------- 1.00 ---------- 29.43 ---------- 0.00 29.43 0.00 BSEISMICRE VALUATION 2,100.00 0.50 0.00 0.50 0.00 EPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 ---------- 0.00 ---------- TOTAL PERMIT ---------- 68.30 ---------- 0.00 68.30 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 68.30 --------------- 68.30 VOICE ID DESCRIPTION -------- ---------------------------- 103 UFER 505 FINAL ELECTRICAL REFERENCE NUMBER -------------------- VISA VOICE ID DESCRIPTION -------- ---------------------------- 304 ROUGH ELECTRICAL Jun 27 07 11:32a CHASE ELECTRIC 925-417-6600 p.3 r O 7066 Cffy Of C UPERTINO CUPS T1N0 PERMIT AP*I•ICATION FORM 3.Of 55, 60 -- APN # .24 4 4., Datc_�% 0 --7 ' rM1,09 tddress (if ifferent fr cn building address)= sad Aad B:.rC n . me: r Phone #: K Qs ► nom Owner's Na . _ Contractor. Aa w V140 Ina. i..icense #�: Contact: - Phone: � Cupertino Business License#: C Cc k.ct Hem r�� r rt i S Fax: G1� `lI'1-1�Io00 7=37- Z�?r Building Permit Tnfo: (�J f � e1eGfl')CGt.Q_YYl;2 i� Z�%C► �►'�� Bld ❑ Electt�—1Plumb ❑ Mech 13 Job Descnp ' • -M a� d ei G� � 2leGfnc Se 1&- IV Comm ai U •- Sq.Ft. Floor AxM: Cost of Project_ Jj r1 Qo Type of Con chop: i5l eanCC� l/ Prosect Size: Standard O qSq.Ft.:�Pancyease check this box if the project is a cond-story addition - Fee Destri tion other &Ph "es ,0er <— 100 000 Btu x > 100K to 500K Btu ter > 500K to 1M Btu w > 1M to 1.75 M Btu 30ilc r > 1.75M Btu c�struction T`. idlO mm! ass on. Tax for B Zonc Hotel and Motel mstax — RcsWMobilr, Icc 600V <t-= 1000A Glec 600Y > 1000A w Svcs 600V L=- 200A Energy Energy Add Multi YnvMtivation fee 1 of 3 ELECTRICAL Jun 27 07 11,32a C'l1PER lNa CHASE ELECTRIC 925-417-6600 p.4 CITY OF CUPERTINO pF,RMI't' APPLICATION FORM Quantity Fee ID 1 Tee Desa tion _ Fee Grnu BR$MSIC'NAD i>1Lmd7 Signs _Add Branch _EI.EC'TRICAi, BREMSIGNS Rem add Si;M, Marquee —ELECTRICAL BREAMMATR i Theatrical Lighting Fix _ELECTRICAL ggEmyENF ; 'Vteit Fan Sin lc Dart ECHANICAi, BREMVENSYS VentDatioa MECIIANKCAL BSCBLVD Sp -b Specific Plan _ BUILDING BSEISMICOM i Seismic Cannnercial _ _ BUILDING BSEISMICRE lielsmic Fee Rcs _ BUILDING BSPECLkL S ' at on _ BUELDI.NG Dswim Sari Pool BI=ING BTEMP T or Power ELECTRICAL STSMPPERM T-empgrarBldit Permit _ BUII.DII�iG BTEWsVCS Tamp Dist Svcs _ELECTRICAL DUSLIC l3nsise ss Lieease --BUILDING ELECTRIC Ele ct ieal foal _ ELECTRICAL EPERMI'TME Elea Permit Isswhuce: F2Pc-TluGA- MPVRlvf FSE Iviechanical . foot -3MCHANICAL MpERMITFLE Mesh Permit Issuance MECHANICAL PPF.P-MITFEE- PlwTLb Permft ftsue _-PLUMBING PPLBG ! S®Mp Fee a foot PLUIVIBIIYG PI.r t?NGRNGCPl__-_- LLR Commel ilti-Fam I_ PY.ANN[NG ,pU.0NGRNGR pLainsln o Lam Ran Re sldenNak _ Pl ANI GNG 3 of 3 CITY OF 7UPERTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: PERMIT C7 Z S' r BUSINESS NAME OWNER'S NAME: j' civ PHONE # GENERAL CONTRACTOR: FAX # `(l 7 _ - r- /A" --"/ 6127 I am not using any subcontractors: /i�j Si e Date T7)1--..,..,L.-A, anA rmmnh-f-p the following information: /,-7 -� 161 1– — -, t� kel-- / ontractor Signature Da 60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing i% 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 /,-7 -� 161 1– — -, t� kel-- / ontractor Signature Da