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07030229 CITY OF CUPERTINO T� TAT h BUILDINGVIVISION' PERMIT e� 4g� yi� �Y �I� • PERMIT NO. BUILD�N1C�agDRELMSFORD DR DON WADE ELECTRIC CO 07030229 l �$UU - PERMIT ISSUE DATE OWNER'S NAME: CHRISTIAN PAQUET 16320 HARWOOD RD 03/23/2007 SANITARY NO. CONTROL NO. 'NE: (408) 377-2323 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 p p LICENSED CONTRACTOR'S DECLARATION Job Description !hereby affirm that I am licensed under provisions of Chapter 9(commencing :vzit with Section 7000)of Division 3 of the Business and Professions Code,and my license is UPGRADE EXISTING ELECTRICAL PANEL TO 200 AMP S y in full force and effect. r�? License Class Lic.A p Date Contractor ARCHITECTS DECLARATION i aa a I understand my plans shall he used as public records )yU U.I- Licensed Professional O a OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors License Law for the 00 following reason.(Section 7031.5,Business and Professions Cade:Any city or county Q. 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 statementSq•Ft.Floor Area Valuation -z a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 $2100 r t=- (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 Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 36209007 AN� not more than five hundred dollars(5500). 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 Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself orthrough 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.). owner of the property,am exclusively contracting with licensed contractors to co tract 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'sLicense Law. C]1 am exem u d e - B&P C for this reason Owner OMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: satioI have and will maintain a Certificate of Consent to self-insure for Workers Compen- n,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 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 Worker's Compensation insurance carrier and Policy number arc: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is forone hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued.I shall not employ anype n any r su as to become subject to the Workers'Compensation Laws a(Califom ApplicantZi NOTICE TO A A If,after making this Certificate of cmption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must O forthwith comply with such provisions or this permit shall be deemed revoked. Z" CONSTRUCTION LENDING AGENCY [�rn I hereby affirm that there is a construction lending agency for the performance of p4 the work for which this permit is issued(See.3097,Civ.C.) W A Lender's Name am rz Lender's Address O I 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 rJ J building construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. Q. (We)agree to save,indemnity 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 ty: SOU RE LATIONS. 0 6 Re-roof; ' S' o tcant/Contractor Da Type of Roof HAZARDOUS 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 roofs shall be inspected prior to any roofing material being installed. ❑Yes If a roo�'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 as defined by the Bay Area Air Quality Management all new materials for inspection. Disulet7 0Yes J?No I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505.25533 and 25534.1 understand that if the building docs t urrentiy have a tenant,that it is my responsibility to notify the occupant of the Date require 4whicmust be met prior to issuance ofa Certificate ofOccupancy. Signatu-e of Applicant All roof coverings to be Class"B"or better Ownc autagent Da CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blc: Lot: APN 36209007. 00 DATE ISSUED. . . . . . . : 03/23/2007 RECEIPT #. . . . . . . . . BSD00000770 REFERENCE ID # . . . : 07D30229 SITE ADDRESS 1180 ELMSFORD DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER CHRISTIAN PAQUET ADDRESS CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4950 RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR WADE, DON LIC # 18388 COMPANY DCN WADE ELECTRIC CO ADDRESS 16320 HARWOOD RD CITY/STATE/ZIP . . . : LCS GATOS, CA 95032 TELEPHONE (408) 377-2323 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 AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 68.30 2287 --------------- TOTAL RECEIPT 68.30 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- ------ --------------- 103 UFER 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL n CITY OF C'UPERTINO cinof' PERMIT APPL [CATION FORM _ CUPEkTINO �03e APN# Date: O 3 e�,qelf `7 Building Address: , Mailing Address (if different from building address): L E I �o C. :: e r 1 r1 �. 9 S U "(-r Owner's Name- Phone#: C. hri Stan uc 4 fr o 8 253 Zr Contractor: ��� W a ci O S, Contact: Phone: 4c,8 3 77.232.3 Cupertino Business License#: Fax: Building Permit Info: Bldg ❑ Elect ® Plumb ❑ Mech ❑ Job Description: e e ' a r Residential W �1 Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: po OccupancxGrou— LC Type of Construction: Please check this box if the project is a second-story addition: El jeroject Size: Standard ® Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Bc filer<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 1 OOK to 500K Btu MECHANICAL BBOILER3 Boi,er> 500K to 1M Btu MECHANICAL BBOILER4 Boil,-,r> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ir.d/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Etec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL / BELEC200 Ele: Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 CITY OF CUPERTINO CITY OF PERMIT APPL[CATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rm,11 Signs Add Branch ELECTRICAL BREMSIGNS Rerr odel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD .icb Specific Plan BUILDING BSEISMICOM _Seismic Commercial BUILDING _ BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Pl zmbing Fee sq foot PLUMBING PLLONGRNGC Plannin LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Change BUILDING 3 of 3 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITI(OF Fax(408)777-3333 "UPEkTINO Buil4pg De =artment JOB ADDRESS: d r I M z fc;A D r PT# (Z 0 PCV- t% L I ci 5C, OWNER NAME: C PHONE # S 3 l 7 GENERAL CONTRACTOR: Vv FAX # I am not using any subcontractors: - C=-' ,2ac' 2 Si afore Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSI14ESS 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 - _ 1Z 23F 1,26(-j er/Contractor Signature Date