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07030099 CITY OF CUPERTINO BUILDING DfvISION PERMIT �N� ;� ItFRM�TIf�N:; PERMIT NO. BUILDING ADDRESS: 20074 WHEATON DR PLUMBERS ON CALL 07030099 OWNER'S NAME: PERMIT ISSUE DATE TODD & WHITNEY MCNAIR 520 MEGI,IACY LANE #12 400 7 SANITARY NO. CONTROL NO. TONE: (408) 871-,-9416 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 0 p p LICENSED CONTRACTOR'S DECLARATION Job Description %m I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z,� with Section 7000)of Division 3 of the Business and Professions Code,and my license is replace fresh water pipes to copper t"cy in full force and effect. { �2 / Z License Clas,4�(� Lam•v - ± Date. �`1- — Contractor ARCHITECTS DECLARATION 7 a< I understand my plans shall be used as public records )yU u. Licensed Professional H OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the ca following reason.(Section 7031.5,Business and Professions Code:Any city or county awhich requires a permit to construct,alter,improve,demolish,or repair any structure -Z y prior m its issuance,also requires the applicant for such permit to rile a signed statement „ Valuation _ that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 >q.Ft.Floor Area at- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $5735 y3. 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 A� Number Occupancy Type not more than five hundred dollars(5500). 31623085 V ❑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 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. ❑-1 am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: - ❑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. afhave 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 CompensaU lnwrance carrier and Policy number am: Cartier. �1Vf �v 'Qolicy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not he completed if the permit is for anc 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 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 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.) ALender's Name Z Lender's Address U Q 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 rJ J building construction,and hereby authorize representatives of this city to enter upon the U ahovc-mcntiuncd 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 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by Date 3-- SOURCE REGULATIONS. ,�. /*-,,Z*4- 3�1 i 7 Re-roofs Signature of Applicant/Contractor Dare T e of R oof r / 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)? t3�e All roofs shall be inspected prior to any roofing material being installed. C:]Yes 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 Area Air Quality Management all new n aterials for inspection. District? ❑Yes [3-lgo I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safcty Codc,Sections 25505,25533 and 25534.1 understand that if Ute building docs not currently have a tenant,that it is my responsibility to notify the occupant of the requirements which must be met prior to issuance of a Certificate of Occupancy. Signature of Applicant Date -t/1—,4 3//ylG� All roof coverings to be Class "B" or better Owner or authorized agent Date 44M Community Development 10300 Torre Avenue ? ;< Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 ,UPEKTINO Building Department JOB ADDRESS: PERMIT # 7 0 -3 0 :�;, OWNER'S NAME: f cG t / PHONE # GENERAL CONTRACTOR: /��. GYM S c,�r C'�!/ FAX # I am not using any subcontractors: 3V/ Si€;nature 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 CITY OF 2UPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: christya COPY # 3 Sec: Twp: Rng: Sub: Blk: Lot: APN 31623085 . 00 DATE ISSUED. . . . . . . : 03/14/2007 RECEIPT #. . . . . . . . . : BS000000686 REFERENCE ID # . . . : 07030099 SITE ADDRESS . . . . . : 20074 WHEATON DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUFERTINO IMPACT AREA . . . . . . OWNER TOED & WHITNEY MCNAIR ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUFERTINO CA, 95014-2340 RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR ROEIE DOBKINS LIC # 27158 COMPANY PLUMBERS ON CALL ADDRESS 52C MEGLIACY LANE #12 CITY/STATE/ZIP . . . : CAYPBELL, CA 95008 TELEPHONE (4C8) 879-9416 FEE ID UNIT QUANTITY TMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPREPIPE NO OF FIXTURE 9 .00 81. 00 0. 00 81. 00 0. 00 PPERMITFEE FLAT RATE 1. 00 38. 37 0. 00 38. 37 0. 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 119. 37 0. 00 119 .37 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 119 .37 14681 --------------- TOTAL RECEIPT 119 .37 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ------------------- 301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: christya COPY # 3 Sec: Twp: Rng: Sub: B1}:: Lot: APN . . . . . . . 31( 23085. 00 DATE ISSUED. . . . . . . : 03/ 14/2007 RECEIPT #. . . . . . . . . : BS000000686 REFERENCE ID # 07030099 SITE ADDRESS . . . . . : 20074 WHEATON DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : TOI>D & WHITNEY MCNAIR ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2340 RECEIVED FROM . . . . : REC'EIPT INTERFACE CONTRACTOR . . . . . . . : ROBIE DOBKINS LIC # 27158 COMPANY . . . . . . . . . . : PLUMBERS ON CALL ADDRESS . . . . . . . . . . : 520 MEGLIACY LANE #12 CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE . . . . . . . . : (408) 879-9416 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BPREPIPE NO OF FIXTURE 9 .00 81. 00 0 . 00 81. 00 0. 00 PPERMITFEE FLAT RATE 1. 00 38. 37 0. 00 38.37 0.00 ----------- ---------- ---------- ---------- TOTAL PERMIT 119 .37 0. 00 119. 37 0. 00 METHOD"OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 119 .37 14681 --------------- TOTAL RECEIPT 119 .37 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING CITY OF CUPERTINO REPIPE/S ` , /MAIN SERVICE ITY OF CUPEkTINO PERMIT APPLICATION FORM APN # Date: / G7 Building Address: Z Gt�1 7 C Owner's Name: Phone#: %-d c Contractor: Phone: License #: Contact: Phone: Cupertino Business License#: ,r,�, /, , ) C it s Building Permit Info: Bldg ❑ Elect ❑ Plumb Job Description: Residential Commercial ❑ Cost of Project: S Qty. if Applicable Fee ID Fee Description Fee.Group BPERMFEE Bldg. Permit Fees BUILDING BPGAS Gas Piping System Fee PLUMBING PPERMITFEE Plumbing Permit Issuance PLUMBING BPREPIPE Repipe of Fixtures PLUMBING BPFIXTURE P 31g. Fixture PLUMBING BPWSVCS Main Water Service PLUMBING BPSEWER S--wers PLUMBING BPSEWAGE Swage Disposal PLUMBING BUSLIC Business License BUILDING J I