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07050259
CITY OF CUPERTINO BUILDING DIVISION PERMIT +G�lR �G �? IQRMTI©N BUILDING ADDRESS: PERMIT NO. 7550 RAINBOW DR �Th�h�r�, �` �'C. 07050259 OWNER'S NAME: PERMIT ISSUE DATE WEINSTEIN MEYER AND RUTH 5/25/2007 qE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH i a p LICENSED CONTRACTOR'S DECLARATION Job Description W F I hereby affirm that I am licensed under provisions of Chapter 9(commencing ;y with Section 7000)of Division 3 of the Business and Professions Code,and my license is SERVICE UPGRADE 200 AMPS, ADD t a ain full force and effect. i ? Liconat:Class Lic.B a��3 11 CIRCUITS,MICROWAVE, SUB ZERO. t-p Date 07 Contractor ARCHITECTS DECLA TION i a a I understand my plans shall be used as public records UJ L) ' LL y Licensed Professional OWNER-BUILDER DECLARATION j- 1 hereby affirm that 1 am exempt from the Contractors License Law for the O following mason.(Section 7031.5,Business and Professions Code:Any city or county $9 which requires a permit to construct,alter,improve,demolish,or repair any structure Z} prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 )(l.Ft. Floor Area tx- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $3500 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($500). 36611042 .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 Required lied Ins eCtIO riS and Professions Code:The Contractors License Law does not apply to an owner of Q p 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.). ❑I,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 Contractors License Law. C]I am exempt under See. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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. ❑I 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. My Workers Compensation Insurance carrier and Policy number arc: Carrier. 5K�'e F K CA Policy No.: 1'71 -775 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ('this section need not be completed if the permit is for one hundred dollars(S 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 [ter I hereby affirm that there is a construction lending agency for the performanec of a the work for which this permit is issued(Sec.3097,Civ.C.) aQ Lendcr's Name a Z Lcnders Address U O 1 certify that 1 have read this application and state that the above information is LL, t-. correct.I agree to comply with all city and county ordinances and state laws relating to C U building construction,and hereby authorize representatives of this city to enter upon the W ahove-mentioned property for inspection purposes. LY (We)agree to save,indemnify and keep harmless the City of Cupertino against HrA liabilities,judgments,costs and expenses which may in any way accrue against said City !�^ U,Z in consequence of the granting of this permit. Lf7 APPLICANT UNDERSTAND AND WILL COMPLY WITH ALL NON-POINT Issued by; Date SOUR ULATI S Re-roofs Signature o pp rcanr/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof 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)7 All roofs ;hall be inspected prior to any roofing material being installed. ❑Yes Q.AIe Will the applicant or future building occupant use equipment or devices which If a roof i;installed without first obtaining an inspection,I agree to remove -mit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes jNo 1 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 does not currently have a tenant,that it is my responsibility to notify the occupant of the require mc which m rtoissuance ofacerifrcareorOccupancy. Signature of Applicant Date ---a-- All roof coverings to be Class"B"or better Owner or authorized agent Date" ` CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: BlR : Lot : APN . . . . . . . . : 36E11042 . 00 DATE ISSUED. . . . . . . : 05/25/2007 RECEIPT # . . . . . . . . . BSC00001471 REFERENCE ID # . . . 07C50259 SITE ADDRESS . . . . . : 75E0 RAINBOW DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER WEINSTEIN MEYER AND RUTH ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUF'ERTINO CA, 95014-5237 RECEIVED FROM . . . . : GERMAN ALEXANDER CONTRACTOR . . . . . . . : TBE, - TO BE DETERMINED LIC # 00096 COMPANY TBI, - TO BE DETERMINED ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY IMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---------- ---------- ---------- BELEC200 METERS 1.00 29.43 0 .00 29 .43 0.00 BUSLIC FLAT RATE 1.00 107 . 00 0 .00 107 . 00 0.00 EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 .00 38 .37 0. 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 174 . 80 0. 00 174 . 80 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 174 . 80 VISA-THOMAS ELECT --------------- TOTAL RECEIPT 174 . 80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 103 UFER 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL . ; CITY OF C'UPERTINO `CTYOF" PERMIT APPLICATION FORM CUPEkTINO LPN# Date: 36 , // e�2 `fes Building Address: Mailing Address (if different from building address): Owner's Name: Phone#: .) vf OBtJfi Contractor: License#: �10nlC6 jSLi Contact: /� Phone:(Ya`6) �6 S —0'6bt 3 Cupertino Business License#: I I� e0WV Fax: Building Permit Info: Bldg ❑ Elect FX] Flumb ❑ Mech ❑ Job Description: Se O ce-e ue� AaC 1 406 &r Residential fLin ,;cfow�� ofer� 5�� Ze-�a Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: I tl t a Cost of Project: Occupancy G oup: 4 3, sd 0 , a -� Type of Construction: E lei C( 0 50- vV�-Q- V?114Ae_ 3 Please check this box if the project is a i4Db C;f v 1 r S �!�� second-story addition: El -Aroject Size: Standard Large ❑ Maj)r ❑ Quantity Fee ID lee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiltr> 500K to 1M Btu MECHANICAL BBOILER4 Boiler > 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Core. Tax for BQ Zone BUILDING BCONSTAXH ]hotel and Motel BUILDING BCONSTAXR Cor stax—Resi/Mobile BUILDING BELEC1000 Elee 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 143 CITY OF C'UPERTINO CITY OF PERMIT APPLJ[CATION FORM CUPEkTiNO Quantity Fee ID 1?ee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME Ne:w Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME In:;pection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE E Idg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK flan Check Fee BUILDING BPLANCKADD Plai Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Rc i e Of Fixtures PLUMBING BPSEWAGE c ewa a Dis osal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Miin Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfrn MECHANICAL BREMAIRHAN A/C-Jnits<= 10,000 cfm MECHANICAL BREMAPPLI E�ppliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT bighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relc Furnace> l OK btu MECHANICAL BREMHEAT Beater Installation MECHANICAL BREMINHOOD Ing tallation of Hood MECHANICAL BREMMISC Vlisc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc t1, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Rerr.odel Res Appliance ELECTRICAL 2 A 3 f , ' CITY OF CrUPERTINO ClWof PERMIT APPL=ICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rindl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Veat Fan Single Duct MECHANICAL BREMVENSYS Wntilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING _ BSEISMICOM Seismic Commercial _ BUILDING _ BSEISMICRE �ieismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP T,Imporary 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 Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING I PLLONGRNGR Planning Long Range Residential PLANNING 3 of 3