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07050262 CITE'OF CUPERTINO BUILDING DIVISION PERMIT = TJE A PERMIT NO. BUILD N DD ESS: �V50 TILSON AVE PAUL MURGATROYD 07050262 PERMIT ISSUE DATE OWNER'S NAME: PAUL MURGATROYD 18750 TILSON AVE 05/25/2007 SANITARY NO. CONTROL NO. NE: BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB METH 00 LICENSED CONTRACTOR'S DECLARATION Job Description v(= 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 SERVICE UPGR'3 DE 200 AMP PANEL. ? y in full force and effect. t z License Class Lic-# F p Date Contractor ARCHITECTS DECLARATION i a< 1 understand my plans shall be used as public records )yV 'u.F Licensed Professional OWNER-BUILDER DECLARATION } 1 hereby affirm that I am exempt from the Contractor's License Law for the .00 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 zy 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 ,rq.Ft.Floor Area r 8 O O f (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 7 ,e, 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 p Number Occupancy Type not more than five hundred dollars($500). 37517042 . �� 0 I,as owner of the property,or my employees with wages as their sale 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 docs 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 salc.)v I,as owner of the property,am exclusively contracting with licensed contractors to 2onstroct 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 conuactor(s)licensed pursuant to the contractor's License Law. ❑I am exempt ec B&P C for is re Owrta Date W S DECLARATION 1 hereby affirm un ERpenalty of77ryone of the following declarations: 0 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 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 are: Carrier. Policy No.: 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 ucd,t 1 not employ any person in y maancr so as o become sub*t to Laws of CalifoIV Applicant NOTICE LI ANT:lCaftcjoMing ftvierhificate of Exemption,you should become subject to the Worker's Compcnsatidirprovisions of the Labor Code,you must 0 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY rA 1 hereby affirm that there is a construction lending agency for the performance of Cl+r7 the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name Lender's ender's Address V C 1 certify that I have read this application and state that the above information is [1., correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. CL (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 �7 V Z in consequence of the granting of this permit. Date �. APPLICANT U ER STANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE AT IO e-roofs SignatureofAppli t/Contrae Da 'I' a Of Roof H OUS RIALS 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,Secty�532(a)7 ❑No All roofs ;hall be inspected prior to any roofing material being installed. �rf��es If a roof i.;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 dcftn by the Bay Area Air Quality Management all new materials for inspection. District? 0 Yes u 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Cade,Sections 25505,25533 and 25534.1 understand that if the building docs not currently errant, t it is my responsibility to notify the occuWofrequirements .. rtoissu ofSignature of Applicant Date , All roof coverings to be Class"B"or better Own r or authori-red gent Datc CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 37517042 . 00 DATE ISSUED. . . . . . . : 05/25/2007 RECEIPT #. . . . . . . . . BS000001477 REFERENCE ID # . . . : 07050262 SITE ADDRESS . . . . . : 18750 TILSON AVE SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER PAUL MURGATROYD ADDRESS 18750 TILSON AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : PAUL MURGATROYD CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY PAUL MURGATROYD ADDRESS 18750 TILSON AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : 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 800 .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 .30 205 --------------- TOTAL RECEIPT 68 .30 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 103 UFER 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL CITY OF C UPERTINO CITY Of PERMIT APPLICATION FORM CUPEI�TINO �9 70,5 CPN# ,3 �c J 1'f7 Date: Building Address: Mailing Address (if different from building address): Ower's Name: Phone#: PI+Uh Im URrho 0 �lc� g 3 /7 c Contractor: 0/a License#: Contact: Phone: Cupertino Business License#: OL.--YNO-r- Fax: Building Permit Info: Bldg ❑ Elect Plumb ❑ Mech ❑ Job Description: 260 Ptoer-- Residential Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Projec • �,/� Occupancy roup ?� , Type of Construction_ Please check this box if the project is a second-story addition. ❑ .-*roject Size: Standard ❑ Large ❑ Maj:)r ❑ Quantity Fee ID lee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILER1 Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boilcr> 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/Conu /Quasi BUILDING BCONSTAXBQ Cori. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Cor stax—Resi/Mobile BUILDING BELEC 1000 Elec 600V <= I OOOA ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 )f3 CITY OF C±UPERTINO CITY OF PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME N,;w Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Ga: Piping System Fee PLUMBING BPINTERCEP Inc.Waste Interceptor PLUMBING BPLANCHK .Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Rei i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT A]t of Drain &Vent PLUMBING BPWATER Inst2.11/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C' Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units<= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT bighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relc, Furnace> I OK btu MECHANICAL BREMHEAT H eater Installation MECHANICAL BREMINHOOD Installation 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 11, Switch & Outlets ELECTRICAL BREMRELOCA Rclocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Rerr ode] Res Appliance ELECTRICAL 2A3 CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmiil Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING _ BSEISMICOM Se smic 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 Meeh Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING 3 of 3 OWNER-BUILDER VERIFICATION 1. (Check one) I or my immediate family parent, spouse or child) will perform: A. the work authorized by this permit B. — A portion of the work C. — None of the work If B or C is checked, c:)mplete 2 or 3 below. 2. A state licensed contractor will be hirec to do: A. All of the work B. _ A portion of the we rk (complete section below) Contractor Address/City Phone # State License # Type of work to be performed 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or portions of the authorized work. I understanc.that I may be an employer (see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. Person/Firm Address/City Phone Number Type of work to be erformed ............................................................................. ..................................... I declare under penalty of perjury that the above is true and correct. I have read and understand the Owner-Builder Information (reverse 5i4e). I _ Property Owners Signature: % ,�'L" � !It Date: J / job Address: l 97 ��s�� Permit# Any changes to the information provided or this form shall be submitted to the City of Cupertino Build Department. Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 ''UPEkTINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: PHONE # - (?� GENERAL CONTRACTOR: Q FAX # I am not using any subcontractors: Signa Da e 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 Own /Con for tore Da