Loading...
06100164 7777777777777 CITY OF CUPERTINO BUIL13ING DIVISION &.0 TgtAGTClIZ URMATI��1. PERMIT BUILDING ADDRESS: PERMIT No.06100164 10554 ORANGE TREE LA OWNER'S NAME: PERMIT ISSUE DATE PRAGNA BIPINKUMAR 10/23/2006 )NE: SANITARY NO. CONTROL NO. BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB Iv1ECH O p LICENSED CONTRACTOR'S DECLARATION Job Description %W I hereby affirm that I am licensed under provisions of Chapter 9(commencing BZW with Section 7000)of Division 3ofthcBusiness and rofcssionsCode,and mylicense is REPLACING ALL UNDERFLOOR DUCTWORK t y in full force and effettO �, j�Z License las Lic.# t,w Date Contractor ARCHITECT'S DECLA ATION Cz U 1 understand my plans shall be used as public records .a O H Licensed Professional a y OWNER-BUILDER DECLARATION X 1 hereby affirm that I am exempt from the Contractors License Law for the p a following reason.(Section 7031.5,Business and Professions Code:Any city or county $2100 ouo which requires a permit to construct,alter,improve,demolish,or repair any structure Z y prior w its issuance,also requires the applicant for such permit to file a signed statement Valuation =G that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area r[— (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 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 21PA Mrfiber IJ IJ Occupancy Type not more than rive hundred dollars($500). 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 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.). 0 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 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: 0 1 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. 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 Workers Compensation Insurance carrier and Policy number are: Carrier. Polity 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 issued,1 shall not employ any person in any manner so as to become su►j@ct frrlbe W rs' ompcnsation Laws of California.Date Applicant ^� ^� NOTICE TO APPLICANT:If,aficr 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 0~ CONSTRUCTION LENDING AGENCY (^'i►�-+ I hereby affirm that there is a construction lending agency for the performance of a; the work for which this permit is issued(Sec.3097,Civ.C.) QLender's Name Lender's Address U 0 I certify that 1 have read this application and state that the above information is LL correct.1 agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against CA 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 SOULATIONS. i Re-roofs Signature of Applicant/Conuactor Date HAZARDOUS MATERIALS DISCLO URE 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)? ❑Yes All roofs shall be inspected prior to any roofing material being installed. �No , 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 materials for inspection. District? / ❑YesT7�Io I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Hcalth&Safcty Codc,Sections 25505.25533 and 25534.I understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements which must be met prior W issuance of a Certifies of Oc panty. Signature of Applicant Date ;V2% J t Owner or authorized agent All roof coverings to be Class"B"or better f Date w Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 ''UPEkTINO Building Department JOB ADDRESS: PERMIT# (055-4 OPS TD EE CjNr �6 / 6-C-( OWNER'S NAME: ckl ( PHONE # 2.(0 — I(o GENERAL CONTRACTOR: Eli CL FAX # I am not using any subcontractors: lUZi-r" O(o Signature Date Please check applicable subcontractors and complete the following information: 21 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 CUPERTINO 3m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 31634017 . 00 DATE ISSUED. . . . . . . : 10/23/2006 RECEIPT # . . . . . . . . . : 36535 REFERENCE ID # . . . : 06100164 SITE ADDRESS . . . . . : 10554 ORANGE TREE LA SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PRAGNA BIPINKUMAR ADDRESS . . . . . . . . . CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : ELITE HEATING & AIR CONTRACTOR . . . . . . . : LIC # COMPANY . . . . . . . . . . . ADDRESS . . . . . . . . . CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - - - - - - -- - - -- - ---- - ----- ---------- ---- ---- -- --- ------- ---------- ---- ------ BPERMFEE VALUATION 2 , 100 . 00 83 . 16 0 . 00 83 . 16 0 . 00 BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BSEISMICRE VALUATION 2 , 100 . 00 0 . 50 0 . 00 0 . 50 0 . 00 MPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00 MPERMFEE SQUARE FEET 1, 600 . 00 128 . 00 0 . 00 128 . 00 0 . 00 ----- ----- ---------- ---------- ---------- TOTAL PERMIT 389 . 89 0 . 00 389 . 89 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER - - - - - -- - - --- - -- -- -- - ------ --- --- - ----------- --- CHECK 389 . 89 131 TOTAL RECEIPT 389 . 89 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- 204 UNDERFLOOR FRAME 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL 514 FINAL PUBLIC WORKS V V1001 c �- 1 CITY OF CUPERTINO CITY of PERMIT APPLICATION FORM CUPEk INO APN# " -7 Date: tck:�! Building Address: nMailing Address (if different from building address): *1 oS' � V42 Owner'c Name- Phone #: pr-q 1� �r irk �kWl11,1y" - 10(i,tf Contractor: ''JJ ��� License #: 41 CQntaci: Phone:�C � 72.(,_ 101 Cupertino Business License#: ,�\ Fax: Building Permit Info: �4,6,tvt c,l\ Bldg ❑ Elect ❑ Plumb ❑ Mech Job Description: Residential X Commercial El Sq.Ft. Floor Area: , Sq.Ft.: Cost of Project: � • O Occupancy Group: ft)VA-C- Type V (O�on of Construction: 1 Please check this box if the project is a a l v1^_ second-story addition: ❑ Project Size: Standard Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 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 Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC 1000 Elec 600V <= l 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 of 3