12060036 CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADURF.SS: 11497IANDYPI- CONTRACTOR:THE SOLAR COMPANY. PF.RMITNO: 12060036
INC
OWNER'S NAME: 'TONG PFT'ER AND LINDA 20861 WILBF.ANI AVE STE 1 DATE ISSIIED:06/06/2012
OWNER'S PHONE: 4082525257 GASTRO VALLEY.CA 94546 PHONE NO:(510)214-9005
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class ->' LicfHl S 4LGS
F r
_ MECH RESIDENTIAL COMMERCIAL r
Contractor / u l- DaterL-
1 hereby JOB DESCRIPTION: UPGRADE MAIN ELECTRICAL SERVICI`-PANEL TO 225
alih-in that I am licensed under the provisions ol-Chapler 9
(commencing with Section 7000)of Division 3 of the Business&Professions AMP
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the fallowing Mn declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,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 Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$800
Section 3700 of the labor Code,for the performance of the work for which this
permit is issued.
APN Number:35624006.00 Occupancy Type:
APPLICANT CERTIFICATION
I certify that I have read this application and slate that the above information is
correct. I agree to comply with all city and county ordinances and stale laws relating
to budding construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 1 g0 DAYS FROM LAST CALLED INSPECTION.
granting of this perntt. Addi)iunally,the applicant understands and will comply
with all non-point Ftmu ce re ulaliau per the Cupertino Municipal Code,Section `
9.I8: Issued by: 567,9 Date:
Date:
Signa(ura� •9
❑ OWNER-BUILDER DECLARATION RE-ROOF'S:
All roofs shall be inspected prior to any roaring material being installed-If a roof is
hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection.I agree to remove all new materials for
the following Iwo reasons: inspection.
1,as owner of the property,or nmy employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date:
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to
construct(he project(Sec.7044.Business&Professions Code). .ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1 hereby affirm under penally or perjury one of the following three
declarations: IIA7,ARDOUS M ATF.RLALS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Ileallh&Safety Code.Sections 25505.25533,and 25534. I will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Cade,Chapter 9.12 and the llealth&
I have and will maintain Worker's Compensation Insurance,as provided for by Safely Code.Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for(he performance of the work for which(his Additionally,should 1 use equipment or devices which emit hazardous air
permit is issued contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the
I certify that in the performance of date work for which this permit is issued,I shall Ileallh&Safely Code,Seclious 25505,25533,and 25534•
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,I Ownr euthori74t gent':
become subject to the Worker's Compensation provisions of the Labor Code,I must ✓ /I
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and stale that the above information is for which this permit is issued(Sec.3097,Civ C.)
correct. I agree to comply with all city and county ordinances and state law's relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's.Address
indeninil'y and keep harmless the City of Cupertino against I iabil ices,judgments,
costs,and expenses which mayaccrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCIIITF.CT'S DECLARATION
with all non-paint source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18_
Licensed Professional
Signature Date
CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35624006 . 00
DATE ISSUED. . . . . . . : 06/06/2012
RECEIPT #. . . . . . . . . : BS000017012
REFERENCE ID # . . . : 12060036 --
SITE ADDRESS . . . . . : 11497 LINDY PL
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : TONG PETER AND LINDA
ADDRESS . . . . . . . ... . : 11497 LINDY PL
CITY/STATE/ZIP CUPERTINO, CA 95014
RECEIVED FROM . . . . : WILLIAM DANENHOWER
CONTRACTOR . . . . . . . : MARK R. DANENHOWER LIC # 31418
COMPANY . . . . . . . . . . : THE SOLAR COMPANY, INC
ADDRESS . . . . . . . . . . : 20861 WILBEAM AVE STE 1
CITY/STATE/ZIP . . . : CASTRO VALLEY, CA 94546
TELEPHONE , . . . . . . . . : (510) 214-9005
FEE ID, UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
-ADMIN HOURS 1.00 41. 00 0.00 41 .00 0.00
1BCBSC VALUATION 800.00 1. 00 0 .00 1 .00 0 .00
1BSEISMICR VALUATION' 800.00 0.50 0 .00 0.50 0. 00
1EPERMITFE FLAT RATE 1.00 44 .00 0 . 00 44 . 00 0. 00
IERT2001K UNITS 1.00 65.00 0. 00 65 .00 0. 00
1TRAVDOC FLAT RATE 1.00 44.00 0. 00 44 .00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 195 . 50 0 . 00 195.50 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------
CREDIT CARD 195.50 VISA
---------------
TOTAL RECEIPT 195.50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
103 UFER 304 ROUGH ELECTRICAL
505 FINAL ELECTRICAL
F Community Development
_ 10300 Torre Avenue
j.• . Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
CUPEf�TINO
Building Ile artment
JOB ADDRESS: PERMIT#
OWNER'S NAME: . ' OIL; j'`7 ,; PHONE #
GENERAL CONTRACTOR:- FAX #
I am not using any subcontractors: _KIeUC
Signature Date
Please check applicable subcontractors and.com Tete the following information:
SUBCONTRAC'T'OR 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
�6-7
Owner/Contractor Signature Da e
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
01 ADDRESS: 11497 Lindy PI DATE: 06/06/2012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $800
*PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration /Addition / Repair
PRIMARY SFD or Duplex PENTAMATION 1REAP3
USE: PERMIT TYPE:
WORK Upqracle main electrical service panel to 225 amp.
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Services 1ERT2001K 225 Amps $65
TOTALS: $65.00
P/...,rb. /Yam Chis A Elec. Plan Check 0.0 1 hrs $0.00
Lha:!r, l'rnuir Fere /'Lund, Po F.,: Elec. Permit Fee: IEPERA4IT
Udmr Llrrh. Ln p. Other Phmrd Insp. Other Flee. Insp. 0.0 hrs $44.00
,lh(h, /tap, /4r' !'lamb. hop. Fr,'; lClrr. !n,/, li,..
NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District,etc. . These fees are based on the prelimina information available and are only an estimate Contact file Dept for addn7 info.
FEE ITEMS (l-cc Itc.sohnion 11-053 ED' Ul.�ll) FEE QTY/FEE MISC ITEMS
Phn'i 01,:(k I er:
.4rrppl_ P( (i',:
PME Plan Check: $0.00
I'cnnil l'�rr:
Sup/+l. lre p Fc,:
PME Unit Fee: $65.00
PME Permit Fee: $44.00
('mull lit non
Administrative Fee: IADMIN $41.00
Work Without Permit? O Yes 0 No $0.00
,I'll 111( o/Plaimili", I ces:
Travel Documentation Fee: ITRAVDOC $44.00
Sll"onP, Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
[31de,Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $195.50 $0.00 TOTAL FEE: $195.50
Revised: 05/01/2012
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GENERAL PERMIT APPLICATION M E P
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 M I
sc
CUPERTI NO (408)TT7-3228•FAX(408)TT7-3333•buildingGncuoertino.orD
PLUMBING MECHAMCAL ELECTRICAL MISCELLANEOUS
PROJECTADDRESS
OWNER NAME, PHONE
I
J/UG' /'�71t5T> JS • "z--
STREET ADDRESS CITY,SFA TE,ZP FAX
ily -7 . }Y ,,�`� -� Esc, /
CONTACT NAME ;;77 / PHONE E.�MAR.
C-.S-s'��-y'YB''S'X 75 S' �Al/E.�Z4//6�tir ���fc'ScYd+'CC f.Qv
STREET ADDRESS , CTTy,STATE, Z@ FAX
,2(i . L' .t,1 cdc AA C-,rS-A? - G:l ti'vs-�1L 7 -'S' '- 172C/y
❑OWNER ❑ OWNER-BUDDER ❑ OWNERAGENr 6CONJRAROR ❑CONTRACrORAGENT ❑ ARCHRECr ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CO CiOR NAME I LICENSE NUMBER LICENSE TYPE BUS.LIC R
r stc !I NnJVY G/c 5'
cD!.iPauY NAME E FAX
JEJ'ZW1EC1.C! d 7J-1E 5''a'74 i J,_6 �i/ 9r?L
STAFET ACfrYSj,ATEZIP PHONE
LoG5
sf475W
ARCHITEC(ENGINEER NAME LICENSE NUMBER BUS.uC R
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑SFD m DUPLiDr ❑ MULTI.FAMI.Y PROJECT INWI DLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑ YES
BURODJG: [3 COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME ❑NO
DESCRIPTION OF WORK
/(�CNr irLc 3 G� 4,4 J21 SEi ,icc f'liti%L. �•J to;l 1°il-A1k5-L-
TOTAL VALUATION: GDU RECEIVED BY:
By my signature below,I certify to tach o the o 'g: 1 anon'
m n' petty owner or authorized agent to act on the property,owner's behalf. I have read this
application and the information I hav ed cortect 1 have d he Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relatin 'n c 'on. I au odu represrntatives of Cupertino to enter the above. Sed pro ry for inspection puf�oscs.
gn Applicant/Agent:g ' / �• �.7 �
Si acute ofA IicandA rn[ iUi Date:
SUPPLEMENTAL INFORMATION REQUIRED t
OFFICE USE ONLY
OVER-THE-COUNTER
Y
F ❑ EXPRESS
u
❑ STANDARD
U
❑ LARGE
L ❑ MAJOR
1kEPMtscApp_201 Ldoc revised 06/21/11