The URL can be used to link to this page

13020103 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 908 ROSE BLOSSOM DR CONTRACTOR:SANFORD ELECT PERMIT NO: 13020103 OWNER'S NAME: SAHAI MAY AND,PRIMA TRUSTEE 20888 PROSPECT RD DATE ISSUED:02120/2013 OWNER'S PHONE: 4086664373 SAP ATOGA,CA 95070 PHONE NO:(408)996-9797 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL L1 COMMERCIAL License Class A,,-//) Li,.# A 43 3 06" UPGRADE(E)100AMP PANEL TO 200AMP,SAME —TT— LOCATION Contractor TR(A/d _ Date **SEE NOTES*** I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 o the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two 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. Sq.Ft Floor Area: Valuation:$1300 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:35906032.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FR ALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the y. Date• 2 7,C7 granting of this permit Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. r �y}q,., ,( RE-ROOFS: Signature -l tla4 i/c ,1,.0 Date 20—Z Oj j All roofs shall be inspected prior to any roofing material being installed.If a roof is T— installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION - Signature of Applicant: Date: I hereby affirm that I am exempt from the.Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(6)should 1 store or handle hazardous I have and wilt maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District 1 performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: D4s _ Date: permit is issued. 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 Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I - become subject to the Worker's Compensation provisions.of the Labor Code,I must I hereby affirm that there is a concoction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I 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 building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs',and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18:' Signature _, - Date GENERAL PERMIT APPLICATION �� M E P COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 O M ' �1 /� CUPERTFNO (408)777-3228• FAX(408)777-3333• building(cDcuoertino.org () V\■V Lj PLUMBING 03vIECRANICAL t29LECTPJCAL MISCELLANEOUS PROTECT ADDRESS ha? DRQI APN' 35-9 - 0� - 03 Z OWNERNAME A I PHO"74d E-MAIL /. /// STREETADDRESS ?,,r �0rF_ 1015 -S �D ITY, STATE,ZIP D 9�u�cA FAX CONTACT NAME ^r AN� PHONE t n ? �� E-MAIL STRE7:7ADDREIS q �(' T FJ CIiY,STATEI�ZIP- FAX 1-4 ❑OWNER ❑o0(WNER-BUIDER ❑ OWNERAGENT M CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHDECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAMEA/1O ^ /�e GCENSENUMBER / 33a� LICENSE TYPE BUS.LICR COMPANY NAME ,V / V (' E-MAIL FAX J STREET ADDRESS -2d,9P PRa�PXe R� CITY,STATE,ZIP n Q PHONE :W ARCHTTEC/ENGINEER NAME LICENSE NUMBER > BUS.LICX COMPANY NAMEE-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF mDUPLEX ❑ MULTI-FAMD.Y PROJECFTNWIDIAND ❑ YES PROJECT 19 E3 YES ISTEEBIDGAN ❑YES BUILDING: COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK RSG l TOTAL VALUATION: RECEIVED BY: By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. 1 have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bWying construe' n. I authorize representatives of Cupertino to enter the above-'dentified propef�y for inspection pu(poses. Signature ofApphcant/Agent Date: Z ZD SUVPLEMENTAL ME29MATION REQUIRED OFFICE USE ONLY OYER-TH&COUNTER ❑ EXPRESS Y U � ❑ STANDARD V ❑ LARGE r_ ❑ MAJOR 2 2� 13 MEPA4iscApp_2011.doc revised 06121111 MN 7- CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 908 ROSE BLOSSOM DR DATE: 02/20/2013 REVIEWED BY: MELISSA APN: 359 06 032 BP#: 'VALUATION: $1,300 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Du lex PENTAMATION 1REAP2 USE: p PERMIT TYPE: WORK UPGRADE E 100AMP PANEL TO 200AMP SAME LOCATION SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Services 1BELEC200 100 Amps $45 TOTALS: $45.00 s Z Mich.Plan Check Plumb.Plan Check Elec.Plan Check 0.0 hrs $0.00 NWeeh. Pennif Few 114mb. Permil Fee: Elec.Permit Fee: IEPERAHT Ocher A1eeh.lnrp.. Ocher Plumb Insp. LLJ Other Elec.Insp. 0.0 hrs $45.00 Mech.Insp. Fee: Plumb. Insp.Fee..' Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District etc). These ees are based on the rellmin information available and are on! an estimate. Contact the Dept for addn'l info. FEE ITEMS(Fee Resolution 11-053 Eff 711/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: 7-71 Suppl. PC Fee PME Plan Check: $0.00 Perrnit Fee: Suppl. Insp Fee PME Unit Fee: $45.00 PME Permit Fee: $45.00 Cons1ractitm Tis: Administrative Fee: IADMIN $42.00 Work Without Permit? 0 Yes 0 No $0.00 7-71 Advanced Planning Fees: Travel Documentation Fee: ITRA VDOC $45.00 Strong Motion Fee: - 1BSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $178.50 $0.00 _ NOTALFEEt; $178.50 `1 Revised: 01/01/2013 1V N