The URL can be used to link to this page

11050207 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10311 GREENWOOD CT CONTRACTOR:GREENTECH ELECTRIC PERMIT NO: 11050207 OWNER'S NAME: CUPERTINO COMMUNITY SERVICES 12333 SARATOGA SUNNYVALE RD DATE ISSUED:05/25/2011 "-"NER'S PHONE: SARATOGA,CA 95070 PHONE NO:(408)280-1180 Lf LICENSED CONTRACTOR'S DECLARATIONr i BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# +a 49 ZS,,✓ d�/ MECH RESIDENTIAL COMMERCIAL Contractor Date �' I hereby r t t I a licensed under the provisions of Chapter 9 JOB DESCRIPTION:ELECTRICAL PANEL SERVICE CHANGE-100 AMPS AT (commencing with Section 7000)of Division 3 of the Business&Professions TWO SEPARATE PANELS 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. I 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 Sq.Ft Floor Area: Valuation:$1300 permit is issued. APPLICANT CERTIFICATION APN Number:36914025.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAY FROM T CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section ) > 9.18. �• ^�"� / :. Issued by: Date: Signature Date OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 0 or authorize Date: forthwith comply with such provisions or this permit shall be deemed revoked. i CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address and expenses which may accrue against said City in consequence of the 'ing of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: TraciC COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36914025.00 DATE ISSUED. . . . . . . : 05/25/2011 RECEIPT #. . . . . . . . . BS000013567 REFERENCE ID # . . . : 11050207 SITE ADDRESS . . . . . : 10311 GREENWOOD CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER CUPERTINO COMMUNITY SERVICES ADDRESS . . . . . . . . . . : 10114 VISTA DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : GREENTECH CONTRACTOR MANUEL CORTINAS LIC # 32286 COMPANY GREENTECH ELECTRIC ADDRESS 12333 SARATOGA SUNNYVALE RD CITY/STATE/ZIP . . . : SARATOGA, CA 95070 TELEPHONE . . . . . . . . : (408) 280-1180 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 1, 300 . 00 1 . 00 0 . 00 1. 00 0 . 00 1BSEISMICR VALUATION 1, 300 . 00 0 .50 0 . 00 0 . 50 0 . 00 1EPERMITFE FLAT RATE 1. 00 42 .00 0. 00 42 . 00 0 .00 1ERT<200 UNITS 2 . 00 84 . 00 0 . 00 84 . 00 0 .00 1TRAVDOC FLAT RATE 1. 00 42 . 00 0 . 00 42 . 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 169 .50 0 . 00 169. 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 169 .50 Visa 010124 --------------- TOTAL RECEIPT 169 .50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 103 UFER 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 950143255 \ (408)777-3228• FAX(408)777-333a •buit ingCaDcu ertino ora � � MISC CUPERTINO ❑PLUMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS APN# j1 OWNER NAME PHONE E-MAIL ii STREET ADDRESS I 1 / Crry,STATE,ZIP FAX CONTACT NAME / PHONE E-MAIL f �// Kea STREET ADDRESS CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME r LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME r E-MAIL FAX STREET ADDRESS CITY,STATE,ZIPCC 9 "I, , H. ll ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX LET'±R:FSS CITY,STATE,ZIP PHONE SE OF ❑ SFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes p No FLOOD ZONE ❑ Yes ❑ No DESCRIPTION OF WORK TOTAL VALUATION: klk '3 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. I 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 building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED '•" - MEPMiscApp 201 Ldoc revised 03116111 CITY OF CUPERTINO �\ FEE ESTIMATOR-BUILDING DIVISION its ADDRESS: 10321 greenwood court DATE: 05/25/2011 REVIEWED BY: larry s APN: BP#: '"VALUATION: 1$1,300 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY SFD or Duplex PENTAMATION 1 REAP2 USE: PERMIT TYPE: WORK electrical panel service change - 100 amps two se erate panels SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Services 1 ERT<200 100 Amps $42 Services 1 ERT<200 100 Amps $42 TOTALS: $84.00 Elec.Plan Check 0.0 hrs $0.00 Elec.Permit Fee: IEPERMIT Other Elec.Insp. OA hrs 1 $42.00 NOTE: Theseees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (1 ee Resolution 09-051 lff 77/1.-10) FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 PME Unit Fee: $84.00 PME Permit Fee: $42.00 Work Without Permit? Q Yes No $0.00 Travel Documentation Fee: 1TRA VDOC $42.00 Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $169.50 $0.00 TOTALFEE: $169.50 Revised: 04/29/2011 Building Department City Of Cupertino Lim I 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Z U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCON'T'RACTOR LIST JOB ADDRESS: r, PE MIT# OWNER'S NAME PI TONE# GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE- OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: _ Signature - Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical J Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date