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11050029 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11502 MURANO CIR CONTRACTOR:A-1 ELECTRICAL PERMIT NO: 11050029 CONTRACTING,INC OWNER'S NAME: PETER WU 1819 POLK ST STE 236 DATE ISSUED:05/04/2011 ER'S PHONE: 4083178870 SAN FRANCISCO,CA 94109 PHONE NO:(415)573-5522 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class G' 10 Lic.# rl 3-A-"I(o MECH f— RESIDENTIAL COMMERCIAL Contractor Date ��4/t l JOB DESCRIPTION:ADD NEW 40 AMP CIRCUIT FOR CHARGING DOCK I hereby affirm that I am licensed u r the ovisions of Chapter 9 STATION (commencing with Section 7000)of i i of the Business&Professions AT GARAGE LOCATION 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:$900 permit is issued. APPLICANT CERTIFICATION APN Number:36658041.00 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, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulat* er the Cupertino Municipal Code,Section 9.18. 4� lit /' Issued b Date: � l Signature ce✓tSl_� Date ( l L 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, Signature of Applicant: Date: Business&Professions Code) 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& Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this 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 i�t=� ol become subject to the Worker's Compensation provisions of the Labor Code,I must Date- 5/A i forthwith comply with such provisions or this permit shall be deemed revoked. C TION 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%ork'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 i• ' *mify 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 gi canting 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 I understand my plans shall be used as public records. 9.18. Signature Date Licensed Professional CITY OF CUPERTINO 5 ITEMS OF 15 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36658041.00 DATE ISSUED. . . . . . . : 05/04/2011 RECEIPT #. . . . . . . . . BS000013382 REFERENCE ID # . . . : 11050029 SITE ADDRESS . . . . . : 11502 MURANO CIR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER PETER WU ADDRESS 11502 MURANO CIR CITY/STATE/ZIP CUPERTINO, CA 95014 RECEIVED FROM ROBERT F WHITEAKER CONTRACTOR . . . . . . . : ROBERT WHITEAKER LIC # 32218 COMPANY A-1 ELECTRICAL CONTRACTING, IN ADDRESS 1819 POLK ST STE 236 CITY/STATE/ZIP SAN FRANCISCO, CA 94109 TELEPHONE (415) 573-5522 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ____ ---------- --------- 1BCBSC VALUATION 900 .00 1. 00 0. 00 1. 00 0 .00 1BREMPOWER POWER UNITS 1.00 158. 00 0. 00 158 . 00 0.00 1BSEISMICR VALUATION 900 .00 0 .50 0 . 00 0 .50 0. 00 1EPERMITFE FLAT RATE 1. 00 42 .00 0 .00 42 .00 0. 00 1TRAVDOC FLAT RATE 1.00 42. 00 0.00 -----4200 ------0_00 ---------- ---------- TOTAL PERMIT 243 .50 0. 00 243 .50 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- --------- CHECK 730.50 #1285 --------------- TOTAL RECEIPT 730 .50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- ----- 101 FOUNDATION 103 UFER 104 REBAR 105 ANCHOR BOLTS 304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY 505 FINAL ELECTRICAL 510 FINAL PLANNING GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 950143255 MISC (408)777-3228• FAX(408)777-3333•building(a?.cupertino.org CUPERTINO ❑PLUMBING ❑MECHANICAL ELECTRICAL ❑MISCELLANEOUS 1 PROJECT ADDRESS `\ )_ �f G- 1 � APN# v V \ OWNERNAIv1E , n PHONE E-MAIL CITY,STATE,ZIP a FAX l��` STREET ADDRESS ` ` i _� A/� ��C1►Y>C� k ME ` C�• l \ CONTACT NA �� 4e PHONE E-MAIL STREET ADDRESS v� CITY,STATE, ZIP F ❑ OWNER-BUILDER ,OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME V J LICENSE NUMBER ! LICENSE TYPE c BUS.LIC# C MPANY NAME E-MAIL �O FAX A\ . r� PxoNE ST TATS ET ADDRESS O CITY,S ARCHIT ECT/ENGINEER NAME 'v. \ /A �( LICENSE NUMBER BUS.LIC# COMPANYNAME f E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE 'SE OFSFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN s RUCCURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes 2-110 Y FLOOD ZONE ❑ Yes E?"go DESCRIPTION OF WORK t ` C�a TCS TOTAL VALUATION: 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 constructs . I authorize represenai=of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: C 1I Date: SUP-PtENENTAL r3FeTZATION REQUIRED _6 TLIL m - N1EPMiscApp_2011.doc revised 03116111 CITY OF CUPERTINO IFFEE ESTIMATOR-BUILDING DIVISION ITADDRESS: 11502 murano cir. DATE: 05/04/2011 REVIEWED BY: bobs. PN: BP#: 'VALUATION: $900 —� PERMIT TYPE: Electrical PerniKPLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY PENTAMATION 1 REAP8 USE: SFD or Duplex PERMIT TYPE: WORK add new 40 amp circuit for charging dock station at garage local SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Other Power Devices 1 BREMPOWER 1 # $158 TOTALS: $158.00 Elec.Plan Check0.0 hrs $0.00 Elec.Permit Fee: IEPERMIT Other Elec.Insp. 0.0 hrs $42.00 NOTE: These fees are based on the prelinWdnary in ormation available and are only an estimate. Contact the Dept for addn'1 info, FEE ITEMS (free Izesolution 09-051 F:ff. 1-"1O) FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 PME Unit Fee: $158.00 PME Permit Fee: $42.00 Work Without Permit? Yes E) No $0.00 Travel Documentation Fee: ITRA VDOC $42.00 Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bld�zyLStds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $243.50 $0.00 TOTAL FEE: $243.50 Revised: 04/29/2011 ld , fir Ci,CyvC3t'^�� -0rc 1 OE�E�OPMENT p 71 O ENS i CO gu1LD�NG DNISIONVE� L APPRO usT be ata A -t and specifications M I to make any et o Plans It is unla to deviate -�hls s uric g construction on same or iot;site the Building Official. ct_,a PBS or alteratiooval from Without app s ecifications SHALL NOT there�r a violation of this plan and P ,oval of th W. The sta Ping ermit or to be an aPP' or State be,'nsl to P of any City Ordinance of any Provisions sYj4ip JOBCopy DATE S �� EMAiN ON PERMI NO• THIS p►.�N SH URINC AT ALI_TI ES D THE JOB W\C,�Y, CONSTRUTION Ca (A\S) CA •� �1 c� Caw v�-c�� - "2 D t v C -C