The URL can be used to link to this page

11030029I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10424 ALICIA CT I CONTRACTOR: ZALUNARDO ELECTRIC I PERMIT NO: 11030029 I OVJNER'S NAME: ADAMS TERRY G AND NANCY S 15680 COTTAGE AVE I DATE ISSUED: 03/07/2011 ER'S PHONE: 4089311012 I MANTECA, CA 95336 I PHONE NO: (209) 823 -2525 I LICENSED CONTRACTOR'S DECLARATION _icense Class c -10 // Lic. # IM OQ�1__ contractor U✓I cIVO1[) 1 J11&11 -CY ate 5-- I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of 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. 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 permit is issued. 0�__ APPLICANT CERTIFICATION I certify that I have read this application and state that the above infonmation 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point so cc reg tions per the Cupertino Municipal Code, Section 9.18. Signature ° Date LJ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 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 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 forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 nr:ify and keep harmless the City of Cupertino against liabilities, judgments, and expenses which may accrue against said City in consequence of the g...Jag of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. BUILDING PERMIT INFO: BLDG r- ELECT r- PLUMB I- MECH I— RESIDENTIAL r COMMERCIAL T_ JOB DESCRIPTION: INSTALL 2 NEW UNDERGROUND ELECTRICAL SERVICE PANELS FOR NEW DETACHED SECONDARY UNIT Sq. Ft Floor Area: I Valuation: $3000 APN Number: 34245026.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date:,T'� RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Own! ed agent: o 7_ Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date I Licensed Professional 1i CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 34245026.00 DATE ISSUED.......: 03/07/2011 RECEIPT #.••.•••.•: 13S000012841 REFERENCE ID # ...: 11030029 SITE ADDRESS .....: 10424 ALICIA CT SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OPERATOR: patg COPY # : 1 OWNER ADAMS TERRY G AND NANCY S ADDRESS . 10424 ALICIA CT CITY /STATE /ZIP CUPERTINO, CA 95014 -2634 RECEIVED FROM CONTRACTOR ... COMPANY ...... ADDRESS ...... CITY /STATE /ZIP TELEPHONE .... CHRIS ZALNUARDO CHRIS ZALUNARDO LIC # 30229 ZALUNARDO ELECTRIC INC 15680 COTTAGE AVE MANTECA, CA 95336 (209) 823 -2525 QUANTITY AMOUNT PD -TO -DT THIS REC NEW BA -- - FEE ID UNIT ---- - - - - -- - - - - - -- ---------- ------- - - - - -- 1BCBSC VALUATION ------ -- -------- 3,000.00 ---- 1.00 0.00 0.00 1.00 0.50 0• 0.00 1BSEISMICR VALUATION 3,000.00 0.50 42.00 0.00 42.00 0.00 1EPERMITFE FLAT RATE 1.00 2.00 84.00 0.00 84.00 0.00 1ERT <200 UNITS 1.00 42.00 0.00 42.00 0.00 1TRAVDOC FLAT RATE 169.50 0.00 169.50 0.00 TOTAL PERMIT METHOD OF PAYMENT AMOUNT REFERENCE -- NUMBER _ --------------- CREDIT CARD --------------- 169.50 VISA TOTAL RECEIPT 169.50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -- - - - - -- ------------------- --------- - --------------------------- 304 ROUGH ELECTRICAL 103 LIFER 505 FINAL ELECTRICAL RECEIVED BY: ' TOTAL VALUATION: owner's behalf. I have read his local owner or authorized agent to act on the property I with all app purposes* I am the property it is accurate. I agree to comply inspection to each of the following: tion of Work and verify for BY my signature below, I certify r ided is ect. I have read the Deentat I I application and the information I to b p . g , tru n• I authorize representatives of Cupertino to enter the above - identified property pp Date: ordinances and state laws relating Qx SE� ate! Signature of Applicant/Agent: ATION REQUIRED mFNTAL INFO gv> R TaM_ [� LARGE a ❑ MAJOR MEPMiscApp_201 I -doc revised 03102111 MEP APPLICATION GENERAL PERMIT olvlsloN DEVELOPMENT DEPARTMENT g5014 misc COMMUNITY -3255 • CUPERTIN , 10300 TORRE AVENUE h��ll�lnQ��uoertino.or 777 -3333 (408) 777 -3228 • FAX (408) CUPERTIt40 ELECTRICAL ❑MISCELLANEOUS MECHANICAL PLUMBING APN # / u G PROJECT ADDRESS I C i GI G f iFr ( E -MAIL PHONE (�OC/_ '' I I 11 Q FAX OWNERNAME T�Y C]TY STATE, ZIP V , 0 I , f 0 STREET ADDRESS 0 q2 L'� G PHONE D (/� J 0 E- Mp1LZ2I� C LQ APPLICANT NAME ZC,IVga��a ZIP C F C 5 J^ CITY, STATE, Min t� � TENANT STREET ADDRESS r / 0 /' Ve ❑ ENGINEER ❑ DEVELOPER (� V C� ❑ ARCHITECT ` ^ CONTRACTOR ❑ CONTRACTOR AGENT BUS. LIC # 2 Q a / ol ❑OWNER AGENT LICENSE TYPE L' ..' /� J er ❑ OWNER ❑ OWNER - BUILDER LICENSE NUMBER CONTRACTOR NAME '7 _ 0 E -MAIL l a—( Vl L � FAX, Q �y . L� J �' C Cl 1 L- h C COMPANY NAME rj ��'v� �O , CITY, STATE, ZIP' /I C �"( PHONE o _ O_ dJ .� o� STREET ADDRESS 1 c 56 ® � BUS. LIC # LICENSE NUMBER ARCHITECT/ENGINEER NAME E -MAIL FAX PHONE COMPANY NAME CITY, STATE, ZIP STREET ADDRESS PROJECT IN WII DLAND PROJECT IN ❑ NO FLOOD ZONE C3 Yes ❑ ND USE OF Commercial URBAN INTERFACE AREA ❑ Yes Residential ❑` STRUCTURE: l► G - - r,xc[ RIPTION OF WORK RECEIVED BY: ' TOTAL VALUATION: owner's behalf. I have read his local owner or authorized agent to act on the property I with all app purposes* I am the property it is accurate. I agree to comply inspection to each of the following: tion of Work and verify for BY my signature below, I certify r ided is ect. I have read the Deentat I I application and the information I to b p . g , tru n• I authorize representatives of Cupertino to enter the above - identified property pp Date: ordinances and state laws relating Qx SE� ate! Signature of Applicant/Agent: ATION REQUIRED mFNTAL INFO gv> R TaM_ [� LARGE a ❑ MAJOR MEPMiscApp_201 I -doc revised 03102111 CITY OF CUPERTINO rMP-1 FEE ESTIMATOR — BUILDING DIVISION imADDRESS: 10424 alicia st. DATE: 03/07/2011 REVIEWED BY: bobs. UNITS APN: BP #: *VALUATION: 1$3,000 xPERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: SFD or Duplex Amps PENTAMATION PERMIT TYPE: 1 REAP ; WORK install 2 new underground electrical service panels for new detached secondary unit. SCOPE .S`11,1g)/, 111sp 1.1 APPLIANCE / EQUIP TYPE FEE ID QTY /FEE QTY UNITS BP FEES Elec. Permit Fee: IEPERMIT Services 1 ERT<200 Other Elec. Insp. Rol hrs $42.00 100 Amps $42 Services 1 ERT <200 .S`11,1g)/, 111sp 1.1 100 Amps $42 PME Unit Fee: $84.00 PME Permit Fee: $42.00 ( °(;nstr71t`rion Tax "t<:r,uslical /,el'ic'it' Work Without Permit? 0 Yes E) No $0.00 TOTALS: Travel Documentation Fee: ITRAVDOC $84.00 Strong Motion Fee: 1BSEISMICR Nf)TR• Thoco foot oro havod on the nreliminary information availahle and are only an estimate. Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 09 -051 Eff. 7i1:10� QTY /FEE Elec. Plan Check 0.0 hrs $0.00 Plan t_' /w k 1,'cv: [1""',0, 1 7'w F, Elec. Permit Fee: IEPERMIT sifh /t /. P(' 1"C , Other Elec. Insp. Rol hrs $42.00 PME Plan Check: cv, Nf)TR• Thoco foot oro havod on the nreliminary information availahle and are only an estimate. Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 09 -051 Eff. 7i1:10� FEE QTY /FEE MISC ITEMS Plan t_' /w k 1,'cv: sifh /t /. P(' 1"C , PME Plan Check: $0.00 11cri, 1111" c °c .S`11,1g)/, 111sp 1.1 PME Unit Fee: $84.00 PME Permit Fee: $42.00 ( °(;nstr71t`rion Tax "t<:r,uslical /,el'ic'it' Work Without Permit? 0 Yes E) No $0.00 Travel Documentation Fee: ITRAVDOC $42.00 Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $169.50 $0.00 TOTAL FEE: $169.50 Revised: 01/15/2011 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -32 5 Telephone: 40S-777- Fax: 40S -777 -3333 o iJBCONTRACT0R LIST G2 CUPERTIN CONTRACTpR / S tv� Co ho t�6Dl� PERMIT # t� Lt PHONE # a$ JOB ADDRESS: �G �� BUSINESS LICENSE # 0 33 AV C��ci'�i( � CITY /ZIPCODE: OWNER'S NAME: "(tV NERAL CONTRACTOR: � ) U� a of Cupertino business license. GE VC in the city to have a City UNTIL THE Q _0 q WILL BE SCHEDULED ADDRESS: `J 6 A CITY OF CUPERTINO ici al code requires all businesses UpANCY IN ORS OBTAINED *Our mun p FINAL OCC ORS HA �"Il FINAL OR S BCO TRA NO BUILDING Date GENERAL CONTRACTOR AND ALL BUSINESS LICENSE. Signature I am not using any subcontractors: information: LICENSE # tors and complete the following BUSINESS Please check applicable subcontra BUSINESS NAME ✓ SUBCONTRACTOR Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / wales Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile signature owner owner / Contractor Sig pate