Loading...
10080052 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10400 PINEVILLE AVE CONTRACTOR:OWEN SIGNATURE PERMIT NO: 10080052 HON ES,INC ONAM BHATIA 445,1.SAN ANTONIO RD STE 201 DATE ISSUED:08/06/2010 NER'S NAME: RAJINDER&PO LOS ALTOS,CA 94022 PHONE 948-9420 OWNER'S PHONE: 4083904215 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ LICENSED CONTRACTOR'S DECLARATION License CA lass # TEMP POWER POLE Contractor Date 21 I hereby ffirm 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 [AP Ft Floor Area: Valuation:$100 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 V Number:36913042.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION e information is PERMIT EXPIRES IF WORK IS NOT STARTED I certify that I have read this application and state that the abov 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 FROM LAST CALLED INSPECTIO indemnify and keep harmless the City of Cupertino against liabilities,judgments, Q costs,and expenses which may accrue against said City in consequence of the Is:ued by: Date: V granting of this permit. Additionally,the applicant understands and will comply with all non-point ourc gulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: nature Date At I roofs shall be inspected prior to any roofing material being installed.If a roof is in:•talled without first obtaining an inspection,I agree to remove all new materials for in;pection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER the following two reasons: 1,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) HAZARDOUS MATERIALS DISCLOSURE 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the C alifornia 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: Vealth&Safety Code,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous strict I Compensation,as provided for by Section 3700 of the Labor Code,for the ���mainta'rnacompl a ce wints as defined th theeCup Bay At no Murea Air nc pal Code,Chapter 9Management '12 and performance of the work for which this permit is issued. tae Health&Safety Code,Seed 255 5, 5533,and 25534. 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 Owner or authorized age Date: o 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 v hereby ork's for which at thpermit is issued(Sec!3097,Civ ending agency for the performance of ere forthwith comply with such provisions or this permit shall be deemed revoked. 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 building construction,and hereby authorize representatives of this city to enter n the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION -emnify 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 CITY OF CITY OF CUPEIMNO TEMP POWER PERMIT APPLICATION ]FORM �O� ODS CUPERTINO Date: APN#3 L , V kfa,by Building Address: l O\�4©c ( (� - Phor}� Owner's Name: o I p (� `'fit �` � ltL C. Phone#: Cosb" 9 Li8 - Contractor: Fax#: L{�; , �t� '� -� Phone#:� CA - 3 Contact: Contractor License#: 3©c41 g o Cu ertino Business License#: Job Description: commercial Residential Type of Construction:N/A Valuation(cost of project): Fee Group Permit Type Fee Description Quantity Fee ID 1REAP14 IE <20 Res. Temp Power-:200 E I Ams E IERT2001K Res. Temp Power,-00-1K Am s lEPERMITFE Electric Permit Issuance B ALL PERMIT 1BCBSC Cal Bldg Standards TYPES Commission Fee B 1BSEISNIICR Seismic Residential B I TRAVDOC Travel &Docurrentation / Fee Revised 06/12/09 CITY OF CUPERTINO FEE ESTIMATOR BUILDING DIVISION ADDRESS: Di►TE: ]gAdditionRepa APN: BP#. $100 FPERMIT TYPE: Building Permit PLAN CHECK TYPE: Apair 1GENRES PRIMARY SFD or Duplex USE: ri w c; a O O 3 � ,a 1 i:1r_ l',e-h h!:•�; rJi'r Pi'„vr! i NOTE: These fees are based on the preliminary information avail able and are on1v an estimate. Contact the Dept for addn'I info, FFEETEMS(FeeResolution 09-051 Ef1.� 711/09) FEE QTY/FEE MISC ITEMS heck Fee: $O.00 200 amps Electrical pp . PC Fee: Reg. Q OT 0.0 hrs $0.0(� $42.00 IERT<200 Temporary Power PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:O Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.01) PME Permit Fee: $42.00 Acoustical Fee: 0 Yes Q No $0.03 Work Without Permit? Q Yes E) No $0.00 $0.00 Select a Non-Residential G Planning Fee: Building or Structure 0 Travel Documentation Fee: ITRA VDOC $42.(0 Strong Motion Fee: IBSEISMICR $01-0Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 t IfBTOTALS $85..'i0 $42.00 TOTAL=F+EE: $127.50 Revised: 8/06/2010 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: ; PERMIT# I t hl0O Z OWNER'S NAME: PHONE# (L� Q LO GENERAL CONTRACTOR: ( BUSINESS LICENSE# J ADDRESS: �. n; CITY/ZIPCODE: L g� S *Our municipal code requires all businesses working in tho city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY IN WECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND 77Y7 TORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. ka! !'O I am not using any subcontractors: gnature Date Please check applicable subcontractors and complete the following information: j/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical 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 CITY OF CUPE RTINO PERMIT RECEIPT OPERATOR: SylviaM 4 ITEMS OF 4 COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lott: APN 369130.12 . 00 DATE ISSUED. . . . . . . ; 08/0002010 RECEIPT #. . . . . . . . . 11 REFERENCE ID # 10080052 SITE ADDRESS 10400 PINEVILLE AVE SUBDIVISION • • • . . . : CUPERIINO CITY . . . . . . . . . . . . IMPACT AREA . . . . . . OWNER RAJINDER & POONAM BHATIA ADDRESS . . . . . . . . . . : 10400 PINEVILLE AVE CITY/STATE/ZIP CUPER-INO, CA 95014 RECEIVED FROM SHAWN OWEN CONTRACTOR ROBER" E. OWEN LIC # 31834 COMPANY OWEN ;SIGNATURE HOMES, INC ADDRESS 445 S SAN ANTONIO RD STE 201 CITY/STATE/ZIP . . . : LOS ATOS, CA 94022 TELEPHONE (650) 948-9420 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC --NEW-BAL- --------- __ ---------- 0 .00 1. 00 0 . 00 ---------- 100 . 00 1 . 00 0.00 1BCBSC VALUATION 1.00 42 . 00 0 . 00 42 . 00 1EPERMITFE FLAT RATE 4200 0 .00 42 . 00 0 .00 . 1ERT<200 UNITS 1 .00 0 . 00 1.00 42 . 00 0 .00 42 . 00 1TRAVDOC FLAT RATE ---------- TOTAL PERMIT 127 . 00 0 .00 127 .00 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ------------ ----- CREDIT CARD ---------127_00 ]R TOTAL RECEIPT 127 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- --------------- 402 TEMPORARY POWER