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10060160CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10655 MARY AVE I CONTRACTOR: CURRO PLUMBING INC I PERMIT NO: 10060160 I OWNER'S NAME: CUPERTINO LOC -N -STORAGE .WNER'S PHONE: 4088477704 LLIICENSED CONTRACTOR'S DECLAARATI N License Class �-` Lic. # v Contractor ' Date r I hereby affirm that I am licensed or 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 whytfi s permit is issued. 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 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 -p int source reg tions p Cupertino Municipal Code, Section 9.18. Signature Date ❑ (/ OVNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of 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) 1, 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 -non the above mentioned property for inspection purposes. (We) agree to save emnify and keep harmless the City of Cupertino against liabilities, judgments, -osts, 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 source regulations per the Cupertino Municipal Code, Section 9.18. Date 7620 EIGLEBERRY ST GII ROY, CA 95020 DATE ISSUED: 06/25/2010 PHONE NO: (408) 847-7704 JO 3 DESCRIPTION: RESIDENTIAL a COMMERCIAL RL -PIPE RELOCATE GAS LINE TO NEW PG &E METER LOCATION APRPX 26" Sq. Ft Floor Area: AT N Number: 32606050.00 Valuation: $2000 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Is, ued b . Date:,/ '--2S- - O RE -ROOFS: At 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 in! pection. 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. 1 will m tintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the H -alth & Safety Code, Section 25532(a) should I store or handle hazardous in rterial. Additionally, should I use equipment or devices which emit hazardous ai - contaminants as defined by the Bay Area Air Quality Management District I w II maintain compliance with th upertino nicip ode, Chapter 9.12 an the Health & Safety Code, Secti s 25505, 25 , a 34. O,vner or authorized agent: Date: CONST CTION LENDING AGENCY I 1 tereby affirm that there is a construction lending agency for the performance of w>rk's for which this permit is issued (Sec. 3097, Civ C.) L mder's Name L !nder's ARCHITECT'S DECLARATION I rnderstand my plans shall be used as public records. L censed Professional Plumbing Contractor Curro Plumbing Inc. 5810 Obata Way Suite # 8 Gilroy, Ca 95020 Existing Gas Line 3/4" Gav Existing Gas Meter In Closet To Be Relocated To New Meter Location New Gas Line To Be 1" Gav Job Site Mini Storage Complex 10655 Mary Ave. Cupertino Ca. 1" Gav Gas Pipe Existing Door IPG & E To Relocate Gas Main To New Location New Gas Meter Location REC E1VED JUN 25 2010 BY, 5 ITEMS OF 5 CITY OF CUE ERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Iot: APN ........: 32606(50.00 DATE ISSUED.......: 06/25/2010 RECEIPT #......... BS000010708 REFERENCE ID # ...: 10060:.60 SITE ADDRESS 10655 MARY AVE SUBDIVISION ...... CITY CUPER-INO IMPACT AREA ...... OWNER CUPER'=0 LOC -N -STORAGE ADDRESS 10655 MARY AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: SylviaM COPY # : 1 RECEIVED FROM CURRO PLUMBING CONTRACTOR JOSEP:i CURRO LIC # 30421 COMPANY CURRO PLUMBING INC ADDRESS 7620 EIGLEBERRY ST CITY/STATE/ZIP GILROf, CA 95020 TELEPHONE (408) 847-7704 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT -- THIS REC NEW BAL 1BCBSC VALUATION ---------- 2,000.00 ---------- 1.00 0.00 1.00 0.00 1BUSLIC FLAT RATE 1.00 114.00 0.00 114.00 0.00 1PGASCOM OUTLETS 1.00 63.00 0.00 63.00 0.00 1PPERMITFE FLAT RATE 1.00 42.00 0.00 42.00 0.00 1TRAVDOC FLAT RATE 1.00 42.00 0.00 ---------- 42.00 ---------- 0.00 ---------- TOTAL PERMIT ---------- 262.00 0.00 262.00 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 262.00 --------------- 262.00 VOICE ID DESCRIPTION -------- ---------------------------- 202 UNDERFLOOR PLUMBING 507 FINAL PLUMBING REFERENCE NUMBER -------------------- 1476 VOICE ID DESCRIPTION -------- ---------------------------- 301 ROUGH PLUMBING CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 166S �S' PERMIT # !j l OWNER'S NAME:l/"st PHONE # G • Pei7- ; V GENERAL CONTRACTOR: 4 c BUSINESS LICENSE # 5 ADDRESS: C)©OAV* WA- CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to nave a k-,ity of',uperuuu WuN111CN3 Imu.1im'. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCON RAC' QRS HAVE OBTAINED A CITY OF C PERTINO BUSINESS LICENSE. ,�,� I am not using any subcontractors: Signature Date Please check applicable subcontra to and complete i he following information: Owner / Contractor Signature Date 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 CUPERTINO - REPIPE/SEWERf "N SERVICE CUPEkTINO PERMIT APPLICATION FORM /0()V0 I COO APN #DLO 0/�. 7 v Date: / ���� v Buildin Address: l06 5-!;— -�W Fee Owner's Name: Phone #: eape.r�ti() (�C -IV- .S-rop &4'C Contractor: Phone #: Fax #: ybl�/ %• ,� fJ a Contact: Phone #: yoQ', 7/0' PS 4� �� Fax #: Contractor License #: Cupertino Business License #: 1BPREPIPE Job Description: 45rAZ4t`G lo457 pc -e, em h,ew 9>6 gr e Y c�tJGWTI 1CPRP / Residential ❑ Commercial 2/ Commercial Gas PiI ing System Valuation: A��-* ,fir Project Size: Expresso Standard Large Major Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Green Building Points: 1BCBSC Quantity Fee ID Fee Description Fee Permit Type Group 1PCSEWER Commercial buildin; P 1CPSS sewer/sanitary sewer 1BPREPIPE Commercial re -pipe per fixture P 1CPRP / 1 PGASCOM Commercial Gas PiI ing System P 1-4 Outlets / 1BCBSC Cal Bldg Standards Commission B ALL PERMIT Fee TYPES 1 BSEISMICOM Seismic Commercia: P Revised 01/07/09 CITY OF CITY OF CU.PERTINO REPIPE/SEWER/NIAIN SERVICE FEE SCHI�DULE CUPERTINO Quantity Fee ID Fee Description Fee Group Permit Type 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential P 1PRSEWER Residential building sewer/sanitary sewer P 1RPSS 1PRREPIPE Residential re -pipe p(. -r fixture P 1RPRP 1BPWS'VCS Water Service P 1CPWS or 1RPWS 1 PPRSEWG Private Sewage Disposal System P 1 PCESS Cesspool P 1BPWATER Install/alter Water Pi -)e P 1 BPFIXTURE Plumbing Fixture P 1 PGASRES Residential Gas Piping System 1-4 Outlets P 1 BPGAS Gas Piping System 5 + Outlets P 1PPERMITFEE Plumbing Permit Fee Issuance P 1PLMBLNCK Plumbing Plan Chec''c P 1PLMBINSP Other Plumbing/gas Insp. P 0 1 TRAVDOC Travel & Document ition Fee B 1 BUSLIC Business License B