The URL can be used to link to this page

10050181 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10350 MENHART LN CONTRACTOR:TATS INC DBA MR PERMIT NO: 10050181 ROOTEI:PLUMBING r"VNER'S NAME: STEPHANIE MCINTOSH 44777 S GRIMMER BLVD STE C DATE ISSUED:05/25/2010 t, VNER'S PHONE: 4082577081 FREMC NT,CA 94538 PHONE NO:(408)271-2822 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT F PLUMB License Class-C q> / Lic.# 8-6 7& �2 5 /) MECH F RESIDENTIAL r COMMERCIAL Contractor /!//rill ' roa/�7f Date '"' 2 /`�o I hereby affirm that I am licensed under the provisions of Chapter 9 JOB D: SCRIPTION:REPLACED WASTE LINE FROM PROPERTY LINE TO BUILDING (commencing with Section 7000)of Division 3 of the Business&Professions INCLUD ING CITY CLEANOUT 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:$5725 permit is issued. APPLICANT CERTIFICATION APN Number:37516016.00 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-poi a ul ' ns per the Cupertino Municipal Code,Section 9.18. / Dater Zf lD /� Issued 4y S�-nature Date U ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roof 3 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, inspecti 3n. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signatu e of Applicant: Date: 1,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 -ead 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. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compli ince 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. contan inants 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 compli nce 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&Sar. 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 Owner o author' e Dat forthwith comply with such provisions or this permit shall be deemed revoked. STRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereb�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 the above mentioned property for inspection purposes.(We)agree to save anify and keep harmless the City of Cupertino against liabilities,judgments, Lende:•'s Address Gusts,and expenses w 'ch may accrue against said City in consequence of the granting of this pe Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point urce regulations r the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date /�ho Licensed Professional CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 375160__6 . 00 DATE ISSUED. . . . . . . : 05/25/2010 RECEIPT #. . . . . . . . . : BS0000_.0477 REFERENCE ID # . . . : 100501£1 SITE ADDRESS . . . . . : 10350 PIENHART LN SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER STEPHAIrIE MCINTOSH ADDRESS 10350 MENHART LN CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . CONTRACTOR . . . . . . . : TATS IDFC LIC # 23496 COMPANY TATS IYC DBA MR ROOTER PLUMBIN ADDRESS . . . . . . . . . . : 44777 : GRIMMER BLVD STE C CITY/STATE/ZIP . . . : FREMONI', CA 94538 TELEPHONE (408) 2 1-2822 FEE ID UNIT QUANTITY AMOUDT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 5, 725. 00 1 . 00 0 . 00 1. 00 0 .00 1BSEISMICR VALUATION 5, 725. 00 0 .60 0 . 00 0 . 60 0 . 00 1PPERMITFE FLAT RATE 1. 00 42 . 00 0. 00 42 . 00 0 . 00 1PRSEWER UNITS 1. 00 21 . 00 0 . 00 21. 00 0 . 00 1TRAVDOC FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 106 . 60 0 . 00 106 . 60 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CASH 6 . 60 CREDIT CARD 100 . 00 MC --------------- TOTAL RECEIPT 106 . 60 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 400 SEWER/LATERAL 507 FINAL PLUMBING 61, / CITY OF CUPERTINO °-O REPIPE/SEWER/MAIN SERVICE CUPS OF PERMIT APPLICATION FORM r _ Date: ilding Address:r, � Re 4) fOwner's Nam ' hone#• — 70 Phone#: _ Contra to . Fax#: boo f,l one#: 5V_ '7��- Contact: aA- L CA A)A Fax#: Contractor License Cupertino Business License#: 76 ;Z!�- Job aescriptio -t-zl Residential '- - Ccmmercial El Valuatio • Project Size: Express Standar Large Major Green Building: Please complete relevant portion of rhe Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Green Buildin g Points: Quantity Fee ID Fee Description Fee Permit Type Grou 1PCSEWER Commercial building P 1CPSS sewer/sanitary sew-,r 1BPREPE Co mercial re-pip-c per fixture P 1CPRP IP 1PGASCOM Commercial Gas Piping System P 1-4 Outlets 1BCBSC Cal Bldg Standard; Commission B ALL PERMIT TYPES Fee 1BSEISMICOM Seismic Commercial P Revised 01/07/09 CITY OF CUPERTINO REPIPE/SEWER/MA[N SERVICE CUPEkTiNO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group 1BCBSC Cal Bldg Standards Commission B ALL PERMIT Fee TYPES ' 1BSEISMICR Seismic Residential P / 1PRSEWER Residential building P 1RPSS sewer/sanitary sewer 1PRREPIPE Residential re-pipe per fi).ture P 1RPRP 1BPWSVCS Water Service P 1CPWS or 1RPWS 1PPRSEWG Private Sewage Disposal System P 1PCESS Cesspool P 1BPWATER Install/alter Water Pipe P 1 BPFIXTURE Plumbing Fixture P IPGASRES Residential Gas Piping System P 1-4 Outlets 1BPGAS Gas Piping System 5+ Outlets P / 1PPERMITFEE Plumbing Permit Fee Issuance P I 1PLMBLNCK Plumbing Plan Check P 1PLMBINSP Other Plumbing/gas Insp, P 1TRAVDOC Travel & Documentation Fee B 1BUSLIC Business License B Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 CUPERTINO CONTRACTOR/ SUBCONTRACTOR LIST JtJ PERMIT# s JOB ADDRESS: r 0 OWNER'S NAME: I� ,� PHONE# 6 t n . /ern-may BUSINESS LIC SE# i GENERAL CONTRACTOR: i•i,� y/ZIPCODE: I . ADDRESS: ' *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSP�CTION(S) WILL BE HAVE OBTAINED AHCITY OF C UNTIL PERT NO GENERAL CONTRACTOR AND ALL SUBC TRACTIy�CS BUSINESS LICENSE. I am not using any subcontractors: 7 a ul' Date Please check applicable subcontractors and c plete the following information: SUBCONTRACTOR BUSINESS N AME 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 Date Owner/Contractor Signature