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10010006 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7400 TIPTOE LN CONTRACTOR:MR.RESCUE PLUMBING& PERMIT NO: 10010006 ROOTER 'NER'S NAME: SAKKAS KOSTA G AND ALYSA R 4231 BUSINESS CENTER DR STE 12 DATE ISSUED:01/04/2010 4NER'S PHONE: 4082420746 FREMONT,CA 94538 PHONE NO:(877)417-3728 113 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class C. J0 Lic.# 113 1 y Lo q MECH RESIDENTIAL COMMERCIAL� Contractor 1(N f C"c S d(4 Cr Date 0 t —CO L/—/ JOB DESCRIPTION: SEWER LINE REPLACEMENT T NCHLESS METHOD 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. Sq.Ft Floor Area: Valuation:$2000 I have and will maintain Worker's Compensation Insurance,as provided for by L Section 3700 of the Labor Code,for the performance of the work for which this Type: permit is issued. APN er �S.f 6�= 0 Occupancy YP APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is 19- correct.I agree to comply with all city and county ordinances and state laws relating P IT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter WITHIN 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. 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 sou gulations per the Cupertino Municipal Code,SectionIssued by: Date• -- 9.18. ,ature Date V RE-ROOFS: ❑ OWNER-BUILDER DECLARATION 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 I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). . HAZARDOUS MATERIALS DISCLOSURE I hereby affirm under penalty of perjury one of the following three declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air he Labor Code for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will Section 3700 oft P maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety C ctions 25505,25533,and 25534. 1 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 Owner autho ' d agent- so �b Compensation laws of California. If,after making this certificate of exemption,I Date:d J 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that 1 have read this application and state that the above information is Lender's Name 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 Lender's Address the above mentioned property for inspection purposes.(We)agree to save nify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature l0000eDate r CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35932061 . 00 DATE ISSUED. . . . . . . : 01/04/2010 RECEIPT # . . . . . . . . . : BS000009480 REFERENCE ID # . . . : 10010006 SITE ADDRESS . . . . . : 7400 TIPTOE LN SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SAKKAS KOSTA G AND ALYSA R ADDRESS . . . . . . . . . . : 7400 TIPTOE LN CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5819 RECEIVED FROM . . . . : RESCUE RESPONSE CONTRACTOR . . . . . . . : MIAN AHMED LIC # 31330 COMPANY . . . . . . . . . . : MR. RESCUE PLUMBING & ROOTER ADDRESS . . . . . . . . . . : 4231 BUSINESS CENTER DR STE 12 CITY/STATE/ZIP . . . : FREMONT, CA 94538 TELEPHONE . . . . . . . . : (877) 417-3728 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---- 1 . 00 0 . 00 1BCBSC VALUATION 21000 .00 1. 00 0 . 00 0 . 50 0 . 00 1BSEISMICR VALUATION 21000 . 00 0 .50 0 .00 42 . 00 0 .00 42 . 00 0 . 00 1PPERMITFE FLAT RATE 1 . 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 . 50 0 .00 106 .50 0 . 00 METHOD OF PAYMENT AMOUNT --REFERENCE NUMBER ----------------- ------ CHECK 106 .50 #1095 --------------- TOTAL RECEIPT 106 .50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- --------- ------ _ - -- ------------------- 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 400 SEWER/LATERAL 507 FINAL PLUMBING CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE CITY E Y T C UI NO PERMIT APPLICATION FORM APN # C Date: ~-� Z. C � . �:, � Building Address: Owner's Name: S-�Pr Phone#: +0T Y 'z--C'?4,6 Contractor: Phone#: h4l(* Contact: ��, �- Phone#: 4,ur— Gret0- 'S$oet t-1 () SS �"of 0 —� �' C7 Fax #: Contractor License#: Q 3 L L{ (o�( Cupertino Business License#: Job Description: s� Residential [ Commercial ❑ Valuation: :1700a Project Size: Express f�3StandardEj 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: Quantity Fee ID Fee Description Fee Permit Type Grou 1PCSEWER Commercial building P 1CPSS sewer/sanitary sewer 1BPREPIPE Commercial re-pipe per fixture P 1CPRP 1 PGASCOM Commercial Gas Piping System P 1-4 Outlets 1 BCBSC Cal Bldg Standards Commission B ALL PERMIT Fee TYPES 1 BSEISMICOM Seismic Commercial P Revised 01/07/09 CITY OF CUPERTINO :rte SERVICE REPIPE/SEWERfMAIN Cin FFEE SCHEDULE CUPEI�TINO Fee Permit Type Fee ID Fee Description Quantity Grou commission B ALL PERMIT 1BCBSC Cal Bldg Standards Co TYPES Fee P 1BSEISMICR Seismic Residential P 1RPSS 1 PRSEWER Residential building sewer/sanitary sewer P 1RPRP 1 PRREPIPE Residential re-pipe per fixture P 1CPWS or 1BPWSVCS Water Service 1RPWS - ----- PRSEWG Private Sewage Disposal System P 1P 1PCESS Cesspool P 1BPWATER Install/alter Water Pipe P 1 BPFIXTURE Plumbing Fixture P 1 PGASRES Residential Gas Piping System P 1-4 Outlets P IBP GAS Gas Piping System 5+ Outlets Plumbing 1 PPERMITFEE Pe rmit Fee Issuance P � P 1 PLMBLNCK Plumbing Plan Check 1PLMBINSP Other Plumbing/gas Ins p• P VDOC Travel & Documentation Fee B r 1 TRA I B 1BUSLIC Business License Community Development 10300 Torre Avenue Cupertino CA 95014 3228 ��,;; Telephone(408)777_3333 Fax(408)777 CtT1f�OF XPEkTINO rtm a nt lBuialdin De a PERMIT # S ' Q-�o� 1r�vz i JOB ADDRESS: � o o 4 ti ? PHONE # ti-v� OWNER'S NAME: x.dS� SA, r..445 _ FAX # GENERAL CONTRACTOR: ►'h r Lk I am not using any subcontractors: ignature Date S • actors and complete the f ollowin information: Please check applicable subcontractors BUSINESS LICENSE # SUBCONTRACTOR BUSINESS NAME Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Date Owner/Contractor Signature Q0%SN11f r4o.D� BOARD OF AIRF.CTORS pYg`I'RICT MANAGM-FE �4'� 0 0 WIL I IAM A.BOSWORTW MARK THOMAS&COMPANY,INC, res r.•a JOHN M•CATTo RICHARD K.TANAKA GUtTIS B.HARRISON k'U YFA:o +e- WENDESRR, � '(C'E ��s I-I-k1. DISTRICT COUNSEL CHRISTOPHER C.L,EE ATKINSON•FARASYN,U-P- RS A HAROLD S.TOPPEI_ 20833 STEVENS CREEK SOULEVARD,SU1TE 1 Oa C[JPKR T'INO,CALIFORNIA 950 14.2,1 SA c408>t 253-707 1 nose J f a r y d fps�c t�c o m www.cupert File: CuSD--MOP Building Dept.—CuPertixlo City of Cupel'ti.11.0 Attu.: 13W.1ding Department 10300 Torre Ave. Cupertino, CA 95014-3202 Subject: Sewer Line Re-pair Name: Sakkas Residence Address: 7400 Tiptoe Laxle APN: 359-32-06:1, permit No. 10010006 ■ videotape and Property Line Cleanout inspected. No additional coudit� �'onsIre uirements by the District. Inspector: George Santos/TOOY Soares....... ..........,:........................ S"itan SewCratapY.'• - ,jOC Date• -07-2010.-- ....... ..... cc: Property Owner 36' Tit 1'/L38" Long 6' Deep SUPPLYING SANITARY SEWERAGE SERVICES FOR:CITY OF CUPERTINO,PORTIONS Or THE CITIES OF SARATOGA,SUNNYVALE,Los ALTOS AND SURROUNDING UNINCORPORATED AREAS