07100180 CITY OF CUPERTINO ` `
BUILDING DIVIS10iV PERMIT ���'7�R���!p� ���������
_. :;: ,..,. .
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� PERMIT NO.
BUILDI r�c��q��ss:COLD HARBOR AVE BAY AREA HAULING & BOBCAT 07100180 •
r�
PERMIT LSSUE DATE
cR'S NAME:
ASHWATH THIRUMALAI P O BOX 36143 10 25 2 07
SANITARY NO. CONTROL NO.
PHONE:
(408)592-9755
BiJILDING PERMIT iNFO
ARCHiTECT/ENGiNEER:
BLDG ELECf PLUMB MECH
� � � 0
i p p LICENSED CON7RACTOR'S DECLARATION JO}� DeSC17pIlOII
� V� I hcreby afGrm that I am liccnscd undcr provisions of Chaptcr 9(commcncing
; z� wiw Scction 7ooU) at Division 3 of ihc Business and Profcssions Codc, and my Iiccnse is s[�] I� I j�j :� POO L DEMO / F I L L
�� y in full Corce and cffect
� � ^ Licensc C1azs ��• #
, �, p Date Conuxtor
� ARCHITECI'S DECLARATION
i a e I undcruand my plans sha116c uscd as public recnnls
�yU
' u. F' Licenscd Pcufcssional
� y � OWNER-BU[I.DER DECLARATION
} 1 hcrchy atTrm tha� I am ucmp� Crom �hc Contraaar's Licensc Law for thc
j p o (ollowing rcasoa. (Secuan 7Q31.5, Busincss and Profcssions Ca1c: Any city or rnun�y
�,°, �i which requiros a permit to conswc4 allr.r, improvc. dcmolCsh, or repair any swcture
? Z} prior to i�s issuancc, alsu rcquires thc applicant for such permit to fiic a signcd sutcmcnt Valuation
•< Uwt hc is IiccnscJ pursuant to thc pmvisions o( the Comrutor's li�ronsc Law (Chaptcr 9 S q. Ft. Floor Area
� F �(commencing with Scction 7000) of Division 3 of ihc Busincss and Profcssions Codc) or $ 4 9 0 0
°�� that he is exempt Weiefrom and the basis [or the allcgcd exempdon. Any violation oC
Section 7031.5 by a�ry applicant for a pertnit subjecu the applicant to a civil penalty of Number Oceupancy Type
not more than fivc 6undred dollars (5500)• 3 6 9 0 9 � 3��
❑[, as owner o[ ttie propccry. or my cmployces with wages az their solc campensadon,
will do �he wodc, and the stcuctuce is noi ir.tendcd or afkred for sale (Sec. 7044. Business Re lllr In s ectio ns
and Professions Code: The Conuacwrs Licenu Law does no� apply w an awner of Q P
property wha builds or improves thereon, and who das such wrork himself or thmngh his
own emplayces, providcd that such improvemen�s are not in�ended or oRered for sale. I[.
however, the building or improvement is sold within one year oC compleGon, t6e owner-
builder will have the bucden o[ proving �Aat he did noi build ar improvc for pmpose of
sak.).
as owner of the propeny. am ezclusively contcacling wi�h littnsed rnnuxtors m
wct the project (Sec. 7044. Businas aad ProCessions Code:) The Coavxeor's Li-
cense Law docs aa� apply �o an owner of propeny wdo 6uilds or improves �hereon, and ,
who contracts tor sucd projects wiW a convutoHs) licensed pursuant a �he Conusctar's
License Law.
' am exem t un i r Sec. . B& P C for this rcason
. ner • Dale o � � _. .
KER'S COMPENSA'I70N DECLARATION
I hercby atTicm under penalty o[ pc�jury onc o[ U�e folbwing declaration�
❑ I hs+e and will maintain a Certifica�e of Consent to self-insure (or Worker's Compen-
sation, as provided for by Section 3700 of the Labor Code. for the perfocmancc of UK
work for which this permit is issued.
❑ I have and will maintain Worker's Compensation Insurana, u rcquired 6y Scction
3700 0( �hc Labor Codc. for Nc perfortnance of the work for which this permit is issued•
My Worker's Compencatian Insurance carricr and Policy numMr a�c:
Cartier. Policy No.:
CER7'IF[CATE OF EXEMP'!'[ON FROM WORKERS'
COMPENSATION tNSURANCE
(Ihis scction necd not be completcd if the pecmit is Cor anc hundred doltars (E I00)
or Icss.)
I cenity th.t in thc performancc aC lhc wark for which Ihis pertnit is issuc4 I shall not
employ any person in any manncr u w comc3� �ct �o Ihe Workers' Compcnsalion
L.aws oC California D � � � •
Applicaiu ^
NOTICE TO APPi.I AM: I a(tc malcing this CeniGca�c of Excmption, you should
bccome subjcct to ihc Workcr's Compcnsation provisions of thc Lalwr Cadc, you must
, O farthwith comply wi�h such provisions or this permil shall be deemed revoked.
z "' CONSfRUC770N LEND[NG AGENCY
(— ► 1 hcrchy a(Grm ihat thcre is a consuucuon Icnding agcncy (or thc performancc u! .
p�., � ihe work (ur which this pertnit is issucd (Sec. 3097. Civ. C.)
W� A Lendcr's Namc �
� z L.cnder's Address
V � 1 certify �hal I havc rcad Ihis application and statc �hat �hc abovc infonnaliun is
�� coercc� 1 agree to comply with all city and county onlinances and sute Iaws relaang w
0 J building conswctian, and hcicby authome represcnutivcs of this city to cn�cr upon thc
� W abovc-mcntioncd properry for inspccuon purFwses.
a (Wc) agrce to save, indcm�ify and kcep hartnless ihe City oC Cupertino against
H � liabiliucs, judgmcnts, cosLt and expcnscs which may in any way accruc against said City
V,'�' in consequcncc oC �hc granung of this permit. � �
� APPLICA[1T UNDER ANDS A D WIL COMPLY W1TH ALL NON-POIM' Issued by: Date : G� .S�c-
SOURCE REG� O S.
p �.',� 20o Re-roofs /°�._,_.��
Signature of Applican�Conuac�or °'� T of Rc �of
HAZARDOUS MATERIALS DtSCLOSURE YP
Will lhc applicant or futwc building accupant store or hanNc h�ardous matcrial
cfi�d by thc Cupenino Municipal Codc. Chapter 9.12. and the Hcallh and SaCety
.�c1c. Scction 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Y� � .
If a roof is installed without first obtaining an inspection, I agree to remove
�II thc applicant or futurc building accupant u:c cquipmcnt or dcvices ahich '
cmit harardous air contaminants as dcfi�d hy �he Bay Area Air Qualiry Managcmcni all new m�.terials for inspeczion.
Disuict?
❑ Y� �
1 havc rcad the twardcws maicrials requircmcrus undcr Chaptcr 6.95 of thc Cali[ar-
nia Hcalth & Safcry Codc, Scctions 25505. 25533 and 25534.1 undcrstv�d that if �he building
docs nat cuncntly havc a tcnan4 �al i� is my ponsibili�y lo notiCy thc oaupant af Ihc
rcyuircmcn�swhichmusi metprior issu orac�Nr�a�aro� . Signature ��fApplicant Date
0 2'" 2°� All roof coverings to be Class "B" or better
Owncr or au�hori•r.cd agrn� �
n��oot8o
CITY OF ��UPERTINO
�,�
CUPEt�TINO PERMIT APPL ICATION FORM
APN # p Date:
3 6 1-Oq" �� �r.� C�C� !�- 2..5- 2@O?
Building Address:
�02?$ _ GOL� J�A�28�� �}VF_� CuPEQ?rNO, G� 45014
Owner's Name: -- -- Phone #: - — -✓ - ---Y
,F�-5 t+w A-T I+ 'i' i-r-r. 2 V P-c 1� L Pr.�. C. 4 0�) 8 3 S- S9 � 7
Contractor: License #:
dA-Y �ac �u�sn�� � (3ot��� i 6 30
Contact: P�"'E� 4og -723 -658 � Cupertino Business License #:
ROgE2T �QQSCr►�Fi FAx: s3o-146-3i 2-4 �7S'
Building Permit Info:
Job Description:
SwZMMtNG �00 L �hMO FlLL _
Residential: � Commercial: ❑
Sq.Ft. Floor Area: Cost of Project:
� � �1 `�� O
Qty. if
A licable Fee ID Fee Descri tion Fee Grou
BPERMFEE Bld Permit Fees BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Bld Permit Fees BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
CITY OF CUPERTINO
2 ITEMS OF 2 PERMI7' RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: Bl}:: Lot:
APN ......... 36��09037.00
DATE ISSUED.......: 10�25/2007
RECEIPT #.........: BS(100003078
REFERENCE ID # ...: 07=_00180
SITE ADDRESS .....: 10�;28 COLD HARBOR AVE
SUBDIVISION .......
CITY .............. CU1'ERTINO
IMPACT AREA .......
OWNER ............: ASFIWATH THIRUMALAI
ADDRESS ..........: 10::28 COLD HARBOR
CITY/STATE/ZIP ...: CU]'ERTINO CA 95014
RECEIVED FROM ....: AS�IWATH THIRUMALAI
CONTRACTOR .......: ROI3ERT ARRIGHI LIC # 24175
COMPANY ..........: BA`..' AREA HAULING & BOBCAT SERV
ADDRESS ........... P () BOX 36143
CITY/STATE/ZIP ...: SAId JOSE, CA 95158
TELEPHONE ........: (41)8)592-9755
FEE ID UNIT QUANTITY i�'IOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ----------- ---------- ---------- ----------
BPERMFEE VALUATION 4,900.00 115.56 0.00 115.56 0.00
BSEISMICRE VALUATION 4,900.00 0.50 0.00 0.50 0.00
TOTAL PERMIT : 116.06 0.00 116.06 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 116.06 VISA
---------------
TOTAL RECEIPT : 116.06
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
704 DEMO
Community Development
� ;��. 10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
CITY OF ' Fax (408) 777-3333
CUPEi�T
Building Department
All Cupertino building permits must nieet certain conditions related to maintaining
environmental quality and public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL,
State law requires that Cupertino, 12 ottier Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District cortrol stormwater pollution. Educating local
residents and businesses and enforcing ��tormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm dr�ins flow directly to local creeks and San
Francisco Bay, with no treatment. Storniwater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze fi•om vehicles and heavy equipment;
• Construction debris, including dir�:, concrete and paint;
• Landscaping runoff containing pe:�ticides or weed killers; and
• Any material dumped or spilled ir�to streets or storm drains
The property owner and the contractor share ultimate responsibility for activities
occurring at a construction site and will I�e held responsible for any environmental
damage caused by subcontractors or employees.
For more information on construction-related stormwater requirements, see the
Stormwater Quality Regulations section �f the City of Cupertino web site at:
http://www.cupertino.orq/city gc�vernment/de�artments and officesl
environmental services
COMMUNITY NOISE CONTROL
The basic noise control requirements for construction sites are as follows:
• Typical construction work hours � re:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street coistruction is prohibited on holidays.
• Residential daytime noise levels from complaint site - 60 dBA
• Nonresidential daytime noise IevE�ls from complaint site - 65 dBA
For more information on noise control, please see Chapter 10.48 of the Cupertino
Municipal Code, which can be accessed at http://www.amlectal.com/cupertino ca/
Greg Casteel
Building Official
Community Development
10300 Torre Avenue
' ' Cupertino CA 95014
Telephone (408) 777-3228
CITY Of Fax (408) 777-3333
CUPEt�TINO
Buildin De artment
JOB ADDRESS: � p�Z g�o L,p HA �2���. }! v� PERMIT #� `� b I D �
Gv �i2 i�+v CA- ��o�Lr � Q
OWNER'S NAME: SN ►..� T ' ��' K 1�-t L.� PHONE # k o g- 8 3�' -- � S g"
GENERAL CONTRACTOR FAX #
�. �
I am not using any subcontractors: � �'���"�-
Si;nature Date
Please check a licable subcontractors and com �lete the followin information:
SUBCONTRACTOR BUSIl`TESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
IIectrical
Excavation �,� a „� � r*L «.; � c l �� �O
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
� to�
Owner ontractor Signature Date