Loading...
07100123 CITY OF CUPERTINO ` BUILDING DIVISION PERMIT ���T'R����� I�����'`TI€�i� ' ,.:. ,,; ,_ PERMIT NO. BUIL �o�np�es�INBOW CT WALTER P[. SPRINGS 07100123 . . PERMIT LSSUE DATE ER'S NAME: , STEVE & KATHY RICHARDS 370 INDL�STRIAL ROAD 10/17/2007 SANITARY NO. CONTROL NO. P"o"E: ( 650 ) 59�:-2922 BUILDING PERMTT INFO ARCHITECT/ENGiNEER: BLDG ELEGT PLUMH MECH � � � 0 i p Q LICENSED CONTRACfOR'S DECLARATION JOb DeSCil�7tlOI1 ^ V� I hcrcby af(irm �hat I am licenscd undcr provisions of Chaptcr 9(commcncing ;z� w ithSccuon700o)ofDivi�ion3ofthcBusincssandProfcssiunsCodc.andmylicenscis REMV TRI;LLIS & DECK COVERING & REPAIR DRY ROT. ��z LicenscClass '��'" �r•x 2 3�-��� REPLACE DECK & TRELLIS p Datc Comraclor : �'» � ARCHiTECI'S DECLARATION j a .a Q i undcrstand my plans shall bc uscd as public rcrnrde )yU ' u. y Licenscd Pmfcssional . � a OW NER-BUILDER DECLARATiON � a� 1 hcrcby aC�rm that 1 am excmpt Gom ihc Con�ractors Liccnsc Law for �hc p o tollowing reason. (SccGon 703I.5, Business and Pro(cssions Ca1c: Any eity or county <,°, � which rcqui�cs a pccmit to co�siruct. alicr. impmvc. dcmolish. or rep�ir any swctucc u—rn prior ui ils issuancc, alsu mquires thc applicant far such permit ta filc a signcd sutcmcnt `, Valuation -?< tha� he is liccnxd pursuant ta thc pmvisions o[ thc Conuacux's Liccnsc Law (C]�apicr 9 ,q. Ft. Floor rea � 4 O O 0 O ti t �(cammcncing wiih Scction 7000) of Division 3 of ihc Busincss and Professions Codc) or L�� that he is ezempt thcrcfrom and the basis for tAe allegcd exemplion. Any violatian of Section 7031.5 by arry applicant Cor a petmit subjecu ihe applicant to a civil penalty of 3 6 6 3 8 0 0:_��N Number Occupancy Type noe more Wan five hundred dollars (SS00). ❑ I, az owncr oC ttie property, or my employca with wages az Weir solc compensation, will do thc work, and t!u s�rucwr is not intended or of[end forsalc (Sec. 7044, Busin�ess Required Inspections and Professions Cade: The Conuacmr's License Law da:s not apply m an owur of propeny who builds w improves thercon, and who does such worlc himselCor Uuough his own employccs. Providcd �hat such improvements are not intended or ollered Cm sala If. however, the building or improvement is wld wi�hin one year o[ compledon, the awner- builder will have �he burden oC proving Wat he did not 6uild or 9mpro� Cor purpose of saleJ. ❑ I, as awner of �he propeny, am eaeelusively conuacting wiih tiansed convactars w constmct Uie projm (Sec. 7044. Businas and Professions Code:) The Contractor's Li- ccau Law docs not apply w an owncr of propeny who builds ar improves tAe�eon, and . who contracts Cor such projects with a contractoKs) licensed pursuant to �he Convacwr's Licenu Law. ❑ 1 am ezempi under Sec , B 8c P C for this masoa :r Dale _ . - WORKER'S COMPENSATION DECLARATiON 1 hercby affirm under penalty o[ perjury onc a( �he foltowing declarations: ❑ i have and will maimain a Cutificatc o[ Cunscnt to xlf-inswc far Worker's Compen- sation, u provided for by Section 3700 of the Labor Code. (or the performance of the work tor which Ihis permit is issucd. havc and will maintain Workcr's Compensation Insurance, u �cquired by Scction . o( the Labor Code. for the perCormance of the worlc for which this permit is issued. ...� Work rs Com ensation Insunnce carticr and Policy number aze: /�� A 7 �-OW�a �A Carrier. Q Poliry No.: � 1 CERTiF7CATE EXFMF'170N FROM WORKERS' , COMPENSAT[ONiNSURANCE (fhis secUon need not hc complc�ed iCthe permit is foronc hundrcd dallazs (5100) . nr Icss.) 1 cenify th�t in thc per(ormancc of thc work for which ihis permit is issucd. 1 shatl not employ any person in any manncr so az w bccomc subject to ihe Workers' Compensation Laws oC Califomia. Datc , Applicant NOTICE TO APPL]CANT: If, af�cr making ttiis Ccnifcam of Excmpdon, you should become subjcct ta �hc Worker's Campensauon provisions of �hc Labor Codc, you muu � z foMwit6 comply with such provisions or this permil shatl be decmed revoked. z O CONSTRUCf10N LENDiNG AGENCY F r►��. I hereby alTirtn ihat there is a constnxtion Iending age�y Cor ihe per[ortnance af - �Y, � U�c wurk Cur which �his permit is issucd (Scc. 3097. Civ. C.) , W Q Lendcr's Namc a z Lcnder's Address U � I certify ihat I havc rcad this application and statc that ihe above informauua is w F cortcct. I agrce io comply with all city and counry ontinances and su�e laws ¢laung ta rJ U building conswction, and hercby auth ' tativcs of �his city to cn�cr u{xm Nc ahovc-mcntioncd property !or inspcc on purposes. �'' a (Wc) agree to save, indcmni( and kecp haemle ihe Ciry of Cupertino against r �', y � IiabiliUes, judgmcn�s, cas�s and expen which may in a way acccuc against said City U,'� in conxquence oC the granting of �his ��. Date ►�+ UNDERSTANDS AND WITH ALL NO -POI Issued by: SOURCE R LA'CIONS. �^ � U �e-roofs Sign of Applicant/Convactor e � T e of R oof HAZARDOUS MA'fERIA[S DISCLOSURE YP Will ihe applicant or future building occupant uore or handle ha•rardous material iefincd by the Cupenino Municipal Codc. Chapter 9.12. and [he Hcalth and Sa[ety , Scction 25532(a)? _�� All roofs �hall be inspec[ed prior to any roofing material being installed. ❑ Ycs 4Q ryo . wll thc applicant or futurc building occupant usc cq�ipmcnl or dcvia�s which If a roof i� installed without first obtaining an inspection, I agree to remove cmii harardaus air contaminan�s as Gncd by Uie Bay Arca Air Quality Managcmcn� all new m aterials for inspeccion. ��su�c�? ❑ Ycs u I havc reaJ the ha�ardcnrs matcrials quirc a uralcr Chap�cr6.95 of thc Cali[or- icalU� & Safcty Codc, Secdons 25505. 33 and 534.1 undcrsmnd thaz iCtlu building nlly have a tcnan4 Ihat il is m ' w notify thc occup t nf �h uircmcnts w h must bc met ' usu ° ��N � t �ignature of Applicant Date � All roof coverings to be Class "B" or better Owncr authori•r.cd agcnt Da O�I l o o ti Z3 � = `��Y CITY OF C'UPERTINO � �YOF pERMIT APPL:[CATION FORM CUPE1�T1(�O APN # � � � � � O � � . � � Date: J D l � � �3uilding Address• Mailing Address (if different from building address): �� �,rn bo �a ��. Owner's Name: Phone #: -K. - t���N f�(� 1� - �_ o�' � �- �� �� - Contr c r: � � ) License #� �✓ ��-P�( � � � I IlI �7� L.CC � �?)�t,J O b tact: � / , / Phone: 6 J D 3 5/6• yyI Cupertino Business License#� �� n I ��V fiVl�/ Fax: (�SD 3D � lj Building Permit Info: Bldg � Elect ❑ I'lumb ❑ Mech ❑ Job Descri tion: �� � � ��,( - � o-�-�- e. Residential Q" �`(�`� c��e k ��2�1 t � Cor�ilercial ❑ " U_1 Sq.Ft. Floor Area: Sq.Ft.: � 00 �Q� c, c�x0. Cost of Project: U �G Li 1�- 'j�'r ccupancy Group: �� �� ��� � Type of Construction: Please check this box if t� project is a second-stor addition: I Project Size: Standard C�'7� Large ❑ Ma or ❑ Quanti Fee ID Fee Descri tion . Fee Grou BAPPLOTHER ��ther Ap liances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to SOOK Btu MECHANTCAL . BBOILER3 Boiler > SOOK to 1M Btu MECHANICAL BBOILER4 Boiler > 1M to 1.75 1�1 Btu MECHAI�TICAL BBOILERS Boiler> 1.75M Btu MECHANICAL BCONSTAX ��onstruction Tax BUILDING BCONSTAX In�i/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC 1000 El ec 600V <= l 000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD ]:nergy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 CITY OF C'UPERTINO 4 ���TM F PERMIT APPL:[CATION FORM CUPf1�TIN0 Quantit Fee ID Eee Descri tion Fee Grou BMISCELL l�iiscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME N�:w Comm Electric ELECTRICAL BNUCOMMM Nev�� Comm Mechanical MECHANICAL BNUCOMMP N ew Comm Plumb PLUMBING BOVERTIME In�pection Overtime BUILDING BPBACKFLOW At�nospheric Vacuum PLLJMBING BPCESSPOOL Cesspool PLLIMBING BPERMFEE �►1d Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Ga;: Piping System Fee PLLJMBING BPINTERCEP Incl Waste Interce tor PLLTMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Pla1 Check Repeat Fee BUILDING gpg�pIpE Re i e Of Fixtures PLUMBING BPSEWAGE :�ewa e Dis osal PLUMBING BPSEWER Sewers PLUMBING BpSpRINK Lav�m SprinklerBackflo PLLTMBING BPSTORM �,torm/Rain Water PLUMBING BPTR�I.P Kitchen Trap PLiJMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Insts�lVAlter Water Pi e PLUMBING BPWHEATER V�'ater Heater/Vent PLUMBING BPWSVCS N:ain Water Service PLUMBING BREINSPECT =Zeinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfin MECHANICAL BREMAIIZHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY F:emadel Busways ELECTRICAL BREMFIXT :�ighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Rel � Furnace > l OK btu MECHANICAL BREMHEAT ��eater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAFp Rerri Non-Res Appliance ELECTRICAL BREMPOLE Pc le/Platform Fixture ELECTRICAL BREMPOWER Pow �r Device/A aratus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA R elocation of Hood MECHANICAL BREMREPALT R�:pair/Alter Heating MECHANICAL BREMRESAPP Rernodel Res Ap liance ELECTRICAL 2 of 3 CITY OF (:UPERTINO ��TM � PERMIT APPLICATION FORM CUPEl�TINO �uanti Fee ID Fee Descri tion Fee Grou BREMSIGNAD Rm 31 Signs Add Branch ELECTRICAL BREMSIGNS Rerriodel Signs, Marquee ELECTRICAL BREMTHEATR Th�;atrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Sin le Duct MECHANICAL BREMVENSYS V��ntilation S stems MECHANICAL BSCBLVD ,�cb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL ��pecial Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Tem orary Power ELECTRICAL BTEMPPERM Tem orar Bld Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL / BUSLIC ]3usiness License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE 1V[echanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plu�nbin Permit Issue PLUMBING PPLBG Plizmbing Fee sq foot PLUMBING PLLONGRNGC Plannin LR Comme/ Multi-Fam PLANNING PLLONGRNGR Plannin Lon Ran e Residential PLANNING 3 of 3 CITY OF CUPERTINO 5 ITEMS OF 5 PERMI�� RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: B11:: Lot: APN ......... 36�>38001.00 DATE ISSUED.......: 10,'17/2007 RECEIPT #.........: BSI)00003012 REFERENCE ID # ...: 07:_00123 SITE ADDRESS .....: 21"'10 RAINBOW CT SUBDIVISION ......: CITY .............. CUPERTINO IMPACT AREA .... . OWNER ............: STI:VE & KATHY RICHARDS ADDRESS ........... 21"'10 RAINBOW DR CITY/STATE/ZIP ...: CU]'ERTINO CA, 95014-4829 RECEIVED FROM . . . . : DEE�I�T WHITE CONTRACTOR .......: WAI�TER M. SPRINGS JR LIC # 22738 COMPANY ..........: WAI�TER M. SPRINGS CONSTRUCTION ADDRESS ..........: 37() INDUSTRIAL ROAD CITY/STATE/ZIP ...: SAP1 CARLOS, CA 94070 TELEPHONE ........: (6_`i0)592-2922 FEE ID UNIT QUANTITY ��'IOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- --�-------- ---------- ---------- ---------- BENERGY PERMIT FEE 453.60 217.73 0.00 217.73 0.00 BPERMFEE VALUATION 40,000.00 453.60 0.00 453.60 0.00 BPLANCHK PERMIT FEE 453.60 605.33 0.00 605.33 0.00 BSEISMICRE VALUATION 40,000.00 4.00 0.00 4.00 0.00 BUSLIC FLAT RATE 1.00 107.00 0.00 107.00 0.00 --�-------- ---------- ---------- ---------- TOTAL PERMIT : 1387.66 0.00 1387.66 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- ------------=-- -------------------- CREDIT CARD 1,387.66 MC --------------- TOTAL RECEIPT : 1 ,387.66