13070202CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7403 STANFORD PL CONTRACTOR: JOHNSTON ELECTRICAL PERMIT NO: 13070202
CONTRACTOR
OWNER'S NAME: GREENLY KENNETH) AND PATTI J 1302 LINCOLN AVE STE 204 DATE ISSUED: 07/31/2013
OWNER'S PHONE: 4082522369 SAN JOSE, CA 95125 PHONE NO: (408)266-0236
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class C / O Lica# UPGRADE (E) 100 AMP PANEL TO (N) 200 AMP PANEL,
SAME LOCATION
Contractor Date.
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: $900
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 APN Number: 35932029.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF T ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS F LED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments, 2
costs, and expenses which may accrue against said City in consequence of the Date 7I
granting of this permit. Addi�ti�,er
plicant understands and will comply e
with all non -point source re Cupertino Municipal Code, Se tion
9.18.
RE -ROOFS:
Signature Date__7 lt 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
inspection.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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)
I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area uality Management District I
performance of the work for which this.permit is issued. will maintain compliance with the Cuper ' o icipal Code, Chapter 9.13 a d
Ihave and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 2 5 3, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 7
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 CONSTRUCTION LENDING AGENCY
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 I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional
9.18.
Signature Date
CUPERTINO
V
GENERAL PERMIT APPLICATION
Ot, MEP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 1j misc
(408) 777-3228 • FAX (408) 777-3333 • building(d)cupertino.org ` I /
❑ PLUMBING ❑ MECHANICAL ELECTRICAL []MISCELLANEOUS
PROJECT ADDRESS31a �v
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❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT
M—CONTRACTOR 0 CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR
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ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
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STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or DUPLEX ❑ MULTI -FAMILY
BUILDING: ❑ COMMERCIAL
PROJECT IN WILDLAND ❑ YES
URBAN INTERFACE AREA ❑ NO
PROJECT IN ❑ YES
FLOOD ZONE ❑ NO
IS THE BLDG AN ❑ YES
EICHLER HOME? ❑ NO
DESCRIPTION OF WORK
TOTAL VALUATION: QD
the property owner or authorized agent to act on the prope owner's behalf I have read this
By my signature below, I certify to each of the followin!n.1
application and the information I have provide I e read the Description of Work and verify it is accurate I agr a to comply with all applicable local
ordinances and state laws relating to buildin s thorize representatives of Cupertino to enter the abov denti ed property for inspection purposes.
Signature of Applicant/Agent: Date: '7 /
S PLEMENTAL INFORMATION REQUIRED
OFFICE USE ONLY
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OVER-THE-COUNTER
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❑ EXPRESS
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❑ MAJOR
MEPMiscApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
117 117117 117 CT7M A rrn12 _ Rl Tll ."-FN(- DlVlClnN
LaADDRESS:
7403 STANFORD PL
DATE: 07/31/2013
REVIEWED BY: MELISSA
MISC ITEMS
APN: 359 32 029
BP#:
"'VALUATION: $900
*PERMIT TYPE: Electrical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Du lex
p
PENTAMATION 1 REAP2
PERMIT TYPE:
USE:
Permit .Fee:
WORK
UPGRADE E 100 AMP PANEL TON 200 AMP PANEL SAME LOCATION
SCOPE
APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES
Services 1ERT<200 100 Amps $47
TOTALS: $47.00
Xtech. Plan Check
Mech. Permit Fee:
Other .lfech. Insp. Li
Mech. Insp. Fee:
P imb. Plan Check
Plumb. Permit Fee:
Other Plumb Insp.
Plumb. Insp. Fee:
Elec. Plan Check 0.0 1 hrs $0.00
Elee. Permit Fee: IEPERMIT
Other Elea Insp. 0.0 1 hrs $47.00
Elec. Insp. f'ee:
NOTE: This estimate does not ineludejjees due to other vepartntems h.e. riammng, runic rrurna, fere, . ws,u,y -.1 .�...,.. y .�.... �.
District, eta). These fiw are based on the prelimina information available and are only an estimate Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 711112)
FEE
QTY/FEE
MISC ITEMS
.Plan Cheep Fee:
SuPPI. PCT( -,e
PME Plan Check:
$0.00
Permit .Fee:
SulaPl. Hasp Fee
PME Unit Fee:
$47.00
PME Permit Fee:
$47.00
(;canstr•uetion .Taa: -FT
Administrative Fee: IADMIN
$44.00
Work Without Permit? 0 Yes (E) No
$0.00
Advanced Planning Fees:
i
Travel Documentation Fee: 1TRAVDOC
$47.00
Strong Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Commission Fee:IBCBSC
$1.00
Wtds
$186.50
$0.00
$186.50
Revised: 07/01/2013