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14030040
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 931 BLAZINGWOOD AVE CONTRACTOR:MAINE ELECTRIC INC PERMIT NO: 14030040 OWNER'S NAME: MURAKAMI SAM S AND HIDEKO 599 LEISURE ST DATE ISSUED:03/06/2014 OWNER'S PHONE: 4082534129 LIVERMORE,CA 94551 PHONE NO:(925)443-3377 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ COMPLETE RE-WIRE(E)SFD.37 OUTLET RECEPTACLES, License Class Lie.# 0 13 SWITCHES& 13 LIGHT FIXTURES.ADD(N) 100AMP Contractor P Date 14 SUB PANEL IN HALL I hereby affirm tha am lice d 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:$45000 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:36920017 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 PERMIT 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 FRO LED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the 6 / granting of this per 't. Additionally, a applicant understands and will comply Y Date: with all non-point ce regulations er the Cupertino Municipal Code,Section 9 18. RE-ROOFS: Signature Date l 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 I,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(See.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 he Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with'. Cuperti Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se io s 25505, 33,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 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 Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY 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 GENERAL PERMIT APPLICATION O E P COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 v\O (408) 777-3228•FAX(408)777-3333•buildina(Mcupertino.org MISC eui��k�trto ❑PLUMBING [:]MECHANICAL ELECTRICAL []MISCELLANEOUS PROJECT ADDRESS I ! APN 0 OWNERNAME 0\ PHONEOb ��/ CITY,STATE, E MAII STREET ADDRESS ) ` `j J, FAX z Q �o CONTACT NAME .r PHONE E-MAIL STREET ADDRESS CITY,STATE ZIP / FAX y ❑ OWNER '❑ OwNER-BUIIAER ❑ OWNER AGENT V CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCIETECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME aLICEISENUIOER f�/1 LICENSETYPE I BUS.LIC# Ottt, COMPANY NAME j `! a E-MAIL FAX STREET ADDRESS e V CITY,STATE,ZIP �1 U PHO r 7 7 N[ ARCHTTECT/ENGINEER NAME LICENSE NUMBER I BUS.LIC# COMPANYNAME E-MAIL FAX STREET ADDRESS CITY.STATE,ZIP PHONE USE OF SFD or DUPLEX ❑ MULTI-11Y PROJECT IN WII DLAND ❑ YES PROTECT IN YES IS THE BLDG AN ❑YES BUILDING. ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑ NO DESCRIPTION OF WORK CVtt!`( &IrI 3 �cY1 odd 4iN41 too- cw tt _ fi � TOTAL VALUATION: By my signature below,I certify to a ch of the following: I am the property owner or authorized agent t n th perty owne f I have read this application and the information I h e rovided f�� ct. I have read the Description of Work and verify it is acc te. with all applicable local ordinances and state laws relating b Ming cotion. I authorize representatives of Cupertino to enter the ab 'e-id (tiff d property for inspection purposes. Signature of Applicant/Agent: t Date: 1 S PL AL RMATION REQUIRED of sE�it MA30R MEPMiscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 931 BLAZINGWOOD AVE DATE: 03/06/2014 REVIEWED BY: MELISSA APN: 369 20 017 BP#: EVALUATION: $45,000 OPERMITTYPE: Electrical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY SFD or Du lex PENTAMATION 1REAP10 USE: p PERMIT TYPE: A WORK COMPLETE RE-WIRE E SFD. 37 OUTLET RECEPTACLES 13 SWITCHES & 13 LIGHT SCOPE FIXTURES. ADD (N) 100AMP SUB PANEL IN HALL APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Recep/Switch/Outlets 1BREMRECEP 50 # $197 Fixtures, Lighting 1BREMFIXT 13 # $70 Services 1 ERT<200 100 Amps $47 TOTALS: $314.000 !''trod/, Plan("hecn Elee.Plan Check 0.0 hrs $0.00 Pe ifil.I".el: T'd anb. flom?f Faze; Elec.Permit Fee: IEPERMIT ()?herLl 0.0?her Plumb Inlyp, Other Elec.Insp. hrs $47.00 t lc=cr Ir.'a1J, 1_y 1'ittfatb trt Fit. I �z: t�ici:.It'r4,� 1�-c.: NOTE: This estimate does not includefees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Theseees 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 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee,: PME Plan Check: $0.00 Sup, d, PME Unit Fee: $314.00 PME Permit Fee: $47.00 Construction Kfx: F Administrative Fee: IADMIN $44.00 Work Without Permit? ® Yes (F) No $0.00 Travel Documentation Fee: ITRA VDOC $47.00 Strom Motion Fee: IBSEISMICR $4.50 Select an Administrative Item Bldg Stds Commission.Fee: IBCBSC $2.00 777-7 g} $458.50 $0.00 TOAI.`FEE: $458.50 Revised: 01/15/2014 41,A40 muf4�1 ' � ICa� q��r� IAZ i a�c� �t �vrD ar• q>©( OFFICE �--- CUPERTI 5 �, i3uilding Departme2014 n 5� i f°9ra9� O '9 i'EVIEV\jr-D F CODE COMPLIANCE e Y: —it it V DQE C 5 a COMMUNi BUILE I G DIVISION-CUPERTINO PPROVE® This set of plans 4nd specifications MUST be kept at th job site during ci instruction. It is unlawful to make an change Iterations on same,or to deviate C a�� therefrom,wit t approval from the Building Office . - Sao The stamping oft is plan and specifications SHALL NO &Vvv z L be held to pent;or to bP roval of the vioiation oy`any pr of any nce or State Law. DkTE 3 / PERMIT NO.