14060147CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10168 RIDGEWAY DR
CONTRACTOR: CONSOLIDATED
PERMIT NO: 14060147
PLUMBING INC
OWNER'S NAME: SHISHIR CHAVAN
3732 CHARTER PARK DR STE D
DATE ISSUED: 06/24/2014
OWNER'S PHONE: 4098996744
SAN JOSE, CA 95136
PHONE NO: (408)978 -3093
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
INSTALL PROPERTY LINE CLEAN OUT
License Class L' 2i 6 Lic.
Contractor 1 Nq 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: $17500
ave and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 34241010 00
Occupancy Type:
ection 3700 of the Labor Code, for the performance of the work for which this
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
WIT 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 DA FROM L ST CALLED INSP N.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
which may accrue against said City in consequence of the
costs, and expenses
Issued by: Date: G/
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9 18.
�' �/
RE- ROOFS:
being installed. If is
Signature ate !
All roofs shall be inspected prior to any roofing material a roof
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 (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 Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections,25505125533, and 25534.
Section 3700 of the Labor Code, for the performan ce of the work for which this
Owner or authorized agent: Date: p 2 t
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
GENERAL PERVIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION MEP
1'0300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 t'�1P
CIJPEiiTtWO (408) 777 -3228 • FAX (408) 777 -3333 • buildina(ftunertino.orG `V MISC
PLtI1vIHtNG_ MECfiANIC ❑ELECTRICAL MISCELLANEOUS
PROJECT ADDRESS D/
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APN # A o10
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CITY, T£, ZIP.
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CONTACT NAhS
PHONE E -MSII
STREET ADDRESS
CITY; STATE, ZIP
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❑ O'A MX '❑ O'AWM- BUILDMt
❑ Q�Vl cR AGENT ❑ CONTRACTOR ❑ CONTRACTOR ACrel.T ❑ ARCMTSCT ❑ ENG NEEER ❑ DEVEL.OPER ❑ TENANT
CONTRACTOR NAME n
LICENSE Nul -dER LICENSE TYPE -36
BUS. LJC #
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GRIP
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STREn-T ADDRESS
CITY, STA
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ARCHITECT/ENGINEER NAME
LICENSE NUMBER.
BUS. LIC #
COMPANY NAME
E-MAIIL
FAX
STREET ADDRESS
CITY. STATE, ZIP
PHONE
USE OF ❑SFD or DUPLEX :❑ MULTI -FAMILY
BUIIDWG ❑'S RO
PROJECT Pi WILDLAND ❑ YES
URBAN Z,7ERFACE AREA ❑ NO
PROJECT N ❑ YES
FLOOD ZONE ❑ NO
IS THE BLDG AN ❑YES
EIm=Hojw ❑ NO
DESCRIPTION OF WORK
L
TOTAL VALUATION
By my signature _low, I certify to each of the following: I am Owner or authorized agent to act on the prope mer's beh I have read this
application and the information I have " ed ' correct. ave a Description of Work and verify it is accurate. I agree to cor with all applicable local
ordinances and state laws relating u' construct' orize re entatives Of Cupertino to enter the above - identified proplerty for inspection purposes.
Signature of ApplicandAgent• Date: ,.
P
AfE1;
ORZ\?ATION REQUIRED
s,W
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t'
kIEPAdiscAPP_2011.doc revised 06121111
CITY OF CUPERTINO
F07W FEE ESTIMATOR — BUILDING DIVISION
imlADDRESS: 10168 ridgeview dr
FEE
DATE: 06/24/2014
REVIEWED BY: Mendez
APN:
I BP#:
VALUATION: 1$17,500
*PERMIT TYPE: Plumbing Permit
Other Plumb Insp. ETrs $47.00
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Duplex
USE:
flhiinh. hiV). Fee:
PENTAMATION 1 RPSS
PERMIT TYPE:
WORK
install property line clean out
SCOPE
APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES
Sewer, Sanitary 1PRSEWER 1 # $24
TOTALS: $24.00
.............
S
FEE
Plumb. Plan Check 0.0 hrs $0.00
L/ ec, 1>/�iP
Fee:
Plumb. Permit Fee: IPPERMIT
F-1 1
Other Plumb Insp. ETrs $47.00
011�er 1�k"" Ins,
"7'
flhiinh. hiV). Fee:
$0.00
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District School
1111"—*- � Th— f— — h"cad an tho nrplimhiary information available and are onlv an estimate. Contact the Dept for addnl info.
FEE ITEMS (&e Resolution 11-053 fff. 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan ('h (,'k F(e:
PME Plan Check:
$0.00
PME Unit Fee:
$24.00
PME Permit Fee:
$47.00
Administrative Fee: ]ADMIN
$44.00
Work Without Permit? 0 Yes 0 No
$0.00
Travel Documentation Fee: I TRA VDOC
$47.00
Strong Motion Fee: IBSEISMICR
$1.75
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
i `O TA ,S:,,'
-OT
$164.75
$0.00 TOTAL FEE:
$164.751
Revised: 04/01/2014
Rick,
Subject: FW: DEANZA OAKS PHASE 6
1. 10148 Ridgeway - John Quitoriano 408 -446 -2335
March l'8, 2014
To Whom It May Concern
Re: De Anza Oaks Homeowners Association
Dear Sirs:
Consolidated;Ptuntbing, Inc. has the association's permission to seek permits for the repairs of any domestic
water lines orsewer Tines located within the De Anza Oaks community <.
Since'
Co munitylmana item Services, Inc.
Bill ui hai`d)Association Manager
De An Oaks Homeowners Association
BH /st
cc: Board of Directors
1935 Dry Creek Road, Suite 203 ■'Campbell, CA ■ 95008 -3631 a voice (408) 559 -1977 ■fax (408) 559 -1970
.r
•
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling <unit including basements
X
X
SMOKE / CARBON MONOXIDE ALARMS
;.
,. .
Of1�hER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING DIVISION
10300 TORRE.AVENUE • CUPERTINO, CA 95014 -3255
CUPkRTIN - -- - -- - - -- ....
Address
PURPOSE
This affidavit is a self- certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC. Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION
Existing single - family and multi- family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon
Monoxide Alarms be installed in the following locations: �� I
AREA
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling <unit including basements
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl
space. Refer to CRC ,Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above - referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
Shah (� cWk ,4 t h.,ra: roar✓ anM arrraa to nomnly with lh-p hprms and conditions of th 'statement
Owner (or O Rrt' N ame :
cS lS-� t D C 1 '�
Sinature ..............................,... ............................... ............... ............................... Date: ...................
Con ctor me:
,
3
Sina re . .. ...... ....... ..................... ....... Date: �� .... ...
Smoke and COform.doc revised 03118114