The URL can be used to link to this page

14070111 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21647 RAINBOW DR CONTRACTOR:S&K ELECTRIC INC PERMIT NO: 14070111 OWNER'S NAME: PATIL SUHAS S AND JAYASHREE S 515 N MIDWAY RD DATE ISSUED:07/24/2014 OWNER'S PHONE: 4083072310 TRACY,CA 95391 PHONE NO:(650)630-4801 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL F] COMMERCIAL ADD 50 AMP CIRCUIT IN GARAGE License Class — Li..# Contractor ✓PctJ 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 kIhransation,as provided for by Section 3700 of the Labor Code,for the ve rmance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$895 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:36637002.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT ' XPIRES QRK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITfIIN 1 0 DAYS OF PE IT 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 INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, d costs,and expenses which may ac a ainst said City in consequence of the Issued b Date: granting of this permit. Additiona ly,t applicant understands and will comply y' with all non-point source regulatio s pyr the Cupertino Municipal de,Section 9 18. RE-ROOFS: Signatu4 Date 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(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 . Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino u icipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25 3 nd 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized age Date C 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 CcNEtRAL PERMIT APPLICATION MEP 4 COMMUNITY DEVELOPh4ENT DEPARTidiENT- BUILDING DIVISION \ Ambk \` '10300 TORRE AVENUE- CUPER T INO, CA 95014-3266 �" IWL (408) 77i-3228 FAX(408)777-3333 buildinaC5�cuc�� U�E�TtI�tO ino.ora m I S (;O ❑PLU1iJBLnG ❑h C`ii�1�ZC.aL -LECTRICA-L ❑1,dSCELL AN-OT-JS//�� PROM-M,ADDR_SS /� L f px.R /n JQ UV IG' WW vv � o n. a nAI Z.j 3O� -Mars, Cc k 0 STS-Z7- ADDP. SS e 1 I C ,STAT t,Zy.• r ��D� 2 x v CO viACT Ncti,r� PHO t g� / I 7:-7J4�TT oMn ❑ o�? -sty oal�AC�°S co.?_acoR ❑coI ix�c DRAG z ❑ E�c—cz ❑TC-= R ❑ Dom=- ?=-FL ❑ 'T CGR kCiOR? tl✓: LC�SETZII 'R I LICi?.ei 3US.L f COI✓DAhYI�at� � � =-I✓ a �. I iAX ss�-z7ADDRE �OUTECI-JENOD'EMNAIJ? I T icr'hSEI,'UI, ER. I BUS.LIC r COI✓.PAT'YNA�S I E-I✓LaII. ( FAX ST =r— ADDR=SS I CITY,STATE,ZIP I PHOKE USE OF ❑SFD of DiJPLi"".. ❑ mpui-iA2✓,II..YI ?RGJ'r.a w v1=LA21D ❑ YES I PROTECT N ❑YES I IS i &IDG F1S IIG ❑1 S Bi-II D : ❑coN�✓:mm"L Vr.3AN 1T�FACEA-% A ❑ ?�0 FLOOD-7017-- [31"o EI CSi.�t HOIlm? ❑ .No DESCRIPTION'Or WORK T O T FT Vp T UATION: By my sig raise below,I ce:ify to each o_=_he followingg: I u]i iP IOi7e Ly O1i]eI of authorized ag--n'io act on the prop' t ovmei' behalf. I hay.e read this application and the info.-nation I hwve provided is correct I hzv r^ d the Desc-iption oft%ork and verify it is acczate. i a� aply v;th all applicable 1x21 ordinances and s`-ate lab's relating to building constructio alit i - nt€fives of CLpc;Lino to enter the above-i citified Dr l tnny for LS-pection purposes. Si`a ireof Palica-,t" ee^t: STJPPLER-ENTAL TUNT LkTION REQTJ=-D �s _ WE - • 1✓�P_'�I sc�'g� 2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 21647 rainbow dr DATE: 07/24/2014 REVIEWED BY: Mendez APN: BP#: 'VALUATION: $895 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 REAP2 USE: p PERMIT TYPE: WORK add 50 amp circuit in garage SCOPE -11 31 s 'X. � 0� r_ Rs Phtinb. Plun C"he<°l 0(4 Elec.Plan Check 0.0 hrs $0.00 Fee: Phim!). Permit 11,11 Elec.Permit Fee: IEPERMIT t)rr,c�,P1,mF;frz��. Other Elec.Insp. 0.0 hrs $48.00 NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 7(f 11113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = amps Electrical Suppl. PC Fee: Reg. 0 OT 0.0 hrs $0.00 $48.00 IBELEC2007 Services PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $48.00 TLLV. F71 Administrative Fee: IADMIN $45.00 Work Without Permit? Yes (F) No $0.00 E) Advanced Plann Fee. $0.00 Select a Non-Residential Travel Documentation Fee: ITRAVDOC $48.00 Building or Structure i Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item BldgStds Commission Fee: IBCBSC $1.00 .-OMN"®� I.S $142.50 $48.00 TOTAL FEE: $190.50 Revised: 07/10/2014