15110153CITE' OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20685 GARDEN MANOR CT
CONTRACTOR: TRENCHFREE INC PERMIT NO: 15 110 153
OWNER'S NAME: AMARENDRA & SUSHMITA VERMA
PO BOX U DATE ISSUED: 11/20/2015
OWNER'S PHONE:
SAN JOSE, CA 95151 PHONE NO: (408) 726-7926
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
�t �7 J
License Class arC Lic. # ` �G 0 � 6J
REPLACE MAIN WATER SERVICE FROM METER TO
PROPERTY.
Contractor _ _ --T�Zolycw7ieoQ Date i Agoh
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
Sq. Ft Floor Area:
Valuation: $2350
performance of the work for which this permit is issued.
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
permit is issued.
APN Number: 36230078.00
Occupancy Type:
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
to building construction, and hereby authorize representatives of this city to enter
WITHIN 1S0 DAYS OF PERMIT ISSUANCE OR
upon the above mentioned property for inspection purposes. (We) agree to save
180 DAYS FROM LAST CALLED INSP CTI N.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of theIt
1W f
granting of this permit. Additionally, the applicant understands and will comply
Issued by: Date: I
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
/)4Qk5-All
RE -ROOFS:
Signature Date
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)
1, 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 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
Owner or authorized agent: /� Date: G
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
ARCHITECT'S DECLARATION
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.
S ignature Date
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GENERAL PE1MllAPPLICATION
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CITY OF CUPERTINO
FEF. ESTIMATOR — BUILDING DIVISION
TOTE: This estimate does not includefees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, Schooi
District, etc.). Thesefees are based on the preliminary information available and are only an estimate. Contact the Deptjor addn't info.
FEE ITEMS (Fee Resolution .1.1-053.Eff. 7/1113)
ADDRESS: 2- 0655- GOVZU PiWOf TDATE: 11/20/2015
REVIEWED BY: Paul
MISC ITEMS
APN:�st —'3() —0
BP#:
*VALUATION:
1$2,350
*PERMIT TYPE: Plumbing Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Duplex
USE:
$0.00
PENTAMATION
I PERMIT TYPE: 1 RPWS
WORK
Replace main water service from meter to property
SCOPE
1,, Perrail [-`ee:
TOTE: This estimate does not includefees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, Schooi
District, etc.). Thesefees are based on the preliminary information available and are only an estimate. Contact the Deptjor addn't info.
FEE ITEMS (Fee Resolution .1.1-053.Eff. 7/1113)
FEE
QTY/FEE
MISC ITEMS
1'kin (.'heck- T`ee:
Aleck Pilin Check
suppL X7 14yee
Plumb. Plan Check
0.0
hrs
$0.00
$0.00
.Pe?,nlil Pee:
1,, Perrail [-`ee:
ee:
Plumb. Permit Fee:
I --t
IPPERMIT
PME Unit Fee:
Fuec Pe mut F :
0iher,A,fech. hfq,-
$48.00
(.7onsfruction Tm,:
OtherPlumblnsp.
L L -OJ
hrs
$48.00
Work Without Permit? 0 Yes (D No
$0.00
Ins,11, Fee:
Plun1b, fmv. Eee:
$48.00
Strong Motion Fee: IBSEISMICR
TOTE: This estimate does not includefees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, Schooi
District, etc.). Thesefees are based on the preliminary information available and are only an estimate. Contact the Deptjor addn't info.
FEE ITEMS (Fee Resolution .1.1-053.Eff. 7/1113)
FEE
QTY/FEE
MISC ITEMS
1'kin (.'heck- T`ee:
suppL X7 14yee
PME}
ME Plan Check:
$0.00
.Pe?,nlil Pee:
S7,q7pL.1nsp Fee
PME Unit Fee:
$25.00
PME Permit Fee:
$48.00
(.7onsfruction Tm,:
Administrative Fee: JADMIN
$45.00
Work Without Permit? 0 Yes (D No
$0.00
Travel Documentation Fee: I TRA VDOC
$48.00
Strong Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bldg, Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$167.50
.. ....
$0.001 TOTAL FE
Revised: 10/01/2015
11/19/2015
To Whom it May Concern,
GVT Homeowners Association has hired TrenchFree to run new pipe from the
outside of the townhouse to the San Jose Water Dept's water main located in
the common area of GVT property.
Listed below are the addresses affected.
Garden Crest Ct.
20713,20717f
20727, 20729
Ca . ��
J�,.
ckie Boyle
President GVT HOA
Garden Manor Ct.
20685, 20693,
20701
Garden Terrace Dr.
11410