06060036CITY OF CUPERTINO
j�Xn�G>fT�Opnr'.Rr AuT N�OL�M'N+JG'}`
BUILDING DIVISION PERNQT
O'Mna�r'
BUILDING ADDRESS:
TNT TRUCK N TRACTOR
P°MTNo-06060036
22323 BAHL S
OW NEWS NAME:
PFRMfI LSIIE DATE
, & JAY TALAJIA
2395 S BASCOM AV
06
10OM
SANITARY NO. Cot Rcc NO.
(408)888-4748
ARCWTECT/ENOINEER:
BUILDING PERMrr INFO
DG
BLF1ECT PLUMB MECH
LICENSED CONTRACTORS DECLARATION
I Emcby a finoLIC that 1 w OMA MR pofvions ATIONt« 9 (comtomcNg
0 �
Job Description��
with ScNun 7()OBIo(Dividon 3 alh Bodnvan�Pr�emmt Code. and my lcemcu
in mu rorce aW off . f7`'g�Z--�� `
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P�ClOOL DEMO 4 FILL WITH SOIL L
L�
'ARCHRECrS DECLARATION
//�
./ 2006
JUN
JUIV
1wtr�nanl muu Nad
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PAG
OWNEA-BUILDER DECLARATION
Lkamed o mbyv fl,
1 hereby allirm tbu I .m urmpt form Nc Cmvurart Lkcmc law for th
following recon. (Sa on 7(131.5. 9ufinas aW Profmuom Code: Any eby or county
which rgWrm a pmmft to cmwfa:L a w. inpma, dcmaui « mpm4 aey awn.
prior b ilk ia.. altortgW= ft spplicmt f« such pumll n nk a ng«d uucmcnl
Cnn Ul ChWp 9
Sq. Ft. Floor Area
Valuation
Nor le u liccmed P.1 to the pmnsbv of l tbo"licen
(c«nmc«ing with Sa.oi. 700(3) a Divukn 3 of th Businea and Praaiom Code) or
that be Et comp rhrtfmm ud th batt for the Ward .,don- Any vioudoo of
Occupancy Type
Semlon 7031.5 by avy ap kB f«• pemdt mbjem We applicnn In aoWn pmultY Of
rat mom Wan fife burdred dalan (SM
❑ L u owou aNc prapmty, «my wpb3vA wiW Topa u hclr fak mepcmtim.
Required Inspections
P
WtIlw WewortaM We tmuawe6rotinaotrd«aRaW f«a.k (iK.7()i1,BYL«at
aW Pmfaslom code Th Caaramrt I ti - Law don oot apply to u ww a
prop«ty.m bwlds «imports Otmo7n, and rM ana num wk hlmvJf m Wrough hit
ow efopby«a, psoddcd dot vsE ImPmfemrm+are tuinlrsdN «oQaW f«salt B.
brefv. We bJWing «impovemrn k sdd whhut arc Sear ammpkdon, tEc awar-
bWldc wi0 Ease the burden a prvNnt dw h dM tam �W v Imprmae f« ptvpoe a
❑ L u owner of We property. am essl Wvery coon rrl wiW li®vd mevcm to
cmth pmjea (see 70 W, ausinm aW Praessiams Code:)The Cont z LL
more law da J mt WW1 on m a of property who Fonds «fire f therrmt. and.
whocoouatvf«f bpmjt,=w acoov..WS)B dPu,=000th Comramors
Lira Law.
❑ Iameaentpttmder See .BdPC for dda rem
Owar
COSAT70N DECLIRATITION
WORM:DtS A/PFN
1 hereby aBbm Leder pevWy of p 3jm one of th following dcclantiate
.
Ibt.e and will mnnulo a CartlEmm of Co=ot In tnlf-wore for WMIores Cnrn e
tW an, u pmNtkd for by Semlan 370() of th labor Cade, for dw pt forma«e of Je
wM for which Wit p.h u I.aoed
❑ 1 have aW will rogn on Worley, CoroWoLCw loo. u req.,. , by Section
3'100 ofde fab« Cotle. for th pNf m Of thw for which tbu penult k Laced
My Warters C. WP o. bfwnanm n aW Policy too( 'oo'
Grriur YYta-- Policy No: J /_rie02—
7
- - (;NMFICA OPE%EMPrIONFRQNWORKERS.-
COMPENSATION INSURANCE
01 s reed nn boe Ioiod Bthe RrmE k for. hontreddoBan WWI
or )
1 c that in Vc Pt rfoon. of W< w for which Wu p it u la«d. l Nail tort
omPloy anyP nIn and mm . u to bcc«oc ntbjat to WCWartcY Camp®rtian
.
Law( of CalfforWL Dam
r
OTO APPLICANT: If. afw making Wu Ccrullc= of EWooPdan, /w (boric
NATICE
boa sobjm on th Woh s C«opematiw pmWloru of dm labs Cade. yeo mon
furWwiih comply wl0 tach provisi«u «Wu pmmu (lull be dmuctl mmtcl
5
,
CONSTRUCTION LENDING AGENCY
I hmoby alliam t1ma Wert u a coommm knthng spay f« We pmf� a
> th vert r« rhkh ddt pmtirt u ut«E (Sec 3057. CN. C)
Irmhfs Nm
Ialdcrs Addrea
L
I tartlfy dot 1 haft read tb t awkatim ud lute thu We abofe information u
carrm 1'. to camPly wit), all d" aW county onll. wd ante tars r, Joz to
boidi hcrtbyamhodx rtprtunmifcf of Wif dtymmsm upon de
alroiuuoctia
wvcunctl propertYrtyfor infpcctian Puryous
(Wc) agree to afo, indemnify aW hep harmlea th Cty of Cupeniuo agaimt
n in co l ;..W a hertt ink ofpemetwbk4 mryin any wyaeers agawu old Cty
Z De ting of
� APPLICA¢N/T�JU�NDER�/fS{ffSA'(N/�OS AND WILL COMPLY WITH ALL/ ON -POINT'
APPL.I ANTU AND I
Issued by: Date
SOURCE
/.
/c1T.n/7N-LYA'P"Y �Y
Reproofs
Type Of ROOF
s gou«e ofApWlounC«tuact«
HAWtDOUs MATERIALS DISCLOSURE
Will de appB or(uwc building as L Hort Or MWkhmrdvu wserul
u def r d by Ne C.Pe . Monioll Cade. Cbapmr 9.1; aW tbo HW W and Lfuy
Cnoo °n 15531147 /
All roofs shall be inspected prior to any roofing material being installed.
❑Ya WNo
If a roof is installed without first obtaining an inspection, I agree to remove
dvsc cgtdprnm or tkvltrs
mit luno appBcant «fmurt JWing oav t which
emit Wu . air mntudmeo u dcOrcd by the Bay Arta Air Qto hY Maoag
all new materials for inspection.
. DUWnT
Yuo
I haft read the hazer ro=ruk x,o.rrcn, tuxkr Chtpumd.9sadc Calif«-
niaH Irb&Safmy Cadc. Scm000; 25Y15. 15573 aW Mt .lundm dutifWc ridding
dam tut c ly Mo a govt dot it u my repvmbility to notify th o¢wpmt a the
g norm wnkhmgpb tp«a wnaaacmww o� 66
Signature of Applicant Date
All roof coverings to be Class "B" or better
owar or autE«aW tent mta
UPERTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS:
22323 /3a -LL 5ft-4-d
PERMIT #
06o6003(:�'
OWNER'S NAME:QA--tSa 77, i
PHONE #c Qi— Vofr -373--
GENERAL CONTRACTOR NT Ir GlJ7rn-001-
FAX #
-�vr/�o✓ �fct... s V-09- P¢5 --Y-7
I am not using any subcontractors: J��,� 6 d�
Signature Date
Please check applicable subcontractors and complete the following information:
Owner/ Contractor Signature
��d
Date
767
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/ Contractor Signature
��d
Date
767
�m 1 of 1
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 32613092.00
DATE ISSUED.......: 06/06/2006
RECEIPT #.........: 34698
REFERENCE ID # ...: 06060036
SITE ADDRESS .....: 22323 BAHL ST
SUBDIVISION ......
CITY .............: CUPERTINO
IMPACT AREA ......
OWNER ............: OM & JAY TALAJIA
ADDRESS ..........:
CITY/STATE/ZIP ...: ,
RECEIVED FROM ....: TNT TRUCK N TRACTOR
CONTRACTOR .......: RON ADAMS LIC # 24994
COMPANY ..........: TNT TRUCK N TRACTOR
ADDRESS ..........: 2395 S BASCOM AVE, STE 5
CITY/STATE/ZIP ...: CAMPBELL, CA 95008
TELEPHONE ........: (408)888-4748
FEE ID UNIT
QUANTITY AMOUNT PD -TO -DT
OPERATOR: amyw
COPY # : 2
THIS REC NEW BAL
BPERMFEE VALUATION
9,000.00
158.76
0.00
158.76
0.00
BSEISMICRE VALUATION
9,000.00
0.90
0.00
0.90
0.00
BUSLIC FLAT RATE
1.00
105.00
0.00
105.00
0.00
TOTAL PERMIT
264.66
0.00
264.66
0.00
METHOD OF PAYMENT
AMOUNT
NUMBER
----------------- ------------
CHECK
264.66
------------------
1037
TOTAL RECEIPT
264.66
VOICE ID DESCRIPTION
VOICE ID
DESCRIPTION
-------------------------------
704 DEMO
--------
----------------------------
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(CGS -
CITY OF
CUPERTINO
CITE' OF CUP ERTINO 0(00-�OGO'E&
DEMO
PERMIT APPLICATION FORM
APN # 3-2-U 3'
(N2
Fee Grou
Date: / D
Bldg Permit Fees
BUILIDNG
Building Address-
ddress:2Z 7-3
-2- 2-
Sfi�e c� �, w
Ll" ?sod
13AItL
Owner's Name:Phone
BUILIDNG
#: C
c%
icy.
�S' 7 - 67
Contractor:
Ttir
Al
License #:
/� - g°9z1 /
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Contact: /`�
BPLANCHK
Plan Check Fee
Phone#: C
Applicant/Contract��f
r/1"P14 o
Bu' mg Permit Info:
Bl
Elelum
ech
Job Description:
Residential: 6 L C
t
G fiLL soy/
Commercial:
Sq.Ft. Floor Area:
$/Sq.Ft.:
Architect/Engineer:
Business License
BUILIDNG
Valuation:
Type of Construction:
Occupancy Group
I V t�—
Otv. if
j
Applicable Fee ID
Fee Descri tion
Fee Grou
BPERMFEE
Bldg Permit Fees
BUILIDNG
BSEISMICOM
Seismic Commercial
BUILIDNG
BSEISMICRE
Seismic Residential
BUILIDNG
BPLANCHK
Plan Check Fee
BUILIDNG
BUSLIC
Business License
BUILIDNG