06060196 CITY OF CUPERTINO
`dU1CDINODIVISION PERMIT �_CONT,IRACTOR NFORMAT ON q
BUILDING ADDRESS: BJ ELECTRIC INC PERMIT ND.06060196
2 BLAZINGWOOD AV
OWNER'S NAME: PERNJr LSITE DATE
SURESH KALBAG 985 SPENCE
lop NESANITARY NO. CONTROL NO.
(408) 971-6849
ARCHr1ECT/ENGINEFR: BUILD WG PFRMR INFO
BLDG ELECr Fl.UMB MECN
up� LICENSED CONRRACfORS DECLARATION Job Description
a�C 1 hacby aRrm Wu 1 am li¢nud coder pmvW«u nrOupc+9(mmmcrcin�
in
CI �h seclbn'/Oflol n(Di�meJu(um autlnra and Rofntlmo Codc.utl mYl I,
full aaand!u 2 2 DEDICATED CIRCUIT .AT REAR YARD 20 AMP
;'�i Lacuc I La.I
F p Drc 't— n DELL I
ARCHIqq 7W plans
M&H ho DFCfAR N
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OWNER-BI trmm DECLARATION
I trmbY alliin coal I am cssMpmpt( CanuamoY.Lion¢I�w rar ft o pnlo,v ng inion.(Semim 701.5,Busmis and Pmfadum Codc:Any city a coavtY .
$(L W bah on,dm a permii m cmaeacL al¢r,noprvae.mmaRat a tolm anY runtime IE$650
_Iy pri«niu inwac.alau lorNms the appliauf«such pumltm fm asig«d.wemat Va UalOn
< that lesllcc� Pomo
dpmmthepmhrtcoaa&C.m rua.La.(maprre Sq. Ft. F1oorArea
(commcocing wild Sccdao 7000)of Dividm 3a(the Boo.and Prem ..Colo)
.. Jus he U exempt thumfmm and ds bins ra coa W c od uemPlim.Any vinlaLLm of
Su.Um 70313 b1 arty appBum far a ptmoit wbjrcu Je applicant m a dWl pwby a! C
o«m«e Wan fiK hundred ddlus(5500).
1,o owou of ft pr.pmy.a my,employ.vW antu u Web ink comPrnadod.
will m We wort a rd the.bunure b onnutrsmd a a(femd lar uk(Scc.70 .Bttoo Required Inspections
and Profecl«u Cade Toafew
The Contra .I t—Ldoe oat ILWY m an awrcr or q P
papeny cobs Euro.«Impm.radrumn,lod wlm don.uch coat tim¢Ifa WrougE hu
ow cmpbYcoa•Dmaded WI inch imPamemeau re icor irreoded aafiemd rar»�u.
baaay.We building ookn oternmt V sold a did are leum cueplmito,the pwncr-
hwlea.m b.ve Je linden of pmWng War x as m bW k«Impmac to,paryo¢or
❑1.a orrncr M de pnPu Y.am ac1tv0ve3Y cmlractlnp WIW Ito
caauuxt We R^Rca(Sec.7061.Be and Pm(co i«u Code)The coouaual.U.
caa Vv dou aor apply m an owma of progeny wEo lid W a heprv,v tharw.and.
who contacts for sud pojcma NW a co tu'anolla)lianaed pmmam to We Co=wwes
Loan¢lr.
❑ Ivn.rept.o sco. .BhPCrortldamama
Owrc Duc
W O ERR COMPENSATION DECLARATi0t1
( I Emeby dRm ondcr puulty a Many noc of the folkwmg dccluubos
I ba.e erdldcmdnWo•C 373 of Cans..lel& .forc(n Wbmbaco of -
voan.u p ch thla for by Sedan]700 or We IaEor Cade.for We pMamaac ar Je
wart for wbieb Wls pmmit U i>auel
❑1 ba,e and jU mm,am W s C mpeodMbn loluruec.u r xidrm by Savin .
3`7()().r We Lana Code.fa the pufom aoa Of the wort fa which Wia pmlt IS ko'd
my W.r ' C peuatlan l rn¢tints nd Policy mmbm are:
Carrier:Oplay No.:
CFRrIFl OF IXFMPr10NFA.: WORKERS
MPENSAOON INSURANCE
rrbls=im sed natbc.plc ed U We pamB la rads hmdtldo0m(SIM)
a las)
I¢r.that In Js pm(amarec or the wom for whah this p 'is 1—cd.I Wall oat
cmp1W any pmmn in anymavrc p y Zbttemcaubt
ICWnrYaa CanpcoWlm
A"N Calirartau.DaYI n
NNOOTTIEITO APPLJCANT:If,afer coaling thia 'fsae of pilon-you monW
became obj=m We Wands Cuopenvdaa porWons a Itr l Cadc,you mood -
.J O ronhwim comply with such provid Rta W dtis p R a 111 be demtd revatc4
z coNSlRurnoN LENDING AGENCY
aW A deafor vI iac,bthis
athpuinmi[m b uua umeda(Soc.
30 97.Cot.Ca.g)
sndrrName c
ory f«We perfarmaria of
'
= z Irndcf.Add,ev
U O I cadfy coal 1 hart r thin appl im"'tato J We abme laomnatlm u
IL F carruv.I agrtc to comply MW all city ud cmmty onmaoccb aril Soto laws mlaung m
OWilding cons ...aril bcm_by.Wa oc, : outi.asor Wu city w cnsrupw We
Wshowtica,M ed pmpc at(a iuptttim p«p«ea
D. (Wc)agra m arc,irgmnN&y and Wcp hamku Js Cry of Cupmim aguou
F+N IlabillJa,Jvdgmcou.caluaMe:pnuawEicbmayNanywYacauc4aiutBaldCity
U z APPmMA UNDE ANoilDS of AND ILL COMPLY WRH NON- UNr Issued by: Date (� ' 2- Z�G
SkL
WR G
O b Re-roofs
Sign t or iamYCanuaoar D"` T of Roof
// IIA2ARDOUSMATERIALS DISCLOSURE Type
WId 4h=ofit.bu0dngompntsmae or handle hazudaua mamrial
u defined by de Cnpudoo Municipal Codc,Chapin 9.12 and the Health and SarmY
Cuda Sermon 2553z(U7 ` All roofs shall be inspected prior to any roofing material being installed.
E]Y. Na
If a roof is installed without first obtaining an inspection,I agree to remove
Will thc applicant«foum buildings pant um gWpomt adcviw wbab
.mit hat r aI,Miamiruota u maned by We Bay Amo Air QWity Mwgcmcot all new materials for inspection.
Diah3cO
❑Yu
I hart road theh Yadamm,o-.:..m7ufmmcrosunJcrmaprrA95ofdeCahfa-
niaHalthkSaf YCadc. 73505.n533ed75534.1undcmaM irWcbA&n{
don not bc� .-coalYponoblikymn yJcp Lacot
mqu: �payWmaaa,�ar.cadrealeor � 6 Signature of Applicant Date
as ' / Dato All roof coverings to be Class "B"or better
Community Development
l
0300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
OF Fax(408) 777-3333
#UPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
92 Z t3 f CcZ- w--6d� a6o�o
OWNER'S NAME: G PHONE # 7-2—s--161o'
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: �^ a
gnature Date
Please check applicable subcontractors and 4ohiplete the following information
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 Date
j,
• MY OF
CUPEkTINO
Assessor's Parcel Number-
Name of owner. �!A r
Project address.
J
Contact person. J N S/ ',0 4�e4 Phone -T ",O 57
Fax.
Net square footage of lot.
Existin Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces inside the garage? ---Y�,
•
Is privacy protection planting required for the project?
On what floor(s) is work being done?
Brief description of work e,
Code editions: 2001 CBC (Y - N)2001 CFC (Y -N)2001 CMC (Y- N)
2001 CPC (Y -N)2001 NEC ON)
IN ACCORDANCE WITH THE CITY Ot
cupERTINO CODES AND ORDINANCES 0� /
c, z -L-� 0 �0
ATE
AGNED
This set ofpansand�specifications Mils-
oe kept on the job at all times and it is un
awful to Make any changes or alteration.
)n same Without Written Permission fron
• he building Dept., City Of Cupertino.
The stamping of this plan and specification
iHALL NOT be held to permit or to be ar
approval of the violation of any provision,
any
Plan Review Process Work Book Page-8-Revised 4/28/04
• �'`""--ems , � � l; es
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4�'S'�4.`ar J i 1-yyr�`yy U-
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RESIDENTIAL PROJECT-V i
-] cry,4 � tN'tc Fi, 4."• ,y ti • Cc,�Gcu' .r3. 4w,
CITY of � L�., ,� i' L; rft�.,.+§- ' „ d Jt4-, a Adtem-
-
CUPERTINO is<,,. o r' ' a y .r r N �3ws .,�In x_
Assessor's Parcel Number:
Name of owner.
Project address.
Contact person. Phone.
Fax.
Net square footage of lot.
Existing Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces inside the garage? Y N
Is privacy protection planting required for the project? Y N •
On what floor(s) is work being done?
Brief description of work.
Code editions:2001 CBC (Y -N)2001 CFC (Y -N)2001 CMC (Y- N)
2001 CPC (Y - 14)2001 NEC (Y - N)
Effective 11/1/02
I
1 -
l
I •
Plan Review Process Work Book Page -8-Revised 4/28/04
CITY OF CUPERTINO
!m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36917013 . 00
DATE ISSUED. . . . . . . : 06/22/2006
RECEIPT # . . . . . . . . . 34986
REFERENCE ID # . . . 06060196
SITE ADDRESS . . . . . : 922 BLAZINGWOOD AV
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER SURESH KALBAG
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : 95014-4619
RECEIVED FROM . . . . : JUSTINE CHENG
CONTRACTOR . . . . . . . : BRIAN CHENG LIC # 26995
COMPANY . . . . . . . . . . : BJ ELECTRIC INC
ADDRESS . . . . . . . . . . : 985 SPENCER AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 971-6849
�EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
----- -- --- -- - - - - - - - - - ------ ----- - - ------- - ----------
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0'. 00
BREMRECEPT NO. OUTLETS 2 . 00 2 . 40 0 . 00 2 .40 0 . 00
EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
BSEISMICRE VALUATION 650 . 00 0 . 50 0 . 00 0 . 50 0 . 00
TOTAL PERMIT 76 . 13 0 . 00 76 . 13 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
- ---------------- ------- - ---- --------
OTHER 76 . 13 AMEX
TOTAL RECEIPT 76 . 13
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
___-------______------------
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
•
06/22/2006 11 :06 FAX 408 777 3333 CITY CUPERTINO 1a001/003
CIr 'Y OF CUPERTINO o oo ft
• CUPERTINOPERMI' C APPLICATION FORM
APN# V�3 Date: ta--/o
Building Addres : Mailing ddress (if,different I'r m bnildiog address),
Owner's Name. Phon
Contractor. License
Contact: /�/ Phi nef��ab' 7/- Cupertino Business/I�cense#:
Building Permit Info:
Bldg ❑ Elect 19 Plumb ❑ Mrcb ❑
— c� 1e e
Job Description: �o� d
Residential > Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Coat of Project! 41.10-0�7 Occupancy Group:
Type of Construction:J Please check this bo:: if the project is a
�l� second-storyadd a: ❑
•
Project Size: Standard ❑ LargeC7 Major❑
uanti Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 FBoiler
er> IM to 1.75 M Btu MECHANICAL
BBOILERS > 1.75M Btu MECHANICAL
BCONSTAXConstruction Tax BUILDING
BCONSTAXnd/Off/Comm/ uasi BUILD ING
BCONSTAXBon. Tax fora Zone BUILDING
BCONSTAXHHotel and Motel BUILD[NG
BCONSTAXR onstax—Resi/Mobile BUILDING
BELEC1000 Elec 600V<= 1000A ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elee Svcs 600V<—200A ELECTRICAL
BENERGY Encr BUILDING
BENERGYADD Ener Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
•
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06/22/2006 11 :07 FAX 408 777 3333 CITY CUPERTINO 16002/003
C1' 'Y OF CUPERTINO
CUPER,TINO PERMI f APPLICATION FORM
• Quantity Fee ID Fee Description Fee Groa
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Conun. Hous' Mit- Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERT VIE Inspection Overtime BUILDING
BPBACKFLOW Atmos heTic Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
MIXTURE Pbig Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMB ING
BPINTERCEP Ind Waste Interoe for PLUMB NG
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDJNG
BPLANCKREP i Plan Check Repeat Fee BURRING
BPREPIPE Re 1 e Of FYxtures PLUMB[NG
BPSEWAGE Sewa eDis oral PLUMBING
BPSEWER Sewers PLUMBING
BPSPRTNK Lawns rinkler/Backflo PLUMB[NG
BPSTORM Storm/Rain Water PLUMBING
• BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMB[NG
BPWATER Install/Alter Water Pipe PLUMBING
BPWFIEATER Water HeaterNent PLUMBING
BPWSVCS Main Water Service PLUMB-NG
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfin MECHANICAL
BREMAIRHAN A/C Units x= 10,000 din MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Buswa s ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV ReloFurnace> IOKbtu MECHAN[CAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREM]POWER Power Device/Apparatus ELECTRICAL
'L� BREMRECEPT I Rcptl,Switch & Outlets ELECTRICAL
BREMPLELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter HeatinMECHANICAL
• BREMRESAPP Remodel Res Appliance, ELECTRICAL
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06/22/2006 11 :07 FAX 408 777 3333 CITY CUPERTINO Ia 003/003
CI' CY OF CUPERTINO
CUPEI�TINO PERM [' APPLICATION FORM
aaa Fee M Fee Description Fee Group
BREMSIGNAD Rmdl Signs Add Branch . ELECTRICAL
BREMSIGNS Remodel Si Marquee ELECTR[CAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special lupection BUILDNG
BSWIM Swimming Pool BUiLDI.NG
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL.
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
PLLONGRNGC Planning LR Commel Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Chane BUILDING
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