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06060028�.,CITY OF CUPERTINO _- a �• ��" = ''°"' " "° `t'' BUILDING DIVISION PERNIIT .,COI!I`�R:*1CTORII�1I1'ORMA'EIf)N BUII�IEADDRM , AQUA FLOW PLUMBING PERMITNO.06060028 11C'OWNEPERMIT LSUE DATE RHONDA NUNEZ 565 N STH STF 06/05/2006 NE: SANITARY NO. CONTROL NO. (408) 265-9504 ARCHREC 7ENG'INEER: BUILDING PERMITINFO BLDG E12C7 PLUMB MECH 0 0 o� LICENSED CONTRACTORS DECLARATION lob Description :WE 1 hmcby dfum tub1 un 11¢8x1 oder Ro•itiou a O.P.9(eomtmrelnt P Biu rdi SoNan7O1D)o(Divirion3of dx Bu9rea,rd Pram,essCoie.id my Ikea L3 13 .mnram ad ens �•' REPIPE GALVANIZED TO COPPER FROM METER TO ALL FIXTURES . REPLACE WATER HEATER •Fo DucCme,cm AreCrS DE LLA ION '� Iundcru,ml my PW",u"awIWuxdupbBc word ,i . yU :p Licensed Pureubw OW NE.BUILDER DECLARATION nI miyo .(Sei oo I em tempt tram tPO Cm um,Co,Lkrnc ly for the :0 pff (ot Oh nt .. (Ssllon 7rt51.5,Buunu„nd K.tenon Coir:Any eay aegmay LL MhlLh IqVftlaPetmlt"'Gton.,lb.hnfor ul imereiii. fimPNr Ny L(WYR .i) P Ml izS ICmn¢.alw"'qui.pOOiUxwU of f«Cm toii',Lk. litn[(Lipter9 c N, k.I: aPmn�n,wN aaNrcam,w ,Lw: =L. (o m9 Sq.Ft. Floor Area Valua[$d000 i� (clmmendng tnth Section 7000)a(Div S of do,Bustle,ud PtMminm Code)o' 2 r$ Na Y u.,I Naef.and one bass for me dktnd metnpdm Any viduim of St 7031.5 by my appO=fa,period,fubjea lle,pplfcmt W advil peudy,ofp,p�NS�mber Occupancy Type s«m«e Nan Bae kW"Idned chum(55001. 3 5 6 2 3 0 4 6 . 0 0 ❑1.m owar of the pmpvey,a my wpbyv4 rub p(U u thea mk mmpenaJon, wal on the w«k.ud One smdmule h rut kmdeL or offered f«uk(See.7 .Buttes, Required Inspections "Proremam Code:The Cmducmh L License U,ions ort apply Wan aww a q P property rho Wad,«Improxs thecmd.ud oro d«„urb wrk mmelf«WrouN his awe empbym,poNtled Jw diet,imptmeme",•dine m1. ._ ,_.«olfemd for ule If, kmvevor.Ne IaNLlnt«impro.®eu u sold.LIMO One yer of.0 dim.the ownv- bild,n mL bade the trade"a Proving Nu he iii and Wild a hopOnK for ptvpox of uk.l. °1.u axecr a one propeny.w veIien"iy cona,ming rich Mame,co,o,uon m consWTI Ne nt;" (see n..Bus of Pr,f wi cte;.0 pn Conmaot,LL FI � pax Lor is o,at'Pt'Inah. apeopmy wh,WdIn«impm.m Nermv.,nd. Like l�,[I](Of.LlCh pda)CN MIdt]La,IlYlm(i)IIR"xd pCf]YW WNC e0,1lY.1Cr, ��� Llavm V.. ❑lam...mpd luldv ace .BdPC(«Nu ream '',N WORKERS COMPENSATION DECLARATION I teneby dam Orderpm,lty,Of perjury arc of the founding decWulvu: yyy��y Le ��1DU0 IhsRand rN m•"•naCrrJflamafConxm Wxlf-vlure(«WahaYe Compenp d�� ,dm.r provi i fpo by Senlmd 7100 a tie Lab«Cock.fm We podrcmrc a the 1�v(I ��� work.t rtkd Thu pvmit u Tim;issned.3 3 hne ud Mill mu0ui,Wor 'eompeouda.I..a rtywtcd by Section a the Libor Cod,In,IM pvfamumsof the rack In,w IOU pump In Lswed My Wo zcompeeaft orrkr W Policy nwober dim: 77� Curkr PoOcy FROM RIIFlCGTE OF EXEMPTION PROM WORKF]LS COMPFNSA710NINSURANCE ' mat, ,lm need on,be,OOi lUdifdx pvm,u fo ono hmtmel down(51001 orleu.) 1 emJfy Net in the ped«m,rcr of Ne work In,w1m li Thu pm,u IS isend.1 swl ons employim.person in any maervm a a became ini in Ne W«ken'rte•.. m IJw'S a Cdlf«du Duo Appllmm NOTICE TO APPLICANT:If,div making this Cenifinle of Exemption.you Odoold Weome ini W ft W« s eutopcneJon prm UiOns a No Iitor Goa you mm .,O ranhwiN cnmPly riN=h Provisom«this Per '"I ne dermad rt+okcd . 'Z CONSTRUCTION LENDING AGENCY [-+IV, I hemby drum NU Jens u,co OnnkdWa,t,teoey r„NC Pcf..of CCS Ito work(«which Jlis Pcrmid u IVIS(S«.]041.CO,C) Ledet"Name .,� Z l<defa Aidan 5 . U0 1 eadfy dtit l have ton this wlkssu rd sue Thu din id,O 0 idomulm u LL I.., torted l and to canply wad,all tidy W,000rf orditwtcei ind Stile lar,mlrint to O U Wilding comouction,aM hemby auJwnv eprmcnuti. of Nir city to enter upte Nc >' W aMvc-mcmi«W papcny(« imlccvm ptapoxs (We),gtce to uta.Indemnify and keep harmlou the City acupmino dune " N Ilabiliiq Judgmeoa,emu admpense,whit maymudy way,cmae,gslw ab City UZ in canapatta atter truvintaNi,puma r. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. _ _ au0 G/S/flG Re-roofs Ignra ',4SHAlA D�OUS MATERIALS DISCLOSURE —� Type of Roof WIII Je WPlkant«(umm hdldint omgmt uac a hadk haa,tloto mamrul u dc0md ty 1h Cupmim MuNcip,l Code.Csaper 9.12,rdtl tic HalN ani Sdmy ewe.s«Jan 255324011 All roofs shall be inspected prior to any roofing material being installed. °m Will ft awlicvlt«Intone Wilding oamp,«ax eatupaiwt rr&M w b If a roof is installed without first obtaining an inspection,I agree to remove ,mit Ilvudou dr mnlLldrlrn,u dcGnd by Ih Bay Atm Air Qdity Mm,tcmcnd all new materials for inspection. Qa ort °Yon I hack mtl One hvaN,rs maxnau mqulmmum mhr CluPWri.95 of Ne CaB(«- LiuHmIIhk WuyCode.Seen..25505.25533 snd25534.Itindesu it IJUl fife Wi4tiet ion not cmmaly Nre a Insane Thu It u my tapomibilidy W nodfy ft omyru a the mquaelre whichmaebcmctpnorWisuanas,eenilkvcor Signature of Applicant Date All roof coverings to be Class "B"or better CITY OF CUPERTINO �m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35623046 . 00 DATE ISSUED. . . . . . . : 06/05/2006 RECEIPT # . . . . . . . . . 34679 REFERENCE ID # . . . 06060028 SITE ADDRESS . . . . . : 11351 BUBB RD SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : JOSE & RHONDA NUNEZ ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . , RECEIVED FROM . . . . : DAVID GREGG CONTRACTOR . . . . . . . : GREGG, DAVID LIC # 21162 COMPANY . . . . . . . . . . : AQUA FLOW PLUMBING ADDRESS . . . . . . . . . . : 565 N 6TH ST STE F CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 265-9504 EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------ - ---------- ---------- ---------- ---------- ---------- BPFIXTURE UNITS 1 . 00 9 . 00 0 . 00 9 . 00 0 . 00 BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BPREPIPE NO OF FIXTURE 1 . 00 9 . 00 0 . 00 9 . 00 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 BPWHEATER PER HEATER 1 . 00 10 . 79 0 . 00 10 . 79 0 . 00 BSEISMICRE VALUATION 4 , 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 102 . 52 0 . 00 102 . 52 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ OTHER 102 . 52 VISA TOTAL RECEIPT 102 . 52 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ---------------------------- 301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING • CITY OF CUPERTINO �m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 3 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : '35623046 . 00 DATE ISSUED. . . . . . . : 06/05/2006 RECEIPT # . . . . . . . . . : 34680 REFERENCE ID # . . . : 06060028 SITE ADDRESS . . . . . : 11351 BUBB RD SUBDIVISION . . . . . . : CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : JOSE & RHONDA NUNEZ ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : DAVID GREGG CONTRACTOR . . . . . . . : GREGG, DAVID LIC # 21162 COMPANY . . . . . . . . . . : AQUA FLOW PLUMBING ADDRESS . . . . . . . . . . : 565 N 6TH ST STE F CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 265-9504 *EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- --- - --- ---------- ---------- ---------- BPFIXTURE UNITS 9 . 00 81 . 00 9 . 00 72 . 00 0 . 00 BENERGY PERMIT FEE 1 . 00 34 . 86 34 . 86 0 . 00 0 . 00 BPREPIPE NO OF FIXTURE 1 . 00 9 . 00 9 . 00 0 . 00 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 38 . 37 0 . 00 0 . 00 BPWHEATER PER HEATER 1 . 00 10 . 79 10 . 79 0 . 00 0 . 00 BSEISMICRE VALUATION 4 , 000 . 00 0 . 50 0 . 50 0 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 174 . 52 102 . 52 72 . 00 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- - ----------- ----------- ------- OTHER 72 . 00 VISA ------------ TOTAL RECEIPT 72 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 C1fY OF Fax(408) 777-3333 J&UPEkTINO Building* De artment JOB ADDRESS: PERMIT # 5 Qtz6 0 6o a-z OWNER'S NAME: PHONE # Z 7 GENERAL CONTRACTOR: FAX # 4� I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete 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 �- , er Contractor Signature Date el as� I CITY OF CUPERTINO aeowoo Q crvoF PERMIT APPLICATION FORM CUPEkTINO APN # ��,—�_ 23 Date:6, Building Address: VJ Mailing Addres (if diff rent from building address): S Ow is Name: Phone#: 4 Co tractor: License#: ,Q Z c Cont Phone: Cupertino Business License#: ct: v z Fax: 2 77— o4 Building Permit Info: Bldg ❑ Elect ❑ Plumb Mech ❑ Job Description: 12�_r p� c-ore,- /ec c Residential K w+a-ce- /.,gQ ,tom Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost Project: Occupancy Group: 7 Type f Construction: Please check this box if the project is a ( J second-story addition: ❑ ro'ect Size: Standard ❑ _Lare ❑ Ma�or ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> I00K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1 M Btu MECHANICAL BBOILER4 Boiler> IM to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of lw) CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER , Sewers PLUMBING BPSPRINK ' Lawn S rinklerBackflo PLUMBING BPSTORM Stomi/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pipe PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 CITY OF CUPERTINO CUPERTINO PERMIT APPLICATION FORM g6Q_uantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL 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 Inspection BUILDING BSWIM Swimming Pool BUILDING 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 Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Chane BUILDING 3 of 3