11080142CITY OF CUPERTINO BUILDING PERMIT
I.I 11,DIiNG, - i;j
KESS: 6264 SHADYGROVE CT
CONTRACTOR: SPRIG ELECTRIC
PERMIT NO: 11080142
O\\NEWS N.\)II;: BRENDAN LAHIFF
1860 S 10TH ST
DATE ISSUED: 08/18/2011
(>wNER'S PI l0NE: 4158675967
SAN JOSE, CA 95112
PHONE NO: (408)298-3134
L
LICENSED CONTRACTOR'S DECLARATION
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BUILDING PERMIT INFO: BLDG ELECT PLUMB
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MECH RESIDENTIAL COMMERCIAL
(• raclor _
S>a121 �� �G .n ��Date `�l °� �
I I:. cby al'Iirii'.
+:.,, t I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: INSTALL NEW E.V STATION AT EXISTING GARAGE
mencin, :
I Section 7000) of Division 3 of the Business & Professions
LOCATION 40 AMP CIRCUIT
and th,�! :;,
. license is in full force and effect.
I hereby affirm
Linder penalty of perjury one ofthe following two declarations:
anll ill
:main a certificate of consent to self-insure for Worker's
casal'.
rovided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation: $1592
rl,icln:c + work for which this permit is issued.
and N,.:'
twin Worker's Compensation Insurance, as provided for by
n 3711+
Labor Code, for the performance of the work for which this
APN Number: 37541032.00
Occupancy Type:
't IS ISti-
APPLICANT CERTIFICATION
+fa th,n I :•
read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
I. I
+mply with all city and county ordinances and state laws relating
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
.-!J;]L
tion, and hereby authorize representatives of this city to enter
{i•.: ;I
:ioned property for inspection purposes. (We) agree to save
180 DAYS FROM LAST CALLED INSPECTION.
immless the City of Cupertino against liabilities, judgments,
hich may accrue against said City in consequence ofthe/��
,#ty,
np, n!
nit. Additionally, the applicant understands and will comply
Issued b Date: CJ
all non-p;....
•ource regulations per the Cupertino Municipal Code, Section
ROOFS:
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�
Ire
Date
any
All roofs shall be inspected prior to any roofing material being installed. If a roof is
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installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
FIR-BUILDER DECLARATION
Signature of Applicant: Date:
I I am exempt from the Contractor's License Law for one of
llol, i+'.
easons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
owner of I
loperty, or my employees with wages as their sole compensation,
Ihr
.d the structure is not intended or offered for sale (Sec.7044,
.1
ons Code)
l n,..
+perty, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
(Sec.7044, Business & Professions Code).
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
r penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
and "
,Iain a Certificate of Consent to self-insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
n<
wided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
,Irk for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
,in Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 25505, 25533, and 25534.
hor Code, for the performance of the work for which this
�
Owner or authorized agent: <AJ Y U Date: J/ i31
I
f "ormance of the work for which this permit is issued, I shall
I'll in any manner so as to become subject to the Worker's
I California. If, after making this certificate of exemption, I
CONSTRUCTION LENDING AGENCY
'Norker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
!I 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
Id this application and state that the above information is
ly with all city and county ordinances and state laws relating
:I, and hereby authorize representatives of this city to enter
ol ed property for inspection purposes. (We) agree to save
nless the City of Cupertino against liabilities, judgments,
ARCHITECT'S DECLARATION
;ch may accrue against said City in consequence ofthe
I understand my plans shall be used as public records.
Additionally, the applicant understands and will comply
I: cc regulations per the Cupertino Municipal Code, Section
Licensed Professional
Date
CITY OF CUPERTINO
Fm FEE ESTIMATOR - BUILDING DIVISION
NnTF.t Thece foes ore hated nn the nreliminary infarmntian availahlo and aro nnly an vctimnto_ f`antart the hent fnr addn'I infn_
FEE ITEMS (lee Resolution 11-053 Eff. 7%111/,)
ADDRESS: 6264 shadygrove ct.
DATE: 08/18/2011
REVIEWED BY: bobs.
APN:
BP#:
*VALUATION: 1$1,592
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION SOLAR -RES
PERMIT TYPE:
WORK
install new E.V station at exisiting garage location.
SCOPE
PME Plan Check:
NnTF.t Thece foes ore hated nn the nreliminary infarmntian availahlo and aro nnly an vctimnto_ f`antart the hent fnr addn'I infn_
FEE ITEMS (lee Resolution 11-053 Eff. 7%111/,)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
0 #
$100.00
Alternative Energy System
iCHRGSTA EV Charging Station
Suppl. PC Fee: 0 Reg. 0 OT
0.0 1
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee -0 Reg.
0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
(.'r�tl5ttitt.litt?a 1'tt.l
_T7
Acoustical Fee:
0 Yes (F) No
$0.00
0
Work Without Permit? 0 Yes 0 No
$0.00
Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
7i-orvei 1'rr,>cwnvwKinoa F e,7,,
Strong Motion Fee:
IBSEISMICR
$0.50
0.5 hrs
$41.00
Admin./Clerical Fee
IADMIN
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$1.50
$141.00
TOTAL FEE:
$142.50
Revised: 07/04/2011