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06030044CITY OF CUPERTINO CON'TRrCTORTNkRMA"fTO,N�'. BUILDING DIVISION PERMIT •• ..sti?r�s 'P ya'�-Lw r; _ mss. vt C.c� w L.�.-FNN'ia' BUILDING ADDRESS: 10481 GLRNVTP.W All HUCK CONST. COMPANY PERMIT NO. 06030044 ER'S NAME: PERMITIESUBDATH DORIS YOUNG 695 S. 15TH 4 NE: SANITARY NO. CONTROL NO. (408)298-2374 ARCH17EC (ENGINEER: BUILDING PERMIT INFO BLDG PLO MEOCH O LICENSED CONTRACTOR'S DECLARATION Job Description 1 thereby srRrm that 1 am ]lammed under PmviYom of clasper 9 (commencing vita Section ]OIIU) of Division ] of dee Bualrteu and Pro(cssium Cadeaed my Ikemc 4 I. full forte ena eRect.l -7� SEISMIC RETROFIT OF. (E) GIRDERS MAL Lxcn lama �LIC.D Dex Contrxcnar AND FOOTINGS DELLA ON Ill W used 1 understand my plans shall be used u public rernNs MAR ZZ sy006a G.CL 11 Elected Profession] OatNEm DECLARATION exempt the Conlns License law for tic I hereby (fro that 11. mcmpt s An Co fallowing enuon. (Section ]113 L3, Business ena Rofeainna Coda: Any city or county watc . RUILDINa which requires a percent w account, slier, impme<, demolish, as repair Any S"Clan prior to its Issuance, also requires Ik applicant fosuch remelt in rile a signed moment Nat he is licensed pursoant o the provislom of the Contractor's UT= law(Chmor9 Sq. Ft. Floor Area a uauon (commencing with Section ]Glp) of Division 3 of the Businessand Prof sedam Code) or $1950 that M x exempt therefrom and dee basis for the alleged exemption. Any violaion of APN Number Occupancy Type Sectiona permit objects the applicant m a civil penalty of �dmplicaN for than Rw ❑ 1, As owner offt property, or my employees with wall as their sale compensation, Required Inspections wi0 da the work ena theawcmre h not inxnded.offered foule (Sm.7044, Business and Profession Cade: The Commwnor'a License Law anus sat apply in an owner of property, who but Ids or improves thereon, and wk dam such wart himsel f o tivaugh his own employem, provided that such Impmwmenu ate notimmnded oroRered forsaln If, Newcomer. the Wilding or improvement is old within one year of compledom. the owner. builder wall have this Wrden of paving dust k did act Wild or improve for purpose of sale.). ❑ 1, as owner of Ik property, am exclusively contracting with licensed Contractors in construct the pmject (Sec. HOW. Business And Pmfcaalans Cade) The continues Li! amnae Lew dam not apply to sn owner of Pmpeny who Wilds or improv thereon. ena, who contracts rot such projects with a comainew (s) licensed punu nt to dee Con vctoi Li,sho Law. ❑ Iamuemptunder See ,B&PCforthisreaAm ar Dem WORKERS COMPENSATION DECLARATION 1 he cby &Man under penalty of perjury ane of the following declarations: ❑ I hamand will maintain • CeNMeuofCememoelldmeem forWormesCanpen- ation, u provided for by Section 3700 of the labor, Code, for the Performance of the work for which this Pearled is iauea. ❑ 1 have and will maintain Workar's Compensation Insomence, as required by Secdan 3700 of the labor Code. for the performance of he work for which this Permit is Issued. My Worker's Compensation lnatennam carer and Policy number am: ' Carrier�T Y /' / Policy No,: —wZYR'17 CA 0 EKEMPIION FROM WORKER$' COMPENSATION INSURANCE (Thu sermon need not k completed athe Permit Is forone hundred dollar (9100) arIG4) 1 amrfy that in Ne per(ormatoa of the wark for which this permit is issued, l shall nut employ any person in say manry�w became jeetmlkwokcri Compenudan sem or Laws of CaRfgnia DYe� Appel /�JA mig NGI7CE PPUCAM: 1 . e tmakin& CeniOcem of Exempion. you should become a rat the Wmkeh Compensation provisions of did labm Cade you mus foMwith comply with each pmvisiom or this permit shall k deemed mvoked. CONSTRUCTION LENDING AGENCY I koby alRrm that them is a construction lending agency for do PCnaanarce of the work for which this permit is issued (See. 3097. Civ. C.) Leadmea Name , Landers Addmss I certify dust I haw and this application and state that the shove information u COMCL 1 &gime o Comply with all City and county ordinanams and sox Ina Rusting o building construction, and hereby aohomme mpreaentalim of this city or enter upon the &boyo-mentioned pmperly for Inspection purposes (We) .lime o saw. indemnify and keep hamntess the City of Cupertino against liabilltius, judgments. costs and expenses which may in say way same against aid City in conxymme of the &Hoang of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON.POIM Issued by: Date 3_ cF:-aC SO CE RE ""An Re-roofs �= - Type of Roof - atumo(Appli or Date 'PliAZARDOUS MATERIALS DISCLOSURE Will tho applicant or future Wilding Occupant nom or handle hiardom material defined by the Cuperna Municipal Code. Chapter 9.12, and the Health and Safety Calc, Sectime 25532(a)? [3 Yes 190 All 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 Will tits applicant o future Wilding Occupant usO equipment or devices which emit hazardous :it cunlaminants u refined by dee Bay Area Air Quality Management all new materials for inspection. DiWxL? ❑Yrs than read the buinlms an erials requirements under Chapter 6.95 of the Califor. nia Health &SaferyCode, Sections 23505.25533 and 25534.1 understand and time Wilding dams nal commonly hew a tenant that it b my o osoffi lity to noth'y the occupant of the rtyvirtmenu ichmuu metpnoroi aatceancerulicamidu Signature of Applicant Date /''�S� All roof coverings to be Class "B" or better L2fjcrunuthariacd agent ppte v 0 1 of 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36911036.00 DATE ISSUED.......: 03/09/2006 RECEIPT #.........: 33509 REFERENCE ID # ...: 06030044 SITE ADDRESS .....: 10481 GLENVIEW AV SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: suem COPY # : 3 OWNER ............: DORIS YOUNG ADDRESS ...........: CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-4512 RECEIVED FROM ....: JOHN HUCKLE CONTRACTOR .......: JOHN HUCKLE LIC # 23822 COMPANY ..........: HUCK CONST. COMPANY ADDRESS ..........: 695 S. 15TH ST. CITY/STATE/ZIP ...: SAN JOSE, CA 95112 TELEPHONE ........: (408)298-2374 • FEE ID ---------- UNIT QUANTITY ------------- AMOUNT PD -TO -DT THIS REC NEW BAL BENERGY ---------- PERMIT FEE 83.16 -------------------- 39.92 0.00 ---------- 39.92 ---------- 0.00 BPERMFEE VALUATION 11950.00 83.16 0.00 83.16 0.00 BUSLIC FLAT RATE 1.00 105.00 0.00 105.00 0.00 BSEISMICRE VALUATION 1,950.00 0.50 0.00 0.50 0.00 TOTAL PERMIT ---------- ---------- 228.58 0.00 ---------- 228.58 ---------- 0.00 METHOD OF ----------------- PAYMENT AMOUNT NUMBER CASH ------------ 228.58 ------------------ TOTAL RECEIPT 228.58 40 IWO CITY OF CUPEkTINO • ;19 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: / <G - I/Fw ✓ PERMIT # 060360"Ll OWNER'S NAME: PHONE # GENERAL CONTRACTOR FAX # —' I am not using any subcontractors: 3 Signature Please check applicable subcon tors and complete the followine information: 60 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 AI ./ 10. - J arr o CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM N#/ / C Date:. �=0� Building Address: Mailing Address (if different from building address): 14244) /C!1/ Owner's Ram— e—:, Phone #: `1"^44 1 G ZI <64:7 Jt/f Contractor: License #: Boiler> 100K to 500K Btu _7z7etf Contact: Phone: Z<& Z3 74t- Cupertino Business License#: 011 HVFax: Building Permit Info: -5 jf }?ET,�O�/TmT � iPi� ➢lE� 3 T��//21�C� Tii�$ BldgN4 Elect ❑ Plumb ❑ Mech ❑ Job Description: 5��✓n/G GT�pr/� �� CX/5T)1, /ez �7S s Residential Commercial ❑ Sq.Ft. Floor Area: q.Ft.: Cost of Proiec �y�a Occupancy Gro Type of Construction: Please check this box if the project is a BCONSTAX second -story addition: ❑ ro'ect Size: Standard ❑ Laze ❑ Major ❑ BCONSTAXBQ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BB,OILER3. Boiler > 500K to 1M 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 BCONSTAXI2 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 CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM uanti Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING 13MTTIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMIvB4 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 PbIg 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 Storm/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 BREIvIAIRHAN A/C Units <=10,000 cfan MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY .. Remodel Busways ELECTRICAL BREMFIXT Lightin Fixtures ELECTRICAL BRENf URN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > IOK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BRE114INHOOD• Installation of Hood HZECHANICAL BREMIvIISC 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 0 CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM uanti . 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 I MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection BUILDING BS)VIM 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 EPERMPTFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL WERMITFEE AZech Permit Issuance MEMANICAL 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 • 3of3 i 11' 1 C� 64P4v�Z DC7 62, OX 20) . L 'tD,Y �rl�FT S/M�/YA-24 W12 -,W w��'�I NA!/S !N /Y�!'.vlN✓•11b7�I�SX1�.l�x �. 6I12dF,��' QST �Q7biiu> , -S ZIP4 4Y7.FA A PS7 /F !w cor.t-- <3ASE, Ti17ED, i2"Fd�T%�') e r P _stcrio.✓ A -A �7yp) Po�T �?F1o✓fa,C�Cn��tfT - MAR 0 9 2006 I I- �f i copy id - �ifTE Ya1t/1VTAR?' PG2 � --