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08060040 BUILDING DIVISION PERMIT CONTRACTQRINk'URMA'CION BUIL1 G CRESS: PERMIT NO. TV� TUSCANY PL ABLE SEPTIC 08060040 OWNER'S NAME: PERMIT ISSUE DATE ALAN ZAPALA P 0 BOX 24819 06/05/2008 NE: SANITARY NO. CONTROL NO. (408) 377-9990 ARCHITEC 'ENGINEER: BUILDING PERMIT INFO BLDG EIEC? PLUMB MECH 0 0 0 0 uoo LICENSED CONTRACTOR'S DECLARATION I Job Description 1 hereby drum that I am licensed under provisions of Chapter 9(Commencing P Z with Section 7000)ofDivision 3 of the Business and Profcasioet-Code.and my license Is PROPTY LINE CLEAN OUT SEWER ^=rn in fun force and effem L('7� Z Lice= 1 a Lk:.0 =p Date eet m< Contractor b ARA sa o elis D LO UCc.d Professional 3 OWNER-BUILDE DECLARATION a� E I Imcrtby air,.that I am exempt form me Conuacmtt License Law for the COO following o uon.(Section 71111.5,Business and Pmfcssiom Code:Any city or..... $ which uquisos a permit to ennWucl alter,impham,dem.lLN,m mpoir any suucturo _Z< FMIW in its 1S4Wnce.0.leaptree the appicart,for such Pennil in BlCaaignefifimm m, x that he is Laved pursuant to the provisions of the Conuacmr's License Law(Chapter 9 Sq.Ft. Floor Area Valuation t�S lesson ;ngwimgttdon7rm)ofpir on5afineeus;�ma.andp f=iom Cmac)m .. $3000 Na,he u exempt rumrrom and the buil for On,alleged esemption.Any violation of Secdon 7031.5 by any applicant for a permit subjects the applicant w a civil Penalty ofe,pN ane Number Occu T e nm more than five hundred dollars(S3W). 35929032 .•PTV' P Y YP wi Lo oema ndpes ny.amywmmndcdoimwadfmsWc(x .7 .Be ern, will Professions Cdthe swctumusvuss License aw dean ,applyo an Business Required Inspections and property who Code:The m tt erson.License law don rot apply m rt owmr is q P Own whobuildsviemphasesthfirpr andwho doessuchwork hamstermlthrough bus awnemployee,provided pr wenem I,sold hart not ear Edcaled mleun.for sale H, however,the Wilding or imPhavemml Ls mid within ore year r improle for the owner- builder will have de bustlers of proving that K did Out build or improve far purpose of u y 0 I,u ower m the Property.sm exclusively contraming with licensed Contractors m 1y�(j sfffgf--{{r�rp��{{�� Ig��pt TARY whoCoefifirfifict Usefor su(Sec.ects Bvinouand Ps)licemv Code:)The Ce Cortrac Li- Fl l\ 1,1 cenre Law does not apply ban owner of Business and pr won dsilds Code:) thereon,ted. '` Csv 1(VI' who Concocts far such projects with a conranor(s)licensed pursuant to the ConvectaYs IW' License Law. ❑lam exwpa under See .lid PCfor Nis reuon Owner Data WORKER'S COMPENSATION DECLARATION 1 nemby aM m under penally of perjury one of the following tr luaaiov: 0 1 ham and will maintain a CerdOexu ofCunsentto self-alum for Workers Compen- sation,u Enervated for by Sauon 7700 of the labor Code.for the performmm of time work for which this permit is issued. 0 1 have and will maintain Worker's Compensation I...,as required by Section 3700 of the Labor Code,for the pcoffirmame of the work forwhl-h this permit b issued. ' My Workee�ss 14 KL Insurance Ties and Polity numWrye c��Q(�-f�-7 Cartier, NI L01-1. the?rs.4WAPORY No.: Weis/ s% CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thusccdon meted wt M completed tithe permit is;foroee hundred dollar(SIM) v less) I anfv mot to me performance of the work for which this Permit us Earned,I send mat employ anyperson in any manner an as m beam. bj.,to the workmar CompevNm, Laws of Califomus,Data Applicam NOTICE TO APPLICANT:If,after making this CenlEnte of Exemption,you should Income subject u,the Worker's Compensation provisions of ft Lahr Code,you mux .,O forthwith comply with men Provision or mu Permit shall be deemed hawked. Z y CONSTRUCTION LENDING AGENCY [r Ihereby-M.that them isoconstrued..lendingagency for the perfurmana of , C the work for which thus pemmil in issued(Sec.3097.Civ.C.) QLeader's Namc lendeh Address fJ Q 1 cattily that I have mad this applica0on and sou this the move infvonalson is Correa 1 agree to comply with all city and county ominsocv and sou laws misting to _0 building conswction,and hereby hath+rim mpo:unudva of this city to tenths upon the abow,-.tmduncd phapteny,for inspection purposes H 1 (Wc)agree to um,indemnify and keep humless the City of Cu adt ins against h inconsegjudgments,cvtsand exthis MMhiten may in any w+Y attme agaivsseid Clty O z in consequence of the tran0ng of this permLL G V% ^ AC�RST D ND ILL COMPLY WITH ALL N.POINT Issued by:91teAa Date f' S EG O /^�� (�6 S Re-roofs Smgnuurt of ApplicanUCon err pati HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or futfira building mcupantsmrc orandm Els h Health s material u de.Sco by time 32(.)? m Municipal Code.Chapter 9.13,and 0e Health aM Safety Cade, Dyes 25532(U? ❑rte 0 N All roofs shall be inspected prior to any roofing material being installed. Will the,applicant or future Wilding occu and rte If a roof is installed without first obtainingan inspection,I agree to remove Pn g p equipment or devices which P it ha'rard.ns air canuminants as defined by the Bay Arta Air Qmmalily Manegcment all new materials for inspection. District? I CYv Cl No I have mad the ha7aMmu.aerials mqumemcros under Chapter 6.95 of the Califur- nuHcalthkSenyCode,Sccu $550 533 dZ534.1undconamd Nuifthc Wilding does not- 0y ators moi i my 'bility to mufy deal fore rty m an ti tan t or is of a Certificate of Qa A� CPf lJ Signature of Applicant Date Owmc ...1hmi.d.';' a All roof coverings to be Class'A.a'or better CITY OF CUPERTINO • 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35929032 . 00 DATE ISSUED. . . . . . . : 06/05/2008 RECEIPT # . . . . . . . . . : BS000005009 REFERENCE ID # . . . : 08060040 SITE ADDRESS . . . . . : 1047 TUSCANY PL SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ALAN ZAPALA ADDRESS . . . . . . . . . . : 1047 TUSCANY PL CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : ABLE UNDERGRND CON CONTRACTOR . . . . . . . : GILBERT, GLEN LIC # 21407 COMPANY . . . . . . . . . . : ABLE SEPTIC ADDRESS . . . . . . . . . . : P 0 BOX 24819 CITY/STATE/ZIP . . . : SAN JOSE, CA 95154 TELEPHONE . . . . . . . . : (408)377-9990 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- IBSEISMICR VALUATION 3, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 1PRSEWER UNITS 1 . 00 20 . 40 0 . 00 20 . 40 0 . 00 1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 102 .48 0 . 00 102 . 48 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 102 . 48 #8132 --------------- TOTAL RECEIPT 102 . 48 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 400 SEWER/LATERAL 507 FINAL PLUMBING • CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE CU CITY PERMIT APPLICATION FORM APN # O 3 , to ' OC) Dater Building Address: ©A+ tuSCkttJy' PL Owner's Name: Phone#: A-w 2 E�T 478,r6 L�(ZL(o Contractor: Phone #: 377 —9cllD m)�L Fax #: 49 2— l ck�8 Contact: Phone#: 377—T310 ICo6eA�Ay `t Fax #: 4QZ— ( OC6 Contractor License#: (;77L(-15- vq30 t0� Cupertino Business License#: Job Description: {.tel tive-i, d{' t ( OLT l Residential Commercial Q Valuation: 31 ODD Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set& the sheet index. "[ - Quantity Fee ID Fee Description Fee Permit Type Group 1PCSEWER Commercial building P 1CPSS sewer/sanitary sewer 1BPREPIPE Commercial re-pipe per fixture P 1CPRP 1 PGASCOM Commercial Gas Piping System P 1-4 Outlets IBSEISMICOM Seismic Commercial P AOL 1BSEISMICR Seismic Residential P f 1PRSEWER Residential building P 1RPSS sewer/sanitary sewer CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE CUPEkTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group 1PRREPIPE Residential re-pipe per fixture P 1RPRP IBPWSVCS Water Service P 1CPWS or 1RPWS 1PPRSEWG Private Sewage Disposal System P 1PCESS Cesspool P IBPWATER Install/alter Water Pipe P IBPFIXTURE Plumbing Fixture P 1 PGASRES Residential Gas Piping System P 1-4 Outlets 1 BPGAS Gas Piping System 5+ Outlets P 1PPERMITFEE Plumbing Permit Fee Issuance P • 1PLMBLNCK Plumbing Plan Check P 1PLMBINSP Other Plumbing/gas Insp. P / ITRAVDOC Travel & Documentation Fee B 1 1BUSLIC Business License B • Community Development r 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 SEUPEkTINO Building Department JO( C){+ADDRESS-1� Ckvu (� • PERMIT # o C3 U� 0c) qC) OWNER'S NAME: W� 2 PHONE # 9&7--— 8 GENERAL CONTRACTOR: f� L FAX # — C I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 66 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� Ownery ____,tor Signature bate FROM :CUPERTINOSRNITRRYDISTRICT FAX NO. :4082535173 Jun. 24 2008 02:44PM P1 • �p 86N17�o� ' DISTRICT MANAGER- NGINEER V7 5�� BOARD OF DIRECTORS MTHOMAS&CO PANY,INC. WILLIAM A.BOSWORTH RICHARDICHARDK.TANAK w JOHN M.6ATT0 DISTRICT COUNSEL YEARS:7f CURTIS B.HARRISON SEAVI'E ATKINSON•FARASN N,LLP_ �•l ql`� WENDELL H.KERR,JR. HAROLD S.TOPPEL /SNNo~ CHRISTOPHER C.LEE 20889 STEVENS CREEK BOULEVARD,SUITE 104 CUPERTINO,CALIFORNIA 88014.21 54 (406)269.7071 PHONE . (400)283$173 FAX www,cupertin0sanitarydistrlct.cam File: CUSD—MOP Building Dept. —Cupertino City oi'Cupertino Attn.: Building Department 10300 Torre Ave. ' Cupertino, CA 95014-3202 Subject: install Pri operty Line Cleanout Name: Zapala Re.idence Address: 1047 Tus zany Place APN: 359-29-032 Permit No.080600 ■ Videotape nd Property Line Cleanout inspected. No addi onal conditions/requirements by the District Inspector: eorge Santos....................................... :!5' Date:...06 3-2008................... Sanitary Sewer Location cc: Property caner 25' Lt P/1, 17' Long 5' Deep S:\WORDS\C1JSD\LL:TTERS\fl JTT,DING DEPT • LE'TTERS\CuSD 2 08 TV inpection-08060040_1047 Tuscany Place 06-23-2008.doc SUPPLYING SANITARY SEWE GE SERVICES FOR:CITY OF CUPERTINO,PORTIONS OF THE CITIES OF SARATOGA,SUNNYVALE,LOS ALTOS AND SURROUNDING UNINCORPORATED AREAS