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06070157t00 iH i ty, 93 i4u tud3 N ;3g SS D 7�9 0� z� aFcGP yC U C UC OE U2 CITY OF CUPERTINOs1"° "/ a°:� ItfA"ORMI4J BUILDHIG DIVISION PERMIT v sCi�HTRtILCIiIt BUILDING ADDRESS: BRETTh REEDER PEaMrr No.06070157 10050 MOSSY OAK CT OWNER'S NAME: PERMIT ISSUE DATE BRETT REEDER07/24/2006 NE: SANITARY NO. CONTROL NO, ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG PLUMB MEOCH O LICENSED CONTRACTORS DECLARATION Job Description Job 1 busby affhm that 1 s m Bosomed under provisions of CMpsr 9 (commencing iniuillrar andaff�iviaton7ofNaBualneaadoProfessionsColo,andmylicc,ucis GFCI PROTECTED DEDICATED CIRCUIT FOR SUMP PUMP Limens, Clan Lk. as Dam Contractor ARCHITECTS DECLARATION 1 understand my plans WII be used as public necomis Licensed Pmrcommal OWNER -BUILDER DECLARATION I hereby affirms NN I em exempt from tM Canmaaors License Law for the, fallowing rtaan. (Section 703 1.5, Business and Proradmons Cade: Any city at county $600 which requires a permit to construct. also, improve, de oulish, or ¢pais any anucbrt Sq. Ft. Floor Area Valuation prior b it, issuance, also requires the applicant forswh permil on Bs a signed ==am Condbri tics=Law (Chapter 9 of the that hes licensed pursuant b the previsions a (commencingwith SecUm7000)of Division7of Ne Susie wdProfeabns Cade)w that he is exempt shmefnsm and the bass for Ne alleged exemption My violation of g;r Occupancy Type Section 7071.3 by any applicant far a permit rvblecu the applicant to a civil penalty of not mom than On hundred dollars (5300). ❑ 1, u owtms of tit property, w my employes with wags u Nei role compewdon, Required Inspections e will do the work. and toe auuctum is roUnunded orcaesed forale(Bec.'I .Basinea and Professlons Cade The Communes Dame law does ant apply b am owner of q P properly who builds or improvns thenen., and who dao such wark himself orthrough bit for man eprovided thinsuch impronm Me, not nteMWor sed sale If. however. me Wildingor improvement within arc completim, the mmer- todhiwill b" the Intention of proving ou he did en dold a Mprow for Immose of am.). I, a awns of the property, am nsclus contracting with tissued anuauon �t, MY U. 7061, owner of and Profnabns Code:) The vesnuaerM I!- caselawdorsretapPr in an ofproperly, who builds rnimprove thereon,Nd La tite proles apply with whocenuanu for tori gajeN wIN a contractor(l) Bcensed perforant b tiro Conuaaora License law. ❑lam axe pt undotSeu .B&PCfar this won owner Due1p O� WORKER'SCOMPENSATIONDECLARATION I hereby Nim under penury of perjury ane of the following declaration 1 have and will malmalm a Certificau of Consent to self -insure for WarYeraCompen- sNan, as provided for by Section 7700 of the Labor Code, for No performumc of the work for which this permit Is hued, 0 1 ban and will maintain Worker's Compensation Insurance, as mquimd by Section 7700 of Ne Labor Codc. far the performance of the work for which this permit Is Word. My Worker's Compensatin Inmuuse artier and Policy number ere: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' , COMPENSATION INSURANCE (TIIs section need not N completed B Na permit is forens hundred dollars ($1011) or lou) 1 certify that In the performance of Ne work for which this permit is issued, l shall not employ anyperson in any t0i r• t9 rvbject to the Worked Compensation Laws of Califomii Applicant NOTICE TOct Nrk ILa along this CiNasof of Exemption. you should Labor most becomehcomp b the Workers Compensation of the labor Code, m ' faMwith comply with rvcA provisions or Nu permit Ntll be dams mmkcd. . permit CONSTRUCTION LENDINGAOENCY Is oats lending agency oar the neoformans of I Hamby Nim that Nem 4 s Newark far which NIa permit is issued (Sec. 7097, Civ. Cd ed (Sm.. 3 ' Lenders Name Ltndefa Addw I certify that I ban tend this application and sus that the above infomatiun Is ' coma 1 agree to comply with all city and county ordinaries, am sus laws relating to Wilding construction, and hereby authorize rep,e enutins of Nis city to enter unto um above-rommio.cd property for Inspection parpaas. (Wed agree to ave. indemnify ad kap harmless the City of Cuptrlmaagainst pewhich may in any way agality i Iiabilitin,JWgmenu,eosu and ansu MersaMersanaid C j APPLICANT 1. eUN UNDERSTANDS ANof this D WILL COMPLY WITH ALL NON -POINT Issued by: Date SOUR • REG ,• 0 I Z�1-�� Re -roofs Type of Roof Signature of App tanUcanuacbo Das HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building wcupantmam orlundle haardaus material as defined by the Cupertino Municipal Cade. Chapter 9.17, and the Health and Safety Cade. Send. 25532(.)? All roofs shall be inspected prior to any roofing material being installed. ❑You �ZNa If a roof is installed without first obtaining an inspection, I agree to remove Will ft applicant of future building occupant ua equipment or dcviw which emit hi ardtun air conuminsnu as defined by the Bay Asn Nr Quality Management all new materials for inspection. District? 0y. No Nu I have mar the hvatdnm materials requirement, under Chapter 6.93 ofthe Califor• ns Health& SafetyCodc. Sections 25303.25577 and 25534.1 undersaM that ift a building data not unready hilve a board. Uta it s m tnpodtUhitiry to ratify tiro occupant of Ne myul nuwh qat a priarto =r Cenlnate.l. Occupancy. Signature of Applicant Date {�'� maw!m=Z All roof coverings to be Class "B" or better G neroraathwim agent Da x , CITY OF `UPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building De artment JOB ADDRESS: LoC7556 07) -Ll- PERMIT # 6 "76/S OWNER'S NAME: • PHONE # a T3- a 33 GENERAL CONTRACTOR: FAX # R 5-7 -'.7 7 5 I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information �. ,/ Owner/ Date 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/ Date •m 1 of 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 34232100.00 DATE ISSUED.......: 07/24/2006 RECEIPT #•........: 35350 REFERENCE ID # ...: 06070157 SITE ADDRESS ...... SUBDIVISION ....... CITY .............: IMPACT AREA ....... i ��Z�LY�� u [ibX�•�i7 \ .��1! y CUPERTINO OWNER ............: BRETT REEDER ADDRESS ..........: CITY/STATE/ZIP ...: , RECEIVED FROM ....: BRETT REEDER CONTRACTOR .......: LIC # *OWNER* COMPANY ..........: BRETT REEDER ADDRESS ...........: CITY/STATE/ZIP ...: , TELEPHONE ........: qEE ID UNIT BENERGY PERMIT FEE BREMRECEPT NO. OUTLETS EPERMITFEE FLAT RATE BSEISMICRE VALUATION TOTAL PERMIT OPERATOR: amyw COPY # : 2 QUANTITY ---------- AMOUNT ---------- PD -TO -DT ---------- THIS REC ---------- 1.00 34.86 0.00 34.86 1.00 1.20 0.00 1.20 1.00 38.37 0.00 38.37 600.00 0.50 0.00 0.50 ---------- 74.93 ---------- 0.00 ---------- 74.93 METHOD OF PAYMENT AMOUNT ----------------- ------------ CASH 74.93 TOTAL RECEIPT 74.93 VOICE ID DESCRIPTION -------- ------------------------ -------- ------------------------ 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL • NEW BAL 0.00 0.00 0.00 0.00 �ll[lL VOICE ID DESCRIPTION --------- ---------------------------- --------- ---------------------------- 501 FINAL ELECTRICAL ENERGY ��rr F CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM IRPN # Fee Description Fee Group Date: ' MECHANICAL BBOILERI P, q c)G Building Address: Mailing Address (if different from building address): Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Owner's Name: MECHANICAL BBOILER4 P one r BBOILER5 Boiler> 1.75M Btu `/ C'� Contractor: Construction Tax BUILDING cense #: Contact: Phone: a 573 - 23 1-7 BCONSTAXBQ Cupertino Business License#: Fax: -- ?74 Hotel and Motel BUILDING Building Permit Info: Constax - Resi/Mobile BUILDING Bldg ❑ Elect 1K Plumb ❑ Mech ❑ Job Description: CrFC;N-- Elec 600V > 1000A ELECTRICAL Residential , Elec Svcs 600V <= 200A Commercial ❑ Sq.Ft. Floor Area: vSq.Ft.: Energy BUILDING BENERGYADD Cost of Project: BUILDING BINVESTIGA Occupancy Group: Co Type of Construction: Please check this box if the project is a second -story addition: El ro'ect Size: Standard ❑ Large ❑ Major ❑ Quantity 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 Boiler> 1M 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 hivesti ation fee BUILDING C J 1 of 3 CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM 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 Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINI'ERCEP 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 rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 din MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Fumace MECHANICAL BREMFURNOV Relo Fumace > 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 2of3 J ID CITY OF CUPERTINO CUPEf OF PERMIT APPLICATION FORM 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 Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Ternp 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 Change BUILDING • 3 of 3