08020042 CITY OF CUPERTINO
BUILDING DIVISION PERMIT T12A�TOltj1 `'V. NIt� Il�'"
BUILDING ADDRESS: PERMIT NO.
10712 RANDY LN LIVE WIRE ELECTRIC 08020042
R'S NAME: PERMIT ISSUE DATE
MAHEMPRA SWAMY P 0 BOX 26041 02/07/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
4 REC LITES ON DIMMER LIVIN lBLw� EO PLUMB
O
o o LICENSED CONTRACTOR'S DECLARATION RM
IhcrcbyAir,.that IAmlicensed underprovisions atChapter 9(Commencing ^^^^^^-^-^^ ^^IQbDescrlptlon
with Section 70110)of Division 7 of Ac Business ad Professions Code,and my Iicc.o is
an 51 in full forte Andaffect. �7 `
Cg3 License Clssaak.•Lt
9 F Da¢
DEC ComLARRAATIOONN
ey ARCHITECTS DEC
y 1 admitted my plans all M mad As Precords
cnn
U
9�p Licensed Profmional
.7 OWNER-BUILDER DECLARATION
<S I kmby affirm that 1 am ucmpt from the Contractor's License Law fol to
COO following moon.(Section 7031.5.Business ad Proposal..Cole:Any city or county
3 8! which re ul=a porous m cmutruc.aMr,improve,demo)W,in repair my mupu e
prior w its iuulsure mquims the applicant farsteh permit to file asigned moment
< (comme ca.cdpunwnuoNepmvisision3 f ftBuhamallce.elaonsCodm9 Sq.Ft. Floor.Area Valuation
(commencing Section tochep(Disiois J of thentrin.smdmau:Law(Code)w
Nat M is exempt Carefree ad the Isis for the Alleged exemption.My violation of
Section 7051.5 by any Applicmt for a permit mbjecu she Applicant a civil penalty of APN Number Occupancy e
net mom thin flue hundred dollars(g51Mp P Y EYP
❑1,u ower of tM property,or my emPloym with wages n delr ink eampemdon,
will do use work and the."ame is not intsMetl OraRertd portio(See.RMA.Buai=s
ad Propositions Code:The Contractors Licem Law dm not apply a an Owner or Required Inspections
property who builds ar lm pmvu thenen,andwho does such work himself.Nmu[h his
Own employ=,provided Nataoch improvements an net intended aroRemd for ale,If,
however.the building in Improvement is mid within ane year of compledon.the owner.
builder will haw W burden of proving that he did at build or improve for purpose of
uk.).
❑L as owner of the property,an eacl.ively contracting with licensed Con reamn in
Construct ties,project(Sac.7044.Business and Profession Cade:)TM Comracmra U.
cern Law d=not apply to an owner of property who Wilds or improwea thinner.and.
who contracts for such projects with a mnuacror(s)licensed pursuant m the Contractors
License Law.
❑I an Attempt under See ,B l P C far that40
m••^n
m Data
WORKERS COMPENSATION DECLARATION
1 hereby affirm under pe.dy of Perjury ane of the fallowing declandmtc
I have aM will Cautious A CeniOwm mrCamm in self-inure fur Workar.ComPen-
on,As provided far by Secd.n 37M of the labor Code,for tie performance of the
work for which this permit is issued.
❑1 law ad will maintain Warkers Compensation IUWa ce.u acquired by Secdon
37M often labor Code,for the perfarmmee of the work for which that permit Is Issued.
My Worker.Camp e..ii..I.umnce Cartier and Policy number am:
Canner: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
rrhh.Mion need not he completed if IM permit Is feranc hundred dollen(SIM)
or leu)
I ce dfy that In the performance of the work far which this Permit M mood,I Ahall no
employmyPeraninmymm!t unh= mbjeel mlM Worker'Compemdan
lawsaf Califamia.Pw�y `_— 9-G�3
Awdcw l7
NOTICE TO Object
in O :If,eller making that provisions;
.n of Exemption,you ushould
a m
.come m omp ro it wasters Compensation p4o.iai=of Nc labs Cade,you muss
.J O foMwith comply with such provisions or that peanit shill o inert.mmtW.
'Z= CONSTRUCTION LENDING AGENCY
[-+ I Mreby AMM lhit Nem is A COMUUCirn Lending agency for the Performance of
a the work(or which this permit is issued(Sec.3097,Civ.C.)
W 0 Lenders Name
D z Landers Address
V Q I acidify that I hive read this app0utian and sum Nu de move information la
CMCCL 1 Agree to comply with all city ad county oNlnmm and into laws relating to
rU^ building convection,and hereby mNorim tepmxnldvra of this city in enter upon the
.ova-mentioned property far inspection purposes
6. (We)mime to un.indemnify ad keep harmless time City of Colmnino Against
V) liabilidu,judgments,coN and expenses which may in any way accrue against said City
C)Zn
in consequence.(the[ratin[Of this permit. L —�
�-' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date CC��
SOURCE ONS.
2 C1'f` Re-roofs
slgmu o App m.m/COnuamor Data
HAznRDOUS MATERIALS DISCLOSURE Type of Roof
Will use Applicator or forum building Ovmpata mm m hurdle h timet ma hai
dcRned by the Cupertino Municipal Code.Chapter 9.11 ad the Health ad Safety
. 25532(a)?z(A)7
0y. JXN.
All roofs shall be inspected prior to any roofing material being installed.
❑
Yu
Will the Amt0anr or future Wilding oermpant em equipment Or dcvi=which If a roof is installed without first obtaining an inspection,.1 agree to remove
emir IraNnu air comminma As defined by the Bay Area Air Quality Management all new materials for inspection.
DimiCL7
❑Yes No
I have real the hound.inand.1s;requirement under Chapter 6.95 of the Califor.
nia Health B Safety Cade,Sections;15505.25577 and 15534.1 understood that lftie Wilding
J=nor curmnrly have A seat,Nor It u my achandbility as notify the.coup rid of the
rcqimmcn hmu M priarroiaaanccof.CcrofnamofOccupreq. Signature Df Applicant Date
Owner or mthodmd agent Data All roof coverings to be Class"B°or better
n
CITY OF CUPERTINO
• CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# �y Date:
Building Address:
C -712,- �
Mailing Address (if different from building address):
Owner's Name: Phone#:
Contractor: Phone:
G�✓2 v✓i,t-�� G�i2.< <�� Fax:
Contractor License#: '7Z7
• Cupertino Business License
Contact: Phone:
6 79 —7S'g -L Fax: C79-7 GG
Residential L9 Commercial
a
Job Description: /cn
Building Permit Info:
Bldg ❑ Elect R1 Plumb ❑ Mech ❑
Type of Construction(Usage Class): Occupancy Type:
1 FR, 11FR ❑ 11, 111, V-IHR ❑ 11, 111, lV V-N —�
Valuatioq/ Square Footage:
• Project Size: Standard Lar e ❑ Major ❑
CITY OF CUPERTINO •
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group IGENRES or
1 GENCOM
1BTEMPPER Temporary Building Permit (good for B
30 days)
1BBOILERI For the installation or relocation of ea M
boiler/compressor to & including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h 29.3kw)
1BBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to &incl 15 horsepower, or ea
absorption ss over 100,000 Btu/h
1BBOILER3 Installation/relocation of ea M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ea •
absorption sys over 500,000 Btu/h to
&incl 1,000,000 Btu/h
1BBOILER4 Installation/relocation.of ea M
boiler/compressor over 30 hosepower
to & incl 50 horsepower, or for ea
absorption sys over 1,000,000 Btu/h to
&incl 1,750,000 Btu/h
1BBOILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1BAPPLOTH For ea appliance or piece of equip M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
IELECINSP Other Electrical Inspections (per hour) E
1MECHINSP Other Mechanical Inspections (per M
hour) •
1PLMBINSP Other Plumbing& Gas Inspections P
(per hour
1MEETINGIHR Application Meeting B
CITY OF CUPERTINO
cuPi RTwo GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description - Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1 CHIMNEY Chimney B
1CHIMNEYR Chimney Repair B
FENCES
1FENCE>6FT Non-masonry, over 6 ft in height B
1FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
1FLAGPOL>20 Flag pole (over 20 ft in height) B
1MODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
1PILECAST Pile Foundation Cast in place concrete B
1PILEDRIV Pile Foundation Driven (steel,pre- B
stressed concrete
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CITY OF CUPERTINO
CUPEIZTINO GENERAL BUILDING APPLICATION •
FEESCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1 RETSTN Standard (up to 50 ft) B
1RETSP310 Special Design, 3-10' high(up to 50 `) B
1RETSP10 Special Design, over 10' high (up to B
50'
1RETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft
1RETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft
SIDING
1SIDEST/BK Siding, Stone &Brick Veneer B •
interior/exterior
1 SIDEOTHER Siding all other B
SKYLIGHTS
1SKYL<10 SF Skylight less than 10 sf B
1 SKYL>10SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'1 B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B
1SRACKS>8 Storage Racks over 8' high (up to 100 B
st
1STUCOAP Stucco Applications (up to 400 sD B
additional stucco application
•
4 of 5
CITY OF CUPERTINO
CUPEI�F GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1 WINREP Replacement windows/sliding glass B
door (ea 8 windows)
IWINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee
r 1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
IELCPLNCK Stand Alone Electric Pln Ck (hourly) E
iMECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1PLMPLNCK Stand Alone Plumbing Pln Ck(hrly) P
ISTPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P). B
when not over counter) hourly-stand alone
/ 1BSEISMICR Seismic Residential B
1BSEISMICO Seismic—Commercial —B
ITRAVDOC Travel.&Documentation B
1BUSLIC Business License B
•
5 of 5
CITY OF CUPERTINO �-
Y
4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot: ..
APN . . . . . . . . : 31602071 . 00
, i
DATE ISSUED. . . . . . . : 02/07/2008
RECEIPT #. . . . . . . . . : BS000003878
REFERENCE ID # . . . : 08020042
SITE ADDRESS . . . : 10712 RANDY LN
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA
OWNER . . . . . . . . . . . . : MAHEMPRA SWAMY
ADDRESS . . . . . . . . . . : 10712 RANDY LN '
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2055
RECEIVED FROM . . . . : ERNEST ECHEVERRIA
CONTRACTOR . . . . . . . : ERNIE ECHEVERRIA LIC # 26452
COMPANY . . . . . . . . . . : LIVE WIRE ELECTRIC
ADDRESS P 0 BOX 26041
CITY/STATE/ZIP . . . : SAN JOSE, CA 95126
• TELEPHONE . . . . . . . . : (408) 425-4006
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW HAL
---------- ------------- ---------- ---------- ---------- --------- ------
1BSEISMICR VALUATION 2, 500. 00 0 .50, 0. 00 0.50 0 . 00
IELECINSP HOUR 1. 00 122 .38 0 . 00 122 .38 0. 00
1EPERMITFE FLAT RATE 1 . 00 40 .79 0. 00 40.79 0. 00
1TRAVD0C FLAT RATE 1 . 00 40.79 0. 00 40.79 0. 00
---------- ---------- -- ----------
TOTAL PERMIT 204 .46 0. 00 204 .46 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- ' .''-------------------
CHECK 204..46 64
TOTAL RECEIPT 204 . 46
t
•
( Community Development
10300 Tone Avenue
��' � Cupertino CA 95014
Telephone(408)777-3228
CITY OF -Fax(408)777-3333
UPERTINO
Building De artment
JOB ADDRESS: PERMIT #
07 Z Y` LIV F0
OWNER'S NAME: CXID �DA PHONE # -2 4-6r:)
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: 2 ' C-?
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
Owner/Contractor Signature Date
4
d