05010069 (2) FCPCY ORCUPEWHNO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION
BUILDING ADDRESS: MARTY ZIMMERMAN PERMIT N005010069
10165 MC LAREN PL
OWNER'S NAME: PERMIT ISSUE DATE
MARTY ZIMMERMAN 01/11/2005
ONE: SANITARY NO. CONTROL NO,
ARCDITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
IOp LICENSED I amCONTRACTORS derp DECLARATION
F❑ 1 krcby affirm(hat 1 am licensed under and
Proems of Chapter 9(commencing Job Description
£zW with Scnion]txk)of Division Jof NC Business and Prufcuinm Code.entlmylic.nuis
opnumroeandeffect. ELECT SERVICE UPGRADE
j 2i License Class Lic.g
e=Fp Dec Cuntraclor
�ty ARCHITECTS DECLARATION
f a V I understand my plans shall k used as public mood;
ou
H Licensed Professional
5 OWNER-BUILDER DECLARATION
ja Z I hereby affirm that I am exempt from the Comnnor's License,Law for,he
O O rollowing reason(Section 71131.5.Business and Pmfeuiom Code:Any city or county
<m which requires a permit to construct,eller.improve,demolish,Or mPxir any structure 8500
-zi prior it)its issuance.also requires the applicant for such permil to rile a signedsmtemcnt
.xM that he isliccsedpursuanttotheprovisionsorNCContractor'sLicenselaw(Chaprts9 Sq.Ft. Floor Area Valuation
-e t- (commencing with Section 7")of Division]M the Business and Professions Cods)or
`t Na,he is exempt tkrtfmm and the basis for to alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects Be applicant to a Civil penalty ofn e
not more Nan five hundred dollars(SSW). CIAO - Occupancy Type
0 1,u owner of the propcny,as my cmpleyces with wages u their sole compensation,
will do the work,and Nestructum is not intended orofrcred for sale(See.]Obs,Business
es
and Professions Code:The Contractor's License Law donot apply to an owner or Required Inspections
property who builds or improves thereon,and who deals such work himselfor through his
own employ.,provided Na,such impronmcnts are not intended or offered farsal..It,
however,the building or improvement is sold within one year of completion.,heowner
builder will have Nc burden of proving that he did not Wild or improve for purpose of J /�
sale].
co I,as ewer of the progeny,.B exclusively contracting with licensedhC Contractor's
to 1
conk a d project(Sec.]BOC,Business and Profession Code:)The Convenor's rad
cmc Law docs not apply je an owner of prop.ny who Wildspor improves Contras and s
who contracts Lactsfor such pmjecu wiNacmnlncmr(s)liccnudpursuamto the Contractor's
mu .
lam ex ,un rSec. ,B&PCf r,hrs mason
CM
once WOR 'S CO ECLARATTION D. (
IkrebY alfi under n , !perjury oro of Ne,folio mil tion:
Ibaveondwillmo n enificute of Consent to self-insum for Worker's Con,em
axtioo,as provided for by Section 37W of Use labor Cade,for Ne kifrormawe of the
wok for which this permit is issued.
0 1 have and will maintain Worker's Compensnion lmuramel.as required by Section
37W of the Tater Code,for the performance of the Wolk for which this permit is issued.
My Worker's Compensation Insurance artier and Policy number am:
Carrier: Policy No.: _
CERTIFICATE OF EX EM MON FROM WORKERS'
COMPENSATION INSURANCE
(Thissection recd not hecompleted if the permit is for one hundred dollen(SIIXp
Or less.)
e cerufv min the performance or the work for which this permit is issued.I shall nut
employ in an mann. scut kcomc subjccuetk Workers'Compensation
Laws of Calif r .Da
Ap rant
N C APL : ler making ,¢am of Eae'iT mption,you should
hjecl to the We' rs opens to provisions of Ne,Labor Code.in.most
Ofor wi comply with aloe prnvim mor rs (mit shall k deemed mvotctl.
Z Vy CON ON LENDING AGENCY
I hereby affirm Na,them its consvuctinn lending agency for Lk Performance of
5 the work for which this permit is iuued(Sec.3097,Civ.C.)
i1 0 lender's Name
�,� Lender's Add.
J T cenify Na,I have read this application and state Nu Be than info ouiun is
y F^ come'.1 agree to comply with all city and county ordinances and suite laws xla,ing to
�O
building gconsned pro,and henbyanthori purposes.rexma,ivcs of Nis city,o cmc(upon Nc
yehove(W t) g pmpeny forimpectionmc,h /
(We,)acre.m rave,indemnify and keep harmless the City of Cupertino against ( /
fin Iialflihes,ju44Sments,c.tu and,.,..a which may in any way acerae against said City
;Jz AcoLI A IC (the rantingof this permit.
" APPLICA DE STANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Dale
SOURCER A
It Re-roofs
Si wen of Applican omn Date
AZAR U MATERIALS DISCLOSURE ��jj Type of Roof
Will the applies w uilding Occupant store or handle loll.4(menial
as dcrmed by the Cupertino Municipal,Core,Chapter 9.12.and the Health and Safety
nae.Se y.do®2ss3xa)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes No
Will thea rant or future buildin Occu ant use a If a roof is installed without first obtaining an inspection,I agree to remove
PP g p yuipmem or devices which g p
..t havudous air contaminants as darned by the Bay Area Air Quality Management all new materials for inspection.
sola'
OYcs (krN.
I have mad the hvardous materials reyviremcnts unrer Chapterti95 ofthe Califor-
nia Health&Safety Code.Sectimu 255(15,25533 and 25530.1 understand this if tk W ilme,
does Bol cement,ban a teem,than it u my respousihiliry m nnufy sk Occupant of N.
mquimme WhohMust kmet prior oissuaneeofaccooraleofaup ow Signature of Applicant Date
tS
0 u a da e , All roof coverings to be Class "B"or better
r Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
�UPERTINO
Building, De artment
JOB ADDRESS: ( O 1 (o S M c 1-OYZ efts = PERW#
C- , f( le-.Tlt-'o C 9So14 pS01 000>Gq
OWNER'S NAME: MA91- -;-LI mm e fZm A1+,3 PHONE # rcr--564-7o-AY
GENERAL CONTRACTOR: /} FAX # 1{ok -Zf5-Z3SG
I am not using any subcontractors: 1 -11 -05
i ture Date
Please check applicable subcontractors and c Tete 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
I —1) - vS
c Signature Date
i
3
S, 10
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
�UPEkTINO
Building De frtment
JOB ADDRESS: 1 O 1 toS Mr LPrR EJB` el-RCE PERW#
Co 95014 ZpS010,0G9
OWNER'S NAME: f)A Ags -_Li vt,�mGRm fVW PHONE # 1j--54o`I-70.1Y
GENERAL CONTRACTOR: FAX # Lfok -Zr5-T3f(.
I am not using any subcontractors: —J
islature Date
Please check applicable subcontractors and cbffiplete the following information
RI SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation X
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping f' '
r
Lathing a ( r
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
T'
ei
e{/C�0 c Signature Date '
OWNER-BUILDER VERIFICATION
1. (Check one) I or my immediate family (parent, spouse or child) will perform
A. X' All-the work authorized by this permit
B. A portion of the work
C. _ None of the work
If B or C is checked,complete 2 or 3 below.
2- A state licensed contractor will be hired to do:
A. _ All of the work
B. A portion of the work (complete section below)
Contractor Address/City. Phone # State License # Type of work to
VG G12 V2vLG4
3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or
portions of the authorized work I understand that I may be an employer (see reverse side). A
Certificate of Insurance covering workers' compensation must be on file at the City of
Cupertino Building Department office.
Person/Firm Address/City Phone Number Type of work to be
_performed
.....................................................................................................................................................................................
I declare under penalty of perjury that the above is true and correct. I have read and understand the
Owner-Builder Information (reverse side).
Property Owner's Signature. � Dam: 1
Job Addrestsr— I���^ YY\�l p E!�W 0 501 O 0 Vcj
Any changes to the information provided on this form shall be submitted'fo the City of Cupertino Build
-Department. _
a
City of Cupertino Building Departmen
t I CITY OF 10300 Torre A---,-,a
C V P E L2 T I N O Phone: (408)777-3
Dear Propel Owner.
An application for a building permit has been submitted in your name listing yourself as the builder of
the property improvements spedfied.
For your protection you should be aware that as owner-builder you are the responsible party of record
on such a permit Building permits are not required to be signed by property owners unless they are
personally performing their own work If your work is being performed by someone other than yourself,you
may Protect vourself from Possible liability if that person applies for the proper permit in his or her name.
y Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all
permits for which they apply._ _
If you plan to do your own work,with the exception of various trades that you plan to subcontract,you
should be aware of the following information for your benefit and protection
If you employ or otherwise engage any persons other than your immediate family,and the work
(including materials and other costs) is$200 or more for the entire project,and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
If you are an employer,you must register with the state and federal government as an employer and
you are subject to several obligations including state and federal income tax withholding,federal social
security taxes,workers' compensation insurance,disability insurance costs,and unemployment compensatior,
- contributions. - -
There may be financial risks for you if you do not carry out these obligations, and these risks are
especially serious with respect to workers;compensation insurance. -
For more specific information about your obligations under federal law,contact the Internal Revenue -
Service (and,if you wish,the US.Small Business Administration): For more specific information about your
— obligations under state law,contact the Department of Benefit Payments and the Division of Industrial
Accidents. -
If the structure is intended for sale,property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees,without a licensed contractor or
subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder
building permit,erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing
their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors State License
Board in your community or at 1020 N Street,Sacramento,California 95814.
Please complete and return the enclosed owner-builder verification form so that we can confirm that
you are aware of these matters. The building permit will not be issued until the verification is returned.
Very truly yours' -
- Building Department,.
City of Cupertino
Printed on Recycled Paper
(Sd CITY OF CUPERTINO (>
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
No APN # aSDate:
NZ/ �
Building Address: Mailing Address (if different from building address):
cup kil
Owner's Name: Phone#:
��? ry 103m 6r'zrn t�tJ —s6 v-7�v
Contractor: SEI,F License #:
Contact: Phone: efAf-5 y- 'may Cupertino Business License#:
/YI/�I2'fy ZImmGR-marJ Fax: yof- ZSV-Z U6
Building Permit Info:
Bldg ❑ Elect Plumb ❑ Mech ❑
Job Description:
Residential �K :UP6RRD6 5-62VIc6 Commercial ❑��
Sq.Ft. Floor Area`` $/Sq.Ft.:, N
Cost of roject: s� Oce ancy Group: /
Typ of ons �o . I NSTatL AV am IPA- bt, Pleas heck this re project is a
second-story addition: ❑
Project Size: Standard IgLar e ❑ Ma'or ❑
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 IM Btu MECHANICAL
BBOILER4 Boiler> IM to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 175M 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 <= IOOOA ELECTRICAL
BELEC1001 Elec 600V > 1000A ELECTRICAL
BELEC200 Elec Svcs 600V <= 200A ELECTRICAL
BENERGY Energy BUILDING
Ask BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
I of3
(CG- CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
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
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 Pie PLUMBING
BPWHEATER WaterHeater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace > I 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
AM BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
2 of 3
aCITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPERTINO Alk
Quantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmd] 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 Insl5ection BUILDING
BSWIM 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
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanical sq. foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot I PLUMBING
ZADDCHG Address Chane BUILDING
3 of 3
06/29/2005 14: 44 4082552356 MARTY ZIMMERMAN CPA PAGE 01/02
r
• Marty Zimmerman
10165 McLaren Place
Cupertino, CA 95014 �" W
(408) 564-7024 11 i I� J
VIA FACSIMILE 408-777-3333 }C ll
Mr. Greg Casteel
Building Official
City of Cupertino
RE: City of Cupertino Permit 05010069
Dear Mr. Casteel:
I am writing this letter to request an extension of time for the above permit to September
16, 2005. The reason I am requesting an extension is that I am waiting for PG&E to do
the work.
The project is to upgrade the electrical service to my house at 10165 McLaren Place,
Cupertino ;From 100 amp service to 200 amp service. I applied for and received a permit
from the City of Cupertino on January 11, 2005 for this upgrade. Upon receipt of the City
• of Cupertino permit I immediately submitted an application to PG&E to do the upgrade.
PG&E required a permit and a deposit on the engineering work before they would take
my application. PG&E indicated to upgrade the service they would have to dig a trench
and install larger cable inside a conduit pipe from across the street to my house and make
some upgrades to their distribution system. The application and deposit to PG&E was
also done on January 11, 2005.
Starting in March 2005, after waiting,a couple of months for them to do the engineering, I
made numerous calls to PG&E on the status of the engineering for the upgrade and was
constantly told they are busy and would be getting it done as soon as they could. Finally,
Mike Valencia of PG&E, on June 16, 2005 informed me PG&E had completed the
engineering for the project and wanted me to sign the contract and pay for their services.
I responded to them on June 16, 2005 and signed the contract (contract number
101590809) and paid the requested fees to have the work done. I understand from Mike
Valencia I am now in the pipeline for the work to be done. I have asked Mike Valencia,
New Business Project Manager at PG&E (phone 408-725-2206) to let me know when the
work would be done as I was rapidly approaching the six month deadline for the City of
Cupertino permit. Mike said PG&E is very busy and backed up on projects. Mike was not
able to tell me when the work would be done. He said PG&E holds a meeting locally
once a week with all the project managers and all the projects are laid out and decisions
are made on the ones to be done that week. Unfortunately Mike could not give me a date
for when my work would be done. I have advised Mike Valencia of the date of expiration
of the permit and asked him to work toward having the work done before that date. As of
• today I still do not know when PG&E will do the work.
06/29/2005 14: 44 4082552356 MARTY ZIMMERMAN CPA PAGE 02/02
Mr. Greg Casteel, City of Cupertino June 29, 2005
• RE: Permit 05010069 Page 2 o£2
For the above reasons I am respectfully requesting an extension of time on the permit to
September 16, 2005. The reason I ask for September 16, 2005 is that the PG&E contract I
signed indicated it was good for 90 days. I signed the contract on June 16, 2005 so I
figure PG&E will need to get the work done within the 90 day period. At least that is
what I hope. I am doing everything as fast as I possibly can to get the work done. If you
want to provide more time that is appreciated.
Please call and let me know if you have any questions or if you can provide any
suggestions on how I might get PG&E to get this work done before July 11, 2005.
"Thank you in advance for your consideration of this request.
R ectfully submitted,
Marty Zi e
Direct: (40):5 -7024
Fax: (408) 255-2356
•
Permits-Permit Application Maintenance72-JE15M
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PERMIT NO 05010069 STATUS W OPEN APPLY DATE 01/11/2005 OPER conniew -" -----
Notepad
MASTER NO J NOTES PERMIT ISSUED 01/11/2005
OPER conniew 'Holds
PROJECT _ - �, CERT ISSUED____) OPER (Cancel
PRO) DESC 1 CERT NUMBER' TYPE _� -- —
APN 31621050.00 ( : UPDATE ADDRESS I''I Field Code D.
User Screens
PARC ADDR 10165 MC LAREN PL C/S/2 CUPERTINO � CA ,, 95014
--
Tort ByCol 3
OWNERiMARTV 2IMMERMAN OWNER2.
B� y Co4'"
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0 ADDR � C/S/2' CUPERTINO CA 11 195014-23351 ---
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PERMIT TYPE, " US_C-404 TYPE 434 � �, ENRGY .CODE�� Geo-Link
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USAGE CLASS, N/A Quit
_PERMIT FORM APPLICATID TANK/SEWER ,.
APPLIED UALUATION 500 APPRUD"BY:� �•
CALC UALUATION _ 0;. D, OWNER PH# 4085647024!
OWNERSHIP r1� PRIVATE ;NOTES (Y/N/D) '. CONTR' PH#'..
SPECIAL CONDITIONS/NOTES IESCROW
LHT SEROIC UPGRADE VERIFIED
FILE LOCTR1
PERMIT`STATUS - f0>pgn, g>losed; : U>oid, <H>01d, 'fR>eject, <E>xpired
•
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PERMIT N0 0501006YI 31621050.00 J� MARTY ZIMMERMAN J - --
------.._.----.---.._-..___. �__-._..-_..------------ ,Feturn
PERM TYPE REAPS 110165 MC LAREN PL r-------
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PERMIT STITUS - <0>pen, <C>losed, <U>aid, <H>old; <R>eject,:' <E>xpired
•