The URL can be used to link to this page

07050296 CITY OF CUPERTINO N �T BUILDING DIVISION PERMITS � FOI.tM �� v PERMIT NO. BUILDJi�lO�4Rl; bERALTA CT TOM' S ]PLUMBING 07050296 OWNER'S NAME: Y PERMIT ISSUE DATE RODRIGUES, ISABEL P 0 BO:: 362 05/31/2007 SANITARY NO. CONTROL NO. iNE: BUILDING PERMIT INFO ARCHITECT/ENGINEER: WATER HEATER REPLACEMENT BLDG ELECT PLUMB MECH a 0 o a p a LICENSED CONTRACTOR'S DECLARATION Job Description U t I hereby affirm that I am licensed under provisions of Chapter 9(commencing y with Section 7000)of Division 3 of the Business and Professions Codc,and my license is H in full force and effect z License ClassLam•N wDate s —Contract. 0 ARCHITECTS DECA 1 i a< I understand my plans shall be used as pu is records >yU U.� Licensed Professional < OWNER-BUILDER DECLARATION > 1 hereby affirm that I am exempt from the Contractor's License Law for the pO following reason.(Section 7031.5,Business and Professions Code:Any city.r county which requires a permit to construct,alter,improve,demolish,or repair any structure Z y prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation _< that he is licensed pursuant to the provisions of the Contractors License Law(Chapter 9 )q.Ft.Floor Area t- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or .. that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars($500). ❑I,as owner of the property.or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of Q p property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. ❑I am exempt under Sec B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑1 have and will maintain a Certificate of Consent to self-insum for Worker's compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑1 have and will maintain Workers Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Workers Com/gr�nsauon Insurance carrier and Policy number are: Carrier. /l.f _ !svT Policy No.: C �2�y CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. z CONSTRUCTION LENDING AGENCY ►�-� I hereby affirm that there is a construction lending agency for the performance of > the work for which this permit is issued(See.3097,Civ.C.) W Q Lendces Name jz Lender's Address U O 1 certify that I have read this application and state that the above information is Lc. ►' correct.I agree to comply with all city and county ordinances and state laws relating to Ubuilding construction.and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. CL (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City U"z to consequence of the granting of this permit. T ►� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. �B.w-c�.Q, vti r_4_>-,_ SAI 'r7 Re-roofs Sigagure or hcant/Contraetor 15se, Type of R oof HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupantstorc or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs ;hall be inspected prior to any roofing material being installed. ❑Yee TO If a roof i:;installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes N° 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant.that it is my responsibility to notify the occupant of the requirements which mast be met prior to i .an a Certificate of Oc pan Signature of Applicant Date All roof coverings to be Class"B"or better Own auth zcd agent Date CITY OF CUPERTINO 3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN 34260013 .00 DATE ISSUED. . . . . . . : 05/31/2007 RECEIPT #. . . . . . . . . BSC00001516 REFERENCE ID # . . - : 07C50296 SITE ADDRESS . . . . . : 10502 PERALTA CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER ROLRIGUES, ISABEL ADDRESS 10502 PERALTA CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JOSEPH CLARKE CONTRACTOR CLPRKE, JOSEPH M. LIC # 10044 COMPANY TON ' S PLUMBING ADDRESS P C BOX 362 CITY/STATE/ZIP . . . : SAFATOGA, CA 95071 TELEPHONE (4C8) 867-6010 FEE ID UNIT QUANTITY FMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---------- ---------- ---------- BENERGY PERMIT FEE 1 . 00 34.86 0 . 00 34 . 86 0. 00 BPWHEATER PER HEATER 1 . 00 10 .79 0 . 00 10 .79 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 .37 0 . 00 38 .37 0 . 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 84 . 02 0 .00 84 . 02 0 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 502 FINAL PLUMBING ENERGY 506 GAS TEST 507 FINAL PLUMBING . :. CITY OF CUPERTINO WATER NEATER CITY OF CUPERTINO PERMIT APPLICATION FORM APN# Date: Building Address: 1 o s D Z ?1t10A J-A c o te Owner's Name: ` Phone#: �s�P L Q Q�t ►2 i c Z 2-1 0— Contractor: Phone. License#: 0 Lve 19 87 Contact: Phone: Cupertino Business License#: 3-0-C, p '�—yo I&' Qa K ,/ Building Permit Info: Bldg ❑ Elect ®-- Plumb Mech Ll' Job DescriW �^ n Residential &�, Commercial ❑ Cost of Project: ftl Strapped VC1 On Platform 4S[- Bondee:l New Location ❑ Replacement Qty. if Applicable Fee ID Fee Description Fee Group BPWHEATER Water Heater/Vent BUILDING PPERMITFEE Plumbing Permit Issuance PLUMBING BENERGY Energy BUILDING BUSLIC Business License BUILDING Community Development 10300 Torre Avenue °;.. - Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 1-UPEkTINO Building Department JOB ADDRESS: PERMIT # •0,-CM Z f"e'Y OWNER'S NAME: �447ez kQ PHONE # 4ZV-- 2?&7 6a/ GENERAL CONTRACTOR: '1 1 FAX # 7 3 q 2 I am not using any subcontractors: of I e-" �-- k D 2 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 Ag�ex !1-, "-" _ J Owner/Contractor Signature Date