07070102 - PUB- --- --------
21
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Pefrriit Information
Permit Number
Status ,
Master Number
Project
Apply Date
Permit Issue Date
Certificate Issued
Certificate Type
Certificate Number
07070102
C - Closed
yj
Notes
061
suety
patg
-PALM
Permit x Property Zoning Applicant -i Contractor 11 Defined Fields
Permit Details
Location I nformahrtt
Address 1049CI MORETTI DR
City/State/Zip CUPERTINO rCA]
APN 37516059.00
U nit
EniitY information
[OwnerName -I JENNY LOUIE
Use Default ❑
Address Home -10490 MORETTI DR
City/State/Zip CUPERTINO
Permit Type
Operator
10/02/2007
Operator
I11-/201200-8
Operator
061
suety
patg
-PALM
Permit x Property Zoning Applicant -i Contractor 11 Defined Fields
Permit Details
Location I nformahrtt
Address 1049CI MORETTI DR
City/State/Zip CUPERTINO rCA]
APN 37516059.00
U nit
EniitY information
[OwnerName -I JENNY LOUIE
Use Default ❑
Address Home -10490 MORETTI DR
City/State/Zip CUPERTINO
Permit Type
JSFDWL-NEW1
;DO NOT USE
Usage Class
IDWL-WNEW
[DWE LLI N G TYPE 5 WO 0 D NEW
Applied Value
45000 -0
SQUARE FT.
2322
Calculated Value
524153 *1
US C-404 Type
E10
[N EW- S FD, D E TACH E D
Permit Form
FAUTOPIERM - PERMIT
0 wnership
F1 Private
Project Size
I
You have chosen to bypass the holds for this permitiparcel
Enter the purpose or any special conditions for this permit
�CA 95014
Purpose/Special Conditions
SFDWL 2,322, GARAGE 468'
-SANITARY IS SUNNYVALE'S JURISDICTION_
GARAGE 56.38 X 468 = 26,386
FILMED- 20111
I[EAdd Default Text
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CITY OF CUPERTINO
BUILDING DIVISION PERMIT
C�NT]�AGTOR I `ORIVIA'MON:
Bu1LDLI'IbApJ�TsMORETTI DR
P071070102
TBD — TO BE DETERMINED
OWNER'S N[A�M`jE :
PERMIT I5SUE DATE
JENNY LOUIE
10/02/2007
PHONE:
SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and my license is
S FDWL 2,322, GARAGE 4681—SANITARY I S SUNNYVALE ' S
in full force and effect.
License class Lie. a
JURISDICTION. GARAGE 56.38 X 468
Date ARCHITECI-S DECLARATION
= 26,386
1 understand my plans shall be used as public records
Licensed Pmfcssional
OWNER- BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contactors License Law for the
following reason. (Section 7031.5, Business and Professions Code: Any city or county
which requires a permit to construct, alter, improve, demolish, or repair any swaure
prior to is issuance, also requires the applicant for such permit to file a signed statement
Contractors License Law (Chapter 9
Sq. Ft. Floor Area Valuation
hat he is licensed pursuant to the provisions of the
Division 3 Business and Professions Code) or
- $524153
(commencing with Section 7000) of of the
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
Number Occupancy Type
not more than rive hundred dollars (x500).
3 7 516 0 5 9J
❑ 1, 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
9 P
and Professions Code: The Contractor's License Law does not apply to an owner of
property who builds or improves thereon, and who does such work himself or trough 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.). .
E�1<1 as owner or the property, am exclusively contracting with licensed contractors to
construct the project (Sec. 7044. Business and Professions Code:) The Contractors 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 Contractors
Ucense Law.
❑ I am exem t Sec , B & P C for this reason
Owner r Dale
-_
( �V *61TK�S CO ENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations
❑ 1 have and will maintain a Certificate of Consent to self -insure for Workers Compen.
sation, as provided for by Section 3700 of the Labor.Code, for the performance of the
work for which this permit is issued.
❑ I have and will maintain Workers Compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of the wort for which this permit is issued
My Workers Compensation Insurance carrier and Policy number am:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(This section need not be completed if the permit is ftr one hundred dollars ($100)
or less.)
I certify that in the performance of the work for which this permit is issued,) shell not
employ any person in any manner o as to become subject to WOricCri C�m�nsatioa
Laws of aliforyra�al2Ts //f`7`7
Applicant / -
-h
NOTICE f-O LI : If, after ma ing this Ceres ncatc ofrEcem(%tion, you should
become subject to the Worker's Compensation provisions of the Labor Code, you muss
,
forthwith comply with such provisions or this permit shall be decreed revoked.
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 (Sec. 3097, Civ. C.)
_
Lenders Namc
7 Lenders Address
DI certify that 1 have read this application and state that the above informadun is
correct. 1 agree to comply with all city and county ordinances and state laws relating to
building construction, and hereby authorize representatives of this city to enter upon the
for
above - mentioned property inspection purposes.
y� (We) agree to save, indemnify and keep harmless the City of Cupertino against
n liabilities, judgments, costs and expenses which may in any way accrue against said City
in consequence of the granting of this permit_
APPLICANT LLUDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date
SOU E'REG -I11) a
0
Re -roofs
' Sigsulture of Applicam /Comractor Dale
HAZARDOUS MATERIALS DISCLOSU Id
Type of Roof
Will the applicant or future building occupant store or handle hazardous material
as derived by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety
Code, Section 25532(a)?
❑ Ycs 0
All roofs shall be inspected prior to any roofing material being installed.
If a roof is 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 l� "0
I have read the hazardous materials requirements under Chapter 6.95 ofthe Califor-
nia Health & Safety Code. Sections 25505.25533 and 25534.1 understand that if the building
does not curre ly ha tenant, that It is my responsibility to notify the occupant of the
rcquirami5nts t be t prior to issuance of a Certificate of Oc upanc .
Signature of Applicant Date
- O O
A]1 roof coverings to be Class "B" or better
ner or authorized agent Date
CUPERTINO
CITY OF CUPERTINO
NEW SINGLE FAMILY DWELLING
PERMIT APPLICATION FORM
APN #
3i5 -ico -o5
•
Date. JULY 13 42007
Building Address: Mailing Address (if different from building address):
kc)490 WCVI�TT 1DewV,E,
Owner's Name:
JENNY LoulL --
Phone #:
4025 l-
Contractor:
License #:
Contact: V I N CCN' 10006 Phone: 40 e134 og TV
Cupertino Business License #:
Fax:
ELECTRICAL
Building Permit Info:
Single Story ❑ Two -Story C7/ Three -Story ❑ Basement ❑
Sq.Ft. Floor Area: Z.3 Z. W J4
201 S�,�T
/Sq.Ft.:
•,
, ,
Cost of Project:
* 45o O c o
ELECTRICAL
Type of Construction: v ', l
BENERGY
Project Size: Standard [j"" Large ❑ Major ❑
BUILDING
Quanti
Fee ID
Fee Description
Fee Group
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
Investigation fee
BUILDING
1 of 3
4 &k�
BMITIGATR
Res. Housing Mit Fee
BUILDING
BOVERTIME
Inspection Overtime
BUILDING
BPBACKFLOW
Atmospheric Vacuum
PLUMBING
BPCESSPOOL
Cesspool
PLUMBING
BPERMFEE
Bldg Permit Fees
BUILDING
BPFIXTURE
Pblg Fixture
PLUMBING
BPGAS
Gas Piping System Fee
PLUMBING
BPINTERCEP
Ind Waste Interceptor
PLUMBING
BPLANCHK
Plan Check Fee
BUILDING
BPLANCKADD
Plan Check Add Multi
BUILDING
1 of 3
4 &k�