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06060014 (2) CITY OF CUPERTINO e s�aha<,.��y.�P;a2��'�* >r°-t> 9�T� �7�'�♦ `r`•""�'r' -? BUILDING DIVISION PERMIT �L�(',L l�ti.®t Q 1E�F [4YltfAL\ -'�3�k'S"u'.D1�Y.n-<;:ail.°+:1v�lm✓1�crz1.`N'hA•a5«,'t+n��.no-i BUILDING ADDRESS: , CLARENCE PETERSON PERMITNo.06060014 10332 CRESTON DR OWNER'S NAME: PERMIT ISSUE DATE A CLARENCE PETERSON 06 E: SANITARY NO. CONTROL NO. ARCHITEC17 E GINEER: BUILDING PERMIT INFO BLDG ELECT PlLiJMB MECH O pop LICENSED CONTRACTOR'S DECLARATION Job Description I hereby of im Na at I am Basad under provisions of Chapter 9(commencing ath Section 70W)of Division 3 ofdse Business and Profcu m s Cod.,and my license is inrwlllorceanee RESTORE ELECTRIC POWER ;'(az Lieenaclaa o co u 1µ b VCM NOW SERVICES PAID FOR BL 6/2/06 Dam I ARCHITECTS DECLARATION i I understand my plans shall he used As public rantde f .LLp Licensed Professional OW NER-BUIIDER DECLARATION ip I hmaso .(Sect this 1 1. exempt from Ne fes ons or'sCod :Any c law for Ne p O whichfollowing mason.(Section NO 1.5.Business and Praere.ft ium Code:Any coy at county :22 which rcgoires a permit m corWtsm,alcor.vnptme,demMmh,or mpsir any ewcmm .sy prior at its issuance,also inquires use appliant for such permit to Me A signed summer .€C Nat he is leaned pursuant to the provisions of the Contractor's Liana Law(Chapter 9 Sq.Ft.Floor Area Valuat 2 0 0 8 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt amsefrous and the imam for the ateged Assumption.Any violation of Section 7031.5 by any applicant ror a permit subjects the appllant to a Civil penahy ofe p �m er 0 0 Occupancy Type sec N3 at man five hundmd dollars a� 4 ❑1,as owner of the property,or my wployew with wages as their ale compensation, will do Ne work ad the structure is at intended or offered rot Axis(Sec.7044,Business Required Inspections ad Professions Code:The Conuacmes Liceme law docs at apply m an owner of q P property who but ids ser im proves thaem.and who does such wart himself ser dunugh his own employers,provided Nat such improamats as nuc intended aro@rod forsale If. however.the building w improvement Is mid within one year of eempledm.the awner- builder will have the burden of purring that he did not build or Improve for purpose or ale,). ❑I,as arm of the property,an exclusively contracting with licensed contractors In construct the project(See.7044.Business and Professions Cade)The Contractor's U- come law docs not apply m an Owner of property who build$or Improves themon,ad, who contracts for such projects with a canua.5or(U licensed Parasol m the Conttatar's Lima law. ❑I an exempt under See .B&PC I.,this mann Owner Dam WORKER'S COMPENSATION DECLARATION I hereby air=under penalty of perjury one of Iha following declatWou I have and will maims.a Cenifmm ofcom.nt m elf-Inum for Workers Compcn- ation•As provided far by Section 3700 of the labra Cade.rex she perm lit.of the work far which this permit Is issue& fAI have ad will maintain Workers Compensation Inwma,As mqulad by Section of the labor Cade.for the performance of the work for which this permit is laved. My Warlmr.Comp,.d.a buutma anis ad Policy number am: Carer. IrkA9_1 fa Policy No.:" 1 CERTIFICATE OF EXEMFnON FROM WOR S' FR COMPENSATION INSURANCE from radon need at I ecanplewd if the permit is form hundred dollars($100) lir Ica.) I artry that In the performance of the work for which this permit is im ed,I shall not employ any person in my muncr m a m bauma abject to the Waken Compar adon Laws of California.Date Applicant NOTICE TO APPLICANT`.If.arm,making this Certificate of Faemption.you should become=him to the Workers Comperoation previsions or W labra Code,you muni Oforthwith comply with such provision m this permit shall he deemed reeked. z ,^N.� CONSIRUCfION LENDING AGENCY (.n Ihe¢by affirm dw theaI..construction ending agency forma performana of !>r > the work for which this permit Is issued(Sec.3097,CW.C.) aQ Iandcr's Name z Lenders Address U Q I certify that I have road this application ad mate that Na above InfmmNun Is II.F correct.l agree to comply with all city and county ordinances and stem laws rcladng m pU building construction,And hereby authorize representatives or this city to Amer upon the 4 aWa A-nvmi...d Pmpeny for inspection p.,pmea. (We)agree to ave•indemnity ad Ftp hamlets tM City of Cupertino against vFr y liabilities.judgments,costs ad expenses which may in my way acme against mid City U',Z, in consequence or the granting of this permit. ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date soearsIlV'qEcu^A ._ -A DZNo- Re-roofs Signmorree or Appliam/Conuacmr Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Nc applicant Or future building aaoprst stare or handle haa,dous material As donned by the Cupertino Municipal Code.Chapter 9.12.ad the Health ad Safety Cade.Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed. ya Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove It hemodues air conmminnts As dcnaed by the Bay Ara Air Quality Management all new materials for inspection. District? >r an > [have road the haardsmsmacriam mqumuncnn wader Clupter6.95 ofthe Califer- niaHahh&SafetyCedc.Seem=255W,25533 a 425534.1 understood thuirthe building does not cammly haw a comm,Lou It u my responsibility In notify Iha oecupat Of the coq `�icn et 'asap lmuana ofa Cruraate ora Signature Of Applicant Date --�17 I7lo�bpatcy All roof coverings to be Class"B"or better Owner or mNo r agem Due CITY OF CUPERTINO .m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32637042. 00 DATE ISSUED. . . . . . . : 06/02/2006 RECEIPT # . . . . . . . . . : 34659 REFERENCE ID # . . . : 06060014 SITE ADDRESS . . . . . : 10332 CRESTON DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : CLARENCE PETERSON ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : NOW SERVICES CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : CLARENCE PETERSON ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : OEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BSEISMICRE VALUATION 1, 200 . 00 0 . 50 0 . 00 0 . 50 0 . 00 EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 178 . 73 0 . 00 178 . 73 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 178 . 73 5034 TOTAL RECEIPT 178 . 73 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- 304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY 505 FINAL ELECTRICAL • Q- CITY OF CUPERTINO Q10D((0 0�q CUPER,TINO PERMIT APPLICATION FORM N# 31- O n' Date: Building Address: L- Mailing Address (if different from building address): rb3 2- Cr �c �V2 r �� Owner's Name: Phone#: Gare. ��� r L\O Zys- 27-23 Contractor: License#: Vv()W r \csz S �1 (.02(pse) "tact: Phone:(r4S73-5$5 Cupertino Business License#: \ Fax: 585- 2-S%(r> Building Permit Info: Bldg ❑ Elect Plumb ❑ Mech ❑ Job Description: Residential yg�) �L- \ mmercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupancy Group: Type of Construction: Please check this box if the project is a second-story addition: ❑ 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 Investigation fee BUILDING 1 of 3 aCEOF CITY OF CUPERTINO CUfPERMIT APPLICATION FORM QuantityFee 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 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 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 HeaterlVent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfin 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 BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2of3 CITY OF CUPERTINO CUPEI�TINO PERMIT APPLICATION FORM Quantity 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 hispection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL I 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