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06070072 (2) CITY OF CUPERTINO BUIl.DING'DI'lSION PERMIT .CONTRACTnRINFQRMA'.�ION :': ° 'da. 2 sixx' - BUILDING ADDRESS: PARKER PLUMBING PERMIT NO.06070072 8119 PARK GWNER'S NAME: PERMIT ISSUE DATE SANKARA VENKATARAMAN 24 CHELTENHAM E: SANITARY NO. CONTROL NO. (408) 374-1832 ARCHITEC irENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH O O !� O ?op LICENSED CONTRACTOR'S DECLARATION IOU Description wF 1 hereby affirm Nes 1 an licensed under provisions of Chapter Y(commencing ?2towith Sccdon 70M)of Division 3 of the Business and Professions Code,and my Became is +=�. iofell fe.cindeffect. INSTALL NEW GAS CONNECTION FROM GAS METER TO License Class LIc.N Dam Conracter KITCHEN ARCHITECT'S DECLARATION f¢ 1 understood my plans shall be used as public records JyU e o y LiccnseJ Professional g OWNER-BUILDER m Ce Contr ON 9y 1 thereby aRnn on 1 am exempt from the Comuaaor'd Liana taw for Use tl O o following elms. (Sccdou Rn L4 Business and Professions Code:Any oily m coumy <m�+ which Bit issuance, a permit h sum the ales,improve,demolish,nr repair ed swmure °z Y prior m ill iuuarteeasu equine lk applicant for such Contractor's Leare signed(Chapter ££ < that licemedpursuanslothcprovisions afthe ComndProrlaonsCodter9 Sq. F[. Floor Area Valua[i(3$600 d�� (eat he is exemng pt therefroon m ad of Division r th al agecBusiness and Professions ladonde)of y�_ that k is exempt Nmcfrom ad Ne buil for he alleged eumptioo.Any violation of Section 7031.5 by any applicant for a permit subjttu the applicant to a civil penalty of EN Number Occupancy Type not mom Nan RK hundred demo(M). 3 5 610059 . 0 0 ❑I.uawner of Ute yppmy,mmywPloYces with vngesuhtevsulc compensation, I °iA tI an will do Ne wark_ad Ne svumureutrotinended oraRwdforsele(Sce.]ON,Busirxu ht[""err/a s and Prefeulons Code:The Conuacmrs License Law does at apply man owner of Rrf'quir�ed I�nspectfyons!'a�P propeny whobuilds or improve thereon,and who d0esuchwork hivuelfor through his sd � awn employees,provided Nal such improvements are not immoded or offered forale,ff. however.the Wilding or improvement is mid within one year of completion.the owner- J(�1 builder will have he Wrdcn of proving that he did not Wild or improve for purpose of 'b L y00La tole.). �p ( tJ ss owner of ci property..m eclus and conuacdns with licensed anoamrs t. conssmcs the es no,(Sec.n so Business srofand property who Code:)The Conuacme.Li cense Law dose not applypr je ts owner of progeny who W lids rs improves thereon,and, who contracts for such projects with a anuawr(s)licensed purwans in Ik Coneasor's Lkimeseslaw. ❑ I ore exe(m/ftt under 55c. , / .B&P C for thus;rLeason Owner IlseV Door-7 I la - WOft 5 COMPENSATION DECLARATION mand will train 1 krtbY affirm under penalty of perjury ore o(he following declarations: I hauin aCertiRamof Comen toself-insure for Woh sCompcn- anion,as Provided for by Section 3700 of the Labor Code,for the perfonnmes of the work for which Be,permit is issued. ❑I now arta will maintain Wmli Compensation Insuramte,as required by Section 3700 of the Labor Code,for the perfmmace of the work for which Nis permit is issued. My Worker's Compensation Insurance artier and Policy number are: Cartier. Poli,No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This anion need at W complemd fide perms,is fmorc hundred dollars(SIM) nr less.) 1 certify that in the performance of the work for which this permit is issued.l awl ret employ any person in my matter so.m become subject in the Wmkcrs'Cwperbuhon Laws of Califorem Dam Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject In the Worker's Compensation provisions of the labor Code,you muu ,J O forthwith comply with such provisions or this permit shall k deemed revoked. z'—' CONSTRUCTION LENDING AGENCY (—� Ikrwhich tic Nasdet i isaconsuu.3M.nding agcnry for de perfmma¢uf (1, Nc work for which Nu permit u issued(See 7097,Civ.CJ 1 Q Lendcts Name z LcMcr's Address C)Q 1 ttnify that I have mad this application ad sum Nat Be,aWsc information is [f. F correct.1 agree to comply with all city ad county oNinames and sum laws relating m 0U Wilding construction,and hereby authorim apresenatims of this city to enter upon the above-mememed Property for inspection purposes. FW (We)agree m save,indemnify ad kap harmless die City of Cupertino against (Z) liabilitics,judgmenm,costs ad expenses which may in anyway acme against aid City V z APPLsequence of the tinseling of ICCANT UNDERSTANDS ANDWILLLWILL COMPLY WITH ALL NON-POINT Issued b Dale SOURCEREGULATIONS. y Re-roofs Signature of AppliaHDam HAZARAZAR DOUOU S MATERIALS DISCLOSURE Type of Roof Will the c Cupertino m future Wilding ocevpal tome m handleduh Health amamrial u deEned by Ik Cupertino Muni/cipal Code.Chapter 9.12,and Ik HeaIN and Safety Cade.OYoonn 25532(.)? 5 All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtainingan inspection,I agree to remove SYII Nc applicator fwum Wilding by the Bt use equipment Qu or dcvica which P g emit ick? nus air conaminants u de0ncd by the Bay Ara Air Quility Management all new materials for inspection. District? ❑Ya G11. 1 have mad the hu ard,ws materials requirements under Chapmr6.95 of Ne Califor. m.Hahh&SafesyCode,Such.23505.25577 and 2553x.l undersand Nxtifthe Wilding docs ms currently hoc a emeru.But it is my responsibility to noily the ocupal of Ik requiremenow`hipchma kmetprio�ssuanmofaCcrdfcamor(i �.� Signature of Applicant Date OwnOho�/u � j All roof coverings[o be Class "B"or better on dagent Dam_ -W Community Development 10300 Torre Avenue Fx_b Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408) 777-3333 iUPEkTINO Building Department JOB ADDRESS: PERMIT # 11q 1C VI LL-q c k IZcLE t6o7©o7a OWNER'S NAME: PHONE # k0La57 A GENERAL CONTRACTOR: e a\jxf;erL FAX # Pi&v' Z-0 71t &37-- I 3yI am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the followin information: 60 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 1SWn• �� n? 139 er/Contractor Signature Date CITY OF CUPERTINO im 1 of 2 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35610059 . 00 DATE ISSUED. . . . . . . : 07/13/2006 RECEIPT # . . . . . . . . . : 35233 REFERENCE ID # . . . : 06070072 SITE ADDRESS . . . . . : 8119 PARK VILLA CL SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : SANKARA VENKATARAMAN ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : SANKARA VENKATARAMAN CONTRACTOR . . . . . . . : STEVE PARKER LIC # 25024 COMPANY . . . . . . . . . . : PARKER PLUMBING ADDRESS 24 CHELTENHAM WAY CITY/STATE/ZIP . . . : SAN JOSE, CA 95139 TELEPHONE . . . . . . . . : (408) 374-1832 �EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - --------- - ------------ ------ ---- -------- -- ---------- ------- --- ---------- BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BPGAS OULETS 1 . 00 5 .40 0 . 00 5 . 40 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 -=-------- - ----- ---- ---------- ------- --- TOTAL PERMIT 78 . 63 0 . 00 78 . 63 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY 506 GAS TEST 507 FINAL PLUMBING • ARCHITECTURAL APPLfICATION Name of Association: Name of Owner(s): OX4 L e?—41 Address of Unit: _ (1 (-- ytr—Liel Work Phone: CC10 5t5t Home Phone: _� �rj� f 2— Applicant agrees and understands that the application does not fulfill all of the conditions and requirements for an approval. In addition to this completed"Architectural Application" form, the applicant must submit to the Architectural Review Committee (and/or Board of Directors) a set of plans and specifications showing the nature, kind, shape height, materials and locations of the proposed architectural alteration. It is also understood by the applicant that the submission must be in writing. There may be additional information required as deemed necessary to make a decision. Until all information is submitted to the committee, the application will be deemed to be incomplete and the application will stand unapproved. GENERAL DESCRIPTION OF PROPOSED WORK(Include drawings, if appropriate) 42 Applicant agrees and understands that, in the event the modifications is approved by the Committee or Board, that they may impose "Special Conditions"of construction and maintenance on the approved work. Any special conditions shall be attached and be a part of the approval. Any deviation from the approved plans, • specifications, or special conditions shall cause the permit to terminate and become null and void. Applicant agrees and understands that failure to conform to these requirements will be automatic authorization by the applicant to have the work brought into conformance with the approved plans, specification, and special conditions. Applicant further agrees and understands that all costs incurred by the Association as a result of bringing said work into compliance shall be a charge against owner's lot. Such costs shall include costs of construction, reconstruction, administration, fees, attorney fees and reasonable court costs, if incurred. It is also agreed that no work will be initiated which would be a violation of any of the provisions of the Association's Declaration of Covenants, Conditions, and Restrictions or any applicable building code; be an annoyance to the residents,or increase the cost of insurance. Applicant agrees to indemnify the Association against any and all acts or claims arising in connection with the improvement, including but not limited to any and all acts, omissions, or claims arising in connection with the approval,construction,operation, maintenance, repair, use or removal of the improvement, including attorney fees and costs of litigation in connection therewith. Applicant agrees that, in the event the application is approved, all maintenance, repair or replacement of the approved item will be the sole responsibility of the unit owner and further that any expense incurred by the Association that is the direct or indirect result of the approved change shall also be the sole responsibility of the unit owner. All work should be initiated with consideration of the grounds, esthetics, time and noise factors. Applicant understands that all necessary permits and approvals from municipalities or other jurisdictions are the sole responsibility of applicant and that Committee/Board approval of this application is subject to the applicant receiving all such necessary permits and approvals. Applicant agrees to the foregoing conditions and accepts those conditions as evidence by the owner's Signature: Date: T 7 fl6 • STAFF USE ONLY: Approved: %/ Denied: Date: rf—/02—U b Signed: fin. /Y CITY OF CUPERTINO 01A 00]Q CITY OF PERMIT APPLICATION FORM CUPEkTINO / // N # Date: V76AC- Building Building Address: Mailing Address (if different from building address): Llt`1 PAaILAAu" C-W Owner's Name: 1 Phone#: lt0 - 57 - E 12- 5(\n)L:LAKA \f.L(Qkq -T-Ll'Rgt^Ar� 4000- C � - �i15 e+ C �� Contractor: License#: -51-"e— {wl ker Contact: Phone: Cupertino Business License#: SO)M E Fax: Building Permit Info: Bldg ❑ Elect ❑ Plumb I]/ Mech ❑ Job Descriptr,sl ti q 1\ 5 C d m�ec Hi �r o.^ TRS ho Residential Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: •G of Occupancy Group: Type of Construction: Please check this box if the project is a second-story addition: Project 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 qW 1 of 3 aoCCITY OF CUPERTINO bTY'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 BOVERTME 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 rinkler/Backflo PLUMBING BPSTORM Stonn/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterNent 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> l OK btu MECHANICAL BREM14EAT 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 BREEMRESAPP Remodel Res Appliance ELECTRICAL 2of3 (+ CITY OF CUPERTINO CIiV OF PERMIT APPLICATION FORM CUPERTINO 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 Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Ternp Dist Svcs ELECTRICAL 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 3of3