03070071 CITY OF CUPERTINO *t > yw a i3+
BUILDING DIVISION PERMIT . CONTRACTt)RINFORMATIC0 :
h*le>�dx'd. �d�x q +sw4�-"eF b .)e +$'
BUILDINGADDRESS: SHAWN RAN PERMITN003070071
OWNER'S NAME: PERMIT ISSUE DATE
SHAWN RAN 3
'HONE: SANITARY NO. q,l 9 CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG BELT PLUMB MECH
00 LICENSED CONTRACTOR'S DECLARATION
I0 I hereby affirm Nat I am licensed under provisions of Chapw,9(commencing lob Description
m with Section 7")of Division S of Ne Business and Pru(estiurn Code,and my license is
^_� in run rome and effect. NEW 71 FENCE
5M4 Liccnsc Clms Lic.N
^ Dem Contractor �'��LAM
ARCHITECTS DECLARATION
S I understand my plans shall he Auto as public records
w
tori LitenmdPrnfe,tlenal JUL 112003
t
OWNER-BUILDER DECLARATION
ZOO hereby maso affirm on 1 1. exempt from the Contractor's Licence Low for the
ZOO E Followwhich
mason.a (aniSucts i 7ln Business andimprove,
ve,demolish.
h.oe:Anyrepair
a y m county
tture
which rtqulma a permit bis construct,icesbeeller,improve,h Permit t car repair any tatemure
gMUM 000
-to poor that he its icsuace.also pursuamgoiru lhovisio applicant for suchPermiticese Uw(ed tlammcm
o (comma cingwdpoetion7 )ofDiviouofineConwancenmlaw(Chapmr9 Sq. Ft. Floor Area
Valuation -
�$ that he 6A..themfrom And
frn(thcegeBusiness end Pro Anyvii1.6,A or
—
that he u emmp,Ncmfmm and Ne hoes for the alleged exemption.Any violation of 32602006 . 00
Section 7051.5 by any applicant for a Permit subjects the applicant o a civil penalty of APN Number Occupancy Type
not more than live hundred dollars(5500).
1,o ownerof the property,or is employees withwager r(heirsolo compensiness
will do the work,and the tWcwm 6 not Intended or offered tarsale(Sea 70N,Business
And Profeeloa Code:The Conlncror't License Law does not apply to an owner of d Inspections
proMnywho builds or improves thereon,and who does such work himselfor through his 102 - PIERS
own employees.provided Nat such improvements are not intended w offered fursale.If. 103 — UFER
however.the building or improvement it sold within one year of completion.the most.
builder will haw the burden of proving mat be did not build or improve for purpose of 104 — REBAR
aid')' 105 - ANCHOR BOLTS
01,as owner of she property,am exclusively cramming with licensed contramors to 106 - SEWER & WATER
convect the project(Sec.7044,Business and Professions Code:)The Contractor's Li-
ecnmLawdoesnotapply to an owner of pmpeny who Wilds or improves themon,and, 202 - UNDERFLOOR PLUMBING
who contracts for such pmjecta with a contractor(&)licensed pursuant to the Contractor's
can.Law. 203 - UNDERFLOOR MECHANICAL
Y
man esemp11 torder SM B&PCCfor tthhbm�aon 204 - UNDERFLOOR FRAME
nee
S�li�s'�i-' �� coal`-�-�==c` 205 - UNDERFLOOR INSULATION
TWO KKER'S COMPENSATION DECIN
I hereby affirm under penalty of perjury one of the following declaration: 301 . — ROUGH PLUMBING
0 1 low and will maintain a Ceriffical Of COnsuard to seir-insura for Worker's Compen. 302 - TUB & OR SHOWER
anon,As provided for by Section 7700 of due fabm Code,rm the performance of the 303 - ROUGH MECHANICAL
weak for which this Permit is issued. 304 - ROUGH ELECTRICAL
1 haw and will arainmin WmAce.Compensation lesuraoe,As leyuired by Section
5700 o(the Iabor Code,for the performance of dm work for which this Permit is Issued. 305 — FRAME
My Worker's Compensation Insurance carrier and Policy number am: 306 — HOLDOWNS _
Carrier: Policy No.: 307 - INSULATION
CERTIFICATE OF EKEM PION FROM WORKERS'
COMPENSATION INSURANCE 308 - SHEETROCK
rlTbecmionnced notbccomplemdifthe permitls rnronchundmddollao RS1(1)) 309 - EXTERIOR LATH
ir1cIL) 310 - INTERIOR LATH
1 certify the,In the performance of the work for which this permit is issued,Isbell nut
employ any person in any Mannar an As to become subject to the Workeri CoMPenadon 311 — SCRATCH COAT
Laws of caliramia.DamAppli313 - ROOF NAIL
NOTICE
OT(at
Ncome subject
APPLICANTthe slier makingthis
rvisionmof Labor od,yuheul0 501 - FINAL ELECTRICAL ENERGY
become subject y the Worker's p Coons ort is permit
of Ihc rural wkc,you mull
.JZ fonhwithcomPlywith achprevisi�nsorthispermiuhallhedcemcdrewked. SO2 — FINAL PLUMBING ENERGY
z0 CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
p-t4 1hereby affirm that them isacombuminnlending Agency Orthe perrormaneof 504 - FINAL BUILDING ENERGY
a > the work for which this Permit isissued(Sec.5097,Civ.C.)Lend505 - FINAL ELECTRICAL
W Q cr'A Narnc
Dz cndertAddm 506 - GAS TEST
U O 1 canify that l haw mad mit application and state that the above informalun is 507 - FINAL PLUMBING
LU f~ correct.l agree to comply with all city and county ordinances and sum laws relating to
OU building construction.and hereby sumorim mptemntatiwa of oris city to enter upon the FIN ME#NWG(CAL
�fal ahovememionetl property for impaction purposes.
F G We)agree to saw,indemnify and keep harmless the City or Cupcnino against 0 9 FI
p) liabilities,judgments.costs ad espenset which may In any way Accost against said Cityin his Permit. CJ APPLICAeNTeUNDERSTANDSof the grarling,of tAND WILL COMPLY WITH ALL NON-POINT Issued by:5 RKS Date
SOURCE REGULATIONS. /
(o Re-roofs
orison of Applian,lCommcmr Dem
HAZARDOUS MATERIALS DISC LOSURE Type of Roof
Will the applicant air future building Occupant store or handle hnmdoa maten.1
As defined by the Cupertino Municipal Code.Chapter 9.11.and the Health and Safety
Code.Sectionz5532(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yet �Jla
Will me applicant or mlAre building Occupant Aar egAipmenl car devices winch If a roof is installed without first obtaining an inspection,I agree to remove
trait haaNnus air contaminants a defined by the Bay Arca Air Quality Management all new materials for inspection.
DalrieIT
❑Ycr PNU
I have mad the haardous materials requimmcnu under Chapter 6.95 of the Califon
nia Health&Safety Code,Sections 15505,25555 and 25554.1 understand that if the building
dues not currently how A than,mos II is my respunsihility A m ily the occupant of me
requimmcnu which must W dpdono lauanceefa CcrddcaM Occupant. Signature of Applicant Date
vrri f3 9/�
ncr air xwhorired agent Dam ' All roof coverings to be Class"B" or better
1 &
• Fence Replacement Description: (Drawing is not to the scale.)
Location: 10980 and 10966, Barranca Dr. Cupertino, CA 95014.
Existing Fence Portion of the fence to
be replaced
`���E WrM
0� � ► �� jI(%CORDANCE WITH F�,�
10980 10966 P�iff r DEQ AND n 0Np�lCl
JA 2?,
hhi&sit C pars and s
be keg e' the jab at all times hbos MUU
3" to 4" lat.'tt,u r*;2 any changes or,eteaharta
UM,
latticerhs�arei�' higher xritte�
7'
i 7-
be a
�. oiln � '�7751¢gp
26" 2,6„
6, 6• 2'6. 2'6"
-� 2.6.,
Posts are 4x4 and
pressure treated.
48'
fl
The above specification of fence replacement is approved both b u 0 9
Owner of 10980 Barranca Dr. Cupertino, CA 95014: 8
SHAIViJ RAN 7/5/0
(Print Name) (Sign) (Date)
AND
Owner of 10966 Barranca Dr. Cupertino, CA 95014:
(Print Name) (Sign) to
DATE
• A NII- L a
DATE
v
R G. r�FPT.
OWNER-BUILDER VERIFICATION*
• 1. (Check one) I or my immediate family (parent,spouse or child) will perform:
A. 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
be performed
• 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). q
Property Owner's Signature
JobAddress�� lbG *4�tcAL PY. Permit.
O a
Any hanges to the information provided on this form shall be submitted to the City of Cupertino Build
• Department.
Cry OF CUPERTINO
CUP TYOF O PERMIT APPLICATION FORM 0
APN # A,- O� ,- O Date: / /p/Z J 3
/ a
Building Address: Mailing Address (if different from building address):
0 uD WrrAkrA. -Dr. 2r1 ,,, C41 q i-v(y4
Owner's Name: P e#
SHA-'lS k1W r J8 Sat 3 01
Contractor: m teh� License#:
Phone: Cupertino Business License#:
Fax:
Buildin Permit Info:
Bid Elect ❑ Plumb ❑ Me
ob escription:
1- 4
Residential ❑ �) ' er
Sq.Ft. Floor Area: $/S &Ft.:
Cost of Project: Occupancy Group:
Type of Construction: tpWha� Please check this box if the project is a
second-story addition: ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK 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<= IOOOA ELECTRICAL
BELEC1001 Elec 600V> I OOOA ELECTRICAL
BELEC200 Elec Svcs 600V <=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm. Housing Mit. Fee I BUILDING
lof 2L�� ?9Z Zy ��
� alyo,
RY OF CUPERTINO
PERMIT APPLICATION FORM
CUPEI�TINO
Quantity Fee ID Fee Description Fee Group
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL
BNEWMULTI Multifamily Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMNINI New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BNUMULTI New Multifamily Res PLUMBING
BNUSFD New Single Family Res 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
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Repipe Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinklerBackflo PLUMBING
BPSTORM StomVRain 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 cf n MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFDCT 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
2of3
010FCITY OF CUPERTIA
PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee ID Fee Description iFee Group
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
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
RSC:RT.VD Scb Snecific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool iBUILDING
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 Mechanicals . foot MECHANICAL
MPERIVIITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issuance PLUMBING
PPLBG Plumbing Fee sq foot 'PLUMBING
ZADDCHG Address Chane BUILDING
i
i
i
3 of 3
CITY OF CUPERTINO 'tTMt v ik ,(,
BUILDING DIVISION PERMIT k CONTRA.CTQR INFORMATI0IV
s.r�n.. .a,.�ti~#_
BUILDING ADDRESS: SHAWN RAND PERMIT N003070071
O NER'S NAME: PERMIT ISSUE DATE
PWAWM PANT
E: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0
+00 LICENSED CONTRACTOR'S DECLARATION ,
TR
to 1 hereby affirmthat I am licensed under provisions of Chapter 9(commencing Job Description
$< wiNScciion7M))of Division 3 ofthe Business and profnedoa Code.and my license is /a
In full fame and effect
3qz License Class uc.Is NEW 7 ' FENCE
F Dab Cknlracr.r
e¢¢ ARCHITECTS DECLARATION
I �j 9
f 2 understand l
my pi ns ahtll lb used As public records v C
y a �/j<O 0�
yatt; Licensed Formal...I
yg OWNER-RWLDERDECLARATION Ai
tt<f 1 botchy reaso .('Sent that I ons exempt(rum the Contractors License Law for the "•
_ following reason.Permit
17o L4 Business and are de inns Code:Any tiny nr county �I
5— which reyulres a pc,min to construct alms improve,dcmnlixh,m repair any structurenon
Zapnor.to its issuance,Blau requires the applicant ror such permiuo rile a signed statement
that he is licensed pursuant In the provisions of the Contractor's License law(Chapter 9 Sq. Ft. Floor Area Valuation
kmn (commencing with Section 7000)(if Division 3 of the Business and Profession.Crude)or
that he Is exempt NereOom And the bub for the alleged exemp0.n.Any violation of 32602006 . 00
Section 7031.5 by Any applicant for A permh subject,the applicant to a civil penalty of APN Number Occupancy Type
not more Nan five hundred della.(5500).
❑1.As owner of the property,Or my employees with wage..their sole compensation,
will cio the work,and the awctu ,is not intended or offered for..Ie(Sec.70/4,Business 1 U i — d Inspections
and Protestant Code:The Consocums License Lew does not apply he an owner of 10 2 — PIERS IERS p
propeny who builds o,improve.Nemo.,end who docs inch work himself.,through his
own employees,provided that such improvements are not intended or offered forsale.it 103 — UFER
however,the building or improvement is sold within one year of completion,the Owner-
builder will have the burden of proving Nan W did not build or improve for purpose of 104 — REBAR
"In.).
105 - ANCHOR BOLTS
C]1.as owner of the pmpcay,am exclusively contracting with licensed comment,to 106 - SEWER & WATER
consumer Ile project(Sec.7044,Bottom and Professions Code:)The Conuacrm's Li-
«ae Law docs not apply to an Ownerof progeny who Wilda Or improve themnsn.and. 202 — UNDERFLOOR PLUMBING
ho contracts for such pmjecm wit A c.ntracter(s)licensed pursuant b the Conso ctoes
'.Law. 203 - UNDERFLOOR MECHANICAL
am exempt node,Sec. .BA PSC for this on 204 - UNDERFLOOR FRAME
� � � 205 - UNDERFLOOR INSULATION
nsr— .R'S COMPENSATION DECIJA�YATION -
IherebyARrmunderpamilyofpcdurycaeofNefollowingdeclantlov: 301 - ROUGH PLUMBING
I have and will maintain a Cenifinm or Consent to selfdnsum for wortrh Compen- 302 — TUB & OR SHOWER
.tion,as px vidcd for by Section 3700 of the Tabor Code,for the performance of the 303 - ROUGH MECHANICAL
w.rcmrwhichthisPermhbiaOed. 304 - ROUGH ELECTRICAL
1 have and will maintain Workers Compensation Insurance,ss required by Section
31W of the labor Code.for Ne performance of Ne work for which this permit is issued. 305 — FRAME
My Workces Cmepenalion Insurance tinier end Policy number en: 306 — HOLDOWNS
Cartier, CERTIFICATE OF EXEMPTION FROM WORKERS' 307 — INSULATION
COMPENSATION INSURANCE 308 - SHEETROCK
(This section need notal completed if the Permit b for one hundred dollar 1$1IX) 309 - EXTERIOR LATH
I'cenify 310 - INTERIOR LATH
employ certify thin in Ise n any mappe of the work for which this permit is eased,I ehall em
Lawsnlnanymannersaato become subject tolW Workers'Compensellon 311 — SCRATCH COAT
Laws.[California.
alir. care' 313 - ROOF NAIL
NOTICE TO APPLICANT:IL after making this Ccnlficem of Exemption,you should 501 - FINAL ELECTRICAL ENERGY
become subject to the Worker's Compenalion provisions of the labor Code,you must
� Z formwith comply with such provisions orthis NOMILshall Wdrained!Banked. 502 - FINAL PLUMBING ENERGY
Z O CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
E4 1hereby alrirmthat them bacmnumminnlending agcncyfor the Performance or 504 - FINAL BUILDING ENERGY
W > the wark for Which Nis permit is!Asked(See.3097.CN.C.)
U3O Under:Nems 505 - FINAL ELECTRICAL
7 z Lender'aAdd= 506 - GAS TEST
V O I cenify that I have read the.application and.tsb thal the W.information is 507 — FINAL PLUMBING
c.rtacL I agme m comply with all city and county ordinances nd auric laws.]Aging b
O U building conswcfionand hereby auNonp representatives tivcsofNit.inytoenbrupnnlha "FINMECCAL
abovo-memioned progeny for inspmi.n purposes.(Wes)agree to ave,indemnify and keep humleu the City of Cupertinoageiat 0 9 g,i Iiabilifies,judgments.costs and expenses which may In any way seem against aid Ciry 5NG
t,),'Z in consequence of the Bnming of this permit.APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:5 WORKS Date
SOURCE REGULATIONS. /
azRe-roofs
ure of Applicant/C.nuacmr Dab
HAZARDOUS MATERIALS DISChOSURE Type of Roof
Will the applicant ser future Wilding Occupant store or handle haardous material
as denncd by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
codes-1 k.25532a)?❑Yea Q[ u All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future wilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
ha.A dour air contaminants ae denncd by the Bay Arca Air Quality Management- all new materials for Inspection.
isuicl7
Cl Yet PN.
I have mad the hmaN.us materials requirement,under Chapter 6.95 of the Califon
ria Hce1th A Sofmy Code,S.W.35505,35533 and 25534.1 understand that if the Wilding
docs not currently have A moat Not it is my malionsihillry to and l'y the wcupanl of Bac
requirements which must ; ip r hr Issuance of a Coal ncele Oecupane, Signature of Applicant Date
f� 9/
er O,akthorlvnda eon Dab All roof coverings to be Class "B"or better -