The URL can be used to link to this page

03070057CITY OF CUPERTINOxyx'M?Wko_ 'N•kn"s`x BUILDING DIVISION PERMIT .• CONTRACTOR�Nk'ORSM BUILDING ADDRESS: MICHAEL & ERIN CELLINI PERMIT NUO3070,057 OWNER'S NAME: PERMIT ISSUE DATE ONE: SANITARY NO. CONTROL N0, ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION ]Ob DOSCrlpIl00 I hereby affrm Nal I am licensed under pmvisbuis nr Chapter 9 (commencing with Section 76tap or Division 3 of the Business and Professions Code, and my license is in full forte and crfect, DECK W/OVERHEAD SHADE STRUCTURE License Class - Uc.g Dam Contractor ARCHITECTS DECLARATION (181 S4.FT.) FINALE® I understand my plana shall Mused as public records C(� n. 9 Z003 2t, Licensed Pmfessiontl OWNER -BUILDER DECLARATION 0 1 hereby affirm that I am exempt from the Contractor's License Law for the Toile Wing reason. (Section 7I3 1.5, Business and pmfcaSlnN Code: Any city or county which requires a Permit to construct, alter. improve, demolish, at mucic any sducmm 1ILDING prior to its issuance, also requires she applicant per such Permit to rile a signed statement the, he is licensed pursnuotM e U..provisions of denormo's .. Law m 01 Sq. Ft. Floor Area Valua t"000 (commencing with Section WOO) of Division 3 of the Business and Profusions Coxi or Nat he is exempt themfmm and Um basis for Ne alleged exemption. Any violation of 31321-Mt*%r00 Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than rim hundred dollars ($500). ❑ I, as owner of the property. or my employees with wages as their sole compensation, Inspections Required Ins quP will do the work, and On atmcma isran intended oroffered (or sale (see . 7044. Business not apply in owner of Licew dont m and Profesamsa code: The ContractorsLicense, La ,.,n, be Wilds or improves Hereon. and who does such work himself or through his 101 - FOUNDAT own employees, provided that such improvements are not intended or offered for sale. If, 102 — PIERS however, the building or improvement is sold within one year of completion, the owner builder will haw the burden of proving that he did not Wild at improw for purpose or 103 - UFER sale)' 104 - REBAR 01. as owner of the property, am exclusively contracting with licensed convectors m construct the project (Sec. 7004. Business and Professions Code:) The Comm elori Li- lO5 — ANCHOR BOLTS. cense Law does not apply man owner of property who Wilda or improves thereon, and, 106 — SEWER & WATER who contacts for such pmjecu with acontramor(O licensed Incident to the Contractees L'enm Law. 202 - UNDERFLOOR PLUMBING - Iamexemptunder e . B Al P C for this reason -7(.kljz, 203 - UNDERFLOOR MECHANICAL G er�y nam 204 - UNDERFLOOR FRAME WORKERS- DEC ATION--f°i-few 205 — UNDERFLOOR INSULATION I hembyaffirmunder penalty of perjur, of renewing declarNom: ❑ I haveand will maintain aCenlfamofConsent to self.imarc (orwmkcr'aCumpcn- 301 — ROUGH PLUMBING nation, as provided for by Section 37W of the Labor Code, for the performance of the 302 - TUB & OR SHOWER wmk for which this permit is issMd. 303 - ROUGH MECHANICAL ❑ I have and will maintain Worker's Compensation Itauance, u yelp ed by Section Poo of the LaWrCode.for the Performance of the work for which this permit Is issued. 304 — ROUGH ELECTRICAL My Workees Compensation lnmana camber and Policy number am: 305 — FRAME Carrier, Policy No.: CERTIFICATE OF E)(EMPnON FROM WORKERS' 306 — HOLDOWNS COMPENSATION INSURANCE 307 - INSULATION ' (Thbsectltm Med notMcomplemd HiHillsmmilisfnronchundreddollan(SIOD) - 30$ — C.JHL-1L`-'TROCK . ) 309 - EXTERIOR LATH. certify But in the performance or 1M workfor which Nperm I canifitis pit u issued. I shall not employ anypewa.manyDido mmncrmasto lamomembjatmdm worteri Compensation 31O — INTERIOR LATH Laws "California. Dam 311 - 313 - SCRATCH COAT ROOF NAIL Applicata - NOTICE TO APPLICANT: If, after making this Certificate of Exemption. you should become subject to the Worker's Compensation provisions or the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked• 501 — FINAL ELECTRICAL ENERGY CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY I hereby affirm thal there Is coatruction lending agency for the performance of 503 - FINAL MECHANICAL ENERGY she work for which this permit Is tuned (Sec. 3097, Civ. C.) j Lender; Name 504 - 505 - FINAL BUILDING ENERGY. FINAL. ELECTRICAL n avers Addm,. I certify Nat 1 have this application and duce that the above iws misting is 506 - GAS TEST % bandit. I egad l9 comply with all city and county ntainanca and atom Iowa r upon t to with Niscity to enter upon the construction, and hereby auicin FIN PLUMB G U pmpresenutivcsof ahmeengconaned shove- property for Inspection purposes. indemnify harmless City Cupertino 08 F I L (we) ito and keep the of against (We) agree to save, Iiabilitla,judgmenu.cosu and expenses which may in anyway acme against an City 5 In consequence or the granting or this oennit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by:5 ING Date s0UCtt E,REGUIgs5TI0NS. n 1 i 514 NAL PUBLIC WORKS y^I� J� ✓ �L-�`-� �L,�I� G Re -roofs Type of Roof Sig rcof ApplicanUConuacmr rtetil HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building oaupanl store or handle harardow material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and safety Code, Section 25532(a)? ❑Yes KN. All roofs shall be inspected prior to an roofing material beim installed. P P Y g g If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or fulum Wilding oaupanl use equipment or devices which -mit hmardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? 0Yes T&1. I have mad the heandoue materials requirements under Chapter 6.95 of the Cali For. nice Halih & Safety Code, Secdone 255(15, 35533 and 25534.1 undemmrd that if the building does not currently haw a tenant. Nat it is my responsibility no nod l'y the occupant of the requirements which and W met prinnn issmMe ora cenifeam of Ocanany. Signature of Applicant Date 4 Xuh All roof coverings to be Class "B" or better nerof authorimd agcn ane OR -BUILDER VERIFICATION WNE 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. 4P 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). Property Owner's Signature: ✓ �/' C./ Date: �7 q nn�' i lob Address: ��' `7' Vfiol jNU� ' Permit # CITY OF CUPEkTINO AY OF CUPERTINO PERMIT APPLICATION FORM W Quantity Fee ID APN # [$ Date: 7 � d3 BAPPLOTHER Building Address: Mailing Address (if different from building address): MECHANICAL !fV2 So -n+ Aur . CvPEK trt 9sUrN Bldg Permits . foot Owner's Name: Phone #: Boiler <= 100,000 Btu Mtu+atL E�2„� Cecun�i �yoY 3y3-3£c7o Boiler > I OOK to 500K Btu Contract o�r: L�iiti� License #: Boiler> 500K to 1M Btu jA 1 BBOILER4 Boiler> 1M to 1.75 M Btu Contact: Phone: Cupertino Business License#: Boiler> 1.75M Btu Fax: BCONSTAX Construction Tax uilding Pe it Info: BCONSTAX Bid Elect ❑ Plumb ❑ Mech ❑ BUILDING Job D n tion- esldential [- _e_lL W;K DVC/l JAJ 54°d- Commercial ❑ Con. Tax for BQ Zone Sq.Ft. Floor Area: $/Sq.Ft.: Hotel and Motel «S 1 5 4 BCONSTAXR Constax - Resi/Mobile Cost of Project: �-a / Occupancy Group Elec 600V <_ IOOOA Type of Constructi1 n: Please check this bo ect is a Elec 600V > 1000A ELECTRICAL second-storyaddition: ❑ W 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 > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of CUPERTINO &Y OF CUPERTINO 0 PERMIT APPLICATION FORM 2 of 3 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 BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTDAE 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 hiterceptor 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 HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfrn 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 Fumace > l OK btu MECHANICAL BREMHEAT Heater Installation . MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREMPOLE I Pole/Platform Fixture ELECTRICAL 2 of 3 S, tg� CITY OF CUPEkTINO 0 CITY OF CUPERTIA PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rcptl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRRAPP 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 RSCRT,VD Scb Snecific 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 Temp 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 Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING Ll 3 of 3 00 Z y a� aQ UO_ 0U U �e Uy7� CITY OF CUPERTINO BUILDING DIVISION PERMIT. CONTRAC�TQRINF.ORMATIQN x.,M, BUILDING ADDRESS: NRY AV MICHAEL & ERIN CELLINI PERMITN003070057 OWNER'S NAME: PERMIT ISSUE DATE E; SANITARYNO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION lob Description I hereby affirm Net 1 am licensed under previsions of Chapter 9 (commencing p with Section ]IXXD ec Division 3.f the Business and Professiuu Cnde. mtl my license ie in full force and effect. �' m as ��® License Class LIc.N DECK W/OVERHEAD SHADE STRUCTUR i�NYg Dam Contractor ( 181 SQ FT ) ARCHITECTS DECLARATION . . OCT 2 9 2003 I understand my plans Nall he used u public records Licensed Pmfcsaional OWNER -BUILDER DECLARATION I hereby affirm Nu 1 am exempt from 0m Contractor's License Law for the aBar�� l�l.\p�Mr BUILDING following reason. (Section RD 1.5, Business and Pmressions Code: Any city or County which requires a Permit in construct. alar, improve. demnlLah, or repair any nmerurc prior to its issuance. she nurtures The applicant for such permll t9 file a signed statement that he is licensed pursuant o the provisions of the Contractor's LleenY Law (Chapter 9 Sq. Ft. Floor Area Valua"1 000' (commencing with Section 7") of Division 3 of the Business and Profusion Cole) or that he is enter, therefrom and the basis for the alleged exemption. Any violation of 3 WV'Mt*er0 0 Occupancy Type Section 9D31.5 by airy applicant for a permit subjects the applicant to a civil penalty of not more Nen free hundred dollars (SSW). ❑ I. as owner of the property, or my employees with wages as than to Compensation, Required Inspections will do the work. and the awcum i& not intended or offered for ale (Sec. 7044, Business and Professim,s Code: The Cantsumrs License Law den not apply in an owner of Pmpertywho buildsm improve, Nemo. and who doessuch work himsevorthrough his 101 - FOUNDATION own employee, provided that such lmprovemem are not intended or offered for sale. If. 102 - PIERS however. the building or improvement is told within one year of completion. the owner. builder will bac me homes of proving that he did not build Or Improve far purpose of 103 - UFER file')' 104 - REBAR 0 I. as owner or the Property, am exclusively conuacting with licensed conuecton, to consumer the project(Sec.7014, Business and Professions Code:)The Convactob U. 105 - ANCHOR BOLTS. cave law docs not apply to an owner of property who builds or improves Dtemon, and, 106 - SEWER & WATER who contracts for each projects with a conuacter(s) licensed puraumt to the Convectors L esu Law. 202 - UNDERFLOOR PLUMBING I am eampt under Sle. . B h P C fthisrcuon r -11' 203 - UNDERFLOOR MECHANICAL o Data K�dt� 204 - UNDERFLOOR FRAME WORKER'S COMPENSATION DEC ATION-1�-- I hereby affum under Penalty of perjury one o following declarations: 205 — UNDERFLOOR INSULATION I ban and will maintain a Canifiesm err Covent in self-insum for Workces Cooper- 301 - ROUGH PLUMBING cation, as Provided for by Section 37W of the Labor Code, for the performance of due 302 - TUB & OR SHOWER work for which Nis permit is issued. 303 - ROUGH MECHANICAL rl 1 have and will maintain Worker's Compensation Insurance, as required by Section 37W of the labor Code, for the Performance of the work for which Nif permit is issued. 304 - ROUGH ELECTRICAL My Workers Comp aidion Insurance urtica and Polity number ate: 305 - FRAME Carrier: Policy No.: _ CERTIFICATE OF EXEMPTION FROM WORKERS' 306 - HOLDOWNS COMPENSATION INSURANCE 307 - INSULATION (Thtssectite need nmhecomplowd iflhe permlttsforanehundraddollars(SIBI) 308 - SHEETROCK or los.) 3 09 - EXTERIOR LATH I certify that in the performance of the work for which this Permit is iuuer, I shall not employ any Person In any manner an as to become subject 0 the Workcrr Compcnsstlon 310 — INTERIOR LATH Tawe of Ctlifomia. Dam Applicant 311 313 - SCRATCH COAT - ROOF NAIL NOTICE TO APPLICANT, AP : IL eller making CanofExemption, shou5 become o the Wokrs Confirmation provisions of the Labor nde, you meet forthwith ComplyWith such provisions nrthis remit shall the aremedm.nked. 501 - FINAL ELECTRICAL ENERGY CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY I hereby affirm Net the. I,. construction lending agency for the perfunnmtee of 503 - FINAL MECHANICAL ENERGY Um work Nawhich ml, Permit Is issued (sec. 309). c19.0.) Isnderhisme 504 505 - FINAL BUILDING ENERGY - FINAL. ELECTRICAL Lenders Addmas d um deal I ceNe Nat 1 have rod Nh application and sum Nu sWvc iw, he 506 - GAS TEST Missing correct. I agree m comply with dl airy and county and sum laws relating is building construction, and hereby emhodm reprtunutives of this city to corer upon the G above property for Inspection purposes. (We) gree to use. indemnify and keep hartnleu the City Of Cupcnino against //(//�(/�/(y�� L V liebiliticsjudgments,cosss sed expense& which may in any way erne against um Cary %AFINPLUMEI, In consequence of the granting of this permit.APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: NG Data SOU CEREGU TIONS. C�� PUBLIC WORKS J�lr � Re -roofs Type Of Roof Sig rc of AppLeanucnnlracmr Dat( � HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building Occupant store nr handle harudous material as defined by the Cupertino Municipal Cole. chapter 9.12. and the Health sed Safety code, seNen:ss32(a)7 �No All roofs shall be inspected prior to any roofing material being installed. dcvice, If a roof is installed without first obtaining an inspection, I agree to remove p❑Yu Will the applicant or future Wilding occupant use equipment or which t has air comeminanu as deDncd by the Bay Area Air Quality Management all new materials for inspection. isuict? OYcs We ' 1 have rem the huamous materials requirements under chapterG95 of the Califor. its Hear" Safely Codc, SnvCos 25505, 25533 and 25534.1 ma crstsnd deal if the Wilding docs not currently have a mmol Nat It is my rupauihilily to noul'y the urcupent of the , requlmmcou which mu bemclpdorwlssmnccora Ccrificamof&cup r. Signature of Applicant Date ' AA Z li U�7 All roof coverings to be Class "B" or better ncr ser aulhonzeJ agcm am