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03070222 CITY OF CUPERTINO .. ' BUILDING DIVISION PERMIT CONTRACTOR INFORMM,10N BUILDING ADDRESS: SHOWCASE KITCHENS INC PERMIT N003070222 .R's NAME: 12333 SARATOGA-SUNNYVALE R PBRMIT ISSUE DATE DALE DEI R PHONE: (408) 253-0412 SANITARY NO. CONTROL NO. ARCHITEC(ENGINEER; BUILDING PERMIT INFO BO BLO PLO MEOCH 100 LICENSED CONTRACTOR'S DECLARATION U 1 hemby arfirm that I am licensed under provisions of Chapter 9(commencing Job Description .Y with Section 7")ofDivision3 of Ne Business and Professions Code.and my license is <„ in full forceond eat KITCHEN REMODEL ;8: Lieenwclnt It Lit. n�� REPLACING CABINETS, CC �& R Dam Lie' r 9.- e A c ITecrs DEC An + 1 1 $ TOWN ` I undersunJ my plans ehtll be used u III records 56F p Licensed Professional A.'1 V 0 p O 2003 OWNER-BUILDER DECLARATION IYV L I I hereby affirm that 1 am exempt from the Contractor's License Law for the p O following mason.(Section 7131.5,Business and Professions Code:Any city or county 3$ which requires B worth to consuw6 alcor,improve,demolish,or repair any structure poor o is issuance,also requires the applicant for such permit to rile a signed statement 2C that he is licensed pursuant to the prevision of the Comment'sLicense Law(Chapter 9 Sq.FI. Floor Area ValuW 000 $ (commencing with Sordes 7")of Division 3 of the Businesand Profession Code)or that he u exempt therefrom and the buss for the alleged emmption.Any violation of pp��n1Boorrnnnn��e Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3 9J010 a ffi6erO O Occupancy Type not more than five hundred delta.000). P Y YP ❑1,u owner or the property,or my employes with wages as their auto compensation, will do the work and the structure is nor intended or offered for tale(Sec.7041,Business tt{(�, and Profession m:CoThe Contr cmn Ltanee Law,don not apply to an owner of 101 — FOUNDAl}D}QNH,6y d Inspections property who builds Or improves thereon,and whocioessuch work himself orthrough his own employees,provided that uch Improvements ere not Intended or offered for sets.It. 102 — PIERS however,the building or improvement is sold within one year Of completion.Ne owner. builder will have the burden of proving that he did not Wild W improve for purpose of 103 - UFER Bale')' 104 - REBAR ❑I.as owner of the property,am exclusively contracting with licensed conuacton to 105 — ANCHOR BOLTS construct the project(Sec.7044,Business and Professions Code:)The Contractor'.Lt. tens,law ewe not apply to an owner of property who Wilds or improve themes,and 106 — SEWER & WATER who contacts for such projects with o contractor(s)licensed pursuant to the Commetofe License Law. 202 - UNDERFLOOR PLUMBING ❑I am exempt under See. ,B&PC for this mason 203 - UNDERFLOOR MECHANICAL Dxm 204 - UNDERFLOOR FRAME WORKER'S COMPENSATION DECLARATION I hereby afrnn under penalty of perjury ow of the following declarations: 205 — UNDERFLOOR INSULATION (have and will maintain a Certificate of Consent to ulf; 301 — ROUGH PLUMBING ❑ Intim for ore.. of In xoomuprovided terms Ss isondao of the vWr Com,res the performanw onhe 302 — TUB & OR SHOWER work, a which this aintaiiBisswe. 303 - ROUGH MECHANICAL ❑1 haus,and will maintain Workers Compensationceofthw rkfor which h required by Section MyW Ns,labor surnat nthepeoormanceoftheworkforwhichChiapermitialsswJ. 304 — ROUGH ELECTRICAL M�y�"W,{"�osk C penution Incur me carrier and Policy number 3 05 — FRAME Policy No.: 306 - HOLDOWNS CERTIFICATE OF MEMPTION FROM WORKERS' COMPENSATION INSURANCE 307 - INSULATION Mix section need not W completed if the pernelt is for one hundred dollars($1011) 308 - SHEETROCK anter.) 309 - EXTERIOR LATH employ this er Ns,n my manor of the woh for subj Nis permit is issued 1 shell not Lawso California.ninany mannerauumbwomc mbjectmtW woheri Compewtian 310 — INTERIOR LATH PPIs^CelifoDam 311 - SCRATCH COAT NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should 313 - ROOF NAIL become mhjwt to the Worker's Compensation provision of the labor Cede,you must �z forthwith comply with such provisions or this perm it that[be maned rewired. 501 — FINAL ELECTRICAL ENERGY Zo CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY I bemby affnm that there its convection lending agency fnnW performance of 503 - FINAL MECHANICAL ENERGY x the Work for which this permit bissued(Sw.3097,Civ.C.) lenName 504 - FINAL BUILDING ENERGY 1.1 Q :)zZ Lender's riAedreu 505 - FINAL ELECTRICAL J p 1 certify Nat I haw read this application and sum that the above information is 506 — GAS TEST � (—' collect I agree to comply with all city and county ordinances and sum laws misting to U building construction.and hereby amhorin,reprcunutives of this city to enter upon oreFIN PLUMB( G N W� above-mentioned property for inspection purposes. 0 8 F I L .. (We)agree m save,indemnify and keep harmless the City of Cupertino against ran Imbl[i0e,judgenons,costs and expenses which may in any way see=against old City 5 f� UZ in ennsegwnea of the glinting of this permit. `//LJ APPLICANT UNDERSTANDS AND WILL COMPLY WI NON-POINT Issued by:5 NG Date S R ZULAT Re-roofs tate of APPlica UContmctor � Type HAZARD ATERIALS DISCLOSURE T e of Roof Will the applicant or fun ilding occupant tlam or Mndle he s as defined by the Cupertino Municipal Com,Chapter 9.12,and the Health and Safely .Section 25532(e)7 All roofs shall be inspected prior to any roofing material being installed. "I Yea YN'u 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 emit hannious air contaminants as dcfincd by the Bay Area Air Quality Management all new materials for inspection. Distrito ❑Yes u I hoe mad the havamous materials requirements under Chapter 6.95 of the Califon nia Health&Safety Code,So:tions 25505,25533 and 25534.1 undco and that if On building ' does not currently haw a tenant,that It u my responsibility in nu I the occupant or Or mqui entswhic .1,s, pilon 'ssuanwoftCcmfiea ofOc ap.ncy. Signature of Applicant Date caner lir suthori.cd agent Dom All roof coverings to be Class "B" or better I CITY OF CUPERTINOeras BUILDING DIVISION PERMIT G OUAC'tC) -JNFORMATI ' .hY`ti -1 .+}j'i°',4 "f�> BUILDING ADDRESS: SHOWCASE KITCHENS INC PERMITNO03070222 NEWS NAME: 12333 SARATOGA-SUNNYVALE R PERMITISSUEDATE DALE DEI ROSS PHONE: (408) 253-0412 SANITARY NO. CONTROL NO. ARCHITECT(ENGINEER: BUILDING PERMIT INFO BLDO ELECT PLUMB MECH 100 LICENSED CONTRACT'OR'S DECLARATION Job Description f 0 I hereby affvm that I am liseved under provisions of Chapter 9(commencing with Section 7010)of DiAsion 3 or the Businrs and Professions Code,and my[icon=is in Licelle Class eel KITCHEN REMODEL Lteena.cla Lle.✓0� &At REPLACING CABINETIZI & FLOOR Dam Cum r ''VV ��.gg C� y p ARC ITECI'S DEC A C �� 1 undersmnJ m ions shall W u=J a lie rzcnN, ( S yi 'Wt; UmsedNores,iomml NOVO,s(a 2003 ,1pe OWNER-BUILDER DECLARATION 2i 2x I herchy,affirm that I am exempt from the Conlmcmes License Law for once LI O (ollnwing=von.(Section 7031.5.Business and Professions Code:Any city nr County 5$ which requires a permit to construct,alter,improve,demolish,or repair any structure lftligno poor to is issuance.also requires the applicant for such permit o file a signed statement E that he is licensed pursuant to the provisions or the Contractor's License Law(Chapter 9 Sq.Ft. Floor Area 1116PUNU.0111AU Valu$UoOO' (commencing with Section 700D)of Division 3 of the Business and Profcssiov Code)or $ that he A 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 or 3 6&)'l0fi616er0 0 Occupancy Type not mom than five hundred dollars($500). ❑I,as owner of the property,or my employees with wages as their sale compensation, will do the work,and the sWmum is not intended to fC.d for ule(Sec.ID44,Business tt1(�d Ins ectlons and Professions m Code:The Concmrs License Law does net apply to an owner or 101 — FOUNDA UN p property who builds or Improvea thereon,and who docs such work himself or through his .we employees,provldedthat such[mpromemcnuAne nut intended or offered(a,Ask.If. 102 — PIERS howeveg the building or improvement i,sold within mm year of Completion,the owner builder will hese Ne burden of proving that he did not Wild or improve for purpose of 103 - UFER sale) 104 - REBAR ❑1,as owner of the property,am exclusively convecting with licensed contractors to 1 O S — ANCHOR BOLTS comvun Ibe project(Sec.7044.Business and Professions Code:)M Convenor's Li cense law,does not pply m in owner or property who Wilds or improves theater.And. 106 — SEWER & WATER who contracts for such projects with a contractor(l)licensed pursuant m the Commctora License Law. 202, - UNDERFLOOR PLUMBING ❑I am exempt under Sec. B a P C for this reason 203 - UNDERFLOOR MECHANICAL =r out, 204 - UNDERFLOOR FRAME WORKER'S COMPENSATION DECLARATION 205 - UNDERFLOOR INSULATION I hereby affirm under penally of pe Jury one or line following declarations. ❑l have and will maintain a Ccmificate ofCansem tow]Nature for worker's Compcn- 301 — ROUGH PLUMBING sedan,As provided ror by Section 3700 of the Inbar Code,for the performance of the 302 - TUB & OR SHOWER work for which this petmnislasued. 303 - ROUGH MECHANICAL ❑I have and will maintain Worker's Compensation Insurance,At mquimd by Section 3700 of the labor Code,far the performance of the work for which this permit i,issued. 304 — ROUGH ELECTRICAL My Wo k Cry�pevation In= carrier and Policy number 305 — FRAME cat , YLtAe Policy No.: 1.n0.6QM 306 - HOEDOWNS CERTIFICATE C COMPENSATION INSURANCE ORKERS' 307 — INSULATION 0"NowetionrceG nm Wcompleted Irm,permit later ane hundreddollam(5100 308 - SHEETROCK oribm) 309 - EXTERIOR LATH I certify that in the performance of the work for which this permit is issued,I shall at 310 - INTERIOR LATH employ any person In any manner an v to become subj.at to tbe Workers Compcnsadon Laws..California.Da Applin¢ m 311 - SCRATCH COAT NOTICE TO APPLICANT.If.after Computation this Cenificne La Labor ushould 313 - ROOF NAIL become with comp m the Worker's oCaons or t is provisions of tW amd Code,you moa �'�,mrsnwith comply with such nrnviilnm or this permit Wdecmed minted. � 501 — FINAL ELECTRICAL ENERGY 0 CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY Ihereby affirm that Here in construction lending agency fomhe performance of 503 - FINAL MECHANICAL ENERGY x i>. the work for which this permit Is issued(Sm.3W7.Civ.C.) 504 - FINAL BUILDING ENERGY 31 Lender's Name jz Lender,Add. 505 - FINAL ELECTRICAL J O I certify that 1 have read this application and,tat.that the above inf.mrstum is 506 - GAS TEST yF correct.l agree to comply with all city and county ordinances and sate laws ablating to 'U buildingconawnion,AndherebyauthorimmprescmmivcsofhisCitytocnmruponthe FIN PLUMBI G Y W above-mentioned propeny for Inspection purposes. O B F I L (We)agree to save,indemnify and keep hasmlcas the City of Cupertino against ti y Rabllitiea.judgmenu.costs and expenses which may in anyway acerae against said City CJ or the granting of J 7 iAnPPLICANT UNDERSTANDSthis AND WILL COMPLY WIT L NON-POINT Issued by:5 NG Date 0/0� �-t s R EGULA S. 2dAIi A Re-roofs arc of Applica VConvacmr .,gel0, - HAZARD ATERIALS DISCLOSURE /I///ami"( Type of Roof Will he applicant or frau IldingoccupantnomorhanJla ha J s m As defined by the Cupertino Municipal Code.Chapter 9.12,and be HcaIN and Safety am,Section 255320)? All roofs shall be inspected prior to any roofing material being installed. p Yc, Nu Will the applicant a,Far..building amcupantumequipment ordevices which If a roof is installed without first obtaining an inspection,I agree to remove emit Normandin air contaminants As dcfincd by the Bay Arta Air Quality Management all new materials for inspection. District? a/ ❑Yes {fQNu IhavemWtheh7a ousmaterialsmquimmenuunder Chapmr6.95orthe Califor- nim Health Safety Cook,SeCume 25505.25533 mad 25534.1 understand that if the Wilding docs not cntremly have a¢nam thm it is my responsibility m nduly the Occupant of the m4 carswhic .$IWmcpriOr( satome.orac'MrIca orOcmpanky. Sig nature of Applicant Date Iza wncr or authorized agent 3 m All roof coverings to be Class"B" or better w � m Y lzz$ r �� 30 2003 e - w N m p 3 W X .p VI J Hill Zia ctme1 e ' N r � Kvw d SPpp1lC Vi m( a i a m 6q�ns 5�, ache { �i N a1 c p" aka ati yHpttitlF� i� v�ia( T f p w — — — — tubing ;, ;• i ''' .i I r+ i 4 I I 1Yt g N o r ;z pt - D G m a5/- I - - - N 3 m z v IL I j m V�I 11'l,•p�V.l'�r LL W N m iv r II m I m of I m vmmi � I o u O I V y N m r F a ri n S ti r N n LQ P m Tn VI N V ~ m N C r[Qm�� m _3 Le T C m � m ph LL a5 V F F i� N W P N41 cd N Q1 yQ$ryuC( O r m ` � � V(iPbl'• XX � u m ` m • w y pppF r> .1 yV�� N N a w �4 O MUM DJUL 3 0 2003 8}S• V666 V 'a N m ZD N m m • Dom clopV, m � � � LL V = N n V rya N QQQ Y m NNN999 �y X< m � M AT OF CUPERTINO CUPEr�TiNo PERMIT APPLICATION FORM APN# / pJDate: /3&103 Building Addiessc ....,.:, Own is Name Phone#: Contractor: License#: 3 Contact: Phone#: rad o Applicant/Contractor: /Building ermit Info: Bldg lect lumb Mech Jo escription• I Cato + Residential: 4 dmmercial: Sq.Ft. Floor Area: $/Sq.Ft.: ' f Architect/Engineer: `t Valuation: Type of Construction: Occupancy Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING 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 BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of f8q �ITY OF CUPERTINO . CUPERTINO PERMIT APPLICATION FORM QuantityFee 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 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 Repipe Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo 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 ciin 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> IOK 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 2 of 3 aITYOF CITY OF CUPERTINO COPE TINO PERMIT APPLICATION FORM • Quantity ee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL BREMRE CEPT 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 BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSF&2FAM Single& 2 Family BUILDING BSFNA Single Family New Add 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 Pi—umbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3