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04060240CITY OF CUPERTINO NF®RMA-comer-. BUILDING DIVISION PERM C®N112A@T, BUILDING ADDRESS: PERMIT No 04060240 1177 CAN OWNER'S NAME: PERMIT ISSUE DATE MEI LING CHANG NE: SANITARY NO. CONTROL NO. ARCIi1TECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description L hereby affirm that I am Iia onder provisions m Chapter 9 (commencing wiNS titer"' of Division3of the Du ass and Pro fcssinns �pdc. and Xli¢nsc is in full derre<t. !j9 S % KITCHEN REMODEL Data cuntr DataCup CONTRACTOR: SCL CONSTRUCTION CO. t ARCHITEATION JUL �2004 used19- m public records 1 understand my plans shell Mused i Karl art 1I p� pnAA I,vq 1111 �11 B y0,�gp ac, Licensed Professional OWNER -BUILDER DECLARATION - 1 hereby affirm that 1 am exempt from the Contractor's License Law for the wa Wa mlai a va aaa i following mason. (Section ]11]1.5, Business and Profcssinns Code: Any city or county which m4uires a Permit of construct, alter, improve. demolish, or repair my rmetum prior of its issuance, also tribunes the applicant for such Permit to file a signed sulement Contractor's 1 Law 9 Sq. Ft. Floor Area ValU�gthe iQ9000 that he is licemad pursuant to the provisions of -mens, o (eammencing with Section 7") of Division 3 of the Business and Professions Code)or ' d that he Is eecmpt therefrom and thc basis for the allcgcd exemption. Any violation of APN Number Occupancy Type Section ]031.5 by any aypileam for a permit subjects the applicanr e0 a civil Penalty of not more dom fin hundred dollars (5500). 36224050.00 ❑Las the pmouccm mymforeacar Required Inspections P will a work,Code: is of ffrad f...k(Sec.7 .Bus eras oan Contractor's Licensernfreadmraampply to Owner Of and Prrywhobu Code: The Convamen. License Law deer not apply if an owner Prdo ofessions The Con 9 property who builds or improveswork himself is and who aresot ch improvements in edthrong:his impmscmcnu venot ear Own employees, providedin orithatvem of c mpecrcd theownr- :hear theaveteorimprovementissold within one year ofcompletion,theowner- W ilaer will have the burden of proving that he did not Mild or improve for purpose of .]a.). C h as owner of the prepeny, am uclusively convecting with licenced contractors to comemm the project (Sec. 704x. Business and Po finsi ons Code:) The Contractor's Li. cense Law does not apply to an owner of property who Wilds or improves Ramon. and, who contracts for such pmjcm with a contncmr(s) licensed pursuant o the Cmata ra License Law. ❑ 1 am exempt under Sec. . B & P C for this random Owner Dam WORKER'S COMPENSATION DECLARATION 1 hemby affirm under Penalty of Perjury one of the following declarations: Ol have and will maintain a Cendi sof Comets to ulf-insuro for Ante sCompcn- n, as provided for by Section 37M of the Labor Code, for the pe forman¢ of the . work for which this permit is ounce. C I ban and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code. for the perfrmunce of use work for which Nis permit is issued. My Worker's Cm[r!,,,nmm�u—oonn� inssuuran`c`e�C37'. and Policy num Wr art: aericr: ER� 3 6 ta'I CERTIFICATE OF E%EMPr10N FbhiIr COMPENSATION INSURANCE 4 // �I/SC,C" This =Iran need not Wcompleted if the pconot is for ane an dmdd 1ae($IW . of less) 1 modify that in the performance or the work for which this Permit is issued. 1 shall not employ any Person in any manner Sand W become subject to ft Worh2r5 eompen5atlon Laws of California. Date Applicant NOTICE TO APPLICANT: If, aper making this Cenifena or Exemption, you should hecome subject to the Workers Compensation previsions of the labor Code, you must 7 forthwith comply with such provisions of this permit chat be deemed ranked. 7 n CONSTRUCTION LENDING AGENCY 1 affirm is inn lending7.Cagency for the performance of for w permit I s ed (See > the work for which Nu permit is issued (Sec. J09]. Ci, C.7 7- Leaders Namc z 4nder's Address D I certify that I have read this application and mute that the above Intonational is ^ comet. I agree to comply wife all city and county ordinances and mute laws relating to building convection, and hereby atrthorrre representatives of Nix city to enter upon the .TJshave-mentioned property for inspection purposes. II(We) agme to save, indemnify and keep harmless the, City of Cupertino against n liabilities, judgments. costs and expenses which may in any way same against said City his Z in APPLICANT =UNDERSTANDS of dc granting of IAND rWILL COMPLY WITH ALL NONPOINr Issued by: Dat SOURCE REGULATIONS. . jg�e'� — z Re -roofs Type of Roof Siam-!:::: Si wrc of ApoicantlContracmr Date HAZARDOUS MATERIALS DISCLOSUa€/ Will thc ant pplicaor fueum building Occupant seam or hon cba/amous mRenal as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Cork. Section 25532(O] All roofs shall be inspected to any roofing material being installed. ❑ Yes IdNu prior If a roof is installed without first obtaining an inspection, I agree to remove wn the applicant or roomMaamg occupant ac =wiPm=rat or devices wm<n •mit hainrdous air conumimohi m earned by the Bay Arca Air Quality Management all new materials for inspection. Nsoic" 11 C Yea yds I bave mad the haaamo s mau rials requlmmcnts under Chapter 6.95 of the Califm- riaHcalN &Safety Code, Sccurns 355(15,]5533 and 255]4.1 ondcrsmad that if the building does wt cmmolly have a benam, that it H my responsibility to notify the occupant of the mvuirmentswhi< mustmMCI Prior mirstranceOfaCCMrIC3=OfOccuPUncy. Signature of Applicant Date 'C All roof coverings to be Class "B" or better aue:omcd agcm Date R -ESIDENUAL'.PROJECT COVER SHEET CITY OF CUPEkTINO Assessor's Parcel Number: Name of owner. Project address. Contact person. S�n/e Z eq,; Phone. e- u O:' 'AI RO Fax. "• cylrPfA�lTii�ir��� Net square footage of lot. NJi� Existing Proposed Square footage: First floor: Second floor: Garage: --� h TOTAL: Are there at least two 10 foot by 20 foot clear spaces inside the garage? N • Is privacy protection planting required for the project? r N On what floor(s) is work being done? • Brief description of work. :J Code editions: 2001 CBC (Y - N)2001 CFC (Y - N)2001 CM 2001 CPC (Y - N)2001 NEC (Y - N) Effective ll/1/02 Plan Review Process Work Book Page -8-Revised 4/28/04 NIVIYA - Showroom: 1132-D-S-['Anza-Blvd. San Jose, Ca95129 (408)253-1998, 366-1542 (fax) HollistL...---------•--- ----r— --�0 Room 1 12-1t—I---25 1/2— 2, 114, 112 13 On 29 I" l 24 '1( � t �28{ a C28�, �//G/—Usyj-[wc•�a 64,oeYE,%w, of e. 5�/ S6 W0,q_ZS3_3zy Not To Scale 17 1 'I` 18 JUN 28 2004 `Yo 112 24 8RDWDRAPT AMY n 1E i�}61�sy�4 7 °�'2D� i'� 11 •z':DW2 ',^=,i ^15 _.,el' 38112. 12 939- !2{2^J .1 40 25 - 24 �, 4 244 'ti244 , 27 11 D 12 92 301/8-1 1 93 1093/8 A8 p�p� PPRO tl ED IN AC F CE THE CfTV OF LUPE S INANCES DATE � R ' Y �W SIGNED This set of plaril and specifications MUST be kept on the job at all times and it is unlawful to make any changes or alterations on same without written permission from the Building Department, City of Cupertino. T,e stamping of this plan and specifications '.!_L NOT be held to permit or to be an ct tae vlo,at!cn of any provisions of • NIVIYA Showroom: 1132-D S. De Anza Blvd. San Jose, ose, Ca95129 (408)253-1998, 366-1542 (fax) Factory: 2000 Lana Way 116ollister, Ca95023 (831)635-5880, 9400 (fax) 11 .2- Room 1 - Wall 1 JUN 2 0 2004 WY OF CUPERTINO R, ill mir, nFpApTijgNr 313116 -149/16- 118 114 Not To Scale 24 17 35 V4 2 J36 41 18 11 35114 35 1/4 ,2- 1:23 3) 23 13114 - 3/4 0 O 00 24- - 2445 ..ST30 1/ 4 29 25 351/4 23 16112- 1(4j [4 313116 -149/16- 118 114 Not To Scale NIVIYA Showroom: 1132-D S. De Anza Blvd. San Jose, Ca95129 (408)253-1998, 366-1542 (fax) Factory: 2000 Lana Way 6ollister, Ca95023 (831)635-5880, 9400 (fax) -36718- Room 1 - Wall 2 V �D JUN 29 MA ay of cUPERVIN® GMCE COM 4- -26718 -12--10 1/2 36 36 1/2 ' Not To Scale NIVIYA Showroom: 1132-D S. De Anza Blvd. San Jose, Ca95129 (408)253-1998, 366-1542 (fax) Factory: 2000 Lana Way Allister, Ca95023 (831)635-5880, 9400 (fax) 35 Room 1 - Wall 3 C � U V 4 JUN 29 2TA CITY OF CUPERYINO gHjj Q9wr npwwjd MT 41 /351/4 57 318�4 Py —301/8--271/4----M V `1 41 /351/4 —12- 12 2� 118 24 J 3s 1/4 41 35 114 23 1/16' 18114 24 , El 70 .. REF36 O 24— „D ❑ ❑ I t tl2 _ 35 28 Hill III -661/8- I(� :eaY1-`:A 24- 4 6 47�� 28 28 15 ..DW24 `6� t�, e�.1N (nY: '�✓Mr' a y�Sr�4t�,.s,r1 3/8— Not To Scale 96 NIVIYA Showroom: 1132-D S. De Anza Blvd. San Jose, Ca95129 (408)253-1998, 366-1542 (fax) Factory: 2000 Lana Way Hollister, Ca95023 (831)635-5880, 9400 (fax) i kM. A PM Room 1 - Wall 4 NO[ 10 xaie JUy 20 2u34 OF CUMIMM10 Mr -9 nPAM-Mr (-22 314) (-1 114) NIVIYA Showroom: 1132-D S. De Anza Blvd. San Jose, Ca95129 (408)253-1998, 366-1542 (fax) Factory: 2000 Lana Way Hollister, Ca95023 (831)635-5880, 9400 (fax) [06-29-04] • Room 1 - Back of Wall 4 Not To Scale O 35 • (-1-1/4)-(-1 52 -77)`�� �'�D JUN 29 2°N4 CrUT C� I � 1/4 14 4 - I 351/4 52 -77)`�� �'�D JUN 29 2°N4 CrUT C� ' NIVIYA Showroom: 1132-D S. De Anza Blvd. San Jose, Ca95129 (408)253-1998, 366-1542 (fax) Factory: 2000 Lana Way Hollister, Ca95023 (831)635-5880, 9400 (fax) [06-29-04] is Room 1 - Wall 5 Not To Scale • J 24 CU'PMHO iENT f-, Eli, NIVIYA Showroom: 1132-D S. De Anza Blvd. San Jose, Ca95129 (408)253-1998, 366-1542 (fax) Factory: 2000 Lana Way jAgilister, Ca95023 (831)635-5880, 9400 (fax) • F Room 1 - Wall 6 JLC 2-. 1.:21+ Not To 0 • s 0 .-� City of Cupertino Plan Check Transmittal Permit# Project Address Owner 04060240 Control# 13350 Plancheck# 1 FileDate 6/29/2004 REPLACE KTCHN CABIN 1177 CANDLELIGHT WAY CHEUNG. Description KTCH REMODEL Plan Check Status (attach comments and return to Building with plan set) Dept Plan check# .;t Date ,, Due Date Staff Comment Date Approval? Building 1 16/29/20041-7/13/2004 POH 6/29/2004 6/29/2004 Assessor 1 16/29/200417/13/2004 C� ' Additional Plan Check Fee • Hours Q Planning Fees Housing Mitigation Fee Amount Heart of the City SENT 6/29/2004 Specific Plan Fee Amount r�(d= CITY OF • CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM 6�0Co 11 APN # 1 � 2- Ds --D Fee Group Date: - n V Building Address: A ( Mailing Address (if different from building address): Owner's Name: Boiler <= 100,000 Btu MECHANICAL Phone #: VedF- 2 - 3z2 1� Contractor:5, Lve 7 & / BBOILER3 License #: .- g Contact: , Phone: (�So-6 g3 /J Cupertino Business License#: BBOILER5 Fax: MECHANICAL BCONSTAX Building/Permit Info: BUILDING BCONSTAX Bldg Lid Elect ❑ Plumb ❑ Mech ❑ Job Description:] �y,v �� -w- U�� S17 e-1- -re�,- 4,90 4,4 Residential V BUILDING i Commercial ❑ Sq. Ft. Floor Arca: BUILDING BELEC1000 $/Sq.Ft.: Cost of Project: BELEC1001 Elec 600V > 1000A Occupancy Group: BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Type of Constnictio BUILDING BENERGYADD Please check this box if the project is a BUILDING BINVESTIGA Investigation fee 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 1 M 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 � 26l 1 of �L 4iZ 5�� � 0? ZPfflAa- CITY OF CUPERTINO OtITY OF CUPERTINO*j PERMIT APPLICATION FORM 2 of 3 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 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 SprinklerBackflo 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 cfm MECHANICAL BREMA]RHAN 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 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 2 of 3 CITY'OF CUPERTINO i CITY OF CUPERTINA 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 Insection BUILDING BS WIM 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 Flee Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING Is 3 of 3