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)
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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
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Room 1 - Wall 1
JUN 2 0 2004
WY OF CUPERTINO
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313116
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114
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-149/16- 118
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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
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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
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(-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
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JUN 29 2°N4
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JUN 29 2°N4
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' 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
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.-� 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