06020063 CITY OF CUPERTINO
BUILDING DIVISION PERMIT °IC0,I�ITR.'1e�'nR INT'�1tMq'TI0'y
BUILDING ADDRESS: PAUL FINDLEY & NAOMI KOTA f'IMIT NO.06020063
OWNER'S NAME: PERMIT ISSUE DATE
PAUL FINDLEY & NAOMI KOTAKE
IMNE: SANITARY NO. CONTROL NO.
BUILDING PERMIT INFO
ARCHITECT/ENGINEER:
BLDaO ELECT O PLO O
3oc LICENSED CONTRACTOWS DECLARATION Job Description
1 hereby affirm that 1 am licensed under pmvidems of Chapter 9(commencing
with Section 70010 ofDlvl.ion 3 of the Business end Professions Code,and my lice—is
n� in full forte And eRut. BATHROOM REMODEL/PLUMBING ONLY
License Clm Lic.0
9 Dam ar.
ARCHITECTS
PS DEDE CLARATION
I understand my plane shall he used as public records
c�a Lwensed Pm(cuionel
OWNER-BUILDER DECLARATION
`
I hereby air,.Nn 1 am exempt from the Contractors License Law for the
Ea
i.°O which
meeoo.Permit
t 7(131.5.mBusiness and se,deroll Cade:My city of colony
$ which requirts a permit ca crostrmL alcor,improve,de Permit
t ore a sig any Macau.tint $3500
priemits issmd ponexalso rtqulme the apions o for such permit Liecom Lav,(ned tsmmem Valuation -
FF
due hcincini, edpunuan to the 7000)o DialomofNeConuecmrenittvclsw(sCode)9 Sq.FL Floor Area
3$ thammencixgwlNSesdainAnd tfDiWionr the
the Bwieasandma MY
or
It Net io is 31.5 b dm¢(mm and the per it lax subjects
th tl uemant to My Noletion of
Seton than by any sed doll fon permit anbkco Ne applicant m a dull Penalty of r Occupancy Type
not mm Nen Bw hundred dollen(SSIIf).
❑1.a maw of she property,or my employees with wages as thehanle eompemdon,
will do the wark.and abamoctum is Out intenda,or offered tensile(Sao 704/,BmML Required Inspections
and Pmfessiorts Cade:The Contracmrs License Law don tat apply m en mance Of q P
property who buildsmimPmwa thereon,end whodoessuchwork himu for through his
own employ=,pmvided that such improvements tie not intended proffered fmaele.if,
builder,Ne building of provingment dust mid
within year of mmpltoq Ne owner-
builder
we r- l�!F%/2'/ SLE
builds will Nil The burden
of peeing Wt he did Out build or impmw,(or purpose Of �r�
safe.).
1.es owner of Ne prepeny,em exclusively contracting with licensed cmdona e,m
street the pmjca(Sec.70th,Buslam end Professions Code:)The Contractor-Li-
cense law does not apply m an ower of property-who builds or improve Iheraan,and,
who contracts for such pmjem with a canuacmr(U licensed pursuant m the Caoveamfs
License law.
plsmc pi under See. .B t P C for this muse.
ner Data 10 0
WORKER'S COMFENSAI IOL DECLARATION
1 hemby don under patstty of perjury use Of the following decluulans:
❑I him and will maintain aC.I from of Comat mself-Insane for WorkefsCompen-
sellan,as provided for by Section 37M of the Labor Code,for Ne performance of she
work for which this permit is issued.
❑1 hew and will maintain Workers Compmtion Imla n.as required by Seton
My ofke labor Code.for the pncecamof Ute work forwbrathts permitlaissmd.
My Workefs Compensation Insurance tertiu and Polity number art:
Carrier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This xcctie and,not Mcompleted ENe Permit is forte hundredd.lus(5100)
or less.)
I anify that In Ne performance of to work for which this permit is Issued.I shell nut
employ any person in any man DecMle subject to the worksn'Coarpmaedm
law of Gaff. Da��/
NOTICE
NOTICEubj ct PLIC L afar making n p Ccsiinnm the
Exemption,you should
booms moony it Worker's r oCompemdon Permit ion,
of Ne labor Codrake,you mud
.,O forthwith comply with such provisions or this prmluhall he deemed revoked.
Z y CONSTRUCTION LENDING AGENCY
[..r thereby scrum that Nem in constmaino lending agency for Ne ierfmmma of
C4> late work tar whit this permit is issued(Sea.3097.civ.C.)
lf1 Q Lender's Name /) Sa-nT r• /O
]Z Leaders Addmas
U O I certffy Thal 1 ban read this applieWon and sum that she above informadan is
rnrrttt I$gra m cam" with dnd l city ecounty ordinance,and sons law relating m
O Ww
building consction,and hertby authmme representatives of this city to cnw upon me
Gkt above-memiuned pmprty for Inspection Purposes.Or (We)agree m esw,indemnify and keep hnmlm the City of Cupertino against
N Ilabilities.judgments,cusp and expenses which may In any wyattrue agalnsesald City
(�z in comgoom a of the granting of this Permit. /
^� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date /� `AD-6
tr-
S OU R C Erly 0,1 — p 2A0Ia b Re-roofs
Signature or AppliesMConuactor / G.. Ty of Roof
HAZARDOUS MATERIA DISCLOSURE Type
Will Ne applicant or futum Wilding occupantstom or handle lovndom materiel
u de0ned by the Cupertino Municipal Cade,Chapter 9.12.and the Health and Safety
Code,Section 25532(.)7 All roofs shall be inspected prior to any roofing material being installed.
- ❑Yes
If a roof Is Installed without first obtaining an inspection,I agree to remove
Will the applicant or rutam Wilding Occupant m equipment or devices which
craft harardaus air cmtsmiaants in defend by the Bay Area Air Quality Management all new materials for inspection.
Disuict7
❑Yrs VN.
I hive mad de IrvarNws materials mquiremc nu under Chapter 6.95 of late Cali for-
ma Haw t SaletyCede,SutersZ305.25533 wW25534.i understand that vale Wilding
dean not currently ban a imam,that h is my responsibility to notify the occupant of the
raquitez which most metpdormismancearaCerd mmofQeu}'°may Signature of Applicant Date
Ile �^ "f �°j o 6 All roof coverings to be Class "B"or better
Own,or usmhariud agent Dam
CITY OF CUPERTINO
I 1 Of 1 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35603026.00
DATE ISSUED. . . . . . . : 02/10/2006
RECEIPT #. . . . . . . . . : 33166
REFERENCE ID # . . . : 06020063
SITE ADDRESS . . . . . : 22431 CARNOUSTIE CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : PAUL FINDLEY & NAOMI KOTAKE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-3949
RECEIVED FROM . . . . : PAUL FINDLEY
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY . . . . . . . . . . : PAUL FINDLEY & NAOMI KOTAKE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-3949 .
TELEPHONE . . . . . . . . :
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 3,500.00 104.76 0.00 104 .76 0.00
BENERGY PERMIT FEE 104.76 50.28 0.00 50.28 0.00
BPFIXTURE UNITS 3.00 27.00 0.00 27.00 0.00
PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00
BPLANCHK PERMIT FEE 104 .76 139.80 0.00 139.80 0.00
BSEISMICRE VALUATION 3,500.00 0.50 0.00 0.50 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 360.71 0.00 360.71 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ----_-------------
CHECK 360.71 4653
------------
TOTAL RECEIPT 360.71
•
C _. ;..�..... k TCC �! � - � �l..�h. r ''•. a5
CUPERTINO
Assessor's Parcel Number: 3sZ_ n Z g� — J
Name of owner.l4_z 1 /s Y�Q,.
Project address. 2- 2— tk3 a4242 D()-r T ZE7 C—T I if-0/ �l2T/,e/p
Contact person. Phone. 1�09 2-S-.7:sSD -C ( 4)
Net square footage of lot. _
Existin Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
. Are there at least two 10 foot by 20 foot clear spaces inside the garage? ` Y N
Is privacy protection planting required for the project? Y LN,)
On what floor(s) is work being done? c� L fA
/7 l�'L�s1`er
Brief description of work. U A 1l MVAV he p--06 i,C : Rl . la cx- C40 W4 kvi rz
"t-,) SLL{'p-en< h0 L hi-eH Zo +x_140 _ -(/OOY- eyye .1: ./1.M-r
Code editions:2001 CBC (Y -N)2001 CFC (Y-N)2001 CMC (Y- N)
2001 CPC ( N)2001 NEC (Y-N)
Effective 11/1/02
•
Plan Review Process Work Book Page-8-Revised 4/28/04
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; ;; CITY OF CUPERTINO
CUPEIZTItyO PERMIT APPLICATION FORM Qej2Ob63
PN# 3.x` 0Z6 — (72 Date:Fed , /o zoos .
Building Address: Mailing Address (if different from building address):
l
Owner's Name: Phone#:
PaL.v d1e.v 1,0 N/,orn i ko to 0 8' — Z 5-3 —,S—
Contractor: License#:
Nom
Ctact: Co- 11 Phone: teog-P6-7zf z Cupertino Business License#:
rawI r1adle
Building Permit Info:
Bldg ❑ Elect ❑ Plumb Mech ❑
Job Description: p P 1v lr- and
Residential O a-t kpvon, NmoA� ` aommerc4D
Sq.Ft. Floor Area: / _ q.Ft.:
Cost of Proiect: 3�S—v o Occupancy Groin
i
Zof Construction: Please check this box if the
project is a
-ekev,, Y-C- 0& f�i,/w V!ti ash a second-sto addition:
ro'ect Size: Standard lis Large ❑ Major ❑
uant ity 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 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1,75 M Btu MECHANICAL
BBOMER5 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
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CITY OF CUPERTINO
' CUP` INO PERMIT APPLICATION FORM
antity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee ; BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOZ•QAM New Comm Mechanical MECHANICAL
BNUCOI MP New:Comm Plumb PLUMBING
BOVERTIME Inspection Overtime - BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
'BPCESSPOOL Ces ool PLUMBING
BPERMFEE Bldg Permit Fees ,BUILDING
BPFIxTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind•Waste Interce for PLUMBING
BPLANCHK Plan Check Fee BUILDING
- _ BPLANCKA:DD Plan Check Add Multi BUIL DING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
'BPSPRATK Lawn S rinklerBackflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER InstalVAlter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
13REMACOVER A/C Unit> 10,000 cin MECHANICAL
BREM A IiAN 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> 1 OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood I1IIECHANICAL
BRENBIffSC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power DeAce/Ap2aratus ELECTRICAL
BREMRECEPT Rc tl Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter HeatingMECHANICAL
BRENI ESAPP Remodel Res Appliance ELECTRICAL
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CITX OF CUPERTINO, , a
cuPEr o PERMIT APPLICATION FORM
QuantityFee ID Fee Description Fee Group
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Si , Marquee ELECTRICAL
BREMTHEATR Theatrical Lighdng Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems 11IECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
BTEMY Temporary Power ELECTRICAL
BTEIIIPPERAI Temporary Bldg Permit .; BUILDING
BTEMPSVCS Terop Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance -ELECTRICAL
MPERNIFEE Mechanicals . foot ; ,MECHANICAL
MPERNMFEE 114ech Permit Issuance I MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
PLLONGRNGC Planning LR Commel Multi-Fam' PLANNING
PLLONGRNGR Plannin Lon Ran a Residential PLANNING
ZADDCHG Address Change BUILDING
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