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01100139, 03060185, 03040059CITY OF CUPERTINO BUILDING DIVISION PERMIT CO,NTRACTORINFORMATION 's BUILDINGADDRESS: AIJMAL KEVAL PERMIT NO. '2 NAME: APPLICATIO ATE PHONE: SANITARY NO. CONTROL NO, ARCHITELTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR 'SDECLARATION ]Ob Description I affirm that I am liccnud under provisions ofC 9 (commencing p mit, with Scaian?f)(N)of Division 3 of the Business and Professions Cndc, entl my license is ionhereby70 In full force and effect. License Class Lic.N ADD 1122 SQ.FT. .� Dam usedaspu ARCHITECTS DECLARATION I understand my plans shall he used as public mcnNs MAR 1 8 2004 DUPLICATE Licensed Prolessional - OWNER -BUILDER DECLARATION I Cathy affirm that 1 exempt from Nc Consns License for the Co O Code: Any city os arty following moron. (Section ?B3su Business and city 1. which improve. or repair any .wase. alter. IMpnm, demolish, requires a perost re rnres prior mits censd alsohiI. the tho applicant for suchpermiunfilessigaw Chtemem its the h Permit Chapter dpurstion Nommecat he is ingWith q. Floor.Area $10 �/�.Fjiafion 700r)of Division 3f the B uinarind Professions (commencing it of Businessand Professionslation basison3ofthe Orcreionn and of Na he u exempt tacmfrom and basis for the ulegcd exemption. Any violation of Ma MIN s --TA.M Ik.,,, 3Mi)MITIICf 00 Occupancy Type P Y YP Seccom,thin.5by anyapplicant or mtit subjects that applicenno ecivil penalty of Out .($50s not more Nen five hundred dollars (I50)). ❑ 1, as owner of But property, or my employees with wages as their sole compensation, will do Nc work, and the structure is not intended or offend for sale (sec.7W. Business 101 - FOUND @Wd Inspections and Professions Cade: The Contractor's Literati, law dose not apply to an owner of property who builds or improves theret and who docssach work himseBormmugh his 102 — PIERS own employees. provided that such improvements arc not intended or offered for ale. If. 103 — IIFER however. the building or improvement is sold within one year of completion. Ne owner - builder. will have that burden of proving tau he did not build or improve fur purpose of 104 - REBAR sale.). 105 - ANCHOR BOLTS ❑I, as owner of Ne property, am exclusively contruting with incrusted contractors to construct the project(See700 Business and Professions Code.) The Connectors Li. 106 - SEWER & WATER cense Law docs not apply to an owner of property who Wilds or improves themon, and 202 - UNDERFLOOR PLUMBING who contracts for such projects wit a contractor(s) licensed pursuant m the Contractors °nro Lis 203 - UNDERFLOOR MECHANICAL exempt L] I un accept undo Scc. . B & P C for this reason 204 - UNDERFLOOR FRAME 205 - UNDERFLOOR INSULATION WORKER'S COMPENSATION DECLARADTION I hereby affirm under penalty of pujury one of the following declarations: 301 — ROUGH PLUMBING I haw and will maintain a Cerrificato of Consent to self -insure for Worixer's Coun,ten 302 — TUB & OR SHOWER sation, as provided for by Section 37M of the Labor Code, for the performance ohne 3 03 — ROUGH MECHANICAL work for which this Firm it is issued. 3 04 - ROUGH ELECTRICAL ❑ 1 ban and will maintain Workers Compensation Insurance, as required by Section 37th of IN, Labor Code. for one, performance of the work for whim this Permit is issued. 3 05 — FRAME My Worker'sComlensationinsurancearrierandPolicynumberare: 306 - HOLDOWNS Cartier: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' 307 — INSULATION COMPENSATION INSURANCE 308 — SHEETROCK (Thu section recd not he completed if the Permit is for one hundred dollars ($IM) 309 — EXTERIOR LATH or loss.) 1 Ce"Ify that in the terformanee of the work for which this FerMlt is issued, I shall not 3 10 - INTERIOR LATH - - -- - - - - employanyperson in any manner so as to become SMOCCttothe WorlecriCom(lensation 311 — SCRATCH COAT Laws of California. Dam Applicant 313 — 501 — ROOF NAIL FINAL ELECTRICAL ENERGY NOTICE TO APPLICANT: I t after Maki ag this Certificate of Exemption, you should werme subject to 0c Worker's Compensation provisions of the Ichor Code, you must forthwith comply with such provisions or this permit shall he deemed revoked. 502 - FINAL PLUMBING ENERGY CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY I Comity affirm that there is a construction lending agency for NC Performance of 504 - FINAL BUILDING ENERGY the work for which Nmi is pert is issued (Sec. 3097, Civ, C.) Lenders Name 505 - 506 - FINAL ELECTRICAL GAS TEST UnderAddress 1 certify Nat 1 have read this application and sure our the shout information is correct. I agree to comply with all city and county mOnancea and suite laws relating m 507 - FINAL PLUMBING Wilding construction. and hereby authodae repnescnmtim of this city to enter upon theFIN rMk — MEC ICAL above-mentioned propcny for inspection purposes. (WM agree to save. Indemnify and keep harmless the City of Cupertino against0 9 F I liabilities. Judgments, costs and expenses which may in any way awme against said City 5 NG in consequence of the granting of this permit APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: 5 C WORKSDate SOURCE REGULATIONS. Re -roofs Type of Roof Signature of ApplicaDate HAZARDOUS US MATERIALS DISCLOSURE Will firm applicant of future buildingoccupant Store or handle Safety i ax defined by the Cupertino Municipal Code, Chapter 9.13, and the iicahh and Safety Health and ' 10 Fres zss3z(.j? E] No All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building Occupant use equipment or devices which emit haaallous air contaminants as de0ned by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes 0 N I have mad thc haizodous materials mquimmenm under Chapter 695 of the Califon. nisHealNXSafety Code. Sections 355()5.35533 and 2553x. l uMcrsmnd that ifthc Wilding dors not currently hoc a trnan4 Nat it is my responsibility in notify the neupmt of dm requirements which mast ho Mel prior to Issuance of a CeruTmare of Occupancy. Signature of Applicant Date All roof coverings to be Class "B" or better owner or authorized agent Date -q, CITY OF CUPERTINO BUMDUIGDiVISION.' CTORIND N PERM I,C_0N-TRA : AJMAL KEVAL BUILDING ADDRESS: 22045 CAROLINE DR PERMIT NO. 01100139 APPLI PHONE- SANITARY NO. :CONnOL NO. 'ARCHITECTIENGINEER: BUILDING PERMIT INFO' BLDG ELECT PLUMB NECH LICENSED CONTRACTORS DECLARATION Job Description hereby affirm that I am licensed under provisions of Chapter 9 (commencing ADD 1122 SQ.FT. with Section 7000) of Division 3 of the Busiftess and Professions Code, and my license is in full force anj effeer. PERMIT EXTENDED -TILL 12/25/02 Licenie Class Co 9 Dale — PER JOE A 12/26/02 SM ARCHITECT'S S DECLARATION I understand my plans shall be used as public records Licensed Professional OWNER BUILDER DECLARATION I hereby 2]TLrm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Profes!i[ons; Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any strucrum -pricinua.its issuance. also,requires theapplicantfor suchpeffnit to file'a signedstatement- 5q,.Fl. Flopr-Ar. _0N 14 D - "I", $ 10 9 4 Fluati on ofthe Contractor's License Law (Chapter.9 ith S 79P Y, -41oni 0 of divislon'3 of the Business Ayl Prulessions Code) or thol a 13 tieni6t Lfielifro�Zria the basis for the Any violation. a4itid cxez6p6ktf1. -of Section -7031 5.brany.-applicaitt for a permit subjects the applicant tora-civil penalty -)of na marethon five hundred dollars ($500). 3 2 6WA N411ibt Occupancy Type D 1, as owner of the prcipertyormq employees with wages as 1heirsole compensation. ,5 fil-doth il-norTrITUded tf offered'fur We(Sdc;'7=7FOUNDA it, int, c, 0 s Code: The Contractor's License Law does not apply to an 10._.. 01 Towner Or property Who build& or improves thereon, and who does such work himself' ,2 PIERS or through his own employees. provided that such improvements are not intended or A or improvement is so '&41,tition, --L--UFER7--- 103 VI `r f. the owner -builder will have the burden of proving that he did not build of improve for puipose of sale.). 104 _REBAR JA ji, 4spwner ol; the p naperty, am exc;usively cunt raicting with lice osed contractors to construct the protect (See. 7044, Business and Professions; Code;) The Contractor's 106 SEWER & WATER LIT �xj uc; V License Law does not apply to an owner of property who builds or improves thereon. .—Irid-who ---—--2--0-2---U- NDERF-L(D()R--PLT-J-M-2-INC,--'.----..- Contractor's License, Law' is reason 0 1 rmyex P,qro this 203 UNDERFLOOR--t-MECHAIN11 CAL 3 6) �, &'C ',43 204 UNDERFLOOR FRAME OR , ff0__ CL MI S D CLARATIO14 0 S� S� ,�T7 - .. - - - - - 205 UNDERFLOOR INSULATION I hereby-affirmundet.p"t ofTr'�ry:maieof.c following declarations;- , . y . p �. 301 - ROUGH PLUMBING, la 0 1 �ve"�nii will"maini1a 'a &�ifi�aV rx of �l'�eni to self -insure Worker's 302 - TUB & OR SHOWER Compensation,- as- provided for -by Sectioa 5700 of the Labor Code, for the n6celufdw wrid;; for which this permi0s issued— 303 - ROUGH MECHANICAL 1711 have'aa '. �Wni, �0;cdorl d will " ain.Workcir's 1. Cord . pe I nsail' 304-- ROUGH ELECTRICAL f0i the. perr6maqoce-of wkilh this permit is 'orke 305 - FRAME fs5W ion Insurance .4. 1,44 -130,6-- --HOLIDQWNS----- V, V0"*- k7i-0 0, :t. S1. .,.'CERTIMCATIQ$,OF,EXEMFrIONFROMWOR IW -... "J"T I' ' - A.-D'VOIT (6TI" COMPENSATION" {u n :nt(7hisseltien sed not ic completed irthe permit is rorone hundred dollars T'. 309 Ld�]ER` IOR LATH (fl DO) or less.)ts' 1�0 �foV'M'ince o ewor, pe -&B*�.l ov§lo�'�ny I�chon' 41 any orkers t 211r=�, 311 SCRATCH 't0k.T.L1 'on L fi �6 is on APPOICAW, If, of otExeroidon"you,thould .3 13-- -7- ROOF b!AIL 501 FINAL ELECTRICAL�`ENERGY rripensatioiiproVision!s the Lal;6r C66- f of you forthwith comply with such provisions or this permit shall be deemed revoked.502 - FINAL PLUMBING ENERGY ``N,C&STRU]214-� 'I 503 - FINAL MECHANICAL ENERGY:-', _';(' heftbl affirm that thd' is tru consdCnONL$2ir of1hework far'which this penrilt is Civ, C) P; 504 FINAL BUILDING ENEftGY. Ieertify that I have read this application and state that the above information' 6riili; I.agm. irl,cpenply,with zll:city'aricj county tp�*nances andstare Iowa relatire, g - ----- - 505---F'INA-L -BLECTRI'CAL 50 GAS TEST 5 �71 NAL PLUMBING I I ru,building construction, mid 6f ihiSeity to enter upon the above-meritioiler].property_for inspection 8 1 I NA 5 L ICAL purpose& in,, iinrilly, arid keep barmle5& the City'of C 5 NAL liabilities w whicl may'lil �aoy way acerae against said .,judgments, cost's and expenses whic Cityiff 6 9equenceofth Ing 6'rthmplFalL. 5 1oA )%PPQC IF ,TD Wal COMPLY'Wiftl'ALL N ON SOLTW ssued v Date OR KS L RI SURE- Re -roofs hwlding nt¢UVA st it of baidle hazardous m¢tetiab =__Type, of Roof the O� 0 1 1 ode, Chapter 95: 12-i, and Lhe Health and Safety I ,as �9(ined lblv 4e t 17, 4F Yes ;KZU Z " N 't," stall _-.-All.roofs -shall be-inspected.prior..to..any-rpofmg-materiat.b.f- ed -ing.in If a roof is installed With6ut first obtainirig ari'iilspddtidn�,�,I�agiee.t&feynove emit bazardrttiiL, ec�iaolin.ts 6 defined by the BayArea illewmhent Didricty materials for inspection, DliCant understands and will comolv with .-all,ndw "all"fi-o-nU-point our I have -re i thp jii�p4s materit4s,requircratelits"under tha6tei.&Yof Jic' Safety Code� Sictions 255D5,25533 and 25534 hunclerstand that -jtqbd,buiIditg cities nb%'Currenlly IiMle ri7tcnanlithatit is ni.�Ws�o silal i � - I L� 16F t* Lhi- Vereg -------- W. 0 uDant'atth, cots hiqll ii bti met 9' I f J i of Applicartfl- All roof coverings to be Class "B" or better J -1, -OFFICE --' - �- CITY OF CUPERTINO CuP �ritvo PERMIT APPLICATION FORM o//tr-o/31 APN # 3 6 p r , o' Date: OcA zG, ZODZ D tLS CAT01- DL4A) 09�Jo Owner's Name: A f �� `� Phone #: b� - 7.Z �oF 73'f-BGaa [6S 2 �8c�ct.54Y� Contractor: License #: Contact: Phone #: Applicant/Contractor: Boiler <= 100,000 Btu Building Permit Info: ld lect um ec Description: q A Residential: ,Z Commercial: Sq.Ft. Floor Area- $/Sq.Ft.: Architect/Engineer: Valuation: G �, Type of Construction: Occupancy Group: Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > IOOK to 500K Btu MECHANICAL BBOILER3 Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler > 1M to 1.75 M Btu MECHANICAL BBOILERS 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 BELEC 1000 Elec 600V <=1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA ' Investi on fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of 3 CITY OF CUPERTINO " �t zia- ace to vrr9 = M r. BUILDING DIVISION FERNIIT CSN CfiUR rog- rA.l iy'n.S.af t i _".: A BUILDING ADDRESS: PERMIT NO. 22045 CAROLINE DR ALL PRO MAINTENANCE 03040059 OWNER'S NAME: PECOML% rEDATE At7 & LUBNA KEVAL 10070 CRAFT DR. #1 04/10/2003 PHONE: SANITARY NO. CONTROL NO. (408) 718 -163 0 ARCHITECTIPNGINEEM BUILDING PMMrr INFO BLDG ELECT PLUMB MECH )Q ��5 4P- 4 A )z )0 �U .a LICENSED CONTRACTOR'S DI7CLARATION 1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 70(11) of Division 3 of the Businessand Profcssinn_sCode, and my license Is In full force and effect License Class Lie. N Date Contractor ARCHITECT'S DECLARATION I undcrstan� my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for rhe following mason. (Section 70313, Basin= and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or mpair any structure pdorlo itt issuance, also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the Coalrsators License Law (Chapter 9 (commencing with Section 7000) ofDivision3ofthe Business and Prore-W nsCode)or that he Is exempt therefrom and the basis for the alleged etcrttpdon. Any violation or Section 70315 by any applicant for a permit subjects the applicant to a uvB penalty of notmore than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as theirsole compensation, will do thework, and the Structure Is notiniended oroffertd forsale (Sec. 7044, Business and Professions Code The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himsdror through his own employers, provided that such improvements arc not intended or offered for sale. If, howevu, the building or improvement is sold within one year of completion, the owner. builder win have the burden of proving that be did not build or improve for purpose of salej. ❑ 1, as owner of the property, am exclusively conLmcting with licensed contractors to Concoct rhe project (Sec. 7D44, Business and Professions Code:)The Contractor's Li- ecnse Law does not apply to an owner of property who builds er Improves thereon, and. who contracts for such projctn with a contrimr(s) licensed pursuant to the Contractors TJrense saw. ❑ S ant txtmpt under See B & P C for this season Owner Dam WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ fheveandwillme3nuinaCetlftcamofComritloself•iasumforWerkeesCompet- sailon, m provided for by Section 3700 or the Labor Code, for the performance of the work for which this permit is Issued. ❑ I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for Oto performance of the work forwhlch this perrall is issued. My Workers Compensation Tmstuance carrier and Policy number am: Carrier: Polity No CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This scetion need not be completed if the permit Is forone hundred dollars ($ 100) or less.) I certify that in the performance of the work for which this permit is issued, f shall nor employ any person la any mannerso as to become subject to rhe Workers' Compensation Laws of Calffornfa, Date Applicant NOTICE TO APPLICANT. If, Aller making this Certifucam of Escmption, you should become subject to the Workers Compensation provisions of the Labor Codc_ you must forthwith comply with such pmvhiau or this permit thall be dermcd revoked. CONSTAUC LION LENDING AGENCY lhemby affirm that there Is it construction lending agency forthe performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lenders Name Lenders Address I certify that I have read rids applicz600 and &Late that the above Inform Wort U correct- l agree to comply with all city and county ordinances and state lawn relating to building construction• and hereby authorixe represenudvcs of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertlno against I labliftics, Judgme nts, costs and expenses which may in any way accrue against said Gly In consequence of the granting of Nis permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT SOURCE REGULATIONS. Signature of ApplieantlContractor Dote HAZARDOUS MATERIALS D15CLOSUltE Vrdl tit applicant or future building occvpanlstaro or handle hazardous msterial as defined by the Cupertino Municipal Code. Chapter 9.12, and the Health and Sardy Code, Section 25532(a)7 ❑Yes ONO Will the applicant or future building occupant use equipment or Jcvlms which cmil hazardous air contaminants as defined by the Bay Arca Air rurality Management D•utrir:0 ❑Yes ONO I have read the haratdous materials requiremcnn underChapler 6.95 of the Califor- nia)health&SarciyCcdc,Sccdons25505,25533 and 25534. 1 understandthatifthe building doesnot currently have a twant, that It Is my responsibility to notify the oaupant or the requirements which must be met prior to Issuance of a CertlOcato of Occupancy. Owner or authorlxed Job Description REVISION--SUBFL PLAN/IN HOUSE USE ONLY NO NEW PERMIT ISSUED, ORIG.#01100139 Sq. Ft. Floor Area Valuation APN Number Occup cy Type nn Required Inspections 101 - FOUNDATION 102 - PIERS 103 - UFER 104 - REBAR 105 - ANCHOR BOLTS 106 - SEWER & WATER 202 - UNDERFLOOR PLUMBING 203 - UNDERFLOOR MECHANICAL 204 - UNDERFLOOR FRAME 205 - UNDERFLOOR INSULATION 301 - ROUGH PLUMBING 302 - TUB & OR SHOWER 303 - ROUGH MECHANICAL 304 - ROUGH ELECTRICAL 305 - FRAME 306 - HOLDOWNS 307 - INSULATION 308 - SHEETROCK 309 - EXTERIOR LATH 310 - INTERIOR LATH .311 - SCRATCH COAT 313 - ROOF NAIL 501 - FINAL ELECTRICAL ENERGY 502 - FINAL PLUMBING ENERGY 503 - FINAL MECHANICAL ENERGY 504 - FINAL BUILDING ENERGY 505 - FINAL ELECTRICAL r 56 - GAS TEST de 0 FINAL P UMB4NG 8�"&111�_4ALFI Issued by: 5 Date , � v `^/ Re -roofs 514 f _rINAL PUBLIC WORKS Type of Roof All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant Date All roof coverings to be CIass "13" or better al(�1-17,;Z-11-1 CITY OF CUPEkTINO C,1 i Y OF CUPERTINO PERMIT APPLICATION FORM APN # Z�r � / Date: !. } ()) C�5 Fee Description Fee Group Building Address: C �,t UO co, . 0 W I Owner's Name: -J.4 WgvLA � aQ. Phone #: cLi ot) � 3 g6zZ Contractor: qQ S_ ALL P2o Cw q_6tI-Z ►M . mArrf rENAr�c� License #: �i �-� . Contact: Cupertino Business Licenset Building Permit Info: Bldg ❑ Elect Plumb ❑ Mech ❑ Job Description:/ O / E v k4le-Y'r5al Residential ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: Occupancy Gra BBOILER4 Boiler > 1M to 1.75 MB tu. Type of Construction: BBOILERS Quantity Fee ID Fee Description Fee Group 13APPLOTHER Other.Appliances MECHANICAL 13BLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler <=100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BB0ILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler > 1M to 1.75 MB tu. MECHANICAL BBOILERS Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING 13CONSTAXBQ 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 13ENEROYADD BINVESTIGA Energy Add Multi Investigation fee BUILDING BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING r• lof3 aCOF CUPEkTINO u1TY OF CUPERTINO PERMIT APPLICATION FORM 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 13NUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING 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 S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING 13REINSPECT Reinspection Fee BUILDING BREMACOVER AIC Unit > 10,000 cfm MECHANICAL 13REMAIRHAN AIC Units <=10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL 13REMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREWIMNOV Relo Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMZSC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2 of 3 :y° 1 CITY OF CUPERTINO CUPFIZTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Grow 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 BREMSIGNAD Rmdl Sips 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 BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary BIdg 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 3 of 3 y�00 tz,� e3e r"p Ito Lo y ...1 a0 �Qo rm� —? 0z z� F4 W� D.i Q �z Uo 0 {J rF•t fn U� CITY OF CUPERTINO NVQRIVIAA� BUILDING DIVISION PERMIT BUILDING ADDRPSS. CAnOT- E PP, ALL PRO MAINTENANCE """03060J-8.5 -22045 OWNER'S NAME: 10070 CRAFT DR. #1 PERMIrISSUEDATE PHONE: (408) 718 -163 0 SANITARY NO. CON7ROLNo. ARCHITECTIENG1NEER; BUILDING PERMIT INFO • BLDG ELECT PLUMB MECH o a o d LICENSED cONPRACTOR'S DECLARATION 9 ' Job Description 1 hereby affirm that I am licensed under provisions of Chapter (commencing with Secdon 70M) of Divlsion 3 orthe Business and Professions Code• and my licence is in full force and effect License Class Llc. n REVISION --IN HOUSE USE ONLY Data eoriumor NO NEW PERMIT ISSUED/ORIG. #01100139/03040059 ARCHITECT'S DECLARATION 1 understand my plans shall he used ar public records Licensed Pr fcssional OWNER-BUI LDER DECLARATION I hereby affirm that I am exempt from the ContranoCs License Law for the following reason, (Secdon 7031 S, Business and Professions Code: Any city or county which requires a permit to construct• alter, improve, demolish, or repair.any siructum prior to its issuance, also mquims the applicant ror such permit to Glc a signed swaracal `hat heis licensed pursuant to the provisions of the Conunctor's License Law(Chaptu 9 Sq. Ft. Floor Area Valuation $0 %commencing with Scotian 7000) of Division 3 of the Business and Prorutions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of 3�iI�dj�psr0 p Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than rive hundred dollars ($500). 0 L as owner of the property, or my employers with wages as their sale tompcnsadon, Req uired Inspections will do the work and the structure is not intended or offered for s33a (Sec. 7044, Business and Protessiona Codc: The Conuscrort License fax docs not apply to an owner of property who builds or improves Ocreon, and who does such work himselfor through his 101 — FOUNDATI-ON own employees, provided that such improvements are not inICnded Or Offered for sak. if. 102 — PIERS however, The building at improvement is sold within one year of completion, the owner- buitder wit[ have the burden of proving that he did not build or improve for purpose of 103 - UFER sale.). 104 - REBAR ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the projoct (Sec. 7044. Business and Professions Code:) The Contractor's Li- 10 5 — ANCHOR BOLTS. cease Law does not apply to an owner of property who builds or improves thereon. and, 106 — SEWER & WATER ' who contracts for such projects with a eantrattor(s) licensed pursuant to the contractors License Law. 202 - UNDERFLOOR PLUMBING ❑ I am exempt under See. , B & P C for this mason j_��X 203 - UNDERFLOOR MECHANICAL O ncr W0 SC MPENSATfONDECLA`RATION`-�C"� 204 UNDERFLOOR FRAME I hereby affirm under penalty of perjury one of the following dec)aratiorw, 205 - UNDER FLOOR INSULATION ❑ 1 have and will mainmina CcniLc=of Consrm oself-fnsurefor Worker's Compen. 301 - ROUGH PLUMBING sauan, as provided for by Section 370001 the Labor Code, for the performance of the 302 - TUB & OR SHOWER work far which this permit is issued. 303 - ROUGH MECHANICAL r]i have and will maintain Workces ComptMation Insurance, as required by Secdon 3700 of the labor Code, for the performance of the work for which this permit is issued. 304 - ROUGH ELECTRICAL My worker's Com pensadon Insurance carrier and Policy number art;: 305 - FRAME Carrier. Policy Na: CERTIFICATE DP FJ EMPnON FROM WORKERS' 306 - HOLDOWNS COMPENSATION INSURANCE 307 - INSULATION - (rhlssection need not be completedifthepermit isforonehundred dollars (SI00) 308 - SHEETROCK nr [CSS.) 309 - EXTERIOR LATH I certify that In the performance of the work for which this permit Ls issued, l shall not employ any person in any mannerso as to become subject to the Workere Compensalton 310 — INTERIOR LATH Laws ifamia.Da¢ Applicantlicant 311 - 313 - SCRATCH COAT ROOF NAIL NOTICE TO APPLICANT. If, after making this Certificate or Exemption, you should became subject to the Worker's Compensation provisions of tate Tabor code, you must forthwith comply with such provisions or this permitshaq be deemed revoked. 501 - FINAL ELECTRICAL ENERGY CON5TRUCTIONLENOINGAGENCY 502 - FINAL PLUMBING ENERGY I hereby affi= that there is a construction lending agency for the performance or 503 - FINAL MECHANICAL ENERGY Omwork for which this permit isissued (Sco,3097,Cir.C.) Lenders Namc 504 - 505 - FINAL BUILDING ENERGY FINAL ELECTRICAL 'Lender'sAddicss ) sonify that f have road this app)icatiun and state that the above informatiun is 5 0 6 •- GAS TEST correct. [ agree to Comply with all city and county ordinances and stale laws rebating to ' building construction, and hereby authorise repmstmaLives afthis city to enter upnn the FIN PLUMBI G above-mentioned property for inspection purposes. agree to indemnify keep harmless City Cupertino 08 FI (We) save, and the of against liabilides,judgmoms.costs and expenses which may In any way accrue against said City C in consequence orthe granting of this permit, •J APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by:5 TNG Date souR REGU A Ns. �,-� '- 514 NAL PUBLIC WORKS Re -roofs Type of Roof Signaturd brppIiMVCOnLr3C1ur 1500' HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant Stam orhandle hazardous material as dcfiocd by the Cupertino Municipal Code. Chapter 9.12, and the Health and Sakty Cale, 2ss32(ay7 All roofs shall be inspected prior to any roofing material being installed. ❑Yrs �No E] Yes If a roof is installed without fust obtaining an inspection, I agree to remove Will Thr: app:icani or future bdilddng occupant use equipment or devieea whin), emit hazarelnus air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. DistricO ❑ Yes OIL have mad the ha?aatfcus materials requirements underChaptcr 6.95 or the Califor• nia Health & Safety Code, Sections 25505, 25533 and 25534,1 understand that if the building docs not Currently have a tenant, that it is my orSponsibilily [a notify the occupant Of the r,n,q whir sl be met prior tuissoanceOfaccaificaicofOccupan Signature of Applicant Date All roof coverings to be Class "B" or better Owner or au)horized agent ata a C�� - I CITY of CUPEkTINO C;t I"Y. OF CUPERTINO PERMIT APPLICATION FORM APN # a Fee Group Date: Building Address: 2204�� iii X2.0 Ll.� f Gu��T7/V Owner's Name J m � BBOILERI Phone #: 7 Contractor: 13H6H7pt2. AGS PrP.a #?q)cm mA1-,J7-rA1,V License #: I 9 77a -- Contact: t L�p$'� 7 ��'_ 16 .2,-0 . Boiler > 500K to 1M Btu Cupertino Business License#: Buil g Permit Info: dg Elect ❑ Plum ❑ MechLl ob Des ption: �- ential ❑ CC- 4W_ - 0 F, er ' C� Sq.Ft. Floor Area: MECHANICAL BCONSTAX t.: Cost of Project: 7 Ind/Off/Comm/Quasi Occupancy G up: Type of Construction: Con. Tax for BQ Zone BUILDING 13CONSTAXH Quantity Fee ID Fee Description Fee Group 13APPLOTBER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler <-- 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 50OK Btu MECHANICAL BBOILER3 Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler > IM to 1.75 M Btu MECHANICAL BBOILER5 Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAX13Q Con. Tax for BQ Zone BUILDING 13CONSTAXH Hotel and Motel BUILDING BCONSTAXR Cons tax — 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 BMITIGA C Comm. Housing Mit. Fee BUILDING 1�0 Icla.-i PC,4-",:t 1 of 3 Z -z3! o CITY OF CUPEkTINO ( iry OF CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWM JLTI New Multi -Family Res MECHANICAL 13MNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMAffi 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 BOVERTINM 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 13PLANCKADD 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 rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterlVent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BRENLkHMAN 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 2 of 3 CITY OF CUPEkTINO CITY OF CUPERTn U PERMIT APPLICATION FORM IV Quantity Fee ID Fee Description Fee Group BREMPOWER Power Device/A aratus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BRENMPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Apptiance 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 BLUDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Tem oraryPower ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMHTFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERN UTFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Numbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3