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04100129 CITY OF CUPEH'PINO "b g, e "4 BUILDING DIVISION PERI . CONTRACTOR INFORM ON BUILDING ADDRESS: KITCHENS BY MEYER PERMIT N04100129 1140 CHADWICK PL OWNER'S NAME: PERMIT ISSUE DATE STEVE & LAURA PETERS 278 CASTRO ST 10/19/2004 NONE: SANITARY NO. CONTROL N0. (415) 968-8318 ARCHITECrIENGINEER: - BUILDING PERMIT INFO BLDG ELECT PLUMB MECH =•Oo LICENSED CONTRACTOR'S DECLARATION Job DesCTI IIOD 1 hereby affirm that 1 an licensed under Provisions of Chapter 9(commencing P zC with Se ition]pw)of Div�yion 3 of Boo Busincx Professions Code,and ylicense is in full tbmA6 a effect/L .JSe� In KITCHEN REMODEL License Class ✓✓ Lic.p n 6 f,u n Dare C nacoo Y CHCTjl�C^LA ATIO Yid rstand la s /p(ed as u rccn w w Liccnsc P�fcsstnnal Oat lam exILDERempt DECLARATION Contractor's onte ON a y 1 hereby.Item that I.m eBusin from the Cisions r l License Law for the O O follwhnwmg rcazna Section]1131.5,Business and ere,de oli h,or Any city m muure 'm which myuie a pctmit m cnnnrucL.tale,imprnw,demolish,nr repair any stmcwre $23744 )''^ priori Its issuance,also tcyuires the applicant mrsuch permit to file a signed elutemenl that he is Beamed pursuant If)the provisions of the Contractors License Law(Chapter 9 Sq. Ft. Floor Area Valuation es'a (cum mencing with Secti on]WB)of Division 3 of the Business and Professions Code)or at that he is exempt thomfrom and the basis far the allcgcd exemption.Any violation of Section]031.5 by any applicant for a amon subjects the applicant to a civil penalty of A W 14 RbT 0 Occupancy Type not more than five hundred dollars 0500). 1,az owner of the merely,or my employees with wages for their sole compensation. will do the work,and Be struclum is not intended or offered for sale(Sec.7064,Business and Prefessmns Code:The Contractor's License Law docs not apply to an owner of Required Inspections pod,ony who builds or improves thereon,and who does such work himself or through his owncmpinle buil ing orided provemailuch entiss sold wilments arcne ear ofdmoffaetl fm salt.If. however the buildingorimprovementis arJwithinone Scar of completion,theowner- builderwill have the burden of proving Nat he did not Wild or improve for purpose of sale.). I ❑1,as owner of the progeny,am uclusively Can...oing wilt licensed aontaetafs to /�/�C•/a{'//( court,La the project(See.o an Business and Profusions Cotler)The Contractor's Li- - :ehe t law docs not apply je m owner of property who sad p or improves thcmon,and whence GO,for such projects with a comnnor(q licenxd pursuanno the Comranor'x License Law. rf ❑lam exempt under Sec. ,Bh PC for this rcazon Owner Date WORKER'S COMPENSATION DECLARATION I hereby orf m under penalty of pstjury one of the following declarations: 1 have and will maintain a Ccnifics,of Consent o self-insure for Worker's Cumpcn- station,as provided for by Section 37M of the Labor Code,for the pedommttce of the work for which this permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 37W of he Labor Code.for the performance or the work for which this permit is Issued. My Workcr' ompcmation Iasurantt Caitiff and Policy number am ".TE OF EXENI OMPENIITIONIINN FROM WOkKERS' COMPENSgT10N INSURANCE (This section recd not W complced it the Permit is forts.hundred dollars($100) nr Icss.) 1 ccnify that in the performance of the work for which this permit is issued,I shall not employ any pursuit in any manner stn M to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,afar making this Ccnlrcme of Exception,you should Become subject to the Worker Compensation provisions of de Labor Code,you must z forthwith comply with such provisions of this Form it shall W deemed revoked. Z O CONSTRUCTION LENDING AGENCY 'tt-+ � I hereby affirm that there is a consuuaion lending agency for the performance of C the work fur which this permit is issued(Sec.3W7.Civ.C.) W Q Under Name G Under's Address � z U(D 1 ccnify Nat 1 have read this application and state that Vic above infmmatiun is LT. P coven.I agree m comply with 211 city and county Ordinances and state laws relating m 0 U building construction,and hereby authorim representatives of this City to color upon the Gdoevc-ammiumod p.,,Iy for inspection pmposcs. E" (WC)agree to save,indemnify and keep harmless the City or Cupertino against cq liabihums,judgments.costs and capcnscs which may in any way accrue against said City U Z in consc,imac..f the granting of la,permit. �� 7 ^' APPLICANT UNDERSTAND AN WIL COMPLY WITH ALL NON-POINT Issued by: Date SOU RE -� — O Re-roofs ignamm of Appliab D m C4L f cant -HAZARDOUS MATERIAL�UISCLOSURE Type of Roof _ Will the applicant of(mune building c.Chaps sere or handle hvaith and as Jcrncd by me Cupcninn Municipal Cu c.Chapter 9.I i,and the Health and Safety Code.Section 25520)7 All roofs shall be inspected prior to any roofing material being installed. F1 Will the applicant or future Wilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove mit havamnus air contaminants as defined ay Arca Air Quality Management all new materials for Inspection. hWm? ❑Yes I have mail Ne basaN oo,bodonifls mquimments under .Chapter 695 of the CEIi(OF via Habh,Y Salcey Cod,Secuuna 255)5.25533 mod 25534.1 undcmamd that if the hullding duct not ctirmady haw a ant.N t my resp os bility m notify tie occupant of the regniro nts�i met issuancenfaCctaircam tOc.,arm, Signature of Applicant Date _ erne,9,aummi edagent D.lc All roof coverings to be Class "B" or better i 2� �I awk I t RE _ - - P�RQv sell A NCE ito tN pCC�ROp U p Ct1PERt1N0� CITY OF c ' INA w _ tV� a 2/ EU enp S?ecdia ena y t�' WILDING DtPti`Ri 1 et P tier ell a e1teMttah � � 3 4 �b�4,e r Y aha�epetm'�1°� t� 3 rAbe Without WCri Oi �uPB't' �tW� tie err ' N9 ►tee Ysitd�ng&of is Plan and 76t� J�J °AU,NOtVIA h o a� Pis°'rr v e09s �i��SiW NIL CWD co w RECRVE ol 4 OCT 181004 � gsi Qn�,G�r n � 14, PL'r_ st)Los I-r ELa_.n7e OFUPERYINO 3u r solNT- VJqmiW1d DEPARI'M04T 0 WA M 0 LS Phi uR7� �r�rt� � DRAWING NO: ED: Etr l$ED: SCAI` "_ _FT. CUSTOMER: LAVQ,4. qTU5 Proud member of.. KITCHENS by MEYER CONTRACTOR LICENSE 323091 THIS IS AN ORIGINAL DESIGN AND ALL DIMENSIONS&SIZE DESIGNATIONS ///�CI�fl'l)L/IL! � �.A'Lf� m«ar 650-968-7866 MUST NOT BE RELEASED OR COPIED SUPERSEDES DRAWING GIVEN ARE SUBJECT TO VERIFICATION �,;J �I`(,i2. 1 I10 Q (A(� wm�ruda aem ree,.sq t 278 CASTRO ST. UNLESS APPLICABLE FEE HAS BEEN JOB CONDITIONS. NO. - JOB SITE AND ADJUSTMENT TO FIT J MTN.VIEW,CA 94040 PAID OR JOB ORDER PLACED. OzSs ` 4I O fff�� I - �hV W�03� L4ji©3v T43110 T5 -&962Y 3L_12 2_q Jg oRU2-4 —,— N1 I CtA Mo S - 630-2Dtt30 l�3�2U1�S go UtRitN`� rM y�� GI t IF ® � V ED EDFts(iuN1 ZLDI s ( P 8/8 i I p CORDRNCE ITN THE CIT f AE' C•0. 28 1 u TING CODE ORDI. at zq ��z zl�ls 7s III r mt F Iw IM M W I SI -tlC dUnS Mus Ga �,c2 LU D3o FC2 n t of P•a0 ut L 611 nines and it a Fru IN Muo DSU gCfJ�3(o , \+Y'/ P t on 1' 0A �t aKe an charges or. alters ` "tx (JIDR to fL" /// 1712 PNC f)f�2to SID PS W2 a Without ;itten permissorr " T PhB � > 3 e�� 6A1flP0� 6ldin8 Dept City of Cupertino, s ►11� t roping of •s plan and specificat zrD O r o �} c `T T e @emit or,to be c.o a8'{yx (�SST3Lo - p NOT be ,a p p at of th vlcc.s��'n of any Pro, GP#k�L 7 t311D IS 2A-5 3(0 —L City Ordml3e+ �rafa to r. Fr �� °tllq o1u� To I&f' i� 3q 21 (; Q3DP6P`d DLv/5� f Y SSP 841ZFC� >Jl To 12" `ftTIno + A u I Mw W� to WRC243� T — > � Tr G+c Q �a ,$A Y-F scl CPQ - Q 9 A !�R-0 F 5 1S Ut4/L 1 - ® °1 PSA T M TT 0-ti-i- pliv 1,3 I 4 ® I R erte,4s C14 rJ;9- QQ f T out4 ue KIT j I DRAWING NO: I LAr�PROVED: I `f _ CUSTOM5R:SCP` FT. / / Qp Proud member of.• (S „�' J��V � R r7. CONTRACTOR LICENSE 323091 THIS IS AN ORIGINAL DESIGN AND ALL DIMENSIONS& SIZE DESIGNATIONS 650.968-7866 MUST NOT BE RELEASED OR COPIED SUPERSEDES DRAWING GIVEN ARE SUBJECT TO VERIFICATION ��1�� f pIGIL � �Fi °i.0 MU aa.u,�.,�n, 278CASTROST UNLESS APPLICABLE FEE HAS BEEN N0. - ON JOB SITE AND ADJUSTMENT TO FIT JPS-�1�� , 4&---e JOB CONDITIONS. MTNyIEw,.CAsaogo PAID OR JOB ORDER PLACED. 111 - — `q� kITY OF CUPERTIN040 cuP TYOF PERMIT APPLICATION FORM N # � C-/ Date: Building Address: Mailing Address ( f different from building address): / / O .'c A Cz Owner's Name: P l Phone #: Contr tor: License #: -'J;t-309 � Contact: Phone: s''' X.75— Y Cupertino Business License#: ► / Wii5i,V1- Fax: 6So)94' Building Permit Info: Bldg ®- Elect 25 Plumb a Mech;Z Job Description: �/ Residential El C �J`7�1 �j< < Commercial El Sq.Ft. Floor Area $/Sq.Ft.: Cost of Project: Occupancy Grou A3 - r Type of Construction: Please check this roject is a YL N second-story addition: ❑ roject 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 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M BtuMECHANICAL 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 • �7 1 of3 SCITY OF CUPERTIN(S CITY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING IMF BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOM 0 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 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 BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm 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> I OK btu MECHANICAL BREMHEAT Heater Installation 1 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 6 BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 {4- WITY OF CUPERTINOO CUPERTO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Sips, 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 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 Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING _ - - ZADDCHG ---- - - Address Chane BUILDING 3 of 3