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05090148 F,470 TY OF CUPERTINO >I+ °'%- xssxaBUILDING DIVISION PERMIT f CONTRACTORINFORMATION u� DING ADDRESS: NULIGHT SOLUTIONS, INC PERMIT"'05090148 COLUMPTIS AV R'S NAME: PERMIT ISSUE DATE SCOTT PARCEL 1900 DOBBIN ERS SANITARY NO. CONTROL NO. (408) 254-6661 ARCHITEC OENGINEER: BUILDING PERMIT INFO BLDG ELECFPLUMB MECH 0 o t� o uoo LICENSED CONTRACTOR'S DECLARATION rk W I hereby affirm that 1 am licensed under previsions,of Chapter 9(commencing Job Description With Section 7")of Division 3.f the Basin.and Professions Code,and my license is n nyimm�mmeamerrev • �ZTt?)}$ SKYLIT (KIT. /LIV. RM) 8�� ® adz LkenuC Cast VU 11 n F p Dau D Cumramaa L a u tJ` ARCHITECTS DECLARATION ' s< I understand my plans shall be used m puhhe records / >0 �z-4- 2605 t o� Licensed Pmfcssional 3 OWNER-BUILDER DECLARATION iS I hereby affirm Nat 1 am exempt from due Contractors License Law for as Ip] ram � (� 00 fuliewing mason.(Section 7131.5,Business and Professipns Code:Any city of county I � e; which mquims a permit to ennmsst,also,borrow,demolish.or repair any sacwrt o I �I \\'I /III 2.0 O 0 prior or its issuance,also requires she applicant(or such permit to fila a signed statement - --_ that he is licensed pursuant to she previsions of the Convector's License Law(Chapter 9 Sq. Ft. Floor Area 'Valuation' YFD (commencing with Section 7000)of Division 3 of the Business and Professions Cods)in y Nat he is exempt shrmfrom and the basis for Ne alleged exemption.Any violation of Section 7031.3 by any applicant for a permit subjects Ne applicant o a civil penalty of r U U Occupancy Type nut mom thane humored dollars(M). I,as owner of she pxapeny,or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale(Sac.71)4,Business Required Inspections and Professions Code:The Contractors License Law does not apply w e an owner of q P property who builds or improves dramon,and who does such wort himself or Borough his Own cmplowca,provided Nat such improvements an,not intended coffered forams.If, however,the building or improvement is sold within one year ofcomplcuon,the owner, builder will haw the burden of proving that he did not Wild Or improve for purpose of sok.). ❑1,as owner o(ft property.am exclusively contracting wit licensed contractors to construct the pmjea(Sec.7044,Business and Professions Code:)The Contncur's Li. cense taw does not apply to an owner of property who builds or improves daemon,and who contracts for such projects with a consracsons)licensed pursuant an the Counselors License law. ❑I am exempt under Sec. ,B At P C for this remon 137Wcr Das WORKER'S COMPENSATION DECLARATION 1 trimly affirm under penalty of perjury one of the following distributions: haw and will maintain a Cartufcam of Consent w ulf-u sum for Workers Compen- n,m provided for by Section 3700 of Ne Labor Code,for the performance of the for which this permit is issued. have and will maintain Workers Compcnauon Insurance.m required by Section of the tabor Cade,for thc performance of the work for which this pore it is issued Workers Crommppeman.Insurance carrier and Policy mann er am: er. JFa FuAtO Polity No.:�(=l,j(jZ��zuy ` CERTIFICATE OF EKEMMON FROM WORKERS' COMPENSATION INSURANCE Cr ussecion need rot be completed if the permit is Toone hundred dollars(SI00) ,it less.) I cessifv that in the p,rfammncc or the work for which this permit is board,I shall nm employ any person in my manner an as to become subject to the Workers Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If.after making this Cattiness of Exemption,you should become subject to the Workers Compenmtion provisions of the Lahr Code,you must .J Z forthwith comply with such provisions or this Permit hall be deemed!revoked. Z O CONSTRUCTION LENDING AGENCY Ihereh affrm that tbere is a mnsnuction binding ac for the f attar F^ r g .)try per isms n C4 7 the wok for which this parrots is issued(S.C.3097,Civ.CJ lt1 tender's Name Z) 2 Lenders mama, ' V 0 1 ce rify that 1 have read this application and sus Net the abow information is torten.1 agree to comply with all city and county ordinances and sus laws relating 10 Q V building convection,and hereby armoire mpresestalwaa of this city to enter upon the above-mentioned pmpe0y for inspection purposes. (We)agree to saw,indemnify and keep harmless the City of Cupertino against ti y liabilities,Judgments,costs and expenses which may in any way aecmc against said City V Z in consequence of the panting of this permit. / �_ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 7 —Z y SOU GULATION ' CZ Re-roofs m /-( sig aof yplicanVCon ar cDau HA: DOUSMATERIALSDISCLOSURE Type of Roof Will the applicant or form building occupant store or handle hazardous material defined by she Cupertino Municipal Code,Chapter 9.12.and the Health and Safes, riYe:2ss3z(a)± N. All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants az defned by the Bay Arca Air Quality Management all new materials for inspection. Disvict7 ❑Yesl.Ylqu I have mal the hzaardousmasrialsmquirements under Chapter 6.95 of the Califor. nia HwithS,SafUryCods,ScNans 25505.25533 and 25534.1 understand Nor ifft Wilding does not- at hoe a tem a Nat is is my rapomibilisy w nodfy the occupant nr Ne requi/rwKyyn`tpyrw'm"aneconcinirCcire�yfol t� y SignatureofApplicant Date Own r apthnNvcd agent `� t Darr All roof coverings to be Class "B"or better CITY OP CUPERTIN0 �' 'a'fi% ai�u�"� '` " BUILDING DIVISION PPR 01CQNTRACTORINFORM BU ILDING ADDRESS: NULIGHT SOLUTIONS, INC PERMIT NQ.05090148 1470 CQIiUMBUS ME NER'S NAME: PERMIT ISSUE DATE SCOTT PARCEL 1900 DOBBIN 0 PHONE: SANITARY NO. CONTROL NO. (408) 254-6661 ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 _00 LICENSED CONTRACTOR'S DECLARATION Job DCSCIIpI100 C 1 hereby affirm in.,1 am licenud under provisions of Chapter 9(commencing U with Section 7") in., Sof the Business and Professions Code.and my license is mhsBmme.ndeffeeL �ZL`•7�'}.� SKYLIT (KIT. /LIV. RM) j�Z Licensee Cl.gs - Lic.p n�,WDau D Contractor 4s` j ARCHITECTS DECLARATION Sa m I understand my plans shall W used u public insureds JyU T w,�„ Liccnud Professional �� OWNER-BUILDER DECLARATION 1 hereby reaso .(Siem thin I em exempt from the Contractor's C :Any cense Law far the COO following reason.permit t 703 cr I.S.Business and Professions Cole:Any city or county Sm which mquiru a permit m cnnsuun,alar,improve.demolish,Or repair any structure $2000 - < prior m its issuance,also¢quota the applicant for such Permit W file a signed statement 1�,-t he is licensed pursuanuothe Provisions ofthcContuctur'sLaxi ,Law(Chapur9 Sq.Ft. Floor Area Valuation .fn (commencing with Section 70K)0)Of Division 3 of the Business and Professions Code)., 'a.9_ that he is exempt therefrom and the basis for the alleged exemption Any violation of Section 71031.5 by any applicant for a Permit subjects the applicant to a civil penalty of rU Occupancy Type not more than five hundred dollars($500). ❑1.as owner of the property,or my employees with wages as their sole eampenution, will do the work,and the swcture is not intended or offered for sale(sa.]04 ,Businm Required Inspections and Profusions Code:The Contract'snse LiceLaw does not apply 1.an owner of q property woo builds i impmvu thereon.and who are r esauch work oreffe edthmugM1 his ownver.th buiprovide)thinsuchem proved wit tient intendedlercd for owner- founder thebuildingouimpmvememissoldwithinone year of completion,provefor the owner- / .Lc.).r will have the buNcn of proving thin he did not build or improve for purpose of Plc.). y ❑I.as owner of the property,,B uclusiv nd confessions with licensed)Te eomracmrs i copse La the project(Sec.]044,Business and Professions Cade:)Thews then tot's Li m cense taw does not apply je an owner of property who builds or improves Comrst and. whocontractsLa .for such prpjeeu with aconuanor(s)liunud pursuant mute ConfeagoYx J License Law. ❑ tum exempt under See. ,B&PCfor this Mason Dau WORKER'S COMPENSATION DECLARATION I hereby affies under penalty of perjury,one of the following declarations: I have and will maintain a Cenificau of Contin W self-insure for Worker's Comp.n- action,as provided for by Section 3700 of the labor Code,for the pMormance of the work for which this permit is issued. 1 have and will maintain Wurkces COmPensminn Insurance,u rcquimd by Scuinn 37W of the Labor Code,for the performance of the work for which this Permit is issued. My Workers Com facreantion Insurance carrier and Policy number�are�:�� Csnicr. I'I'�TL�, �u I to Policy No.:�LSLlZ52 1`A' CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thisunion need notbecomplead ifthe permit isforonehundreddollarsg Ip) ,it less.) I certify shat in the performance of the work for which this permit is iuucd.I shall oat employ any armor in any manner an as to Wrome subject W the WurEcof Compensation Laws of California.Dale Applicant NOTICE TO APPLICANT:If,after making this Ccnificau of Exemption,you should _ become subject to the Worker's Com penPtion provisions of the labor Code,you must .J O forthwith comply with such provisions nr this permit shall M deemed mveled. Z CONSTRUCTION LENDING AGENCY �-+�+ I hereby affirm that there is a construction lending agency for the performance of ce 7 the work for which this permit is issued(Sec.3N7.Civ.C.) , W Q Lender's Name raj z Lender's Address V Q I ccnify that 1 have read this application and sure drum the above information is W r Correct.l agree 10 comply with all City and county ordinances and sum laws existing O V building construction.and hereby amimire upmunutives of this city to curer upon the FT7 above mentioned properly for inspection purposes. (•+C (We)agree to save,indemnify and keep haemless the City of Cupertino against rq liabilities,judgments,costs and eapenses which may in any way see=against said City V Z in eonuquence of the granting of this permit. �— ,S I .. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date G ,Yy SOURCE GULATIONS Gy� �' C((Lt �oS Re-roofs ,57 /'Y J'A'-f Sig mys of pplicanvconu cur Dam ' HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Ne applicant m fumm building acupam sum or handle barallous material as defined by the Cupertino Municipal Code.Chapter 9.13,and the Health and Safety tin. Dns3zwr' Dy. No All roofs shall be inspected prior to any roofing material being installed. Yes Will thea applicant or future building occupant us,equipment or device,which If a roof is installed without first obtaining an inspection,I agree ro remove pp a nc a yvipr Qu emit District' us air cnnuminanu az JvBncJ by me Bay Arca Air Quality Management all new materials for inspection. District? ❑Yes 4No ' I have mad the hararduus mamriterequircmcnu under Chapter 6.95 of rbc Califon pia Hmlth&Safiny Cafe.Seedau 25505.35533 and 35534.1 umkrsund thin if tic building d.nor if baro a mnanL that it u my msWnslhility 10 notify them upam of the rcyuirc n clypr d 1Pn r I issuanw ofa CcniIII of Gecu ancy. L �� ,9 � � t wf, Signature of Applicant Date own eti,—� meicedasent. e-J Dal to All roof coverings to be Class"B" or better F) ® CITY OF CUPERTINO Item 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36205002 . 00 DATE ISSUED. . . . . . . : 09/21/2005 RECEIPT # . . . . . . . . . : 31301 REFERENCE ID # . . . : 05090148 SITE ADDRESS . . . . . : 21470 COLUMBUS AV SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : SCOTT PARCEL ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4971 RECEIVED FROM . . . . : MARK EDWARDS CONTRACTOR . . . . . . . : MARK EDWARDS LIC # 26128 COMPANY . . . . . . . . . . : NULIGHT SOLUTIONS, INC ADDRESS . . . . . . . . . . : 1900 DOBBIN DR. CITY/STATE/ZIP . . . : SAN JOSE, CA 95133 • TELEPHONE . . . . . . . . : (408) 254-6661 FEE ID UNIT QUANTITY . AMOUNT PD-TO-DT THIS REC NEW BAL ----- ----- -- - - ------ -- - - --------- -- -------- -- - ------- ---------- ---------- BENERGY PERMIT FEE 83 . 16 39 . 92 0 . 00 39 . 92 0 . 00 BPERMFEE VALUATION 2, 000 . 00 83 . 16 0 . 00 83 . 16 0 . 00 BSEISMICRE VALUATION 2, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 BPLANCHK PERMIT FEE 83 . 16 110 . 98 0 . 00 110 . 98 0 . 00 TOTAL PERMIT 234 . 56 0 . 00 234 . 56 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER -------- -- --- --- - --------- - - - ------------------ OTHER 234 . 56 VISA TOTAL RECEIPT 234 . 56 I OCITY OF CUPERTINO* CITY OF PERMIT APPLICATION FORM CUPERTINO APN # S U Date: (� "Z— Building Address: Z ( L" O C o 'u�5 cS Mailing Address (if different from building address): Owner's Name: SLo Phone#: Contractor: N N �r I Sol tido License Contact: n a Phone: '3(,� ��1 Cupertino Business License#: Dav,89 cAFax: z C 1 2<2> Building Permit Info: i n S{q it S�y t �1 AS 1G(4CAPA Ltd'Acl rL0,3^^, Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Job Description: Residential Commercial ❑ Sq.Ft. Floor Area: q.Ft.: Cost of Project: 20 G 0 . 00 Occupancy Group: Type of Construction: c Please check this box if the project is a �/ (J second-story addition: ❑ Project Size: Standard Or Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M 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 <= 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 4- 31 1 of C` -CITY OF CUPERTINO* CITY OF PERMIT APPLICATION FORM CUPERTINO IMF 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 S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER WaterHeater/Vent PLUAIBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfin MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace . MECHANICAL BREMFURNOV Relo Fumace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREME%HOOD 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 2of3 ,��Au av"I 1ILTY OF CUPERTINO -' CUP TYOF O PERMIT APPLICATION FORM QuantityFee 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 BSWIM Swirnrning Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Ternp 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 PPERNHTFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Change BUILDING • 3 of 3 ;a "Taft 211,11 ' M MIR CUPERTINO Assessor's Parcel Number:— Name of owner. S:0 -4PCVC-e Project address., 21 -+(D X-C Contact person. a e Phone. QOZ3�9 -T-141 Net square footage of lot. Existing Proposed Square footage: First floor: Second floor: Garage: TOTAL: Are there at least two 10 foot by 20 foot clear spaces inside the garage? Is privacy protection planting required for the project? Y On what floor(s) is work being done? I—r-t A Brief description of work. �fkA-C kCD —L--(- V \X k 0 0 r.^, U U �J Code editions: 2001 CBC N)2001 CFC (Y -N)2001 CMC (Y- N) 2001 CPC (Y - N)2001 NEC (Y - N) Effective 11/1/02 Plan Review Process Work Book Page -8-Revised 4/28/04