06050056 CITY OF CUPERTINO �'°•'� ` ^w..i.�*.^T-
C
'BUILDING DIVISION PERMIT CL1rN AC 'QIt INFU, tMA,TIQN,Pf
BUILDING ADDRESS: PYRAMID REMODELING PERMIT ND.060500 S6
22998 CRICKET HILL RD
OWNER'S NAME: PERMIT ISSUE DATE
KIRSTEN ESPE 4617 BLUE RIDGE DR 05/08/2006
ONE: SANITARY NO. CONTROL NO.
(408) 252-1052
ARCHITECTADIGINEER: BUILDING PERMIT INFO
BLDG ELECT PLIIMB MECH
I�p
LICENSED CONfRACTOR'SDECLARATION JobDescrlP
Description
I Division
hcseby arRrm that I am licensed under provisions of Chapter 9(commencing
M Suction 70(10)of Dlvon 3ofde Bualneu and Proleuwns Cade.Nd my Beene is
+� in full roeean!affal BATHROOM REMODEL. RELOCATE VANITY & LIGHT FIXTU
• Z License ClassLac.g qqq Date Contractor AND CEILING FAN
3 ARCHITECTS DECLARATION
I I understand my plana shall be used u public retard,
c Limited Pmfevdanal
d that I M-BUILDER DECLARATION
1 hereby mrso .(SSeen that I am aurin fax the CanwnCoLicense: c Law for site
p o following moon.permit
1 n131d,Business and se.4conll Cala:Any city or county
S$ which equirm a permit re mires tact alter,Improve,h Permit
ore A Sig and swaare
-iy priorwits iuuanco.auu sequitur tieapplicut for wchpermr tofmareLa (Clumem112000
<
that heHlimnsedPurwenttothcofDWisioofdeContactor,Usnsclaw(CluPter9 Sq.Ft.Floor Area Valu
pq $ (commeneing with Scedom7000)m Division Sarthe Busineuend Profeulans Grain)or
e - that he is exempt therefrom and the basis for the alleged ademption.Any violation of ppppm� h
Sends 7031.5 by airy applicant for a permit actions,the app0mdl M•civil Faulty of 3 4N N of 0 0 Occupancy Type
an mare than five hmdsd dollies ISM
❑1,u ownu of die propmy.m my wployen wW nim u theh wleeompenudon,
will do the work.and the nwclure 1,ant intended aaffeem formic,(Sm.7W.Bmweu Required Inspections
and Profesdam Cade:The Contractor',License law dam not apply to in owner of q p
property who buildsor Impmlesthereon,and whoda ssuchwak himaelfarllwukh his
own emplayme,provided that inch improvements are nminended ornReed lunatic.if. p
bhowever.
lder will have Ne hard.rar Frovement is of proving thatbanan�bund or Immppmw far purpose of I L
ask.).
1,u ander of the property am exclusively comm cling with licenced camsecton w
construct the project(See.7044.Business and Professions Cade)The Comactors U. p U`
canoe law don amt appy to an owner of propvsy,who,builds m improves answer.red, H u i' 10 6
who contracts for aitch pajama with a mnuamods)limited pursuant w the canuanur,
O^
Lkensa Law. ft All
❑1 am exempt under See B A P C for this moon
Owner /</—,WORKERS COMPFNS TION BUIL
D. �
1 hereby affirmaffirmunder penalty of perjury aro of the fallowing declaration:
❑I have and will malnW n a CeniOnto a/Consent to elf-Wore for WarkerICampen-
aauon.as provided for by Section 3700 of the labor Code.fa Me parfonn.of One
wad,for which Nis permit is isma d.
❑I have and will maintain Warkoes Compense0on friends,as mqulmd by Section
37M of the labor Cade.for the performance of the work far which this permit is Wind.
My Warker,CampensWen lours carrier and Policy number am:
Carrico Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
v
(ThesseNm sW not ho completed If the permit ufaronchundmAdalWs($100)
or lms)
I anify that in the performance of the work for which this permit B Iumd,I NJI nor
employ anypersen In any manner w u to become rv!,Jem a oCompcon
Laws of California.own •O G
don
Applicant
NOTICE TO APPLICANT:If, net making this CeniRm¢of EsmpOun,you should
became subject he the Wolteh Compensadon provision of the labor Code-you amu
Z forthwith comply with such provisions or this permit shall be deemed rooked.
,Z.mO CONSTRUCTION LENDING AGENCY
[-i IAcahyaDUmthatthem u a construction lending agency for de performance of
p: > the wed,for which Lida permit u issued ism.3097.Civ.C.) -
a Q Lenders Name
]2 lander,Addmst
U0 1 ramify Nat I have read this application and rote that the show informadn t is
comm.I airs In comply with all city Lid county eminence,and rote laws missing to
�U
Wilding construction,and hereby suthade npnsenutivu of this city to enwr upon the
above-menduacd pmpcny for impaction purposes.
(We)agree to save.indemnify Lid kmp harmlee the City of Cupertino against
mf".m Cn liabilities judgments.ensu and apenua Which may In try toy accrue against said City
U Z in APPLICANT UNDERSTANDS ANof this D WILL COMPLY WITH ALL NON-POINT Issued by: Date
IL
SOUR�nEGULATI
!`C�_ nom
'Y'-6 -0c Re-roofs ��-
Signuum afApplimn/Conuu es, Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or fetus Wilding omuputuare orh+mdle hazardous material
as de0nod by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety
41 Cade,Sued.35532(a)7 All roofs shall be inspected prior to any roofing material being installed.
Oyer Me
Will the applicant of Tutee Wilding occupant use equipment or @vias which If a roof is installed without first obtaining an inspection,I agree to remove
emit huum us Jr contaminants u dented by On,Bay Area Air Quality Management all new materials for inspection.
Martel?
Yes
I haw mad Ne huamawmmdaumquimroenu un@rCluper6.95 orthe Calitw-
nia Realthd:SarctyCade,Swiau35S05,25533md25534.Iuedeatsadthat Ude building
dace not currently have a¢rant that It Is my esponsihiliry he notify the Occupant of the
requiemcns which mum be ma pyprwu,uammafa certificate ol;cu 0y. Signature of Applicant Date
L+-- o •b -o C
Owner a authorized Zen, Date All roof coverings to be Class'B"or better
'
Community Development
10300 Torre Avenue
aClOF
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408)777-3333
OUPEkTINO
Building Department
JOB ADDRESS: 2 2 9 9$ X at- PERMIT#
r19- Sep66-ro0
OWNER'S NAME: X,'rscc, c'S c PHONE # 'loo- Yyr 3ro2
GENERAL CONTRACTOR (6 ems,�!a FAX # SS 1,c
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
/Ii e /Is C-cnpp GSP� / f a ��! 7;� SYZ ' 7'/_ OP Y- C (
'95
; CFi`UET�
• MAY 0 81006
F—la,u'/ VVe SGI.OwC'—
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.J�.f. t "C
J `9 IN ACCORDANCE WITH THE CITY 1
UPERTINO CODES AND ORDINANCE:
E S^-
L '!
f y it( NED
Th s set of plans and specifications MUS I 10E
oe kept on the job at all times and it is w 0
lav ful to make any changes or alteration
)n same without written permission iron
he building Dept., City of Cupertino.
rhe stamping of this plan and specification!
;H LL NOT be held to pe mitto be v'• o roval of the violation of any p 1sion•
v rf1,. n tl n•,n'n - ser 1 Pw
r� r /'s Ze --) L= Sel- do Y- CG C>
• 2 � 9 5' 8 Com, �/cam.- /�,-�, /�f r�
:cC1TIVED
MAY U 8 2006
�/a cu.�!' ��l" Show c•_
fv "y '
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C D I
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ASSESSOR COPY L
ly ui i ctn
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CITY OF CUPERTINO
•em 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34241004 . 00
DATE ISSUED. . . . . . . : 05/08/2006
RECEIPT # . . . . . . . . . : 34288
REFERENCE ID # . . . : 06050056
SITE ADDRESS . . . . . : 22998 CRICKET HILL RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KIRSTEN ESPE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2639
RECEIVED FROM . . . . : KIRSTEN ESPE
CONTRACTOR . . . . . . . : ALBE TREMBLAY LIC # 23497
COMPANY . . . . . . . . . . : PYRAMID REMODELING
ADDRESS . . . . . . . . . . : 4617 BLUE RIDGE DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95129
TELEPHONE . . . . . . . . : (408) 252-1052
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 12, 000 . 00 191 . 16 0 . 00 191 . 16 0 . 00
BREMFIXT NO. FIXTURES 2 . 00 2 .40 0 . 00 2 .40 0 . 00
BREMRECEPT NO. OUTLETS 3 . 00 3 . 60 0 . 00 3 . 60 0 . 00
BENERGY PERMIT FEE 191 . 16 91 . 76 0 . 00 91 . 76 0 . 00
BREMVENFAN NO UNITS 1 . 00 45 . 39 0 . 00 45 . 39 0 . 00
PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
BSEISMICRE VALUATION 12, 000 . 00 1 . 20 0 . 00 1 . 20 0 . 00
EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
MPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 450 . 62 0 . 00 450 . 62 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 450 . 62 2333
TOTAL RECEIPT 450 . 62
•
CITY OF CUPERTINO O O� I�.(�
l CUPEI�TINO PERMIT APPLICATION FORM
APN# 3� I, +1 _ O O q Date: 5140 1 o „
Building Address: 2 ZS4$ er, mak« H y R Mailing Address (if different from building address):
Owner's Name: V Phone#:
5'0 0, Svc 3 / o Z
Contractor: A �6 c 6 lGr License#: 7 2 Q
Contact: // / P 4,,v c 9 `.3 Z Cupertino Business License#:
S2 /<)S- 2
Building Permit Info: v�4 C 4 r 0 C'h P C H, u C C� �c /o C q N, ti p +•'�� r
Bldg ❑ Elect Plumb
Job Description:
Residential ❑ Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: �� vc� Occupancy C�roup:3
Type of Construction: Please check this box if the project is a
4; second-story addition: ❑
ro'ect 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 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
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CITY OF CUPERTINO
CUPE�TF PERMIT APPLICATION FORM
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 Pb1g 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
BRENLkU HAN 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 Fumace> 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 •
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9i'1- CITY OF CUPERTINO
CUP
EI�TINO PERMIT APPLICATION FORM
QuantityFee 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
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Chane I BUILDING
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