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06050132 CITY OF CUPERTINO BUILDING 61VISION PERMIT b, Q R� 1'�1, QR�+IATION«� BUILDING ADDRESS: PAUL TAKACSI & KAISA HOL Mrr NO'06050132 10553 FARALLONE DR OWNER'S NAME: PERMITLSSUEDATE PAUL TAKACSI & KAISA HOL 05/16/2006 ONE: SANITARY NO. CONTROL NO. ARCHRECl/ENGINEER: BUILDING PERMrr INFO BLDG O PLO MEOCH ±op LICENSED CONIRACrORS DECLARATION Job Description RHI I hereby affum Nat 1 am liaenvd under provisions or Clop co g(commmem, p INSection7")or Division Joftho Busin and Rnfeanom Cndc.andmylkenseb isrmlto=awefren RE-TILING SHOWER PAN AND REPLACING VANITY & SIN j Z License Clues lJe.N .2— Dam tr Le.# .-Contractor fyt•az vss ADDITIONAL LIGHTING FIXTURE 3 ARCHMICf'S DECLARATION AMERICON PAID FOR BL 5/16/06 IS THE ONLY CONTRA I I underatanJ my plain Mall he used u public ranrJs e and Licensed Professional b OWNER BUILDER m ft Commences ON I Wmhy.(See w 1 1. exempt from Nc Cssions o :My Law for ft county p O following moon.(Saito 7031.5. t,Waess and improve. de nn Code:My city m roomy whkh requires a perms ro romwc4 atter,improv,de ermit t m mash any structure iy Priemiuiensedpatanntus ft Neasion o far Cosuch Penvu LNoasigned summcm g (men he is commecinuithSeuan37030)ofDivision3oftCamfacros'andPralaW(Gapte9 Sq.Ft. Floor Area Valuation p $ (commencing with Section at And of Division 3 car al eged auontl Prafas 0 HoonCode)or $4000 e Natio u 31..b themfmm and the baa4 far the alleged eaemgion Any rioudm of Section Lim 1 by wry)replicons fon pewiuubjecu the aoplmam ro•civil penalty of APN Number Occupancy Type nm roam Nan five hundred dollua(SSOOk ❑I,emvmr of uie ptopn[y,amy wployw with wgesu Ne'v sale rompewdon, willdo thtru e woL and the scture uma nmmndod offoad rmuk(Sec.7044.Bar. Required Inspections and Profession Cade The Conua)wss 7070 Ya License law do3 apply an owner or q p Property who Wildsaiceprowa thermn,am who daessuchwak hivurJfor througnhis howemployen,progor improvements Nmsuehimpmwmenuwne year dedorocow.ffered fur salol(. '® ® qh ref howewn the aw th Bordenofproving within of year afrorvpkum.the owner• eRvE■�//MraL build)will naw the When of proving thn he aid 703 W31tl w improve far purpose ar sak.l. CU ❑1.As caner a the Property.am=CWd"IY conuacting with IlavaW roreamarr to contmn the pmjca(Sec.7044.Business and Professions,Code)The Conuaemts Li. J1 1N 91 t1 uLg006 armed Law m r law donot apply an oweor property who Wilds or Improves themtn,and, VV T who contncu for trach pmjeeta with a eonuanof(s)licensed pursuant 70 the Conuaemfa ' Lice law. BUILDING a /7�y aa� ❑Iemnemptuntle Sea .BAPCfor Nisocum LfY■T®_/■��� Owner Dam U WORKERS COMPENSATION DECLARATION 1 hereby alarm under penity,of perjury am of t m following daluadom; I haw and will maintain aCeNfieate of Contact he aelf•Insum for Wormys Camper- utian,u provided for by Suction 3700 of and labor Cade,far that performance of Ne work for which this permit is issued. ❑1 naw aM will maintain Worker's Compensation Inunnce.u required by Section 370Daf the Labor Cade,fa the performance of the wart forwhkh Nu permit Is Issued. My Worker's Compensation Ina nsuree carrier and Policy number am: Cartier.F Y ��� Polity No.: %A&—OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (Thu section need not be completed if Ne permit is farom hu r oBan(3100) or kat) 1 arury Nm In NC puf c w k fa bleb 3 pe it ue41 slWl oat employ anYPcmon' an W o osubl 33 3 Wa YCompenuuon Lawn of Califs V AlmI r NOIiCE TO AP CANI`.I( Trot making Nu iRcam of Fa pan ,you ahold me cut lect Ne worker's Comp)nNan iaJo u ar the Code,you moil ,JO forthwith comply with such provision a Nu pernitrholl W revokod. ,z., s~�+ CONSTRUCrION LENDING AGENCY Ehereby affirm that Nem us,conation kndmS agency for the performame of . E4 > No work for which this permit•4 issued(Sue.3097,Civ.C.) a0 tendert Name 7 z Under's Address U Q I anifY that I Mw read this application and sum that the above Inforradun is {3.F correct.l agree As comply with all city and county mUl upas and sum laws relating to _ Q U buiidingconawction and hereby authorize representatives of Nis city to enter upon tho 0. above-mentioned p pen far inspeedon Purpoms (We)Agree .indemnify aM krep harm) City of Cupertino againt tF—t H liablliunjudgmo u, u and expenses which y y yeccroc PC All- U z in cornrgmme ranting of this perm it ^� APPLICANT N STAND AND W P WITH AL NON OIM Issued by: Date — r(-p SOUR ONS. Re-roofs �—� Sigma a ppll 'tlConu r xAZorf US MATERIAL Type of Roof u the a Copect m come building aavpanluom ams1 t e h ealdh a mamrtal sa ticOmd by tiro Cupenlne Muctcipal Cadc.Chapter 9.@.aM the HnIN anJ Str(esy Com.Semon 25733(x)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes tltl No Will Na applicant or future Wilding occupant net equipment or devices whim If a roof is installed without first obtaining an inspection,I agree to remove emn huardous air canumimnu u de0nct!by Ne Bay Area Air Quality Management all new materials for inspection. District? ❑Yes N Ihaw mM a rdunmemriabrequim n r After of the URfao nu Health ASafn ,Sacam 3,2533 .I thwiflo Wilding doe not cu cat h a inn 4 It u my any mufy ane up t of the mgmmmn win aux t runiss a to at of Signature of Applicant Date Own tar tharbcdgcm Dam' All roof coverings to be Class "B"or better Community Development 10300 Torre Avenue i. Cupertino CA 95014 I Telephone(408) 777-3228 CITY OF Fax(408)777-3333 WUPEkTINO Building Department JOB ADDRESS: PERMIT# OWNER'S NAME: I PHONE # y •2:-1 GENERAL CONTRA OR: PtsF # yb% .Gc?I _ 8(Q\ I am not using any subcontractors: 5 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 • /t75S3 I-AieA1- ,kjC Dx . CUaozrun OJA qZ7. N �kIST'i7J G i�ra7A1213Uf°l IkAb �JewaZ rll �j rar_k£T 0 APPROVED- N A ORDANCE WITH THE CITY 01 o CUP INO CODES AND ORDINANCES ° -copy )ATE;IGNEI . This s of pians and specifications MU 41 oe ke on the lob at all times and it is u IayAul make any Gha^;es or atteratio on Sal without written permission iron. he b ing D,Qpt„ City Qf Cupertino. The s pittg Qt thls plan and sor ifi aeons ns �j ;HAI ,NQ G@ h@.d to rw,srons &—DpmM pgJQ @>f tt1@ yi�Hon of any V a 0 9�ratYce or Mate law. —� �J A73J26D t1 ���- T'f L� • �. r� sdowfl2 P>J 11)65 Z P ARALLLIVE 3k. L+�Erzs^ruo , CA 9SDry 3. rsFz kb(4- 4 user rom&E gbou�s+l�wft2 _ Jam. XI�W SNUWo- YAUC�r' Po�s£� I�pnJkavr� (, ;U�„v S,n,x rra ue�r- . El�l�_6eCl�N!C�r . 1-� IdP K�xNcE.s s�us� TI-Ec. PAS 2 D21]I ti( 0 I:L • {�, i'DL'K£T �6llY �L�,ODN GFS ,l�E'AR6D>1 n /Q553 FA-A? LLL-i, E • Cu 2� sxrn O-A q,576)4 L�LIS7'/ tl G 8,mT—Al2 -Dm �n u I r�btymr ; ss IL o OA, ,Q�DR111)1�1 • �. T/-LE S40wo� Pu Cl)4cszrim D CS"Dvq 3. Cc F= kb(C- y L16gr Fixnpr Abba£311DW£F2 g, Vtw ,S)�bwfr P��r,aet� ►�t�rtJkm�r� _ (,. 1U�,� S,ux r�aue�-. L, 1T F,x,�,tEs �uanp ' a"-gxeccea TnEZ PA" TOILET" RL ' 2 DRpI rJ oUu • YLK'K£T �dl1k` GFI A.7E7JR6U M CITY OF CUPERTINO !m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36939034 . 00 DATE ISSUED. . . . . . . : 05/16/2006 RECEIPT #. . . . . . • • . : 34423 REFERENCE ID # . . . : 06050132 SITE ADDRESS . . . . . : 10553 FARALLONE DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : PAUL TAKACSI & KAISA HOLMAN ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : AMERICON CONSTRUCT. CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : PAUL TAKACSI & KAISA HOLMAN ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : 4kEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 4 , 000 . 00 104 . 76 0 . 00 104 . 76 0 . 00 BPLANCHK PERMIT FEE 104 . 76 139 . 80 0 . 00 139 . 80 0 . 00 BENERGY PERMIT FEE 104 . 76 50 . 28 0 . 00 50 . 28 0 . 00 BREMFIXT NO. FIXTURES 6 . 00 7 . 20 0 . 00 7 . 20 0 . 00 BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00 BREMRECEPT NO. OUTLETS 3 . 00 3 . 60 0 . 00 3 . 60 0 . 00 BSEISMICRE VALUATION 4 , 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 411 . 14 0 . 00 411. 14 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 411 . 14 2104 TOTAL RECEIPT 411 . 14 • CITY OF CUPERTINO Q(�Qj013 2- OF PERMIT APPLICATION FORM CUPERTINO FLPN# -?-.) 5cl- p'� Date: INI 14Y 16 , 0L Uvto Building Address: Mailing Address (if different from building address): 1 f)5- 141 o sw ,Owner's Name: Phone#: L T l ISA YUAN Contr torr t eM P License#: ":&1 $ D Y Co act: Phone: Cupertino Business License#: YL 1l.lY Fax:--4n-;n I-(>2tv I ( Building Permit Info: �Rit:w 6 -s*bwoz 1%,K1 Av.lA U,EQ1.aC' A(s V A W-r4 -t S1*1�4 A'�a�ttoNAL Llkrrifi�Nk c'ixrUvr. Bldg ❑ Elect $1 Plumb [RJ Mech ❑ Job Description: Residential [9 Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: t I ' �� Occupary Gr3oup: ^�> IL Type of Construction: — Please check this box if the project is a Ih waow oz. V-A-TILS -6)-MWE l5econd-storyaddition: ❑ ro'ect Size: StandazdX Laze ❑ 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> IM 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 1 of 3 CITY OF CUPERTINO CUPEf�TINO PERMIT APPLICATION FORM uanti 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 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 din 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 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 ` W1R0F CITY OF CUPERTINO CUPPERMIT APPLICATION FORM uantity Fee 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 Inspection BUILDING BSWIM Swirruning 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 I Address Chan e BUILDING 3 of 3