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03040027
I CITY OF CUPERTINO BUILDING DIVISION PERMIT �e CONTRACTOR INF09MAxION BUILDING ADDRESS: PERMIT NO. 884 FERNGROVE DR VANNI BROTHERS CONSTRUCTI N 03040027 OWNER'S NAME: PERMIT ISSUE DATE t FALK ALAN L AND CLAUDIA M 914 HYDE AVE 04/04/2003 (408) 253-7028 SANITARY NO. CONTROL N0. ARCHIECDENGINEER: BUILDING PERMIT INFO BI.DO ELECT PLUMB MECH oo LICENSED licensdunderSDECLARATION m Iism")Bnnwtl,mutteBdinssAndPsimmonsCda.chapter 9(wmmendng Job Description with Scotism7") Sof the Business end Profession Codw.and mylicense 8 9=01 ll �! P =0 m rm1 came arta Affect. Il� B�:]ds� ipz UmnscClass tie." INSTALL BEDRM WINDOW F Dasscontractor ARCHITECTS DECLARATION APR 2 8 2003 Ny 1 understand my plans shit W used u public records o Licented Profepional OWNER-BUILDER DECLARATION BUILDING I III1..©'pg/� HOS I hcmhy affirm that I Bm exempt from me CommmorVs Limn.Law far[be g H G i pm O following reason.(Section 7031.5,Busln"s and Pmfessiom Code:Any city or county _ which requires•permit to construct.slier.Minnow,dcanot h,Or repair any structure FZY prior m its issuance,also requires the applicant for such Permit to file a signed statement p < DmtneianccnrApmusu.mmNeproakensofineContractor'sU..Law(Chapter9 Sq.Ft. Floor Area Va a Lon y $ (commencing with Section 7")ofDivision 3ofthe Business and Professions Cam)or $1 Nat he is exempt thmefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by stay applicant for a Permit subjects the applicant to a civil penalty of 3pf �T t r 0 0 Oane not more than me hundred dollars(M). ceu P Y.ZYPe ❑I.u owner of the pmpmy,m my employca with wag"u reek wle eompenadon, will do the work end the wuaum is not intended or offered(mule(Sec.7044,11"mace. Audi Prssi feom Code:The Comrwwre"•s LtLaw does MI apply m an owmt of 101 - FOUNDM(Tt(I W Inspections prpenywwbuilds or Mprvesthermn.and whodoessuch work himselfm through his 102 - PIERS own employees,proaided matsuch improvements are not intended moRcmd fmsete IL however.the Wilding or improvement is sold within one yeu ofeompleion,the owner- 103 — UFER Wi mer will herr Ne btmw of proving that he did not wild or impure for purpose of 104 — REBAR ❑1,as owner of ass property,am exclusively convecting with licensed centnmors to 105 — ANCHOR BOLTS construct the pmjem(Sec.7044 Business and Pnfucaom Code:)The Comment's Li. 106 — SEWER & WATER scrum Law docs not apply w in owner of property who wilds or impnom thereon.Aud. soh sonnets fm such prjeem with acontrsomr(q ri"mea pumu.m mNe Contnnora 202 — UNDERFLOOR PLUMBING meow lAm 203 - UNDERFLOOR MECHANICAL ez p nderS ,B&PC o moon 002 204 - UNDERFLOOR FRAME �• WORKERSDFGGR COMPENSATI NAD q 205 - UNDERFLOOR INSULATION I hereby Mmm under penalty of perjury one of the following d"laratiom: 301 - ROUGH PLUMBING wand will meinwna CertlRum ofConwntto sea-taunt mrworterscompen- 3O2 — TUB & DR SHOWER u pnNdh (pe ro Ssis 3700 of Ih labor Code,rte the performance of he 303 - ROUGH MECHANICAL work far which this perish is issued. ed. ❑1 have and will maintain Worker's Compensation Insurance,a required by Section 304 - ROUGH ELECTRICAL 37M of the tabor Code.for the perfeureanre of me work for which this permit is issued. 3O5 — FRAME My Workers Compensation insurance mother and Policy number art: Cani": Policy No.: 306 - HOLDOWNS CERTIFICATE OF EXEMPTION FROM WORKERS' 3O7 — INSULATION COMPENSATION INSURANCE massession need Out weomPmrcdiftbeFmit risrmonehundreddonars(SIBS) 308 - SHEETROCK unless') 309 EXTERIOR LATH 1 certify that In the Mrfnrman"of me work fm which this Permit is ismod.Ishit am ., 310 — INTERIOR LATH employ any person in any mAuner an as N become subject to dss Workma CempevuDon 311 — SCRATCH COAT Laws of C.lifi..m.Dam Applicant 313 - ROOF NAIL NOTICE TO APPLICANT.Work IL AfterCom making this provisions of the Labor on,you u mu15 st becowithcocmm the Workars ansn provision of Ne Laver Cnde,you must 501 - FINAL ELECTRICAL ENERGY forthwith comply with such provisina m Nis permit shall be damned reeked. Zo 502 - FINAL PLUMBING ENERGY CONSmis.c0NLENDINGAOENCY 503 - FINAL MECHANICAL ENERGY [-n Ihemhy e(frm the them CONSTRUCTION LENDING A agency for du performance of C� the work for which this permit u issued(Sm.3(197,Civ.C.) 504 - FINAL BUILDING ENERGY W�Q Under's Name az LcndersAdd. 505 - FINAL ELECTRICAL U O I certify that 1 hoc mad this application and scale that me.bow information is 506 - GAS TEST D. F comm.l agree m comply with all city and county ordimnaa and sue Is"misting 10 5 7 - F I NAL PLUMBING O V building construction.and herebyauthorim,representatives of this w enter upon me yshove-mentioned property for impenion purposes. O — F I N L MEC I CAL (we)agree m sew,indemnify and keep harmless the City of Cupertino against y Ilabilitlea,judgmenm,costs and expenses which may in any way acme against said City O9 FI U in conmquenee M the granling of thispermit. 5 NG APPLICANT UNDERSTANDS AND WI COMPLY WITH ALL NOt1;P I Issued by: Date SOURC�R ULA S. — Y _ lAjnpTllq S m°fApplicanUComrscto ay Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will th applicant or future building occupant store or handle huudous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Cotle,Scction25532(a)T All roofs shall be inspected prior to an roofing material being❑rte �"° P P Y 8 g installed. Will the applicant o r No building mcupan um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove eraNnus oiI concamin nm u defined by the Bay Arta Air Quality Management all new materials for inspection. m?❑Yrs u I have read dm harardou amwtials requirements under Chaplin 6.95 of the Califon nia Health&SarctY Code,Sation 25505,25533 and 75534.1 understand mat if the wilding dum not currently hahuman,a mnt mat it u my mapandbility m notify me occ t M omui m �uabem 'ormissgg .f 'Bcamor cupep /T/ y SignatureofApplicant Date Uomm r ad'redagent am All roof coverings to be Class mB"or better v- CITY OF CUPERTINO v 3 Z7 ` CITY OF PERMIT APPLICATION FORM CUPEkTINO WVAPN # * j J G7 Date: 4 P R 1 L Lt Z-oo7 Building Addres . IFg Y/ F��/Y r 0 Ur �' U Owner's Name: L Phone#: 14 AI e CI-A u A/* T,�-Lc� Ko 8 - ;L S 3-66 zv Contractor: License#: 'Vel-�i//V/ /312oT�E72S Contact: A4 es L- V/E' Cupertino Business License#: / 1�1X// Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job Des tion: 6 EO RaD tv Residential 4' I NfV4 Lc D Dw Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: jr /5 Occupancy Grou _ Type of Construction: e AML� ✓ I Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING 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 BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of 3 / O r � E � CITY OF CUPERTINO v ,�.- CUCITY TYOF O PERMIT APPLICATION FORM QuantityFee ID Fee Description Fee Group BMITIGATR Res. Housin Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL 13MNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMME 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 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 Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIIU AN A/C Units<= 10,000 cfm MECHANICAL BREMAPPLI A liance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Li tin 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 amCITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group 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 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 Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3