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03040016CITY OF CUPERTINO �d��AR� .., f'h'•,, BUILDING DIVISION PERMIT BUILDING ADDRESS: PERMIT N0. 10172 FIRWOOD DR LENTZ CONSTRUCTION INC, J 03040016 OWNER'S NAME: HOLBORN HARRY 5087 MAITLAND DR PERMITLSUEDATE 04/02/2003 (408)264-0555 SANITARY NO. CONTROL NO. ARCHnECUENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION 1 hereby allow)fNet 1 Ann licensed! undo sA of Chapter 9 (cmrnmcn Job Description ud Prof a is Section ]gp)p(DIVWon)o((NCB 'n am Rofeedms Code. end mYlksrrms / I. full forts sod r1fe- I. I.kmse Class Date on . �� C-'"' S — 'wStI�I£aTj117.&IbTCHEN SKYLIGHT (3'X3') ARCHITECi'SD ON 0,! 1►r.16.C1.ai ant 1 a my Pw. shell W ant reeam APR 0 8 2003 Licensed Professional OWNER -BUILDER DECLARATION 1N i barely affirm Net 1 m law for UI eBusin from Ne feantrattoo L li Code: Anse Any city or county ](B 15, Buelect. following moon. IS.it Pa. 1 h.omem alter. Improve. demolish. , m in dem sig any, with rcqulres a permit ro cones, BUILDING On e a tat ! priorut its Wuana.dmnpuims Prevision for such ommucitto OleanLnedCwcmem that hmutin of the Sq. FL Floor Area Valuation (commenringwiNStetion7000)ofDivision 3oftheBusinessamApfuaionaCause) Or $1875 ! that he is exempt Nertfrom and One bels for Na Mlcgcd ea suplloe, Any violation of Section 7051.5 by any applicant for a permit objects NC appllCNl As A CMI Penally Of pK I,1}j0.�er• Occupancy Type not short Nen f.w hundred dollan(SSOOL l.i `�L-� O O ❑ tuowner Of Ne propeny,m mY employees with mjucotirelr tole compewtion, will do On .6. and Ne eWnum Is rpt Intended or offered fa ... 1. (SIG. ]DW. Bull.. And Professions Code: The Convacwh Liaise Law does not Apply w an owner of 101 - FOUND.$Tq1Db10 Inspections property whobuilds or implores Neman, And whodaessuch worichimvlforthrougn his 102 - PIERS .?,employ.. provided Nat ouch Immeurt m pmvenanot intended offered forcole. If, howear,Ne bulldingor lmprovememis Cold wildnoneyear ofeompledon. Ocowner. 103 — UFER 4�'a will have the burden of proving Nat rte did not wild or impmm fa purpose of 104 — REBAR D 1, as Owner of the property. Am exclusively contracting with licensed contractors to 105 — ANCHOR BOLTS corutmn the protect (Sec. TOW, Business and Profusions Code:) The Convolutes U. carmen law dote not apply to An owner of property who wilds or Improves thereon. And 106 - SEWER & WATER who contracts for such project.witha�n"clortg licensed pursuant an the Comtittees usenm law. 202 - UNDERFLOOR PLUMBING 01em.a P See BCfa this ..a203 - UNDERFLOOR MECHANICAL °�%•@�If(/+�� 204 - UNDERFLOOR FRAME 205 - UNDERFLOOR INSULATION WORKERS COMPENSATION DSC6AILATION hereby �m under penally of perjury one of the following dalatationa: 301 - ROUGH PLUMBING Wl .ndwmm.inwnAewBamofComenttoself-ImneI.Wergee.Coman. . n pmvidm for by Sawn 3700 of the labor Cade. for On performance of the 302 - TUB & OR SHOWER went for which Nis permit Is issued. 303 - ROUGH MECHANICAL D 1 hers and will maintain Worker's Compensation Inam.na. a m,uimd by seNan 304 - ROUGH ELECTRICAL 37M of Ne "Wr Code. for the performance of Ne wpt for which this parnmit is Wutd. too t Compenaatim Insurance curia and Policy numbs art: 305 — FRAME Grri 306 - HOLDOWNS CFRfIFl COMPENSATION ATIONI NFRANCE ERS' COMPENSATION INSURANCE 307 - INSULATION 011baemam need not wcomple"9 Or Permit is fame hundred dollars (SIM) 308 - SHEETROCK ate"') 309 - EXTERIOR LATH 1 anify that In the perfnrm.na of tha won for which this permit te bound, I shall MA 310 — INTERIOR LATH employ Any Perron in any manner ao As A, become subject to thewpAxts' Compensation laws of C.Himor ia. Dep 311 — SCRATCH COAT Applicant 313 - ROOF NAIL NOTICE TO APo W you should After senting this Grtons the Worker' of Labor nprmiit Provisions of dmtawr Code. most bcGmmeSubject h copy it workers Coons in Oil oNwiNamPlywwCONSMch iCTIONENDIitAGENmcmedmoted. 501 - FINAL ELECTRICAL ENERGY 502 - FINAL PLUMBING ENERGY CONSm1.A c ONLENDLNOAOENCY 1 heresy e(finn Net there IC • ronumcvnn tending Agcnry far On performums of 503 - FINAL MECHANICAL ENERGY the wort for which Oil pnrmlt is Wood (Sec. 3097. Cw. C.) Lader's Name 504 - FINAL BUILDING ENERGY 505 - FINAL ELECTRICAL LenaeesAddress 1 certify Net 1 have reed this Application And Souse that dm atom Information is 5 0 6 - GAS TEST comes. I agree to comply with All city and county ONin.mss and state laws relating to building construction. and hereby authorize rePato xuladws of this city enter upon On S 7 - FINAL PLUMBING anew -mentioned property for Inspection purposes AL F I L MECtII (We) agree to cove, indemnify and kith hay an tion City of Cupcnino e) Srcngcosvande nifyAswhkhmginenywq¢aaagainslmigaii,, j Ilabilides in id Citl FI i in consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT SO Issued by:5% Date RCE REGULATIONS, n S" e -•' c ---' '59'){'J' Re -roofs ignalua of App1iclumCOntraCtor Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will On, applicant or future wilding occupant pore or candle h.rardDos material As defined by use Cupenino Municipal Code. Ch.p c, 9.11• W the Health and Safety Cmc, section 25531(.)? C] yes All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building excupam use aqulpment or dcvism which If a roof is installed without first obtaining an inspection, I agree to remove a'rardnte it contaminants co defined by the Bay Arta Air Quality Management ittT all new materials for inspection. Dyes Ihaveouselthehucall ws materialsre uiremewunder. Clupter6.95ofthe Uifor. nu H.I" SafctyCode. Saves 2550.15533 uv125534.1 umtismm thniftw wilding don rat currently Nae a knesm, Nat it IS my tupomibillty m mtify On occupnnt a the uirtmcns which muss w sect prio WofaCifte O Signature ofApplicant Date ✓a qw� All roof coverings to be Class "B" or better Owner orautham<d.gent Yate 0 De Anza Oaks Homeowners Association itectural NAME OF OWNER ADDRESSOFHOME: �Cl�% _ �^ %�i✓/�d�j ��>2/(/!� UNIT#tl) F'6 TELEPHONE NUMBERS GENERAL DESCRIPTION OF PROPOSED WORK: I hold 0 2 5 CONDITIONS OF APPROVAL: 1 Applicant understands and agrees that this Application does not fulfill all of the conditions and requirements for an approval. In addition to this completed "Architectural Application" form, the applicant must submit to the Architectural Committee drawings and specifications showing the nature, kind, shape, height, materials and locations of the proposed architectural alteration. The submission must be in writing. The Architectural Committee may require additional information as it deems necessary to make a decision. Until all information is submitted to the committee, the application will be deemed to be incomplete and the application will stand disapproved. Applicant further understands and agrees that in the event that the modification is approved by the Committee that they may impose "Special Conditions" of construction and maintenance on the approval of the Application. Any special conditions shall be attached and be a part of the approval. Any deviation from the approved plans, specifications or special conditions will cause the permit to automatically terminate and become null and void. Applicant understands •and agrees that if applicant fails to conform to each requirement then applicant authorizes De Anza Oaks Homeowners Association to have the work brought into conformance with approved plans, specifications and special conditions. Applicant further understands and agre tha 1 g�sincurred by the Association as a result of bringing said work into compliance will be a personal obli ration �Pthe'�ovTter' Such costs shall include the costs of construction, reconstruction, administrpfees',Ranotne'lf�,rip&&afid consultants charges, and court costs, if incurred. It is also agreed that no work Tidi (lg tie ' i ' ed k 8t111111EMiolation of any of the provisions of the Association's Declaration of Covenants Condit' tri s or any applicable building code. (2) be an annoyance to any resident; or (3) increaseiRe costm. . ..09: v_tite.Association. It is further agreed that Inithe;eve t; p icatiopcisiapprowyed all maintenance, repair or replacement of the approved item will be the sole responsibility ,thealot ow{ter; pnddfurthnr,that any expense incurred by the Association that is the director indirect result df;the ipproygd chapgeoliall alsoubeoe;sole responsibility of lawwwtc . lk9pwo ee�I¢?��% initiated with consideratiomofthe�terrain;tslgpe, estheticds#time and noise considerations ?I? I UI 1( the building Dept., City of Cuperprt9, �jl �UJLUfiJ �j Applicant understands that allinecessary.;permitsiattd approvalstfrom applicable governmental jurisdictions are the sole responsibility of the applicant and tharComm itteeiepproval of this application is subject to the applicant receiving all such necessary permits 3nd(apprd%;@s.vWalk" of a*)( pwootu 4 any City Ordimom Ev 9Ae KAW. Applicant agrees to use licensed and insured contractors for any and all installations or to make the Architectural Committee aware when this is the exception. Applicant agrees to notify the Architectural Committee upon completion of the project so the Committee may inspect and determine compliance with each and all of the conditions of approval of the application. THE UNDERSIGNED AGREES TO THE ABOVE CONDITIONS M • Homeowner's SignaVe 1 Approved \� Denied ucapp.doc CURB MOUNT INSULATED GLASS SKYLIGHTS SPECIFICATIONS: Curb Mount Glass Skylights shall be Model No—, as manufactured b, HPK, INC. of Phoenix, Arizona. The skylights shall be factory assembled u made by HPK, INC. are available in either Single -Glazed or Dual -Glazed. 5 5 ) skylight units come with 1/4" Laminated Safety Glass with a .030 liner. Dual Gla are manufactured with 1" insulated glass. All insulated units have 1/4" Tem ere outer glesms 1/2" air space and a 1/4" Laminated inner piece of glass. These units are als de with a breather tube installed to allow for differences in air pressures. Glass is avai Bronze, Clear, or Gray. The skylight frame and retainer cap shall be 6035T5 extruded aluminum with a minimum wall thickness of .062 inches. The skylight frame shall have an integral evaporative condensation gutter, exterior drip and drainage slots. The glass skylights are also available In a SELF -FLASHING style frame per request. 7N' 11T W 1vY ., 4 r P c N rI Ma g?. 95e' _ Io o 'A $ • rd . w. Fi Sfi BY� 9 0 w ' ^ CqnfllSm Y� A O O _ s B e o: M WD r ry y P?3"8�;� ..tee sg y O � 7 Y 3 fq Y M 5 0' n��ogS gS0 E A L �N � ' o c io'g43r'u� O r P c N rI Ma g?. 95e' _ Io o 'A $ • rd . w. Fi Sfi BY� 9 0 w Skylight Framing Detail Roof Framing Around Openings • Headers with a span exceeding 4' must be framed with trimmers and header rafters that are doubled or of lumber of equivalent cross-section. • The ends of header rafters more than 6' in length shall be supported by framing anchors or rafter hangers unless the rafters bear on a beam, partition or wall. Load-bearing wall or beam Double headers - when span exceeds 4 feet �_ Tail rafters Width Length 2 2003 Double trimmer rafters ce,uOy -30'sis when header span exceeds 4 feet Rafter Wall or foundation II� Rmd,APony. CITY OF • CUPEkTINO *rY OF CUPERTINO 0 PERMIT APPLICATION FORM 63-�4 &--°i4 Quantity Fee ID APN # Date: BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Building Address: BUILDING jo/72 Boiler <= 100,000 Btu Owner's Name: Phone #: Boiler > 100K to 500K Btu ,/f)rn 6 0/2/) Y 71 Boiler> 500K to 1M Btu Contractor: 7License #: Boiler > 1M to 1.75 M Btu T. LLETZ L'�✓I57- //)C 4-156 rY/lo Boiler > 1.75M Btu Contact: Cupertino Business License#: Construction Tax 4-e;--)72 /S 763 Ind/Off/Comm/Quasi Building,) rmit Irifo: BCONSTAXBQ Con. Tax for BQ Zone BUILDING Bldg Q Elect ❑ Plumb ❑ Mech ❑ Hotel and Motel Job De ption: (, BCONSTAXR i ential ❑x sr`s,ra�� 3'x31 It Tc 2n sl itc N, Commercial ❑ BUILDING Sq.Ft. Floor Area: Cc��c� v�) $/Sq.Ft.: ELECTRICAL 9 Elec 600V > 1000A ELECTRICAL Cost of Project: Occupancy Group: _Z ELECTRICAL BENERGY Energy BUILDING Type of Const ction: Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 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 EEO Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING lof3 iE tTY OF CUPERTINO CITY OF „ PERMIT APPLICATION FnRM 2 of 3 Quantity Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi -Family Res MECHANICAL BMNEWSF&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 BP13ACKFLOW 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 j BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING imp BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Stonn/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pipe PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 clip MECHANICAL BREMAIRHAN A/C Units <=10,000 cfin MECHANICAL BREMAPPLI A liance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Li htin Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL is BREMFURNOV Relo Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc A aratus ELECTRICAL �BREMNRAPP Rem Non -Res A liance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2 of 3 Im as CITY of CUPEI,TINO • CITY OF CUPERTI�O PERMIT APPLICATION FORM n 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 Sips 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 BSPECLU 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