06060223 CITY OF CUPERTINOr'p° �aT '`"'- ••J
BUILDING DIVISION PERMIT ` OLt:°J:11C1� RiINF"'. d�
urns ^�, acv t . .$ext v,Ms¢3
BUILDING ADDRESS: D & D CONSTRUCTION PERRMdITNO'06060223
21075 F
OWNER'S NAME: PERMIT ISSUE DATE
GERALD PAN 1447 HAMPTON
NE: SANITARY NO. CONTROL NO.
(408) 666-5298
ARCHITECrIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
30p LICENSED CONTRACTOR'S DECLARATION lob Description
rd 1 hereby alarm that 1 an licensed under pmvidons of Chapter 9(commencing P
wM Section 700(r)of Divuion 3 of the Butin=and Profcaduns Coda.and my license Is
+� in full force,andeBea ADD TWO SKYLIGHTS TO ATTIC SPACE AND BATHROOM
Lkenx Class Late,
[e Dmc Contractor
? ARCHITECTS DECLARATION
�C I understand my plans shall be urAu public moods
�6
yC Licensed Pmfcnianal
m OWNER-BUILDER DECLARATION
I hereby.(Torn the 11. exmpt from Nc Conlnnof, :Anse taw for the
my
C CO which re wan.permit
cion 7031.3,B.then. and Proimprove.
de nuns Code:Any city o,county
to
Which RgYssa' ,penult re Coresthe alxl. Ufor su demi leis ore a sig ed Strosturestatement 1000
L-zY priormiu Issuance.also requires the applieantfar such Permit Ole uignM rooms=
< teat w u licensed pausmnl to due palons of the ConlrtetoM1 Law w(ChAmm9 Sq.Ft.Floor Area Valuation
If (commoncing with Section 70W)of Division 7of Ne Businunsand Pmin
favns Code)or
Q S.. Nat he Is ewnpt therefrom and the bub for the alleged ce mptim.Any violation of
Section 7031.3 by any applicam for a permit subjects the applicant to a civil penalty of ep Occupancy Type
not mom than Bae hundred dollars ISM
❑1,n owner of the pmpmty,a my employ=withwag=u Ihek tele wmpcwdw.
will do the worisand the aouemre lanotimunded croRared fmsak(Sm.714/.Busi=, - Required Inspections
Nd PmTCxiaN Cade:The CanVKm =r's Limmut Law doot apply m N ns owner of q P
property who builds or improves thef ren,and who does such work himsel f or duough his
own employees.provided that such improwmmta are Iwtinich ded oraRered forsale If.
however,the building or improvement is sold within ora year of cmnpktion,the owner.
builder vel Ne burden of proving Nat he did not build or Improve,for pamoem of
uk FI LC
I,u owner of dx Property,w meem ively contracting with licensed commerusa m
rooted the es Act Apply
7004,own.
of and Prof hIons Code:)The Cmvsexr'. rad
wtae law docs sot apply e an owner of property who builds of unmown Norton,and.
who Contracts for such proJecu with aeonvacmr(sHiunxd punuammNe Contractors * �]}7 La
0 l a Law. Q�',]'' l�' 2096
❑lam asempt undm See .BdPCfm Nis moon
n _f� �� Data TION r � Bw, aarvu DING
KE COMPENSATION DECLARATION �.■7�mBlr taN�L
1 hereby On m under pcvalty of perjury ane of the following dechmadons:
I have and will malmdo a Ceriffeau of Doused ro self-iuum for Went Compen-
ution,u provided for by Section 3700 of the Labor Code,for Ne performance of tix
work for which this permit Is luted.
❑1 haw and will maintain Workers Compensation Insurance,u rtquired by Section
37000(Ne labor Cade,for the Performance of the work for which this permit is Issued.
My Workers Compemulon Insurance varier and Policy number Me:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thusection need not becompleud lithe permit Is faom hundred mllais($lip)
or leu)
I certify that in the par(omlance of Ne work for which this Permit Is Mated.I shall ttm
employ any power in any manner an As an become subject to the Workers'Compemadon
lave of Cmiforma.Date
ApPlkant
NOTICE TO A LICANT.1, r making Nu CcNaou of Eacception.you shmld
become Entice,m Na Worker's ompensatian provision,of the labor Code•you mut
.J O forthwith comply with such provisions or Nu permit shall w dcmW rewhd.
CONSTRUCTION LENDING AGENCY
F Iherohy.M.Nat them lea construction lending agency for the Performance of
Ga a7 the work for which ids permit u banned!(Sec.3097.Civ.C)
�W Q Lenders Name
}z Lender,Address
U0 1 certify that i haw rad this application and sou Nat the shove information 6
it,F' earem i Agree to comply with all city and county ordlmnces and sum laws relating to
0 U building construction.and hereby authorize representatives of Nis city to enter upon Inc
r La ahnw-mcntiumed pm,,ty for inspection purposes.
G (We)agree to saw,indemnify and kap horml=the City of Cupertino against
TIF„rA liabilities,Judtmenu.cow and espenaes which may Mn any way went Against mid City
U,'Z in conaegaae or the grsnting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS,
(014- l— ' Re-roofs
Signature of I n r Dau
HAZA OUS MATERIALS DISCLOSURE Type of Roof
Will dx applicant or future building occupant pore or MMIC haurdons material
as defined by the Cupertino Municipal Code.Chapter 9.13,and dte Health and Safety
Com.Salon 25732(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yet C
Will du applicant of future wilding occupant use equipment or devl=which If a roof is installed without first obtaining an inspection,I agree to remove
mit husrdnm air motemlnsnu u=need by die Bay Aro Air Quality MUMScment all new materials for inspection.
District?
❑Yes ala
I hew cowl the Word.ttwcriaurmpiremems unc er Chapter6.9f oflhe Califor-
niaHmlth&Safety Com,SactiomriM5,25533aM25531.1u.dcmwdd if No wilding
d=oat currently have a unapt.Nat It u my reaPo will,an a olly ft occupant or dx
requirements which mut be metpmr to Issuance oft Certificate of Occupancy. Signature of Applicant Date
owne,a Norir , c DamI All roof coverings to be Class "B"or better
CITY OF CUPERTINO �a�,�� �
BUILDING DIVISION PERMIT
BUILDING ADDRESS: D & D CONSTRUCTION PERMrr"°'06060223
21075 FR D
PERMIT ISSUE DATE
OWNER'S NAME:
GERALD PAN HMPTON DR. 97
NE. SANITARY NO. CONTROL NO.
(408) 666-5298
BUILDING PERMMNFO
ARCHITECT(ENGINEER:
BLDO ELECT
O mums
O D
"a5zLICENSED CONTRACTOR'S DECLARATION Job Description
4 I Mreby M.Mat 1 am 1,anowd under Provisions of Clupmr 9(commencing
e wits Sermon TWO).(Division 3 of Me Business stud Professi...Code,andmYlicweu
inmRfore.i.deffeaL ADD TWO SKYLIGHTS TO ATTIC SPACE AND BATHROOM
Line.Clan Lie.P
'- Dam Cr
ARCHITCT'S DECLARATION
4as 0
<
Itudena.d my plansstill W need u Public-Cards
Dyu
t
4,t; Licensed Professional
`03 OWNER-BUILDER DECLARATION
N
ny Iherebymaxo affum o that 11. exempt from Me Camns Cot License Law for IW
i p O following reuan.(Saint 703 1.5,Business and aw,exroli Calc:Any city or county $1000
0 0 0
which mquima a permit to nano t eL pWr.Improve,h Permit t ore pair ed Team¢¢
m
prior mits issuance.
ensedpalwnt10 the the aisinsof forMe Contractor's
LicessLaw(Cemmam Valuation
2�5< (comm.cing itInman,to Mc or Diviem of rite aBusin ss an snttlAw(s Copmr9 Sq.Ft. Floor Area
l 0 (commencing with Section 7000)nf Division 3 o dm Business and Prefruinm Code)or
..
that he is exempt Ihemfrom and the buil for Ne alleged exemption.Any vloladdr,of
Section 7031.3 by any applicant for a permit subjects Me applicant to a civil penalty of Occupancy Type
nm more Nan five hundred dollars(SSM).
i,u owner of IW propcny.ar my employees with wag-u their sol.7W.Business
andNewark.ands: hs Commitee,LMM: affired w"fontApplysax.70 N.Bminm Required Inspections
and enywhoProfessions Code:The Committee,License Law don not apply if rt Owner Of
is
property who builds i improves thereon,and who does such work aro ffa or Nmugh his
own employees,provided Nat such improvements sac not intended ora@rcd tarsale.if. /
however,Ne building or improvement1.sold within one year of improve
for th purpose
ower-
Wild,,wit a Ne burden of proving Net M did not build or improve far purpose of
nam
a 1,as own-of me property,am exclusively contracting with licensed contractors ut /-
Construct the project(See.7044.Business IM Praferalans Cade:)The Contractor's U.
crone Law dean not apply m an owner of property who Wilds or improves Mercer,and
who contracts for such pmKcu with a cOmnecter(s)licensed pursuant to tic Conumcmes
License Law. /
❑I ma exempt under See .B d P C�far
Mu nex�mm.
Owner
' KE ' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury One of IW following dechradate
❑Ihaw and will maimminaCerefiramofCenannuoulf-insumRoWmIcesCompen-
urian,as provided for by Section 3700 of the LaWr Cade,(a Ne performance of Ne
work for which Nis permit is Issued.
0 1 have and will maintair Walkers Compensation Imuran=,u required by Semon
3700 of me,Labor Cade,far Ne Performance of Me work for which this permit is IasuM.
My Workers CampemaUon Inuvmen Carrier sand Polity numWr am:
Cartier. Path,No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This soman need not W completed if de permit Is formas Wndreddollan(SIM)
or lass)
I canify Met In the performance of the work for which this permit ts issued.l shall not
employ any person it any manner an u to WComa subject to Me Wonboa Cnmpothadon
Laws or California.Dam
ApPlic nt
NOTICE TOA IJCANT:1 fpr making this Cer iOcam of Ea,onuh n,you should
become Subject in Ne WmImen Compensation provisions or On"W r CMe,you mer
Z forthwith comply with such provision or this permiuhall he deemed revoked.
Z O CONSTRUCTION LENDING AGENCY
I hereby afrstm met then is a construction lending agency for Ne performance of
E rte+ Ne work fur which this Input,Is issued(Sec.3097.Civ.C.)
a Q Lenders Name
J ender's Address
U Q 1 certify that I have read this application and sum that Ne above information is
U,� cares'.l a area to comply with all city and county ordinances and state laws relating to
Q U building eonsuuni I.and he w,indCyauMand represcn lc.Me
orCaNncrop.n ago the
W ahove-mentioned properly for insNcunn proposes.
f-a LL (Wc)agrees.cove,indemnify and which
harmless the City accrue
Cupenst against
y liabilitlu.judgmcnts.<oats and expenses which mey in anyway eccmc again=,said City
U Z in consequence of the gmni ng of this permit. -6'
^' APPLICANT UNDERSTANDS AND WILL COMPO, WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Re-roofs
Signatureor pre am r Dom- Type of Roof
HA2A OUS MATERIALS DISCLOSURE yP
Will the applicant or future Wilding Occupant store or handle hxuasdeus material
as defined by Me Cupertino Municipal Code.Chapter 9.12.and Me Health and Safct3
Cade.section 255320)7 / All roofs shall be inspected prior to any roofing material being installed.
❑Yu $Nu
Will Mc applicant or future Wilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
• emit hevallous air contaminants u defined by the,Bay Arca Air Quality Management all new materials for inspection.
Dustier]
❑Yes ONu
I have read the hnardous mamrialsrnquimments uakr Chxpter6.95 of Me Califon
nu Health&SofetyCMe.Seedam 25505.25533 and 25534.1undersmnd MatiflW Wilding
dna vat currently hose a mnant,Nat It is my responsibility Innotary Me mecup r,of Ne
requimments which must be met Met to issuance of 2 Comfiaate of Occupancy. Signature of Applicant Date
owner. lhorir ane Data. All roof coverings to be Class "B"or better
JUN-26-2006 10:25 AMERICAN FAMILY FUNDING 408 879 9365 P.01i01
06/26/2006 10:22 4085590 CMS PAGE 01
41, COMMUNITY MANAGEMENT SERVICES, INCORPORATED
Jane and Gerald Pan
21075 Freedom Drive
Cupertino, CA 95014
June 23, 2006
Dear Jane and Gerald:
This letter confirms the action taken by the Board of Directors to approve your application for
installation of two skylights. This approval is given on condition that you will be responsible for
the repair of any roof leaks in the general area of the new skylights and the skylights cannot have
colored glass.
Sincerely,
ROGER WERT
Association Manager
Commons of Cupertino HOA
cc: Board
File
r
90oz z Z fvnr
711
1935 Dry Creek Road Suite 103 -Campbell CA 9SOOB-3631 voice (40 8) 554-1977 . fax (408) 559-1970
TOTAL P.01
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j '- CITY OF CUPERTINO • ���02�3
CITY OF ION FORM
CUPEI,TINO PERMIT APPLICATION
A IL
N# 3w— 5
8 — hVzl Date:
Building Address: Mailing Address (if different from building address):
Owner's Name: Phone#:
dr VOF- 77-7
Contractor: License#:
Contact: Phone: O Cupertino Business License#:
GGr�c Fax: d —��/ 3
Building Permit Info:
Bldg L?-' Elect ❑ Plumb ❑ Mech ❑
Job Description: /hh�, Q"n
Residential ❑ .LC_ _&-o 6' Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy Groy:
Type of Construction: Please check this box if the project is a
CtbL second-storyaddition: El
Pro ect Size: Standard ❑ Laze ❑ Ma'or ❑
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/Off1Comm/ nasi 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*
�rro PERMIT APPLICATION FORM
CUPEkTINO
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 PbIg 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 Stomi/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 cfin MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFLXT 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
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