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02040005 CITY nrvESSIIONNO CONTRACTOR INFORMATION: PERMIT BUILDING ADDRESS: PERMIT NO. 1697 GALWAY DR PARRY MARTIN H AND JENNIFER A 02040005 OWNER'S NAME: APPLICATION SUB DATE ,mdft1EtARRV MARTIN H AND JENNIFER 1. 04/01/2002 HONE: SANITARY NO, CONTROL N0, ARCHITECTJENGINEER: BUILDING PERMIT IlYFO BLDG ELECT _ LUMB MECH O H= LICENSED CONTRACTOR'SDECLARATION Jobb 'o 1 hereby affirm that 1 em licensed under provision,of Chapter 9(commencing IyC with Section]000)afDivision3nRheBusinessandProftssionsCode,andmylicenu BATHRM RE is in full force and effect. rc 6 License Class Lic,0 I O a O Data Convector ' I 0< ARCHITECT'S DECLARATION T s 1 understand my plans shall be used as public rtcards 1 i o o Licensed Professional ,r ' OWNER-BUILDER DECLARATION y 1 hereby etrronth t 1 A.am.pt from the Contractor's License Law for,he Gfollowing reason (Section 7031.5,Business and Professions Code Any city or county $1000 0 which requires a pendit to construct,alter,improve demolish,at repair any structure .. prior to its issuarce,also requires the pplicam forsuch permit to file a signed stainnen _._. .-.. thoof lice ddhe sions ors a horn aimg wdpectiht,7"propvision ,he,he (Chapter 9 Code) - 0�`0- ]s�{ y�pp Vahlanori (comment ng with Section ofDivisionbasin 3.(,he Bunnea and ioA.Any v Code) orS do Is 3li5 byA rcfrbm'and the.aerofor the ctsthd edema Myviolaeon -of Section 7036.56y any applicant fon permit subjects she epplicanuon purl penalty- 'of not room than five hundred dollars($500). I, / lOINpN TDATION ' "'t ` Occupancy Type ❑Lasownarof Ne property,or my employs with wagesaz flmrs.lc,mA,n,mmA, V --will'do'the work;And the'structure'is not intended'orofferedTor sam .e,.']0 , - -Business aid Professions Code:The Contractor's License Lew does not apply to an 103 — UFER Required Inspections,' owner of property Who builds or improves thereon,and who does such work himself , r through his own empl yeas provided that such p mens are not intended or 104 — REBAR Rvedfon sale wnerf. ol<ld thebuildinghaver p mens-sola wuhm one yen of 105 — ANCHOR' BOLTS , , - ,-completion,the owner-bit Ider will have the burden of proving the,he aid no,build or " improve fee purpose of sale.). 106 - SEWER & WATER q,I u er of the propertyem xclosively<ommn gwith.sensed contractors to 202 = UNDERFLOOR-PliUMBING construct the project(Sm.Ito a,Business and Professions ilode)The ves Contractor's 2 0 3 — UNDERFLOOR MECHANICAL License ,c time not apply man owner th s.e property h builds or improves Hereon, 4_ O a whocovtracu lar such projata.with.0.can[mc,or(s)bcetued pursaent.m.the ... _ _._._..2 04--'-' UNDERFLOOR-FRAME • _:... _ . _ ._.ommcto Lawla n B&Pcm tnaRasnn205 - UNDERFLOOR ,INSULATION i u �' OZ301 - ROUGH PLUMBING CO ATION RATION 302 - TUB & OR SHOWER 1 here y of imi under penalty of Perj fy one of Ne follow g d I tions: 303 - ROUGH MECHANICAL 1 have and will inainmin a Cer[ifcne of Consent to self-insuro for Worer's 304 - ROUGH ELECTRICAL ompensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this panni,is issued. 305 — FRAME ❑1 have add will nmiansia.Workos Compensation insurence az railairml by Section 306 - HOLDOWNS CAmd.: or Cod form performanceI=dpf.r work for th prem,is 307 INSULATION e, Ce pc t oniocicomer e d Pol cy n to - _ _ ssaea MV W�� lrrida. `dmiyN - _ 308 'r SHE$TROCK, 3700o the lab u RTIFlCATIONOFE%EMPTIONFROMiWOR1�ER� y �• ' •309 P'•EXTERIOR'•LATH' i - COMPENSATIONINSURANCE' .z-" INTERIOR--I ATH - ttbii s tton'nied not be mirpleied if the permi,is for one hmMred dollars at (sldb)oness.i 311 - SCRATCH COAT ' r pe Y _„ . . ::. •313-"- "ROOF NAIL--- I nifYtTe,in thepeAo ante of the �� "� � � - ety'r ' work for which this permit e issued,I snail no,employ.un rson in an mann sues mbettmeab3ecnathewokem' 501 - FINAL EI;ECTRICAL 'ENERGY Compen,et on Lows of Cel fbm Date'" ,_ApPBun,. ,. _- ... _ .:_. ...._.. _ .. 502. .-- FINAL PLUMBING ENERGY-._NOTTC _,.., ..__. .Womhe TOAPPLICANTdo,Worker's If.C rmakin..p Cesi,an,of of d,LAW,lon.de,y should " z become,0bjecitotheWorker'sCompensmtanproiiionsdftheLaborCode,youmust 503 - FINAL MECHANICAL' ENERGY p G to„nwtthttmplywnn'manproyrsmnaor,ni,prtn- -- attmedreyakea. 504 FINAL BUILDING ENE _ ,ren 'CONSTRUCTION LENDING AGENCY 505 — FINAL ELECTRICAL , 1 hereby afE.that there Is a c nstmet o d ng agency for the performentt :. r a.L�. bfNewokfrwhich this puiti,ismad(Sao3097CivC) 506 _— _ GAS TEST Under*.Address 507 FINAL PLUMBING �.7 — U:0 I certify that I h read this application and state that the above information is '' 5 0 8 - FINAL ME CHAN KCAL W cohb 1-gree,o comply w th all city and county ordinances and state laws mlating 509 — F I NAL GRADE 0. m building g c nsvaidion,a d hereby suthon f representatives of Nis city to emerupon tit the above-mentioned property for inspection purposes. 510 - FINAL PLANNING pays 6i (We)bMe i.save;indemnify and keep ha'rmlds3,he Cliy of Cupemino against lie 'ud , o u a d expense,which may in say ay ecome.&...[,said 514 - FINAL PU I C WORKS U: C y i� ce the grenbA,of Nis palati[ ( PL STANDS AND WILL COMPLY WITH L ON-POINT / Q L ONS. L Issued by: Date l �' i a pl o ' Data 'j .': Re-roofs HAZARDOUS MATERIALSDISCLOSURB '' Will the appllc'en[o t ry bit Idmg oaopant Wore o handle haxatdous ma¢nel Type of Roof.., .. -. - A defined blithe Cupertino Mun¢pal Code Chapter 9,12,and the Health and Safety C6de tcaxinui 25532(01 All roofs shall be irspected,pnor_to any.roofing material being installed- Will the epplice f or flum building occup-nt use equipment or devices which If a roof is installed without first obtaining an inspeetioi;I-agree'to�remove t heemdou,air contem iris az defined by th Bay Area Ar QuOily Management m=`7 all new materials for inspection Applicant understands,and will comply with . _ . . _.. q °406 'i>.:- ",i 0 i rr; all non-point source regulations,�; i,:� neve reed the haurdous materials teiIormucts anduchapier�6.95 of the CaIIIaoAidH` efety Cade;Sec ions25505,25533 and 25534.1 understand that ifN m,n on ally haveatt be to iseomti,9ility,onotifythf o o Ne s;which must b mej P#. to issuance 'h a of Signature of Applicant Date w r.a a, Da,e All roof coverings to be Class"B"or better ' r . ,. . .- "OFFICE z 1697 Galway Drive Cupertino California, 95014 Christy Akatiff Administrative Clerk City Of Cupertino Community Development/Building Division 10300 Torre Avenue Cupertino, CA 95014 27 September,2002 Dear Sirs, MH Parry Permit Number 02040005 Bath Remodel Thank you for your letter dated August 27, 2002, notifying me that the above permit will expire on October 1. The above remodel is being carried out by me, the home owner. Although this is a modest project, due to current work commitments,progress has been slower than expected. The work has been started was inspected on Thursday September 26 by the Building Department. Your letter implies that a request for extension is not necessary if the remodel work has started. Therefore I assume the permit remains valid until completion of the project, which is scheduled during the next 3 months. I may be contacted at Martin ParryAa Maxtor.com, or call during office hours office on(408) 8944813 Thank you for yourass' ce, A/L- Martin Parry CITY OF CUPERTINO BUILDING DIVISION PER CONTRACTOR INFORM.00N: BUILDING ADDRESS: PERMIT NO. 1697 GALWAY DR PARRY MARTIN H AND JENNIFER A02040005 OWNER'S NAME: APPLICATION SUB DATE PARRY MARTIN H AND JENNIFE A 04/01/2002 SHONE: SANITARI'N'O. CONTROL NO. 4089967587 CUPERTINO CA, 95014-5 40 ARCHITECT/ENGINEER: PHONE# BUILDING PERMIT INFO BATHRM REMODEL. BLDG ELECT PLUMB n1EC L. J 1 I 1 I .I I I oai o o INSPECTIONS DATH INSPEC TO ARRANGE INSPECTION JOB DESCRIPTION a CALL 777-3228 MONDAY-FRIDAY 24 HOURS R 1SID�, ENTIAI: o z FOUNDATION/PIERS/H.D.S. ➢CFORE REQUIRED INSPECTION.JOB ADDRESS D SFDWL Cl KITCHEN REMODI 5 y AND PERMIT#ARE NEEDED WHEN PHONING. ❑ ADDITION ❑PLUMBING RE-PIPE w r w UFER GROUND ❑ MULTI-UNIT O STRUCTURAL PAD/SETBACK-CERT RESIDENTIAL_COMMERCIAL_OTHER_ MODIFICATION w 5 vo.o y GARAGE.SLABS/PkEG11NITE ❑ INTERIOR ❑CHIMNEY REPAIR HA$ARI)ll IS FIR .AR A s .Qi POUR NO CONCRETE UN'PIL ABOVE HAS BEEN SIGNED IMPROV EMEN"I' ❑ SWIMMING POOL: rsJ t ❑ BATH REMODEL/REPAIR❑ DEMOLITION a o o UNDERGROUND/SLAB C YES B yc.-1 unJcmm�J n,w a CIaxA rnormxnn,Iy i�reyuhed. OTHER ` e NO Initial LC.B.O.# i 3 .,DO NOT'POUR FI.On[Z.k)N'rILAB(JVE IIAS BEP.NSIC;NI71) _. EXISTING ROOF COVERING ......._. CORIMEIiCIAL: ❑ NEW BLDG/ADDITION ❑DEMOLITION PLUMBING ❑ TENANT ❑ FOODSERVICE MECHANICAL _ Nwnbuo(eaistingeovenngs IMPROVEMENT., ELECTRICAL To be renmved To be remind ❑ OTHER FRAMING VENTS INSULATION PLACE NO SUBFI-OOR UNTIL ABOVE HAS BEEN SIGNEDTYPE OF ROOF COVERING ROOF,SHEATH/DIAPHRAM EXISTING, PROPOSED, PLUMBING ❑ Built-Up Roo( ❑ Built-Up Roo( TUBS&SHOWER PAN ❑ Asphalt Shingles ❑ Asphalt Shingles .. . .. MECHANICAL >'-U2 (,J ❑ Wood Shakes ❑ Wood Shukes ELECTRICAL-/POOL BOND -- (-c:�_ /. 0Wood Shingles ❑ Wood Shingles FRAMING/STAIRS/E.EGRESS ❑ Other lSpeci(y1 Ovid ert.B.6.R INSULATION/VENTILATION Provide I.C.B.O.Repos No. COVER.NO WORK UNTIL A13OVE HAS BEEN SIGNED Provide Mfgr.Installation Specs. EXTERIAL SHEAR/I10LD DOWN INTERIOR SHEAR/HOLD DOWN INSPECTION SPECIAL INSPECTION REQUIRED O DATE INSP .SHEEfROCK/SHFETROCK SHEAR .EXTERIOR LATH/.W-SCREED, I . - SHOWER.LATH,•." 7—D, Y--Q9 . -NOTAPEOR PLASTER UNTILABOVEHAS BEEN SIGNED. ..SCRATCH COAT (f -SEWER/WATER ._TEMPORARY APPROVALS OCCUPANCY j ANNING 777-3308. Q .GAS TEST' ;� ..GRADE(P.W.'777-3354) C"> [r7 r ='Z .HANDICAP U 0 ELECTRICAL:' _ OF PLUMBING rtUj :.MECHANICAL _ENERGY ._ . .. .. ._ __._ .. ... U YZ -_VISUAL FINAL ONLY - )... .. BUILDING :.00CUPANCY,GF.BUILDING IS.NOT PERMITTED .. .. . . ..UN"IlL'�BL'ILDING FINN.IS SIGNED BY BUILDING, ' CERTIFICATE OF OCCUPANCY❑ - IN"5PEC'TUR.. - ,' PRE-INSPECTION:"'-"' PLYWOOD: IN-PROGRESS DATE INSP. DATE INSP. DATE TEAR 017E INSPECTION;, ,. . . BATTENS: . - FINAL.: .. ._ . INSP. DATE INSP. DATE - INSP. .DATE 'NOTE: OSHA APPROVE® ACCESS TO ROOF SHALL BE FROVI®E®, FOR INSPECTION APPLICANTS POSTING COPY OVOER-BUILDER VERIFICATIV 1. (Check one) I or my immediate family (parent,spouse or child) will perform: • A. � All the work authorized by this permit B. A portion of the work C. _ None of the work If B or C is checked,complete 2 or 3 below. 2. A state licensed contractor will be hired to do: A. _ All of the work B. A portion of the work (complete section below) Contractor Address/City, Phone # State License # Type of work to vc caa vauacu 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or • portions of the authorized work. I understand that I may be an employer(see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. Person/Firm Address/City . Phone Number Type of work to be erformed .......................................................:............................................................................................................................. I declare under penalty of perjury that the above is true and correct. I have read and understand the Owner-Builder Information(reverse side). / Property Owner's Signature: 1 / Date: b JobAddress: `f V ��"� Permit# 040(-)011S Any changes to the information provided on this form shall be submitted to the City of Cupertino Build Department. • • • R • City of Cupertino Building Department CITY OF 10300 Torre Avenugft C U PERTINO phone: (408'777-3 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as owner-builder you are the responsible party of record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself,you may Protect vourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work,with the exception of various trades that you plan to subcontract,you should be aware of the following information for your benefit and protection If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is$200 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer,you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding,federal social security taxes,workers' compensation insurance,disability insurance costs,and unemployment compensation contnl7utions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers compensation insurance. For more specific information about your obligations under federal law,contact the Internal Revenue Service (and,if you wish,the U.S. Small Business Administration). For more specific information about your obligations under state law,contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale,property owners who are not licensed contractors are allowed to perform their work personally or through their own employees,without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder building permit,erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors'State License Board in your community or at 1020 N Street,Sacramento,California 95814. Please complete and return the enclosed owner-builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, Building Department, City of Cupertino . Printed an Recycled Paper Q CITY OF CUPERTINO Pa 0 CITY OF PERMIT APPLICATION FORM 10 D CUPERTINO APN # �/� �y�/� Date: all Building Address: Ailing Address (if different from building address): D/< Owner's Name: Phone #: �c� q P�2�y Lt C) &- Cl 9 �- Contractor: N I License#: Contact: Phone: ac,<t a asci Cupertino Business License#: )N t2 Fax: Building Permit Info: Bldg Elect ❑ Plumb 2/1� Mech 13' Job Description:/ Residential I� Commercial ❑ Sq.Ft. Floor Area: S/Sq.Ft.: Cost of Project: Occupancy Group: c� Type of Construction p Please check this box if the project is a second-story addition: ❑ Project Size: Standard Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> IOOK 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 <= IOOOA ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<= 200A ELECTRICAL / BENERGY Energy BUILDING BENERGYADD Ener Add Multi BUILDING An L BINVESTIGA Investigation fee BUIUILDING I of 3 � � � V-7 p' WITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPERTINO 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 MIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interce for 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 cfrn MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Fumace MECHANICAL BREMFURNOV Relo Fumace > 1 OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREND RAP 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 WE BREMRESAPP Remodel Res ADvIiance ELECTRICAL 2 of 3 *CITY OF CUPERTINO CITY PERMIT APPLICATION FORM CUPEkTINO Quantity 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 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 ZADDCHG Address Change BUILDING • 3 of 3