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03070155
CITY Or CUPERTINO OmLDINC DIVISION PERMIT CONTRACT4,R,INFORMATION^F BUILDING ADDRESS: WEGNER CONSTRUCTION PERMITNO03070155 0229 KRTSTA 2=22 OWNER'S NAME: 1069 CRAIG DRIVE PERMIT ISSUE DATE HE (408) 252-2345 SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 E 0 0 alOo LICENSED CONITRACIOR'S DECLARATION w❑ I hereby affirm that I am licensed under provisions of chapter 9(commencing Job Description 1aW Rorsum!g ] ) Jofthc Businc nd Fouressinns Cook.and my license is _c)„ in 11der sl REVISION--IN HOUSE USE ONLY D4z sLic.p Ido - tonna NO NEW PERMIT ISSUED ORIG. #01110029 �r3 CHITECTS ECL ATION , nu shall be used az Public recnrm 3 0 1, LiccnaJ Prnfcssinnel 1 S OWNER-BUILDER DECLARATION / \ aP 1 hereby affirm that I am exempt from One Contractor's License law for the 00 following reason.(Section 713).5.Business and Pmfcaaine Code:Any city or county - n %'o which require a pmmit m enaamuet.elm,morrow,demoliab,Or repair any structure V In—r^ priocto it,issuance,also requires the applicant for such Permit to file a signed statement =ire that he is licensed rursvnnun the pmvisipru of me Comanur's Liansv low(CAapmr9 Sq.Ft.Floor Area luat10A1Q7 orr— (commencing with Section]fyp)ofDivision]orthe Business and Professions Codc)or �.) 4 �r;§ that he ix exempt Nmefrum and Ne basis for Ne alleged cxcurrin n,Any violation of Our in.. . by anydpddoll for sDpd.hsubjects due applicant macivil renally of 34+2`$T�10*100 Oecu ane -Type net more manfiw anndreddmuar 2 plan. P Y YP El 1,as owner of the progeny,or my employcox with wages As met,sok compenauon. will do me work,and me aouctu¢is not intended or offend for sale(Sec.7044,Business and Pmfessions Code:The Convectors License Law does not apply to to owner of Required Inspections property whobuildsar improves thenron.and who does such work himsclformmugh his 101 - FOUNDATION own employees,provided that such improvements are not intended or offered formic.If. pO2 — PIERS however,me building or improvement is sob within one year of compleion,me owner. builder will have tha hurt.of povbg that be did not Wild or improve for purpoae or 103 — UFER 01. 104 - REBAR ❑1,ru owner or ct Sic.7tP.m exclvs;ncas and concocting with licensed contractors m Construct Law it p nota ply toanavm,crofFo ProfessionsCom:)or i pro Cs thercon.Li lOS — ANCHOR BOLTS. come Law dors notch apply tots owner or progeny who Wilds or ant in ms Contra,and who comarufor such projects wimacomanorts)nanad pursuant to me Comnnor'a' 106 — SEWER & WATER staw. 01 son m empt under Sec. ,B&P C for mc this reon 202 - UNDERFLOOR PLUMBING 203 - UNDERFLOOR MECHANICAL Divot, Dam COMPENSATION DECLARAOTION 204 - UNDERFLOOR FRAME Ihereby amrmunder Penalty ofperjury one ofinefollowing declarations: 205 - UNDERFLOOR INSULATION bate and will maintain.Cenficnc ofCmvcnt toren-insure rot WorkersComrcn- 301 — ROUGH PLUMBING n As provided for by Section J]IIO of the Labor Code,for the retrmicauce of the work for w3 0 2 - TUB & OR SHOWER which this permit is issued. ❑1 have and will maintain Wonori Comprnatinn Insu must,as required by Section 3 03 - ROUGH MECHANICAL J]ODofineLalarrCrate,for mePerformanaofthe work for which this permitishaued. 304 - ROUGH ELECTRICAL �YmWorIcIaCK n1.. n bu0m0aarrieoa Pobw nun,Wt are: 305 - FRAME erG Per, / CERIFICATEOFFXEMPTIO OM WORKERS' 306 - HOEDOWNS COMPENSATION INSURANCE 307 - INSULATION u It.,MtnsectionneednutlecompletedislefarmItisforonehundreddollarsDlip) 308 - SHEETROCK 1 eer iry ten in the performance of the work ror wbch this permit is word.I shall not 3 09 — EXTERIOR LATH employ any Knout in any manner an as in Wmmesubjecc to the Workers'Compensation 31O — INTERIOR LATH Laws of California.Date A,Ffiam 311 SCRATCH COAT NOTICE TO APPLICANT:If.after,making this Certificate of Exemption,you should 313 - ROOF NAIL become subject to the Worker's Compensation provisions of me Labor Code.you must Ozp ronnwahcomply wimsurnpmmsinasnrmisrtmitanauWdeemedrevokrd. 501 - FINAL ELECTRICAL ENERGY ?� CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY 'r I hereby affirm that thin,is a construction lending Autrey for the Performance of a> the work for which tura .it is manta(Sec.Jo9z rev.C.) 503 - FINAL MECHANICAL ENERGY aGj Lenders Name 504 — FINAL BUILDING ENERGY =z <mer:Adamss 505 - FINAL ELECTRICAL U O 1«oiry that 1 have read this application and state that the above information is coned 1 agree m comply with all city and county ordinances and ante laws¢lacing 19 506 - GAS TEST pU building cumatnemn,and hereby aummionmprcsentanivesorfor city toenter upon um FIN PLUMB G W annve.menaoncd rmpmny for inspection rpmnaca. n G (we)agree to save,indemnify,and keep harmless the City of Cupeninp tgainst Q$ F I L h Iiebilitie.judgmcnu.costs and"penes which may in any way accost againscaidc."I 5 t.)Z in consequence of the 'ng of this permit. .-r SOURCAPPLICAN GU ER N ND WILL COMPLY WITH ALL NON-POINT Issued by:5 ING Date ' Re-roofs 4 NAL PUBLIC WORKS . ma an ontaeor Dam 6 2 -% OOF PLYWOOD NAIL HAZARDOUS ERIALS DISCLOSURE Typeo"%M3 - ROOF BATTENS WillmeeDplicantum futurebuilding Occupant sorenr handle I abousmateriel a de.Sed by the 32(.)?nn Municiral,Code,Chapter 9.12,and the Ncallh and Safety 6 04 - ROOF IN-PROGRESS Code.Section 255J2(a)? ❑Yea ❑No All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future buildingnecupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove ha,amnus all eomaminanm az derned by me Bay Arra Air Quality Management all new materials for inspection. tied ❑Yes ONO 1 have real me hamM[)us mamriais requimmenu under Chapter 695 of me Glifor - niaHwlm S Safety Code Seemms 2 R)5,25533and 25514.1 undcaund ma ifine building coca not crime maLit is my responsibility m nudly the mcurant of me rrq some wh Ir or iso o acemfiamproccupancy. Signature of Applicant Date _o rto, vcJagcm a1e All roof coverings to be Class "B"or better �0�� � ( l ( 00 2-7/ lml- CITY OF CUPERTINO CUCITY TYOF O PERMIT APPLICATION FORM 0 7 AMIL PN # Date: 3 - -00 3 1 7-/8'- 0,7 Building Address: Mailing Address (if different from building address): 0 9 Owner's Name: Phone#: Pa a a -o5'35- Contractor: License #: Z T 3% Contact: Phone: Yo£!-ZS2�2T�Y Cupertino Business License#: Fax: c;W B/Uilding Pe it Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job D ription: // sidential © fft oo6l i�i ' , Commercial ❑ Sq.Ft. Floor Area: $/Sq'Ft.: \ Cost of Projects Occupancy Group: ? a> Type of Construction: Please chec his box if the 6ject is a second-story addition: ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL 7 BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to I M Btu MECHANICAL BBOILER4 Boiler> IM to 1.75 M Btu MECHANICAL BBOILERS 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<_ I OOOA ELECTRICAL BELEC1001 Elec 600V> I OOOA ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGYEner BUILDING BENERGYADD Ener Add Multi BUILDING BINVESTIGA investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 1of3 C c. CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO uanti 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 BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINIBRCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Repipe 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 BREMAIRHAN A/C Units <= 10,000 cf n 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 2 of 3 Sao CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group ' 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 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 F-UH1447 "CY OF CUPER'l'INO ^' ".x"a�?n '*, r ;s - r = "'�` ' BUILDING DIVISION PERMIT ,CO TRACT R NFORRMATIO DING ADDRESS: KALLIO CONSTRUCTION PERMrr NO03080032 f iR'S NAME: 1492 WALBROOK DR PERMIT LSSUE DATE HO STIMSON F AND HELEN Y "E' (408) 873-9777 SANITARY NO, CONTROL NO. ARCHITECrIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECfI +00 LICENSED CONTRACTOR'S DECLARATION O O O 'u P 1 hereby.(Film that 1 am licensed oder provisions of chap.,9(commencing Job Description tea wrm Section 7IXMy.f Division 3oftW Business and Profession,Colk.mil my license is _ in roll form and effect. KITCHEN REMODEL License Clan Lic.M i F m Da. Contractor ARCHITECTS DECLARATION 1 understand my plans shall W used as public records o N Licensed Pmfeuioo,l S OWNER-BUILDER DECLARATION <I I hereby affirm that 1 am exempt(rum Ne Contractor's License Law far the 00 following reason.(Section 70315,Business and Professions Code:Any city Fir county 5th which.quires a Permit to cnntwct,tlml improve,demolish.or repair any structure -Zi priortoits issuance,also requires the applicant forsuch Permit o file a signed statement .z¢ that he is licensed pursuant.the provisions of the Contractor's License Law(Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section 7000)of Division 3 of the Busmeas and Professions Code)or $ mat he is exempt themfrom and the basis for tho alleged exemption.Any violation of 36205040 . 00 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not mom than five handled dollars($500). P Y YP I,as owner orthe property,or my employees with wap.its their sole compensation, will do the work.and the swctum is not intended or offered for sale(Sec.7064,Business and P fcs„'�oons Code:The Contractors License Law dors not apply to an owner of 10 2 - PIERS d Inspections Propertyw builds ofimprove&th<mon.and whoamssuch workhimxlfor through his own employees.provided that such improvements are not intended or offered for sale.If. 10.3 — UFER bowevcn the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not Wild or improve for purpose or 104 — REBAR 5117' 105 - ANCHOR BOLTS ❑1.as owner or cL property,.Business uclus and confessions with licensed contractors i. censwm does notapply.oanOwneanaPletaooesdsoriproCsthimor', Li 10 — SEWER & WATER cense Lawdoes such plyman with or property who Wilasmimpro the Comon,and 202 - UNDERFLOOR PLUMBING who contracts for such projects wile a eonmetor(s)licensed pursuant m dee Conuactor's License Law. 203 - UNDERFLOOR MECHANICAL ❑ I am exempt under Sec. ,B&PC for this reason 204 - UNDERFLOOR FRAME Date 205 - UNDERFLOOR INSULATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty ofcedur,one of following decimations: 301 - ROUGH PLUMBING I have and ill maintain.Ceruream of Consent to self-Ines.for Walker',camprn- 302 — TUB & OR SHOWER sation,as provided for by Section 37W of Ne LW(Col .for the peformance of the 3 03 - ROUGH MECHANICAL work for which this permit it issued. 304 - ROUGH ELECTRICAL ❑1 have and will maintain he performance Compensation Insurance,az his pend by Section 37W of he l.abo,cwle.ler the peno,man<<orme work ler which this permit is issued. 305 - FRAME My Worker's Compensation Insurance carrier and Policy number am: 306 — HOLDOWNS Cartier.- Policy No.: CERTIFICATE OF EXEMPTION MOM WORKERS' 307 — INSULATION COMPENSATION INSURANCE 308 - SHEETROCK ta) tlm permit This section need not W comple.d lfeit is Poneunars( rhundred dollars 309 — EXTERIOR LATH 310 - INTERIOR LATH I Certify mat in the pe any masse of the work for which this permit is issued.I shall not employ Laws of in any mannermazfo Wcomesvbjecua the Workers Compensation 311 - SCRATCH COAT Laws of California.Dam Applicant 313 - ROOF NAIL NOTICE TO APPLICANT.If,after making this Ceni(cane of Exemption.you should 501 - FINAL ELECTRICAL ENERGY become subject to the Worker'a Compensation provisions of the Labor Code,you must zmnhwimComply with mChloonimtrorthis arm, hall xdecried mvnmd. 502 - FINAL PLUMBING ENERGY 0 z CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY F (herebyafrom Omft.is.cmawcti..lending agencyfmore cpomanmur 504 - FINAL BUILDING ENERGY a> Nework Im ichtnixp if isiuucd(Scc.JIN7,Civ.C.) aName lender's Name 505 - FINAL ELECTRICAL SW. Q =)Z <wersneelex 506 - GAS TEST U p 1 ccnify mat 1 have read this application and serw that the above information is 507 - FINAL PLUMBING eL commm.1 agree comply with all city and county. n< dis and sum laws relating to pUbuilding consuouction.and hereby audborine representatives or his City to enter upon the FINA MECHAUNWG AL above-mcmiu ind property for inspection purposes. (We)agree to save,indemnify and keep humless the City of Cupertino against 0 9 FIN UN liabilidtiSjudgmcnu.costs and expenses which may in any way scenic against said City ,Z i-conxgacncc of the granting of this pa,mit. 5 A APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:5 ORKS Date SOURCE REGULATIONS. Signature of ApplicanUComracmr Dem Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building Occupant store or handle hanNous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Section 25532(a)? ❑Yes C:]No All roofs shall be inspected prior to any roofing material being installed. Will the applicant of future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove tit ha...do.,air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. inrict?' C Yes [)No 1 have reel the handl msma.rials requirements under Chapme 6.95 of the Califon nia Health 6 Safety Code,Sections 255(15.25533 and 25534.1 understand Nat if the building docs Bol currently have a.nam Out it is my respmuibib y m notify tM Occupant of the requirements which mum W met poor w issuance of a Ce,imme or Occupancy. Signature of Applicant Date Owner tar m1honmd a gem Date All roof coverings to be Class "B" or better