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02100201 ITY OF CUPERTIN O CUA; TINO PERMIT APPLICATION FORM 0 APN# �-0 ��,�---- Date: Building'Address: 1 � �t �.. er's Name: ikoc Phone#: Contractor62L Z53—_� �Z-- ° License#:—19 Contact: 4 Phone#: tt/Con oPermit Info: Elect Plumb Mech ription: esidential: Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: Architect/Engineer: Valuation- Type of Construction: Occu ttanti .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> IM to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Constriction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTA)MQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTA.X.R Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V<.== 1000A ELECTRICAL BELEC 1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BE RGY _J�nergy BUILDING BENERGYADD EpLra Add Multi BUILDING BINVESTIGA investigation fee BUILDING BMITIGATC Comm. Housing Mit.Fee BUILDING 1 of 3 . t *lTy0r. CITY OF CUPERTINO CuPfR,TtNo PERMIT APPLICATION FORM aanti Fee ED Fee Description Fee Group BI4IITIGATR Res.Housin Mit Fee BUILDING MINEVMULT1 New Multi-Family Res MECHANICAL B WSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCONCqE New Comm Electric ELECTRICAL BNUCOMIMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single f2p2iiy Res PLUM13ING BOVERTME hmection Overthne BUILDING 13PBACKFLOW Atmospheric Vacuum PLUNIBING BPCESSPOOL Cesspool PLUNMING BPE FEE _Aldg Pe 't Fees B DIlYG B FUCrURE Pblg Fbdure PLUMBING BPGAS Gas Piping S em Fee PLUNIBING BPINTERCEP Ind Waste Interceptor PLLTM13ING BPLANCHK Pian Check Fee BUILDING BPLANC D Plan Check Add Multi BUILDING BPLANCKREP Plan Check R eat Fee BUILDING BPREPIPE Repi e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUM13ING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Tm PL ING BPVENT Alt of Drain&Vent PLUMBING BPWA'I'ER Install/Alter Water Pie PLUMBING BPWHEAT.ER Water Heater/Vent PLUNMING BPWSVCS Main Water Service PLUMBING BREINSPECT RefiWection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BRENLkMHAN A/C Units C= 10,000 cfm MECHANICAL BREMAPPLIA fiance Install MECI CAL BREMBUSWAY B I+ KIRemodel Buwa ELECTRICAL Ltn res ELECTRICAL BRE RN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECO CAL BREW Heater Installation NOCHANICAL BREMINHOOD Installation of Hood NIECHANICAL BREMIMLSC Misc Apparatus ELECTRICAL BRE APP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL s 2 of 3 a aOFC E O CuPE�ttNo '�° PE T APPLICATION FORM uan ` Fee ID Fee Description - Fee Grow BREMPOWER Power DevicSLAMaratus ELECTRICAL BRE CEPT _,AcR#,Switch&Outlets ELECTRICAL BREMRELOCA Relocation of Hood ME�NICAL BRE PALT Re aYrlAiter Heating MECHANICAL BRET%MSAPP Remodel Res A Mliance ELECTRICAL BREMSIGNAD Rmdl S igns Add Branch ELECTRICAL BREMSIGNS Remodel& ,MEguee ELECTRICAL BREMTH[EATR Theatrical Li tin Fisc ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Pian _ BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSF&2FAM Single c 2 Famii BUILDING BSFNA Sin le Family New Add BUILDING BSPECIAL S ecialIn ection BUILDING BSWIM Swimming Pool BUILDING BTEMP Tem o Power ELECTRICAL BTEWPERM Temporary Bldg Permit BUILDING BTEMf'SVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical!q foot ELECTRICAL -EPERMUFFE Elec Permit Issuance ELEcnuCAL NVERNIFEE Mechanicals . foot MECHANICAL -MPERNUTFEE Mech Permit Issuance MECHANICAL PPERWTFEE Plumbine Permit Issue PLUMING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3 CITY OF CUPEKI'INO �+ tr is •'' „ • "�' + '�;;, ': BUILDING DIVISION PERMIT CONTRACTOR INFORMATION' ' b• Rte,-5 :;tt R.. ' Bu1(1U@60f?ts'LINDA VISTA DR SHOWCASE KITCHENS INC PERMIT NO 2100201 sT4hIMAD & MEHRNAZ YAZDI 12333 SARATOGA-SUNNYVALE ErPucAT13;51y5`1TY2002 PHONE' (408) 253-0412 SANITARY NO. CONTROL NO. ARCHITECI'RMGINEFR: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 00 LICENSED CONTRACTOR'S DECLARATION Job Description�� F Z I hereby affirm that 1 am licensed under provisions of Chapter 9(commencingage sa S �� O with Section 7CO(d.f Division 3of mo Busi s and Professions CodC,and my license is BATHRM REMODEL 'v�i�'�li in Iul1 fort an DDWDDW��ffeeeeeeyyyyyy'''444444��_��_ ''11,, Q Zp�Z Licen f�.(�]L�2— Lick 7L1� F==� ° 5Y / G^mmt r MAR 0 7 2003 /yp Cl ill he liste R 1 ��y Innarmo,tnmypl.taanallbenardaaponliercemda I'�"G • o.owD �LL0I Lieenvdl4nfrxaiota' BUILDING OWNHR�pUILDER DECLARATION t�.<Z 1 hereby affirm that 1 am exempt from the Contractor's License Law for the $27500 m-o O following reason,(Section 7031.5.Business and Promaxions Code:Any city or County u K g which requires a permit Io conarun,alar,improve,demolish or repair any strucmm Fiy prior to its issuance.also requires the applicant for such pm.iuo file a signed snimntent SS< Nal he is licensed pursuant h)the provisions of the ContmeLor's License Law(Chapter 9 3*6Et7IF1f338A@9 Valuation KFS heo.menei OR with Section7OQd of Division 3 of the Busi nom and Professions Code)nr is. $ that he is exempt drt¢frnal and Ne basis for the alleged exemption.Any violation of Section 713 1.5 by any applicant for a permit subjects the applicant to a civil penalty of 1 UAPI1NTPRFDA'iEJNOccupancy Type not more than five hundred dollars($500). 102 — PIERS p y yP ❑Lo ownerof and progeny,.is employees with wages r Nei(ante 04ol.Ruatinn, will Pr dm work,and the he Cont is not intended or offered for sale(Sm.Loan B arm of and Professions lexor The Convacma. adwho,Law does or apply to sat owner it 104 - REBAR Required Inspections progeny who builds or improves thereon,sod who aces such woe himself or chmugh his howOwn ever,thecs.ping orided that such rovememp(ouemwthin not your fcompled Rerea forsithe owneIf,r. 105 — ANCHOR BOLTS however,the the burden of provinshalJe within one yeat of completion,the owner- 106 - SEWER & WATER builacr will have the harden of proving that he did not bulla or improve fur purpose of sale') 202 — UNDERFLOOR PLUMBING 01,as owner of the progeny,am exclusively contracting with licensed convectors to 203 — UNDERFLOOR MECHANICAL construct the Pmlrm(Sec.70el Business and Professions Code:)Tire Commences Li. cense law does nm apply m an came,of property who wilds m improves therms., ad 204 — UNDERFLOOR FRAME who comment for such projects with a contraao(s)licensed pursuant to the Commences' License Law. ROS — UNDERFLOOR INSULATION ❑I am exempt under Sec. ,B&P C for this recon 301 — ROUGH PLUMBING Date 302 TUB & OR SHOWER WORKER'S COMPENSATION DECLARATION 303 — ROUGH MECHANICAL I hereby alTum under Penalty of perjury one of the following declarations: 304 - ROUGH ELECTRICAL 0 how and will maintain a Certificate ofcons<mmselwnsumfor Worker's conaNh 305 — FRAME cation,as provided for by Section 3781 of the labor Code,for me perfmllance of the work for which this permit is issued. 306 — HOLDOWNS ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 3 07 — INSULATION 37(111 of me Labor Code,for the performance Oldie work for which this permit is issued. My Worker' con ensati Insumnc caller enJ P^licyn bot a�e,:��/��.,.� 308 — SHEETROCK Ca cr: Pulic o.: LK�"lsak/Q 309 — EXTERIOR LATH CERTIPICA OP XEM OM WORKERS' COMPENSATIONINSURANCE � 310 — INTERIOR LATH phis YOitm aced.n necomplcied if torrential is fortune hundred dnllais nI0d) 311 — SCRATCH COAT orle5's') 313 — ROOF NAIL 1 certify that in the Performance of the work for which this permit is issued,1 shell not 501 — FINAL ELECTRICAL ENERGY employ any person in any manner so as to Mcome subject o the Workers'Compensation ".aorcapfomis.Date 502 — FINAL PLUMBING ENERGY Applicant NOTICE.TO APPLICANT 11,after making this Cenificmc^f Exemption,you should 503 — FINAL MECHANICAL ENERGY became subject,,the Wnrkcca Compensation pro Wmas of the Labor Code,you most 504 — FINAL BUILDING ENERGY OO forthwith comply with such provisions or this permit shall M deemed rcvokcJ! 'Z' CONS'fRUCI']ON LENDING AGENCY ! 505 — FINAL ELECTRICAL Fut ( n,crcny.1131.mot there is a construction lending agency lot the urlarmameol 506 — GAS TEST 04 „>„ the waits nowhich this per.it;lissued(sca.mr97.Co.c') 507 - FINAL PLUMBING W O Lender's Na.. g) z Lender's Address 508 — FINAL MECHANICAL U O 1 certify that I have read this application and state that the above information is 509 - FINAL GRADE LLs F Costa.1 agree to comply with all city and county ordinances and state laws relating m 0 buildingconswetion,and herebyauthorim«prcmntativcsofthis Citytoenter upo.the 5 FINAL PLANNING ahove-mentioned property for inspection purposes. t" 0. (We)agree to save.indemnify and keep harmless the City of Cupertino against 14 — FIN BLIT W RKS rW liabilities,judgments,costs and capitols which may in any way accrue against said City / U Z in consequence of the glancing of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date O R -RE UL 'I NS. Re-roofs nature of Applican✓Conoacmr HE -`� ate Type of Roof HAZARD ATERIAf yP Will the appiicam or future but ..,not smrt or handle dr micous rhamdol as defined by the Cupeninn Muni; al C e,Chapter 9.12,and the Health and Safely ave,0Yen 2ss3zlayr N All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future h' ing Occupant use equipment or deviecs which If a roof is installed without first obtaining an inspection, I agree to remove Coil haa.Nom air Contaminants defined by the Bay Arca Air Quality Management all new materials for inspection. Disarlcl7 ❑Yes N'l 1 have read the harardmus m:nened,ami i"no ms under Chapr,6 95 tuf me Cali far Dia Health&Sdrtyc de,See iuns255115,25533 and 25534.1 understand Nat ifile building does not suturally haus t tenant,unit it is Illy resrymsihility to notify the mecupim of the mq.i C Ed In rot mel pBllr In lisllimC aCCrtiBC2m ac,u cy. . Si nature Of Applicant Date wnCr or authorized.gent Date All roof coverings to be Class "B" or better CITY OF CUPERTIN® _ t BUILDING DIVISION PERr,.AT BUIflDprg0[jRESJIINDA VISTA DR SHOWCASE KITCHENS INC PERMITNO2100201 OwA9ID- & MEHRNAZ YAZDI 12333 SARATOGA—SUNNYVALEV?PLIcAT11TV{�i3 TY 2 0 0 2 PHONE: ,(408) 253-0412 SANITARY NO.r CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH P30p LICENSED CONTRACTOR'S DECLARATION Job DCSGrl tion x w E~ I hereby affirm that I am licensed under provisions of Chapter 9(commencing p Hz with Section 7000)of Division3oftheBusit�escandProfessionsCade,andmylicenseis BATHRM REMODEL H<y in full for! an J( z p z License Cl Lic.# � C y F m D Contra r _ _ A CHITECT'S AR I- g 9®w U I understand my plans shall be used as public records ► �ir,� m 3 U.t,, Licensed Professional OWNER-BUILDER DECLARATION q W I herebyaffirm that I am exempt from the Contractors License Law for the a O following reason.(Section 7031.5,Business and Professions Code:Any city or county $27500 x; which requires a permit to construct,alter,improve,demolish,or repair any structure ay„ prior to its issuance,also requires the applicant for such permit to file a signed statement E-Zathat he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 36t7.E1 A&@ Valuation tom- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or a that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of Ply`IN Occupancy Type not more than five hundred dollars($500). 102 - PIERS I E-,RS l7 y yP 0 I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and he structure is not intended or offered for sale(Sec.7044,Business and Professions Code:The Contractor's License Law does not apply to an owner of 104 - REBAR Required Inspections property who builds or improves thereon,and who does such work himself or through his own am ployees,provided that such improvements are not intended or offered for sale.If, 105 - ANCHOR BOLTS however,the building or improvement is sold within one year of completion,the owner- 10�1 - SEWER & WATER builder will have the burden of proving that he did not build or improve for purpose of sale.). 202 — UNDERFLOOR PLUMBING 0 I,as owner of the property,am exclusively contracting with licensed contractors to 203 - UNDERFLOOR MECHANICAL construct the project(Sec.7044,Business and Professions Code:)The Contractor's U_ cense Law does not apply to an owner of property who builds or improves thereon,and 204 - UNDERFLOOR FRAME who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. 205 - UNDERFLOOR INSULATION 0 I am exempt under Sec. B&P C for this reason 301 — ROUGH PLUMBING Owner Date 302 — TUB & OR SHOWER WORKER'S COMPENSATION DECLARATION 303 - ROUGH MECHANICAL I hereby affirm under penalty of perjury one of the following declarations: 304 - ROUGH ELECTRICAL 0 I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the 305 - FRAME work for which this permit is issued. 306 - HOLDOWNS 0 I have and will maintain Worker's Compensation Insurance,as required by Section 307 - INSULATION 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Work�nsa carrier and Policy n berare; 308 — SHEETROCK ca eePali � 309 — EXTERIOR LATH COMPENSATION INSURA CEEORKERS' 310 - INTERIOR LATH (This section need not be completed if rite permit is for one hundred dollars($100) 311 - SCRATCH COAT or less.) 313 — ROOF NAIL I certify that in the performance of the work for which this permit is issued.i shall not 5 01 — FINAL ELECTRICAL ENERGY employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date 502 _ F I NAL PLUMBING ENERGY Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should 503 - F I NAL MECHANICAL ENERGY became subject to the Workers Compensation provisions of the Labor Code,you must 504 — F I NAL BUILDING ENERGY 0 Z forthwith comply with such provisions or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY 505 - FINAL ELECTRICAL H I hereby afflon,that there is a construction lending agency for the performance of 506 - GAS TEST �° ✓~ the work for which this permit is issued(Sec.3(197,Civ,C.) 507 — FINAL PLUMBING w Z Lenders Address 508 - F I NAL MECHANICAL Lenders Name Z U0 I certify that I have read this application and state that the above information is 509 — F I NAL GRADE w correcL I agree to comply with all city and county ordinances and state laws relating to 5 FINAL PLANNING ® building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against 1 _ FIN PUBLIC WORKS r�«r CJ.I liabilities,judgments,costs and expenses which may in any way accrue against said City ` J U Z in consequence of the granting of this permit, ,L( �_y,�// t"t APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON'-POINT Issued by: Date t,f SO R•E RE UL NS. - '} 1 Re-roofs 6ygnature of Applicant/Contractor �.ri arc HAZARD ATERIA J Type of Roof Will the applicant or future bui ' upant store or handle hazardous material as defined by the Cupertino Muni' al Code,Chapter 9,12,and the Health and Safety Code,Section 25532{a>future All roofs shall be inspected prior to any roofing material being installed. Q Yes ��N.' Will the applic ' sng occupant use equipment or devices which If a roof 1S Installed Without first Obtaining an inspection,I agree to remove emit hazardous air confined by the Bay Area Air Quality Management all new Materials for inspection. District? 0Yes I have read the hazardous materials requirements under Chapter 6,95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and25534,I understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the requi a hi hmu metpLio tai�aCeruficatce�Occu !y. Signature of Applicant late 1 ''5wn mor authorized agentDate All roof coverings to be Class"B"or better nfi 50 0,U fill, 1311/2 VAM2756 VAM2766 VAM2756 rr CW1260 Cjj_E C°Ni26 i - CW2260 CW1260 FC-NB FC-NB FC-NB FC-N8 CD558.5"H 558.5'"H �4 X53 CD$58.5"H CD558.5"H XS3R 2 i i VD27 21 TVCC551(S/R 71381) TVCC551(5/R 71381) EX53L EX5311 f t, SHOWCASE KITCHENS Client: AMMAD YAZDI MFG: Crystal View: Plan 12333 SARATOGA-SUNNYVALE RD. Phone: 408-252-7681 CUPERTINO Door style: Country Classic fo-COF Scale: Seale-to-fit SARATOGA, CA 95070 Design: YAZDIMASTERBATH.ROM Pull: None Date: 10/30/02 408-253-0412 Designer: JOHN SWARTZ Builder: JOHN SWARTZ Page: 1 } -333 54 i I I I ` f I I E I V3018 I V 018 ! i EX53PA I I I VS824 3 951/2 �` �',vl Gt7 951/ xt M' , r 36 i✓1 r LI a{a L.i L F SHOWCASE KITCHENS Client: AMMAD YAZDI q MFG: Crystal View: Pian 12333 SARATOGA-SUNNYVALE RD. Phone. 408-252-7581 CUPERTINO Door Style. Country Classic fo-COF Scale: Seale-to-fit SARATOGA, CA 95070 Design: YAZDIHallbath.ram Pull: None Date: 10/30/02 408-253-0412 Designer: SOWN SWARTZ Builder: TOWN SWARTZ Page: 1 zs.'� �s.•_ _ €$zsa .R Iisa "s�sT.'' xgH <s>g aExsc�s s €s ' �x� `e€_ _ a = ass' a =_ �oas�k_a `; E x-.gr a'�x"€a0 s$ #sig$D. ase £ 3` ° s s : Exe cep � 's .€ a. x� :'xx `-a •zaxa; €_ ax s`fe R " €` :€ a m3 E €. s j a €ga $�a z^� '`€� '�:NF-H =y if " '� z 'v'� �-y `'j�iv'�� •- o � G'J � ,�,g ,� Ell - t u; �o x PVa e a _ a4 IN l � Y12,0 �-x'�, #- - eL� E un vi _ro3a o.c.«g Xe` it ac. n a 0 a 3 o =s» E23 UP 2 1--01-Hil =.$z" a�s5xm ° =--"=as °°-'__ °a 8s ow _ bs=s.x aha- Rai ss ews -_ aK �_u._u�o