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02080067 CITY OFCUPERTINO ':' fah ,,. +.,le: a. .arz .. BUILDING DIVISION PERM* :CONTRACTOR INFORMA'�N:,. g�D'T6NG DOWN RD XOTEK INC � IT 02 B,t3gg74080067 'M MF4•IALKER 3300 E CASTRO VALLEY BLVD. APPLIIFglN ffJ3002 PHONE: SANITARY NO. CONTROL NO. (510,) 538-1987 c o ARcxrrEcnPsicINEER: f BUILDING PERMIT INTO BLDG ELECT PLUMB MECH 0 O y Z LICENSED CONTRACTOR'S DE ion of CION Job-UAL PANE) Ozy 1herebyahvmiv1amIkenseduodctpitPreeofChapter 9(cmmlucens{ REPLACE WINDOWS lD scrip Pt's with Sectio. ud.fDivision Jof Ne Bueine)s and Professions Code,and my license is in full fgfm/and ellen. yL G.e�.4 Liceme C4M Llf e 3a Contracto''rr� O Tri ARCHI7'ECI'S OEC"yssgAT10N \ \ t t S I understand my plans 0.11 be wed to puDbNNc mconds �Ny aLicawProkenonal p0 o ed R aOWNER-BUILDER DECLARATION 0, I hereby etfirm that 1 oto exempt form the Cmmmurr's License lax for the L:Z< following mason.(Section 70313,Boameas and Profusion,Code:My city ea countyOO re O which quite ro •permit to wtrocL cher,improve,demolish,or repair any srmcsure �j3$ —pneatoiuksuune,elan mquim tk appiiunt for such permino fikesignnd summers. - -- .... ._ _ __.._.._.___ _ tMt h6 Blimis(ed ponuinne ds�piovisians of the CanwctoB License Law(Che mr9 r •-, da� BiletiQra;•. 1 'r Valuation (commencinse gwithd..,700q)ofDivisionJof Ne Busmonand Pmrwiow Cade) or dui he is exempt therelmm dud to basis for Ne alleged ekemptiud.My violation ofnottamthane hundr�edid�o1.($500).nit'uDlm++dmapplicantwacivilpevlry 101APNMI1ZOATION Occupancy Type ❑I.u owner of Ne property,tar my employee with boa{e es their sole compematinn. . 102 — PIERS will do the"A.and the structure Is not intended or offered for We(See:7044, B ],O3 — UFER mimi.anit Profesioe TM Convector's TConvector's License Law does out apply to an Required Inspections owner of property Wha builds or improves thereon,and who does such work himself 104 - REBAR 11 Nrovgh his awn employee.provided Nat such improvements tae not intended or .6= employee. IL however,the wilding or impre emam is sold within'one year of 105 — ANCHOR BOLTS completion,that owner-wilder will have the when of proving Nes M did not wild or improwmrpurpomarek.). 106 - SEWER & WATER i a. a"rhe" " _. _. _-.._ .__ _. ..-. . io 202 - "UNDERFLOOR PLUMBING - _ property,am eclusively convecting with Bttwed coauecmn b ' co t da.porjem(sec.7M4,Bsalnes and Profesioe Coda:)The Contractor's 203 — UNDERFLOOR MECHANICAL ;p License law dar not apply to an owner of property who wilds or improve Nemo., .and who mmrmis for such p jece.wiN.a .n=w,(.)licomed.pursunnt to Ne 204 _ UNDERFLOOR- FRAME - _ o ,B&PClmdhisquon 205 - UNDERFLOORw:INSUliATION oiaQeyf' D:m ,.�� 301 - ROUGH PLUMBING /V R'scOMP ON DECLARATION 302 - TUB & OR SHOWER I hereby arum ander penalty of perjury oite of the following dedamdons: 3 0 3 - ROUGH MECHANICAL ❑ 1 have and will maintain a CenlBcata of Consent so sell-insum tar worker's 304 - ROUGH ELECTRICAL Compensation, a provided for by Section 37M of Ne Laver Cade, for Ne perf..e of the work far which Nu permit is issued. 305 - FRAME ❑1 have and will maintain Woher'e Compensation Insurance,u requited by Sation 306 — HOLDOWNS 3700 of the Labor Code,for the performance of the weak for which this permit is 307 — INSULATION issued.My workers Compensation Insurance terrier W m Policy number e : 308 - ' SHEETROCK' .cdaTIM ATIONOF 6tAF MOMWORMRS'_ coMPFddsnnoNwSL3RANCE. , - -310-:-„-I-NTERIOR--LATH ._. ... .__... ....__. _.-._ ._.. ' (Thia'eectios'need not In,completed if the permit is for one hundred dollars 311 '— 'SCRATCH COAT (5100)or kss.) 313 ROOF-.NAIL -.. .I tenplo rain the of the work forJoua this to iasoea,i 501 - FINAL ELECTRICAL'�ENERGY A. tin oy wsy n any manner so m bac me subject to Ne Worked' — Com n do of mie:Dae �'l:•u£ 502 FINAL PLUMBING ENERGY N c .efk,makm'NisCanlrosofExemption,you should 503 - FINAL MECHANICAL 'ENERGY o pbecome subjm w the Workeh Compensation provisions of the Low,Code,you must form wit comply wiNaucbprovialaworthis permit%hall cdramedrevoked, 504 - FINAL BUILDING ENERGY CONSTRUCTIONdormisLENDMG AGENCY SOS — FINAL ELECTRICAL ” - 1 hereby whom this Nem is a Issued(Sco.017-C agency for the peiformonu of the work for which his permit is Issued(sec.3097.Civ.CJ ` 506 GAS TEST y.0 Lender',Name.. .... . .. . . . .._.. . . .. . -:.. 507' = FINAL PLUMBING .. .. .. .... . . _ _. ... �Z Irnder's Mdrtss ,'•' V .,� I codify Nal I have read Nis application and state Nat Ne above information is 5 0 8 FINAL MECHANICAL : ' E„t correct.I since to comply with ell city and county ordinances and mete laws relating 5 — I NAL GRADE f, to wilding connotation,and hereby audmdm rePonam rivew of this city to enter upon (� the above-mentioned propcmy for iwpecoo_n pugwses. 5 O — INA P NG Qa' (We)agreerossve.indemnify am!keep hmmlemthe CiryofCupertinoagainst 51 - INA B RKS y liabilities,judgments,cans and espenus which may in any way accrue against said V'^ City in consequence of the gaming of this pnmit. APPLI III 'E ,4YD5'A.ND WILL COMPLY WITH ALL NON-POINT a c s.-- 8.'ag:o z Issued by t Date nnu pplkanULonvanor D Re-roofs HAZARDOUS MATERIALS DISCLOSURE !7 Will Ne'epplicam or fume wildu,occupom stom or handle harIDtlow m.u,ied ..._ as coined by Ne Cupertino7'e, ode,Chapter 9,12,and Ne Health and Safety Type of Code.Scout, 253J2P17, : , ...., r 1 r,• ' 1°.8` !`fR ave' All roo s shall be.inspected prior to any.roofing material being installed. Will the applic to orng«rupw�t we equipment ar acw;cr4 wmrh If a roof is installed without first obtaining an inspection;I agree to remove emit harardous air conmminanB n fined by the Bay Arca Air Quality Management Diauin7 all new materials for inspection.,,Applicant.understands and will comply.with aYe Na all non-point source regulations., - I have read the haendous mmerialsrequircme u.under Chapter 6.95 of the California Health k Safety Code,Sections 25505,25333 and 25534.1 understood that if Ne wddingdoe not cumendy have a teem,that it is my responsibility to notify the ' occupant of the requirements which muse be met prior to I....of a C,mi,ua of Occupancy. _ _ Signature of Applicant Date .: Ow auN Dore L All roof coverings to be Class,"B"or better ..... OFFICE .. .. - . ... . Q- PITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEI�TINO APN# Date: 492, yv , 0%6 9•�302 Building Address: 22963 Lanal,640% 90. 1 Ix 50;y Owner's Name: Phone#: yo4. 25 5. `I 61 C Contractor: License#: XO k \, 70066y Contact: Phone#: Qa\^cr Q�r cr goo 00. 330`1 Applicant/Contractor: Fax#: Acz*k � l.lg Vc r 5%0, 133 - 0.03'-7 Building Permit Info: Bldg Elect Plumb Mech Job Description: Residential: Q 4�; Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: 1136 Architect/Engineer: Valuation: Type of Construction: Occupancy G u . uanti Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX hid/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 13ELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Enerev BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BNEWMULTI New Multi-family Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUWING lof3 iib . 0 ._ _ 22°163 �oLown �oa2 —t 77 SUBMITTAL IMA4GOMAIN` GvW"ft4EtGITY(OF,. SUB .. V6 ORDINANCES. Min;e09 1 'luor and specifications MUST Nxi 14of t on'.. ,'job at-all Unm and it is-un - _ . .. . . Va !tu4 3o makaany chango 4r alterations ,-• _ can soma without written permission ftom ;yio building Dept:-, City of-Cupertin0i _-- -- - - - — - - -- - •--- ---- The stamping of-thisplan and s ecificaticH ^ _ SHALL NOT be held to permit of to ba an —` pP vof the ance.on'of, any P.ro Ill Jn ._ra. env.Gity Qrdinance ot_S4E9 LM - - 5\eePr 7 OFF CE 01 I 34"cLFa,R 20" CLEAR N MINIMUM OPENAFILE AREA 41" CLEAR OPENABLE=' . • 5.7 SQ. FT. AREA 24 MINIMUM CLEAR 5.7 SO. FT. MINIMUM j MINIMUM MINIMUM SIZE MINIMUM SEZE WINDOW WWDOVVFOR FOR 24"CLEAR HEIGHT I 20"CLEAR WIDTH I SILL HEIGHTI I 44" MAGBM� TTAL R1JOR MINIMUM SIZED RESCUE OR ESCAPE • WINDOWS FROM SLEEPING ROOMS Sec. 1204 CITYof c DIIVISSIIONN� BUILDING CONTRACTOR INFORMATION: RMIT NO. B�R}2D�N Y LONG DOWN RD XOTEK INC PE0208000y67 Ask rin"WALKER 3300 E CASTRO VALLEY BLVD. APPLICFgN/13/002 IfPHONE: (510) 538-1987 SANITARRYNO. CONTROL NO. 8D ARCHITECTMNGWEER: a BU LDING PERMIT INFO BLDG ELECT PLUMB MECH Z 6 L = I-__U r... fJ I- LICENSED CONTRACTOR'S DECLARATION o m 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing IO DOSCCI tl ❑ °„ with Section 70(1 of Division 3oftheBusinesanaPmfessionsCoca,onamyhrense REPLACE WINDOWS (DUALpP�1NE) -ase isiense)fprcyenJ erten. - NALE13 K 6 License Qa74 LIE.M I�B E M �a OContractor 3 D In ARCHITECT'S DECfx ATION et S I understand my plans shall he used as pts c records FEB 1 8 2003 yo o Licensed Professional - x o K OWNER-BUILDER DECLARATION p� til 1 hereby affirm f irm that 1 am exempt from the Contractor's License Law for the BUILDING C Z following reason.(Section 7031.5,Business and Professions ConAn Costa: y city or county $7000 I O which raquirtx a permit to construct,thin,improve,demolish,or repair any strunurc Oor to its uuani also req rtes the applicant for such person to rile a signed statmem - rw. that he Rlmseled pursuanto the piovrions of the Contractor&License Law b7thapter9 i,,. 34$.nµs/('� Qrkg3yea l r 1 Valuation (o ting with Se,,1m7(XMof Dinar 3 tittle Busmcssnna professions Cruel �,su xl�Nt _, &..`,Rl j.ys' i.ta' t. .F l..A 3.u,.,.l or that hen exempt thcrt6om end the basis for the alleged exemption.Any violation of Section 703P.5 by any applicant for a permit subjects the applicant to a civil penalty Drum mon thom Co.hundred dollar(s($50, 1 O 1 APN)rbU3MAT I ON Occupancy Type ❑1,as Dant,of the loo,my,o my employees with wages as their sole rimimm&mma, 102 - PIERS - urdo_the'work: ad he swaurc Is nnnmended or nvena'farsile(Ser.-70W. 103 - UFER Required Inspections •`J' Business and Professions Cade The Contractor's License low does not apply to an " owner of property Who builds or improves thereon,and who does such work himself 10 4 - REBAR othrough his own employees. thailded_that such improvementstissolwi not intone dedyear or 'corenami&m< Irho theWavethe men of lin etndnotWildor -_.. -_ - ANCHOR BOLTS &prove for tin owner s Iter will have the bud of Dmv g thin h did not build or completion.me paryon of sole.). 106 - SEWER & WATER 1 l ' c tig w 202 -UNDERFLOOR--PLUMBTNG-- 1 e o� f hempeny.amexcaly nt const tBusiness -- the p deet(Sec lona, tad Pnf<sslons code 7 due Commcto's 2 0 3 - UNDERFLOOR MECHANICAL- License law does not apply to an owner of property who Wilds or improves thenen, road who contracts ra such prod n.wimaeontractor(,)Ettaxed.potsaon,.t m . .- -.- --204 - UNDERFLOOR­-FRAME _ _ .---- f C , est Lmense t ❑I m< tam sea 11&PC far do, son 205 - UNDERFLOOR'"'INSUliATION o Date � 4+g.1; 3 01 - ROUGH PLUMBING R'S COMPENSMt10N DECLARATION 302 - TUB & OR SHOWER I hereby affirm Under penalty of perjury one of lo following declursomm: 303 ROUGH MECHANICAL ❑ I have and will notation's Certificate of Comsent'm self-instill for Workers 304 ROUGH ELECTRICAL Compensation, as provided for by Section 3700 of the Labor Code, for the 3 05 - FRAME performance of the'work for which this permit is issued, 111 luveandwill maintain Worker's Compensation Insurance.ax iegaitM by Section 306 - HOEDOWNS 37W of the Labor Code,for the parromiamte of the work fon which this pursuits 307 - INSULATION -' issued MyW rk es Cminfiercuitivin Insula ce came,and Policy umber arc -- 308. SHEETROCK"- CERTIFICATION OF •Pra101RTd6 FROM WORN K�RS'1 - - _ '1 ' M .30'9.' f- .:EXTERIORi.LATH"(_: _ COMpENSATIONINSURANCE -INTERIOR-LATH -- '- - - --'-'- ----- '1 (Tbn seciliin need ret W ai nplend if the permit is for one hundred dollars 3 11 '- Y.Ci CRATCH COAT F x stool 1e.,1 . _.3.13...- ROOF._NAIL-. ,.. 1 can fy that t the pe urn race f tit k for whish tit' pc ,Coni tall,o.. wofNf)rmWD nn rs� i;be t mew-,ken 501 - FINAL PLUMBING ENERGY thatI t to n NOT wire&men 502 FINAL PLUMBING .ENERGY P.y/i yA provisions g p Certificate P ate .. - .. - .-_ ... ._ . . .... /Ry`� ttM�Ime rmakin nrrE mm.yooshouldumust 503 - FINAL MECHANICAL"ENERGY '- •' " bcc h comp m the such pr Compensation Provisions of the Labor Cook,you roue O C forthwith comply onsorthn ret nmlxa deemed 504 - FINAL BUILDING ENERGY ----- �1 - CONSTRUCTION emisaconstruction LENDINGAGF.NCY ' SOS - FINAL ELECTRICAL ' 1 hereby affirm that Vert tx- con, rat n leading v.C. for the perfmmmtt s- - rl• a o{tn Niume - ' Permit issued 3097 Civ.ed 506 - GAS TEST Lrnder sN e. . _.,.,.. c -507- .. .. a q . _ .. ._.. 507 ..-_•.FINAL'-PLUMBING Z ten&npdmaa 5089,-11,'. FINAL MECHANICAL - J v.s.f. 1 certify tom I have mail this application and sure that the above information is 5 - INAL GRADE ka-F rarren.bagr<e tmmnp1y,with all city and county oNimaws mces and stare lrelating O'V mbuildingconstcctmin.and hereby ammonia iepresentmivesofthisthyroenterupon 5 0 - "INA P NG '.-raj .the abo a me tioned p perry far inspection proposes., (..rL (W) gneeruV a ndematfyandk phi mlessthe City olCupmsooagunst 51 - INAL B RKS h liabilities,dudgmems cous azul,es,rue,which may in any way accrue egaimt said / f, City in cirmeNtonct,of thgr rat f tit t / 'APPLI INTUNDEPSIANDSANDWILLCOMPLYWITHALLNON-POINT'' {� , OUP E REOU ONs: 6 D Issued by; Date at PPI can ontisctor DRe-roofs HAZARDOUS MATERIALS DISCLOSURE Will the applicant or fiature pudding occo,con,states handle hat o nammil Type Of ROOF .a d fuiW by Cis n Mutt oil Chapter 9 13 d the Health d Safety _ s Coda Sttu on 553 - y,i s sl-3i ❑Ye. - N tT- 1'.S .,.f l f a All roofs shall be ins petted pnor.to any roofing material berg installed__ ... m . Will theeppl to tarcbd ,a, .cup t serq 'p ,a,deuce which If a roof Is installed without first obtaining an inspection,I'a ree'to''remove emit heard us sir collum nano es fined by the Bay Arca Air Quality Management Distinct? r _. P ..g -Applicant d will comply,with „ ,ore - -,, No -. a new materials or inspection. A lean[understan s an all 66n-point source re ulatlons,� 'I hoed read the hazardous med'aals rcquircmenu under Chaise r 6.9510!the ` Cilifomia Health'&Safety.Code,Sections 25505,25533 and 25534.1 understand that lifthe larldingaoes not currently have d nnsnLthat itis myyresponsibility tanotify the - 'o2cupem of the requirements which must be me,prior to issuance oft Certificate of °`ap°°ey Signature of Applicant Date o urn otk�L All roof coverings to be Class-"B"or better . :. . .. -OFFICE... .. . . .. __. .. ....- .. . _ . ........ ..._