05090175 CITY OF CUPERTINO dl&x' dse -'
BUILDING DIVISION PERMC�NTRACTQRINFOR 'TA„
AlnS�, "'�:,*a4 aP tsu^W, .�W�ygh
JIWTNG ADDRESS: PERMIT NO.0 5 0 9 017 5
147 LOREE AV
OWNER'S NAME: PERMIT ISSUE DATE
ROYALA, DEEPIKA 09/27/2005
PHONE: SANITARY NO. CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
'Loc LICENSED CONTRACTOR'S DECLARATION JobDescri tion
m 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing P
Z with Section 70bincr Division 3ofthc Business and Pofumm.Code.and my he...is
infull Into andeffect. ?' REMOVE MSTR BATH STALL SHWR WALLS AND RESTORE
z License Class�Lk.N,
�La Dalc— Q— Cantrecmr '? DAMAGED WOOD MEMBERS, WALL FRAME SUB-FLOORING
7t �' acHPrEcrs DEeuJoillow
I understand my plans shall W wed as public records
1wg C Licensed Professional
g OWNER-BUILDER DECLARATION
2I hereby eRm
that 1 em exempt fru.the Commemr's License Law for the
CO following mason.(Section 703 1.5,Business and Prufegiog Code:Any city or county
S29!
$9! which require•Permit,ocwro mct,almr.impmw,demolish,or repair any saucture
prior to its issuance,also requires the applicant for such permiuu rile a signed statement
RRNet he u licensed pursuant I.the provisions of the Communist's Lkense❑w(Chapter 9 Sq.Ft.Floor Area Valuati
a (cosamecing with Section 7000)of Division 3 of the Business and Protrusions Code)or
Q�$ slut be is exempt therefrom and the login for dm alleged eemp0on.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant m e civil Penalty ofqAp}�+�i AM
er Occupancy Type
m
not mothan five hundred dollars(5500). 3 /�V I 00
Q 1,as owner of Ne property,or my employees with wages as their sale compensation,
.,It do Me work and the structure is not Intended ar offered far sale 7044,Businw Required Inspections
and Pmfiwd ons Code:The Conuacme nsr'a License law does not apply to an owner of q P
property who builds or improved thmeon,and who doe such work himself or through his
own employees.ping or thmsuch impro i4 ms tMi re.ynot eardedoroReted for ask.If,
j
however,Ne building or improvement is halt within one year of improvCroulloman.for the owrrcr
builder will have the bothers of proving that he did not Wild or improve far purpose of
sale J.
❑1,as owner of the property,em exclusively contracting with licensed convenors to
construct the poke,(Sec.70da,Business and Pofegiog Cade:)The Commences LF
orae law dog not apply m an owner or pmpeny who Wilde or improve Norton,sod,
canmcm for such projeeo with s eomsector(s)licensed pursuant to the commerce,
Ise law.
am exempt..or Sec. ,Bd:PC For this moon \/ J
Owner Data
WORKER'S COMPENSATION DECLARATION
I hereby alaran under penally of perjury one of the following declarations:
❑1 ham and will maintain a Cerificate ofConsem to selbinaum for Workers Compen-
satum.as,provided for by Section 3700 of the labor Code,far Ne perAmeanm of the
work for which this permit Is issued.
0 I have and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of Ne work for which this permit is issued.
Myworkees Co Rsatlanin ranee on end Politynumbmam:
Carrier. Policy No.:/7�;?e��d _
Im CATEOFEXEMPTIONFROM WORKERS'
COMPENSATION INSURANCE
(This section need not W completed if the permit is foronc hundred dollars($1110)
less.)
1 certify Net In the performaneo of Ne work for which this permit is Issued,I shall not
employ any person in any manner an u W became subject to the Worker'Compengdon
Laws of California.Date
Applicant
NOTICE TO APPLICANT:IL after making this Cediacsm of Exemption.you should
became subject to the Worker's Compcgauan provisions of the Labor Code.you must
.JO forthwith comply with such provisions at this Permit shall be deemed revoked.
r N CONSTRUCTION LENDING AGENCY
t~ I hereby affirm that them its construction lending agmmy lot the performance or
ix ?
0
• CITY OF CUPERTINO
Item 1 of 1 PERMIT RECEIPT OPERATOR: christya
COPY # 5
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 37507030 . 00
DATE ISSUED. . . . . . . : 09/27/2005
RECEIPT # . . . . . . . . . : 31364
REFERENCE ID # . . . : 05090175
SITE ADDRESS . . . . . : 19147 LOREE AV
SUBDIVISION . . . . . . .
CITY . . . . . . : . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ROYALA, DEEPIKA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : BOBS
CONTRACTOR . . . . . . . : STEFFENSON JR, JIM LIC # 19668
COMPANY . . . . . . . . . . : HOMEGUARD INC
• ADDRESS . . 510 MADERA AVE
CITY/STATE/ZIP : SAN JOSE, CA 95112 '
TELEPHONE . . . . . . . . : (408) 993-1900
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 5, 000 . 00 115 . 56 0 . 00 115 . 56 0 . 00
BENERGY PERMIT FEE 115 . 56 55 .47 0 . 00 55 . 47 0 . 00
BPFIXTURE UNITS 1 . 00 9 . 00 0 . 00 9 . 00 0 . 00
PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
BSEISMICRE VALUATION 5, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 218 . 90 0 . 00 218 . 90 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 218 . 90 39038
TOTAL RECEIPT 218 . 90
•
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4CITY OF CUPERTINO*
S111YOF
CUPEI�TTINO PERMIT APPLICATION FORM
APN# Date:
3 -7- 0 �-03 0 q_2--7 -o r-
Building Address: Mailing Address (if different from building address):
/"A F41, d/
Owner's Name: y Phone#:
L'6
ontr ctor: rLicense#:
Contact: Phone: Cupertino Business License#:
Fax: p —
uilding Permit Info:
Bldg ❑ Elect Plumb ❑ Mech
Job Description: Pl-icvt /"p ll 3" �
Residential WJvommerciaBl (]� �''/��Y V•� �r�
Sq.Ft. Floor Area: q.Ft.: a
Cost of Project: Occupancy Group
Samoa o yL_?:
e of Construction: Please check this box if the project is a
second-story addition: ❑
Project Size: Standard ❑ Laze ❑ Major ❑
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
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<= IOOOA ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V <=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
I�
1 of h '
ITY OF CUPERTINO*
CUPEII;o PERMIT APPLICATION FORM
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
BPFIXTURE Pblg 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 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 clin MECHANICAL
BREI UMIAN A/C Units <= 10,000 cfrn MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFD{T Lighting Fixtures ELECTRICAL
BRBMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Fumace> IOK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BRENU 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
BREMRESAPP Remodel Res Appliance ELECTRICAL
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SCITY OF CUPERTINO*
CUPEI�TINO PERMIT APPLICATION FORM •
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
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Chane BUILDING
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Irk
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CUPERTINO =
Assessor's Parcel Number: J'
Name of owner. po 14
Project address..
Contact person. T2,ao .)-.. Ae9e� Phon . / 40
Fax. yy
Net square footage of lot.
Existin Proposed
Square footage: First floor:
Second floor:
Garage:
• TOTAL:
Are there at least two 10 foot by 20 foot clear spaces inside the garage? Y N
Is privacy protection planting required for the project? Y N
On what floor(s) is work being done? [S/ f 2
Brief description of work. 4t4- A-1QQ o zl -�;V �l1�/co,
e�
Tez
Code editions:2001 CBC (Y -N)2001 CFC (Y -N)2001 CMC (Y- N)
2001 CPC (Y -N)2001 NEC (Y -N)
Effective 11/1/02
•
Plan Review Process Work Book Page-B-Revised 4/28/04
• WOOD DESTROYING PESTS AND ORGANISM INSPECTION REPORT
Building No, Street CityZIP Date of Inspection Number of Pages
19147 Loree Avenue Cupertino 95014 8/9/2005 Pa e 1 of 3
510 Madera Ave
�[
San Jose, CA 95112
HomeGuard (408) 993.1900 • Fax (408) 993-1944
Incorporated Registration # PR1452 HomeGuard Rpt#: 100174 /
Ordered By: Property Owner/Party in Interest Report Sent to: Escrow#:
Deepika Rayala Deepika Rayala
19147 Loree Avenue 19147 Loree Avenue
Cupertino, CA 95014 Cupertino, CA 95014
COMPLETE REPORT❑ LIMITED REPORT SUPPLEMENTAL REPORT ❑ REINSPECTION REPORT ❑
General Description: Limited to master bathroom and wall on outside of Inspection Tag Posted Kitchen sink
structure beneath the master bathroom only. other Tags Posted None Noted
An Inspection hes been made of the structure($)shown on the diagram in accordance with the Structural Pest Control Act.Detached porches,detached Steps,
detached decks and any other structures not on the diagram were not inspected.
Subterranean Termites❑ Drywood Termites ❑ Fungus/DryRot I] Other Findings ❑ Further Inspection ❑
• II en of the above boxes are checked,it Indicates that there were visible problems in accessible areas. Read the report for detalls on checked Items.
Key to Items on diagram: [1]Section 1 Items [2] Section 2 Items [3] Unknown Further Inspection Items
1 . .SEP 2 72005 20�D
OS V
1A
1B / VV
FRONT
Diagram Not To Scale
• Inspected by: James H. Steffenson Jr. License#: OPR8210 Sigmmare: ,.r_(_
// -------- ---
J
You are entitled to obtain copies of all reports and completion notices on this property filed with the board during the preceeding two years.To obtain
copies contact:Structural Pest Control Board, 1418 Howe Avenue,Suite 18,Sacramento,California 95825-3204.
NOTE: Questions or problems concerning the above report should be directed to the manager of the company. Unresolved questions or problems
with services performed may be directed to the Structural Pest Control Board at(916)561-8700, (800)737-8188 or www.pestboard.ca.gov.
uilding No. Street City ZIP Date of Inspection Number of Pages
9147 Loree Avenue Cupertino 95014 8/9/2005 Page 2 of 3
It has been requested that this report be limited to the master bathroom and wall on
outside of structure beneath the master bathroom only. It is recommended that the
entire structure be inspected. HomeGuard Exterminators will, upon request, inspect
the entire structure at an additional expense.
NOTE: WORK PERFORMED BY OTHERS WILL BE REINSPECTED BY THIS
COMPANY FOR A REINSPECTION FEE OF $125.00. OPEN WALL AND OPEN FLOOR
INSPECTIONS ARE REQUIRED IF A CERTIFICATION IS DESIRED FROM THIS
COMPANY. REINSPECTION MUST BE PERFORMED WITHIN FOUR MONTHS OF
THE ORIGINAL INSPECTION DATE; SCHEDULING FOR REINSPECTION MAY
REQUIRE AS LONG AS TEN DAYS TO BE MADE.
NOTICE: Reports on this structure prepared by various registered companies should
list the same findings (i.e.termite infestations, termite damage, fungus damage, etc.).
However, recommendations to correct these findings may differ from company to
company. You have the right to seek a second opinion from another company.
NOTE: WE GUARANTEE CHEMICAL TREATMENTS DONE BY THIS COMPANY FOR ONE
YEAR AND FUMIGATION'S DONE BY THIS COMPANY FOR ONE YEAR FROM THE
DATE OF COMPLETION. WE GUARANTEE WATER DAMAGE REPAIRS FOR THIRTY
(30) DAYS FROM THE DATE OF COMPLETION. WE CANNOT GUARANTEE WORK
• DONE BY THE OWNER OR OWNER'S AGENT. WE MAKE NO GUARANTEE AGAINST
FUTURE INFECTIONS, ADVERSE CONDITIONS, OR CONDITIONS PRESENT BUT
NOT EVIDENT AT THE TIME OF OUR INSPECTION.
NOTE: THIS IS A SEPARATED REPORT WHICH IS DEFINED AS SECTION I AND SECTION II
CONDITIONS EVIDENT ON THE DATE OF INSPECTION. SECTION I CONTAINS
ITEMS WHERE THERE IS EVIDENCE OF ACTIVE INFESTATION, INFECTION, OR .
CONDITIONS THAT HAVE RESULTED IN OR FROM INFESTATION OR INFECTION.
SECTION II ITEMS ARE CONDITIONS DEEMED LIKELY TO LEAD TO INFESTATION
OR INFECTION BUT WHERE NO VISIBLE EVIDENCE OF SUCH WAS FOUND.
FURTHER INSPECTION ITEMS ARE DEFINED AS RECOMMENDATIONS TO
INSPECT AREA(S) WHICH DURING THE ORIGINAL WSPECTION DID NOT ALLOW
THE INSPECTOR ACCESS TO COMPLETE HIS INSPECTION AND CANNOT BE
DEFINED AS SECTION I OR SECTION II.
Section 1 Items
NOTE: The owner has opened the exterior wall and exposed damage to the framing. A bid
is given for replacement of all damaged wood members. At the request of the owner
all findings, recommendations and bids are listed below.
1A FINDING: The studs, rim joist and stucco blocking have been damaged by fungus at the,
exterior wall.
RECOMMENDATION: Remove and replace all the damaged wood me•rbers. If any damage is found to
extend into any enclosed areas a supplemental report and 'Did will be issued.
• (SECTION 1 ITEM)"—
NOTE: The above bid includes restuccoing the area on tI e outside. HomeGuard Inc. will
match as close as possible the existing stucco texture. However, an exact match.
may not be possible.
1B. FINDING: The subfloor and wall plate were found to bra damaged by fungus extending under
the precast shower.
Building No. Street City - ZIP Date of Inspection Number of Pages
19147 Loree Avenue Cupertino 95014 8/9/2005 Page 3 of 3
RECOMMENDATION: Remove the existing precast panels remove and replace all damaged wood`
members. Then reinstall existing panels to eliminate all damage.
`...'"(SECTION 1 ITEM)..."'
NOTE: If new material for the shower walls and pan is to be purchased the cost for this item.
will increase by$3,500.00.
NOTE: In performing the above mentioned repairs sheetrock will be removed
adjacent to the shower. Our bid includes replacement of sheetrock. However, does
not includes painting this area. The existing shower door and glass will be reused.
NOTE: HomeGuard Exterminators does no texturing, painting, or wall papering. However, we will
cover exterior wood work with one (1) coat of white primer weather permitting.
NOTE: If damage is found to extend into any inaccessible areas, a supplemental report will be issued
listing additional findings, recommendations, and bids.
NOTE: HomeGuard Exterminators assumes no liabiiiiy for, nor do we guarantee, work done by
others. All guarantees, warranties, and permits should be obtained from the parties
performing the repairs.
NOTE: Should the local building department require additional changes or repairs not outlined in this
report, additional funds will be required.
NOTE: There may be health related issues associated with the findings reflected in this report. We
are not qualified to and do not render an opinion concerning any such health issues. The
inspection reflected by this report was limited to the visible and accessible areas only.
Questions concerning health related issues, which may be associated with the findings or
recommendations reflected in this report, the presence of mold, the release of mold spores or
concerning indoor air quality should be directed to a Certified industrial Hygienist.
NOTE: Thank you for using HomeGuard Exterminators, Inc. If you have any questions regarding this
report, please call and ask for James Steffenson. Please bear in mind that the inspectors
have full schedules during the day and can only be reached by phone early in the morning and
late in the afternoon. The inspector will make every effort to make contact with you when he
is available.
If you require further assistance or wish to schedule work as recommended in this report,
please feel free to contact our office. We are here to essist you!
•