06020172 CITY OF CUPERTINO '" �'
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BUILDING DIVISION PERMIT COMHU' CTnR INFO AVOW* '
a`ysa.3c F.'t�na~Tx,>x ,X. t.;i to
fiU1LDING ADDRESS: ROCKY LOWELL CONSTRCUCTIO PERMTN006020172
�- 371 MANN DR
ITS NAME: PERMIT LSSUE DAM
KATHLEEN ELLIOTT 10311 MANN DR. - 02/28/2006
ONE: SANITARY NO, CONTROL NO.
(408) 930-6786
ARCHITEMENGiNEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
30p
LICENSED
LDCONTRACTORS DECLARATION
loaffirm that
Iamlicensed under previsions ofChimer 9(commcming
Job Descriptiontion
wide Section 700)of Division 7 ofshe Business and Pfesoc,Code. nd my tic^"a u
In fall faaeand.11m.
ADD HALF BATH & CLOSET IN BEDROOM,
Lkanm Class Lie.Is Contractor MINOR STRUCTURAL
' pt Dak TSDEC
"} ARCHITECTS an DECLARATION
7 1 uMcrewnd tela plain than M uutl u public mcmdt
14
It c Licensed Professional ��
OWNER-BUILDERmDECLARATION
I hereby.(fire that I nm exempt from dac CononesCo License Law for the v
O following m n,a. on,t R131s.B.saw.a and Profnsaiuns Cod,:My city or county v/O
which mquirea a pumh to construct.alter,improve,dcmaliit t fl repair any aWqum
1e mantes Removed pursuant
requites thoapplicant fa Coninumi's Uccrosiguedsuumcm
G Neth,isncing wit putauant loth)of Diawiuo(Me Co,Irumra el Protiaw(s Code)9 Sq.F[. Floor Area V81Dat1
$ that he Is engwith therefrom
and
basison3 oftbueged ecompti n.My
Code)or
that he ls eumpt therefrom and sere bolt for,gat alleged eumptim.MY violation of
Section NOLS by am/applicant far a permit subjects the applicant to.civil penally of plan ber Occupancy e
not mare than five hundred dolWs(SXD} 32645028 . 00 - Typ
❑L se,owner of the property,or my employes with wgu as their role compensation,
Will do the wort,and the amumure isnot intended or offered forsak(Sec.7044•Business
and Piefesaians Code:The Carmichael Littnle Law does not apply to N owner of Required Inspections
property who bantam improves thereon,andwbu6masuch work hinisa fan through his
peso employees,provided that such Improvements are notinurued ano0ered fm We.IL
however•rte building or Improvement is sold within am year of completion,the owner,
binder win ham the burden of proving that M did ret Wild m Improve fm purpose of
"to I.
❑1.u owner of the property.1m reclusively cmmuung with licensem
consumer the pmject(Sea 7044.Business and Professions Cade:)The Co metals U.
tense law does not apply to an owner of property.who Wilda or improves,themes•and,
who carmen for such proJeeu with a eorambod0 licensed pursuant to the Contnmors
L.Icense Law.
s lam reemp1 under ,B&P C As,this maxon
r
s' WORKER'S COMPENSATION DECLARATION
1 heaby allim under penalty of perjury tem of the fallowing declanUmu
❑I
Inward will nummin•Ceniscom fCament m self--imus for Warrens Cowper.
-salon,u provided for by Section 3700 of the labor Cade.for the perfamance of the
work for which this permit is IabuN.
❑1 have and will maintain Warke's Compermtim hoodam,u requited by Scam
31
M00af the labra Coda far the performuseaf the wank fm which this Permit is issued.
My W,nkel Compensation Instant=carfier and Policy number am:
Calder. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
or kis.)(Tltii=I—rend amt be completed if the permit is for am hundred dollars g$100)
1 canlify that in the performance of the and fm which thus permit Is Lamed,10.11 not '
caploy anypermnin any manrcrwu ecom b' otheS Pr r pensNm
Laws of Cuifornia.pyg - / '
Applicant �j(
NUTICE Tp—LICA .If.after making this Cenlacme of Exemption,you should
become subJect he the Wallace-Compensation provisions of the Labs Code,you most
., forthwith comply with such provisions or this permh Nall he dttrmd rewkm.
z H CONSTRUCTION LENDING AGENCY
[-i 1 hereby seam that them Is a construminn lending agency for the perfurm ace of
CYi the work for which this permit a Issued(Sea 3097,Ci,C.)
6i Q lentleh Num
lenders Address
U6Q 1=fly that I have read this application end!tete Nn the abort mromalim 1.
LL w+ comm.I agree to comply with all city and county ordinances and fou laws mining in
O>, building construction•and hereby authamm repaunwlma of this city to near upon tlrc
[fI�L. above-mcmiomd property for impaction purpmes.a LL (WW,)agree to cow,indemnify and keep homeless the City of Calamine,against
I..i y liabilities,Judgments.emu and expenses which may In any way game against said City
V 7 In consequence of the Starting of this permit. -2-0(-'
��'v
C APPLICANT UNDERSTANDS AND WILL COMPLY WITH A N -POINT Issued by: Date �- a
• CE UytT10N - �f/O�
"f Re-roofs 2�-
IgnuurcalApplican onmecta' Dau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will ds applicant m future building meupanl same or handle hoodoos maurlal
farad by the Cupertino Municipal Code.Chapter 9.12.and the Heald and Safety
Smiles 25532(.)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes ❑Nu
Will the applicant en(more Wilding. Pant use egoipmant m tkvies which If a roof is installed without first obtaining an inspection,I agree to remove
it hazardous air conWninsnls u relined by the Bay Ma Air Quality Managemma all new materials for inspection.
DluricR p
❑Yes ❑No
I ham mad the hasum ous materials requirements underChapier 6.95 of the Ceilfor.
rat Heslk&Safety Cade,Semiom25S05.M533aa125534.iundemundthuifthe building
data not cumntly have a saint.that,It L my impeccability to floury and occupant of the
m i�my�iwh}'�hmuuWmet 'I talssoanceo .Canneries ofOccupancy. Signature of Applicant Date
.?—z8—ay
Owner or authorudaganl pqs All roof coverings to be Class"B"or better
A,*7 �Wa r ►' ✓ e� �
• Elliott Remodel Specs
Note: no new square footage added —remodel of existing space only.
Pining 13ac4+'OUM ' '
Room Remodel td Bedroom+ 1/2 Bath
Move existing HVAC register to ceiling in bedroom — c In soffit'
Add one outlet each to 2 exterior.walls
Closet
5' louvered French doors opening from center
'Center ceiling fluorescent light on switch w/motion sensor
57" rod across back
Shelf above rod
1/2 Bath
3 5' louvered French doors opening at center(right side with bolt)
Kohler Wellworth pedestal lavatory w/single hole faucet drilling 22"W'x 18"D x 34" (K2293-1)
Fluorescent light above mirrored medicine cabinet over sink
1'x2' Milgard double pane slider window centered on exterior wall 6' high
Tile floor
Kohler Wellworth Lite round front toilet 27D x 20"W x 28"H (#K3423)
Delta single handle faucet o
2GFI outlets
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SUNROOM MASTER
(UNCONDITIONED) . N� BEDROOM OFFICE
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UVINC/DINING 0 BATH 1 BEDROOM 2 I
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� Y� - CITY OF CUPERTINO
MTPI&I4A
cuP a 172—
7,xN 3 21 6 497 02 8 Date:o2 _021t - v'LOO&
BBiuiilding Address: Mailing Address (if different from building address):
0 3-7/ I;Va- nn JD rI' ✓V-
ner's Name: Phone
4 D i q 7 3 _ 5-9
/moo D
Contractor: License#:
t o" CoNSfru��iol�l 3 8 7 70
Conta t: Phone: -725--0/17 Cupertino Business License#:
konkv Fax: -y ZS- 8/bh
Building Permit Info: Con`�Cjfvuc¢ inj YA :C l3aVti q C/07Xe f in x 4 i 11
bldg a Elect ® Plumb ® Mech �
Job Description:
Residential ® Commercial ❑
Sq.Ft. Floor Area: I-Mq.Ft.:
cost�o�o�O occupauc�oyp:
Type�lof Constructio Please check this box if the project is a
second-story addition: ❑
o'ect Size: Standard ® Laze ❑ Major ❑
uant ity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BB,OILER3. 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 End/Off/Comm/Quasi BUILDING
BCONSTA-XBQ 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
BELEC200 Elec Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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