02100044 CITY OF CUPERTINO
BUILDING DIVISION p TCONTRACTOR INFO 4TION,;�
4i hr.. 4•� rsn<fl 9 rro':x.
BU112r2Gp9ggespalERCEDES RD WM H FRY CONSTRUCTION COM ANYN(�)2100044
OWDAV,,TE:& MELISSA RUSSELL 10351 SAN FERNANDO AVE APPLICATTUU&Ds�TF/2002
ONE: ' (408) 99 6-8173 SANITARY NO.// vv // CONTROL NO,
ARCHITECTIENGINEER; BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
�00 LICENSED CONTRACTOR'S DECLARATION
F 1 hereby affmh that 1 am licensed under Provisions of chapter 9(commencingCf
with Senion7f0fol'Division Sofdm Business and Professions Code,and mylianse REVISION--IN 8 2 ��� ONLY
infuufomeandeffea CHANGE GARAGE DOOR HEADER W/NEW
:oq'a Limanmclua Contra
ORIG. #02100044
OZ—
n t: Dam ComDECL
ARCHITECTS xu a DECLARATION
I uMcrsund my plain Nall he used as public recorOs
aO�U
µ� Licensed Professional
k OWNER-BUILDER DECLARATION
¢� p 1 hereby affum that 1 am esempt firm The Conuaelnra License Isw for the
00 following memotSecuun 703 1.5,Business and Professions Cote:Any city or county
$� which requires a Pamir in construct.alter,improw.demolish,or repair any structure
'^ poorto its issuance,sive requires TW Pe
applicant for such rmit to rile a signed statement
HNy�
that he is licensed prment m the pmviriov of TM Contractors License Law(Chapter 9 Sq. Ft. Floor Area $2VE00tlon
� (commencing wise Section 70011)of Division 3 of me Business and Professimn Code)or
n
Nhe u camp,mcmfrom roof the.ba is for The alleged exemption.Any violation of
Section 7031.5 by any applicant for i permit subjects the applicant in a civil penalty of
not mom sen five hundred dollars(M). e Occupancy Type
❑I.as owner of the property.or my employees with wage as their sale compensation.
will dome we&.and the structure is not intended or offered for We(Sec.70M,Business
and Professions Code:The Contracurs Liam Law dor not apply m n owoer of 102 - PIERS equlred Inspections
property who Wilds or improves thereon.and who doessuch work himselfor through his
own employaa,provided instructs improvements are iminunded or offered forule.If. 103 — UFER
however.the building or improwdu nt is sold within mho .of completion,the owoer-
builder will have me burden of proving that be did not Wild or improw for purpose of 104 - REBAR
51.1. 105 - ANCHOR BOLTS
❑I,u manor of the property,am exclusively contracting with licensed contractors to 106 - SEWER & WATER
covwn is project(Sec.7W.Buri•-..aM Profwimu Code:)The Corm acmes Li-
comm lswdoesdo,apply Tse•a owner ofpropenywhoWilds orimprovesthereon,and 202 - UNDERFLOOR PLUMBING
who convects for such project,aim a conuacur(q limned pursuant m the Contractors
Liens203 — UNDERFLOOR MECHANICAL
License,Law.
❑I and esempt under Sec. ,B&PC for this mason 204 - UNDERFLOOR FRAME
Owner Dam 205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATIONDECLARATION 301 - ROUGH PLUMBING
I hereby alritm under penalty or perjury We of the following declarations:
❑I haw and will mainWnaCGNRCamm(Coventwwlfdsnsum(orWorkerComPen- 302 — TUB & OR SHOWER
sation,u provided for by Section 3700 of the I&Wr Code,for the performance of The 303 - ROUGH MECHANICAL
work for which this permit is issued. 304 — ROUGH ELECTRICAL
1 haw and will maintain Workers Compensation Insurance,u required by Section 3 O 5 — FRAME
3700 of the LtWr Code,for The performance of the work for which this permit is issued.
My Workers Compensation lvururce carrier and Policy number art: 306 — HOLDOWNS
Carrier: Policy No.: 307 - INSULATION
CERTIFICATEWORKERS'
COMPENSATION INSURANCE
AAN308 — SHEETROCK
mo,section need nut M completed if The permit is fnnme hundred dolu.($IN)) 309 - EXTERIOR LATH
orless.) 310 - INTERIOR LATH
1 ccnify that in the performance of the work for which this permit is issued.I shall no, 311 - SCRATCH COAT
employ any person in ray member so u co
to become subject the Worked Compemuion
Lew,of California.Data 313 - ROOF NAIL
Applicant
NOTICE TO APPLICANT.If,after making this Certificate or Exemption,you should 501 - FINAL ELECTRICAL ENERGY
lemma subject Tr the Worker's Compensation provisions of the LaWr Code,you must 502 - FINAL PLUMBING ENERGY
O `z forthwith comply with such provisions or this Permit shall be deemed revoked.
wz 0 CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
[••�� I Wreby affirm that then is a consuuction ending agency tat the Performance of 504 - FINAL BUILDING ENERGY
W Z the work fur which this permit is issued(Sm.3097,Co.C.)
W Lenders Name
505 - FINAL ELECTRICAL
Q
aZ <nder,Aeare55 506 - GAS TEST
U O Icomfy mat 1 hew mad this application and sum that the above informeiur is 507 - FINAL PLUMBING
f' correct.1 agree in comply with all tidy and county ordinances and sum laws relating To
OU buildingconswction.ndherebyauthodxrtpasummivamfthisCitytoenteruponthe U,� j INAL MECHANICAL
W above-mentioned pmpenyfor ivpmoonpurpoees. IN
P. (We)agree m saw,indemnify rad keep h.less me City mf Cupenino against
V) lobiliues.judgmenu,costs nd expema which may in any way scout against said City N GU 7 in consequence of the granting of this Permit.APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued byI WORKS Date r V
SOURCE REGULATIONS.
Re-roofs
Signature of ApplicnJCoARDO m De
HA7ARDOUS MATERIALS DISCLOSURE Type of Roof
Will y t appllcan,mforum Wal Cg maupnuroro or auntie Health
material
u defined by the Cupertino Municipal Coda Chapter 9.12,and the Health end Safety '
Code,Section 25532(e)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yea ❑Na
Will the applicant or forum Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit Womem Tait conumnan
iTsudofhncd by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes ON.
1 have mad me hauMru m tiod.la requirements under ChaPmr 6.95 or he c difor.
ria Health&Safely Code.Sections 25505.25533 and 25534.1 undersand Jou if dm Wilding
does WI currently hoc a sent,that it is my reepovihility or notify the cempnt of the
rcquimments which mm,be met pd.,to Issuance of a Certificate of Occupancy. Signature of Applicant Date
Owner ore ilmrircd agent Dam All roof coverings to be Class"B"or better
� 4
UgM11ZAl. ��.t; .
o�g By
ry
• a J
J
APPROVED
IN ACCORDANCE WITH THE CITY OR
N UpERT D C(',fYBAN ORDINANCES
i IGNED_f I
This W'' c of plr and specifications MUST
;'a l' !t n the 'Ob at all times and a is
ilawtel toiakr>veny changes or alterations
_ ;on tome Mitt' sit written permission from
Hthr�uildig Cept., City of Cupertino.
The ,,,'-,,,,ng�f this plan and specifications
iH�l LL �) he held to permit or to he an
a rp;,�ovs�of t�.e violation of any provisions
,�°,ny fityrdinance or State Law.
0
tA
y
•
LARRY COFER STRUCTURAL DESIGN PHONE & FAX
431 ENCINA AVE, MENLO PARK, CA 94025-1864 (650) 363-0940
•
J
RUSSELL RESIDENCE WE
GARAGE DOOR HEADER REPLACEMENT
APPROVED
IN AgCOR9A%CE ITH THE CITY OR
PfJ?TIN COD'S AN ORDINANCES
DArE
R 2002 22790 MERCEDES ROAPGNED
CUPERTINO, CA This sett of o' ns and specifications MUST
be kept on the job at all times and it is un
lawful to make any changes or alterations
$Y on same without written permission from
• the building Dept„ City of Cupertino.
The stamping,of this glen and specifications
SHALL NOT bo told to pe�utt or tj be an
STRUCTURAL CALCULATI'ONSI of the viotWatt W any provisians
nv City tlydlnRtPra P.r�*„ ��;v,
1
SEPTEMBER 6, 2002
" $ S3664
TU 9
CA Ll4 9 &f o 2—
AXP t'o'3o�20a�
•
LARRY COFER STRUCTURAL DESIGN Project R V 5 S E L L r— S Pg�_of S
431 Encina Ave., Menlo Park, CA 94025 '22--1170 (ZD By L. Cofer
• Phone & Fax (650) 363-0940 GUPL---T"! NO Date '7/3 D 2
L oA-e 5
CDR -
4u DECi��Cti iU, S
---
5t_UPE Ff�2TV2 x 1, oS'
UL = 17 PP.--
'10(.-"T-
sJolsT- .2 2 . 2
GEIL�L7JS7— ?XbCalb�� ! S
115 L- 2. 0
---------------
. 2x aofM-b5 ¢,S
Jol5t5 2,0
17L = $�sf
LARRY COFER STRUCTURAL DESIGN Project P065,EL'L 12 5 Pg 2 of
431 Encina Ave., Menlo Park, CA 94025 Z-2 Igo MErL6EDES Rb By L. Cofer
Phone & Fax (650) 363-0940CUVl-p'r`lt)0 Date '71 -9102-
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5 2,s
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M St. /. D
7L = � Psf tiL- 17rsf
LARRY COFER STRUCTURAL DESIGN Project Pg 3 of
431 Encina Ave., Menlo Park, CA 94025 22JQ0 ME2CGbEs 12b By L. Cofer
Phone & Fax (650) 363-0940 Date 9 3 02
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LARRY COFER STRUCTURAL DESIGN Project 9J! 5SaL L 12—&S Pg of
431 Encina Ave., Menlo Park, CA 94025 229 R0 M I;p6EDF-s Fz171 By L. Cofer
Phone & Fax (650) 363-0940 Date..J3 D 7-
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LARRY COFER STRUCTURAL DESIGN Project r-u6Sr--LL rRCS Pg S Of s
431 Encina Ave., Menlo Park, CA 94025 22- D F^ C-lZcsPL-.? I-'r--) By L. Cofer
• Phone & Fax (650) 363-0940 CiJPFR1"I N o Date 9 3ZQ2
pooh. ffil
FA�+L '(-J t '51)4,x/ R --
f(E� 171=L 10- 2,o E fJ�gBy tFEE �(= 2f03p51 G 29�r51 CD CF
0pr 1 2
l ro, 5 k�l crc2 4b ` 3-+0 i N 2900 1,Z5'k:15
` = 346Sps,
C�T 3 SiS S wEsr •�1.L= 0,43"= p/4100
0, 210
r�
Voo� (oxl4 i euve waRQ h1. L J
n roof = LI7-P /fo> i2 + isf(�'(Z254 2') + $P5� (/0ave) y = 423o
(u =1650"
-77
' rear I PQ u¢. 25,5) (aa[
I(I� fllv)(ZS + y ) + 143p(fZ + Z') +. SPf(e')3 .= 2=
r P i decd waQ
� 2Z° ICI(a-+ 4-0)r 2 t 2L l + (\g + Cg0� 3 I 3 �sf (3'� + Z3P(J16,5 X17, /00 .
upppt� I
dee-L sdPwaCQ Cr11M,
+&0) /Zk � � )+ ,QP��1C �Z) + g �sf(g')�i2) -
Rt%AsT ' r7�10o# (I(cS \ t
F/4-1 18 0
60, 3 oa '
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� n
oe s�r7 /�O )(i(pis'>�Iz3 _ 5&4 &j V 1
3004 (2,oY./D r4L _�74 Lit,
X63 = 30
3 (Z.oxl06?1 ) 2 (16,5') -T-
3,5
3,5IzIZI l` _ 1
QrL c
• oTz� = Il b uc 1044 --
T
• (E)2x DECK BOARDS
FC�P
u u U L�3 ECVJ)OISU
LJ eROfESS/p
u V-
(E)4x8 HEADER
Ws
GAP S36
(E)FLAT ROOF F 9pCTUR �P l(y 0 2
of craggy%
0�,4
a� l
(E)CEILING
FRAMING (N)6x6 BLOCK
(ASSUMED)
• (N)ST6236
EA. END OF BM
(N)PARALLAM
5.25'x18"DF2.OE
(REPLACES EXISTING
GARAGE DOOR HEADER)
(N)A35 (N)2x6 STUDS
(N)ST6224 (N)6x6 POST, DF#1
EA. SIDE OF POST EA. END OF BEAM
0 GARAGE BEAM END CONNECTION
LARRY COFER STRUCTURAL DESIGN RUSSELL RESIDENCE V = 1 0
431 ENCINA AVE. 22790 MERCEDES ROAD 9/6/2002
MENLO PARK, CA CUPERTINO, CA
(650) 363-0940
SR- 1
2i
k�<
�> y �
�644
CITY OF CUPER'1'INO £ " «�• "a !4a
BUILDING DIVISION PERMIT CONTRACTOR4NFORMATION:
eml2rr2GrglpnsMERCEDES RD WM H FRY CONSTRUCTION COM P€fWN(02100044
' 'lI�E & MELISSA RUSSELL 10351 SAN FERNANDO AVE APPLICATITr'�U6 `"2002
IONIi: (408 996-8173 SANITARY NO. ,,// CONTROL NO,
ARCHITECfIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MEET
ispi I.ICENSF.DCONTRACTOR'S
under
DECons Of CON )❑h� �pu
m u F 1 herchy affirm that 1 em licensed under pmvisinns nl Chapter Y(commencing REVISION— —IN H VUSGrl7 S ONLY
w with genian LMNry of Uivisinn hR�llc Ousineve anJ Pafeseinns CsJe.and myliccne is
infull force and eHeeL CHANGE GARAGE DOOR HEADER W/NEW
Z;ce License Class I.ic.N ORIG. 402100044
0
Dat Compto Int
—ry ARCHITECTS DECLARATION
O m V
RI understand my plans shall he used.public recordNs
S Licensed Professional
OWNER-BUILDER DECLARATION
<Y I botchy often that 1 am exempt from the Contractor's License Law for the
ii 6 00 following reason(Section 9131.5.Business and Professions Code:Any coy or county
X9 which requires a pamil las cormlmcl,alter,improve,demolish,or repair any structure
FZ< prior In its issuance.aim)requires the epplicam for such perrod to life a signed statement
f�C
that he is licensed pursuant In the pmvisiom in the Contractor's License Law(Chapter 9 Sq. Ft. Floor Area 2 tion
$ (commencing with Sectioul(ft)oflovision 7olthe Business and Prntemions Code)Or
�., that he is exempt therefrom unit Ne heads for the alleged exemption.Any violation of
Section 7071.5 by any applocal for a permit subjects me applicant to a civil penalty of
not more than five hundred doll..($50(p. e Occupancy Type
0 I,a owner of the property,(ir my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7840.Business 181
end Professions Code:The Convector's License Law dors not apply to an owner of 102 — PIERS
egwred Inspections
property who builds or improves thereon,and who does such work himselfor trough his
Own employees,provided that such improvements me not intended or offered for sale.If. 103 — UFER
however,the building or improvement is sold within one year of completion.Nc owner.
builder will have dm burden of proving that he did not build or improve for purpose of 104 — REBAR
male.). 105 — ANCHOR BOLTS
01.as owner of the property.am exclusively contracting with licensed comments to 106 — SEWER & WATER
consumer the project(Sec.70tu4,Business and Profeuiom Code:)no Contractors Li-
cemeLaw does not apply to an owner ofpmpevywho Wilds orImproves damotand. 202 — UNDERFLOOR PLUMBING
who contacts for such pmjecu with acomranar(q licenmed pursuant ato Ne Contractors
License Law203 — UNDERFLOOR MECHANICAL
I am exempt under Seo. ,B&PC for this reason 204 — UNDERFLOOR FRAME
net Dart 205 — UNDERFLOOR INSULATION
WOR KER'S COMPENSATION DECLA RATION 301 — ROUGH PLUMBING
Ihereby affren under penaByofpxrjugone ofthe following decimations: 302 — TUB & OR SHOWER
p
I have and will maintain a Cenifcate of Consent 1..1 Finmrt for Worker's Compen-
smion,as forced for by Section 3710 of the Ichor Code,for the po fem oom of me 3 03 — ROUGH MECHANICAL
work(orwhichthispermhisissued, 304 — ROUGH ELECTRICAL
0 I have and will maintain Worker's Compensation Insurance,m required by Section 305 — FRAME
311)of me Labor Calc,for Ne performance of rhe work for which this permit is istand.
My Worker'Compensation Insurance carrier and Policy number art: 306 — HOLDOWNS
Carrier: Policy NO: 307 — INSULATION
CERTIFICATE
COMP17NSAT[ON IWORKERS'
INSURANCE
308 — SHEETROCK
(This section need not be completedifthe permit is fnrone hundred delta.olw) 309 — EXTERIOR LATH
ode's.) 310 — INTERIOR LATH
I certify thm m the perfommnce ul tire work for which this permit is issued,I shall nor 311 — SCRATCH COAT
employ any person in any manner so as m become subject to the Workers'Compensation
Laws of California.Dale 313 — ROOF NAIL
Applicant you should 501 — FINAL ELECTRICAL ENERGY
NOTICE TO APPLICANT:r Cies making this Candidate of Exemption,y
becomes comply with
the Worker.po Compenmm isprovisions na the de Labor Code,you must 502 — FINAL PLUMBING ENERGY
OO forthwith comply with such provisions or permit shall tat deemed revnkctl,
z CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
F .N. Iherehyaffirmmatthereisaconswctionlending agency[ortePerformanceof 504 — FINAL BUILDING ENERGY
IY, >
the work(o'which'his
radradisissued Sm.3lN7,Co,C.)
lender's Name 505 — FINAL ELECTRICAL
W Q
tl Lcnchm,Address 506 — GAS TEST
UQ 1 certify Nal I ban read this application and sure that the above information is 507 — FINAL PLUMBING 1 __
W
F.
toren.l agree to comply with all city and county ordinances and sum laws relating to
building consumnion,and hereby amhotlx rtprcanutivcs of Niscity mcnmrupnn rbc 5 FINAL MECHANICAL
Wmove mentioned pmpeny for inspection purposes. 0 9 FIN
(We)agree to save,indemnify and keep harmless me City of Cupertino against
iy ll.bll llles,judgments,costa and expenses which may N my way arome against mid City 5 N G
U in consequence of the granting of this sbould.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITII ALL NON-POINT Issued by51 I WORKS Date r V
SOURCE.REGULATIONS,
Re-roofs
Signature oMpplicaDam
IiAZARDOiAZARDOUS MATERIALS
occupant
DISCLOSURE Type of Roof
Will me applicant
or(Cure i,l Co to Chapter 9.
or handle Health a material
defined Yes by tM Cupeninn Municipal Coda Chapter 9.13,anJ the Health enJ Safely
de,section ass3xar' All roofs shall be inspected prior to an roofing material beim
poen pNo p p y g g installed.
Will the applicant nr Imurc building meapant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
'mit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
District?
D Yes NO
[have read the harumous materials rcquircmenu under Chapler6.95 rd do Califon
ria Halm&Salcty Cndc,Stttinns255115,25513 unJ 25534.1 mah sound matifthe buildmg
does not eurendy have a tenants Not it is on,m.,amuility to nmiry the occupant of the
requirements which must be tact prior to issuance ofa Ccnificam of Occupancy. ,Signature Of Applicant Date
Owner oraumuri.<dagent Date All roof coverings to be Class"B" or better