02020100 CITY OF CUPERTINO '
BUILDING DIVISION PERMIT CONTRACTOR MORMATIO
BUILDING ADDRESS: PERMIT NO.
10303 MIRA VISTA AV 02020100
OWNER'S NAME APPLICATION SUB DATE
MICHAUD MARTIN R AND DERRYL F 02/26/2002
i HONE: SANITARY NO, CONTROL NO.
tofs100 ARCHITECVENGINEER: BUILDING PERMIT WFO
s u F BLDG ELECT PLUMB MECH
�a
LICENSED CONTRACTOR'S DECLARATION
'5 L 1 hereby term That I am licensed underprevisions of Cha ter 9(commencing Job Description
)y_� ye P 8
ha+ with Section em]t,jfDivision3ofsheBusiness and ProfnsionsCadaarWmyli<enu CHANGE WINDOWS & OPNG ' S/WDWS .
t' Lim full forteppnd a a. 7 -7 ����®
n�a License CIazK�_ Li[.•N / I 7 S �I
m SDECnar_d[6_
s ARCHITECT'S DECL ons
S 0 1 unaers,and my pions shall be used as public rt[oNs
OCT 2 2
a u p M Licensed Professional 2002
o
OWNER-BUILDER DECLARATION
1 hemby aRrm Thai I am exempt from rhe Contractor's License Law for,he A
I'Z;; fallowing reason.(Section 7031.5,Business and Professions Code:Any city or county B UILDII r y.�/�1
�1 o a o 0
E I o which requires a permit,o construct,alter,improve demolish,or repair any swcmrt
i 3$ ..prior in i¢issi ante ssiso requisez the applicant for such pumit to file aaignad naemcm
That he is,Iicenscd pussuam ld the roxhatm of the Contractors Licenu Law(Chaper 9 � r $$gg r ggaa Valuation
(commencing with Section]000 f the)of Division 3 oRapists,and ftfessime Coda) 'y S 3 t ice..
or that tie is exempt mcrc(mm and the bnzia for the ilbectl acmp,ioh.My vi°htion
of Sttdon 1031 S bYanY applicwl for a pmnit subjects she vpplinm,o a rivil pemhy
of not mare man fivehurMrea aollara(3500). l 0lA N��DATION Occupancy Type
❑I.d owner of rhe pro dic-s ni my employees with wages rs ed f sole le(Sea s7 i .
willlne the work, ssi Thi ode:Th is Connortractor's
intended ore Law for sale apply
100a,
102 - ERS
Business end Professions Code:The Comrthave License Law s such
no,apply to an 103 - UFER Required Inspections
owner of T his ow Who builds or improve thereon,aha who encs such work himself
or through his own howeveecs. buddin Nvt such improvements arc not intended or 104 -_ REBARoffa
completion,for sale.If.,buil r,the building a olanvemem n Sala within one Wild of 10 5 - ANCHOR BOLTS
completion,the owner-wilder will have the wrdcn of proving That he did no,build or' '
improxeranpurpeeit"ila.). 106 - SEWER & WATER
0C.;'owrK,oiThe p<spa";an;axau:i.d>contracting with licensed c-onwe,oato" 202 - UNDERFLOOR PLUMBING
om uct the prejat(Sec.9010,Business and Profesuons Code:)Thr Cantractor,
License Law rims not apply to an owner of property who builds or improwas thercon. 203 - UNDERFLOOR MECHANICAL"
e, and who contracts for such projects with a comncta(s)licensed rsuant to the '2
. .._....
CommemrsLicense,Law. pu204 ' - UNDERFLOOR 'FRAME
°tem exempt under Sac. B 9 P C furthis reason 205 - UNDERFLOOR INSULATION
Owner Data 301 - ROUGH -PLUMBING
WORKER'S COMPENSATION DECLARATION
I herebyafBlm under penalty of perryry one of use following declaration: 302 — TUB & OR SHOWER
�/ Consent - ROUGH MECHANICAL
f I have and will maintain a certificate of C .ent to 6elf-in.um for Worker's 304 - ROUGH ELECTRICAL
', Compensation. as provided for by Section 3700 of the Labor Cade. for The
performane°of the work for which this Perim,Is issum. 305 — FRAME
°1 have and'will"main Worker's Compensation Insum,ce,rs required by Section 306 - HOLDOWNS
3700 of she labor code,f«Tire performance ofshe work tem Npram
an which pn is
I65UC 307 — INSULATION
v y Or Cr6 peosnio^, Aomn lnsurnnce rimer W PoI number a e:
. .rr`;cERrIPI�� Ewu[YN .
,-;,3 CK '
CATION OF E%EMPDON FRDM WORKERS'; s ' -`3'09' 11i"EXTER2-OR"LATH-
,,s' ,_-„-;., -_ COMPENSATION INSURANCE, ' _
_.... .
i
`(51M),o lassccuon ncW not be compl<tW if Tire permit is for one hundred dollars 311 - SCRATCH COAT
'"'1 anify that
in the perfarmancc of me work for which Nis permit is issued,l —
313 ROOF "NP IL '
shall not employ any
person In any meaner so a6 To
become subject to
she Workers' 501 - FINAL ELECTRICAL` ENERGY
Compensation Laws of Califomia.Date
.AMImd. � :- ' — 502 - - F-I NAL PLUMBING ENERGY - - — --
NOTICE TO APPLICANT:If,after making this Cenifcnte of Exemption,you should
Z becomekubjearnTheWorker5CompcnsetionpmvisionsoftheLvborCaee.yoummt 503 - FINAL MECHANICAL ENERGY
00 mnhwish comply with such
pr.visinaa or this permit mall be a«mad evoked. .504 — .FINAL BUILDING- ENERGY
CONSTRUCTION LENDING AGENCY SOS — FINAL ELECTRICAL .”
I hereby affirm that roue is a amsauc6on Tarring aScrlry for the parks ce
Y .> aftheworkfarwhich apemdisissus(Sec:3091,Cv.c.) S06 - GAS TEST
iWQ 'Lenders Name . i:.,. .".. ._, .., .. : ;... .. .. _ _.__.. x.. ._. . ..
5 Z Laedrxas' drca 507 - ' FINAL PLUMBING
Z.
, I IcanifyThat Ihave mad This appb6donand staetha(meabove inrom,ationis 508 - FINAL MECHANICAL
f+.i,�+ carriers.I agree to empty wish all city and county ordinariness and nae laws relating 509 - FINAL GRADE
to Wilding wm
nstction,and hereby audlonce reprasenutives ofthu city to enter upon
rem the awxemanenndProp pnionpup°6a6. 510 - FINAL PLANNING
S r (We)kgra ro mdeonify and kap harmless The'City of Cupertino against
FF'.s'In limitirics,judge co"'-
alla expace"which may in any way act.against said 514 - FINAL PU IC WORKS
t.J. City m tonsc a of Ne ming aft �enMC "
AP L1CAP ERST VILL COMPLY WITH ALL ON Issued b
cE R. n unitarian
... . . "Vac 7! Re-roofs
gn p 6y: Datew
',.; A]dRDOU i TE DISLIOS ,
Win y dhe C ratme wear' apt stare m liar t e hasHeard and Safety Type o Roof .. _
C ,S. m me 32(.,no We.Chapter 9 12 and me Hcilm and Safety '
Coda S«tion 153731aJ '. ._ J n:i (':` I x ,. .•• 1" 1 `.;
°Yes '" 7 x All roofs shall be inspected prior totally roofing mater al being installed.
' .
, .wU she applicant or force wilding xcurym use equipment or devices which If a roof is installed without first obtaining aninspectiofi;l agree to'remove
mit ha$rdous ah conram,mne,es definad by she Bay Ma An Quiliry Management
Distiiarlall new materials for inspection. Applicant understands and,will.comply with
�[p
°Y« " '`-'/ONO - '' all no pmt source at ons
6 n- 'o' - regal i
1 have read the hazard ui mrtquircrnenu ondcr Chapter 6.95 of rhe
3 u,d 8530.1 understand that
gy ry my responsibility to notify me
re cup w in a61 of eurrand have a mnanL Net it u to issuance of a Certificate of
Celifomi{lealm&Safe Code.Suuo Trans),s),rxa5.1553
1 Y
p of e rc uemen, which shun be met nor
::• _ Signature of Applicant Date
ate. Al] roof coverings to be Class "B"or better
O
FFICE
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I
L
L
;in
`* O
Z
9.25" 56.51'. 9.25' C
Q
GENERAL NOTES:
1. USE A MINIMUM OF 4X6 DF#2 HEADER NNO) familyroom
bedroom 4
2. LUMBER SHALL BE DOUGLAS FIR#2 OR BTR
f ( 3. WINDOWS SHALL BE DOUBLE-GLAZED, VINYL OR ALUM 0 n
O a
I
I— (0W610SL0 I
5 �3050 DH 2-WIDE F- ZNEW WIINPDOwFOR ) PATIO a(4X8 HEADER)
t0
4
.N .
2-3= L CIO °° t_
WIDEN C bedroom 2 bedroom 3 dining kitchen — r,
N (4X8 HEADER)
r DETAIL POST B
CIO WH
j SCALE 118"= 1". 1
i f
hall C
EXISTING ROOF/FRAMING-
bedroom 1 clo living room �
* IWINDOWS,
Rerrsnre!':P NNG, 2-car garage %'� i .....
.
C4
bath F
-- -
r----------
2 ---------------- -- -- i
20300H \3065 4-3050 QH ! i -- ---_
^''O50 DH er-tlng
rt-..v�nNro`s r�aMry >orch 2X4 CRIPPLES @ 16-OC (TYP) .. .-_ .
cc
(4X8 HEADER)
-------------------------
TO
TOP PLATES v
FLOORAITE PLAN -14x6 Typ .
SCALE 18,=1'-Cr r -
112'SHT ROCK FINISH
' co
i I Window i
0 1
a
PROPERTY LINE (TYP) 1
Ad
Pr
WOOD SILL/APRON
STUCCO FINISH/
2-
2-LAYERS
BLDG PE & LATH
MIRA VISTA RD 2x4 sill�oY EXISTINQ +t
2X4 PLATE N
280
*own t EXISTING FLOOR FINISH
copy
NORTH —
o � SITE DATA: Lot Parcel No. 357 DZ 03900
y; �f EXISTING PORCH LEVEL
m STEVENS CREEK ..
so
JANICE AVE SUBMIT L - SCOPEOFWORK: (see number inFloor Plan)
o ,,t� 1. Remove living room windows and f
to o ri" 1 remainder of the brick fireplace. DETAIL SECTION A
® ` APPRO '-D Install new windows and trim, as shown; SCALE v8^ = 1!" a p
N ACCORDANCE WITH - CrfY oe 2. Replace existing 2030 bath window, I-
g -UPERTINO C04itIonsDINANCES 3. Replace existing windows, as Shown.
widen existing opening
FE 2 6 rusing a 4x8 header.20024. Replace existing bedroom 1 window. Widen
EDi his Sef ,;i s.. . p . . MUST - existing opening using a minimum of 4x8 header, - NA.T'& ASSOC1ateS '
e kap. „ ,< ; as ' zs and it is un 5. Replace existing window. Widen opening using Campbell, California
awful to r = ary o::._^�,s or alterations a 4x3 header; Tel (408)244-2005 Fax(408)244-1159
m samewdi_L,: ' =n pe mission from 6. Replace existing 60610 slider, as shown. PROJECT : WINDOW REVISION
ne bm,daa Dep- C ty of C-:pert no.
Fire stamping of .h: p.cn _nd specificationsLOCATION : 10903 Mira Vista Road.Monte Vista. CA
LOCATION PLAN CMTS) iHALL NOT be ha d permit or to be an
OWNER Mr.& Mrs.Mrs. Mich�d I
\ 1pprmal of the vio aeon of any provision Drawn By: Approved By: Drwg No. Of
inv City Oid.r:an--e or State Law.
__ r
CI nun OF
c DIVIISIOrvNOPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10303 MIRA VISTA AV 02020100
WNER'S NAME: APPLICATION SUB DATE
W.MICHAUD MARTIN R AND DERRYL F 02/26/2002
E: SANITARY NO. CONTROL NO.
CzeZITECT/ENGINEER: BUILDING PERMIT INFO
ala
00 BLDG ELECT PLUMB MECH
I". L---J I_..I
y LICENSED CONTRACTOR'S DECLARATION
,""'Fl= herby affrm ha 1 am licenses unser provisions of Chupmr 9(commencing Job Description
>vFowihScainn]U00)ofDivision3ofheBosinosand ProfessionsCsde.and mylicenu CHANGE WINDOWA& PING ' S/WDWS .
is win full Scion�?)ode a. 7z ¢ Limnse CIasK ,X_ Lie 7 S iacmmmARCHITECTS DECL Al N0; I understand my plans shall w used as public records
Ep O Licensed Professional _.g/
o s OWNER-BUILDER DECLARATION
1 hereby affirm that 1 am exempt fmm the Contractor's License Law for the
F z following reason.Section 7031.5.Business and Pmressions Coda:Any city or county $10000
which requires a permit to construct.alter,improve,demolish,or repair any smvcture
to 3 z .pow wits uance.also importer the applicam for such Puma to file a signed statement
that rtex licarsecipurstaintdhcprowsioosofhe Commemes Lssaw lnw(Chap¢r9 gF,t,, Fl�sp Arga Valuation
Nomme cng 'h Sect 7") fDivision Sof the Bussiness and Professons Cade) ( y Aq �'1`3�,/�u"L:()'.�t$r..:QV'Ci.Z? 'r
or that he is exempt therefrom and the basis for the allegm exemption.Any violation
-of Section 7031:5 by any applicant for a permit subjects the applicant to a civil penalty
of not more than rive hundred dollars($50()). 101PPN �' DATION Occupancy Type
01,as owner of the property,or my employees wih wagez m their sole compensation,
will do The work.-and thi 9mcture isnotintended or offered for sale(Sec.70t1. -
Business and Prnfcsslmva Cods:The Commerce's License Law does not apply to an 103 — UFER Required Inspections"
.act of property who builds or intpmves hereon,and who dues such work himself
sir through.]own employee.. building
that such impm t is sole are not intendedn,or 104 — RE BAR
offered for sale.If.Imseed.amm-twilds the building or arden oemem n sued within one year or - A
ompmmn.the owner-wilder„an have m<wreen mf rroving mat he sire not vide or 105 — ANCHOR BOLTS
improve for purpose or vale,). _ 106__— SEWER &_ WATER
ER
_ 1 —smam" rthepmpcny,amesdusivelycommctingwihliccnudcomraclnrsm 202--- UNDERFLOOR PLUMBING - - -
- - onstruct the project(Sec.70W.Business and Professions Coded The Contractor's
license law does,not apply to an owner or proPxnY who w]ds or improves thereon, 203 — UNDERFLOOR MECHANICAL'
G and who contract,for such prnjecrs with a<ommctnas)licensed Paramount to he - - . . 204 --=—UNDERFLOOR -FRAME. .. - ". .._ .
Contractors License Law. "--_---
❑lamexempt undoSee. .BdPCfonhisreason 205 - UNDERFLOOR INSULATION
Data 301 - ROUGH -PLUMBING
WORKER'S COMPENSATION DECLARATION
'wnerIhanda, M.and<rpeailtyofscip,oneohhefo1lmvingdealam0ons: 302 — TUB & OR SHOWER
303 _ ROUGH MECHANICAL
jVI have and will maintain a Certificate of consent to self insure for Workers 304 ROUGH ELECTRICAL
Compensation, as provided for by Section 3700 of the Labor coda for the
. pufwmnn<e or the work for which this permit is issued. 305 — FRAME
01 have and will maimain Worker's Compmourn li m rerun.as require]by Section 306 — HOLDOWNS
3700 of the LidW,Code,fur the performance of the work.far which this permit is
gT_�FuuwD PmueyNm M."."F_.30x9I )PE, RIORKL _.__issued M1 1y Worker Compensation m. e �d P I cr be are 3 0 7 INSULATION
r 10ERTIFICA1IGNOF EXEMPT ION FROM WORKERS( ATH
COMPENSATION INSURA NCE
310,., —. ^INTERIOR LATH'"
sioo ;,;m",ctmn need not be amnpletw iI ate peen t to create nnnart]sonars 311 — SCRATCH COAT
ad 1. . .. 313 - ROOF NAIL -
"'a'
AIL .,t;�,.:. .__..
1 J tnhPf tenth kf M1h pc 1 . —
�nnn not employ any Person
� r Bann _ as�n npa rte nI<t m m<workers 501 — FINAL ELECTRI CAL t ENERGY
O p ) prvii proviso"ao. 502 .— F-INAL- PLUMBING ENERGYArmbmaw
-
Com . t I.m"mrc Calif.,,
Dor
NOTICE TO APPLILANI u f crisl Creme rat cxe nptlon yam anowu 503 — FINAL MECHANICAL ENERGY
beamei b<mrotheWorker,
k C sat sip 'ons u(he Lahbr Cole you oust,
ZO hadnwihcoml hsmcn tmxpe n.nallbe]e<mmrevoked. t 504 - .FINAL BUILDING_ ENERGY -
F tin -" 'CONSTRUCTION LENDING AGENCY 505 — FINAL ELECTRICAL
y gagers y e
of,'
r thewrk far which his peearmt rs tacdl5ce309],civ.CJ for the fnmmnp 506 — GAS TEST
n per
G], Lender's Name '
'DTZ <haerynaareax 507 FINAL PLUMBING
U-O i certify that I have read this application and state that he above information is 508 — FINAL MECHANICAL
WW (:4 correct.1 move m complywithall city and county ordinances ad emw laws relining 509 - FINAL GRADE
0 V to ww
wilding construction: d hereby authorize reprasentativesnfhis city its enter upon
y� me above.mem, a torm'.ca"'mpurawes. 510 - FINAL PLANNING
�.y IN'a)'e,rca a do nifyandkeepharmless the City ofCuparinoigainst —
W liabilities,judge nYS C , xpenses,which may in any way accrue against said 514 FINAL PU I C WORKS
U.Z Ci,,, in muse )))d7 !thou a sit n oaf tJy'tyermlt� '
r SP RCE '' TRST MTVILL COMPLY WITH ALL 'ON�P INT ' Issued by: Date
alin v
ign, e p can onVanor r ate Re-roofs
AZARDOU TERIA DISCLOSUR
Wlll he diry l Future wildin - i share or handle haeard.,mrdedhd Type of Roof
.as def ed by me Capa.dion, cade.Chapter 9,12.and he Health and Safety T - .
Code Section 255321a) •,'s , I t rr t) F t 'sl t'^ \ .e •
aYea - All roofs,shall be inspected poor,[o_any roofing.ma[erial being installed. .
Will the applicant or future w Iding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as defined br he Bay Arm Air Quality Management
DismcL all new materials for inspection. Applicant understands and will comply with
oyes -- )QNn all non-point source regulations.
V I have read the hnairdb/us materials requirements under Chapter ISM of he
Califomi Ili ffi Safcty Codc,SaGons 75505.35533 etc 2553x.I undemund that
if he w' n of cotrcntly have a tenant,het it is my mponsibility m notify he -�
f rc i mem which must w ran riw m iswence of a C<nificate of
Signature of Applicant Date
a1C All roof coverings to be Class-13;'or better.'
OFFICE .. . . .