Loading...
06090270iaz A a°N Z 02zC C a> a Uz UC 0 F �" tL a Uz CI1Y OF CUPERT 10"M BUILDING DIVISION PERMIT CORACTOR TNF�RMATIt:Na:�` ;vs?.`ft=1^rcc.93�M=.;+£ai3°°SxWc's?Me1iEtd BUILDINGADDRESS: PATRICIA FUJII "U""ND'06090270 20336 NORTHBROOK SQ OWNER'S NAME: PERMIT ISSUE DATE PATRICIA FUJII 3270 TRACY DR NE: SANITARY NO. CONTROL NO. ' ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description Mreby affirm that 1 am licensed under pmvvisisof Chap c, 9 (com en"I.S witho7IXX0ecWoa DivJafthc ButlressaMro4eti Pov CodO,and my license4 in fullllfa=me and affect.PARTITION LIVING ROOM TO ADD NEW BEDROOM, MINOR Lb. Llama clet, Commoser STRUCTURAL & ELECTRICAL ARCHITECTS DECLARATION 1 understand my plans Mall be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contactors License Law for the following mason. (Schon 71131.5, Business and Professions Cade: Any city at county which mquiret a permit In construct, Ater. improve, dema14h. or mpai, any structure pnor to its issuance. also requires the applicant forach permit to rile a signed eotementValuat that he us licenced pursuant m the provisions of the,Commusuel Uterae law (Chums 9 Sq. Ft. Floor Area 1$� 7 0 0 (commencing with Section 700M of Division 3 of the Business ars Profesimu Code) or that he 4 exempt thmefrom and the beta for the alleged exemption. My vlolatfon of - APN Number Occupancy Type Section 7031.5 by arty applicant for a permit emblem the applicant an a civil moaLLy of sot mom than five huMmd do1Wa (5500). 31639013.00 0 I, as owner of the property, or my employees with wage, as deb sok eompmuation, Required Inspections e q P Will On the worl, Md the aWLWm B not hlmaded ar+named on"ah, Business, and Profealom Code: The Coneaemrs License Law don set apply W an Owner of property who builds Or i m protea therm,. aM who doer such work himself m duough his awn employees. provided Wan such improvements am atinendesd aroffesed for sale. IL however, the building m improvement Is sold within ore yea of s mptetion, the Owner. builder w01 have the bunds of paving Wal le did rot Wild or improve fee Pugose of ,ale.). L. so muse, of tie property am excledvely cap=let Nib Ii easW conealan W trtat tie project (See. 7W. Business ad Prefesdav Code:) The Contraamra u• cave Law does out apply On an owner of property who builds or improv theme n• and, who comments for suM Projects; withaconexmr(s) licensed peravnl to the ConaMora License Law. ❑tom/fie tundra See. . B k P C for this + cats, Owner `�i�^=�,�.�! Data 7 WORKER'SCOMPENSATI� DET CLARATION� 1 hereby aDtrm under penally of perjury ase of the following declanliov: 1 haw and will maintain a Cer ficae of Consent Io self-malicefee Workers Cmnpen- ation, as provided for by SeNon 3700 of the Labor Code. for the performance of lac . work far which this permit is massed. C1 I have and will maintain Workers Compensation Ivunna, a required by Seeman 3700 of tM labor Code, for the performance of the work for which this permit Is iatunL My Workers Compeaution Issuance earner and Policy number are: Cartier: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thus accdm teed not W completed if the permit 4 (mase hundred depart (SIM) ter less.) 1 Umfy Wt in tis p llu nvice of the work for which this permit 4 eased. I "I TIO employ an non in on e subject to Pe Wmkcn'Com cvadon p%• rp r gi'1�'YF9'�'� I p lawn of L. .e gr�I.�s`�• N- -- If, after makings p misOcrietc of Exemption, you shoos TO the Worker's of the labor Code, you most become eubjpt m the Woher4 Compeoatian Ncome subject Permit l forthwith comply with such Provisions w this Amit Mall be deemed mwtcd. CONSTRUCTION LENDING AGENCY I hereby affirm last them Is a commuction lending agency for the performance of the work for which this permit is ismed (Sec. 3097• Civ. C.) .. Lenders Name , Lenders Address I cenify that I have rend this application "Mete door the Mee imfamstmo la comet. I agree to comply with all city and county ordinances and mute laws misting to building construction, and hereby authorim reprosemarives of this city to enter upon the alevc-mentioned Pmpeny for inspecdon purperea (We) agree to ars, indemnify and keep hamles, We City of Cupertino against Itabilitiv, judgment. costs arm expenses which may in any way amroe agalral said City in consequence of We ttafies of this permit. UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT -d-6"APPLICANT Issued by: Date SOURCEREGULAnONS. Re -roofs – —= Type t � f/_a o G Slgaa tans of AppRca✓ConeCm! ane HAZARDOUS MATERIALS DISCLOSURE of Roof WIII the applicant or futum building occupant store or handle h mardous material as defined by the Cupenim Municipal Code. Chapter 9.11. and the Health and Safety Code, Section 15531(x)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yv x]Na If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit haardnw sr cenmoivntt as defined by Ute Bay Ana Air Quality Management all new materials for inspection. District? ❑YU IfNo I have mad We haardmta materials mquimmcm, under Chapter 6.95 or the Califor- nia Hvlth,kSafety Code, Secdsv 25505, 25533 and 25534. 1 understand then iflhc building does not currently hoe a tenant. Wu it 4 my mapevihility m notify the occupant of the m mcluwhi:'hmust bcmet pn iauaeof&onufen,ofoccepancy Signature of Applicant Date I ���' All roof coverings to be Class "B" or better Owner or Authorized agent �3 0 h i Z171 rCUPkTINO Y ' n tt� VTIAL PROJEC�T„�COVER`SFf'EE'T;_ �' Assessor's Parcel Number:--�/ 63 id 13 Name of owner. rU 1 I Project address. Contact person. Phone. dell (�fo?) Y7a v Fax. Net square footage of lot. Existin Proposed Square footage: First floor: 1/00 A n CA Second floor: `(2 11r -1.` r Garage: G low J7 n TOTAL: /7,2 a 22,9 Are there at least two 10 foot by 20 foot clear spaces inside the garage? DY N Is privacy protection planting required for the project? Y ON On what floor(s) is work being clone? r1Gt' Brief description o I work. 4& r /Y� w�/n �m �G�t�— • 6!%sJ tNcCB 7rstit, • 'R�'�'��� �� Code editions: 2001 CBC (Y - N)2001 CFC (Y - N)2001 CMC (Y- N) -On �LCf caQ� 2001 CPC (Y - N)2001 NEC (Y - N) Effective 11/1/02 rill -2006 ppb Plan Review Process Work Book Page -8-Revised 4/28/04 rI 0 o c 3 d so e o M w � .o ; A � ;t OR p Z Od oa Fw+ O rt � IJ ovo�, caw ac :, o ., V 2 N p N-1 w O7pC r � cR,R ? .fl ..c d u 0 fA A n 0 a on 0 0 O c m a *em 1 of 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 31639013.00 DATE ISSUED.......: 09/28/2006 RECEIPT #••••.....: 36248 REFERENCE ID # ...: 06090270 SITE ADDRESS .....: 20336 NORTHBROOK SQ SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: PATRICIA FUJII ADDRESS ..........: 3270 TRACY DR CITY/STATE/ZIP ...: SANTA CLARA, CA 95051 RECEIVED FROM ....: PATRICIA FUJII CONTRACTOR .......: LIC # *OWNER* COMPANY ..........: PATRICIA FUJII ADDRESS ..........: 3270 TRACY DR CITY/STATE/ZIP ...: SANTA CLARA, CA 95051 TELEPHONE ........: • FEE ID UNIT QUANTITY BPERMFEE VALUATION 3,400.00 BENERGY PERMIT FEE 104.76 BREMFIXT NO. FIXTURES 1.00 EPERMITFEE FLAT RATE 1.00 BREMRECEPT NO. OUTLETS 2.00 BSEISMICRE VALUATION 1,700.00 TOTAL PERMIT METHOD OF PAYMENT ----------------- OTHER TOTAL RECEIPT • AMOUNT ------------ 197.51 197.51 OPERATOR: amyw COPY # : 2 AMOUNT PD -TO -DT THIS REC 104.76 0.00 104.76 50.28 0.00 50.28 1.20 0.00 1.20 38.37 0.00 38.37 2.40 0.00 2.40 0.50 0.00 0.50 ---------- ---------- 197.51 ---------- 0.00 197.51 NUMBER ------------------ MASTERCARD NEW BAL 0.00 0.00 0.00 0.00 0.00 0.00 5 111werej i � 1 CITY OF OCUPER,TINO • • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Deuartment JOB ADDRESS: PERMIT # 2-0336 —20 OWNER'S NAME: PHONE# >F Z— / GENERAL CONTRACTOR: .h FAX # lam not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Owner/ Contrac or Signature e z le ( ate SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing . Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/ Contrac or Signature e z le ( ate CUPERTINO CITY OF CUPERTINO 0�m ovo PERMIT APPLICATION FORM APN # 31 _ 39 _�p3 Dat e: VIA O G Building Address: Mailing Address (if different from building address): LO o r o Owner's Name: � P one . / BBOILER1 Boiler <= 100,000 Btu Contractor: License #: Contact: ©/ pt Phone: (, Cupertino Business License#: Fax: Boiler> 500K to 1M Btu Building Permit Info: C r },,} ori biy--trte Ilan aX,�, (j l-roo», vv --e%01- S-4�,vv BBOILER4 Bldg Elect ® Plumb ❑ Mech ❑ Job Description: Residential ® Commercial ❑ Sq.Ft. Floor Area: 1 Sq.Ft.: Cost of Project:Occupancy ,01i deo Group: - 3 Ty"ofCotruction: /'" . Please check this box if the project is a W mo/ second -story addition: ❑ ro'ect Size: Standard E Large ❑ Major ❑ Con. Tax for BQ Zone Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILER1 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 BBOILER5 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 <= 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 1 of PEW CITY OF CUPERTINO PERMIT APPLICATION FORM Quantity 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 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP 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 2 of 3 • • aim CUPEkTINO • uanti IN CITY OF CUPERTINO PERMIT APPLICATION FORM Fee ID Fee Description MSIGNAD Rmdl SiRnS Add Branch CBLVD TR :nt Fan 'entilati Scb Sp Elec 3 of 3 ins, Marquee �ighting Fix 'ingle Duct n Systems :ific Plan mmercial Fee Res Power I Lem Svcs cense foot suance � foot Fee BUILDING