S 0588 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING.ELECTRICAL PERME'r NO.
BUILDING DIVISION APPLICATIONIPERMIT PLUMBING MECHANICAL S 0588
BUILDING PROJECT'IDbIN1'1F'ICATION'
BUILDING ADDRESS: SANITARY No. nM[TIN[;O
'1'I
x/57 V(u/+- �f �OWNER,tiLIC$ N/C ARC(IITIiCT/ENG( EF,R: LIC NO'. D ❑
MTACI: PHONE: BUILDINConsultant Fees Paid by Applicant Qniliap NLDG ELL❑'CIf
CH
LQ7//zAR
LICENSED CONTRACTORS DECLARATION QTy. Iil,IiCTRIC PkiRMIT FEE JOB DESCRIPTION
1 hereby affirm that 1 am licensed under pr^vial^n,of Chapter 9(comm....us
Oat msectlon 9lq(pa'Divi.inn3 ofthc l+nstnrss anA Prnressions Ci,,1 odtny bctmwis RESIDENTIAL
top PERMIT ISSUANCE
F gq= n full force and effect. ❑SFDWL KITCHEN kI1MOUliI.
QUU License Lick APPLIANCES-RESIDENTIAL. ❑AUDITION ❑PLUMRINf,kCPlPfi
yQii are Comncmr ❑MULTI-UNIT [I STRUCTURAL
ARCHITECTS UEC ARATION PANELS
~aa,z Iendenund Typlone,holl d:used ac public records MODIFICATION
OZ14- Up 1'020OAMPS ❑INTERIOR [:1 CHIMNEY REPAIR
(-.v�u] LiCenscJ Professional 3U1-ILtlUAMPS IMPROVEMENT - OSWIMMINGPOOLS
ce,f; OWNER-BUILDER DECLARATION OVER 1000 AMP'S ❑BATH REEM 1IBt/���P,/k/It ❑DEMOLITION
ffyy a,6 I hereby afffnn that 1 am exempt from the Contractor's license Law for the ❑OTI R -A5/"+1 7j
a(3g O following rmann.(Section 7031.5.Bn.nincss and Proevonnx Codc',Any city or county SIGNS ELECTRICAL, 41�.ra
W W y which requires a ry.rmit m rnmwct,ahce improve,Acmnlish,or repair any xwcmre L/
E_'BA j priervt its issuance.ako requites the applicant for such permit to file u signed statement SPECIAL CIRCUI UMISC.
CQ; chat he is licensed pursuant the powniam of the Contractors License Law(Chapter 9 COMMERCIAL,
W.Lap (commencing with Sttninn](M,01 of Division 3 of the Ruxinewicad It besot...Code)or TEMP.MEfERORPOLE ST.
A.pp,�a that he is exempt chcrefmm and the hast,for the.11e,cd cxempean.Any violation of ❑NEW BLDG/AUDITION []DEMOLITION
'
aq•'+ Section 9031.5 hyany applicant lin aprinut,ubjcsn the ulpliaml hiu civil penalty of POWER DEVICES ❑'DiNAN'f ❑ROOD SIiRVIC17
y ounoro than five hundred drllam(55(X). IMPROVEMENT
❑Los nwncr of tM1e pmpenY.or my employees with wages..their.udc compensation, SWIMMING )L ELE(TUtIC ❑OTHER
will till the work,and the structure is not intended or offemJ for sale Sc,"Erect.Business
af' OUTL -SWITCHES-FIXTURES
W 3 and 14nfcssinnn Code the Contractor's License Law Jces not apply m°^owner of
pmpany who builds ser I up,,Lha con,and who dews such work hi""'If or through
his own employees,provided that such improvements are not untendrJ or offered Lv iN' HFSIUIiN'1'IAL ELffC'TR SV Irl.
sale.I,however,the building or improvement is sold within one year ofeompleuon.mr sQ.In' .( L SnQ.Fr.
owner builder will have the burden of proving that he did nor Hudd nt improve for pr, e
p^seofsolc.). r TOTAL: X'gVY 1 9 /�a.
1,n.owner of the pmpeny,am exdusivcly ennmmfmg with Ilcensed contractor m .a EIFr)11
con.uruct the project(Sce.7(W.Basin—and Pndes.ions Cidc)'I he Contruam's Li-
coarse
i- r4•Y u
c se law does nm apply to an owner of progeny who builds or improves thereon.and QTY. PI JBING MIT I'LL Clay
who contracts for such ptnjects with a contracwgs)licensed pun
nuano the Commrna's CITY
Ur who INU
Licence Ltw. PERM IT ISSUANCE
El I tonexempt under Sec. ,B&P C for this rcaum
AAER-DRAIN&VE '-W ER(EA VALIIA'I'ION
Owner Done YJ
WORKER'S COMPENSATION DECLARATION HACK FLOW I'H(TfECI'.DEV( - !�
*1.7( I hereby affirm under penalty of perjury one of the following declarations:
X)mtWLawrCw1e.f
have and will maintain aCeni ficme of Consentin self-insure fort Worker's Capon- DRAINS-FLOOR.ROOK ARBA. 0 STORIES TYPE CONSTRUCIIOI
n.provided for by Scdion 37(X1of the Lobar Code,for the performancen1'the for whichthis permit is issued. Iq%TURES-1'ISR THAM
have and will maintain Werke/s Compensation Insurance,a.required by Sectionor the,dormancemfthewmk for whichthis permit in ismaf. GAS-FA.SYSTEM-I INCA OUT( - S (;fC.GROUP AI'N
My Wnrkcr' GI^_••J��Ayj"y'r ti rant policymy//ly/�.7.� GAS-EA.SYS UiM-OVEN :A)
MyCarW,,:T�'1'E1s-/v'a nf-�(!corns Policy Na ?
CERI'IIgCXFE Oil IX EMPTION PROM WORK17RSGNICASUINDUSTRL STE IN I'ERCEPIOR
COMPENSATION INSURANCE BUILDING DIVISION FEES
(This sections«door be complmMif the permit is lnrone hundteddollan($I(X)) GREASETRAP PLANCHECK ITE
of less.)
I candy that in the perr^miance of the work for whiel tM1l.permit i..isucJ,IxIm11 SEWER-' NITARY-SIX)RMEiA.2WIT.
not employ any pco tiny m.itt nBroas In recline aubjeclmthe Wnrkcrs'Contpcm ENERGY LLE
Z .scion laws of Califomia.DaleWAI HEAI'Ek WNENT/ELECIR GRADING ITE
.C) Applicant
NOTICE TO APPLICANT.If,after making this Cenificate Of Exemption,you should ATER SYSTEM)TREATING
because subject to the Worker's Compensation provisions of the Labor Code,you nIn,,
SOILS FEE
� '> tonhwith rurally with Csuch ONSTRUCTION DN hcNmuIsPAl bedanel revoked. WATER SERVICE
Q
ENDING AGENCY NIiW RCSIDIiNTIAL PLMB. $O.IT. PAID
Z Dam Rcreiplp
V Ql hemby affirm thanhere is a construction handing agency I the performance of
the work for which this permit is issued(Sec.3097,Cil C) TOTAL:
OF Lender's Name 'DUAL: -
{U Lender's Address BUILDING It]!E
0. 1 cenify chat 1 have read this st,dieainn..it Stam that ane.nM.ve inflammation is
F-' y cormct.I agree to comply with all city stat county(romances and state laws relming to QTY. MECHANICAL PERMIT FEE SEISMIC FEE
L) z bdLJingcnmuuction,and hereby umhorize reprcee^mtives of thiscity memeruponthe
aMrvomcntioned property for impaction purposes. PERMIT ISSUANCE HIECI`RIC FEE
(We)agree In nave.InJemnily and keep hound...Ne Goy of Column agates
IiaM1ilitics.juJgmenn,men and expenses wM1ich may in any wayarcmeogeinnslid City ALTER OR ADD10 MECII. PLUMBING Igili
in emscamuce of the granting of this pc.is/7
APPLICANT UNDERSTA S AND W L sti`l WITH ALL NON-MINT i
jNUT(TO 10.00(CFM( MECHANICA1 FEES URCF Ilh OA. T(DYE?k IU.1 .IMI G1INETHGGIION'LAX
SignamrCofAPPlkam/Con Date /DUCT' HOUSING MITIGATION FRITHAZAR )US MATERIALS UISCLOSUHEWill,M Oppliru o. mumhilg(reeap:int. f handle hmmdou.mmeial I .If In BTU1a.AdinalbytheCupcn' nMunicipalCalc.Chapter9.12,nnJ n.Hcahh anA&dtyHR Illt.(IINt III'U)
Code.Section 25532(n
❑Yes 0 N VENTILAT AN SINGLE RESID) PAID
Date Receipt N
WII the applicant or future hooding«cupam ac equipment or devices whichMRESIDINIIAL.
P OH I(Xl.l)fl(1 BTU)
�t'n hanoous air cinotaminano as defined by the Bay Arca Air Quality Mamigcowat TOTAL
svinR ER UX)JXXI BTU)
❑Yes C]NO
1 have real fhe ety Code,Se tamdas 5q 2553 an u2553 Chapter o to of the if ffe
ISSUANCE
buildigdoes&Scurry Coda,e aten.25hat i 25ni, and2SSJi.1 I 'if,the
that if Inc NEW .MECII. SQ.IT.building Joel me sarrenth have u renonL(hal it is sea respn^sihllhy ci ramify ccupan tpmn
of the{uiremems which mustMmd prior¢.issuance Ufa Cenifieu¢of OccurymcyOwnernramhnrimd agentDateTOTAL: ISSUED BY:
OFFICE
t,
1 c'
e Resolution of Board of Directors
of
Westmont Park Villas Association
Re: Architectural Approvals
WHEREAS Westmont Park Villas Association is a non-profit mutual benefit
corporation charged with the responsibility of architectural control of the
residential Lots and Common Area within Tract No. 5040; and
WHEREAS the Board of Directors of Westmont Park Villas Association is
charged with the responsibility of managing the affairs of the Association;
and
WHEREAS Article VIII of the Declaration of Covenants, Conditions and
Restrictions recorded December 1, 1971 in Book B 246, Page 531, et. seq. ,
Official Records of Santa Clara County, California pertaining to Tract No.
5040 provides that no building, fence, wall or other structure shall be
commenced, erected or maintained upon the Properties, nor shall any
exterior addition to or change or alteration therein be made until the plans
and specifications showing the nature, kind, shape, height, materials and
• location of the same have beer. submitted to and approved in writing by the
Board or its Architectural Co=ittee; and
WHEREAS Article III, Section 2 of said Declaration provides that no
structural modification, alteration or addition to the exterior of any
Villa shall be made. except with the approval of the Board; and
WHEREAS Article IV, .Section 1 of said Declaration provides that the
Association shall provide exterior maintenance upon each Lot and Villa
including replacement and care for roofs and exterior building surfaces;
and
WHEREAS Article IX, Section l(a) of the By-Laws of Westmont Park Villas
Association empowers the Board of Directors to adopt and publish rules and
regulations necessary or convenient for carrying into effect the
requirements of the Declaration and other proper rules; and
WHEREAS it is the intention of the Board of Directors of Westmont Park
Villas Association to adopt a uniform policy relating to architectural
• approvals for exterior modifications to Villas where modification will
involve a penetration of the existing weatherproof membrane of the Villa.
I
The implementation of the Modification shall be that it be completed without
• encroachment on adjacent properties.
NOW, THEREFORE, be it resolved as follows:
I. The Board of Directors requires written submission of detailed
plans and specifications for any addition or modification to a Villa in
accordance with Article III, Section 2 of the Declaration of Covenants,
Conditions and Restrictions.
2. Prior to approving any addition or modification which will involve
a penetration of the waterproof membrane of a Villa, the Board of Directors
will require all owners of the subject Lot to execute a hold harmless and
idemnity agreement conforming to the form of Agreement attached hereto as
"Agreement" as the same may be amended from time to time by the
Association.
3. A condition of any approval for exterior modifications involving
penetration of the waterproof membrane will be the recording of the
document referred to in "2" above with the Santa Clara County Recorders
Office and a copy of the recorded document (stamped) must be returned to
• the Association prior to any approval by the Board to commence construction.
Costs of creating and filing the document are to be borne by the homeowner.
4. The provision of this resolution supplement the policies and
practices and guidelines of the Association concerning architectural
approval and supersedes such policies and practices.
Board of Directors
Westmont
t P�ark-Villas
illassAsssociia'ttiono
Dated: By t� ahe _ !
� t QCbLv4.1 C/1 MM tte F.
I •