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04060182 CITY OF CUPERTINO ' £ "� ' € BUILDING DI VISION PERMIT C0N7RA.CT.t�R INFt1VIA.TION BUILDINGADDRESS: LENTZ CONSTRUCTION INC, J PERMITHO04O60182 10144 POTTERS HATCH PERMIT ISSUE DATE OWNER'S NAME: V & M SOMASUNDARAM 5087 MAITLAND DR 06/22/2004 _ SANITARY NO. CONTROL NO. + ONE: (408) 264-0555 BGPERMITINFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH uO0 LICENSED CONTRACTOR'S DECLARATION Job Description U C 1 Mmby afRrm that 1 am licensed under Provisions of Chapter 9(commencing - . withScckkron]1NM)7of Division Sof the Bu' c and P{ys° (peCode.and myliccnsc is N(ml r.�p +d arc S ®/ 4/ ADD STAIRWELL SKYLIT.E/LIGHTS 5 IS Liven e s Lic.M n_tQ•9 Da — Coaln _ v aA CHITECT'S ATION < 1 undcrimad my plans shall he used an public records 7L,U }u. LironscJ Pmfcssionel O< OWNER-BUILDER DECLARATION f 1 hereby.(Seto that 11. escmpt Bum the Camedols e:Any Law for the ❑O following rens a(Section To s5,Business andimprove. Professions Code:Any oily or county $4000 which requires n permit to construct,the blurt improve,demolish,or repair ed structustatement FZHr PHonoimissuena.also rcquimsthcapplicant far such permit to tile asigncdnammcnt Ft.Floor Area - Valuation < that he is littnscd pursuant to the provisions of the Contractor's License La.(Chapter 9 Sq• cd (commencing with Section 70W)of Division 3 of the BusWousand Pmfessiana Code)or that be,is asem t thercfmm and Nde Ne basis for alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty Of g Occupancy Type not more than five hundred della.MOD). 0 1,as owner of the prop my,or my employees with wages as their sole compensation, will do the werkand theevucture la wtimended oraffered forsal.(Sec.7014.Business Required Inspections and Profemime m Code:The Coreciar'a License Law does donot apply to an owner of 9 p own enywho yces.pdsnrimpmwsthereon. prooand who Ardoes such wodhimself dlere though his own employees,provided Ihatsuch impmwments Are m year f-oro V red for Sala If, hunter Ne building," uilding uimprovementg Said within am yen of completion.the owned builder will have Ne burden of proving Nn he did not build or improve for purpose of Sale.). 1, ❑1,ru.wear of the property,.B exclusively convecting with:)Tho .met es to / construct the es not (Sec..an Business and property who Code:)The Convector's fid �� cense law dao not apply je es own.of property who builds or improves thereon,and / whence Lasts for such projects with aconvazmr(S)Iicense0 pursuant the Convector's Y License Law. ❑1 em exempt under gee. .B&P C f.this moon Owner Data WORKER'S COMPENSATION DECLARATION I herchy grain under Penally of perjury we of the following declarations: c1 1 ban and will maintain a CeNReale.(Consent to self-insum for Workeb Compete anion,as provided far by Section 37W of the labor Code,far do.perf.mana of Ne work for which this permit is issued. 0 I have and will maintain Worker's Compensation Inst nocc,as required by Section 37110 of the lab.Code,for the performance of the work for which this permit is issued. My Workda Co eos`aq'on los nttnrt/der and Policy nu be rc: Z� Ca r: / HM Polity No.: v CERTIFIC •0F EXEMPf1OM ORKE S'�� COMPENSATION INSU A CE iThis section need not be completed if the rc, ' oranehunlroddollars(SIO() or loss.) I certify Net in the perfa mane.of the work for which this permit is issued,l shall not employ any person in any mannerso as to become Subject in the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If.stmt making Ihia Cerdlitalc of Exemption,you should beCOMa Subject to the W.ker's Compensation provisions of the Labor Code,you must 'JZ forthwith comply with Such provisions or Nis Permit shall he decmed mwked. .Zi CONSTRUCTION LENDING AGENCY P Ihereby affirm that thin,is a construction lending agency for the performance,of (.��✓ t4c work for which this permit is issued(Sao.3097,Civ.C.) QLeaders Name z Lender's Address U T certify that I have read this application end site that Ne above information is V (A F covect.1 agree to comply with all city and county ordinances and slam laws relating to DU building construction,toand m,indeyaifyand epee ronless the this city lu cnter uponno ago the W above.-mcntiuned pmperly for inspection pupwses. LL (we)agree to save,indemnify and keep harmless the City of Cupertino against J h liabilities,judgments,corm and expenses which may In any way acerae against Said City U'jam in consequence of the granting of this permit. r4 + ti APPLICA NDERSTAND C PLY WITH ALL NON-POINT Issued by: Date SOURC ULAI I rya Re-roofs o Applic ✓ octet WHORDOUS MAT IALS DISCLOSURE Typo Of ROOF ' Will the applicant or future building acupant stem or handle hazardous matarml defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety Code,Section 25532(.)? All roofs shall be inspected prior to any roofing material being installed. • DYcs YI NO Will the eppiicamor fun rc building occupant usc.yuipmenl or dkvieas which If a roof is installed without first obtaining an inspection,I agree to remove -mit ha'ramous air contaminants .defined by Ne Bay Arca Air Quality Management all new materials for inspection. District? Yes 1 have read the havardousmamrials requirementsunder Chapter 6.95 of the Califon .is Health&Safety Code,Sectors 25505,25533 and 25534.1 understand Net if ft Wilding Does not cu fitly hawawn at" y mihility to notify the occupant of the rcyvire which. me car ccofaCcrollof apanry. Signature of Applicant Date 71 All roof coverings to be Class"B"or better • TM • CURB MOUNT INSULATED GLASS SKYLIGHTS SPECIFICATIONS: Curb Mount Glass Skylights shall be Model No_,as manufactured by HPK, INC. of Phoenix, Arizona. The skylights shall be factory assembled units. Glass skylights made by HPK, INC. are available in either Single-Glazed or Dual-Glazed. Single-Glazed (SG) skylight units come with 1/4' Laminated Safety Glass with a .030 liner. Dual-Glazed (DG) units are manufactured with 1' insulated glass. All insulated units have 1/4'Tempered outer glass, a 1/2' air space and a 1/4' Laminated inner piece of glass. These units are also made with a breather tube installed to allow for differences in air pressures. Glass is available in either Bronze, Clear, or Gray. The skylight frame and retainer cap shall be 6035T5 extruded aluminum with a minimum wall thickness of.062 inches.The skylight frame shall hav an integral evaporative condensation gutter,exterior drip and drainage slotsT tg are also available In a SELF-FLASHING style frame per u C M43M I t.a 11100 222K%*x46W'% ` 4052 2414'a 46u' 5252 46%':46%' aCSSutau SSxw YaawiAR ofiIM1 GUM GLASS,W40l ALWAYS OUT) 1 •Aumu TUN ,-,?INsuuno Au ven NonlNl IAIMOONIAI KOC" AGlutrul •M to SU J `LM V 101 11[ 1 GAZING VINYL �COAAOfWN Ue OT W" sjW Buuld Ms O I7 lwsr wr .fig $ e�{lu.AUNAno Uwa lrWa su[w3 suoml e& .'Wy��,M, 0 30 am SNSTY UNIT Bu�� 00 04 ICOAROHON . ATING Vl'-W Y� " ROOFING InV AU11 61•1 90 11"9814-L 811,1 �/p(�1■p AND ROOFING oY 1sWn__w�.�1•1 �N�I�YIis o , �� 3v0 , R ►ry � 40 k03 ddtl a� 4 uncnes auove We plane of the roof on a curb constructed of ma- _.• •L lerials asiWred for the frame.Skylights may be installed in the plane of the roof r L Ali VIE W. ��r� r��' //� when she roof slope is 45 degrees or greater from horizontal. C�zX, ; -z sk PRQVIDI= ICg041- yota3 r 71 AND MANUFACTURERt5. 5PECS PRIOR TO FRAME INSPECTION Z)ay riA_ SIDE OF.. CFP1'aN1NGi-SSfIEV_T-ROCjL G v -SKY I I-TE �T Section 506—Vent Termination UNIFORM PLUMBING CODE • (a) Each vent pipe or stack shall extend through i— I_ lilng and 906 UNIFORM MECHANICAL CODE shall terminate verllcallynol less Iia the roof nor less than one I n six(6)Inches(152.4 mrn)above –1' the roof througL.liwh ch itep venting systems lessshall than 4 feet from any portioanot less than 2 feet of the (b) Each vent shall terminate (.3 m) from any vertical surface. or at least three minate not less ) p building which extends at an angle of more than 45 degrees upward from the ( ) feel shall Than len(10)fee( 9 oPening, air Intake or vent 9m) above, any o enable window, door m, horizontal. - n OP enable direction from nor less than Three 3 , (p Vent 7ennhreis.Venting systems shall terminate not less Than 4 feel below m any fol line;alley and street excep ed.1 (9 rrs) in vl - I or4fect horizontallyfrom,nor less than l foot above•any door.window or gravity air Intel into any building, 7R V S S Roo.= SEE r CaLCULA rio/J5 / y 1f pueu.vs g2� � � l�E : CVT 7J7VSS _Ch'oRps To � .-L.e. S1�& of-TvpuN 'gA#r6 6'%e4 z.— • De Anza Oaks Homeowners Association Architectural Application NAME OF OWNER (S): V 4 r1 Sari AS UN-P A KA'M ADDRESS OF HOME: 1014L{ PDT-TMS HO-TCy GAIMDA/ UNIT # 62- TELEPHONE ZTELEPHONE NUMBERS: (H) (t 3" 19 4-7 (w)(52 8) 5 8-9 S£fS GENERAL DESCRIPTION OF PROPOSED WORK: n s rct.U- s �t L- C C f) 6v - ,b{'ac vLca o biz CONDITIONS OF APPROVAL: Applicant underst °an , g9roo, "aft p i to 0 of fulfill all of the conditions and requirements for an approval. In ad� comp p]' tion"form,the applicant must submit to the Architectural Committee dra t o c ,kind,shape,height,materials and locations of the proposed architectural alteration. The submission must be in writing. The Architectural Committee may require additional information as it deems necesany.,tc,(Y o aldecision. Until all information is submitted to the committee,the application will be deemed roto iAcompleje°anli the application will stand disapproved. Applicant further u e Ia ',CeJ PEP-TINGhat the modification is approved by the Committee that they may impose`5pecil t itiml ofZron'srtru t ��t�rnanee on the approval of the Application. Any special conditions shall b��pp�(�QQFF��, ,Wt�'yfc� �Q�'4ny deviation from the approved plans specifications or special conditions'ZBijPbaLSe to he permit to automatically terminate and become null and void. Applicant understands and agrees that if applicant fails to conform to each requirement then applicant authorizes De Anza Oaks Homeowners • Association to have the work brought into conformance with approved plans,specifications and special conditions. Applicant further understands and agrees that all costs incurred by the Association as a result of bringing said work into compliance will be a personal obligation of the owner. Such costs shall include the costs of construction, reconstruction,administration,fees,attorney fees,experts and consultants charges,and court costs,if incurred. It is also agreed that no work will(1)be initiated which will be a violation of any of the provisions of the Association's Declaration of Covenants,Conditions and Restrictions or any applicable building code,(2)be an annoyance to any resident;or(3)increase the cost of insurance maintained by the Association. It is further agreed that,in the event the application is approved,all maintenance,repair or replacement of the approved item will be the sole responsibility of the lot owner,and further that any expense incurred by the Association that is the direct or indirect result of the approved change shall also be the sole responsibility of the lot owner. All workshall be initiated with consideration of the terrain,slope,esthetics,time and noise considerations. Applicant understands that all necessary permits and approvals from applicable governmental jurisdictions are the sole responsibility of the applicant and that Committee approval of this application is subject to the applicant receiving all such necessary permits and approvals. Applicant agrees to use licensed and insured contractors for any and all installations or to make the Architectural Committee aware when this is the exception. Applicant agrees to notify the Architectural Committee upon completion of the project so the Committee may inspect and determine compliance with each and all of the conditions.of approval of the application. THEZRSIGNED AGREES TO THE ABOVE CONDITIONS / DATE: D T Homeowner's Signature FOR COMMITTEE USE ONL ( 1 Approved Denied Date In I\ " ri Comments: _ 1 1 �ITY OF CUPERTINO� Ck1PERTIN0 PERMIT APPLICATION FORM G'fla60X� AP(/N # s /c� �� Date: / !/ 7' Building Address: Mailing Address (if different from building address): Owner's e: Phon _ Contractor: License #: '� G/LfZ Carr s�L�jr Contact: Phone: Cupertino Business License#: i" Z Fax:41%,rX6 f ?�V4r0 Bui ding Pqfmif Info: Bldg Elect_ v Mech ❑ Job Description: Residential fel i leommercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: Occupancy Group Type of Construction: Please check this box if the project is a second-story addition: ❑ ro'ect Size: Standard ❑ Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> IM 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 EnEgy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of a *ITY OF CUPERTINO* CUPEIiiTINO PERMIT APPLICATION FORM QuantityFee 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 PbIg 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 I PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm I MECHANICAL BREMAHUTAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Fumace MECHANICAL BREMFURNOV Relo Fumace > 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 Heatin]==±=MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2of3 CITY OF CUPERTIN(P CUPEI�TINO PERMIT APPLICATION FORM uanti Fee ID Fee Description Fee Grou BREMSIGNAD Rmdl Si s Add Branch ELECTRICAL BREMSIGNS Remodel Si s, Maz uee ELECTRICAL BREMTHEATR Theatrical Li tin Fix ELECTRICAL BREMVENFAN Vent Fan Sin le Duct MECHANICAL NBBSlEMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING P.lq MICOM Seismic Commercial BUILDING SEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Ins ection BUILDING BSWIM Swimmin Pool BUILDING BTEMP Tpmnnrary Power ELECTRICAL BTEMPPERM Tem ora Rldo Permit BUILDING. BTEMPSVCS Temp Dist Svcs• ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical s foot ELECTRICAL EPERNIITFEE 'Elec Permit Issuance ELECTRICAL MPERIJIFEE Mechanicals . foot MECHANICAL MTERMITFEE- Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPT BG Plumbin Fees foot PLUMBING ZADDCHG Address Chane BUILDING • 3 of 3 CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRA.C�ORQ I, f37tMATIQN „� BUILDING ADDRESS: _ LENTZ CONSTRUCTION INC, J PER1,1ITNc04060182 10144 POTTERS HATCH WNER'SNAME: - PERMIT ISSUE DATE V & M SOMASUNDARAM 5087 MAITLAND DR 06/22/2004 6: SANITARY NO. CONTROL NO. (408) 264-0555 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH L O o LICENSED CONTRACTOR'S DECLARATION 06 1 hcuby affirm Most I am Hcanead under provisions of Chapter 9(commencing Job Description U whips. on701MI)OMiA,ion3ofNe Busjpcyand Pfy(Tss-ion`Cmm.andmyl.monc is ^ � in full fa deft ✓ S4/`®/ •fi/ ADD STAIRWELL SKYLITE/LIGHTS �? License a Lic.p ® Q� t� p� �^ Dd;7— Como Od`1Yd a�t�tstml ='4W A CHIICCrS ATION a 1 understand my plans shall b,used u public records I ;�� Licensed Pmfcaional jU - 12 200"1,gy OWNER"BUILDER DECLARATION 1 hereby affirm that I am exempt from Ne C.mrsomr's License Law for the o0 following mason.(SmMm 7031.5,Business and Professions Code:Any city or county �)t �! ,' % $ which requires a permit to meL a constlar,improve,demolish or repair any stmcture U tl_� 1O prior m its issuance.alae requires the applicant for such Permit o rite a signed statement that he is licensed pursuant to the provisions of N.Contractorla Contractors License w(Chapter 9 Sq.Ft.Floor Area Valuation m�m (commencing with Section 7000)of Division 3 of Ne Business and Proforroms Crele)or Nat he w exempt therefrom and the basis for the silcgcd exampt...Any violation of Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of aJ Occupancy Type not moo than five hundred dollars($500). ❑I,a a owner of the property.Or my employees with wages as Neirule compenutlon, will do 0.weak and the sometum is not intended wenered Waste(Sec.7W.Business and Proreuions Code:The Contractor's Lt..taw does not apply u an owner of Required Inspections Property who builds or i mprovm thereon,end who does such work hi mal f or through his own employees,provided that such improvements rte nmintendN muffered Russia.If, however,Ne building orimprovemenl is sold within one year of completion,the owner- builder will have the burden of proving Nat he did oat build or improve for purpose of ale.). ❑1,an owner of the property,am exelusivcly contracting with licensed convectors to construct the project(Sec.70X4,Business and Professions Cade:)The Conuactor'a Li" came law does not apply man owner of property who Wilds or improves Norton,and, who contracts for such projects with a contractor(s)licensed pursuant M the Contractor's License Law. ❑I am exempt under Sec. .B&P C for this remora Owner Dau WORKER'S COMPENSATION DECLARATION 1 hereby unions under penalty of perjury mm of dm following declarations: 1 have and will maintain aCertifiau of Come.,to alGimme for worker'sCompen- notion,a provided for by Section 3700 of du Isbor Cods,for Ne performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,a required by Section 3700 of the Labo-Code,for the performance of the work for which this permit is issued. My Werkcr's Cn area on Ins race ca end Policy nu Wr ce r. policyNo.: Z� v CERTIFIC EOF EXEMPr10 WORKERS'I,/ COMPENSATION INSU CE ffhtssection need nolbecomplcudif the M mons haddseddollam(SIM) or teas.) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner an as to become subject to be Workeri Compsnsm m Laws of California.Date Applicant NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should become subject to Ne Workers Compensation provisions of Ne Labor Code.you must vJ aZ forthwith comply with such provisions or this permiuhall W decided revoked. �Z,,,O CONSTRUCTION LENDING AGENCY [•+ I hereby alarm that thea is a construction lending agency for ths perfurmancc of (Yi 7 Ne work for which this permit is issued(Sm.3097,Civ.C.) WQ Lender's Nam. 0.z Lcnder's Address V P 1 cegree that 1 have sad this application and atste Net the sum iws rmaing la Hwilding(agree to comply with ell city and county ordinances and sou laws miming to O fJ alwoveng ntionectionand hereby authon urepresenmliws of Nis city mentor upon the 4T7 above-(we)are properly for inspection purposes. {.• V, d,ju agree to ave,indemnify and keep harmless the City of against against Iiebmdro,judgmc the crowing of this Permit. may in any my seem egein¢aid City V A PL CA race of the granting of this permit. SOURCA NDERSTAND CO PLY WITH ALL NON-POINT Issued by: Date SOURC ULATION "'Re-roofs ldcfio Appli V RDOUS MA IALS DISCLOSURE Date Type of Roof Will the applicant or future building Occupant store or handle harzrdous mau ial no M ncd by Ne Cupertiunicipal Code.Chapter 9.12.and the Health and Safety ode,SceYcons 8532(4)? ❑ 'I�/t�j\I No All roofs shall be inspected prior to any roofing material being installed. Will the applicant or f"utorc building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove it Immodest air coommin m .defined by du Bay Am.Air Quality Management all new materials for inspection. � Disuict? ❑Yes I have mad the br adleds materials re,.Wnddrts under Chapur6.95 ufthe Califor" ria Heclth&Safety Code,Smd..25505,8533 and 25534.1undcrsmnd thmifthc building does not c ndy haw a ten t y mibility to mdfy,the mm,ord of me myu' whichm me r cof.Cemfictmor cupaney. SignatoreofApplicant Date AA, Date All roof coverings to be Class"B"or better 07 r.uteOnlm