02060122CITY OF CUPERTINO
BUILDING DWISION PE T
-' - " - -- - --'
,,CONTRAC;TMINF6 -ON: -
BUILDING ADDRESS:
PERMIT NO.
908 PROVIDENCE CT
SHOWCASE
KITCHENS INC
02060122
OWNER'S NAME
GRANT THOMAS J AND MELINDA K
12333 SARATOGA-SUNNYVALE
APPLICATIO14 SUB DATE
RD06/19/2002
HONE:
(408)253-0412
SANITARY NO. CONTROL NO.
OZ ARCHITECTIENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
r - r_ I LJ (.J
i LICENSED CONTRACTOR'S DECLARATION
C Ihrcby RnnNaLLamliccnudunder provisiomofChop¢r9(commencing
with Section]((((1lll000000007 lvision3 of the Bosinessp}a �pfessi.nsC Im4aml
KITCHEN
Job Description
REMODEL/R§'-PRACiE�,�WaINID W &
rs in full f, cgreadg, t. .JV X77, G0 1\O_�c,
uanua rJQ
ELECT/DRAFT
v `�
RECON.
tic.«
Dmc Contrac or
�n 1 N Ur, DEC ON
SEP 19 2M-
2 l u d gr.ma m 1 s�lt Kurds
i "ens Pr nonal - J
OWNER -BUILDER DECLARATION
BUILDING
w 1 hereby affirm that I em exempt from the Contractor's License law for the
a following reason. (Section 703 1.5, Business and Professions Cale: Any city or county
❑ which requires a permit to construct, alter, improve, demolish, or repair stay structure-
. prior m iu issuance, also requires the applicant far such pemdt to fide a signed suument
- that he It lictimand pursuant to the provisions afthe Consuclor's London Law (chapter 9
Sq, Ft..Filoor.Area_,
•°.�.i
--5,;,
Valuation
(commencing with Section,7000) of Division 3 of the Businesf pnd Profession Code)
or that he is exempt therefrom and Ave basis for Ne shifted examp d,., Any violation
: j C' _
, ,
a 2 a ; ;
-IfSection 7031.5 by any applicant for 4 permit mbjeats the applicant to. civil penalty
.of not more than Ave hundred d.11am 18500).
AP
n
Number
Occupancye
�P
❑1, as owner of the property. Lir my employees with wages 35 their sole compensation,
ini -
FQllNQATTQN
-"will'do the work, end the swnute is not Intended or afraid for nate (St.. ]OM,
'Business and Prof ..Ion, code: The C..tr cum'. License Law does net apply t..n
102 -
- - - - - - - - - -
PIERS Required Inspections
owner of progeny Who Wilds or improves thereon, and who does such work himulf
or through his own employees. provided that such improvements are net intended or
10 3 -
UFER
.feral for ,ale. If. however, the or
or improvement n sold he
have
J_ Q 4 —
_
REBAR '
did not build
owner -Wilder l t
completion, the owner -builder will have the WNcn.fproving Nat he did not build or
impr.ve far purpose ofeal").
105 -
ANCHOR BOLTS
..
C 1, m owner of Ne progeny em with tic m
106 =
SEWER & WATER.. - - -- - "
Business a d Professi The Conctors
Code:) The Contraries's
construct theLaw
project (Sec, ]044 owner o and noy who
License d°ctsnot plymsm wnowum°rimproves thereon.
ash
202 -
UNDERFLOOR PLUMBING
Who co for rojeem a comm
for such pmjecu wish a cpotnctogs) Icewed pursuant to du
ane who 's License
comm�or,Li,emeLaw.
- -203 -
UNDERFLOOR --MECHANICAL - - - -
❑IamexemptuaderSec. ,B&PC for this mason
204 -
UNDERFLOOR `FRAME
Owner Date
205 -
UNDERFLOOR INSULATION
- WORRER'SCOMPENSATION DECLARATION
301 -
ROUGH PLUMBING
- 1 hereby from modar penalty of perjury one of the following declarations:
302 —
TUB & OR SHOWER
❑ 1 have ane will maintain a Cenlficau of Cement to self -insure for Worker's
3 03 -
ROUGH MECHANICAL
Compensation,y S
Compensation, he provided for by Section 3700 of the Labor Cada for hePerform
the work for whim crtnh is issues.
304 -
ROUGH ELECTRICAL
C 1 have and will maintain Works i Compensation Insurance, as required by Section
305 -
FRAME
3]00 of the Labor Code, for the performance of the work for which Ni, permit is
issuW.M W rkers C. enation In rang artier dna Polic num rare:
306 —
HOEDOWNS''
pyo,,
307.,'INSULATION
,... ....... .
'
.. c of of PnONFROM.W s,
+.'•308 '''SHBTROCK'••i';
COMPENSATION INSURANCE' r309„
-
EXTERIOR -LATH
(This section need not be complemmin
tl if the pert is for one hundred dollars
(8100)or less.)
310 -
INTERIOR LATH '
-1 certify that in Ne perforn4dre of the work for which Nis Permit is issued, l
31.1 -
SCRATCH COAT
shall not employ any person in any manner so m to become subject to the Workers
313 -
ROOF NAI L -
Compemution Laws of California. Dau
Applicant
501. -
FINAL .ELECTRICAL. ENERGY _.
NOTICE TO APPLICANT: If, .f er making this Cenificau of Exemption, you should
become subject to the Worker 'sC.mpemation pr°vinank f,h, Labor Code, you must
502 -
FINAL PLUMBING ENERGY
j forthwith comply with such provisions or this permit shall ba deemed revoked.
503 -
. FINAL MECHANICAL ENERGY
I CONSTRUCTION LENDING AGENCY
lenaingagenry far the perf.mence
Ihercar wPom this the.a..round
504 -
FINAL BUILDING ENERGY
Saon
Na work for which this mit is issued Sac. 3097, Civ. C.)
505 -
FINAL ELECTRICAL
iof
boder',N.me
Lenders Address
506 -
GAS TEST
� .Iccnify Nmlhave rzad Nis application and nate thauhe about inf.rmni.n is
507. -
FINAL PLUMBING
I tom t6I agree to comply with all city and county ordinances and state laws relating
508 -
FINAL MECHANICAL
to building construction. and hereby authodm represemetives of this city to enter upon
the above-mentioned property for inspection purports.
509 —
FINAL GRADE
(We) agree to ansa, mdcmnify and keep harmless th, Ory of Cupertino against
1' liabilities, judinums. court and expenses which may in any way accrue against said
5510 -
FINALPL
City inconaeque c ofN granting of Nis pemtiL
PIP V U D ST YDS ARD WILL COMPLY \4'ITH ALL YON- OINT
ursc R c L 1
1714 �=
D
Issued y:
_AWING
/
NA WORKS Ul/
Date
rgn w o Apple anvC.duracmr Data
Re -roofs
HAZARDOUS MATERIALS DISCLOSURE
It On applicant or fumrc huilding«c°pant... an or handle harardoaa materiel
Type Of.ROOf
.. ... -
as defined by the Cupertino Municipal Code. Chapter 9.12. and the Health and Safety
...-.. - ._... .
Core, Senion 255321a)1 -
❑Y«
•• •
,' .� f . ` .'•s •. r .
All roofs shall be inspected prior io any•rooffng material being installed.
Will the applicant or future building occupant use equipment or devices which
emit hazardous air con tam tins defined by the Bay A,_ Air Quality Management
If a roof is installed
without first an obtaining'inspection, I agree to remove
P g
District?all
Yes "°
new materials
for inspection. Applicant understands and will comply with
PP P y
all non -point source
regulations:
I have
I the ha materials rtquirtmema under Chapter .f the
-
Health Code,
California Health & S.fery CWe, Sections 25505, 25577 end 255]4. 1 undersmnd that
understand
if Ne building does n° randy haveaun.nt. Nat it is my rc,ponsibilitymnmify the
occupant .f the rtqui •m nu hien must be run poor m issuance of a Ca ficam.f
ccupanr
Signature of Applicant Date
U
All roof coverings to be Class "B" or better
de Or NrteaDI
g Date
OFFICE - -
CI OF
CUPERTINO
CITY OF CUPERTINO
PERMIT APPLICATION FORM
oZv6`/zZ
r
L
Quantity Fee ID
APN #
Date:
BAPPLOTHER
Buildin ddress:'(� y
MECHANICAL
BBLDGFEE
Bldg Permits . foot
Owner' Name:YIS\ A4 one #: 5 /
1,
BBOILERI
Contr t
License #:
BBOILER2
Contac : Phone #: -014Z
4d
MECHANICAL
Applican ontractor:
Boiler> 500K to 1M Btu
Building Permit Info:
BBOILER4
'Bldg Elect Plumb Mech�-
MECHANICAL
Job Description:tL U 13
Boiler > 1.75M Btu
Residential: Commercial:
BCONSTAX. ..
Sq.Ft. Floor Area:
$/Sq.Ft.:
BCONSTAX
Architect/Engineer:
Valuat' n: 5
BCONSTAX13Q
Type of Construction:
Occup Group:
r
L
Quantity Fee ID
Fee Description
Fee Group
BAPPLOTHER
Other Appliances
MECHANICAL
BBLDGFEE
Bldg Permits . foot
BUILDING
BBOILERI
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
BCONSTAX13Q
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
I BUILDING
BINVESTIGA
Investigation fee
BUILDING
BMITIGATC
Comm. Housing Mit. Fee
BUILDING
I
lof3�,77
1
O
6
U
Yea
FF�
OZ=
int
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Oy
f3as,
t�0
5at5a?
W�
CI iVO
BUPER
IL nc DONPERMIT
CONTRACTOR INFORMATION:
BUILDING ADDRESS:
PERMIT NO.
908 PROVIDENCE CT
SHOWCASE KITCHENS INC
02060122
WNF.R'SNAME:
THOMAS J AND MELINDA K
12333 SARATOGA-SUNNYVALE
APPLICATION SUR DATE
3RANT
RD06/19/2002
PHONE:
(408)253-0412
SANITARY NO. CONTROL NO.
ZO ARCHITECT/ENGINEER:
BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
I- - I G7 LJ LJ
i LICENSED CONTRACTOR'S DECLARATION
Job Description
yafmt.adam IrpVmvisionsofChopm �m
w with acn��f0)pvistonJ.fihaBasin,& n�C odm4amse
l
KITCHEN REMODEL/REPLACE WINDOW &
Chcub
LicmenrumI
Lic. a
_ ELECT/DRAFT RECON. FBALE3
Date Coca r
1 A Hl ECT'5 D CL TION
in
J/�Indn, lam°
SEP 1 9 2002
0 een. Peliestonal
i 1 OWNER -BUILDER DECLARATION
I hereby affirm that 1 no enempt (,..,he Cmaimar is LicLicenseLaw for the
y: following reason (Seen.. 7031.5, Businessand Professions Code: Any city or county
,, 11 :f
��kk++
B{./'`Dllag
O which mquirev a Iron lit to connived.olmc improve. demolish, or repair any structure,
prior to its lsuance, also mquiin the applicant for such pumiuo file a signed statement
S Ft Floor Area ., Tf,
�,ONTJ\iiLQ S. %l: ,4TItil':
Valuation
- IbthgislicenwdpuRuanltgthcpmvisiomoftiContractorsUi nulaw(Chapur9
(commencing with Section of Division 3ofine Business and Professions Code)
170001
or that he rs exempt tfierefrom and the basis for the alleged etempuhn. Any violation;rln6i
lalZ
nn
j
of Section 7031.5 by any applicum for a permit subjects the app]icanl m a civil penalry-
of aa, mare than eve hundred dallot, a50o).
APN Number
l-, i Occupancy Type
01, os owner of me p,.,.y. or my employees with wages as their sale compensation.
-will-do the work: and Professions ora:smarT e not Intended a seofferedLaw for apply to ay-
Bui nets and Professions Cale: The License Law does not apply to an
-- - - --
102 - PIERS Requ¢ed Inspeetwns -
wner of propcny re,es,homContractor's .
nuilae or ovided merlon, and who does .ren work
10 3 - UFER
arr
or through his own employees. proviJed or mph imprnvementc ore oat inteycar ata
intended or
"-completion-sale lidwevdethe gbrF prov years
-m erprovn iaW within -wire -'l r'
_
104 - REBAR�•.n, .::,.•.•.
of,
l have
compinlon, me owner -builder will have me amen arpmmng mm he die not Haile or
,
improve fe"mroa.emrsme).
105 - ANCHOR BOLTS
- .. - --' - - - ._._.. -- --'--
grope yam esdmissand tromssion,licensTh wmmcmtto
❑1, us owner cr the n
..-- --- --- -. _.
— - __. _L i,,. •-.. nr.'.P
'
eonawnaw ices n race. mean BaneBusino and erornhiob ewe:) The vesCoolant.,emon,
- License Law does not apply to an owner or progeny who builds or improves thcmon,
2 02 - UNDERFLOOR PLUMBING :'. ' "'r''
_ and who commands mr,such projects -with a.cormmctor(s) licensed Parinam.fo mc_
-_ __ ____-2 0'3-'-'-'UNDERFLOOR—'MECHANICAL -----' -"--
Contractor I License Law. ,
_ ❑Iamamain made, S.. -, .'B&PCfor this mason
204 - UNDERFLOOR'i'FRAME"'•
Owner ^" 'tiara' '
205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION
301 - ROUGH PLUMBING
Ihereby affirmunderpenaltyofperjuryoneofthefollowingdeclarations.
302 - TUB & OR SHOWER
❑ 1 hav<'anJ'wiil mainwin a Crnificmp at Consent to self -insure for Worker':
3 03 - ROUGH MECHANICAL
Compensation, as provided for by Section 37W of the L.ahor-Coke, for the
permrmance'ofmd week, far, which this, pe man is issued.
304 - ROUGH ELECTRICAL
01 have and will mainmin Workers Compencom on Insurance as sequined by Section
3 05 - FRAME
PW of the Lal r Cost the a6marnme or the work for which this perm t 's
306 HOLDOWNS
issuaJ M W r�kerTa. C it t�i-nn In ins c and Pol�`�
I
�`q-v
INSUliATION._-..__1......_...._........._.�.,:.1,�...,.,.'....,,._.-_,..__._-.-
�r lr,C • F A 10, OF EX PITON FRDMWO KERS's
� : g!�• z 3 0'8L. • '-s'SHSBTROCWC'+%' V:
COMPENSATION INSURANCE "• ^ t s z _'
1 _
v r✓ (This section need not be completed if the profit is for one handrail dollars
310 - INTERIOR LATH
cslW)arleaa
_;.-"•_ _ ..._ -- -
'damitythatin
--=-31-1=`-SCRATCH =COAT--.-__,:_.. _.
_
nnrt in
L'a,fCald in any manner so m m become subject to the Workers'
mann theast forwhich thisct toteWorkerl
.....,..:„fps,,,,A.I.
313 - ROOF NAI L O1 " '' '
anon
Compensation
Compensminn Law. of Culdnmia, Data
nppBeanf' ' ' --"
..-.-- .- ...50.1_ - _FINAL..ELECTRICAL._ENERGY-.. -..
NCHICETOAPPLICANTILaircrmakinglM1ivCcnifca¢afEnanption.youshmulJ
502 - FINAL PLUMBING ENERGY'
become subject m the Workers Compensation pho,ksi v, of the Labor Coke, you must
j roriinccomplywithsuchprovmonsorthispermhahanl>rdeemedrevand. _
5.0,3_ -_-_ FINAL MECHANICAL -ENERGY__
r "CONSTRUCTION LEN DING AGENCY
504 - FINAL BUILDING ENERGY
1 h achy ofrno that mere i, a conswn nt lendng agency To the performance
or the work far which this permit is issued (Sed. 3097, Cil. C.) "
•t .. ,.
505_- FINAL ELECTRICAL
°Hila nes`.
1 nfythat lh a read this application and talethat m b information s
_.. ------
506 - GAS TEST
507 - FINAL PLUMBING"
I agrees,m comply with au pity and e try ardman..and elate I... rani ng
508 - FINAL MECHANICAL
to budding consweimn. and hereby amhorim representatives of this city to enter upon
the anove-mursomed,property for inspersion purposes.
(We) aa, w care. indemnify and keep haonless the City of Cupenin. against
509 - FINAL GRADE
FINAL LA ING
liabilities , jaggment:. poen and enpensea which may in any way accrue against said
510 - /
.' Chy in cafaegfe p of in noting anhia patten.
A; [.I �'-0ID 1sT UDS' AND WILL COMPLY WITH ALL NON-OINT'
R It ..
)a
514 �= NA CJ WORKS
I$$Get: Dole
yi
no o
n w o AppbaanAZAR tcmr " Deco
,,h
Re -roofs
HAZARDOUSMATERIALS DISCLOSURE "' .
C beau ant mote or handle h amaun
pp s I
, d ,Will then Bron ata
Type of Roof._ _._.. .....- ..,. _ ., m. .._...- __.._.
Municipal
m if al by lM1 Cpem M 'p lCd Charter 91 Jd Health and 5afdy
Safety
Cw lel ,r ,�
r
��11�Tv{,' '•�{ a II „
❑Yen 'SSl
No f
' ; a i
1i.r.
- All ioofs shall be inspected_ prior to any, roofing_matenal being mstalIed
_ _
w'o the future holding occupant use q 'p r devices which
e
"rmmnm
,.
If a roof is installed without first obtaining an inspection; I agree to'remove
tau tan lefned by the Pvy P,e iQual¢y Menage nem
Dimdptl a -
District?
all new materials for inspection_- Applicant understands and will comply with_,
- Dues -; - - Na- — —: '-
`—'all non -point source regulations. -
1 have rend the hazvdoa; materials requirements under Chapter 6.95 4 the
'
Calirornin Health & Safety Code Search, 25505.2553 and 25534. 1 understand that
-tM1 a nit mg Joel no nervy eve remain, mut it tsany responsibility m notify the
6ccupom of the ro,i'm its vhiah must be met prior to issuance of a Ccnireme of
' cupzn<
Signature of Applicant Date
war o j m rima ag t _ .. Dare
All roof coverings to be Class "B" or better
...OFFICE - - .. ... _ ._ .. _ .._ ...... _ .... _
of I
it
n FP
�Y
JUN 2 5 2002
7*
It
4.
-5TANDRRD IMM 1.W1NPQ J 1%AAOI/N67
�6 Oosr ln2Ary
AePROV ED
In aDAt3r CeVITN, THE NA Ofl
./ m
hlsse u:d aas an it 15 UT
tta lob at'all tPneor naweratious
tawtut to jos"-- "" ermission frolb
m pane ihaut wri.ten P rtino.
;he bur,dalb r7ePt., City of Cupe
The stamWnfl of th:s plan and specificatioaO
ns
. o he d to permit or too ions
e ..( Iatianot D
aav f;tv prdinance or
Law•
DF
z,, xy¢ —
fr(E� 8 f-.�M1 � � y � iliL Out Diu
Lc�G�R.7'iNa _ C!9 9Sd ref
SCW2436K—
FC-165H
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COS16"H
EXS1L
4ROS
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129
74" BOWJ-WIN00\
- - -
�I
rkr-%,)SS81"B
I
JI
BFD09
OILr1
5824
TOSF
GLE SINK
I
ri4� IPC
COPY
W4236
—1943/4
DIPTR30
30"CT
30"OVEN
This set of plansofid specifications MUST
be kept on the job at all times and it is un
lawful to make any changes or alterations
an same without written permission from
the building Dept.. City of Cupertino.
Tho stamping of this plan and specifications
P3/4x26x90 Ptlh1Az$��Tqbo h6d to pe mit or to be ars
B42 ®®I®vat of the violation of any provision•
SFgie Law 6 3/4" WALL
4ROS BR309024
45
JUN .] 9 2002
WE3fi18
CDS88"H
COS16"H
EXS1L
4ROS
JUN .] 9 2002