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02060165Z 6 Sy <P< t: gy a. p zi3a Eao j. �60 q�Z E3' 102 C .Z, v a� as C oz UC W'' E O.0 �a Uz • CITY OF CUPERTINO BUILDING DIVISION PE IT - - '- CONTRACTOR INFOROTION: " BUILDING ADDRESS: PERMIT NO. 908 PROVIDENCE CT SHOWCASE KITCHE23S INC 02060165 OWNER'S NAME: APPLICATION SUB DATE GRANT THOMAS J AND MELINDA K 12333 SARATOGA-SUNNYVALE RD 06/25/2002 PHONE: N0. CONTROL N0. (408)SANITARY 253-0412 ARCHITECT/ENGINEER: BUILDING PERMIT INFO ' BLDG ELECT PLUMB MECH 1_7 u I-, LJ LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that 1 am IicermadA�nder pmvisions of Chapter 9 fcommencing with Section 70001 of Division Joflbe N,,msend Professions CodOired my license Job DescrT tion P REVISION SUBMITTED ON 06/25/2002 is in full fo e ✓ Uciemra ar U Lic.«, (ORIGINAL #02060122) Date •' Co.' a 3 ARCHITEC Co LARA 1 N NO NEW PERMIT ISSUED. I und<rman my plans sluill be used es public records xLicensed Professional OWNER -BUILDER DECLARATION 1 hereby arum Ihat 1 on""I from me Complete"'License Law for the 2 following reeaen. (Salion ]0l IS. Busina s sed Pmfe s WI Code: Any oily or county which rcquirta v permit m consuacs. vhcr. imp5vva, damo'I! orrepairany structwe. priorlo its issuance._io -itu dm epPlrtanl Porsuch pearmI.OleasigrmM suumem , Ihm he islicanxd plusuanl re the provtsions of the Compactors Lianse Uw(Ch-Par' lcommenciog with Scelion 700010(Division l of the Busixss and Processions Ceder S Ft.. Floor Area., ; -l. l 9' $11iluation or tMi he is exempt Therefrom and IM basis for the alleged aemprom Any sivlim n 1 y )• '" " " " ' " • " pissed. fssed '13 L5 by any are icam for a permoodsjacu the applica t to m civil Penalty- Ofnot more Than Ove hamdred did(SSW ). N yy� 3 5 61tip(7 6"ll'."U�r Occupancy Type ° 1, as owner of the properly, or my employees with wages os their sole compensation, will do the'wO*, and the structure is not Intended or Offered for sale (Sec. 7014, - - 101 - FOUNDAT I Mquired Inspections Business and and Professions Code: The Cmurucror's License Law door nm apply to as owner of propeny Who builds or improves mesion, and who does such work himself or through his own employees, presided The, such improvements ere not Intended or offered Far late. If, however, the Wilding or improvement is sold within on. year of 102 - PIERS •, "' completion, ide n, the meaner bolr will have the human of proving that he did mat Wild or 1O 3 - UFER improve for purpose ofxme.). 104 - REBAR co L as owner nl me property, am exclusively contracting with licensed contracmrs no 10 5 - ANCHOR BOLTS' congm,t the pprejeet (Sec. 76 . Bell.. mrd Nolessiom Cnd=D The Conlmclor's License Uw doex not apply as an owner of property who Wilds or improve domon, 106 - SEWER & WATER ". ..ad who cmltracu for urth ptvj=cu with a compactors) licensed pompom to Ne Contracmr,Licenselaw. _„ 202' - UNDERFLOOR PLUMBING El I am,xempt pMer See & P C for Oil reason 203 - UNDERFLOOR MECHANICAL ower Date' WORKER'S COMPENSATION DECLARATION 204 - UNDERFLOOR FRAME ,M. 205 - UNDERFLOOR INSULATION I hereby ands, pares, of Perjury one of the following drolmadcom: 301 - ROUGH PLUMBING ❑ I has= rend caul maiden a Cby Section cons nl to saLabor a roe work re Compensation, as provided for by Se,tion J7W of Ne Lobar Code, for Ihe 3 02 - TUB & OR SHOWER Parliarmence of wank for whim this permit i5 issued. 3 0 3 - ROUGH MECHANICAL 111 have and will mm d I mker's Cemportance routines. m required by Section 304 - ROUGH ELECTRICAL 37W of the Labor Code r r he performance of p ° war or which Ihin pail is Iuucd. My rkarmC aq nsa[ion lnsumnce ynumber are and rout 305' FRAME �,,�-{� er Policy rvo: rl� 1 L 306, CERTIFICATION OP EXEMPT ION FROM WORKERS { 307'. 'INSULATION ... COMPENSATION INSURANCE '308 - SHEETROCK ... __ )(This section diced not be, completed if the Permit is for on, hundred dollars (SID(rises.) 309 - EXTERIOR LATH _ ' ..I cemplo than in the work fur which this trail lured,, nany 310 - INTERIOR LATH" ns i Winn r s shell not employ any Pecan in any menet,r m as to become subject to the Woll:eri ct c 311 - SCRATCH COAT ' Compensation Upas at Culifomia. Data Applicant .313 -' ROOF NAIL... .... ..._ . ... ... NOTICE TOAPPLICANT:IL alpr making this Cerificate of Exemption you should WcomesubjectmthaWoher'sCompenwtionpro,isionsof,h.LOW,Code,youming - 501 FINAL ELECTRICAL ENERGY forthwith comply with5am Intimidates or him p mil5nann d reed e.nkad. 502 -..FINAL. PLUMBING.ENERGY CONSTRUCTION LENDING AGENCY I hereby infirm hot Nem is o smomtclio t lending urgency Por the Notern once 503 - FINAL MECHANICAL ENERGY ` , -the work for which this Permit isIssued(Sor3097.Cis, C.) 504 FINAL BUILDING ENERGY Lender's Name . - .... Lendm's Address _ .. .. 505 - FINAL ELECTRICAL. Icmifythatlhuvereedthisvppiicmionendsmtelhmlhuahovalnfomarionis 506 - GAS TEST nate lowsmlil conch.Lngu<mcomply With all ciryand Itpre oNutletso this m -ad ".,on 507 - FINAL PLUMBING th movegcontoned en,fo inspection paperenmtiveseFthiscityuremerupon pollen, inspection p the abov>mcmlee 508' - FINAL MECHANICAL m on keep Unpls. (We)agreet, Save, indemnify andn ,orind whi ImIa I."dl<L'llo mCYpmlllla In old I in co sequence cogs and expenses which may its any wey n core °gains said 5 0 9 - FINAL RAD U city City in consequence of the ming of Nis permit. �s'V[ICANT '\'DERST .' A 'D WILL CO\IPLY N'I NOV.POI�T 1 O r1 F A G Issue yyksY� CER ! AT10�'. e�fr �1 W Date Re -roofs Si,n of p'leanV mrucmr Dau HAZARDOUS MATERIALS DISCLOSURE ... III the applicantmfdwrtWildingm -upon gemmhandle hazvdummaterial 'as TypeOf.ROOE...... defined by the Cupcnino Munici ode. Chapter 9.11 andlhe Health and Safety Code. '. '. ' ' I .; .:. S„tion U5J1ta)?.. .. °Y” ' ' . • ; . • . ':.... . All roofs shall be inspecte prior to any roofing material being installed. Will the applicant or future Wilding.,.pant In, egpiprom or devices which emit hazardous If a roof is installed without first obtaining an inspection, I agree to remove air ecomminan s as ed b he Bay Amt Air Quallly Management Dir,"cl? °Y" all new materials for inspection. Applicant understands and will comply with all non -point source regulations. I"'read the hazard us mammals requirements under Chapter 6.95 of Ne California H. [I & Safely Code, Sections 25505.155)1 and 25530. 1 understand ohm if the building does not currently have a lenany diet it is my rcspnnsib' iry to n°sify to ' Occupant of the regUolou wI Imus, W met prior to i"romee of . caroolaam of upset v 11 } Signature of Applicant Date ill All roof coverings to be Class "B" or better Vanne dmneed. eat Dole OFFICE z CITY OF CUPERTINO A •CITY OF CUPERTINO PERMIT APPLICATION FORM 112,41 64 /6r Quantity Fee ID Fee Description Date:lding BAPPLOTHER 74,PN# Address: qner' MECHANICAL Name: Phone #: BUILDING I\ INK Ind/Off/Comm/Quasi BUILDING Contr fAD^ License #: BUILDING Contact Hotel and Motel Phone #: BCONSTAXR Constax — Resi/Mobile BUILDING BELEC1000 Elec 600V <= IOOOA Appli ontractor: Fax #: Elec 600V > 1000A R Lx BELEC200 Elec Svcs 600V <= 200A Building Permit Info: BENERGY Bldg Elect Plumb \ Mech BUILDING Job Description: bWz)W llu — W • ( � M Energy Add Multi Residential: — :J Commercial: BINVESTIGA Sq.Ft. Floor Area: $/Sq.Ft.: BMITIGATC Architect/Engineer: Valuation: Type of Construction: Occupancy Group: Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances 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 <= IOOOA ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi -Family Res MECHANICAL BNEWMULTI New Multi -family Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING 1 of O w ¢i ZOOZN F I- K a°O� vo s"h¢ mho ay�o �Z i2 zF i3 - CI TINO OF PERONPERMIT BUILD NG D CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO. 908 PROVIDENCE CT SHOWCASE KITCHENS INC 02060165 OWNER'S NAME: APPLICATION SUB DATE - �GRANT THOMAS J AND MELINDA K 12333 SARATOGA—SUNNYVALE'RD 06/25/2002 PHONE: SANITARY NO. CONTROL NO. (408)253-0412 Z 0 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH __I i - LICENSEDCONTRACTOR'SDECLARATION 1 hereby om tha fBrt 1 am license oder previsions of Chapter (commw cing Job Description o witnSection 7")ofDivision 3of1li bass and Profe.wim,CNe,and mylicense in full fn Ih REVISION SUBMITTED ON 06/25/2002 am.a a<.x Da" cont°° (ORIGINAL #02060}}��p n ARCHITECT'S LARA N NO NEW PERMIT ISSIIEIAA,ee® g 1 undentan my plans shall be used as public rcrnNs SEP 1 9 2002 J Licensed Professional y OWNER -BUILDER DECLARATION 1 hereby aRrm the, 1 am exempt from the Convector's License Law for the following reason. (Section 7031.5, Business and Profcshime, Code: Any city or county [� which requires a permn it ) conso et. alter, improve, demolish, or repair any structure. U! LDIMr _.Orin, to its issuance[, ad. equhh, use applicant for such'hunum file assigned s...an, - S Ft.Fl000-Area luation r„��;4t j i1h i.R yq, u tirA 4'?5'i:'xP �rS:1T iJ���` e.W - ihatheisllttnsedpunue,1.hepresihlonsoffieContracmrsLicenseLaw(Chapter9 (coinmericiag with Section.7000)of Division 3 of the Business and Professions Cale) or that he IS cxeriiprthercfrom and the basis for the allege' ciainptiuri. Any violation ” - of Section TO 15 by any uppileum for a panni, ab,,,,o the applicam m a civil penalty of not not mom than five hundred dollars ($50oI. 356 jA PhjuV6r Occupancy Type ° 1, as owner of the property, or my employees with wages us their sole compensation, will do the work: and the structure isnot intended or offered for sale (Sece:'7044; Business and PNfessions Code: The Convenor's License Low dues not apply man - - ----- 101 - FOUNDATIMquired Inspections owner of property Who builds or improves thereon, and who does such work himself or through his own employees. provided that such improvements am not intended or10 2 — PIERS offered Toe sale... If, however the building or improvement is sold within one year or 103 — UFER - completion, the owner -builder will have the huNen of proving that he did not build or improver„rparp,,se ,,,solo). 104 — REBAR - ”' . , - - -- . ... with IimnxE coovvcmrs to ."on:ateowner"pii the p(Sec.7am <ndinessacomroning ... 105 - ANCHOR BOLTS construct the the project (Sec. ]loan Busies and Professions CWo:)The ves Contractor's License Law does nmapply man owner property afmprovesttoth, s+ 106 - SEWER & WATER with f .and who commars for such projects with a cummnnrp) licensed pursuant to the mrs Liceade Law. __....._._ ....... ..... .. ... ... 2'02 "= "UNDERFLOOR PLUMBING — _. D I a. ❑lam<semptuneersa.•- e�Perntms nn 203 — UNDERFLOOR MECHANICAL o f '' 204 — UNDERFLOOR FRAME WORKER'S COMPENSATION UF,CLARATION I hereby affirm under Penalty ofpar by, one ohne meowing declarations: 205 — UNDERFLOOR INSULATION 3 01 - ROUGH PLUMBING .' 0 1 have and win'n,aimam'a Cerdficam of Consent ,, x if„more for Worker. 302 - TUB & OR SHOWER Compensation, as provided for by Section 37W of the Labor Chile. far the performance of the w ark farwhich thfsm ,petitisissue. 303 - ROUGH MECHANICAL 0 have J willmountain Worm Co.. of t surasrequiredby Section - 9.n 304 — ROUGH ELECTRICAL 4700 of the Lab or Code, f th p ro f work f hich tl's Permit . - 3 05 — FRAME issued My W ker's Cn n aeon Insu c and I' I' y be e: . _ tt' anaN : r�� .... __..... _. .. ». ,.-....�... ,.�. ..... ...-,......., .... ...._.._ . 306 HOEDOWNS'' 11.,.",,V, s , f CERTIFICATION OF EXEMPTION FROM WORKERS ' +_h� 13"0 T` INSULATION''at_1-1 COMPENSATION INSURANCE ° " to _ 3'08 SHEETROCK __,._. __.... . mriss,ctroneJ no,he completed tithe .it is for one hundred dollars 309 EXTERIOR LATH (500 - wifth, 310' -'INTERIOR LATH ... .... ... ... .... I nytary pr ndna of ih'dwmk for wha,I a f,fasted, 1 f ,, .f„ shall not employ an, person of any manner so as to twer me sobiect m the Workers 311 — SCRATCH COAT - - ' Compensation Laws of California. Dote .Apptcaat. - - .313 -- ROOF NAIL. 501 - FINAL ELECTRICAL ENERGY NaICE 10APPLICANT. If, after malangthis CertincmeatExemption. you.shnmd herome tsubjec,, the Worker's Compensation pro, inions ofahe Labor Cale, you must j rortnwimcomply 'with such pro.ismnsnrthis permit shall bedeemed revoked ' _ 502 - FINAL. PLUMBING _ENERGY ” `CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY ' " 1 herchy affirm that them is a construction lending agency for the performance untie,oivarn,,,,'m<hthis_prnonitissued(s<c.3097.Cov.C.) 50,4 — FINAL BUILDING ENERGY j Imam. Addre, - . 505 - FINAL ELECTRICAL;_ I c nf, that l have hand this application and state that the abooe 'rani is carts Ia to Cohn, with allatY and< ry mdanothar1l and.t't Irg 506 - GAS TEST 507 - FINAL PLUMBING taWld Wildingconstruction. ndn by auto p . mtiv of this city to int pun a m bo e,p p<nyr nspectinparpos. 508 — FINAL MECHANICAL <I (W'g em x indemnify and k pha I . the City of Cupetims gain.,, 509 — FINAL RAD libli. md'unerr est. and eapcnce hchmyin any yc gat:traid cty q -'D ria- ungmm.ps i • I „ AaD WILL COMPLY �7 .. ATIO\ rJ. (� \Dnata C, _ 10 t) F A G IssuPTT Date S n p a nV< rnvwmr ,Dara � g the � Re -roofs ' Re -roofs applicantmr.rrt Wildin•u:cupam smrt}I HAZARDOUS MATERIALS DISCLOSURE uior handle wrwuan measured _.. Type of Roof_... as d f W by the Cupertino M' u p W Chapter 9 12 d the Health and Safety code OcYon 2557214) ; r •, , ?'.-R t y r !'}<. % All roofs shall be inspected prior to any roofing material being Installed. ' will the ppicent or future bu Id' g occupant use equipment or devices hicn emit hN it contamnams as d edh h Ry, A`�5 Quality Management If a roof Is installed without first obtaining an inspection; I agree to remove for inspection. D t t °Y all new materials Applicant understands and will comply with all non -point source regulations: I have read the hoz us matenakh rtqornaments under Chapter 6.95 of Ne California Health & Safety CWc, Sections 25505. 25533 and 25534. I understand that ithe building does not currently have thathis mYmse'orsi,'ityro notify the ccupam ,,f the rcyuimme uhell must be mot prior to wn:mce nL Cenifcaa of - �"° " yaytenant. Signature of Applicant Date `-' "� i m„rrzW .gent Data All roof coverings to be Class "B” or better i OFFICE