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03090210 CITY OF CUPER'f[NO ^*` •ora Wa?.+ * _ BUILDING DIVISION PERMIT s CONTRACTOR INFORMATION." BUILDING ADDRESS: PERMIT N0.03090210 ' R'S NAME: PERMIT ISSUE DATE ISUNG KI MIN03 NE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH CJ 0 0 +Op LICENSED CONTRACTOR'S DECLARATION Job Description N1 hereby affirm that I em limned oxer nroZ'[ons Cmofcnapmr v(mmmense is p ii with Scctiortl�Aq of Division Jof the Ru sand Pmfcssinns Codc.and my license is s<6 in full forteaw effect. i'q_ Gimaccl Lief lZ5324 REPLACEMENT/RETROFIT WINDOWS II-- Dam cmntru CONTRACTOR: ASPEN WINDOW & DOOR 4 q ARCHITECTS D RATION ��� 2226 U 5`I nticrsmMua rc nJ my plans shall used Public cnrds F'N .i =ot; Licensed Professional MAR 2 5 2004 1 3 OWNER BUILDER DECLARATION Z a f I hereby.(sero o the,1 1. exempt from the Commas Co :An,c Lew for the 5 00 following mason.fermis t IDnstr Business and ve de funs Code:Any city or county $E whim myuims n permit re conswct,alter,improve,h fermiit t ri e a siganyned statement_ZQ faionoitscensed pursuant thcaprovisions or rorsucthe Contractor's icesaiaw stsmmcm Nat he is licensed pursuant to thepmvisions of the Contmctoes LicenA taut(CheplerY Sq. F[. Floor Area 2 (commencing with Section 701X))ol'Division 3of the B usiness and Professions C,Jc7 ser that he is exempt therefrom and the basis for the alleged exemption.Any violas'ion of Section 7031.5 by airy applicant for a Permit subjects the applicant to a civil penalty of 3AINSlI91Re OO Occupancy-Type not more than five hundred dollars($500). P Y I,ea owner of the properly,of my employees with wages As their.anle compensation, will do the work,and the structure is not intended or offered for sale(Sec.7W,Business RRee and Professions Code:The Communities Licenz Law does not apply to an owner of 101 - FOUNDATT16rSd Inspections property who builds or improves thereon,and whodoeuuch work himself or through his U1V Own cmploycea,provided that such improvements ire not intended oroRered for Ale.If, 102 PIERS however,she building or improvement is sold within one year of completion.the owner- builder will have the burden of proving Nat he did not build or improve for purpose of 103 - UFER AR.). - 104 - REBAR I,as owner of Ne properly,,B exclusively crowning with licensed contractors i. - conswet the project(Sec.]Bd4,Business and professions CodeUThe Conmacmr's Li. 1 05 — ANCHOR BOLTS cmum Law dors not apply be in owner of property who builds or improves thereon,and 10 6 - SEWER & WATER who contracts for such Projects with a contractor(a)limned pursuant to the Conuacmh License Law. 202 - UNDERFLOOR PLUMBING ❑l am exem Is under See. ,B&P C for this reason 203 - UNDERFLOOR MECHANICAL' Data204 -- UNDERFLOOR _FRAME er WORKERLA 'S COMPENSATION DECRATION I hereby M.undpe only of Paj.,be.,rtbe 1.1owing declaration: 205 - UNDERFLOOR INSULATION Nie and will maintain•Certificate of Consent to selGinum for Wortrri Compcm 301 - ROUGH PLUMBING sation,u provided for by Section 3700 of the Labor Code,for the pesformanee of the 302 — TUB & OR SHOWERwork for 01banand illaparmit isinWorrcd. 303 - ROUGH MECHANICAL ❑1 have end will maintain Worker's Compensation Insurance, h required by Section nr>oofinehb,resefor es,=perrorm.n=e,fOne work far wmrntnapermitiaiA,ea. 304 - ROUGH ELECTRICAL My Worhees Comlcrom on Mae Ironer and Policy number are:_ wv�s 305 — FRAME Cnrricc VPolio Nu.: ��r-r RTIFICATE OF EMP170N WORKERS' 306 — HOLDOWNS COMPENSATIONIN NCE 307 - INSULATION (This section need nm he completed if be permit is for anchundred dollars IS 100) 308 - SHEETROCK ,.Ica,.) 309 - EXTERIOR LATH employ cerlify Nat in the n an mane of Ne work for which this permit la issued,1 shell nm Lawoanyperaonmany mannerAumtrcome subject to Wortrri Compenatan 310 — INTERIOR LATH Laws ofCalifornia,Dam Applicant 311 - SCRATCH COAT NOTICE TO APPLICANT:IL aper making this Certificate of Exemption,you should 313 - ROOF NAIL become subject to the Wortrri Compensation previsions of the Labor Code,you must �Z forthwtthcomplywithsuchprovisionsorthispmemishallIngdeemedrevoked. 501 - FINAL ELECTRICAL ENERGY Zo CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY l nder's or whichhereby am.bar them is.conmuctmn lending agency for the performance of 503 - FINAL MECHANICAL ENERGY x> to work issued 504 - FINAL BUILDING ENERGY Uder's Name ILnJees Address :)Z 505 - FINAL ELECTRICAL ;J p 1 eeNfy o c 1 have read UnaApplication and tour end auto the the sham iws relation is 506 - GAS TEST oohing l agree to comply hereby auchori rprea ordinances and sine laws r Open the buildingconvection,and herebyection reosica. fives of this city to ewer upon Inc � U ahme. - FIN L PLUMB NG Q. mcn)Mac I.cava for dcoamftion Purposes. — (sac)agree to Ave,intlemnify and keep humleu the City of Cupertino.faint O FI AL h liabi In]..jutlgmcno,costs, ,pe"isnes whoccomiich may in any wsyamroc again.said City _ ..) rZ-t AcoW qp nccOr on"STA g u$AND WILL COMPLY WITH A NO POINT Issued by: 5 - ING Date S URC G Ns, Re-roofs S rte re of ApplicaHAZARemr k HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or futurebuildingCode,Chapttlomor handl Health And Safety Reed by the Cupertino Municipal Codc,Chapter 9.12.and Ne Health.nd Safety Se=ders usJ2(a) All roofs shall be inspected prior to an roofing material beim ❑res �e+, P P � Y g g installed. Will the applicant or future building occupant use equipment or devices which If roof is installedwithout first obtaining an inspection,I agree to remove I havardous air contaminants A defined by the Bay Arca Air Quality Management all new materials for inspection. xtria7 Wain (C?No I have mW the Wardiwsmaterials requirements under Chapter 695of the Califon nix Health&SafelyC ,Saran 25N15,25577 and 25574.1 mumonand one ifths building does ly het tenant Nat it u my m.pm onsibilky redly the omi,am of me �ts =n abcMCI pri,rwsnun iametieerdfi=stn ,man= - Signature of Applicant Date mer 4ftion7ml agent „= All roof coverings to be Class"B"or better r CITY OF CUPERTINO BUILDING DIVISION PERMIT QONT"GTan MOR' A.TI0 `?.taw BUILDING ADDRESS: PERMIT NO.0 3 O 9 02 10 7917 RATNPnW DR OWNER'S NAME: PERMIT ISSUE DATE S 03 SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELELT PLUMB MECH 0 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION I hereby affirm in I.m I 'it dor provisions of Cbapier v(commeneina Job Description 6 with Sectihr 7 MDow.3of NC Bu s nd Profcssians Code.and my license i, n full tart- effect imeese ct Iic.1 12cj32� REPLACEMENT/RETROFIT WINDOWS Dam ConaacCONTRACTOR: ASPEN WINDOW & DOOR i� ARCall heu•da RATION FIN p ��� YI undcrambd my plain shall he used as puhlic remrda /qL�a iU h Licensed Professional 3 OWNER-BUILDER DECLARATION MAR 2 5 2004 p 1 herchy affirm that I am exempt Tram the Chatrano,',License Law Inc,he {O following mann.(SeNun 7031.5,Business end Professmm Code:Any city or county I .which myuires a permit sea construct,alma improve,demolish,or repair any swctum .e prior us its manner,also mquims the applicant for such permitio file a signed s,ammcat G that W is licensed pursuant to the pro ommus of the Contractor's Licenm Law(Chapter 9 Sq. Ft. Floor Area BUILONS432 ;$ (commencing with Section 7000)of Division 3 of the Business and Prafessions Cher)or .— that he is exempt therefrom and are buts for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3ARN Htif Rt O O Occupancy Type . . not marc Nan five hundred dollars($500). . 1,as owner of the limitary,or my employers with wages as Neo sole compensation, will do the work and Ne structure is not intended or Offered for sale(Sec.7044,BusinessRR�� U dins ections and Professions Codc:The Cantncal's Lt..Law docs not apply m an owner of 101 - FOUNDATT d1 p pmpeny who Wildsarimproves Nemo.,snit who doessuch work himself or through his Own employees.provided thatauen improvemems aremn intended M.11i ed fortune.If. 102 — PIERS however,the building or improvement Issald within one year of completion,the owner, builder will have the burden of pmving that W did not Wild Or improve far propose of 103 — UFER saleL 104 - REBAR 1,as owner of the pmpeny,am exclusively contracting with licensed conewars to 10 5 — ANCHOR BOLTS construct the project(Sec.7044,Business and Professions Code:)The Canncwr's Lt come law does no,apply an an owner of property who Wilds or improves themon,and, 106 — SEWER & WATER who contracts for such projects with a con"clor0)licensed pursuant m the COMONU r'a License Law. 202 - UNDERFLOOR PLUMBING I am cxemp,under Sec. .B k P C for Nis mssan 203 - UNDERFLOOR MECHANICAL Owner Dam 204 UNDERFLOOR FRAME WORKER'S COMPENSATION DECLARATION I hereby affrrmunder penalty of perjury ON of the fallowing doclam,ionr. 205 - UNDERFLOOR INSULATION ' eveandwillmaintain.CeNOcateofConsenttoself-Insumforworker'sCumpen 3O1 — ROUGH PLUMBING Was provided ter by Section 3700 of the labor Code,for the mce Perforanof the 302 — TUB & OR SHOWER work for which this permit is issued. 303 - ROUGH MECHANICAL ❑I have and will maintain Worker's Compensation Insurance.as required by Section 3700 of No Labor Cod0.ter lW performance of the work for which this perm it is issued. 304 — ROUGH ELECTRICAL My Workers Compen ,ion lnwnnennier and Policy number�m: o��� A 305 - FRAME Cortico• i iVsR J' , Poli Na.: G 306 - HOEDOWNS - ,( 'RTIFICATE OF EMPnON WORKERS' ,G/ COMPENBATIONIN NCE 307 - INSULATION (Thu section need not W completed if the fermi,Is for Wehundmars d doll (S 100) 308 - SHEETROCK (Klass.) 309 - EXTERIOR LATH 1 C.r fy wet I.the perrmmare.of the work fm which this permit is issued.)anon nut 3 10 — INTERIOR LATH employ any Person in any manncno u to Income subject m IN Workers'Compemation Laws of California.Data 311 - SCRATCH COAT Applicant NOTICE TO APPLICANT:It.after making this Certificate of Exemption,you should 313 - ROOF NAIL become subject to the Worker's Compensation previsions of the Labor Code,your must ,Z forthwith comply with such pravism.Or Nis Permit shall he seemed reversed. 501 — FINAL ELECTRICAL ENERGY 0 502 - FINAL PLUMBING ENERGY 73 CONSTRUCTION LENDING AGENCY I nearby amrm Nat them is a constmcium lending agency for the permanxice or 503 - FINAL MECHANICAL ENERGY Ne work fur which that permit unamed(Sec.3097.Civ.CJ 504 - FINAL BUILDING ENERGY QLender's Name ;z LumeraAdd.. 505 - FINAL ELECTRICAL p I certify that 1 have mad this application and sum that the above information is 506 - GAS TEST carted.l agree m comply with all city and county ordinances and sate laws Misting to 'iUWilding convection,and hemby auWodae mprrsenlativos of Nis city in Omar upon the — FINAL PLUMBING ahove-men0uned Pmpeny rte inspection Purposes AL (We)egnm m save,indemnify and keep bumless the City of Cupertino against O = F I liabilities,judgments.eosua xpea...which rosy in any wey accmc against said City 1 in ca uuFFa.Or the gnnO go his Permit. A LI AIT iaRSTA S AND WILL COMPLY WITH A NOIssued by: 5 - ING Date S URC rI eG NS. e Re-roofs S nes rc of ApplicanUConwctor D% m HAZARDOUS MATERIALS DISCLOSURE Type Of Roof Will Nc applicmtur furore building accupents,orc or handl vudous material as defined by the Cupertino Municipal Code,Chapter 9.11.and the Health and Safety Code,section W32(a)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes �u Will the applicant or future Wilding Occupant use equipment or Devices which If a roof is installed without first obtaining an inspection,I agree to remove haxerdells air contaminants m JcOned by Ne Bay Arca Air Quality Management all new materials for inspection. ict7sssCC[,,,'''''' ❑Yc. L sets I have mad Nehvsrduusmamrlalsmqui.dc 5vodcr Chapmd6 .Lifthe Caldiag M HralN&SafetyC .Secuum25505,1557J and 25534.1uodersund NniflW Wilding -- does c ly he tensa.Nat it 4 my mspomihility m notify the occupant ar the cis lch W met prior m issuance of a Ccrulleate uparrc Signature of Applicant Date noriraa ascot ate All roof coverings to be Class "B" or better 1 i a° u D O t� SEP 4 2003 On APPROVED TN ACCORDANCE WITH THE CITY OR D11PERTINO C ESA 0 INANCE9 DATE SIGNED This $e of jails and spec'lica— oo— n_s MUST be kept on the job at all times and it iS un lawful to make any, changes or alterations on same without written permission from the building Dept., City of Cupertino. The stamping of this plan and specifications SHALL N07 be hold to permit or tobe or. no approval of the vluletlon of any p ,f Rog Olty Ordinance or Stete Law, • I y% C*Y OF CUPERTINO CUPERTINO PERMIT APPLICATION FORM N # Building Address: Owner's Name: VPhone #: I `l3I ,2Z Contractor: License#: Con act: Cupertino Business License#: Building Permit Info: Elect ❑ Plumb ❑ Mech ❑ J Description: Residential Commercial ❑ Sq.Ft. Floor Area $/Sq.Ft.: Cost of Proj � l l ��Z Occupancy Group: r i Type of Co truction- 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 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 BMITIGATC Comm. Housing Mit. Fee BUILDING I of 3 COY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO uantit Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING 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 Repipe 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 HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units<= 10,000 din 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 BREMMHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2of3 CITY OF CUPERTIl* Cl of PERMIT APPLICATION FORM CUPEkTINO uanti Fee ID Fee Description Fee Group 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 BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAI,, BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING_ BSPECIAL Special Insection BUILDING-- BSWIM Swimming Pool BUILDING ,,. BTENT Temporary Power ELECTRICAL% BTEMPPERM Temporary Bldg Permit BUILDING, BTEMPSVCS Ternp Dist Svcs ELECTRICAL 6/1 BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING j 3 of 3