03080085 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT ' C®rNTItACTORkINF®RMA I�g
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BUILDING ADDRESS: SHOWCASE KITCHENS INC PERMIT"°03080085
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WNER'S NAME: 12333 SARATOGA-SUNNYVALE R FBRMIT ISSUE DATE
MARSHALL WI 2003
PHONE: (408) 253-0412 SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
JOO LICENSED CONTRACTOR'S DECLARATION Job Description
f'0 F❑ 1 hereby affirm that I em licensed under Provisions of Chapmr 9(commencing P
Zto with Section 7")nf Division 3 of the Business and ProfcankmA Code,and my license is
<<pN Lisellforce and crfec .. '7t 3 -
>'d? License Cl Lic.s ,
i� Dom Contactor
¢¢ ARCHITECTS DE ATION
Ia l understand my plans shall W used as Mile records OCT 2 2 2003
0
ii Licensed Professional
g OWNER-exempt frDECLARATION
'tad00 1 hereby affirm that ore exempt from the Gnnlrn.lCo License Lew for the BUILDING o O which imass.(Section 8131.5,Businors and improve,
demolish,
Code:Any city Cir county w
m whichitsissuance,
requires a Permit re cores the alcor,Improve,h farmsis m repair any structuretatement $14918
3Zi thatheor its iensedpalso
uantto the ponvis nsofant theaehpctor'toicensle a signed stammcm
< amo incingWiInSection7theprovivioor 3ofthemdmcrosandPrmlaw(Chapicr9 Sq.Ft. Floor Area Valuation -
Y $ Igommencing with Section 7000)of Division3nf the Business and Professions Crxlc)ur
that he ts exempt nccmfrom and he basis for the Waged exemption.Any violation of 35619019 . 00
Sectlon]031.5 by any applicant ser a permit objects the April...i to a civil penalty of - APN Number Occupancy Type
not mort than five hundred dollars(S50)). "
I,as owner of the propcny,or my employees with wages a their sole compensation,
-mill do the work,and the net..is nut intended or offered for sale(Sec.7W.Business 11.11 — FOTJ dInspections
and Professions Code:The Conmctnrs License Law does not apply m an owner of 102 Z — PIERS
progeny who builds or improves hereon,and whodoes such work himsclfor through his
own employees,provided that such improvements are not intended or offered for sale.If. 103 — UFER
however,he building or improvement is sold within one year of completion,the ownc>
builder will have the burden of proving hat he did not build or Improve for purpose of 104 - REBAR
sale 1. 105 - ANCHOR BOLTS
❑1,as owner of the property,am exclusively contracting with licensed contractors to 106 — SEWER & WATER
construct the pmject(See.7044,Business and Professions Coal The Contractor's Li.
cense law door naupply to an owner of property who Wilds or improves therean.and 202 - UNDERFLOOR PLUMBING
who contacts for such projects with a contrsstor(s)liceved paramour o he Contractor's' 2O3 — UNDERFLOOR MECHANICAL
License Law.
❑I am exempt under See. .B&PC for his reason 204 - UNDERFLOOR FRAME
wncr Data 205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of he following deelarauom: 301 — ROUGH PLUMBING
l have and will maintains Ccnifcam of Cnnsdnua self-insure fe Wmacrs Compen- 302 — TUB & OR SHOWER
ration,as provided Corby Section 3700 of he Labor Code,for he performanm of the 303 - ROUGH MECHANICAL
work for which this Permit is issued. 304 - ROUGH ELECTRICAL
have end will maintain Worker's Compensation Insurance,as required by Section
of he Labor Code.for the performance of he work for which his permit is issued. 305 — FRAME
My Worker'.Compensation Insurance carrier and Policy iounkram: 306. — HOLDOWNS
Cann?, Policy No.: OO o 307 - INSULATION '
.1� - CERTIFICATE OF EXEM MON FROM WORKERS'
COMPENSATION INSURANCE 308 - SHEETROCK
rrhisacctisnced notlaccompmmd irthe Permit Is roroac Wndreddollaroni l) 309 - EXTERIOR LATH "
t'ri"`) 310 - INTERIOR LATH
I ccnify that in the perrnrmanec of he work for which his permit 0 issued,l shall not
employ any Perron in any manner an as In become subject to the Workers'Compensation 311 — SCRATCH COAT
Laws of California,Date 313 - ROOF NAIL
Applicant
NOTICE TO APPLICANT:IL after making th is Certificate of Exemption,you should 501 - FINAL ELECTRICAL ENERGY
become subject to the Worker's Compensation provisions of the Labor Code,you must
�Zrorthwhh comply with such provisions or this permit shall W deemed myokcd. 502 — FINAL PLUMBING ENERGY
z 0 CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
I hereby alrpm that there is a construction lending agency for the Performance of 504 - FINAL BUILDING ENERGY
t:4 the work for which this parmit is iuucd(Sec.3097.Civ.C.) 505 — FINAL ELECTRICAL
:T7 A Landers Name
Z Landeranddreas 506 - GAS TEST
J p 1 certify that I have read this application end state that the above inforrn.d..1. 507 - FINAL PLUMBING
correct.).gore to comply with all city and county oNinancea and sum laws rclaring m
Z)U building construction,and hereby authorrin representatives Of oil City to enter u,nn the — FIWM
AL
a above-mentioned pmpany farimpenion purposes.
(We)agree Io sere.indemnify and keep harmless the City Of Cupertino against O 9 F I
.w N V,
liabditicr,judgments,costs and cspcases which may in any way accrue against said City 1U in con qucnce Of the granting of this permit.
APP CANT UNDERST S AND WILL COMPLY WITH ALL N N-POINT Issued by: 5ORKS Date
SOU � EGULATIONS
Re-roofs
rare of AppliwnUConuactor IV D tc
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building Occupant store or handle haamdous material
As darned by the Cupertino Municipal Code.Chapter 9.11,and the Haahh and Safety
Inde.Section 25532(.)R All roofs shall be inspected prior to an roofing material beim
Ayes P P Y g g installed.
Will the applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove .
It hazardous air con semi menu As defined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yea
I have mad the hamolous materials requieemeo s under Chapmr6.95 of he Califor.
nia IIcalth&Safety Code,Stedom 25505.25533 and 15534.1 understand that if the Wilding
does nal currently have a senoras drat itis my respnnsibility m nnfify he Occupant of the
requ' ants which must bens donnissu ofv Cctificate Oce S ignature of Applicant Date
j,
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o aeeamarimdagent am All roof coverings to be Class"B" or better
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N HALL NOT e h 1 to permit or to be ar,
a e proval of the vi tion of any pr visussr
0 o any Cit in a or State Law
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SN2 C%Y OF CUPERTINO 03 v ��
CITY or PERMIT APPLICATION FORM
•CUPEkTINO
APN # 6 Date:
/ Q3
Building Address: I Mailing Addre s (if ciffferent from building address):
/S 7F 4-4 10-
Owner's Name: 1U / � Phone#:
Contractor: License#:
�ik7-59?
Contact: Phone: 2st3 -OW R Cupertino Business License#:
r`TDI'�s!/ lLT/ oc�2 Fax: 15'7-CW(
Building Permit Info:
Bldg Elect Plumb 1$ Mech
Job Description:
Residential Commercial ❑
Sq.Ft. Floor Area: / $/Sq.Ft.:
Cost of Project: Occupancy Group:
qIf/
Type of Construction: Please check this box if the project is a
/�� •
second-story addition: ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERi Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 1 OOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
_ BBOILERS 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 <= I OOOA ELECTRICAL
BELEC1001 Elec 600V> I OOOA 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
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(CC C*Y OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee ID Fee Description Fee Group
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMUI TI 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
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmos beric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pb1g 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 PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C-Units<= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> 1 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
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CITY OF CUPERTIA%
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
i Fee ID Fee Description Fee Group
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 MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL 'Special Ins ection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bld Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
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
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