00110069OFFICE
CITY OF CUPERTINO _
BUILDING DIVISION PERMIT
- ' ' -'-ORM'ATION: -"i
CONTRACTOR•INF=
-atuu.Dllvr,'nt1!tTW?2
SCENIC CL _
BRAND KITCHE14S &• DES
:,RY°•ffbi 100E,9
owNER's N4`413ODY STEVEN J- AND JILL C
13715 QUITO
QUITORD
APPLICATIOj$,uYDAA�1 12000
1
{pNE:
(A08 1 07 1-8 1 90
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SAN] 'IY NO. CONTSOL NO,
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ARCHfITC'UHNGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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LICENSED CONI'RACIOR'S DECLARATION
10b Description '
I heathy aff res tti h 1 o.l h 1 p ' sof Chapter 9 teommtna ng
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Cwthti,ct
un ]IMx»nl D"' T flc Bu JI Icaimr. C,d, anJnyl,ensi.
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is in WII (ores air t
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KITCHEN REMODEL
Date %I C f 7/-�� g� y
O ta
ARCHITECI' S DECLA A� N
g
1 understand any plan% shall be Dud as public mods'
Licensed Pndeaional
OWN1iR-BUILDER DECLARATION
pO
o
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-1 beach, olun,'let' 1 ant oxompl from m, Co ..aunt. L'manm Law for the
following mason, (Section 7IDI.5. Business Pmlcssinas Code: Any
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and city nr county
which requites a permit to.msnan, alter, improve, demolish, or repair any structure
_
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3m
priortuits lssnum,,also,autres the npplicvn tnrmch,wurly pI,a,i,wdemacaww
Sq. Ft. Floor Area
Valuation "
that he islicenced pursuant tothe provisions of the Contractors License 1yw(Chapter9
boarwoncing with Sectiontg()or Division 3nfihe Busine..sand Pipalco n,Qde)
or tha he is exempt therefrom and the basis for the alleged exemption, Any vloldinn
,
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of Scc'ioa 7031.5 by any to,,twdnt fora permit sub cats the appllcam to a civil penaty
nfnntmnmthan loo,handedanlmrs(SSW)
APN Number
OCA p pe
❑ L as ow6er of the pmp,ny, or my employe,, allot wags as Oteir snlc.,.......... tio ,
will Jo the ssork, and the structure i.s not intnded or offered for sale (Sec, )(114.
Business and Professions Code: The Contractor'. License Law arcs not apply to an
35:72A 702
equired Inspections
r a proluny who tonna o, nnmw
'e. m
huan, and who doe, etch work himself
or ihrnugh
Ills own employees. prm•ided that who improvement, are aot intended nr
offered for sale. If. however, the Wilding or impros-ement is add within one year of
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101 — FOUNDATION
madncn, m, O,ore,hadder will har a tet burden .1 owing that la did not build o0
billions, for parpow of sale.).
.102 '^ PIERS
❑ 1, as isonscrot he pnapenY, um cxalnsnulycontracting with Il......I ,onmmmrs to
103 — LIFER
Lmsanm m, project ISoc. 7044, Business and Pon,... car, Gde:)'ILc Contractor's
icenseLawdoesamapply,, wo owner of property who Mild, ar intpmves thereon,
-
10/4 —' REBAR
and whir conaras for such project. with a commemrr.) licensed ..Daunt nh the
Cmtpacmd lh„ns. Law.
5
1@�I — ANCHOR BOLTS
0 m expnd and.. See. ,B&P C to, this,mons
106 — SEWER R WATER
0s"t"rDY1C
W'ORKER'S COMi1ENSAI'has DECLARATION
202 — UNDERFLOOR PLUMBING '
I nercny adnnn radar peonhynt crjhny naso, the fnunwingde,wrali......:
_ 203 — UNDERFLOOR -MECHANICAL ' -
I have sold will maintain a Certificate of Coaaemt 6, self inmm for workers
204 — UNDERFLOOR FRAME
'ompanndon. as pn,vded for h, Semina 37011 or be Labor Code. ro, he
antt the work for 'his is issued.
s 205 — UNDERFLOOR .INc I '
W tJL AT 11hl
p,rlwar of whichpermit
❑ 1 nave.nd will maintain Works', Cnmpcnsafmn Inwmnce, us required by Section
301 — ROUGH PLUMBING
`302
371X) of the Lobar ode, r,r me podawar,a of the work rot which this peranit i..
— 'f I IB R OP. SHOWER
_.
iarre M' m atinn lnzurunce canter and Policy mmrher are:
Ca-' curru�IATn1Nop1±Poloc L11,97_
303 — ROUGH MECHANICAL
ioN1'IMP wo s
- 304 — ROUGH ELECTRICAL.
COMPENSATION INSURANCE
305 —"FRAME
(This seainn need nm Ix anntplcted it the ..snail is far are hundred Jnllars
Isl«n orlesx.)
306 H01_DOI+INS .
1 cent(, but in me performance of the work li,r which this permit is issued, 1
,:r07 —' INSULATION
shall not employ any person in any manner m as to become umject to the Workers'
Comical3308—
Laws of California Late
SHEET R OC ( 4
N(YfICETOAPPLICANT.ILaRernhaking[his Cenilicatcoflixemption.youaradd
309 — EXTERIOR LATH" '
Z
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heroine subject mete Workers Cnmpensadia. prnvloon, of'he Inner Code, you .a,,
forthwith erally withsuch orwi,imSecured
— '
31.0 INTERIOR LATFI .
CONSTRUMON LENDING AGENCY
- 311 — SCRATCH COAT '
naerrhy afiinn mat nhnrc,.arnahametioah leannhg as,n.y far roan ro..ratee
the work for which this poon:t is issuediv. ed (Sec. 3197, CC.1
313 — 'ROOF NAIL '
o
Leaerndneax
501 — FINAL ELECTRICAL• -ENERGY
1 rectify that I have read this apprcation sad etre mat be nbnve Infanmation is
502 — FI NAI_ PLUMBING ENERGY
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t.7
c,rreildir,em<o..hplr,]heretoullitta,'arstyomimme,.I,ad.n,l,mw.r.I:htins
'heith-a-atatmdinmanJ hemby..mhmlmreprescnm'iva. nfthis city m,mur aeon
503 — FINAL'hIECHANICAL ENERGY ' -
C6
C6
mea (We)oncelostrowd pinrcnyforif,andke.orep •e,,
(We) ounce mmce,a,m,hnairy and keep na'mleX. me City of capemno against
504 — FINAL BUILDING ENERGY
m
fiaboinie Pulgm,nt., cons aad,xpa...,s which may to any way arrrou anal...l said
505 — FINAL ELECTRICALZ
City in consequence of the granting of this permit.
AIURCAN CUND1RSNANDSA DW LCOMPLYWUHALLNON-POHl
C
Issued by: 506 — GAS TEST Dille
f
r�-r•••'--
_
Re -roofs • .
508 — FTNAI, MECHANICAL
Squat sof ppr.:mUCo an-... Data
HAZARDOUS MATERIALS DISCLOSURE
Will theapprcaat or metre bunhfing (occupant slur, or handle ha,aw,a. torlanal
Type of Roo
'
as defined hythe Cupeninn Municipal Code. Chapter 9,12, and the Health and Safety
09 — FINAL GRADE
Coda, Section 25532nd?
°Yc` ElNo
All roofs shall Winsflettkr'iSAilot 0AjlRRf"mtiterial being installed. "
Will ih,a licuor nrfmur, towline, neon t,,,ac vim. which
PP 6 pun
hazaNuux
a rt �,jj�I� IRI 1p
If a roof IS In�tfthbd WltSlf3l (`ills' ODI:AFBIn, 6n irl�@hta�n, I agree to remove
emit Area
mr ennmminunis as defined by mo Buy Arcu Alr Quality S1anngcmrnt
Qua]i(y
tiataYe
all new materials for inspection. Applicant understands and will comply.with
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all non -point source regulations. ,
1 have read the hamNous materials requirements under Chapter 695 df the
California health & Safety Code, Sections 25505. 25533 and 25534. 1 understand that
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it he butdingdoe,notuu.'ranhly hes, atenamn that It is wly re.pmuihllity mnuti fy the
-
..,car of the requirements which man be met grin, to i.awwr, of a Certificate of
Oc,.Ponry
Signature of Applicant � h Date
ild ,(aPQ•(J
All roof coverings to be Class "B" or better
own, or am d agent Data
OFFICE
CITY OF CUPERTINO
• 1 of 1 BUILDING PERMIT RECEIPT OPERATOR: nancyc
COPY q 3
Sec: Twp: Rng: Sub: Blk: LOC:35707020.00
DATE ISSUED.......: 11/14/2000
RECEIPT #.........: 14003
REFERENCE ID 4 ...: 00110069
SITE ADDRESS .....: 10422 SCENIC CL
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OWNER ............: MOODY STEVEN J AND JILL C
ADDRESS ... .......:
CITY/STATE/ZIP ...: CUPERTINO CA, 95014
RECEIVED FROM ....:
DAVE S
CONTRACTOR .......:
BRAND, DIETMAR LIC # 21744
COMPANY ..........:
BRAND KITCHENS & DESIGN
ADDRESS ..........:
13715 QUITO RD
CITY/STATE/ZIP ...:
SARATOGA, CA 95070
TELEPHONE ........:
(408)871-8190
FEE ID UNIT
BPFIXTURE UNITS
BREMFIXT NO. FIXTURES
BP FEE VALUATION
ENFAN NO UNITS
1 ITFEE FLAT RATE
BSEISMICRE VALUATION
EPERMITFEE FLAT RATE
MPERMITFEE FLAT RATE
TOTAL PERMIT
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
11
QUANTITY
2.00
15.00
50,000.00
1.00
1-.00
50,000.00
1.00
1.00
110,01 1
16.66
16.65
500.00
41.63
35.52
5.00
35.52
35.52
686.50
AMOUNT NUMBER
____________
686.50 10481
e_686.50
PD -TO -DT THIS RED NEW BAD
0.00
16.66
0.00
0.00
16.65
0.00
0.00
500.00
0.00
0.00
41.63
0.00
0.00
35.52
0.00
0.00
5.00
0.00
0.00
35.52
0.00
0.00
35.52
0.00
0.00 686.50 0.00