03010050CITY OF CUPERTINO
BUILDING DIVISION PERMIT
ti
CONTRACTORINFORMATIQN;
".
BUILDING ADDRESS:
LOVAZZANO MECHANICAL INC
PERMITN003010050
OWNER'S NAME:
RoMpapplUR
113, MONROE
ST, UNIT B.
PERMIT L50UEDATE
124 19, 1-1
E:
(650)367-6216
SANITARY NO. C ONTROL NO.
ARCHITECrIENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
o
1 hereby affirm That 1 am licemed under provisions of Chaplet
r 9 (commencing,
with Section 700BB of Division 3 or Ne Businrsa and Professions Code. and my license is
infull force and eft"''
REVISION--FUEL
OIL LEGEND/SCHEDULES
License Class Lica
Dale Contractor
IN HOUSE USE
ONLY, ORIG. #01070021
ARCHITECTS DECLARATION
I understand my plans that[ he used or; public records
CONTRACTOR:
LOVAZZANO MECH.
Licensed Professional
OWNER-BUILDER DECLARATION
\\
I hereby affirm that 1 am exempt from the Contractor's License Law for the
following mason, (Section 703 L5, Business and Pmfeainm Cole: Any city or c m ty
which requires a permit In construct. alter, improve, dcmolm, or repair any structure
prior m its issuance, aim mquims the applicant for such Permit to rile a signed statement
that he is licensed purmanl to the previsions of the Contmcmr's License Law (Chapter 9
Sq. Ft. Floor Area
aluatl
(commencing with Section 7") of Division 3 of the Business and Professions Cede) or
Nat he u esemp Iemm and Live basis for Ne alleged aemp0on. Any v[olollon of
$26737262
APN Number
Occupancy Type
Section 703 1.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars (5500).
3 6901029.00
❑ 1, as owner of the property, or my employees with wages as doo sole compensation,
Required Inspections
will do the work, and the structure is not immnded or offend for sale (Sec. 7044, Businca
and Professions Code: The Contractor's License law does not apply a m owner of
e 9 P
property who builds or improves thereon, and who doasmch work himseHorthm igh his
own employees. provided that such improvements arc not intended or offered for Asia. It.
101 —
however, the building or Improvement is mid within one year of completion, the owner.
.FOUNDATION
builder will have the burden of proving Nat he did not build or improve for purpose of
102 -
PIERS
103 -
UFER
A. owner of the property, em exclusively contracting with licensed conractna to
REBAR
consimcl the pmjecl (Sec. 7044, Business and Professions Code:) The Contractor's U.
104 -
ccme law does not pply to an owner or progeny who wilds or improves thereon. and,
105 —
ANCHOR BOLTS
who contracts for such pmjecto with a contractor(s) licensed pursuant to IM Contractor's
License Law.
106 -
SEWER & WATER
C�f'n6r/thler/c�mon
�° `�E'RX,
202 -
UNDERFLOOR PLUMBING
DB"IO&�NP
lOM
203 -
UNDERFLOOR MECHANICA
LWIH
R�s
' SATIO DECLA
under pe ally or perjury ow of the fmlowing decluninm;
204 -
UNDERFLOOR FRAME
I has and will maintain a CcniBeotaofeonanuo self-insum fo Woracr's Compcn-
205 —
UNDERFLOOR INSULATION
ration, fm
As provided for by Section 37W of the labor Code, fns the parmance of the
3 01 —
ROUGH PLUMBING
work for which thispermwsissued.
302 -
TUB & OR SHOWER
❑ 1 have and will maintain Worker's Compensation Insurance, u required by Section
37W of the labor Coda, for the pcdormamcof the work for which this perms It issued.
303 —
ROUGH MECHANICAL
My Work�mMnsnd Policy number am:304
—
ROUGH ELECTRICAL
olicy No.:ONFROMWORKERS'
305 —
FRAME
INSURANCE
306 —
HOLDOWNS
This section need not As completed if the cono Is for one hundred dollars l5 100)
307 -
INSULATION
odea)
308 -
SHEETROCK
that in the performance of the work for which this permit is issued, I shall not
employ manner muwhecoma subjenmlhe Workers' Compensation
309 —
EXTERIOR LATH
Lawscalifomninany
Laws of California. °etc
Applicant
310 -
311 -
INTERIOR LATH
SCRATCH COAT
NOTICE TO APPLICANT: IL after making this CeniBcate of Exemption, you should
become subject to the Worker's Compensation pmvisiom of the labor Code. you most
forthwith comply with such provisions orthis Permit shall hedeemed mvnked.
313 -
ROOF NAIL
CONSTRUCTION LENDING AGENCY
501 -
FINAL ELECTRICAL ENERGY
I hereby eMr. that there its eomtmninn leading Anc, for lM perrormamc of
502 -
FINAL PLUMBING ENERGY
de work for which Iia Permit it issued (Sec. 709'1. Civ. C.)
Landers Name
503 -
504 -
FINAL MECHANICAL ENERGY
FINAL BUILDING ENERGY
Iemi Add.
I cenlfy that I have rad INS application AM mm that the above information is
505 -
FINAL ELECTRICAL
correct. I agree to comply with all city and county oNMY
Inae and scale laws orating to
building construction, and hereby mthorim representatives of this city to enter upon the
GAS EST
shove-memiuned property for inspection purposes
(We) agree to ave, indemnify and keep hamdess the City of Cupertino against
0 7
F I
liabilities, judgments, costs and expenses which may In any way accroc against aid City
5
CAL
%VIC,
inconsequence of the granting of this permit.
APPLICANT UNDER TANDS AN WILL COMPLY A ONPO�NT
Issued by: 5
Date
SOURC' EGULATI S.
blu
(
Re-roofs
5 4 -
INAL PUBLIC WORKS
S store of ApplicanA Date
RD
HAZARD 5 MATERIALS DISCLOSURE
Type of Rio 2 -
ROOF PLYWOOD NAIL
Will lc applicant or futu building occupant or handle haraNum material
As dafined by the CupeninoMuni 'pal Code, Chapter 9,12, saw an
the Iloalub d Safely
603 —
ROOF BATTENS
cwe.sec
mnzs0s3xar. /
All roofs sW4)e insggF ripjop being installed.
❑Yes Nu
C;G-AgElgaterial
If a roof is installed
without first obtaining an inspection, I agree to remove
Will the applicant or future building occupant use equipment or devices which
I hosalloua air c"nmMnan0 cfned by tha Bay Area Air Quality Maak'e11mn1
all new materials for inspection.
Dimict7
r-1 Y.,
"
I have mad the hasmdous materials requirements under Chapter 6.95 of the Califon
nia Health & Safety Code, Swoons 25505,25533 and 25534,1 underetaod that if the building
dos not cundn0y hors a mnaml m iI is my msponsihility m nattily the mcupal of gtc
requimmcnnw c1hmusl d: me du brine amre Can'scalof9mu Y
Signature Applicant Date
Q
?
of
-
All roof coverings to be Class "B" or better
Owoe
amhoriV�em Date
I0
CITY OF
C,UPEkTINO
CITY OF CUPERTINO
PERMIT APPLICATION FORM o3 0 � crus
45
Owner's Name:
Contractor:
Contact:
# i r7
-Bufifd—ing
Bld• Elect P Plumb
F; �� _I-;- t, ,
Job Description:
t
Residential:
Sq.Ft. Floor Area:
C
1lr
Architect/Engineer:
Type of Construction:
LAomnipTclirl:
$/Sq.Ft.:
Valuation:
Occupancy Group:
fm
N
N
1 of 3
Fee DescriDtion
Other,��lla�ces—
Fee_qrq!!p
MECHANICAL
i Construction Tax
'BCONSTAXH
Con. Tax for BQ
Hotel and Motel
or
BCONSfA3d�
BELEC1000
C6nii—ax-- Resi/Mobile
Elec 600V <-- 1000A
NOR
ELE CT CAL
BELEC1001
BELEC200
L.=BENERGY
Elec 600V > 1 OOOA
Elec Svcs 600V <= 200A
Energy Add Multi
ELECTRICAL
ELECTRICAL
BI
BMITIGATC
gation fee
1� Comm. Housing Mit. Fee
in M t ee
BUILDING
Now Multi -
ELECTRICAL
BNUCOMME
BNUCOMM--M
l� New Comm Electric
New omm. Mechanical
ELECTRICAL
)MMP
New Comm Plumb
•N
1 of 3
x
CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
10
3 of
Fee Desc tion
Fee
2.r on�
-
►
oS
Ventilatin stems..
MECHANICAL— j
Seismic Commercial
i-- ---
•
Seismic Fee Res
,
- =01
•
--- ily New Add
n
Temporary Power
ELECTRICAL
T orary Bldg Permit
BTEMPSVCS
Temp Dist Svcs
ELECTRICAL,
MEMO
Electrical sq foot
ELECTRICAL
EPERMITFEE
1
1, Elee Permit Issuance
ELECTRICAL
v 10:1
IN
Mech Permit Issuance
Mn �PerTqU Issue
•
suff ni$ Egg=#
-01—.kd—dress c
BBOILER1
Boiler<= 100,000 Btu
v
E �i —er> 100K to 500K Biu --
f loll
31-J1.006
L)4�4�g-to 1M Btu
U—
BBOILERS
Boiler 1.75 M Btu
MECHANICAL
10
3 of
I
CITY OF CUMRTINO
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
20488 ST VENS CREEK BLVD
LOVAZZANO MECHANICAL INC
PERMIT NO03010050
OWNER'S NAME;
PROMETHEUS
113 MONROE
ST, UNIT B,
PERMrr MUE DAM
r.
PHONE:
(650)367-6216
'/24/2003
SANITARY NO. CONTROL NO.
ARCHITFENGINEER:
M
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job Description
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) ol'Division 3 or the Business and Professions Code, and my license is
in full force and effeCL
REVISION --FUEL OIL LEGEND/SCHEDULES
License Class Lie #
Date contractor
IN HOUSE USE ONLY, ORIG. #01070021
AREI_41ikl'S DECLARATION
I understand my plans shall be used as public records
CONTRACTOR:
LOVAZZANO MECH.
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason, (Section 703 1.5, Business and Professions Code: Any city or county
which requires a permit to construct, alter, improve, demolish, or repair any structure
prior to its issuance, also requires the applicant for such permit to file a signed statement
that he is licensed pursuant to the provisions of the Contractor's License Low (Chapter 9
Sq. Ft. Floor Area
Valuation
(commencing with Section 7000) of Division 3 of the Business and Professions Code) or
$26737262
that he is exempt therefrom and the basis for the alleged exemption. Any violation of
Number
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars (5500).
36901029.00
01.85 ownerof the property, or my employees with wages as their sole compensation,
Required Inspections
will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business
and Professions Code: The Contractor's License Law does not apply to an owner of
property who builds or improves thereon, and who does such work himself or through his
own employees, provided that such improvements are not intended or ofrered for sale. It.
101 -
FOUNDATION
however, the building or improvement is sold whom one year of completion, the owner -
builder will have the burden of proving that he did not build or improve for purpose of
102 -
.
PIERS
sale.).
103 -
UFER
J, as owner of the Property, am exclusively contracting with licensed contractors to
construct the project (Sec. 7044. Business and Professions Code:) The Contractor's Li-
cense Law does not apply to an owner of property who builds or improves thereon, and
105 -
ANCHOR BOLTS
who contracts for such projects with a contractor(s) licensed pursuant to the Contractoes'
License Law.
106 -
SEWER & WATER
of am ex pt under S 3 & P C for this reason
202 -
UNDERFLOOR PLUMBING
203 -
UNDERFLOOR MECHANICAL
WORKER' OMPRNSATION DECLA ION
204 -
UNDERFLOOR FRAME
I hereby affirm under penalty of perjury one of the following declantions*
re
205 -
UNDERFLOOR INSULATION
0 1 have and will maintain a Certificate of Consent to self -insure for Worker's Compen-
sation, as provided for by Section 3700 of the Labor Code, for the performance of the
301 -
ROUGH PLUMBING
work for which this permit is issued.
302 -
TUB & OR SHOWER
0 1 have and will maintain Worker's Compensation Insurance, as required by Section
370D of the Labor Code, for the performance of the work for which this permit is issued.
303 -
ROUGH MECHANICAL
Worker' a 'a"' Policy "unsheran"
My e I'a I I so nc c
rope '241
304 -
ROUGH ELECTRICAL
Carrier: Policy No..
--JENS
'305
- FRAME
N FROPORKERS'
EXEION
CERTI& FEX
CO A NCF
INSURANCE
306
- HOLDOWNS
(This section need not be completed if the permit is for one hundred dollars ($100)
307
- INSULATION
or lass.)
308
- SHEETROCK
I certify that in the performance of the work for which this permit is issued. I shall not
employ any person in any manner so as to become subject to the Wonkcre Compensation
309
- EXTERIOR LATH
Laws of California. Date
310
311
- INTERIOR LATH
- SCRATCH COAT
Applicant
NOTICE TO APPLICANT. If, after making this Certificate of Exemption, you should
become subject to the Worker's Compensation provisions of the Labor Code, you must
forthwith comply with such provisions or this permit shall be deemed revoked.
313
- ROOF NAIL
CONSTRUCTION LENDING A40ENCY
501
- FINAL ELECTRICAL ENERGY
4 that there is a construction lending agency for the performance of
I hereby affirm
502
- FINAL PLUMBING ENERGY
the work for which this permit is issued (Sec. 3097, Civ. C.)
Lender's Name
503
- FINAL MECHANICAL ENERGY
Lender's Address
504
- FINAL BUILDING ENERGY
I certify that I have read this application and state that the above information is
505
- FINAL ELECTRICAL
correct. I agree to comply with all city and county ordinances and state laws relating to
building construction, and hereby authori7t representatives of this city to enter upon the
GAS451EST
above-mentioned property for inspection purposes.
07
L- T NTZ Y T T M M AT
F-
I
(we) agree to save, indemnify and keep harmless the City of Cupertino against
I liabilities, judgments, costs and expenses which may in any way accrue against said City
5%
ICAL
in consequence of the granting of this permit,
APPLICANT UNDER§iTANDS AND WILL COMPLY WITH ALL ON -POINT
Issued by: S.
5
Date
SOURCTRE,GULATIT S.
ii
510
NAL P NING
T 0
t
Re -roofs -
5 4
INAL PUBLIC WORKS
Date'
of Applicantl "is
�sNfiraurc
HAZARD MATERIALS DISCLOSURE
Type of R%ot 2
- ROOF PLYWOOD NAIL
Will the applicant or future building occupant store or handle hazardous material
asdefined by the Cupertino Muni pal Code, Chapter 9.12, and the Health and Safety
i
603
- ROOF BATTENS
C..'section25532(a)? L
All roofs s444)e ins"e#riplJo M(yeq1ggpqaterial being installed.
0 Yes No f
I
- first obtaining an inspection, I agree to remove
If a roof is installed without f
Will the applicant or future building occupant use equipment or devices which
emit hazardous air r contaminants defined by the Bay Area Air Quality Management
all new materials for inspection.
District?
0 Yes
I have read the hazardous materials requirements under Chapter 6.95 of the Califor.
nialicafth &SafetyCode, Sections 25505,25533 and 25534. 1 understand that ifthe building
does not currently have a tenant; that itis my responsibility to notify the occupant oflhc
'requirements wNch must be t f Cc rdlicatic of Occ
I' W' ii, c - u1*00-3
Signature of Applicant
Date
iss �t
\�u
roof coverings to be Class "B" or better
75tuc
neAll
ap.lh.,��
Chris Vaughn -Hulbert
Webcor Construction Inc.
20452 Stevens Creek Blvd.
Cupertino, CA 95014
Dear Mr. Vaughn:
City Hall
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
FAX: (408) 777-3333
Our records indicate that pen -nit application #03010050 for 20488 Stevens Creek Blvd will
expire on July 07,2003. You can request a one time only extension. The reasons for this
extension must be beyond your control. The extension request must be submitted in writing to
the Building Official for his review. If we do not hear from you by July 07, 2003, your
application will be voided and you will need to reapply and pay new fees.
Applications for which no permit is issued within 180 days following the date of application
shall expire by limitation and the plans and other data submitted for review shall be discarded.
If you have any questions, you can contact me at (408) 777-3246. Thank you for your attention
to this matter.
Sincerely,
Susan Winslow
Administrative Clerk/Bldg Department
Printed on Recycled Paper