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03080059CITY OF CUPERTINO, r BUILDING Drv)slory PERMIT"IUCTOR INFORMATION... BmLDINCADORrss: ARGONAUT GLASS & MIRROR PERMIT NO 03080059 20061 SUISUN DR ER'S NAME: 12361 SARATOGA-SUNNYVALE R RMMISUEDATE KOOROSH AFLATOONI 08/14/2003 PHONE: (408)777-8194 SANITARY NO, CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description escrP 1 hcmby air,,. hot 1 am licensed under provisions of Chapter 9 (commencing with Section 700B).(Divislon 3 of the Business end Professions Coda, end my license is m0s0mreaanderrea WINDOW UPGRADE Li cense Class Lic.N FINAL�LE® Dam Contractor ARCHITECTS DECLARATION I undcrsmnJ my plans shell be used cd public DECLARATION SEP 3 2003 Licensed Pmfersiunal OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the BUILDING following reason. (Section 703 1.5, Business and Professions Code: Any city or county which requires a permit to construct, aper, improve, demolish, .r repair any structure $10000 pd., m its issuance, oho teyviies the applicant for such foramina file s signed statement that he is licensed pursuant m the previsions of the Contractors Loa selaw(Chapter9 Sq. Ft. Floor Area Valuation (commencing with Section Wash (if Division 3.f the Businca and Professions Code)or 36928004.00 Nal he is exempt therefrom and the basis for to alleged exemption. Any violation of APN Number Occupancy Type Section ?031.5 byanyapplicant fool edealsubjects Neepplicanl los civil pcnaltyof not more than rive hundred dollars (5500). ❑ 1,. owner of the prepeny, or my employe. with wages as Nei, sol. compensation, tot — Foul e Ir d Inspections will do Ne work. and theaWaum is of intended or offered fonele (Sec. (W4, Business and Profession Code: The CO mmcmh License Law does not apply to an owner of 102 - PIER radii who builds or improv. thereon, and whodoessuch work hrd.1frrthrough his own employe., provided that such improvements are not intended oroaered for ate.It. 103 — UFER however. the building or improvement is sold within one Year of completion, the owner- 104 — REBAR builder will have the burden of proving mat he did not build or improve for purpose or 6i1..) 105 - ANCHOR BOLTS a owner of the property, am exclusively contracting with licensed contracmss m �K1.tona 106 - SEWER & WATER tmet the project (Sec. 7004, Business and Professions Code:) The Com.,farh Li cense Law does not apply to an Owner of property who builds or improves thereof. ad 202 — UNDERFLOOR PLUMBING who contracts for such projects with a contractors) licensed pursuant m the Co adicmM1 LicmeLaw. 203 - UNDERFLOOR MECHANICAL ❑ lam exempt rade Se Bk PC far mix moon - 204 — UNDERFLOOR FRAME Dale 4 205 - UNDERFLOOR INSULATION ENSATION RATION 301 - ROUGH PLUMBING I hereby eft under penally is perjury ane of the following dealaratinna: 302 — TUB & OR SHOWER ❑inwand win aimall CeniOcnteter Consent to nal f-insum for Worker'scodien. sari.., as provided for by Section 37W of Ne Labor Code, for the peso ma es, of that 3O3 — ROUGH MECHANICAL rnPermit weak(a,whimi,Permnod. 304 - ROUGH ELECTRICAL ❑ 1 have and will maintain Worker's Compensation Insurance, as required by Section 3 0 5 - FRAME 3700 of Oc labor Code, for the performance Of the work for which this permit is issued. My Worker's COmpemation Insurance carrier and Policy num her am: 306 — HOLDOWNS Carrier: Policy No.: 307 - INSULATION CERTIFICATE COMPENSATION SINS RAAN EPTION FROM ORKERS' 308 — SHEETROCK (Thisacction need mmhecompimed ifthc fordiitisfinrorchundraddollara($100) 309 - EXTERIOR LATH micas.) 310 - INTERIOR LATH 1 certify mat in the performance of the work for which this Permit is hisucd, I shall not 311 — SCRATCH COAT employ any person in any manner sat a m become subject m the Workers COmpcnarion Laws mf QahfOram'DarO Appi team 313 - 501 - ROOF NAIL ' FINAL ELECTRICAL ENERGY NOTICE TO APPLICANT. If, after making this Ccrificaa of Exemption, you should become subject to the Worker's Cam radiation previsions of the Labor Code, you most 502 - FINAL PLUMBING ENERGY forthwith comply with such provisions or this permit shall M deemed revoked. 503 - FINAL MECHANICAL ENERGY CONSI'RUCf10N LENDING AGENCY I herebya(Frm that mere is a construction lending agency for the performance of on, for which this Permit is issued (Sec. 3(67, Civ. C.) , work Lenders Name 504 - 505 506 - FINAL BUILDING ENERGY FINAL ELECTRICAL GAS TEST Lender's Address I cenify Oil I have mad this application and sate that the above information is 507 - FINAL PLUMBING correct. 1 agree to comply with all city and county semina..., and stem laws relating to hooding cunsuanion, and hereby amhorim representatives of this city to offer upon the FINAL MECHAN CAL ahave-meminded property for inarcnimi pto,r . O9 FIN (We) agree m save, indemnify and keep harmless the City of C.,niao against liabilili.,judgmcnts, coati and.pcnus which may in anyway...a againataid City A NG in eonscquenec of th granting of this Permit. APPLICANT T NDS AND WILL COMPLY WITH ALL NON-POINT Issued by:5 WORKS Date SOURCE RE 10 Re-roofs Type of Roof 11 C Asiv ground, o! p' V rwor Dam HAZARDOUS MATERIALS DISCLOSURE Will c applicant or future building occupanhtmc m1fandlc hawdous nodded a defined by the Cupenum Municipal Code. Chapter 9. 12. and the Health and Safety " e, Section 35533(.)? All roofs shall be inspected prior to an roof. material bei. Installed. P P Y g g ❑Y. .I�Nm If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or forum buildingoccupomusc equipment or devices which emit a hazardous air contaminants defined by the Bay Area Air Quality Management coatrlm? all new materials for inspection. ❑Yes NO I have mad the Imood us; materials requirements under Chapter 6.95 of the, Cantor. ma Fee"& Safety Code, Section 35505.35533 and 25534.1 undersand dust ifthe building docs not cu n m a tennt, that it is my responsihility to Amity the Occupant of that rcyui,ema L pd.,,, isadedo..fa Cesarean a(GCcupaney. Signature of Applicant Date � 14 C All roof coverings to be Class "B" or better wna,m dmeagent Dam C)C Z� W� U U< U CITY OF CUPERTINO '' `•'`'r` '" INORMACI. BUILDING DIVISION PERMIT• CONTRACTOR s.. „ ... ....; BUILDING ADDRESS: ARGONAUT GLASS & MIRROR PERMITNO03080059 20061 SUISUN DR OWNER'S NAME: 12361 SARATOGA=SUNNYVALE R RMIT ISSUE DATE KOOROSH AFLATOONI 08/14/2003 NE: (408) 777-8194 SANITARY NO. CONTROL NO. ARCHITECrIENGiNEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION lb Description o om encing I hereby affirm that 1 am liaread under provisios nor Chapter 9 (cm with Section 7M)) or Division 3 of the Business and Prefamiom Code, and my license is mllmmaaodeBect. infullLicense WINDOW UPGRADE Ea® Class Lic. N FINAL Date C.mracmr I"ti6t6 ARCHITECTS DECLARATION 1 understand my plans shall W used as public records SEP Ep 0 O q 2003 L 3 . Licensed Pmfcssion d OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the ! following notion. (Secom 7131.5, Business and Professions Code: Any city or County BUILDING which requires a permit In construct, alter, improve, demolish, or repair any structure $10000 ! prior iBitauance, also requires the applicant for such permit to Ne a elgnedstatcmcnt that he is licensed pursuant to the provisions Of the Contractor's License Law(Chapmr 9 Sq. Ft. Floor Area Valuation (commencing wdh Section 7000) of DivLdor 3 n1the Business and Proresamns Code) or 36928004.00 Beat he is exempt therefrom and the basis for the alleged exemption. Any violaion of APN Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not an. than two hundred unit.. ($500). I, as owner of the property, or my employees with wages ss their sole compensation, tot — eq Ired Inspections will do No work. and the strunure is not intended or offered for sai.(Sec. 7041, Business and Professions Coder The Conovmetor's Liana, Law does not apply to an owner of 10 2 - PIERS property who builds at impres thereon, and who does such work himself or through his ownemploy.es, provided that such improvements arcnotimended m Offered(oriolc. If. 103 — UFER however, Be building or improvement Is sold within one year of completion, the owner - 104 REBAR " builder will have the burden of proving that he did not Wild or improve for purpose of - sale.). 105 — ANCHOR BOLTS FF I, as owner of the proycay, am exclusively contacting with licensed convenors r'0 10 6 — SEWER & WATER astruo the project (Sec. ]044, Business and Professions Code:) no Conuactc r. Li- censefawdoesnotapplytoanownerofproperty who Wilds or improves thereon,and 202 — UNDERFLOOR PLUMBING who contracts for such projects with t contranor(s) licensed pursuant to the Contractor's' Licones Law. 203 — UNDERFLOOR MECHANICAL ❑ I amexemptundc Se ,B&PC err ihisrcsson 204 — UNDERFLOOR FRAME r Date Ii 205 — UNDERFLOOR INSULATION IPENSATION D RATION 301 — ROUGH PLUMBING Ihercbya r code rally perjary one of the meowing declarations: 302 — TUB & OR SHOWER Ihaveand will about act ate or consent to sel6insum for workers Comort- inion, as provided far by Section 37W of the Labor Code, far the performance of the 3O3 — ROUGH MECHANICAL work for which this permit is issued. 304 — ROUGH ELECTRICAL ❑ I have and will maintain Worker's Compensation Insurance, as required by Section 3 05 — FRAME 3700 of the labor Code. for the performance of the work for which this permit is issued. My Workers Compensation Insurance camor and Policy number am: 306 — HOLDOWNS Carrier: Fully No.: 307 — INSULATION CERTIFICATE COMPENSATION iINSURANCEOWORKERS' 308 — SHEETROCK Mal,seclionnccd nolaccomplowdifthe permitlaforonehundredchitars(SIW) 309 — EXTERIOR LATH prem.) 310 — INTERIOR LATH I certify that in the perfnrmancc or the work for which this permit is issued, I shall not 311 — SCRATCH COAT employ any person in any manner so as to become subjectto the Workers' Compensation Laws of California. DateApipt 313 - 501 — ROOF NAIL FINAL ELECTRICAL ENERGY tTO NOTICE APPLICANT: If. after making this Certificate of Exemption, you should become subject to the Worker's Compcnsatiun provisions of the Labor Code, you must 502 — FINAL PLUMBING ENERGY forthwith comply with such provisions or this permit ahal lW deemed revoked. ? 503 — FINAL MECHANICAL ENERGY " CONSTRUCTION LENDING AGENCY I hereby affirm Nat Nene is a construction lending agency for the permrmancc of the work for which this remain is issued (See. 3W7, Cis. C.) Lenders Nam. 504 — 505 — 506, - FINAL BUILDING ENERGY FINAL ELECTRICAL GAS TEST !mien' Address 1 certify that I have read this application and sum that the above information is 507 — FINAL PLUMBING correct. I agree to comply with all city and county ordinances and state laws relating n building construction, and hereby authorim representatives of this city to enter upon the MECHANICAL ahoya-mcmroned property for inspection purposes. FIN(We) agree to save, indemnify and keep hrmless the City of Cupcnino againstliehililies,judgments,costs and expenses which may in any way accmc against said City %FINAL NGOtimsequcnceof th gmntingurthiepermit.APPLICANT T NDS ANDWILL COMPLY WITH ALL NON -POINT Issued by: WORKS Date SOURCE RE 10 Re -roofs Type of Roof $I4(0" gesture ofp' nV o rac or Dam HAZARDOUS MATERIALS DISCLOSURE Will itinli.m.rfutum building Occupant amrc o7hknda lc herd... material ' as defrI d by the Cupertino eo Municipal Code, Chapter 9.12, and the Health and Safety Code, Section 25532(a)? � All roofs shall be inspected prior to an roofing material being installed. P P Y g g C] Yea I�Na If a roof is installed without first obtaining an inspection, I agree to remove hk Will the applicant or future building occupant use equipment at devices which nil hazardous air contaminates az defined by the Bay Arca Air Quality Management all new materials for inspection. ❑ You C7, NO ' 1 have mad the hmardouus materials requirements under Chtpsr 6,95 of the Califon ria Health & Safety Code, Sections 25505.25533 and 25534. I understand untif the building - y dms note.n c a tenant that it is my reaponsihility m nudly tW accuptat of the roquircm.n . a pdortnissaan.caracenifi.,mora.apvr.y. Signature of Applicant Date IY o" All roof coverings to be Class "B" or better or wror rardagent one r C) O O .� X C 7 00 0 0 O a� v_ CO 00 co rb 3 CU 0 xm 'y0 L y lqr a c 2 1 Api ROVED IN ACCORDANCE)IITH TjnOl NOE This set of pl�s and specmcauuu� �aujlo mayd it is L @anyob achaall ngeseornalteratic on same it,, jt written permission fri the building Dept., it of Cupertino.. The stamping of this plan and specificatii SHALL NOT be held to permit or tooves approval of the violation of any p if any City Ordinance or State Law. • is CITY OF CUPERTINO CkY OF CUPERTINO * D 3 02 c 6S^� PERMIT APPLICATION FORM 'qOAPN # > Date: %A 77 Building Add 2p061 SLLI1 v% CA a -Dly Mailing Address (if di fere t from building address): Owner's Name:, K6�RoSt♦ ��ToO�L Phone #: Contractor: 1 ,i n w\ 1 ,Y� License #: Contact:Keororti: '408_1 �y� _ hone: 9Y o mk w�',\J " o`3-3}6_e-to13 Fax: Cupertino Business License#: Building Permit Info: Bld Elect ❑ Plumb ❑ Meeb ❑ Job Description: Residential ❑niercial ❑ Sq.Ft. Floor Area: $/ q.Ft.: Cost of Project: ! �� i Occupancy Group: r Type of Construction: p ( Please check this box a 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 > 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 1 of C*Y OF CUPERTINO CUPEI�F PERMIT APPLICATION FORM Quantity 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 BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric 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 rinkler/Backflo PLUMBING BPSTORM Stonn/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 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Fumace MECHANICAL BREMFURNOV Relo Fumace > l 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 2 of 3 CITY OF CUPER,TINO * CITY OF CUPERTINIA PERMIT APPLICATION FORM Qua 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 Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg 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 3 of 3 10 •