00060005 CITY OF CUPERTINO
floILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRGSS: PFIRMI'r N(l.
21A . 0 YA! AYE 000F,0009
I f.
OWNER S NAME APPLICATION SUR DATE
- SANI'T'ARY NO. CONTROL NO.
� - �
BUILDING PERIODINFO
woo
`❑W� 21 Y t BLDG BLECr PLUMB MECR u0 1.I I-1 LI I=1
SawJob Description
i
LICENSED CONTRACTOR'S DECLARATION
—O I hereby alfimt that I a vin licensed anal!mal I ons ofChapter ClAc.t ecommencing
d wish fall inocandefDivi,iunJ of the Bnsinav and l•mfessinno Gd dmyli<erou
-� in full troll nnA Affect.
�it Licca,Clio Lie.«_C_ 2 4 3 g I
lic u Dale comractl„ 845 L�•�lI �IS�e 500 GARAGE
ARCHITECT'S DECLARATION
.Qa I undenmmd my units,hall be used a,public otword,
I,I Lieemed poor es,i„na, tt n, 03
el F5 OWNER-BUILDER DECLARATION 0
1 Mmby affirm that 1 am exempt from the Contractor's License Law for the 0
follow OR reason.(5otloor 7031 5.Peonies, adI fr,ioirwC I Any to,a,county
G w ..h 4 til I I....offuct.alne, p liFh 1any Iu,brc 81JIL f-111
a job Prot t a Iso y lM1applicant1 u M1p, ml 8 d,°neat
,tato f .edpn ui tt the provisioncoodreContractors LLa (Chalmcr9 Sq. Ft. Floor Area Valuation
(commencing with Section 7700)of Division 3 of the Business and Pmfc%stnn%Code)
,r nor,he is peanut merd it,and the s fpr thc alleged escmplion.Any violation
of Section Tuns by any applicant ton a peroa txnbj,,,cplc I,Iicma a,a civil poi of no,nom than roe hummd dofiar,D5a,). A PN Number Occupancy Type
❑1,us owner of the pre,ot or my employees with wages as their sole mmpmsmfon.
will do the work,and the,ructub is nm 61
intended or offered for sale(Sec.74. m v r -
unaneaa and prot,siona Code:the Conlm,foro License Law does unit apply m:in
equired Inspections
o� r of pmiW,icry Who tri or mtproves thervm,and who docs such work himself
�hmugb his own ampinyce,provided that .,It Improvcmenu are nil intended.r
offered for..ale.If.however.the building orhnprovennalis wild within care year of 101 — FOUNDATION
imcompletion'me uwner-nniidcr will hove the burden el proving mot he did„m bund or 102 — PIERS
prove rnr..,pose oamc.).
❑Las manerofineproperty.alnexclisivelycommeungwith rceneacommeor,or 103 — UFER
Imjmuct the project(Sec.7044.Business and Profession.Code:)The eomeaaor. 104 — REBAR
imne Low doer not apply n,an owner of prnpery who balUL or improves thereon.
unl who conumor,Inn,itch project,with a cnmm.mr(O henrved pursuant a,the 105 — ANCHOR BOLTS
contraltos Lmenae Law.
Of amexnrmt.ade,Sec. .B k PC farthismsan 106 — SEWER 8. WATER
O,nbr Dao ._02. — UNDERFLOOR PLUMBING
WORK17R'S COMPENSAIION DECLARA I DON
I hereby ofim,ander Pcronty.1 ,jagwaeonhc Wilow'inBdcAmitioma 203 — UNDERFLOOR MECHANICAL
I h,,c and will tna iohan a Cernrcta,of Con—a ,,,cif-inane to,Worker, 204 — UNDERFLOOR FRAME
ennpA,taatoom, a., nroviden for by %carton 37at or non Labor Code. sort otic 205 — LIhIDERFLOOR INSULRTIOhI
larfsmance of the work for which Ibis permit i,issued.
❑1 have and will maintain W'..W,.s Cuntpsnsmion Iw
nmnce,as required by Section 3!O 1 — ROUGH PLUMBING
371a1 of me Luhor Cads,for to,pc,tb..lanrc of the wore t...which mi,permit Is 402 — TUB 8 OR, SHOWER '
loused My Wakrr',C,nb,r,ruon Insurance carrier a ad pultAy.a,mncr.,1: 303 — ROUGH MECHANICAL
Carrie CERTIFICATION 01:EXEMP1IONFROM WORKERS' 304 — ROUGH ELECTP%ICAI..
COMPeNSA'IION INSURANCE 305 — FRAME
(Thio section acid not fu completed if the permit is for one hundred dollars 30E, — HOI_D04JNS
(SIUD)orlca,J
I dolly'III,is me nal ornn,ncnf Ile wok on which,6..permit i.i.a.ed,l 307 — INSULATION
shall oat trust,any peon in any beer ncf,o as In become subject w the Workers'
CmnpemerniorsLa,.,ofewifomia.Date 308 — SHEETROC!i
Applicant 309 — EXTERIOR LATH '
NO[ICEIO APPLICAN'It 1L;,Ocr°,kine this Cenilicaraof El,enedion,you °°torto
Z bnnme,.b,icelmthe woAc,Coaltalxarial revisions of the LonorCale,ynomnal 31.0 — INTERIOR LATH
Q Q forthwith comply with such pmebion,or his permit shall be deemed ros6.cd
L CONSTRUCI]ON LENDING AGENCY 311 — SCRATCH COAT
Dwreny conn tont mere ix a"Immiction loodiag agency far the perfom,ana, 3J3 — ROOF NAIL
of the x'rnA fir which this pcnnil i,b,ucd(Sou.3W].Co.C.)
wer,N
L q 1< a,„a 501 — FINAL ELECTRICAL ENERGY
= Z Lender's Addmc%
UQ Iesdity ba,lbase road d6applicnrnnaa,]more met heabove art orr.inion is 502 — FINAL PLUMBING ENERGY
itsF Aorrco.lauto,me)III,lyw,no all city,ad con,Iyn,rnaoAe,IIuntcme—fling 503 — FINAL MECHANICAL ENERGY
Q CT to building nmstruaion.and hereby uulhnriu rxprexmmlives of this city,,curer uPon
a s
the abreve.mentioned pw,smyfar ltlspecrms'aoP 504 — FINAL BUILDING ENERGY
Ey L (We)agree or sae,imlemnily vad Ace„harmless the Citynf Cuperino against -
fn Iioul.re,,j,mgmem,cod,aw exprm,c,whim omy is any way accrue again,raid. 505 FINAL ELECTRICAL
City is con.,,nnmc nl the grannn,of this pa.rnll.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON POINT Issued by: 506 —04<]_EST Date
SOURCE REGULATIONS. y'
Signameot Ap,heanl.Contraclor Data Re-roofs "Ll I P120113 f NO
11ALARDOIIS MAI ERIALS DISCLOSURE 508 — r'INAI_ MECHANICAL_
Will the applicant or future building o ct,cmo memo handle h...of material Type of Roof
na defined by the Cuperino Municipal code.Chapter 9.12,and the Health and Sarmy 509 — FINAL G RADE
Code.Section 25532(x7!
El Yes I No All roofs Shall W I�ir sp'FctLFlc .WAI.to uy I�rbPNK'aterial being installed.
Will the appi cnntn future holding occupant use equipment ,r devices which If roof is installtd-withcEtltWAlobtEibkBg.3ri_inadRF�Y, 1 agree to remove
emit havurdonrn
, r cnnu tnatinanas defined by the B.,Arca Air Quality Management
Diaries: all new materia1ilifru'inspRflblF PFp�lii:LHitlfLifiUeNtadds and will comply with
_
El ye, XjNn all non-points9.vU8regulN BATTENS
I base read the hoard...material,reyuirtmcros under chase,4.95 of the
California Health A Safety Crude.lection%25505.25533 and 25534.1 understand that . 60 — ROOF IN—PROGRESS
it the huilding cows not east haven tenant.that it is illy msrymsibillty ,,unify the
•^�
2IDan ' All roof coverings to be Class`B” or better
OFFICE
CITY OF CUPERTINO
1 of 1 BUILDING PERMIT RECEIPT OPERATOR: christya
COPY 8 1
Sec: Twp: Rug: Sub: Blk: LOt:51726D01.00
DATE ISSUED.......: 11/02/2000
RECEIPT q. ... .....: 13915
REFERENCE ID # . ..: 00060005
SITE ADDRESS . . . . . : 21470 VAI AVE
SUBDIVISION . . .....
CITY ..... . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . ........ . . . : MURTHY, PRATHIMA/NAGARAJ
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
RECEIVED FROM ....: CHUCK
CONTRACTOR . . .....: LIC q
COMPANY .. . . . . . ...:
ADDRESS . . . . . . . . ..:
CITY/STATE/ZIP .... ,
TELEPHONE . . . . . . ..:
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ---------- .
BENERGY PERMIT FEE 1,876.00 562.80 699.60 -136.80 0.00
BMITIGAT SQUARE FEET 4,345.00 4345.00 0.00 4345.00 0.00
F'"' SF&2F SQUARE FEET 3,845.00 269.15 0.00 269.15 0.00
! � SQUARE FEET 3,845.00 269.15 0.00 269.15 0.00
BTAX FLAT RATE 1.00 438.25 0.00 438.25 0.00
SPERMFEE VALUATION 371,465.00 1876.00 0.00 1876.00 0.00
PPERMITFEE FLAT RATE 1.00 35.52 0.00 35.52 0.00
BPLANCHK PERMIT FEE 1,876.00 1594.60 1982.20 -387.60 0.00
BSEISMICRE VALUATION 371,465.00 37.20 0.00 37.20 0.00
BSF&2FAM SQUARE FEET 3,845.00 269.15 0.00 269.15 0.00
EPERMITFEE FLAT RATE 1.00 35.52 0.00 35.52 0.00
MPERMITFEE FLAT RATE 1.00 35.52 0.00 35.52 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 9767.86 2681.80 7086.06 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 7086.06 101
a •••
TOTAL RECEIPT 7086.06
CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PHRMIT No.
21470 VRI AVE WEGNER CONSTRUCTIO4 00060005
OWNER'S NAME: APPLICATION SUB DATE
1069 CRAIG DRIVE 06/01/2000
4Q,t,pHONF.: SANITARY NO. COIN I'ROL NO.
(408) 252-2345
❑z a ARCHIIECIYENGINIiER: HUILDING PERMIT'INFO _
° n _
BLDG ELECT PLUMB NIECH
[
=j =ll
y%
v u' LICrten I a,licensed
DECLARATION
Z 5 '= I he.eby arrolm mat i am beensd nide.nmN11 1 of Chapter 9lenntmenemg Job Description
04 with Sntion]l�x'�x1p�.owf.Ua�lavaisJyon��9 iiia Hroincn,and Pnn. •,�fy,iiunw D
xf< is run, oreeYT�i B FINALE
re�< License Class. I.ic.p
�Wn�{°a Date_z �i - Gmm�memr. ae, nr_r
u+31+I's': ARCHITECT"S DECLARANON Q
I-u.0 5 I nnJcrsnanJ Illy plans mull nc used as puhlic rcttdNs Jul 0 3 2002
Y�i x117
ti ,ee Litttnnl Pmfcs>iunal
OW Nlat-BU....EIf.a tiro AHAnON
mom Ih.reby.HireThat 1. .Bouin ,anIlirfessin,Cs :Art,ctawlarme BUILDING
F-Z�' %hich followingguirev a permiScent
to
NULS.H.altos and w.durions Code:Any tiny nr coupre
�e�+d,2 O which ms issu a pennon u,letested.ulrer,improv..demolish.or repair and au vert
I,`,3� pri he isscensedaldsorcqul.cs thcapplicanl la.suchpenniu Lice-cfile ignulsnncmcm
EE — (thin comms regwithSectionparomat nm10)ofD.onsn3ofthe mnnIactnselaw(Chapter 9 Sy. FL Floor Area Valuation
(commencing c anon,Section from and
Division J of nuc Hmincss and Prowu.An,vi Code)
ul that he is emmpl mercfnnn hied the tbasisn for the ct,tit J,lid ion.Any violation
of Section7rthISby anydirdsi euliftu'pur..til nuM1jcdxthe npplicam b;udvil 1rnulny
nrnm marc man eve nandred nrnar.($ew). APN Number Occupancy Type
❑1.as us net ohne pri ur my entployae,with wages as their sole compensation,
Will do the work,nod the slmcane is not intended nr ,Ilc,,d for vale Sec.7(94.
foudcss and Profusions Code:The Contractor',Litman I.aw doe,ten apply man Required Inspections
r of pmpeny Who builds or impmves thereon,and who does such work himself
tar thnegn hi,own employees,pmsided that such dr,rovnncnn are n..n intended nr
,nic..I for.vcic.If,howev.9 the building In IntPmvanenl Is sold within true'aur of
completion.the owner-builder will have the harden of proving that he did nil fund or t
impmvc fir pit'I of,alc.). C
Cl I,as owner of ilia property,am uxulasivuly c In,ling with licemed couraumry m
construct the pndjecl(set.7044,liusinea and 11...lesion,Codep're,Commelor's
License I-aw does not apply m an owner of pmpcny who milds or impmaes hercon.
and who contracts for such projects with a conmacmr(s)licensed pummnt to the
Cnnbaam's Lottie I.W.
❑1 en exunpn under See. .U A2 PC lar this n.dsu
Owner Date
W(1NKIiit'S COMPI!NSAl9(1N DECLARATION
I hereby from under penalty,,f perjuryone of the following declarations:
Cr I huvu and will provided
n v Ccrlilicae of tomo it It uUlmr rc for Worker's
'Cforroarveo he provided furWhich
by Section 3is,t of the WMn Cdc, for Ili.
' pert c f tit Work f b ch m permit d.
❑11' J will intWorker d nq n 1 : oras yr Thy oin,is
5700 l Labor Lad f tit r v f rte 1 Ili Work f 1 tit'. y Sec t is -
ivsud My VA'I rC:Ce pe . n n Insurance d Pul v he
Curr vs��rI _r(41,v _.I ,1'I y N J3/U�7S �G
CE141'1ITICNI HAN(16I:YEMIT ION FROM WORK17RS
COMPENSATION INSURANCE
(Phis W,linn iced not he co und,d it'the permit is fir unc hundred dollars
[511X11 rat less-)
I certify that in the perk seance of the work for which this permit is issued.I
,null not employ any pall....in any manner so us ,,become while,In the Worker,
Coe'ti'miott Law,of California.Dam
Applicant
NOTICE TO APPLICANT,IC after making his Ccni ,.,a of Exemption,you should
hc ,;ue,,bjc,l m the Worker's Compensation provision.of the I.ubrCode,you nest
Q O nfoMwith comply with welt novi,ions or this pcelil shall be denied revoked.
FIZ) CONS'rRUCI'ION LENDING AGENCY
a , I nemhy al'linn full mere iv a cnnvtraction landing agency for the perfin'mnce
Ilia work for which his pnn,it iv issued(Sec.3097.Ci,CJ
L wdr's Name
7 7 Lender's Address
f.7 1 cemly lm 1 have read this application and state that the xhuvc information i,
'+ Correct.1 agree r)comply xilh all city and county ordinance and state laws relating
Q V mhnimr,r
ingOuuction.and this hereby authorize representatives olcity no enter upon
that
ads I.....wrioned pngerly for inxpcetitrr pugn..r,.
lwe);tgree,no save.ird.multy and keep handless the city of Capenino against
eA liabilities,judgments,cods and espouse,which Ina.in a y way acerae ag.inm said
U L city in ctrnmyue c of the d - g of mud,permit
^ AI'1'LICAN"I'U, IRSTA l' \NDWILLC ITIfALh lJONPIINT Issuedb Date
SOURCE
": Re-roofs
HAZARDOUS mi-EHIALS ..OS IRE
Will dteapphe.me fblum Fu'Ildingtceunnt sforenn ndla hamrdols lnmcnal Type of Roof
as defined by the Cupertino Municipal Ce.Chd,Nr 9,12,'d she l health and Safety
Code.Section 25533(.)!
El ye, E3 No All roofs shall be inspected prior to any roofing material being installed.
-
Wtutheapplicantorfmure building occupant use eyuipmrnlordevices Which If a roof is installed without first obtaining an inspection, I agree to remove
.mit humrdoux sir mnleninums is dclined by me Bay Area Air Quality Management
Disa;np all new materials for inspection. Applicant understands and will comply with
0Yes 0N all non-point source regulations.
1 have read the li,a dous nuncrials requirements under Chapter 695 of the
C'ulil'antiu HeAlu k Sefay Code,Sv,lois 255115.255))Imd 25514.1 undersmfnd that
it he M1uiliingJm,noncunendy have a imm,that Isure.capnnobda, 1, the
-cupann of the require, Is s hick Inas he nmgrin c of a Certiftcat of
occupancy. 01Date
Signature of Applicant
owns nr All roof coverings to be Class "B" or better
OFFICE
W// c•u>!t 7//e. C' 39/�%.�''t:V U q\tci[1/ `�� [ s: - `� �i [ .. <.
li.. . ,,,...x,: .�.� /. ,,�� :�d•Ic�1//l:., [a, _` ' /er F+o � /e rd ;a- .�� [• I /!e a\'`�.% /h, ;? l(/%p\
IT -� � !¢ �� �I,�j!In0`\Q���i�:, n��_°Jh,.� _c, l��� �'-."�i�* a.:ylr �� ._^__a/�i �i7,�C •„�_ �� y
'
•�\[ �;' - � . , ��/1 1��. .y :_ �_�\fir / � �j\�; .i�.. �.�.�; �`�i / 1�1i1� :n:. `I l:�\_ .
i /- -----' ----- —'- "- '-' - - '------ -'-- —'--'- -tom
�v
'A t� rx t tratr. of Orruvaltry -� {
I C to
(fitJ of CRu prt'tnn
0_ �
470r,}iartmrnt of drilling ,mvprtion .
This
certificate issued pursuant to the requirements- qf Section 307 of the
' . Uniform Building Code certifying that at the time of issuance this structure ntis
F� in compliance with the various ordinances of the city regulating building
' construction or use. For the following: t
-` sr
Use Classification nWEI.T TN6 Bldg. Permit No. 00060005
tl�tF Yy
Group R3 7ypeConstruction V-N Use Zone R1
OwnerofBuilding _ Address 21470 Vai Avenue ya1
/-
Building Address 21470 Vai Avenue Cupertino,: CA 95014 !"
��. g Locality P
By: _T geph Antonucci
'r+ Date: July 0 2002
"`tt Building Official -�a
POST IN A CONSPICUOUS PLAcr
``M1/I .�f�n � 1 = =1.�1�/ ,.�'eE ; y '�11�,� �p� e < 31p���Jc/.�� _ � ���cy.��� "`[.` ;�i��p,-•, t : -gliy.\�QI.`'�.:.. 'I�yz'��r- ,.-�er---. I'IfTllr'�1
z _ '!//•" �. _ ..c�' � /:. "q1,' 'Ild� p/u/-'- - � q[N .. nlli+° 1 �'`.y\..` 'lq:+" . n' IN,//ry�r - '.���;
•�- � /!e�° �,iS\� -N".:,,;/i �t• /.. ^' ��.•Siiu� 9iii - �t:Wi ": �\ 9, �•4i - �.
/1:::�t %y.I J,n. '-:It� ./' ...P?.:, j9/ /f,'I�ti'i... \::/H.:�/ !/��y'I�G •N i r'''rj .oyA!71: -=!S`. �Q�f• ':>// -ilia\^�://1/h \V �/ .`k\,��n./// !
�.. ':/,y/. 1 •!.%-/!.� .d+ C i '�%/y'/=- =s.:`:}' /u//..•,_ ..:`\\.. <� .4.:1 /Pi•" �n.,�hrl �:�. 1� "// ./�_� ���Ab. '"T+.- {'%:4/, 'F ..�`
'rover