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06010092CITY OF CUPERTINO BUILDING DIVISION PERMIT CONTRACTOR INFORMATION . x�x>R:.n? .*ar�i§, Au,4€p�h `-->6sfFe n•—ie� �.. BUILDING ADDRESS: PERMIT NO.06010092 31 VICKSBURG DR R'S NAME: PERMIT ISSUE DATE DAVID PIETROMONACO 01/18/2006 : IHNE SANITARY NO. CONTROL NO. ITEC (ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED DECLARATION CONTRACnder Job Description I a p under provision ofChapterCode. 9 (commencingsis I hereby affirm Nat I am lfire P Hu with Section ]aXq of Division 3 afire Businvs and Professions Code. and my license is imfall fa ... ndeffect. REPLACE WINDOWS & SLID. DOORS Liccnac Class Lls.p Dale Carl., ARCHMICI'S DECLARATION 1 understand my plans shall he used as public records Licensed Pufessirnel OWNER -BUILDER DECLARATION 1 hereby nlLren that 1 am exempt from Ulm Contractors License Law for the following mason. (section 71131.5. Business and Pronasions Cade: Any city or county which require a permit to comarect, alterimprove. demolish. or repair any structum $4706 prior tints issuance. also require the applicant for such Permit o Glc a signed statement that too is licensed to the of the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation pursuant prrvisions (commencing with Section 9(00) of Division 3 of the Business and Profcssions Coda) in, that he Is exempt therefrom and the buffs for the alleged exemption. Any violation of Section 7031.5 by any applient for a permit subjects the applim, so a civil penalty of 3 er Oceu ane T e Y am mom than fin hundred Malan (M).P P ❑ 1, as rawer of she property, ar my employees with wages as their sole compensation, will do Ne wort, and the strucsum is not intended or offered for age (Sec.]064, Business Mt! Profcssions Cods: The Contractor's License Law does not apply m in owner of Required Inspections ' property who builds or improves themon. and who does such wart himself or through his . own employees. provided thm such ineprowmenB are not intended or Offered tarsals. If. bawewq Ina building or improvement is said within one year of completion, Ne owner- c ' / builder will nave the burden of proving that he did not Wild or improve for purpose of aalc.). ❑ 1, as owmr of tic property, am exclusively contracting with licensed commaturs to / construct the project (See. 7044, Business and Professions Code:) The Contracmri Li- cense law docs not apply to an owner or property who builds or improve Norton, and who conlracu for such projcaus with acomeactor(s) licensed purmanuo the Contractors License Law. Iire crapt unM Sq, B&PC far this moon er ! Date WORKER'S COMPENSATION DECLARATION I hereby aRtm under Penalty of perjury, am of the following dechutions: - ❑ I have and will maintain a Certificate Of Covent to self-insurtfor WorkdsCompen- satian, as provided for by Section 3]00 of Or labor Cade, for the perfarcomem of the Wfor which Of, permit is issued. ❑ 1 have Fail will maintain Worker's Compensation trounces, as required by Section 3]00 of the labor Code, far do, performance of Or work for which this permits issued. 'Y' names Compcvation Wurxnce carrier and Policy number art: L•I:RIe6 Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu section need not he completed if the permit is for one hundred dollars (SIM) Pr Mss.) 1 certify that in the performance of the work for which this permit is issued. I shall not employ any Person in any manPcr m umbecome subjccuo the Workers CompcnsFtion Laws Of Califorv'a-p r / _ _� APPlicant !T--jTrtvT NOTICE TO APPLICANT: If, after making this certificate or Exemption, you should become subject to the Worker's Compensation provisions of the Labor Cade. you must forthwith comply with such provisions or this permit shall W deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby alarm that Vert is a consuucton lending agency for the perfownanm of the work far which this permit is issued (Sm. 3097, Civ. C.) Lender's Nauta Lender's Address I comfy Nal 1 ban read this application a" state that the above information is crarect. I agree to comply with all city and county oreh arucn and sole laws meeting to building construction. and hereby monorim representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) indemnify agree to save, and keep harmless the City of Cupertino against and expense which may in any way accrue against said City Liabilities, judgments,rso rthocosta i in cavequcncc of the granting of this permit. APPLICANT UNDERSTA DS AND WILL COMPLY WITH ALL NON -POINT SOURCE RF,&i `/I Issued by: Date .LAT10 % /1 / Re -roofs Signature o(AppbcanVCanlrxlor Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building Occupant tare orbandie hanialous material clued by the Cupertino Municipal Code. Chapter 9.12, and the Health sad Safety .es 25532(a)7 0 Yes ONO All roofs shall be inspected prior to any roofing material being installed. Will the applicants or furore Wilding arupem use equipment or Ucvicrs which If a roof is installed without first obtaining an inspection, agree to remove iection, I P Omit hate doe air conuminank6 as defined by the Bay Area Air Quality Management all new materials for DNUICI? Inspection. ❑Yes C) No 1 have read the hvardnus materials min ireavar. under Chapter 6.95 of the Califor- m-HeAth & Safely Code, S a ions 255(M 25533 and 25534.1 under and thm if the Wilding does not currently haw a termnt that it is my responsibility to notify the cupnl of the mgairannors, nigtmns tprim.isswancearaccr,ileamr(Qem cy. Signature of Applicant Date ,l�!� All roof coverings to be Class "B" or better Owner or authorind agent te 0 • / JA Nj 8 L k�x 2006 Work 0 Room Kitchen O' Computer Room Bed- room 2 OvE Living Room Brief Description of Work for 10312 Vicksburg Dr (APN: 369-14-007-00): Replace existing windows/Doors with new units. Bed_ All new units are double pane and will have Low -E glass. They will fit into A room Master existing rough openings in the 1 framing. Bedroom To Street The exception is that the window in Bedroom 2 is currently a type B and will be lowered 1' and replaced with a type A to meet newer egress codes. The existing header will not be A 0> changed. Units to be installed as flange fastened new units, not retrofit style. A Window: 96"W x 47"H (XOX) C Window: 24"W x 36"H (X) 0 Sliding Door: 144"W x 96"H (OXXO) B Window: 96"W x 36"H (XOX) p French Door: 72"W x 78 3/4"H (XX) 0 Item • 1 of 1 0 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36914007.00 DATE ISSUED.......: 01'/18/2006 RECEIPT #.........: 32852 REFERENCE ID # ...: 06010092 SITE ADDRESS .....: 10312 VICKSBURG DR SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: conniew COPY # : 3 OWNER ............: DAVID PIETROMONACO ADDRESS ..........: CITY/STATE/ZIP ...: CUPERTINO CA, 95014-3320 RECEIVED FROM ....: RENA TAKAHASHI CONTRACTOR .......: LIC # COMPANY ..........: ADDRESS ..........: CITY/STATE/ZIP .... , TELEPHONE ........: FEE ID ---------- UNIT ------------- QUANTITY ---------- AMOUNT PD -TO -DT THIS REC NEW BAL BENERGY PERMIT FEE 115.56 ---------- 55.47 ---------- 0.00 ---------- 55.47 ---------- 0.00 BPERMFEE VALUATION 4;706.00 115.56 0.00 115.56 0.00 BSEISMICRE VALUATION 4,706.00 0.50 0.00 0.50 0.00 BPLANCHK PERMIT FEE 115.56 154.21 0.00 154.21 0.00 TOTAL PERMIT ---------- 325.74 ---------- 0.00 ---------- 325.74 ---------- 0.00 METHOD OF PAYMENT ----------------- OTHER TOTAL RECEIPT : • AMOUNT ----- 325.74 ------------ 325.74 NUMBER ------------------ VISA C�c.e CITY of CUPEfi\TINO A& rx,TY OF CUPERTINO PE 11T APPLICATION FdkM 06 2. 6 o v Fee Description Mailing Address (if different from building address): Building Address: 3/ I � Owner's Name: V10 PI Pf6 M&JACD Phone #- 17 Contractor:P.0 I1LV-1G o6� Cu z1 /NO License #: Contact: gc--k'A- -wASrt l Phone: 'K S1-7 8"t 1 . Cupertino Business License#: wiwF� Fax: N(A--q) Building Permit Info: f2t�p4cr, Cxrs-INC- Ur�gacJs 2s�l�icn� Bldg 21 Elect ❑ Plumb ❑ Mech ❑ Job Description: Residential m Commercial ❑ Sq.Ft. Floor Area: q.Ft.: Cost ofProiect: 0 eg Occupancy GrouD: BBOILER5 Boiler > 1.75M Btu Type of Construction: Please check this box if the project is a Construction Tax second -story addition: ❑ Project Size: Standard E— Large ❑ Major ❑ Ind/Off/Comm/Quasi Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL B1301LER3 Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler > 1.75M Btu MECHANICAL 13CONSTAX 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 1 of 3 u CITY of CUPERTINO ��CITY OF CUPERTINO PER;MT APPLICATION FAM uantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERM4E 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 Cbeck Repeat Fee B=ING BPREPIPE Re i e Of Fixtures PLUISIBING 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 InstaU/Alter Water Pie PLUMBING BYWE EATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BRFNLkHU AN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance lnstall MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREIYIINHOOD Installation of Hood MECHANICAL BREMIvIISC Misc Apparatus ELECTRICAL BREND RAP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power DeAce/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 aW-0- CUPEkTINO SITY OF CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Sips, 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 Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporag Power ELECTRICAL BT Tem ora Bld Permit BUILDING BTEMPSVCS Tem Dist SvcsAEC TRICAL BUSLIC Business LicenseILDING ELECTRIC Electricals footTRICAL EPERMTTFEE Elec Permit IssuancTRICAL MPERMFEE Mechanicals .footHANICALMPERMTFEE Mech Permit IssuanHANICALPPERMTTFEE Plambin Permit IssMBINGPPLBG Plumbing Fees fooMBINGPLLONGRNGC Plannin LR Commel MuNNING*PLLONGRNGR Plannin Lon Ran a ResANNINGZADDCHG Address ChangeII DING • 3of3