03010191 CITY OF CUPERTINO t 9��� .° �° ri •�•' ' '�% �^ „a.�
BUILDING DIVISIONPERMIT (CONTRACTOR INFORMATION-
- '
GILDING ADDRESS: EAST BAY REST SUPPLY INC PERMIT NO.
10933 N WOLFE RD 0,4010191
RR'S NAME: 49 4TH ST APPLICATION SUB DATE
FANTASIA COFFEE 01/29/2003
ONE (510) 465-4300 SANI'T'ARY NO. CONTROL NO.
ARCHITF.COENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MEC 11
0 0 0 0
wOp LICENSED t I am RNTRACnOR S rpreviConsof CON
�p Ihemhy ))of lhmlam RecruitedunderFormations
Code and(my licensing Job Description
t•al
with Section Way))of Division Jof NC Business and Prafcssiom Gavle,and my license is
z Ll4in full force and effect' TI--RESTAURANT REMODEL
License Clava Lie.#
OZFO Uate Coulool DELL FINALE®
ARCHITECTS sallused
DECIARATION
OU IundcrstanJ my plans shallMuud as public records
3u Licensed Professional APR 8 2003
a_t�C OWNER BUILDER DECLARATION
af 1 hate by infirm that 1 am exempt item the Contractor's I.Icense Law for the
—00 (nllmem,reason,(Booboo]1131.5,Business and Pndessions Gude:Any city or county
$ which requires a permit to construct,alter,improv,demolish,or repair any structure
prior to its issuance,also rcyuims the applicant for such permit m rile a signed statement vs.,f,roc
t-z< ING
that he is licensed pursuanunthe provisions ofthe Conrawfor'sLicense Law(Chapter Y Sq. I't. l'IOOrATCa $l0a040tlon
0� (commencing with section 7000)of Division 3 of the Business and Professions Code)or
$ that he is exempt therefrom and the hais for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects Ne applicant to a civil penalty of
not more than five hundred dollars(8500). B Occupancy Type
01,as owner of she proper,or my employees with wages sat their role compensation, 4
will do the work,and the Inioni is not intended or offered for sale(Sm.7B14,Business
and Proficient...Curie:The Contnctnrs License Law does nut apply to as owner of 102 - P I ERS equlred Inspections
property who builds or improves thereon,and who does such work himself orthmugh his
n employees,provided that such Improvements arc not intended or offered for sats.If, 103 — UFER
however,use building or improvement is sold within one year of completion,the owner-
builder ,will have the burden of proving than he did not build or improve for purpose of 104 - REBAR
sale.1 105 - ANCHOR BOLTS
❑1,In owner of the property,am exclusively contracting with licensed contractors m 106 - SEWER & WATER
construct the protect(Sec.7144,Business and Professions Code:)The Contractors I.I.
cense law docs not apply to an owner at property who builds or improves theme.,and. 202 - UNDERFLOOR PLUMBING
who contracts for such projects with a conactor(s)licensed parsaanuo the Contractor's 203 — UNDERFLOOR MECHANICAL
Limuselaw.
lam exempt underSm. oif ,B&PC for this reason 204 - UNDERFLOOR FRAME
to 1 205 - UNDERFLOOR INSULATION
WORK ChoE ATIONDECLARAT 301 - ROUGH PLUMBING
the
by affirm under penalty of perjury one of the meowing declarations: 302 — TUB & OR SHOWER
I have and will mainuin eCeniricate of Comam,to self insum for Workers Compere
ratio,as provided for by Section 3710 rat the Labor Code,for the performance of the 3 0 3 - ROUGH MECHANICAL
worklotwhichthisPem,hisissued. 304 - ROUGH ELECTRICAL
❑1 have and will maintain Workers Compensation Insurance,a required by Section 3 0 5 — FRAME
374 of the Lalwr Code,for the performance of the work for which this permit is issued.
My Workers Compensation l nsumnce carrier and Policy number art: 306 — HOLDOWNS
Carrier: Policy No.: 307 - INSULATION
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE 308 - SHEETROCK
(This section need not W compined if the Permit is for one hundred dollars IS 100) 309 - EXTERIOR LATH
orlea.) 310 - INTERIOR LATH
1 ccnify that in the performance of the work for which this permit is issued,d shall not 311 - SCRATCH COAT
employany perumm anneru ambecnrrl s jeer the Wnrkcts'Compenation
Lawaofcal 1 313 - ROOF NAIL
N CE APPLI A .IL te nakr gt s mficatenfGxcmpunn,you should 501 - FINAL ELECTRICAL ENERGY
bec0 noctinthe Worker'aCompensation provisions ofthe daMCCode,you must 502 FINAL PLUMBING ENERGY
O z forth th comply with such provisions or this permit shall be deemed revoked.O 503 - FINAL MECHANICAL ENERGY
CONSTRUCTION LENDING AGENCY
Ft IherchyallirmthatthereisaconstractionlendingagencyIirtheperformanccof 504 - FINAL BUILDING 'ENERGY
x um Underk for,Nameichhisprmilisiaucd(Scc.31 ],Civ.C.) 505 - FINAL ELECTRICAL
1 Q Lenders Name
5 z
Lenders 506 - GAS TEST
U O 1 artily that I have read this application and sum that the above tromm.inn is 507 - FINAL PLUMBING
ry (~ collec(.1 agree to comply with all city and county ordinances and state laws rotating to
O U building construction,and hereby authori representativesofthiscitytoenterupomthe FINAL MECHANICAL
r ahtwe-mentioned propcny fur inspection purposes. 09 FIN
S (We)agree to save,indemnify and keep harmless the City of Cupertino against
F' Izq liabilities.judgments,costs and expenses which may in any way acme againstaid City 5 Ga
in
of the
U ^' APPLICANT UNDERSTANDS nting of AND WILT.COMPLY WITH ALL NON POINT Issued by;51 WORKS Date
SOURCE REGULATIONS.
Re-roofs
nawm ApplicanUCo am am
HAZ t GUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant store or handle haaolous material
dcfmcJ by the Cupertino Municipal Code.Chapter 9.12,and the Ilcalth antiSul'cty
e,Section 25532(an All roofs shall be inspected prior to an roofing material bei. installed.
❑Yea �'Iun P P Y S g
Will the applicant ser fm buildingoccupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
n hazardous air contaminants a defined by she Bay Arca Air Quality Management all new materials for inspection.
ismer?
[3 Yet Nc
I have mad the haardnus mals requirements under Cut fi.95ofin,Califor-
nia Health X Safety Code,Sections 25!105.25533 and 25511.1 understood that ifthe Wilding
does not currently have a tenant that it is my respnmihilit m notify the occupant of the
uiremcnI whichmustbemoil priorInxsuanccotuCcm �m ,rOrcnpan _ro Signature of Applicant Date
morivcd age / /_Z ate All roof coverings to be Class "B" or better
r
LILY OF CUPERTINO ` y
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
RCILDIYG ADDRESS: PF.R.NR AO.
C
Ox'NERIS.NAAE: APPUGATTON SUB DATE
PIIDNf. 9AYR>0.Y]O. CONTROL.',
ARCHITECTIENGINEER. PHQNEA BOISDSNG PFR4RLNFO
Dzz
T CT O ELECT PL SIL-il
INSPECTIONS DATEV- INSPEC. _ - 7QARRASGEIriSPECTION JOB DESCRIPTION
CALL 777.7228 MONDAY-FRIDAY 74 HOURS RF NIDF-MAI
BEFORE REQUIRED INSPECTION.JOB ADDRESS CSFDML D KITCHEN Rf.MCDL!
+^aI FOUNDATIONIPIERSlFK75a ANO PERMTRARE NEEDED WHEN PHONING DADD"ION Cl PLUMBLIC ki PIPE
A 7 CFER GROUND - �MVLibONfT 'D ML CTCk\I.
PAD/SETBACK-CERT MODIFICATION
` GARAGE SIABS/PREGUNITE RERCI
SIDIENTTAL'_COMMEAL_OTHER_ CINTERIOR DCHIMNEY RF.I-UK
5-�
^i IMPROVEMENT
`z HAIARDOCS FIRF AREA• ❑SW ISDIING 1'nr11.5
-_--� POUR NO CONCRETE UNTIL ABOVE HAS BEEN STONED D BATH RENIODEUREPAIR D.DENICTUTP I♦
^I UNDERGROUNDISLAg - Q OTHER
-z� -- RTES DYe.�IrnJcwnJ T:n ClmAnui nr:mNpuRyuu:J.
-' UNDERGROUND PLUMBING —'L
'(>' ---- -
EiR- U'NDERGROL;ND ELECTRICAL ! L7 No Imnal-_, Ica�e •_ —._
f[N1S1 R L\IDO NOT '
UNDERFLOOR FLOOR
LIMAINUNTIL ANOVE HAS BEEN SIGNED "FIDSTING ROOF ING NEx'BLOCIADOITNOA' [y DE\IUL4L UNDERFLOOR PLUhIB ING ❑TEN-AST ❑ FOOD SEk'.'..I.
LINDERFIOOR MECXANICAI Nrmdro(:nminF rmrrinrn �IMPRONEMENT ,
L:NDERFL000.ELECTRICAL L OTHER —
.TOYumwaJ_-_- T:rd rcl.uneJ'
UNDERFLOORFRAAIINGVENTS F-- -
UNDERFLOORINSULATION I ---- _
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEFN SIGNED TYPE OFROOFCOVERING
ROOFlHEATHlD(APHRAGM "PROPOSED:
P.USIBI,C 4 -TI d> t. 09 -L'p Ra# [ BuiR-Cp Rad
TUBS,S:SHOWER PAN C Aapdh Sh'.& _A yn,h Shm8111
M SCILANICALx'pldSNtcr
_ L-LT-e> ❑ f_ War:Shales
• ! ELECIKIC.ALTOOL BOND ?-L L ❑N''Rul Shm&, ('T KecW ihr118Io
FRANIINGSTAIRS/E.EGRESS �- ! _ ❑ OldriSpcofyl Onmr:STA:-t:r
_INSCLATION,'VENTILATf �N I I Rm•de I C 0.0 Rcpaa90
COVERNO WORK UNTIL ABOVE HAS BEE\SIGNED PeR.MR 4fr.InuOauon 5pes. - —
EXTERIOR SHEAR;HOLD DCR N --'—'
INTERIOR SHEAIUHOLD DOx'N'
SPEc
5rEETROCK.'S HEPIROCK HEA i. - rN -1o.. SPECIAL LN'SPECI'-f O:N:REQl.11RC-0[
E'(TERIOR LATW W-SCRs D
aHO%ER LATH j I
'SOTAPEORPLASTER UN ILABOVE HAS'BEENSIGNED
iCRAP_-COAT _ I I_ / , x
SEWER xA'ER ST 7X L
TE?IPORARYAPPRO%ALS
OCCUPANCY I
I I
Z 1 FLNALS
Z f: PLAN::\NSG 7:-..)
= > GAS TEST
O GRADEIP.%k 777.]);.!1
�ZI FIRE-CALL NHil 37.S-4o 10
_7_=1 HANDICAP
Z; ;J ELECTRICAL
PLLUIBING
Z- MECHANICAL
ENF.RG':' T
\'Ii L:AL FINALONLI1 I -_ -
B_ILDINOi - - I i pI —_..... .__
OCCUPANCI'OF BUILDISGI5 NOT PERMITTED l _
i
UNTIL BL'ILDI, G FINAL TS'SIGNED:BY BUILDING
• ! INSPECTOR. CERTIFIC.iTEOF000LPANCY L_
PK!v ISS7!{CTIn] PLYWOOD'
I.N.PROGRES'S.
Nip OAT! _. LNSPD.Vc INSI'
TE AR UFF:]NPFCI ION O.\TTENS --_---__.DATE ---
FINAL
•.. -U.I TE .__
INS? DATE --_ INSP --_DATE
NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE.PROVIDED FOR INSPECTION
cNA7 AZb7EO £O-$i-daS