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05070054 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT C0TRAC-TOR INFORMATION�7a Aa� .e.`s1�., . ..d,..t.„ g ,cave S.csTld,•R a wt�,x z BUILDING ADDRESS: RENAISSANCE BUILDERS PERMIT N%5070054 11072 FIRETHORNR DR OWNER'S NAME: PERMIT ISSUE DATE dh RANDALL REISINGER 945 BERRYESSA RD 2005 WINE: . SANITARY NO. CONTROL NO. (408) 720-1100 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH °00 LICENSED CONTRACTOR'S DECLARATION w I hewby affirm that I am licensed under provisions or Chapter 9(commencing Job Description i with Simon.7Illlo)of Division 3 of the Business and Professions Code.and my license is _.ZnOnufo.madeffect. SOLARTUBE SKYLIT License Clm Un.N C O DOW Contractor ARCHITECTS DECLARATION 1 understand my plans shall be used a public records it ;a� Licensed Professional OWNER-BUILDER DECLARATION I herohy.111.Nal I am exempt from the Contractor's License Law for the 00 following mouton.(Section 7031.5,Business and Professions Code:Any city of county $ which roquirez a permit to construct,alter.improve,demolish.or repair any structure $500 poor to I%Issuance,also requites the applicant forsuch permit to rile a signed aammem ££ < that beisiiccoeuu dpumenotheprovisionsoftheConlrse,tor'sLicenhw(Charter9 Sq.Ft. Floor Area Valuation y~0 (commencing with Section 7MBof Division 3 of the Business and Profusions Code)or 5_ than he u exempt Nemfrom and the buls for the alleged exemption.My violation of Section 7031.5 by any applicant for a permit objects the applicant to a civil penalty of B Occupancy Type not mom Nan Five hundred dollars(6500). ❑1.uownafofthepmpwy.ormycmploycuwithwag my irsolecompenmdon, will do rhe work and the awcmro is not intended or offered for sale(Sec.IDU.Business and Professions Code:The Conuactors License Law does not apply to,n owner of Required Inspections property who bufldsor impmvca thew,n,and whodoes suchwork himself or through his own employees,provided Nat such improwmcnu are not intended or offered for We.If. however,Ne building of improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build of improve for purpose of sale.)/ euro az,thea of ct propeny,.Business uand convecting with licensed eonuzms i- P f� convect the project pply tooaa,wneand Py whoi Wilds Code)The es thamon. Li- CII\ t S Fp' tllt� cense law docs not m an owner of pmpcny who builds or improves lhemon.and I� d li � whoaonmctsforswitprojeemia acontrumr(s)Iimnudpunuantwt Contractor's Limose law. E3 1. eacm oder Sec. .B&P C for this owner' D,re CO NSATION DECLARATION (( 17 40 hereby I under'pe Y of perjury One of the following declarations: Ihaveandwill aloud imbricate of Consent to seff-asum for Worker's Compcn- aai9n,as,provide Section 37M of the labor Code,for the performance of the work for which this permit is issucd. ❑1 have and will maintain Wwkch Compensation Insurance,as required by Section 3700 of thc labor Code,for the performance of the weds for which this permit is issued. My Worker's Comperuadon Insurance carrier and Policy number art: Carrier: Policy No.: _ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE CITU taction rcM mol be completed if Ne Mfmil isforc ne hundred dollars(SIM) or loss.) 1 cenify Out in the performance of the work for which this permit u issued,1 shall not employ any perun in any I an bee csubjc No rkcg Cwpcuation Laws of Coliform D .f/.n I"' �rY] Applicant a/�T� NOTICETO APPLI cr ng this Ccnificaa of Eacmption,you should _ nccome suhjccn to c Wo mpcualion provisions of the IaMr Code,you moa z forthwith comply with such provisions or this permit shell be deemed revered. ?O CONSTRUCTION LENDING AGENCY .�.. I hereto affirm that them is a construction lending F Y g agcnq for the perfulmanec or a 7 the work for which this permit is issued(Sec.3(9'!,Civ.C.) aQ Lander's Name 7 z lender's Address U C 1 cenify that I have read this application and sate Nat the above inforfambi n is Iy (- canon.I agree to comply with all city and county ordinsnces and state laws relating to 0 building construction.and himby audlofireociexnuties Of this city in corer upon the r fSl above-enenniuned property for inspection proposes. f~ G (We)agree to save,indemnify and keep harmless the City of Cupenino against C.)z lia`ililities,judgments,costs and expcnsu which may in any way scenic agalut said City in vequence of the granting of this'mo.L ^ APPLICANT UNDERSTANDS W LY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. &� Re-roofs t Signature of ApplimUCon{��tot Dam HAZARDous + lA SCLDSURE Type of Roof Will lhcapplicamorfutur toss'y � ipantuomorhandlclearafdoua smcrial u do ectmcd by th Cupertino Municip TCode.ensurer 9.11,and the Health and Barely ode,Sion 255]2(a)? ❑Yo W4� All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant uta equipment or devices which g it harardo.,air conuminana as Jcfrlcd by the Bay Arca Air Quality Management all new materials for inspection. District? �,fr/ ❑Yes 1 have read the haaardousma cruds mquifemcnu under Chapwr6.95 of the Califon nice Hwlth&Safeycode.Saar 255,5.M33and255]a.lundersandlhaifthe building docs non commit,haw a Ion Nat it u my responsibility to notify the occupy t of the r mqunem ih et tit issuance or acemnrlcateofaapancy Signature of Applicant Date �I owner uanori.d int ^Date All roof coverings to be Class"B"or better JUS U g 1�7u5 � l July 7, 2005 / Randy Reisinger 11072 Firethorne Drive Cupertino, CA 95o14 Re: Cupertino Countrywood Homeowners Association Dear Mr. Reisinger: The Cupertino Countrywood Board of Directors have approved your request to install a Solatube skylight, subject to the following conditions: • A licensed contractor professionally installs the skylight. • Any necessary City of Cupertino permits are obtained. • DRI Commercial (a.k.a. Davey Roofing) 510-372-21oo needs to inspect and approve the roof before and after the installation, so the roof warranty is maintained. • The skylight can only be installed on the sloped shingle portion of the roof. • You are responsible for any damage, repairs or maintenance caused by the skylight installation, including leakage around the skylight. Thank you for submitting your architectural request to the Board of Directors. Please keep this approval letter with your other important real estate documents. Sincerely, Community Management Services, Inc. Bob Soares, Senior Association Manager Cupertino Countrywood Homeowners Association BS/S cc: Board of Directors File: 4 - ' CITY OF CUPERTINO z� CITY OF PERMIT APPLICATION FORM °S�7 v �S / CUPEIZ;TINO APN #✓ Z/ `cs^ a a Date: Building Address:? Mailing Address (if different from building address): .2 CKPCR-T7+✓0 C-k Sa I Own 's Name: Phone#: �D ��s �� F - 733 -- /3 Contractor: License #: 6 3 7 0 5 8 Tf-A 1.5 3 S Contact: Ph"�A- Phone: y o k-720'1(0 0 Cupertino Business License#: Fax: Building Permit Info: a-DDct-toe of 5o'-ltTu.06 o✓fR-- STp-rft-w a-L-L— Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Job Description: So t A T(3L SKy C-t 64 7- - 11 Residential E ' Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost ofProject: Soo Occupancy Group: Type of Construction: Please check this box if the project is a second-story addition: ❑ Pro'ect Size: Standard ❑ Lare ❑ Ma'or ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL 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 *� 3 , 1of3 Community Development an 10300 Torre Avenue 11 Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 'UPEkTINO Building De artment JOB ADDRESS: PERMIT # 1/072 0-5o2-7 v s OWNER'S NAME: L - AJ6PHONE # o 3 —/9e/ GENERAL CONTRACTOR: y,, f ,cp FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet R er ontractor Signature Date i•1' Community' Development �. 10300 Torre Avenue t' Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 UPEPNO Building De axtment JOB ADDRESS: PERMIT# _ / i072 Fie; -.�c�L QSo'7o� S OWNER'S NAME: %�� [ , �f s , �c L PHONE # Yo y- 737 . _ GENERAL CONTRACTOR ��,,�,ssa,�c t �u c n �s FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the followin information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishingo-z,, Electrical Excavation ` Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving ! Plastering Plumbing _ Roofing Septic Tank t [ISheet et Metal 1q Rock ,-- /Own /.Contractor Signature s Date CITY OF CUPERTINO 740 PERMIT APPLICATION FORM CUPERTINO Quantity 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 BOVERTME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg 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 Storm/Rain Water PLUMBING Amik BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER InstalVAlter Water Pie PLUMBING BPWHEATER Water Heater/Vent 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 Furnace MECHANICAL BREMFURNOV Relo Furnace> 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 BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2of3 Fz - ' CITY OF 'CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group , BREMSIGNAD Rmdl Sips 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 BSAr M Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Ternp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/ Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Change BUILDING 3of3