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03010123 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT kfCO,NTRACTORdINFORMATION ;. . lints i u�..r ,•.^«:, BII I LDING ADDRESS: MARTEN GARY L PERMIT NO. 21522 REGNART RD NER'S NAME: APPLICATION SUB DATE MARTEN GARY L 01/23/2003 PIIONE: SANITARY NO, CONTROL NO. ARCIIITEC(ENGINEER: BUILDING PERMIr INI70 BLUG ELECT PLUMB MECH �00 LICENSED CONTRACTOR'S DECLARATION lob Description ¢ G 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing p �¢a with Section 700)of Division 3 of he Business and Professions Code.and my license is _<�„ mrmintmeanaerree,' REMODEL-REPLACES PERMIT 30084 CQ�JJ j� Z py, Latenrc Class Conor �� AECTS DECLARATION C� 1 understand my planss shall shall be and as public records ipwG Liccn¢d Professional JUN 0 3 2003 OWNER-BUILDER DECLARATION fy, i Y 1 hereby affirm that I am exempt from the Couranor'a License Law for the a MO following maatm.(Section 7031.5,Business and Professions Code:Anycity orcounty 52 a From,raiares a prs ,m construct,short,improve,demolish,or repair any structure 7Y0 av FAY}+ pdorto its lssuance,a4i requires the applicant liumch permit ml ilc aMilned.nmemrnr ggM� < that he is licensed pursuant to the provisions ofthe Contmetor.x Licenw Sq Law 9 . Ft. oor Area $ tion �� (commencing with Section7000)of Division 3ofthe Businessland Professions Code)or — Nat he u exempt Ncrefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjecu tM applicanno a civil penalty of 3 5 A PW 14 Occupancy Type not more than five hundred dollars($5(10). 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the strucwre is not intended or offered for sale(See.7W,Business 18T — and Pmressiens Code:The Contractor's License Law docs not apply m an owner of 102 - P I ERS equtred Inspections property who builds or improves Nercon,and who does suchwo,k himself or through his man employees,provided that such improvements are not intended or offered for safe.If. 103 — UFER however,the building or improvement is sold within one year of completion,the owner builder will have the burden of proving that he did not Wild or improve for purlase of 104 — REBAR 6d1e') 105 - ANCHOR BOLTS 01.as Owner of the property,am exclusively contracting with licensed contractors to 106 - SEWER & WATER construct Ne proles(Sec TAA Business and Professions Codr:)no Contractor's Li� erre Law docs not apply to an owner of property who builds or improves ihemon,and, 202 — UNDERFLOOR PLUMBING Lesom LLaawu for such projects with acontracter(q licensed pursuant to the Contractors 203 - UNDERFLOOR MECHANICAL Qlam exempt n ,Sec. ,B&P C far is reason 204 - UNDERFLOOR FRAME 1 eR o •Is P DECLA oN 205 - UNDERFLOOR INSULATION Iherchy affirm der penalty of perjury one of the following declarations: 3O1 — ROUGH PLUMBING ❑ 1haw and will maintain acenificareorcnnsentlrself-Insure forWorkerscominn- 302 - TUB & OR SHOWER amino.as provided for by Section TW of the labor Code,for the performance or the 3 03 - ROUGH MECHANICAL work For which this permit is issued. 304 - ROUGH ELECTRICAL 1 have and will maintain Wory<rs Compensation Insurance,as maluired by Second 305 - FRAME 3701 of the Labor Cade,for the performantt of the work for which this permit is issued. My Workers Compensation Insurance carrier and Policy number am: 306 — HOLDOWNS Carrier: Policy No.: 307 - INSULATION GER'1'll'L ATE OF COMPENSATION INSURANCE ON FROM ORRER$' INSURACE308 — SHEETROCK (This semionneed not he completed it[be permit is forme hundred dollars(510) 309 - EXTERIOR LATH ,it leas') 310 - INTERIOR LATH 1 certify mm in the performance of N work fit who Nis pct, I is issued,l shall nor 311 - SCRATCH COAT cmployany persn anym ser 'zam $ 9s tekeri Compenaatinn Lawsofcabf Date — 313 - ROOF NAIL Apiop91 NOTIprJ da ' gChiaCertilicateofExemption,youshould 501 - FINAL ELECTRICAL ENERGY been ceubjectmthe orker'sCompensationProvisionsoftheLMoCmlc.youmust 502 - FINAL PLUMBING ENERGY OO forthwith comply with such provisions or this permit shall he deemed mvokcd. z CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY I hereby affirm that there is a constmetion lending agency for the performance of 504 - FINAL BUILDING ENERGY C4 > 'he work ichNisplanar isissued(Sce.3(197,Civ.C.) Lender's Name 505 - FINAL ELECTRICAL W Q .D7 LanearaAaarcas 506 - GAS TEST U p 1 certify that I have read this application and sure that the abeve information is 507 - FINAL PLUMBING W F correct.1 agree to comply with all city and county ordinances and sore laws relating to building comminution,and hereby amhOHM representatives of Nis city to conn upom Ne 5 FINAL MECHANICAL r LUt1 alrowe-mentioned property for inspection purposes. O9 — FIN G (We)agree m save,indemnify and keep haronlcss the City of Cupmine,against V103 Iiahi;ities,judgments,costs and expenses which may in any way accme against said City 5 N G 4 in consequence of the griming of this permit. APP LIC T UNDERSTANDS AND WILL COMPLY WITH AL-1,NON POINT Issued by51 WORKS Date sou EGULfsTlp � A/ LRe-roofs Sign re o A plit rd/Conua mr /"am (10 HAZARDOUS MATERIALS DISCLOSURE. Type of Roof Will the applicant or future building accupam store or handle haranious material as defined by the Culxniou Municipal Code,Chapter 9.12,and the Hexhoh and Safety Seeae,oYcs z553z1a)v �Ni All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If roof is installed without first obtaining an inspection, I agree to remove emit hazardous air contaminants az defined by the Bay Area Air Qual ity M anagement all new materials for inspection. District? ❑Yca L}go If ave&Safety ut Codc,ardiars ictions materialsrequirementss 231Lunder Chapter fi 95 of be Califi 6 �� nits llealN&Safer Code Srniins 255(15,2.5533 wJ 25533.1 understand that if the but lJ'a" dcet not Curren hnvev¢nant,Nat it is 2ap+esihililym ul}ytM occupant of me O uireme mh must Jpt/sem��orm' mccofa Cenificriw eti c. "t . ll nt - Date ✓ tent amirir.dafied, Date All roof coverings to be Class "B"or better CITYBUILm c DPERONNO PERMW tCONTRACTORINFQRMA 11 ' BUILDING AD'nREss: MARTEN GARY L PERMIT NO. '21522 REGNART RD 03010123 `WNER'S NAME: APPLICATION SUB DATE '.MARTEN GARY L 01/23/2003 PHONE: SANITARY NO. CONTROL NO, ARCHITECffENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 oo LICENSED CONTRdundersDECLARATION JobDescri tion Id f hereby afnrm that I am licensed under and Professions of Chapter 9(commencing p U with Section](11X1)ef Division Sof NC Business and Prnfealona Cede,md my license is imfall @meandaffect, I REMODEL-REPLACES PERMIT 30084 Z O LI F License Class Lin g C FNt, Dmc Congactor F' A G� a�1 ARCHITECT'S DECLARATION /v y I untlersranJ my plans Nell W used as public records _ JUN 0 3 2003 u�LL G� Licensed Pndessinnal . Ip-y Dat I am exempt O rapt fr DECLARATION fs/.'1/]. S J Sy 2 0 R 1 hereby Affirm that 1 pm exempt from the Contractor's License Law for the • —• �L� po fallowing match.(Section 7031.3.Business and Professions Code:Any city or county r�V .�� / ��'��I�� $rE which requires a permit m consumes,oke m w improve,demolish, repair any auucm C� prior in its issuance,also requires the applicant for such permit to file a signed su¢ment Itvss < Out he rovi is licensed p....nt to Ne onionskins of Ne Contractor's License La.(Chapter 9 Sq. Ft.Floor Area $79'81ttTatlon (commencing with section 7")of Division 3 of the Business and Profession,Codi Oat he Is exempt themfrom and the bads for the alleged exemption.Any violation of Section 7031.5 by any applicant for a Permit ubjects the applicant to a civil penalty of not...than five hundred delta.(S500). bC Occupancy Type ❑1,as owner of the pmpeny,or my employees with wage,a their sole onmpewdoa, will do the woh.and Ne manure is not intended or.Ifered for ase(Sec.7W.Business and Profession,Code:The CmWacmues Lt..law delta nota 1 to an owner of a cared Ins ectlons propenywho build,orimprou vNma en,and who due...hwork himself.Omagh his 102 - PIERS_ q p T howown ever.sheesldingoctlthaauchimprowmentsmenetintended auofcompBemd for,theo owner. 103 — UFER T however.she We[beorimpro proving nsmt he year or completion theowner 104 — REBAR builder will have the burden of proving that he did not build or Improve for purpose of ale.)' 105 - ANCHOR BOLTS ❑ I.as owner of f ProPeny,am excludvely contracting with licensed conuaaonm 106 - SEWER & WATER construct the project(Sec.7064,Business and Profession Code*The Cenu¢me.Li cense Law docs not apply to an owner of progeny who Wilda or improve,Nemo,and 202 - UNDERFLOOR PLUMBING who contracts for such projects with a contractor(s)licensed pursuant in Ne Conlraclor', 203 — UNDERFLOOR MECHANICAL Lee.Law. C[lamexotnint,yn rsec. �s f/Tor�N-I��^n 204 - UNDERFLOOR FRAME —�f ER o :fs 1 OECL oN 205 - UNDERFLOOR INSULATION Ihembyam.lon,poultry ofparjttryma,ofOltfollowing declarations: 301 ROUGH PLUMBING Thaw and win mpimema Ccnincete of Cnnsennn selG 302 — TUB & OR SHOWER ❑ for the 303 - ROUGH MECHANICAL anon,u provided for by section 3700 of the Labor Code,for Ne performmce of the work for which this permn is issued, 304 - ROUGH ELECTRICAL ❑ 1 have and will maimain Workcfs Compensation Insurance.u required by Section 305 - FRAME 3700 of thlt label Coda,for Ne performance of Ne work for which Nis Permit to Issued. My Worker's Compensation Insurance terrier and Policy number am: 306 — HOLDOWNS Carrier: Policy No.: 307 INSULATION CERTIFI COMP NTE OF SATONION FROMINSURAN WORKERS' 308 - SHEETROCK (rnusecnon ruednmhecompletedinW pennhbforane hundmd Collars($100 - 309 — EXTERIOR LATH mI.) 310 - INTERIOR LATH 1 certify Nat in the perfoonencc of th work for wh' Nis F t is issued,I Chan not 311 - SCRATCH COAT employ any persn In anym nor L 1kcom In 't�hm'Cnmpemadon Laws ercalir Date 313 ROOF NAIL NOTIa r�f .. m de ' ginsCenificnmofExemption,youshould 501 FINAL ELECTRICAL ENERGY ozWen esunallothe orkmiComponsasionpmvisionofthelaborCuth.youmust 502 - FINAL PLUMBING ENERGY forthwith comply with such provisions or this rommit mall k deemed invoked. z CONSTRUCfIONLENDINGAGENCY 503 — FINAL MECHANICAL ENERGY F .N. IhcrchyaRrmOat 0ocisaconsuocsionlending agency for the porfmarmmof 504 - . FINAL BUILDING ENERGY W�,� the work Na which this permit is issued(Sec.3097,Civ.C.) 505 - FINAL ELECTRICAL Ira M Lender's Name IL Z aneniAaere„ 506 - GAS TEST UO lttnifyOat Ihave mad this application and more Oat fshrive information is 507 - FINAL PLUMBING {1,F correct.l agree to Comply with all city and county ordinances and sure laws mlating to 0 U building conswcdon,and hembymthonmreprescnutivexofNiscity toColor uponrhe 5V9 - FINAL MECHANICAL t.[7 ahovc(We) eioneee to save, indnspeaian keep ha. FIN .sand msave,orinspl(yandkcanhmmicatheCitynrCupeninageimtSN % G liabilities,judgments,costs and expenses which may in my way scout against aid CityU7 in consequence of f granting of this permit.APPLIC UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by$ WORKS Date SOU eeui�,'rrp /�QQ,, ,z Re-roofs Sign re. A Alit,nVComraftor Daay� t1 4 HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or(umm building occupant store or handle ha'rallon material as defined by the Cupertino Municipal Code,Chapter 9.12,and the HcaW and Safety 1,ntle. nn2553:(a)7 ElYes No All roofs shall be inspected prior to any roofing material being installed. ❑ � Will the applicant or fumm building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove trait haemdous air ronmmina��nuttt as defined by the Bay Arca Air Quality Management all new materials for inspection. District? pXJn ❑Ya Ikwmml Neh.Srd m$usu5505.s533mdo 5M.dcr Chapuditi6.95 fNe Calding nice HcalN&Safny Cnlounuo slSNill.requirements e tri mtl 25s ands, hipia, thin if tle Calif. does nor cusum how a meant,than t is nommicibility,to tify thc nmr<upof the mquireme ich mumy�q� no' anceofa Cenincates Dec., ignat O lI nt Date ` Z Aa 9// u 7/✓ All roof coverings to be Class "B"or better cr ver uthufi ad ego^t Da¢ g 55 Epe gd�t_;ylew; insert Fgrmat�Records Lods-y9nilow delp -- _ _ - x )nput Permit Number: 30084 PERMIT#: ® ARCHITECT: VALUATION: 790 APN: LICENSE#: ISSDATE: SITUS STREET: REGNART SUBDATE: 6/20/96 PLCHKDONE: SITUS NO#: 21522 TYPE: RS% LATE CODE: AVE.CT,ST.RD: RD O BLDGDEPT: N,S.E.W: DESCRIPTION:.ELECi.PLB,MECH ENGDEPT: NO#: 95 PLANDEPT: CITY: PLCHKREO: CMA: ZIP: 95014 CATEGORY. CTRRRE: LOT#: O DATEDUE: SANDIST: ID: MARTEN Commercial HLTHDEPT: OWNER: MARTEN CA-sq#Ilp STRCTENG: OWNER SAME CEscIll D TOTAL: ADDRESS: CNsgphp. INSPHOLD: CITY.STREETZIP: CUPERTIN0 C4950/4 Residential PHONE: 4082558992 t-yTt� RN-sgpll# 1 r I CONTRACTOR. ��t—I� REsq#II#: LIC#, L J PUSsq#llp: ' Sea¢h by AdAddiese .Fmm Vlew,ter:"'.. ryry CAPy�S U1M • ��f Stail IMwx•.::. ��4GLS euem:.'= Pem�tu:i�L':1Mkidi..: Ifs C.:. ®Niuoe ,'.',': Ei®SYLItiYZ3O PM. • Inspection Query for a Specfic Permit Print V 3 I 1/17/0 I.'..._. PERMIT# jSrrUS I SITUS STREE—T--7A—VECTST,RDI Lot# JINSDESCRIPT InsType DATEDESIRED1 DateDone Inspector Qni s Je?ass/Fail' 30084 21522 IREGNART jRD FOUNDATION 11/18/96 CC 1 F ' 30084 21522 IREGNART jRD FOUNDATION 11/27/96 11/27/96 CC I2 P 30084 21522 REGNART iRD FRAME 10/21/97 10/21/97 AD 4F 30084 21-522—REGNART IRD SHEETING 11/4/97 11/4/97AD91599 REGNART IRn Ir OF SHE THI 9/131A 913198 An —41 2P 30084 21522 REGNART RD JEXT.ELECT,7 O /30/98 7/30/98 AD ;-3 P 30084 21522 REGNART RD EXTERIOR P 3l 1/28/99 1/28/99 1 1 P. ... _ 30084 21522 REGNART RD SCRATCH CO 6/30/99 6/30/99 AD -7-113- 30084 1 P • 30084 21522 REGNART ARD 30084 21522 REGNART RD IMECHANICAL 1/3/00 1/3/ 2P 30084 21522 REGNART RD 7/11 7/11/00 JB 1 30084 21522 REGNART RD ELECT-R 7/11/00 7/11/00 JB 1 30084 21522 REGNART RD FRAME 11/00 JB 1 30084 21522 REGNART RD ELECT—R- 7/11/001 7/11/00JB 1 30084 21522 REGNART RD FRAMING INS 1/10/00 30084 21522 REGNART RD FRAME 1/11/01 1/111/0110 3P 30084 21522 REGNART RD INSULATION 7/16/01 7/16/01 AD 2P 30084 21522 REGNART RD DRYWALL 308 1/22/02 1/22/02 AD 1 P 30084 21522 REGNART UNDFLR F 1/22/02 1/22/02 AD 111 P 30084 21522 REGNART UNDFLR PLB 1/ 1/22/02 1/22/02 AD I 11P 30084 21522 REGNART 2ND FIREPLC 1/22/02 1/22/02 AD 1=,[P 30084 21522 REGNART RD 308 SHEETRO 308 7/22/02 7/22102 AD 1 ✓SOS � �I L�D3 � , 5 D �= -- POSTTHIS CARD NEAR FRONT OF BUILDING U�O/ CITY OF CUPERTINO PERMI,r,o, ,a BUILDING DIVISION _ 3 •'BUILDING PROJECT IDENTIFICATION BUILDING ADDRESS: - „l SANITARYNO. ]APPLICATION SUBMITTALDA O WN IY}.S NAME: IIIOL - CONTRACTORS NAME,:_ LIC NO: NIC CONTROL p �RLHITECUENGINEER: LIC NO: y. ADDRESS: • . -• . . '.BUILDING PERMIT INFO�.-'•',,„TI .INSPECTIONS DATE ' INSPECT' ❑ Consultant Pces Paid by Applicant(Initial) r BLDG ELECT ' PLUMB MEGH FOUNDATION/PIERS/H.D.S. INSPECTION RECORD JOB DESCRIPTION UFER GROUND NOTE: ALL GRADING AND DRAINAGE RESIDENTIAL: PAD/SETBACK-CERT SHALL BE INSTALLED TO COMPLY WITH ❑sFDWL ❑KITCHEN REMODEL THE APPROVED PLANS AND CITY OF ❑ADDITION 0PLUMBING RE-PIPE GARAGE SLABS/PREGUNITE CUPERTINO STANDARDS. ❑MULTI-UNIT ❑STRUCTURAL D POUR NO CONCRETE.UNTIL ABOVE HAS.BEEN SIGNED MOIFICATION TO ARRANGE INSPECTION MOD ❑CHIMNEY REPAIR UNDERGROUND/SLAB CALL AFTERNOONS (12:30 PM - 4:00 PM) IMPROVEMENT, - ❑BATH RE-MODEUREPAIR ❑DEMOLITION PLUMBING 777-3228 M O N DAY TO FRIDAY 24 HOURS BE- []OTHER ELECTRICAL FORE REQUIRED INSPECTION. JOB ADDRESS DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED AND PERMIT N ARE NEEDED WHEN PHONING. COMMERCIAL PLUMBINGATTENTION CONTRACTORS: ❑NEW BLDGiADDMON ❑DEMOLITION MECHANICAL NO PERSON(S)SHALL PERFORM WORK ON ❑TENANT ❑FOOD SERVICE THIS JOB SITE WITHOUT BEING IN COM- IMPROVEMENT ELECTRICAL PLIANCE WITH WORKERS'COMPENSATION 0OTHER . FRAMING VENTS - INSURANCE REQUIREMENTS. INSULATION PLACE NO SUBFLOOR UNTIUABOVE HAS BEEN SIINSPECTION SPECIAL INSPECTION REQUIRED ❑ DATE INSP. G ROOFSHEATH/DIAPHRAM �� ,� �/ �i(�/J7 yt �I PLUMBING • �/ .)r / TUBS A SHOWER PAN MECG ` C �' HANICAL041/ ' ELECTRICAUPOOL BOND 00f Itj \,.✓ FRAMING/STAIRS/E.EGRESS INSULATION/VENTILATION .rte .COVER NO WORK.UNTILABOVERAS BEENSIGNED' J1/•/ / EXTERIALSHEARMOLD DOWN INTERIOR SHEAR/I-IOLD DOWN SHEETWROCK/SHEETROCK SHEAR PIAZ_?., OL EXTERIOR LATH/W-SCREED i rV O `ef SHOWER LATH -NO TAPE OR PLAST_ER UNTILABQVE HAS BEEN SIGNED., SCRATCH COAT �1'I, aK F SEWER/WATER TEMPORARY APPROVALS"`„ _ - �• L �� OCCUPANCY ELECTRICAL GAS soiv GAS TEST GRADE FIRE `11d 1J; Ir: r +^ HANDICAP ELECTRICAL -AMWLUMBING ECHANICAL /-.2 a 3 ENERcv VISUAL FINAL ONLY CERTIFICATE OF OCCUPANCY 0 BUILDING IMPORTANT: ISSUANCE DATE OCCUPANCYOF,BUILDING-ISNOT:PERM.ITTEO::" PLEASE READ REVERSE SIDE BEFORE UNTIPBUILDING`EINAC.IS S[GNEDBY,BUILDINff CALLING FOR FINAL INSPECTION!! ” )INSPECTOR. s1t1. - N�'}' ISSUED BY: - . APPI ICANT'C Pl1(ZTI Kir Cf)PV — __ NOTICE When callina,for FINAL INSPECTION,"), ''Lhc. oC"'Urs prior to the release of utilities: The Building Department coordinates the requesi for final inspection with the following-City depart- ments, as required, to assure that the s ite/bi_ll!ding complies with the requirements of these depart- ments. ' 1. BUILDING: Complies 1,vith all building code requirements. 2. ENGINEERING: a. Nelia driveways, sidewalks, curbs, gutters completed. b. Lot fine grading to drain or bond posted. C. New water system in epera.lion. d. New se�,ver system,in operation (Sanitary District). e. New streets paved, with sinwer manhole and valve boxes raised to grade. Sewer c!eanoui at property line to grade. f. New subdivision lot corners sst. 3. FIRE: a. Fire hydrants properly installed and operating. b. Fire sprinkler system properly installed and tested. c. Fire alarm systems cornpletecl and tested. d. Fire extinguishers installed, dated and tagged. e. No parking sinjs in required fire lanes. f. Restaurants, hood fire extinguishing systems operating and tested. ;?< 4: PLANNING: a. Required l;Yn rJscajiiric:] and inigation system installed. b. Paved parking, trash enclosures, exterior light fixtures, etc. C. Documents (CC & Rs, easements, etc.) 5. HEALTH: All food handlina facilities must meet the requirements of the Santa Clara County Health Department. Upon receipt of approvals in the Inspection Division from all the above departments, gas and electric utilities will be released, and you may'then occupy your building. If new owners are attempting to occupy the buildirig for the first time and the utility release has been delayed, check with the contractor who is responsible for meeting all the above requirements of the various departments. BUILDING INSPECTION DIVISION CITY OF CUPERTINO Y • CITY OF *PERTINO 10300 Torre Avenue Telephone 777-3228 j. INSPECTION NOTICE • BUILDING DIVISION JOB DATE / r^ 7 ADDRESS � � �� - — �/ eCdI/ATIME DAILY REPORT ED CORRECTION NOTICE❑ VIOLATION❑ TYPE INSP.: BLDG.❑ ELEC.❑ PLBG.❑ MECH.❑ ❑ STOP WORD( ❑ REINSPECTION FEE \ , J1 - t f , , WEATHER lJ��B2� Ei_c�INSP. —� CARD TO REMAIN ON JOB-SITE { -- s t •. • ..:, , ..l n.i h 1. \ ,: '':1,. ;i i r