Loading...
04040190 (2) CITY OF CUPERTINO BUILDING DIVISION PERAW n CONTRAC LIa�Z INT'OB rpN L's',4..t'k' fl n.hNL:+`.�. .SN. V Yn;{p V+ &,a•.,.:,f f, BUILDING ADDRESS: OSSIBILITY KITCHENS PERMV4040190 I OWNER'S NAME: PERMIT ISSUE DATE 4 29 2004 • PHONE: SANITARY NO. CONTROL NO. 408) 924-0204 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH Loo LICENSED CONTRACTOR'S DECLARATION Job Description F❑ I hereby affirm that I am Nexamd under provisoes of Chapter 9(commencing zWR with Section R%IB)of Di�ionJor the Ousincu and Prafcsiiunx Cndc.end ylicenm is in ren ore na erma.� i318 KITCKEN REMODEL F09WWAALE® jaLi<cnm ,talo L ip —Contractor r 1i e� ZDate I p U 1 uAkr and my planx.hal M used a pub a�ds AUG 3 2004 3Qy Licensed Professional OWNER-BUILDER DECLARATION af 1 berehy Ilan that I ore exempt from the Contractor's License Law for tbe O O Ir+S �6G following reason.(Section 7031.5,Business and Pmfccsions Code:Any city or county BUILDING vU��®�Ntl I-E! which squires a permit Rs construct,after.improve.demolish,m repair any.ITUChr a 2 2 0 0 0 p:iorto its Wearer also requires the applicant for such permit o file a signed statement that he is licensed pursuant Sq. FL Floor Area Valuation ttm yl-� (commencing with Section 7000)of Division S of the Businem and Professions Code)or i that he is exempt thesfmm and the buts for the alleged exemption.Any violation of Section 7031.5 by airy applicanlfar a permit aubjecu tW app]icam to a civil penalty of 326ABI9bl6m&@ Occupancy Type oaI mom Nan Eve hundred dollars($500). a ❑I.mown ofthe property,m my employees with wages at their mle Compensation, will do the work and the someone is nounrendcl or offered rarsam(Sec.7W.Business Required Inspections and Professions Cade:The Contractor's License law docs not apply to an owner of q P property who builds or improve thereon,and who does such work himself or through his awn employees.providcd,hat such improvements art not intended oroRertd far sale.If. however,the building or impmvro ens is sold within am year of completion,the owner. Wilde,will hast the burden of proving that he did be,build of improve far puryose of uleJ. ❑I,as owncr of are,property,am exclusively contracting with licensed contractors to construct he pmjcct(Sec.]Oso.Business and Prafamio is Code:)The Contractor's Li tic taw does not apply to in owner of property who Wilds or improves themon.and, who commas ommanbe for such projects with aconr(s)licensed pursuant to, CantraClara M.law. ' ❑1 am exempt under Sec. .B k P C for thio soon Owner Date . WORK ER'S COMPENSATION DECLARATION I hereby affine under penalty of perjury one of the following decluatimae thaw and will maintain a Ccnifiam of Consent o ial6iuus for Worms's Compcm cation,as provided for by Section 37M of the labor Cade,for the performance tar the work for which this Penni,is issued. ❑1 haw and will maintain Workers Compensation Iuunnce,u squired by Section 3]00 of the labor Code.for Ne performance of Ne work for which this permit is issued. My Worker's Caflarram a,ion Insurance artier and Policy numb a cZ V 1 .c,[A !7 a 5- "� rill [l Polity No.7I Ste- O Z( CERTIFICATEOFEKEMPr10N F$Oh].)V'ORKERS' ( I V� COMPENSATION IN�NR�CNCE / (Thu section need,mtM completed lithe Permit is fico ooh indmddollars(SIPS) lir less) 1 eeniry that in the performance of the work far which this permit ie issued.)shall nut employ any person in any mannerso as to become subject o the Workeri Compensation Laws orcabronda.Dam Applicant .. NOTICE TO APPLICANT:If.after making this Cenifica d of Exempian,you SWuld became subject to the Worker's Comp<nmtian provisions of the labor Chile.you most .JO forthwith comply with such provisions or this Permit shall W deemed revoked. Z CONSTRUCTION LENDING AGENCY Thereby affirm Na,there is a construction lending agency ter she Performance of / tY. the work for which this permit is issued(Sec.1097,Civ.C.) V W Q nZx Namc Lx D Z landcrAddress V .2-a 1 certify that 1 have read this application and Stam that the above information is W correct.1 agree to comply with all city and county ordinances and state laws relating to p U building(W Construction.etoand hereby indemnify and e p harmless th f this of Cu enter upon the i W show-rumioned property for inspcmmn purposes. (We)agree,a save,indemnify and keep harmless the City of Cupertino against .Fi N liabilid.s,3udgmcnu.costs and expcmes which may in any way manic against mid City OY U in consequence of the graming of this permit.'' LA- Date ti APPLIC r, NS DS% WI{.ys.OMPLY WITH ALL NON-PANT ISSUCd by: SOUEC U NS. GC Z1 Re-roofs igmd.oCof ApplicgnVCom nor Date DOUS MATRIZM DISCI URE Type of Roof Will the applicant or future building occupant slam or handle har<rduus material as defined by the Cupertino MUnicipal,Code.Chapter 9.12,and,he Health and Safety Codc,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. Dyes Will the applicant lir future building oceupin,use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove condo ha/a dnus air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. • District? i / ❑Yes C3taO . 1 have read the hasardnm materials requirements under Chapter fi 95 of the Califon ali Hcxlth KSaf4 y Code,Sections 35505,25533 an 5534.1 und.,i.d thm ifthc Wilding I Jce.not correct have a mnam or nsi ugly m nosily the Occupant lir the r<qu;mm nit. lento <%P' r .is <enr.anifiamafoleu Sig nature of Applicant Date rent All roof coverings to be Class "B" or better owner or aumad.cd a Rare Y. �t! • ES�ERRE�`u1RED SPARK ARR In 15 191 68 121i —If— 27 C�„taJ I 261 f 18 74 V 3P —�2-- 48 ,RM n i W 27 B24SS :I 4DB I ISH. S II BCF BSr 27 24 ISG 67 B 7 W X36 6 3B1 --I I 18 12 BHI 1181 JJJ D 15 I 1 15 AX I • 14C 3 i 1 ©6B9@f} MC3084 5y� W3611224 24 I 3— 18 f 18 30 41 3 ' 40 3671 69 3f> 89 191 1081 APR 2 3 2004 CITY Gi I "ANO r, - Ta�fli: X71 Ia- 1� a; 1 r 1 Desi 03119M Dwp no. 3180AEC3 Scale:l/d"=1' Bn' All dimensions ct size designations THE This a an original copied and mus[ Date 0429104 iron are d adjustment to ent toa6on on not be released or co ad unless choi,pamela job site and atljustment to fit job HOME DEPOT order placed has b been paid or job wntlrtlans. order placed. Designer kat pPR 2g �,C04 1084 - T•, X 36 - 71���� 12 0 4 )1 o 0 F, 8f61 • 72 0 ®®® D 341 'vz 36 30 '-i8 3 8-AY OMCE COM • All dimensions 8 size designations THE Thia is an original design and must 3190AEC-5rI,7111C"LmII ale: Dgno. gmn are subject towilicaticn net be released or copied unless job site and adjustment to litjob HOME DEPOT applicable lee has been paid or job choipamelaconditions. orderplaced. 1181 ' t A,/- 24 36 15 .' 401 hPR 2P) �4 r rl�r j: 18 :,SII 49} 12 8�6} • 54 5.4 v I 34} �- 27 ' - 36 15 -IV- 331 'l • All dimensions&size d sipnatlons THE This is an original tlesign and most 3180AEC5 Swle:12"=1' Owg no. given are subject to verification on HOME DEPOT not be releasatl or wpiad unless chci,pamela esipner job site and adjustment to lit job applicable fee has been paid or job ccndibons. order placed, WaIVC Line e 3 rl 67 — T APR 2 2uu4 nn 12 49} 96 • 84 34i /F- 12 27 may' 24 —� Ogg ®P • All dimensions 8 size designations THE This is an original design and must F90PAE�C,5. Scala:12'=1' 0vrY no. given are subject to verifs,=or' not be released or copied unless esiBnarjob site and adjustment to fit jab HOME DEPOT applicable fee has been paid or job conditions, order placed. Wall1C Line e 1 r • 1541 R Ur Clr C� I ,a 491 3A °� �1R ,.I�n�� 8461 e 9 341 e /6 1211 27 -1 231 --/3L 18 f- 24 36 2' 48 - 1 OFFICE copy • All dimensions 8 size designations THE This is an original design and must 31g0AEG5 Scale:3/8"=1' Q g no. given are subject to verification on not be released or copied unless asigna job site and adlustmantb ti[job HOME DEPOT applicable fee has been paid or job choi,pamela conditions, order placed. WalVG Line 0 2 •CITY OF CUPERTINO• o CITY v ! G CUPEkTINO PERMIT APPLICATION FORM APN # �43bis l Date: Building Address: 1060 R A Pnl C2 Mailing Address (if different from building address): Owner's Name: D�i G,.A Cts ( Phone#:LI013 8� t �3e6 1 Contractor: // License #: 8 ( 3 e,3 8 �OSSrg ( uty °� ti�(�('C� S Contact: II ^/ Phone: yo$=Z302/�C Cupertino Business License#: CouR NC-y / 910 Fax: gD6-01240205 Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Job Description• Residential ( K l TC i.FC0 Mpp C2 Commercial ❑ Sq.Ft. Floor Area: G $/Sq.Ft.: Cost of Project: r/ Occupancy Group: 22, O U� Type of Con traction: Please check this box if the project is a second-storyaddition: Quantity Fee ID Fee Description Fee Group BAPPLOTHER_____7 OtherAppliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING 13BOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> l OOK to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1 M 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 <= IOOOA ELECTRICAL BELEC1001 Elec 600V > IOOOA ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL U BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING Ask BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of3 *ITY OF CUPERTINO ID CITY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUH DING 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 i BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER AdT 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 Fumace> 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 BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Sips, Marquee ELECTRICAL 2of3 Souun 40CITY OF CUPERTINA CITY OF PERMIT APPLICATION FORM CUPERTINO Q.pantity Fee ID Fee Description Fee Group / 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 Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL l MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING • 3 of 3 CITY OF CUPER'1'INO t�:""a •t '%a 3 "a � '» ',.•� tu�;a BUILDING DIVISIONPI✓RMI1' CQNTRACTORINFORMATION BUILDING ADDRESS: OSSIBILITY KITCHENS PERMV4040190 1 OWNER'S NAME: PERMIT ISSUE DATE 1; LINCOLN AVE 04/29/2004 DONE: SANITARY NO. CONTROL NO. 408) 924-0204 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG PLUMB MECH °00 LICENSED CONTRACTOR'S DECLARATION �` Alk p U C 1 hereby affirm that 1 am lice atil under provisions Of Chapter 9(commencing Job Descltfmli //�+k 1 -n Ali wnh Sm,km]LMM))efDi 'sion 3nfthc Business and Professions Codc,and mylittnm is f.��s EO in fuB rad effect. L3 u?� KITCHEN REMODEL �i Licen¢j�r�(5�r)s n —E Dau `� o Contractor 1 's.CrY hi IU 3 v 2004 ARCHITECTS DECLTTs�gqpp7Tg1OA W i I u rand my Plans shall be used ss p� ,,Jx pppr1I1 B lga�1yI■�waa.a�.� I,t; Licensed Professional BUIMIYQW 0 OWNER-BUILDER DECLARATION <y 1 hereby affirm that I am exempt from Ne Contractor's License Law for the 00 following reason.(section 7031.5,Business and Profesions Code:Any city or county which mquims a Permit In comanict,alit,improve,demolish,or repair any structure $22000 Fiepoor to its issumcc.also requires the applicant for such permit to file a signed statement that he is heso.dpursumnuo the provisions of the Com.om's License law(Chopter 9 Sq. Ft. Floor Area Valuation ,FO (Commencing with Section 7000)of Division J or the B usi«ss and Professions Cook)or u. $ that he is eaempt derefmm and are basis for Nc alleged caem tion.Any violation of Section 7031.5 by any applicant for a Permit subjects the applicant to acivil penalty of 3 2 6 ABI9 SI6m� Occupancy Type not more than rive hundred dollars(8500). D L u owner or the property,or my employees with wages as Noir sole compensation. will dothework.ands: he Comisnotintendedorawdo forsale(Sec.]obs,Business and Professions Crete:The vesthemon,License Law aces nut hind man owner or Required Inspections ownenywho s,pmarimprovesch improve ants d«ssuc twork or offered his how employethe holdin or int oonmemps mid wits au not ear o cd completion.eered rot ovimcf. howeverillhaw thebrdeno cnngthat edidnot yearofimprovortheowner- builder will have the burden of proving that he Nd not build or improve for purpose of salt.). D h as owxr of the pmpeny,am ewhisivaly committing with Beetled concacton to construct the proper(Sec.7044,Business and Profusions Cade:)The Contractor's Li. cense law docs not apply to an owner of property who Wilds or improve themon,and who concordat for such projects with a eontraetords)Iieesved pursuant M the Conermum's Lieemee law. D l am exempt under Sec. B a P C fur this mason Owner Dau WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penally of perjury o«of Nc following dimboatio ne ]I he and will maintain a Certificate of Cement to ulf-insu¢for Worker'sCompen- snien,as provided for by Section 3'100 of Ne labor Code,for Ne performance of the work for which this permit is ias«d. D I have and will maintain Worker's Compensation Insurance,as required by section 7700 of the labor Code,for But perrormmce of Ne.,it for which this permit is issued. My Worker's Compensation Insurance carrier and Policy^p�uum a6, V�(U CC.Ca S/A,tc FVN� Policy No..�g1 O CERTIFICATEOFEKEMPf10NFq 0�ORKERS' COMPENSATION IN G1hb section used not hceompleted If m permit is for one hundred dollars($100) in kaa) I certify Nat in the pe foremme,of the woslr for which this permit is issued,1 shall nm employ any person in any mmncrm as or become subjects o de Workcrt Compensation , Law!of Calirorniv.Dau Appli,am NOTICE TO APPLICANT:If,after making this Cedric..of Exemption.you should become subject ro the Worker's Compensation provisions of the labor Codc,you must .,z forthwith comply with such provisions or this perm it shall be deemed revoked. z2 ECONSTRUCTION LENDING AGENCY " sem-, I toothy affirm Nat Nerc iso mrsstmctinn lending agency for Ne picamoamt or athe work for which this permit is issued(Sec.7(1)).Civ.C.) W Q Lcndcls Namc 6r landcr's Addmss U O 1 certify that I have read this application and sum that de above information is a F correct.I agree to comply with all city Nd county ordinances and sure laws relating to 0 V building constriction.and hereby amhorin representatives of this city to enter upon the / r U move-mentioned property for inspection purposes. (Wc)agree m ave,indcmnirY and trop humless ate Ciry of Cupertino against 1/17 F'Taj] liabilities,judgments,costs and expenses which may in any way accme against said City U z APPLICANYDUNDEof do,RUANDSrant!ng of tAspe Wl*OMPLY WITH ALL NON-P INT Issued by:9i400t�4w Date SOUR. U NS. Re-roofs ignamre of ApPlic dC°rat DOUS MATE ISCL URE Dau Type of Roof will the applicant tar future building.,.,an,am.or handle havardoox maunal or dcRned by Be Cupenino Municipal Coca.Chapter 9.12.and the Hulth and Safety Codc,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes Will the am or future building«dm ant mm equipment pr devise,which If a roof is installed without first obtaining an inspection,I agree to remove pp id 6 P havardnus air conaminanu as defined by the Bay Area Air Quality Management all new materials for inspection. nmia? / DYs. gxu 1 nave orad Ne ovaNnus maurialxrtyui¢mcnts under ChvPterb q5 of the Califon nice'."k Safr yCadc,Secure 25505,25577 5J4.Iunticrsund Nuifde Wilding rotes not canto have a tenem mihility m nouly the taeupant n Nc mVuimm ts mhm mpr r«pnctmrisampross Signature of Applicant Date ownerm.mthenvcda dm Date All roof coverings to be Class "B" or better