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04060166 (3) CITY OF COPERTINO BUILDING DIVISION PERMIT CO�'TRAG' 'cRxrrT 'o 011T BUILDING ADDRESS: SHOWCASE KITCHENS INC PERMITNOO4060166 7571 LOCKFORD PERMIT ISSUE DATE NER'S NAME: RONALD CLEMENT 12333 SARATOGA- SANITARY NO. CONTROL NO. PHONE: (408) 253-0412 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB MEOCH �a0o LICENSED CONTRACTOR'S DECLARATION lob Descriptio F 1 hereby affirm Net 1 am licensed under pr visions of Chapter 9(commencing with5 tion 70(10).(Di1mkm3af dm Beat. rufcssions Cram-mJmylicemeis NIU zi In fall aadOffc 5�3 KITCHEN REMODEL/SKYLIGHT UPGRADE n Z Data laza C..p 1 00] O 9nV b 1� (i J1, pace Contractor W❑ an CTSD ION 1 trade end my plans shell.111boW usml es p c records 6U ®31VNI3 34 Licensed Professional .�Og OWNER-BUILDER DECLARATION <f 1 hereby.(firm that I am exempt from the Contractor's License Law for the p D following mason.(Section 7031.5,Business and Professions Code:Any city or county ,2 which requires a permit us construct.alter,improve,demolish,or repair any structure 9975 prior m its issuance,also requires the applicant for such permit m File a signed statement Valuation Ihathe is licensed pursuant to the provisions of the Comment"License Law(Chapter 9 Sq.Ft. Floor Area (commencing with Section 7")of Division 3 of the Business and Professions Code)or Out W is exempt therefrom and the basis for On alleged exemption.Any violation of Section 7031.5 by any appliomtt for,a permit subjects On applicant to a civil penalty of f5r Occupancy Type not mom than Bva hundred dollars(SSW). 0 1,es owner of the proper,or my employees with wages as their sale cempcausur n, will do the weak end the measure is not Intended ar offered fosmc(So,.7W,Business Required Inspects 5 and Profession Cone de:The Convectors License Law doat apply m an owner of 9 property who build;or improves thereon.and who does such work himself at through his ` own cmplaycrs,purvided that such improvements amnm intended oroRaced fersek.IL sNraA sa004 however,the building or improvement is sold within one rev of completion.the owner- SEP O ` builder will have the Wrden of proving that he did Out Wild or improve for purpose of sale).� ❑Lai owner JCCL property,nm exclusively contracting with:)TheeCon ntmoom i. BUILDING came La Ne project(Sec.o an Business and rywh000 Cade:)TheConnector'sdomed, n carve Law docs not apply je an owner of proper(who sed p or s improves Contra,and who contracts for such projects with a conlrecmrp)licensed pursuant to the Convanoh License Law. 0 l And exempt under Sec. ,B&P C for this moon caner Data WORKER'S COMPENSATION DECLARATION 1 hereby ante under penally of perjury one of the fallowing declarations: 0 I have and will maintain a Certificate of Consent to self-Insure for Wmkcr's Compen- sation,as provided for by Section 3700 of the Labor Code.for the performance of Nc work for which this permit is issued. , 0 I have and will maintain Worker's Compensation Insurance,o required by Section 3700 of be Labor Code,for the performance of the weak far which this Permit is issued. My Workur'a Co pens tion lns�ntt cavi end Policy numbcrart: //'',/ Cartier: Policy No.: 0 Q l vV� ' CE PICA73e OF E%EMPI'IOMFIGM WORKERS' I COMPENSATION IN URANCE (ThH section need nothecompleted if the permit ice for one hundred dollars($1 00) or less.) I ecrdfy Not in are performance of the work for which this Permit is issued.)shell not employ any Person in any manderve As to become subject to the Workers'Compensation Laws of California.Doc Applicant NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should become subject to the Workers Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or Nis permit shall W deemed revoked. Z y CONSTRUCTION LENDING AGENCY [-i I hereby affirm that Nerd is a construction lending agency for the performance of rli> the work fur which this permit is issued(Sec.3097,Cih,C.) W Q Lender's Name Lender's Address V C I conify Out 1 have read this application and sate Net the above Woodman is 4A N cmrecL I agree m comply with all city and county ordinances and mate laws relating td as pr upon the U buildingconstruction, ageetoand w,indeyauthand repr homlesste Nis city mcnano Agaist W above-mentioned property for iopecdon Purposes . ea v G (Wu)agree to save,indemnify and keep harmless the City of against s against y liebiliticquence fWecmaeng ofthisomit. may in any way accre agunstsvd City Acan`ANT of Nc RSTAN of Ibis pmmit.APP ANT UNDERSTANDS AND WILL COMPLY WITH ALL SON-POINT Issued by: SOU E GULATIONS. -,'--2 • 0- Re-roofs re of Applic.d9Commcm, Dam of Roof HAZARDOUS MATE IALS DISCLOSURE Type Will the applicant or future Wilding occupentstomor he charardmu nmilrmi o defnted by the Cupertino Municipal Code.Chapter 9.11,and dm H"IN and Safety C.d.Section 25532(.)? All roofs shall be inspected prior to any roofing material being installed. EYcs 14FNa Will the applicant or future building occupart use equipment or ddvimm whim If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? OYcs I have mad On harardausnaminalsmquimmcmis under Chapwr&95 of the Califor- nia Health&SafetyCude,Sections 25505,25533 and 25534.1 undersand Nalif the Wilding Jel cumcmly haves to Net it Nit is m y responsibility to natty the occupant of he rc mem I,which most bc prior In is.an neclifie�ateefaapP Signature of Applicant Date vyr �!' ��� All roof coverings to be Class"B" or better • CITY OF CUPERTINO 0 e 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp: Rng : Sub: Blk: Lot : APN 36226042 . 00 DATE ISSUED. . . . . . . : 06/18/2004 RECEIPT # . . . . . . . . . : 25980 REFERENCE ID # . . . : 04060166 SITE ADDRESS . . . . . : 7571 LOCKFORD CT SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : RONALD CLEMENT ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5047 RECEIVED FROM . . . . : SHOWCASE KITCHENS CONTRACTOR . . . . . . . : JOHN SWARTZ LIC # 23049 COMPANY . . . . . . . . . . : SHOWCASE KITCHENS INC ADDRESS . . . . . . . . . . : 12333 SARATOGA-SUNNYVALE RD CITY/STATE/ZIP . . . : SARATOGA, CA 95070 TELEPHONE . . . . . . . . : (408) 253-0412 *EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 340 . 00 102 . 00 0 . 00 102 . 00 0 . 00 BPBACKFLOW BREAKERS 1 . 00 9 . 99 0 . 00 9 . 99 0 . 00 BPERMFEE VALUATION 29, 975 . 00 340 . 00 0 . 00 340 . 00 0 . 00 BPFIXTURE UNITS 3 . 00 24 . 99 0 . 00 24 . 99 0 . 00 BPGAS OULETS 1 . 00 5 . 00 0 . 00 5 . 00 0 . 00 BPLANCHK PERMIT FEE 340 . 00 289 . 00 0 . 00 289 . 00 0 . 00 BPSEWER SEWER SYSTEM 1 . 00 19 . 98 0 . 00 19 . 98 0 . 00 BPWATER UNIT 1 . 00 8 . 33 0 . 00 8 . 33 0 . 00 BELEC200 METERS 1 . 00 27 . 25 0 . 00 27 . 25 0 . 00 BPWHEATER PER HEATER 1 . 00 9 . 99 0 . 00 9 . 99 0 . 00 PRERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 BREMAPPLI NO OFAPPLIANC 3 . 00 19 . 50 0 . 00 19 . 50 0 . 00 BREMINHOOD NO UNITS 1 . 00 9 . 50 0 . 00 9 . 50 0 . 00 BREMPOWER POWER UNITS 2 . 00 61 . 05 0 . 00 61 . 05 0 . 00 BREMVENFAN NO UNITS 1 . 00 42 . 02 0 . 00 42 . 02 0 . 00 BREMVENSYS NO UNITS 1 . 00 9 . 50 0 . 00 9 . 50 0 . 00 BSEISMICRE VALUATION 29, 975 . 00 3 . 00 0 . 00 3 . 00 0 . 00 EPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 MPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 ---------- ------- --- ----- ----- ---- ------ TOTAL PERMIT 1087 . 66 0 . 00 1087 . 66 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CK 1087 . 66 006852 AL RECEIPT 1087 . 66 OCITY OF CUPERTINO* CUPEI�F PERMIT APPLICATION FORM ' APN# 2 Date: z� o� 2— G Building Address- / Mailing Address (if different from building address): Owner's N Phone#: Contractor: License #: X7..5 3 Contac Phone: ,2 Z Cupertino Business License#: �-� O NT/ Z Fax: 1S> G Building Permit Info: Bldg Elect Plumb tR— Mech Job Description: oc Residential a o ercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: Occupancy Grou . / Type of Construction: Please check th's box if roject is a second-sto adds ion: ❑ Pro'ect Size: Standard Laze ❑ Major ❑ 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 1 of C) � 7 WITY OF CUPERTIN(* OCITO PERMIT APPLICATION FORM CUPEkTINO 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 BOVERTIME 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 rinklerBackflo 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 A/C Unit> 10,000 cfin MECHANICAL BREMAEUTAN A/C Units <= 10,000 cfin 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 2 of 3 WITY OF CUPERTINO CUPEIiITINO PERMIT APPLICATION FORM QuantityFee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch. ELECTRICAL BREMSIGNS Remodel Si s, Marquee ELECTRICAL BREMTHEATR Theatrical Lioj#ng 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 Inection 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 MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG i Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3of3 7 .3.4— � 9:1%2 • - I WQRE592R o WQRE592RT ' I � I 4VE362g I I I II BI2 EXSR3 i�za�s w l HE J $LS3fi Li I — (➢B2F epr, IrLD/Cj-S (� l N6-� - I vD "' waao3 z � cz 3 '." 3 $y I 8030 . It I I o ve $ wall, sOOV p n SL 0 0 v c� r• ffg@k000Atc.l;s �"T7 m C rm M w m m LAA Y ® m Z ■ F89-6e4 �2-=-12 µ2V;E12: 24i2 P.ANRY o h[DA MD ACOA �B9bI2 lN2 30 W243(i W-4 0 SHOWCASE KITCHENS 12333 Saratogo-Sunnyvale Rd., Saratoga CA 95070 Client: PON d ELAINE CLEMENT MFG: Crystal View: Plan (408) 253-0412 Phone: 408-873-8780 Door Style: Claremont fo-CPF Scale: Scale-to-fit NOTE: THIS IS A COMPUTER RENDERING ONLY" Design: CLEMENT-KITCHEN-ROM Pull: None Date: 6/18/04 IT IS NOT INTENDED TO BE AN EXACT DEPICTION. Designer: JOHN SWARTZ Builder: JOHN SWARTZ Page: 1 • C JUN 18 004 CITY OF ClERTINO 7 BUILDING D ARTMENT o 2 '1 fl �2 iv `7� b1�Q' yHhl -7 ��1S : eor - £ 1/ ' S5 RRAIVED JUN 18 2004 BUILD I JG D ARTM T OFF1 3M y • n -.---- _.- ---- - - ---_ REC . IVEP I. TY OF CUPERTINO ONE C4Y 5 oy 7, rl-/l-9-5- /Vo !$NO/ 11 ) 97 q Al ov->jss�n� i aooy 3 � • s I ;Z 17 CEIVED a OF - PERTiNO BUIL INM n - PAPTr�4FNT I • �� � L _ 0F ICE COPY r ,H , I � 43so 3Gf/�v waw Nott 'Yo nsai ala l 6011 ED JUN 13 21j�4 CITY OF CUPERTINO $UILDIN Z nr-PAPThAFNT i ICE C�Py .5ZV/V I IV 04 � I N JUN-9-2004. 01:54 FROM: TO+14OB2530411 P.1/2 enure Po. Wood Beam Calculator CtAs RUCTIONCALC _, amneXaRr ew'.% erar•nva aaltawb wn wawa rra.ryalu•r.a •. McMlgW mr4la'labw. 6a0eetYer1101t/a1a W/. MWfWOE�}I mrinll•NrR.R MRa - fanpi•d•s arl. oyrarMbedgaAdwroNar6 oda wrwaan lafA•IbrW Gera ipoMdaeb I1bsYCauaWen AR eon labeet.aoefaYeanary ew.tl4e Ma/iwfq LM debegneM.ne enY Rvbmonear•aK eaeaerwp•aee Mep.e•Ntr job winatiml Cteowd 6tiont LIX:l MOSCOW Other bda: For ablrretopai0 6e�y I(IfOtdliflm food and 9pM Dlapam pia7s 6edy SpM,L• &.50 It t00 Ma.Albom Um Odwf*',,L/ 36D -am �. Max AllwosdTold OdW$W%L I L-2R—.. •au. 200 toad w%Oon r.ra•MU --[] 9 1- too ii i0 Add3W VVt7 r•Y.--*—M .1m x A e e to Loads Cthw Than " 00, ljwt m awls? �L] dpwnn Uniform Lobos Owr Full Lan01h af Member ' IftAwy U maUm ROMM&Iha Ildt Owd tJYa, d fM et wm.it Lou,W Lomo0- Imo W , Red Load•(not ln&dn0 May 20 1 10.00 R 200.0 MO 200.0 IIA 15MO rbM Roof3rww(*HY) 10.00A - Flaw!Lvods . Floor 2 Loot . floor L daft . Wag Owd Loud . Othw'pof load and Nb Wdth I - ' AdAc ad'plr Urif.Um loade.�l7r+lph.cri AdddwW'pr"..Dead food•L_ 0 loud te160o011e 200.0 m7t 200.0 IWIt 160.0 Iblt TOW LXdr• Lagoa w•® ft feaot•n Cooftmd Trial lWlmn Lod Wr' 350.0 62 • n • r d%And Lamar(TWO" __� mbar Matedd Cavin ft-L" —�❑.� (la ! mbw fide IaOY•N•3 Ll Repe4lw 0 X 1d Member UM7 p)2%12 1 AXia 6x10 w � 9x6 1 trXtr —'rte 2,OPPoraflam t1SL Oldam Qmda iaV1 LTJ 1.mP%0.17f S "%0•t/�" Rtlnd"XF/I{" I 7"XaiM" 1N14X76 5.19trrtr V�IIIQ >trr a'a•1f1" L1�% /LLIV Truax Jd•tMacl�lanl JOWa (Aeylae Orly o 0E•dee OeedLanirrerdBaaP) t ! 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