02080067 (2) CITY OFCUPERTINO ':' fah ,,. +.,le: a. .arz ..
BUILDING DIVISION PERM* :CONTRACTOR INFORMA'�N:,.
g�D'T6NG DOWN RD XOTEK INC � IT 02
B,t3gg74080067
'M MF4•IALKER 3300 E CASTRO VALLEY BLVD. APPLIIFglN ffJ3002
PHONE: SANITARY NO. CONTROL NO.
(510,) 538-1987
c o ARcxrrEcnPsicINEER: f BUILDING PERMIT INTO
BLDG ELECT PLUMB MECH
0 O y Z
LICENSED CONTRACTOR'S DE ion of CION Job-UAL PANE)
Ozy 1herebyahvmiv1amIkenseduodctpitPreeofChapter 9(cmmlucens{ REPLACE WINDOWS lD scrip
Pt's with Sectio. ud.fDivision Jof Ne Bueine)s and Professions Code,and my license
is in full fgfm/and ellen. yL
G.e�.4 Liceme C4M Llf e
3a Contracto''rr�
O Tri ARCHI7'ECI'S OEC"yssgAT10N \ \
t t S I understand my plans 0.11 be wed to puDbNNc mconds
�Ny
aLicawProkenonal
p0 o ed
R aOWNER-BUILDER DECLARATION
0, I hereby etfirm that 1 oto exempt form the Cmmmurr's License lax for the
L:Z< following mason.(Section 70313,Boameas and Profusion,Code:My city ea countyOO
re
O which quite ro
•permit to wtrocL cher,improve,demolish,or repair any srmcsure
�j3$ —pneatoiuksuune,elan mquim tk appiiunt for such permino fikesignnd summers. - -- .... ._ _ __.._.._.___ _
tMt h6 Blimis(ed ponuinne ds�piovisians of the CanwctoB License Law(Che mr9 r •-, da� BiletiQra;•. 1 'r Valuation
(commencinse
gwithd..,700q)ofDivisionJof Ne Busmonand Pmrwiow Cade)
or dui he is exempt therelmm dud to basis for Ne alleged ekemptiud.My violation
ofnottamthane hundr�edid�o1.($500).nit'uDlm++dmapplicantwacivilpevlry 101APNMI1ZOATION Occupancy Type
❑I.u owner of Ne property,tar my employee with boa{e es their sole compematinn. . 102 — PIERS
will do the"A.and the structure Is not intended or offered for We(See:7044,
B ],O3 — UFER
mimi.anit Profesioe TM Convector's TConvector's License Law does out apply to an Required Inspections
owner of property Wha builds or improves thereon,and who does such work himself 104 - REBAR
11
Nrovgh his awn employee.provided Nat such improvements tae not intended or
.6= employee.
IL however,the wilding or impre emam is sold within'one year of 105 — ANCHOR BOLTS
completion,that owner-wilder will have the when of proving Nes M did not wild or
improwmrpurpomarek.). 106 - SEWER & WATER i
a. a"rhe" " _. _. _-.._ .__ _. ..-. . io 202 - "UNDERFLOOR PLUMBING -
_ property,am eclusively convecting with Bttwed coauecmn b
' co t da.porjem(sec.7M4,Bsalnes and Profesioe Coda:)The Contractor's 203 — UNDERFLOOR MECHANICAL
;p License law dar not apply to an owner of property who wilds or improve Nemo.,
.and who mmrmis for
such p jece.wiN.a .n=w,(.)licomed.pursunnt to Ne 204 _ UNDERFLOOR- FRAME -
_
o ,B&PClmdhisquon 205 - UNDERFLOORw:INSUliATION
oiaQeyf' D:m ,.�� 301 - ROUGH PLUMBING
/V R'scOMP ON DECLARATION 302 - TUB & OR SHOWER
I hereby arum ander penalty of perjury oite of the following dedamdons: 3 0 3 - ROUGH MECHANICAL
❑ 1 have and will maintain a CenlBcata of Consent so sell-insum tar worker's 304 - ROUGH ELECTRICAL
Compensation, a provided for by Section 37M of Ne Laver Cade, for Ne
perf..e of the work far which Nu permit is issued. 305 - FRAME
❑1 have and will maintain Woher'e Compensation Insurance,u requited by Sation 306 — HOLDOWNS
3700 of the Labor Code,for the performance of the weak for which this permit is 307 — INSULATION
issued.My workers Compensation Insurance terrier W m
Policy number e :
308 - ' SHEETROCK'
.cdaTIM ATIONOF 6tAF MOMWORMRS'_
coMPFddsnnoNwSL3RANCE. , - -310-:-„-I-NTERIOR--LATH
._. ... .__... ....__. _.-._ ._..
' (Thia'eectios'need not In,completed if the permit is for one hundred dollars 311 '— 'SCRATCH COAT
(5100)or kss.)
313 ROOF-.NAIL -..
.I tenplo rain the of the work forJoua this to
iasoea,i 501 - FINAL ELECTRICAL'�ENERGY
A. tin oy wsy n any manner so m bac me subject to Ne Worked' —
Com n do of mie:Dae �'l:•u£ 502 FINAL PLUMBING ENERGY
N c .efk,makm'NisCanlrosofExemption,you should 503 - FINAL MECHANICAL 'ENERGY
o pbecome subjm w the Workeh Compensation provisions of the Low,Code,you must
form wit comply wiNaucbprovialaworthis permit%hall cdramedrevoked, 504 - FINAL BUILDING ENERGY
CONSTRUCTIONdormisLENDMG AGENCY SOS — FINAL ELECTRICAL ” -
1 hereby whom this Nem is a Issued(Sco.017-C agency for the peiformonu
of the work for which his permit is Issued(sec.3097.Civ.CJ `
506 GAS TEST
y.0 Lender',Name.. .... . .. . . . .._.. . . .. . -:.. 507' = FINAL PLUMBING .. .. .. .... . . _ _. ...
�Z Irnder's Mdrtss ,'•'
V .,� I codify Nal I have read Nis application and state Nat Ne above information is 5 0 8 FINAL MECHANICAL : '
E„t correct.I since to comply with ell city and county ordinances and mete laws relating 5 — I NAL GRADE
f, to wilding connotation,and hereby audmdm rePonam rivew of this city to enter upon
(�
the above-mentioned propcmy for iwpecoo_n pugwses. 5 O — INA P NG
Qa' (We)agreerossve.indemnify am!keep hmmlemthe CiryofCupertinoagainst 51 - INA B RKS
y liabilities,judgments,cans and espenus which may in any way accrue against said
V'^ City in consequence of the gaming of this pnmit.
APPLI III 'E ,4YD5'A.ND WILL COMPLY WITH ALL NON-POINT
a c s.-- 8.'ag:o z Issued by t Date
nnu pplkanULonvanor D Re-roofs
HAZARDOUS MATERIALS DISCLOSURE !7
Will Ne'epplicam or fume wildu,occupom stom or handle harIDtlow m.u,ied ..._
as coined by Ne Cupertino7'e,
ode,Chapter 9,12,and Ne Health and Safety Type of
Code.Scout, 253J2P17, : , ...., r 1 r,• ' 1°.8` !`fR
ave' All roo s shall be.inspected prior to any.roofing material being installed.
Will the applic to orng«rupw�t we equipment ar acw;cr4 wmrh If a roof is installed without first obtaining an inspection;I agree to remove
emit harardous air conmminanB n fined by the Bay Arca Air Quality Management
Diauin7 all new materials for inspection.,,Applicant.understands and will comply.with
aYe Na all non-point source regulations.,
- I have read the haendous mmerialsrequircme u.under Chapter 6.95 of the
California Health k Safety Code,Sections 25505,25333 and 25534.1 understood that
if Ne wddingdoe not cumendy have a teem,that it is my responsibility to notify the '
occupant of the requirements which muse be met prior to I....of a C,mi,ua of
Occupancy.
_ _ Signature of Applicant Date
.: Ow auN Dore L All roof coverings to be Class,"B"or better
..... OFFICE .. .. - . ... .
Q- PITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEI�TINO
APN# Date:
492, yv , 0%6
9•�302
Building Address:
22963 Lanal,640% 90. 1 Ix 50;y
Owner's Name: Phone#:
yo4. 25 5. `I 61 C
Contractor: License#:
XO k \, 70066y
Contact: Phone#:
Qa\^cr Q�r cr goo 00. 330`1
Applicant/Contractor: Fax#:
Acz*k � l.lg Vc r 5%0, 133 - 0.03'-7
Building Permit Info:
Bldg Elect Plumb Mech
Job Description:
Residential: Q 4�; Commercial:
Sq.Ft. Floor Area: $/Sq.Ft.:
1136
Architect/Engineer: Valuation:
Type of Construction: Occupancy G u .
uanti Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX hid/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
13ELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Enerev BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BNEWMULTI New Multi-family Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUWING
lof3
iib . 0
._ _ 22°163 �oLown �oa2 —t 77
SUBMITTAL IMA4GOMAIN` GvW"ft4EtGITY(OF,.
SUB
.. V6 ORDINANCES.
Min;e09 1 'luor and specifications MUST
Nxi 14of t on'.. ,'job at-all Unm and it is-un -
_ . .. . . Va !tu4 3o makaany chango 4r alterations ,-• _
can soma without written permission ftom
;yio building Dept:-, City of-Cupertin0i _--
-- - - - — - - -- - •--- ---- The stamping of-thisplan and s ecificaticH
^ _ SHALL NOT be held to permit of to ba an —`
pP vof the ance.on'of, any P.ro
Ill Jn ._ra. env.Gity Qrdinance ot_S4E9 LM
- - 5\eePr
7
OFF CE 01
I 34"cLFa,R
20" CLEAR N
MINIMUM
OPENAFILE
AREA 41" CLEAR
OPENABLE=' .
• 5.7 SQ. FT. AREA 24
MINIMUM CLEAR
5.7 SO. FT. MINIMUM j
MINIMUM
MINIMUM SIZE MINIMUM SEZE WINDOW
WWDOVVFOR FOR 24"CLEAR HEIGHT I
20"CLEAR WIDTH
I
SILL HEIGHTI I
44" MAGBM� TTAL
R1JOR
MINIMUM SIZED RESCUE OR ESCAPE
• WINDOWS FROM SLEEPING ROOMS
Sec. 1204
CITYof c DIIVISSIIONN�
BUILDING CONTRACTOR INFORMATION:
RMIT NO.
B�R}2D�N Y LONG DOWN RD XOTEK INC PE0208000y67
Ask rin"WALKER 3300 E CASTRO VALLEY BLVD. APPLICFgN/13/002
IfPHONE: (510) 538-1987 SANITARRYNO. CONTROL NO.
8D ARCHITECTMNGWEER: a BU LDING PERMIT INFO
BLDG ELECT PLUMB MECH
Z 6 L = I-__U r... fJ
I- LICENSED CONTRACTOR'S DECLARATION
o m 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing IO DOSCCI tl ❑
°„ with Section 70(1 of Division 3oftheBusinesanaPmfessionsCoca,onamyhrense REPLACE WINDOWS (DUALpP�1NE)
-ase isiense)fprcyenJ erten. - NALE13
K 6 License Qa74 LIE.M I�B E M �a
OContractor
3 D In ARCHITECT'S DECfx ATION
et
S I understand my plans shall he used as pts c records FEB 1 8 2003
yo o Licensed Professional -
x o K OWNER-BUILDER DECLARATION p�
til 1 hereby affirm
f irm that 1 am exempt from the Contractor's License Law for the BUILDING C Z following reason.(Section 7031.5,Business and Professions ConAn
Costa: y city or county $7000
I O which raquirtx a permit to construct,thin,improve,demolish,or repair any strunurc
Oor to its uuani also req rtes the applicant for such person to rile a signed statmem - rw.
that he Rlmseled pursuanto the piovrions of the Contractor&License Law b7thapter9 i,,. 34$.nµs/('� Qrkg3yea l r 1 Valuation
(o ting with Se,,1m7(XMof Dinar 3 tittle Busmcssnna professions Cruel �,su xl�Nt _, &..`,Rl j.ys' i.ta' t. .F l..A 3.u,.,.l
or that hen exempt thcrt6om end the basis for the alleged exemption.Any violation
of Section 703P.5 by any applicant for a permit subjects the applicant to a civil penalty
Drum mon thom Co.hundred dollar(s($50, 1 O 1 APN)rbU3MAT I ON
Occupancy Type
❑1,as Dant,of the loo,my,o my employees with wages as their sole rimimm&mma, 102 - PIERS
- urdo_the'work: ad he swaurc Is nnnmended or nvena'farsile(Ser.-70W. 103 - UFER Required Inspections
•`J'
Business and Professions Cade The Contractor's License low does not apply to an "
owner of property Who builds or improves thereon,and who does such work himself 10 4 - REBAR
othrough his own employees. thailded_that such improvementstissolwi not intone dedyear or
'corenami&m< Irho theWavethe men of
lin etndnotWildor -_.. -_ - ANCHOR BOLTS
&prove for
tin owner s Iter will have the bud of Dmv g thin h did not build or
completion.me
paryon of sole.). 106 - SEWER & WATER 1
l ' c tig w 202 -UNDERFLOOR--PLUMBTNG--
1 e o� f hempeny.amexcaly nt
const tBusiness
--
the p deet(Sec lona, tad Pnf<sslons code 7 due Commcto's 2 0 3 - UNDERFLOOR MECHANICAL-
License
law does not apply to an owner of property who Wilds or improves thenen,
road who contracts ra such prod
n.wimaeontractor(,)Ettaxed.potsaon,.t m . .- -.- --204 - UNDERFLOOR-FRAME _ _ .----
f C , est Lmense t
❑I m< tam sea 11&PC far do, son
205 - UNDERFLOOR'"'INSUliATION
o Date � 4+g.1; 3 01 - ROUGH PLUMBING
R'S COMPENSMt10N DECLARATION 302 - TUB & OR SHOWER
I hereby affirm Under penalty of perjury one of lo following declursomm: 303 ROUGH MECHANICAL
❑ I have and will notation's Certificate of Comsent'm self-instill for Workers 304 ROUGH ELECTRICAL
Compensation, as provided for by Section 3700 of the Labor Code, for the 3 05 - FRAME
performance of the'work for which this permit is issued,
111 luveandwill maintain Worker's Compensation Insurance.ax iegaitM by Section 306 - HOEDOWNS
37W of the Labor Code,for the parromiamte of the work fon which this pursuits 307 - INSULATION
-' issued MyW rk es Cminfiercuitivin Insula ce came,and Policy umber arc --
308. SHEETROCK"-
CERTIFICATION OF •Pra101RTd6 FROM WORN K�RS'1 - - _ '1 ' M .30'9.' f- .:EXTERIORi.LATH"(_:
_ COMpENSATIONINSURANCE -INTERIOR-LATH -- '- - - --'-'- -----
'1 (Tbn seciliin need ret W ai nplend if the permit is for one hundred dollars 3 11 '- Y.Ci CRATCH COAT F x
stool 1e.,1 . _.3.13...- ROOF._NAIL-. ,..
1 can fy that t the pe urn race f tit k for whish tit' pc
,Coni tall,o.. wofNf)rmWD nn rs� i;be t mew-,ken 501 - FINAL PLUMBING ENERGY thatI t to n
NOT
wire&men 502 FINAL PLUMBING .ENERGY
P.y/i yA provisions g p Certificate P ate .. - .. - .-_ ... ._ . . ....
/Ry`� ttM�Ime rmakin nrrE mm.yooshouldumust 503 - FINAL MECHANICAL"ENERGY '- •' "
bcc h comp m the such pr Compensation Provisions of the Labor Cook,you roue
O C
forthwith comply onsorthn ret nmlxa deemed 504 - FINAL BUILDING ENERGY
-----
�1 -
CONSTRUCTION emisaconstruction
LENDINGAGF.NCY ' SOS - FINAL ELECTRICAL
' 1 hereby affirm that Vert tx- con, rat n leading v.C. for the perfmmmtt s- - rl•
a o{tn Niume - ' Permit issued 3097 Civ.ed 506 - GAS TEST
Lrnder sN e. . _.,.,.. c -507-
.. ..
a q . _ .. ._.. 507 ..-_•.FINAL'-PLUMBING
Z ten&npdmaa 5089,-11,'. FINAL MECHANICAL
- J v.s.f. 1 certify tom I have mail this application and sure that the above information is 5 - INAL GRADE
ka-F rarren.bagr<e tmmnp1y,with all city and county oNimaws mces and stare lrelating
O'V mbuildingconstcctmin.and hereby ammonia iepresentmivesofthisthyroenterupon 5 0 - "INA P NG
'.-raj .the abo a me tioned p perry far inspection proposes.,
(..rL (W) gneeruV a ndematfyandk phi mlessthe City olCupmsooagunst 51 - INAL B RKS
h
liabilities,dudgmems cous azul,es,rue,which may in any way accrue egaimt said /
f, City in cirmeNtonct,of thgr rat f tit t
/
'APPLI INTUNDEPSIANDSANDWILLCOMPLYWITHALLNON-POINT'' {� ,
OUP E REOU ONs: 6 D Issued by; Date
at PPI can ontisctor DRe-roofs
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or fiature pudding occo,con,states handle hat o nammil Type Of ROOF
.a d fuiW by Cis n Mutt oil Chapter 9 13 d the Health d Safety _ s
Coda Sttu
on 553 - y,i s sl-3i
❑Ye. - N tT- 1'.S .,.f l
f a
All roofs shall be ins
petted pnor.to any roofing material berg installed__ ... m .
Will theeppl to tarcbd ,a, .cup t serq 'p ,a,deuce which If a roof Is installed without first obtaining an inspection,I'a ree'to''remove
emit heard us sir collum nano es fined by the Bay Arca Air Quality Management
Distinct? r _. P ..g -Applicant
d will comply,with
„ ,ore - -,, No -. a new materials or inspection. A lean[understan s an
all 66n-point source re ulatlons,�
'I hoed read the hazardous med'aals rcquircmenu under Chaise r 6.9510!the `
Cilifomia Health'&Safety.Code,Sections 25505,25533 and 25534.1 understand that
lifthe larldingaoes not currently have d nnsnLthat itis myyresponsibility tanotify the -
'o2cupem of the requirements which must be me,prior to issuance oft Certificate of
°`ap°°ey Signature of Applicant Date
o urn otk�L All roof coverings to be Class-"B"or better
. :. . .. -OFFICE... .. . . .. __. .. ....- .. . _ . ........ ..._