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02040023 (3)I "FWOy FFC <UC sz �vZ,Cu CZK< as or' i'a j.' i�oc 1�2a pe . Z zz°O err ;D O U0_O UU U �a V Z CITYDING But PEIIBMII_�•A�.. DpEI:ONNo CONTRACTOR INFORAIAT N:~ i BUILDING ADDRESS: PERMIT NO. 1075 MILKY WY I 02040023 OWINER'S NAME: ZAMLICH JAMES G AND GWENDOLY APPLIC TION SVyB DATE f W04/2002 HONE: SANITARY N0. CONTROL N0. ARCHITECT/ENGINEER' { BUILDING PERMIT INFO If BLDG ELECT PLUMB MECH L-1 L2 C: -1 I.. LICENSED CONTRACT'OR'S DECLARATION _1 Job Description 1 1 hereby nllirm,hat 1 ore licensed under provisionx of Chapmr 9lcomrne,leing wilM1 Section7fKln)of Division lof the qusincss and Pmfessiooa Code. and mylinnx � FIREPLACE REPLACEMENT.. j full tQpryryo� and eRca. urpp xapfa: 'y -i uc.a 73" ' f - Commcmr 1 C'0p �-/� ` 9� Ov�ALED 7T"' AItCHITF.Ci'S DF.CIA ION 1 unJcrstand my plans shall M used es publemds MAY 0 2 2002 jLicensedPmlex.lanal DECLARATION OWNER-BUILDERreptform License Lair, county 1 hereby alrmn tem I am exempt from tha C,,ions follwhich ng mason. (semho constru t. she, and .e. denuna coag: Any ria o,ru county o ,r rc tarn a mm m construct. n tar. imprice, emu, a , De orensiignnyawment y ] BUILDING $3000 yniresme nnrrrann ro,sarn Dermi fsoicense gaodataemcm applicant .. - _ .- ._. _ ..... .. d pursuant a Contractors Ic"ha (honhenchrifxth Senhnn70W1 Division 3 BusinessLinnsclausims,mr9 3 �� B e� 4r. f6a Valuation ro,moygm of of the nap ion. Any vi code) or that to cum n nhn,crnm:,oe the basis for he alleged exemption. Any D g portly . r 7031.5 of Section nm s ny day appfinran rpt a py,mh,ubima me oprrram m. civil pyml,r l of opt mare in.. five hundred dooms ($!dy). 1014PN 44MI IDAT I ON Occupancy Type 1 CLmownerofdmpmpeny.mo,yc ployeeswih wageansheiramecomisms"n,,. t wwill do he work. and he someone is nm intended or offered far sale (See ]044, q-ioss, and Professions Code: The Comment's License Law does not appin m an 103 — UFER Required Inspections jowner of pmreny, Who builds an improves hereon, and who does such work himself 10 4 - REBAR ho �hh ply .p :don l: onrt adori 're re: I If. W h Wildg p n m within .ye or - 105 — ANCHOR BOLTS ..... -.. _ .` ... I' fiction.the hu1J11did[ m1 the 1d frgththat net or p4rof renes f I) r106 — SEWER & WATER 01, as owner ofth propcnn an; exclusively contractingwin,l used so I aboactimsh, - 202 = UNDERFLOORS PLUMBING mune, be poijec, (Sec 7044 Bus fess and Profession, Code) The Comment's License Law does not apply to an owner of proproy who Woldrmpm,es hereon, , 2 0 3 — UNDERFLOOR MECHANICAL ' and who contracts for such Projects With . contractors) unnxd.purauant to he 204 — 'UNDERFLOOR FRAME . Customer's Licensetaw. am . . fin uspn 0 daemon smacr SeeB & P C f rc 205 — UNDERFLOOR INSULATION Owner Data " 301 — ROUGH PLUMBING WORKER'S COMPENSATION DECLARATION i 302 — TUB & OR SHOWER Ihereby afrmrunder penalty ofperjury one othe following dnh,moons: 303 — ROUGH MECHANICAL ❑ I have and will maintain . Cenirc.m of Coastal to sylemsme hr Worker's 3 04_ ROUGH ELECTRICAL Compensation, as provided for by Section 3700 of ,he Labor Code, for the performance of the work for which this permit is issued. 305 FRAME k❑ 1 have and will maintain Worker's Compensation lrmummn , as nqui,ed by Section 306 — HOLDOWNS 1 37W of the Labor Code, for the performance of the work for which this permit is 307 — INSULATION k issued. My Worker's Cnmpcn.mtiva lnnumnec res cr .nd Policy number ore: Aw:ikFY.CI>4t µ jis!. Cyoi93T'nj 308 SHE] TROCK iryn .— , . CERTINCATIONOF M NFROM WORKERS': 309 - EXTERIOR LATH COMPENSATION INSURANCE _. .31.0...._..INTERIOR LATH.. (Tat f union Baa not be eo,,,Plenee if the p<rtmi n is for one tonere: dollars (51001 or leu.) 311 — SCRATCH COAT .313 — ROOF NAIL eafhe for Perron enfyhrinerson in an shall 11 as to becomeshs , employ ny pen y ginner ,o becomes Eject , rte Workers' tothe Woken 501 — FINAL ELECTRICAL ENERGY Applicant Law: of California Dan e - ... 502 —. FINAL PLUMBING ENERGY NOTIApplicant thExemption. ottee, you ould Ncame subject the NT:IL anmmnsationg Provisions icate li become sutjccunnhc Worker's Compensation prorisionx of the Lotter Code, you must st 503 — FINAL MECHANICAL ENERGY Ibahwihromplywihsucnpmvtionao,hisNord, shall bedeemed invoked, 504 — FINAL BUILDING ENERGY CONSTRUCTION LENDING AGENCY 505 - FINAL ELECTRICAL I hereby arum, than there is a construction lending agenry for the performance of he work for which this Permit isissued (Sec.3a97.Civ. C.) -' 506 — GAS TEST Lender's Name - -' •' LemeasAddress 507 — FINAL PLUMBING 508 - FINAL MECHANICAL I certify the, I ban mad this .ppheader mad.mle hnkie aabove information is coven. 1 agree to comply with all city and county ordinances and state laws relating 509 — FINAL GRADE toWilding construction, and hereby authorize represenwives of this ch, to enter, upon heaWve-mintmneapropertyforinspectionpraircats. 510 — FINAL PLANNING (We) agree rb.ave, indemnify and seep h tmolesa the City of Cupertino against liabilities, judgments, costs dad anpeaxs which may in any way game .gains, pie 514 — FINAL PUB I C WORKS l City in consequence of he graming of his permit i RCP HCAT7 'CDERSTANDS AND WILL COMPLY WITH ALL NON -PO NT AE}:I c 'IONS. y— y .o . I Issued by: Re -roofs 6 V Date g,gnturcorAirplicaaucooenew, e:.'... HAZARDOUS MATERIALS DISCLOSURE . Will he applicant or future Wilding occupant store or handle haimdWa material u defined by the Cupertino Municipal Code Chapter 913. and the Hahh am Safety Type of Roof ' f Code. Section 355321.1^ 6 ❑ Yet INo: ,.`.: - �', All roofs shall be inspected.prior to any roofing material being. installed. aorfmW alk,a Will cappBm um ndmgoccupant asennipmenror devices which nctus If a roof is installed' without first obtaining an inspection, I agree to remove haratd air contaminants as defined by the Bay Arca Air Quality Management ii, all new materials for inspection. Applicant understands and will corn ly.with oven all non -point source regulations. ' 1have read the hazardous mmcrial% mquiememn under Chapter 6.95 or the �r California Health & Safety Code, Sections 25505.25533 and 25534. 1 understand hal :f the Wilding does not cvtrcntly have a moon that it is my responsitility, to notify the --No. of he rtquirtmen,s which must be men prior to issuance of a Certificate of 0 c S4 -OL Signature of Applicant Date _ �wd6: All roof coverings to be Class "B" or better ora hpriva agyn, - .,e nOC sem tz 2 Jy-u eec�a O JLLry S�pC wal-'ff Z> CFS O_ z zz w o UO, OF.t U cwt UZI —CITY OF CUPCH2TIN0 �y� I rn7TTD �t!"rni? YXTTl n njii&A TTnl3.T` staff afar_ nnncrnv BUILDINGADDRESS: 1075 MILKY WY PERMRNO. 02040023 OWNER'S NAME: ZAMLICH JAMES G AND GWENDOLY iAPPLIC IONSUB DATE 104/04/2002 . PHONE: PHONE: I�SANT IARYNO. CONTROLNO. f GARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION 1 hereby aRrm that I em licenced under, provisions of Chapter 9lcommencing with Smi.n71g101of Division 3 oflhe Busiac,arol Professions Coderthd my license is lob Descri p tion FIREPLACE REPLACEMENT. in full reye d affect. t L .sac b—y Lm.. 73' S''- y - cJ '— Corer cmr i I ARCHITECT -5 DELLAQ TION 1I 1 understand my plana shall be used es publif rerom, i, Licenced Pmlerrimmi OWNER -BUILDER DECLARATION I hereby a10nn that 1 and exempt from The Contractor's License Law for the p following am. (s«tion 7031.5. Business and Proallions Cada: Any city or county which requites v permit to construct. ahcr, improve, demolish, or repair any annotate $3000 Peart T. a al. q 'be pplcanl forc-0, pe nn. m fileaslgnedamemem That he is I certed Thormuchto 'be p sof the ts License Law (Chapter (commencing with Section 7") Division 3 Business Valuation of or the and Proletarians Cade) or hat he is exempt thercroun and The brosis for the alleged exemption Any violation I ' of Sect on 7031.5 by any appl cam for v Permit subjects the applicant to a civil penalty or not more than five hundred dollars(a500)' 101`�PN Y'7Lh�}DATION Occupancy Type 131.-1awmar of.ha pmpcny. maty employees with wages as theirsole compensation. l _ PIERS willdothe walk. had the structure IS mol haludad m mfico d'for sole (See 7(ma, Business and Professions Code: The Conbaam! a License Law docs not apply to an I 103 - UFER Required Inspections owner of property Who Wilds or improves thereon, and who does such work himself or through his lava empmytts. provided that Inch improsImm s ate am intended or offered far rale.If, however, the building oI 'mapacIocanam is s Id without o(" : 104 - REBAR -. year complta thene-Wlmerxllhavethehm r ., proving as lot buaa or 105 .. - — ANCHOR BOLTS '.:. ..-. ... impry f p gorse fro`') 106 — SEWER & WATER 11 ].-as .. aaarPrIany. aut exclusively vantratzting wallha kd Erahn 202 — UNDERFLOOR" PLUMBING-... ..... ... . consumeri the Project (s c 7tosi Business and a ofd. sildM: Th cm Theyl-:Fs 's LicenseW tl t apply t erofp party who cop esn f 2 03 — . UNDERFLOOR MECHANICAL hemm and whocontractsnfor such p j ¢ with a conTtact t(s) Iicenud,p rsmm s. the an th' Contractors License Law. 204 —'UNDERFLOOR FRAME O lvo exempt under Stt. , B k P C for this revs.. 205 — UNDERFLOOR INSULATION Owner Ea" 301 — ROUGH PLUMBING WORKER'S COMPENSATION DECLARATION 302 — TUB & OR SHOWER ]hereby underpenalty. one rWho 303 - ROUGH MECHANICAL • Cyalicrue of xill Consent TO m1wimm. f ❑ i have end wise maintain a Cenmcae or Consent t. seUbe,re for work he Compensation, he provided for by S¢Tion 7]00 or the LaWr Code,, for the 3 04 — ROUGH ELECTRICAL pert.rmameeathe work for which this permhisirsne°' 305 - FRAME 01 have and will maintain Wicker's Compenuti.n Insurance, as required by Section 3 06 — HOLDOWNS 37M of he Labor Code. for the perfmmance of tha work far which this Permit it issued. My Worker's Compensation Insurance carr'cr and Policy numWrarc: 307 — INSULATION E>6y5yc i+oF� tdy m . Cw1y37'/1 �Camcr' 308 ." . SHEHTROCK — CERTIFICATION OF EM N FROM w"iKERs':' . COMPENSATION INSURANCE I 309 " - EXTERIOR LATH '(Ib s season aced nm W completed if the perms Is for one hundred dollars _... 31.0--- INTERIOR -LATH.. .._.._.. 311 — SCRATCH COAT ' I c n fy that is the perf.sm chae of Inc work for which NIS PcnrfT is issued. I - -- 313 — " ROOF " "NAIL shall not employ any person In any manner lo as to become subject to the Workers Compo roan Laws of California Dae 501 — FINAL ELECTRICAL ENERGY AOTCE' o 'NO77CET0 qYn after Making thatvisionofthcan, of 502 —. FINAL -PLUMBING ENERGY _ the WorkersCmpensti becamesubjectm the Worker's Compensation Permit alml the Labor Code, you must Laboronyou ,youmust 503 — FINAL MECHANICAL ENERGY r.nnwim comply With such provisions or This Permit shanWaeerneacarried, AGENCY 504 - FINAL BUILDING ENERGY. CONSTRUCTION LENDING 1 heraby, vrfom tha Nem is a mnswdi.n lending agency, for theIxrlormance 505 - FINAL ELECTRICAL Of work for which this permit is issued (So. 3097, Civ. C.) S 0 6 - GAS TEST tamer's Name' - 507 — FINAL PLUMBING-- Lenaeranaegss- � Icenirythalnavereaa]his appiiemi...admatemmthe oWceinfruoauonis 508 — FINAL MECHANICAL correct. 1 since m--PIY with all city and county ordinances and state laws mhung to building construction. and hereby aumbriie nepometnaiwa of this city to 509 — FINAL GRADE enter upon the above-mentioned propany for inspection purposes'. (We) agree m an, a, indemnify and keep liar nfini he City of Capone. against 510 — FINAL PLANNING liabilivaa, judgments, count and expenses which may in any way accrue against mid 514 — FINAL PUB IC WORKS City in consequence of the of this permit.. AP 'M)ERSTAN'DS AND x' ^ T / ILL COMPLY SI"ITH ALI.NON-POINT t ' RCEEGL . DNS. at _ y ,o .. Issued by: v Date Signature of ApphcanUC.mmcmr ' ....'. '.. ' ' ' . Re -roofs ,/ HA7ARDOUS MATERIALS DISCLOSURE - -' Nvill the apPiahart or future Wilding Occupant more or handle hastanclotax material m Thar dcficed by Colman Municipal Code, Chapter 9. 11 and The Health and Safety of Roof - Code,3cetion 25532(0?,.. rY� 1, \ No p wuIncomed - All roofs shall be inspected.prior to any roofing material being. installed. me.ppl a.nt. Wum.B. pantam equip.st d swhich emit harstraborts, air contaminants as defined by the Bay Area Air Quality Management If a roof is installed without first obtaining an inspection, I agree to remove °s'""' eP11all �Y new materials for inspection. Applicant understands and will comply with all non -point source regulations. 1have read the haureous materials requirements under Chapter fi 95 of the COlfomiv Health C safety Cade. Sections 25505.25533 atld 25530. I understand Na ifthe W ilding does am c.meITdy have a tenant that it is my re possibility no notify the Occupant epaid of The requirements which must W men prior to issuance of a Cenihn¢ of �- Y ta L Signature of Applicant Date All roof coverings to be Class "B" or better wnbrn umhon.ad ogent ale dh O 0 APR q)4 Z i; IN ACCORDANCE WITH THE CITY 06 CUPERTINn CGOES SND ORDINANCES b phis set cl pa n peg..cations MUSE hee kep"NED kep: on V) a ., I t!mcs and it is un awful to maP c ;cs or alterations 'n same v^rdh u a -3.m'.ssion from he hw.dxg I . p . i.'; ' Cj,rertmo. he stamping �! J s c n n I specifications ,HALL NO ee a ,' ,. ; = ra.t or to tre an oproval of, Nr. v i,xn •.i any provision -,v P...'� 0 car S"ate law SUBMITTAL #1 f3y_t�f_�` Q4_61 }9 rrrjz.0-. Cttirv-1 NC/ CITY of • CUPERTINO 1 0 . • CITY OF CUPERTINO PERMIT APPLICATION FORM 0204100 z2 APN # (,j jJ Fee Description Date: - D y - O 2 Building Address: /075- /11 iC KY u/ Owner's Name: Z Ai-? C. C. N, Tia -f E -S Phone #: 735 - ZoSo Contractor: v5/�%'CL TS E✓r' £'.eP,.eJ 5Lr'5 License #: �33,f� Contact: Phone#: z9z-i,3 L Applic Contractor: Fax #: q71- 07 5-7 Building Permit Info: Bldg Elect Plumb Mech Job Description: Residential: �EOzcj r' Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: Architect/Engineer: Valuation:�� Type of Construction: Occupancy Gro : 4 Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING 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 13Q 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 ENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of 3 CITY OF CUPEkTINO • CITY OF CUPERT O p PERMIT APPLICATION FORM . APN # (,� U Date: - O `/ _ OZ Building Address: /075 144 Y W Owner's Name: Z A rq L i G k, 7A- f t= S Phone #: 7 3y- ZOSv Contractor: E,vr f'�P.ef SL' S License #: -j%33 S y Contact: 15/ e -7,7 Phone#: z?z Applic Contractor: �jh�� -S Fax #: o7 5-7 Building Permit Info: Bldg Elect Plumb Mech Job Description: Residential: ICiQe-AlkIr �fP FJ T Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: Architect/Engineer: Valuation: , Type of Construction: BBOILER4 Occupancy Gro Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILER1 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 ENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee I BUILDING 1 of 3 7 J