99110041 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY VU
CITY OF CUPERTINO BUILDING-ELEC'I'RICAI, 1'IiRMII'NO.
BUILDING DIVISION APPLICATIONIPERMIT PLUMB IN
BUILDING PROJECT'IDENTIFICATION
BUILDING AODRHSS: Q II ,ate rk a SANITARY NO. UN SO B, AL DATI
36r Via �`J(J�l' rn
OW, R'SNA.MF,: / I'HO'i: pp CONTRACrOR'SNAMIi LIC NO:
2li �h QS
NIC
CONI'ROI.a
WRIFHf TECT/IENGINEER: LIC NOADDRISS: ❑
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CONTACr: PHONE: BUILDING PCRMIT'INFO
❑ Consultant Fees Paid by Applicant(Initial) BLDG ELEM PLUMB MP.CH
LICENSED CONTRACTOR'S DECLARATION QTY ELECTRIC PERMIT FEE
I hereby apirn Thal I an,licensed made,provisions of Creole,9(wntmendng JOB DESCRIPTION
CZ with ScIien]000)uf Divisiondofthe ltusinessmxd Professions Calaundmylicenmis RESIDENTIAL:
O
� ❑ C1�� in full l'nrca nnJ PERMIT ISSUANCE
clime'. SFDWL KITCHEN REMODEL
aVU License Claes Lica APPLIANCES-RESIDENTIAL []ADDITION ❑PLUMBING RE-PIPE
.<,LDam GuntNCmr
"� ARCHITECTS DECLARATION PANELS ❑MULTI-UNIT [ISTRUCTURAL
pN,Z. I understand my plane shall be used as public records MODIFICATION
41—aUP'10200 AMPS ❑INTERIOR ❑CHIMNEY REPAIR
1-•�.F.W Licensed Prnfeusional 201-101MAMPS IMPROVEMENT C)SWIMMING POOLS
OWNER-BUILDER DECLARATION
pC C C Q I hereby affirm that I am exempt Ram the Contractor.Liceme Law for the OVER IOtlf1AMPS [I BATH RCMfj�'.VHEPAIR (]DEMOLITION
x 6 V following reason.(SMi""1031.5.Busine,and Fadassin I,Code',Any shy of county SIGNS ELECTRICAL EI OTHER
41311.vFi which requires a Permit in construct,ager.improve,demolish,or repair any stmcwrc
prim eiiU issuance.alwrequimsthe a,limud far eochpenun to file ao,real Imanent SPECIAL CIRCUFUMISC.
} 'hat he is licensed Funaare m'be provisions of the Comrachav License law(Chapter 9
41,C0 (<""""Oneing wire Sectinn]1kMb of Division]ofthe Rosiness and Professiam CWe)nr TEMP.METER OR POLE INST. COMMERCIAL:
ZZ FL ey that he is exempt therefrom and[he basis for the alleged exemption.Any violation of ❑NIiW BLDG/ADDITION ❑DEMOLITION
W"N Section7031.5byany applicant for a permit subjects the applicant'oacivil penalty 0f POWER DF,VICES TENAM' 01`0013 SERVICE
t an m'ban Eve hundred dollars(8501). IMYROVIiMENT
FZQ ❑ 1,as owner of the progeny,or my employees with wages as theirsole coopcma'ion, SWIMMING POOL ELECTRIC
,t will Jo the work,and the structure is not Intended or uttered l'or sale(See.J044.Business 1'HF.R
L 3 m and Professions Code:The Comeacmrs License Law does not apply an an weer of OUTLETS-SWI'PCHIS-FIXTURES
properly who builds or i1111r0ves Ihcaon,and who docs such work annself or through
his own employees,provided that such Impmvonetns am not intended or offered for NEW RF'_SIDEN'rIAL ELECT R SQ IT.
sale.11.however.the building mimpmvemem is sold within one year ofcomple'ion.the sQil?R FLtpRARBN LSQ m'.
owner-buBder will have the burden of proving'hrl he did not build or Improve fur
pct of,do). TOTAL
1.as owner of the property,am exclusively exams flag with Licensed e,oraams to
resect the project(See.1614.Business and Professions CWe:)The -marantions Li-law does aapply to 11 of pr"pcny wino hair, pro
o,imve'hame,and QTY. PLUMBING PERMIT FEE NOV - 81999
whom ow ho contracts for such projects with a commmagn)licensed purwannn the Concrete,'s
License Law. PERMIT ISSUANCE
❑lam es(et�(� der Sec. ,B&PC for this feaws
ygry a ALTIiR-DRAIN&VIiNf-WATER(EA) VAIAaaL��ATIn
W'O NlSC DECLARATION �� t 4 BACKFLOW PROTECT DEVICE
I hereby o iro under penalty of perjury one of the following declnox ons:
I have and will maintain aCedificuteof Conserv to self-insum for Worker's Cor,en- DRAINS-FLOOR,R(UF AREA,COND. STORIES 'TYPE CONSTRUCTION
radon,as provided for by Section 37 0()of the Labor Code.far the perfamnwmc of he
work far which this perm is issued. FIXTURES-PER TRAP
n,I have and will maintain Workers Compensation Insurance,as required by Section
3]0()of the Ldor Cade.for the Performance ofthe work for which this Permit is issued. GAS-CA.SYS'1EM-I INC.4 OUTLETS OCC.GROUP MIN
My Worker's Cmnpcanard I Ineutuncc currier and Policy number ora: 5
Caer: S
Policy No.: GAS-EA.SYT3`F's' J r pk
EM-OVER 4(EA) ``Q
rti -["]�A
CIiRTIFICAI'E OF li%17 IL ION FROM WORKERS' GREA51%INDUS'1'RL WASI'L INHiRCE1ROR
COMPENSATION INSURANCE BUILDING DIVISION hl?itis
(Tha-en raced not M:c"repleted ifthepean,,is forma(hundreddollaa lS 1001 GREASE'TRAP
or les.) PLANCHECK FEE
I cenify that in the performance of'he work for which this permit is issued,I shall SEWER-SANITARY-STORM EA.2W FIT
not employ any person in any manner so as m beeonne subject to the Workers'Connpen- ENERGY PCE
,Z nation Laws of C.Ifmia.Dam NATER BEATER W/VENTIELECTR
ZA Applicant GRADING LEE
(41 NOTICE TO APPLICANT':If,after making this Certificate of Exemption,you should WATER SYSTLM/I'REATING SOILS FEE
Lesion xahj,cuo the Worker's Compensa i I pownion,of the Labor Code,you matt
ILl forthwith comply with such provisions or this pemni'shall be Jearma revoked. WATER SERVICE
Q
= z CONS I is a c[ON LENDING AGENCY NEW RESIDENTIAL PLMIf. SQ,17K PAID Date Receipt
U p Iherehy affirm that there is acnnstmmion lending agency fears performance of
P
'he wok for which this gamem'm iswcd(Sol,3(y)],Civ.C.)
Lender's Name TOTAL:
IcnJcr's Address TOTAL: BUILDING FEE
6. I cenify that 1 have mad,hi,application and Nam that the above nomination Is
F rA enamel.l agme m comply with all city and county ordinances and s';ne laws mating to QTY. MECHANICAL PERMIT FEE
U7. building constmetiun,and hereby authentic,expssammives of this city to enter upon the SEISMIC FEE
above.wntlaned pngFry lir ae,,wolna pu,pascs. PERMIT ISSUANCE
(We)agree to save,indemnify and keep mundess the City of Cupertino against ELECTRIC FEE
Ilahil i'ir,adgmcnts,cents and expenses which may i many way accrue against said City AUITR OR ADD TO MECH.
PLUMBING FEE
in consequence of the UNDERSTANDS
Sthis permit.
APPLICANT ULATIO TANGS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO IO.OIIB CFM) MECHANICAL ItiB
SOU d11AT10NS.
I1 AIR HANDLING UNIT(O\'ER IO.000 CFM) CONSTRUCTION TAX
Signature plicae A7md cov D e EXHAUSTHODDOOMUCD HOUSING MITIGATION FEE
IIAL\RDOUS MAT HR ALS DIS0IASURE
Will the applicant or future building occupant store or handle Initiation material HEATING UNI1'LTO 10101p R'1'U)
as dv5r,d by the Cupertino Municipal Coal ,Chapter 9.12,moth.Health and Safety
Cala Section 25532(.)'1 HEAHNG UNIT(OVER 100,000 B'TU)
❑Yes 0 N PAID
VENTILATION PAN(SINGLE RABID) PAID
Rcccip'a
Will the applicant or future building occupant use equipment or device which BUFFER OHP OR HP.BM BTU)
nit harardoes air commodities as defined by the Bay Arca Air Quality Management 'I OTAI, '
District? BOILER-COMP(OVER Uhk000 BTU)
❑Yes [-I No
I have rend the noreduus naiwrial,requirements under Chu to 6.95 of the Coli AIR CONDITIONER ISSUANCE DATE
qui, p
bonnier Hcahb u Safety Coda,amnions 8505.25533 and 255Y1.1 understand (a if the NEW RESIDENTIAL MECH. SQ.FT.
of the a docs nut am,endy lanart noant,that n ie my ce'If sibility ut notify the occupant
of the requimmem which mus'be ren Prior m issuance n[t CaniOc.m of(kcapmcy.
Ow.,m.mumIcd.,car Dam I'OTAI': ISSUED BY:
OFFICE
' Covered Porch Plan
23616 Oak Valley Road, Cupertino
Rain/runoff drainage
unchanged/unaffected
-- — Tiled area(sleigh), over
91 ? — — _ concrete slab, 5"think.
— — 8"high step
zzz
41
. ....................... 4x 12 beams, 9' elevation,
................._..............................._................................. r supporting roof
Dorian Columns,9' elevation
surrounding 4x4 beam
i+
New/extended Concrete porch
same elevation as original
1 Old/original concrete porch
l
Notes:
1)The covered porch roof extends the existent house roof,with same design/shape
2)Dorian columns around 4x4"supporting beam at each corner
11/7/99 I
• ��2" GD`�C q�U1{� �
Extended roof is of same
structure and shape origutal
house roof
Framework/truss supporting roof
beams
2x6" frame supporting roof,
same structure as original roof.
of Same eave and gutter as house
4x12"beams,9' elevation,
9' supporting roof
Dorian columns with 4x4"beam
Concrete base
24" 8"high step
. 17, Tiled area,pitch @ 1/8"per ft
Notes:
I)The roof frame construction is same as original house
2)The roof cover is same color and texture as original house
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11/7/99 2
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