02060081 (3) CITY OF CUPERTINOBUILDING nlvtstoN PER i CONTRACTORaINFORIC4 ON
tY .�
BUILDING ADDRESS:. - - -
81'41_ PARK VILLA CL __ PERMITNO.
:. OWNER'S NAME: ..- 02060081
KAZUKO HAYAMA APPLICATION SUB DATE
06/13/2002
SANITARY NO. CONTROL NO.
DO ARCHITECTIENGINEER:
KKK BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
8 'I 2 LICENSED CONTRACTOR'S DECLARATION
C� II
z= I hcrcby aRirm Nat 1 am licensed under provisions of Chapter 9(commencing Job Description
,_C rid,Srnlon7000)of Division 3 of he Business and Professions Code,and my license KITCHEN REMODEL
I
Lien lull forte end en. u E
o i License Class Linc.# s r�
3 3 a Dem Contra wnor
u.04 Iunderstand myPins shalARCH�usedaspublic records DEC 13 2002
i-
i es o O LmrnssdProfasonal
OWNER-BUILDER mmd,e RATION
er",., BUILDING
I hereby affirm OW I am exempt from,he G.nwn.f x License Law for rhe
?o following reason,(Senion 7031.5,Business and Professions Code:Any city or county
€ r which requires a permit,o cons 11,alma improve,demolish,or rcpau any structure $63000
Ell: •prior,.itsissu.nce,also requ'ves the applicant for inch Permit file.signedsmmmcnr
rha(he is licen¢d pursuant to the pi.visions Of the Cnnrrenol.Licnnse Law(Chapter 9. -
(c shot in'y with Senion]000)of Division 3 of the Assine.Old Prof mons Code) rs3§$•_ �O.Y67.-U.lf b� : t ValUatlOn
q ..... ..
a Ne,he is Is, In d,el<fmm and d,e basis for the alleged esemphon,Any violation
of Section]031.5 by any applicant for a permit subject,the applium ro a civil penalty
;.(not more,hen five hundred dollars I35o0).
10 IAP� ljDATION Occupancy Type
❑I,as owner"Ne progeny,m my employers wish wages u theirrole compenution,
will do the work,end the swctum is not intended or Offered forsole 109
Business end Pmtssiom Code:The Conwcroh License Lw does S
rotapply to 103
owns of property Who builds or impr°ves,hcreon,end who d«,such work himself - UFER Required Inspections
or through his own employees,provided that such
Offered for tile.It himprovements are not intended or 104 — REBAR
owever.the Wilding or improvement is sold within one yea,of _
completion.the owner-builder will have he burden of proving that he did no,build or 105 — ANCHOR BOLTS
improv.for papou.f sale). 106 — SEWER & WATER
❑I,es owner of she property am exclusively comractmg wi,hli«nsed convenors,o 202 UNDERFLOOR PLUMBING
conswn,he project(Su.]p44,Buxinees and Professions Code:)The Conuaaor's '
"arts'LewdoesnOl.Pplyt..a.wmr,.rpt.,tm whcWim,I"Ionto rcZ 203 — UNDERFLOOR MECHANICAL
and,who,c°mins.for such.p l"sk with
a mmmnor(U'I" pursuant.,.Ne
O f am asc tl7m I,Se•. 204 — UNDERFLOOR• FRAME .
Of am
eaemp,under Sec: ,B&PCfor Wit reason 205 — UNDERFLOOR INSULATION
owner RI Este 301 — ROUGH PLUMBING
' WORKER'S COMPENSATION DECLARATION
Ihereby nrrmunder Penalty°fperjnryare of aIci°wingd«lora,icen: 302 — TUB & OR SHOWER
O 1 have ane will mainuin a Certificate of Consent to sslGin 303 — ROUGH MECHANICAL
ompema,ion, as provided for by Section 3]00 of the Isom Code. for do, 304 - ROUGH ELECTRICAL
performance.f d,e work fa which this permit i,issued, 305 - FRAME
O 1 have mC will maintain Work.,,Compensation lo,amdce,.required by Section 306 - HOLDOWNS
- 3700 of the Labor Code,for the Performance of the work for which,his permit i,
issued.My Worker's Compensation Insurance carrier and Policy number am: 307 - INSULATION
Carticu..r _,.. ... .
• r•)
CERTIFICATION OF Policy N.: 30$ 1 - SHEETROCK
P ATIONT S FROM WORKERS •3 0 9 '— 'EXTEARI OR -LATH
•` •' COMPENSATION INSURANCE
. -
"(Thliseetion need no,be completed if she permit is for one hundred don,rs _- .. 31.0..x`--.INTERIOR•..LATH.._ ..._... ___. ...._.__..._
n"''> 311 — SCRATCH -COAT
•- 1 certify that in she pe,farmance.f the work for wNch this permit i,issued,I - __ROOF--NAI-L-"
shelf not employ enY'person In any maanenIo a�s�o'becOW a sub'at so the Wake,:• 31'3 -' ..- ........ ....._........ .
CompematiO IswkofCaliromi Dam;_(�r�.s] L 1 501 — FINAL ELECTRApplICAL ENERGY
. NOTICE •�L—_v —. 502 FINAL PLUMBING ENERGY
NOTICE TOAPPLICANT.It WameW gd,a Certificate of Exemption.you should
zOZ becomembjecnothe WorkeesComMusahoaprovisions°f,h,ke,coCodgYou most 503 — FINAL MECHANICAL ENERGY
Q forthwith comply with such provisions or this permit shell.deemed revoked.
��••��mm 504 — FINAL BUILDING . ENERGY _
CONSTRUCTIONr.ENDINGAGENCY SOS FINAL ELECTRICAL
thereby a%,m this share isaconswnion lending,,.) for she perfomunce
g;w12 .f thew«ame- mtniapatniti,i.aard(sa.3o9],civ.c.) 506 GAS TEST
�+Q! Lender's Name'- •- .. .. -
p•Z t.ndersAddrexa 507 — FINAL PLUMBING.
U �tL-
1 rarity that l have read this Application and state that the above information is 508 — FINAL MECHANI CAL
O:[� correct.1 agree,o comply with all city and county ordinance,and cute laws,elating
V to building cons,mctlon,and hereby authazerepresentatives ofthis city,oenterupon 509 — FINAL GRADE
�l( ,Ute above-me boned property for inspersion purposes. 510 FINAL PLANNING
A. (We)agree,.ash.indemoi(y and keep hamless she City of Cupertino againu
to• liabilities,judgmems.costs and eapewu which may in any way accrue against said 514 FINAL PUB I C WORK
,. City in consequence of she granting of this pemdt. -
APPLICANT UNDERSTANDS'AND WILL COMPLY WrfH ALL NON.POINT 6
SOURCE R ULATTONS. Z Issued by: Date
Sign ,e_ ppscan onmana- - Date Re-roofs
HAZARDOUS MATERIALS DISCLOSURE'
WII the epplicint a future Wilding«rnpun nok ar handle husta.ns nu¢dal .Type Of Roof
as definedby the Cupertino Municipal Code,Chapter 9.11,end Ne Heald,and Safety -
Code:S«6on 8532(.)7, ,:. - .. .. .. .. . _
All roofs"
shall be inspected prior to any.roofing material.being,installed.
ecoWIl,he eppl cam Tut Wilding« pentuu equipmem devices which
it h..ndbus.rc.n,am, steams darned by the Bay Area Air Quahry Menagemem If a roof is installed without first obtaining an inspection,I agree'to remove
t_� DQimct?❑Y. - .. ONO all new materials for inspection. Applicant understands•and will comply with
1 have rtaa rhe heasuc i umarriala requirements.neer Chapter 6.95 or rheall non-point source regulations.liromia Health k Sarery Coda S«tions 8505,25533 and 8534.1 understand that
he Wilding tl«s not currently have a mnam,she,it is mYrespomfbiliry10naifyshe
cupant Of she requirements stitch must be met prior to issuance of a Califma,eof
ttbpa«.
() Signature of Applicant Date
All roof coverings to be Class "B" or better
.: i; .:: .. .. .'..• OFFICE '
0 .
CITY OF CUPERTINO p Z o b o a �r
CITY o
CUPEkTINO PERMIT APPLICATION FORM
APN# 3 ` /Q _ G Date:
U • /3.o Z
Buildi4 Address:
191 I e, ao QA
Owner's Name: Phone#:
p . 2�flSy7
C ntractor: License#:� I S 3
O0j 0
Conta} (/-Contact: n Phon�O 3
Applicant/Co tractor: Fax #:
SL1 o I
ng Permit Info:
Bldg ct Plumb ech
escription:
Residential: �cwL'L /�� (��./ (Commercial:
Sq.Ft. Floor Area: $/Sq.Ft.:
Architect/Engineer: Valuati / (0O
Type of Construction: Occupancy {Group:
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V <= 1000A ELECTRICAL
BELEC1001 Elec 600V > 1000A ELECTRICAL
BELEC200 Elec Svcs 600V <=200A ELECTRICAL
BENERGY Energy BUILDING
B$NERGYADD 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 PLUMBING
1 of 3
05-28-02 12 : 23 HOME DEPOT ID= P02/05
' e
4PPROVEC-
IN ACCORDANC WITH THE CITY OB
CUPERTINC ES A OR NINCM
DATE Rc
� COPY
SIGNED__-On"
—;t� specific
This sot of D
be kept on the l00 achain eseor a terafions
lawful to make any R ` p
on same wltUo wCtY of CuG tino. from rG
the stomp3 P f
The stamD•nR of this p.an Intl specifications
milt or to be an �---
SHALL NOl be he d Il p,
f Inv orovision 188
pproval arp t aw
40 101
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All dimanalanpdsira da:IgeaOona THE This is an odpinal dezryn and must 4100D889 Scaler matimum Wfe =5202
grvnn are wbject to wrslptbn on not be released or mpiad dnlew KAZUKO HAYAMA
job site and adju.oMn[to fit Job HOME DEPOT 'epplkbl6 too bas seen poid WJob 9141 PARK VILACIR0.B pcioner
eeralitianx m/ar placed. CUPERTINO CA ANTONIA
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All dimensions&size designations TME This is an original design and must 410ODS63 Scale:mmdmum O,vg na0
given
n dea dacivstlonentto verification HOME DEPOT 8 ;�as i,�sn Idia�m KAZUKOHAYAMA ONI w
' condElons. orderpl 8141 PARK VILLA CIRCLE WatUGUnefl 3 EA
CUPERTINO CA
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All dimenslons 8 slze designelms 1tte This Is an original design and must 410008M Scale:maldmum ria'a
iven ares est to verificaltan on not be released or co led unless eslgner m
KAZUKO HAYAi7k
job sfre and adustmant m rd 10, HOME DEPOT applicable been paid or job T
8141 PARKVM CIRCLE m
oondftions. order pla CUPERTINO CA WaIXI-Ine# 2 N
to an tem •
1 Cabinet Material Color
2 oldin Mle natura Model/Part Number
Mae le Con
natural Antonia Home De o
3 Sink Kohler double sink SC
Kohler
4 Faucet whiteAvo SR SIN WHTE
• 5 Counter To ran to KS932-00
8 -- s lash Tile ' a w/brown whRe
JUPERANAST. �1 /
ntlows Wood.fa l� F
a siove Its rsr- .�
' rame o —
9 Refri Orator Sub-Zero n
e cabinet 700T
1
oar ite ak or a samas
11 Pet door a I ii ht wood 00 or Refri era Fae er
Llvin Rm 13 I his
n Orson se es
1 swin Door Wood frameFrenchwood Outswin 13 2002
2 n ow o natural Patio Door w/retract�p�
3 Floor a natural
let Bed oom
Ite Oak or Hard Me I ht wood color w/retractable screen
- _
1 or
2 Closet door
3 endow, ood frame
4 loor White Oak orwhite
and a I li ht wood color W/ tractable careen
5 Blind Wood
white Sundance Shutters
ed Room Clarion
1 oar
2 C oset oar
3 Wmdow oodframe
• 4 Floor Wh to a or Hard Me 1 II hit wood color w/retractable screen
te
5 Blind W white Sundance Shutters
ed Room u
( pstalrs) Clarion .
14 Doors
2 Closet door
3 2 Windows Wood frame
4 Floor as t white retractable screen
Entrance Tie bei e
Bathroom oor erracotta
lo
se Door bURANGO AMBRA
A I sent
white
7 Base board Wood white Chair Ralf 390-MOF
'—� Doors687-277
Wood 4 anels white Coventry solid Core
Tickness 13/4 80,H
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All dimensions 8 size desi nations - 32107B60 no.
9 TME This is an original design and must Scale:maximum 0'�9
gN are subject to verification on-1 not be rel r copied unless esigner
siteand adjustment to fit job HOME DEPOT applicablesbeen paid or job KAZUKO HAY9MA ANTONIA
nditions. order lace 8141 PARK VILLA CIRCLE
P rnocorin�n rn Wall/C Line# 3
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Note:This drawing is an artistic TME 32107860 pwg no.
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interpret ti the general HOME DCPOT KAZUKO HAYAMA
' • appearan a floor plan.It is C 8141 PARK VILLA CIRCL
not meant an enact rendition. n i 1 PAR in r n .
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Nate:This drawing is an artistic THE
32107860 Dwg no.
apperetationotthe general HOME DEPOT KAZUKO HAYAMA
not meanWthe floor plan.It is - 8141 PARK VILLA CIRC
not mean an exact rendition. CUPERTINO CA
to
Il
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FNThs drawingisanartisticTME 32107860 Dwg no.
t. etatio fthe general HOME DEPOT KAZUKO HAYAMAran#e Floor plan.If is 8141 PARK VILLA CIRCL
eant an exact rendition. 81 1 PARn rn
Existing Design
glass glass
wall Sliding door wall
SUBMITTAL
#1
Change to
J-q I 1
Swing ut door
glass glass
wal window window wall
1
wall wall
soon DHa uasoaa eaz TOVV999896 YVJ 90:6T nxz zoirTiso
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i 603 ,' 4C wi 24 .' 36 z 36
Scala:ma)dmum
All dimensions 8 size designations .mE This is an original design and must 41�08ti3 Owg nc m
given are subject to reriflcalm on not be released or co led unless s gner P,
g HOME DEPOT p KAZUKO HAYAMh
]ob site and adjustrnerrt to tR ob, applcabte has been paid or Job A O
PARK VIIIA CIRCLE m
conditions order PI _ UP CERTINO CA We Yc UnsW 1 [n
UP
y J •
• Y
L
20" CLEAR
34m
CLEAR
I� MINIMUM J
SU ITT
OP&JABLE
AREA 41" CLEAR47
'
OPENABLE.• ••.
5.7 SO. FT. AREA 24"
MINIMUM CLEAR
5.7 So. FT, MINIMUM
•:' MINIMUM
MINF"SIZE WS"SIZE WPDOW
W DC W FCR FOR 24"CLEAR HEIGHT
20" CLEAR WIDTH JUN 13 2602
SILL HEIGHT
44" MAXIMUM
- RSXP
MINIMUM SIZED RESCUE OR ESCAPE
WINDOWS FROM SLEEPING ROOMS
Sec. 1204
sy