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06070007 (2) F Y OF CUPERTINOeALDING DIVISION PERMIT xONTRAG�TORiINF,,ORMArT:IONNGADDRESS: SEARS HOME IMPROVEMENT PERMI "06070007 51 STOKES AV 'S NAME: PERMIT ISSUEDATE UYEHATA KIYOKO K 283 E. AIRWAY LLVD- 07/031/2006 IFINE: SANITARY NO. CONTROL NO. (925) 245-2000 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH toZ' LICENSED CONTRACTOR'S DECLARATION - Job Description m❑ I bemby affirm Nal 1 am licensed under previsions of Chapter 9(commencing Zm win Section 700)of Division 3 of thc Businev and Profcmiuns Cade ndmy1hemanis +'„ infull(orteaadefi INSTALL 1, 476 VINYL .SIDING FRONT - LEFT & RIGHT Pv�2 Licenu sayL. INCLUDING GABLES + 182 LF FASCIA Dam — ContDEC As shall use DECL9, �a I urWcrsunJ my plans shall W recd u public rtrnrth )yU eoi; Licensed Professional 0 3 Dal I mn eUILDER anDECLARATION C I hemhy.(item Nat I am exempt Wm the Cantracmrs license law far the o O following mason.(Sayan 710 L5.Business and RofesGum Cale:Any city at county <m� which requires a permit m construes,eller,improve,demolish,m repair any structure aiy pror m its issuance.also acquires the applicant far such permiuo file a signed eumment < that W is licensed pursuant in the pmvisimss of the Contractor's Lfenum Law(Chapter 9 Sq.Ft. Floor Area Valu$IbH 973 Y�$ (commencing with Section 7")of Division 3 of the Business and Professions Cods)or — that ba a exempt therefrom and use hasp for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of N umber Occupancy Type not more Nan five hundred dollars(550). 3 g O 1,an owner of the property,or my employees with wage as then sole comfier adon, will do the work and to ancam is not intended m appeared(a,sal(Sec.706/.BusinessIeChOns and Pmfesdons Cade:The Congxmrs License law class ret apply N an owner of ns P property who Wilds or improves themon,and who doessuch work himselforthrough his own employees,provided that such improvements are not intended araReaed for sale B. / y hnswon,the Wilding or improvement u sold within arc year of completion.the ownes. k rC..O �fl(IC builder will have the burden of proving that M did not Wild or improve for purpose of �11'llll sal) BUILDING + I� ag f�y /� ry tfa ®p .res ❑1,construct owner of ct Sec.cny,.B exclusively cafessi ng with )Theed contrnmrs m I,�f® g]ill gy p �1t q ILa N p n 01.asthe project(Sec.7064,Business and Professions Cade:)ens Contrmmr's Lie '1t91i^✓P,ygyTOe�1{gly/fBWi:9LMgrI%►771tg/i�Ill6'916�Vy7[p��'1^a'aa—Fy cense law does not apply man owner of property who Wilds at improves thereon,and who contracts for such projects with a conuacloKs)licensed pursuant to the Contractor's Lemon law. O 1 am exempt under Sec ,B&P C far this Tenon Owner Date WORKE15 COMPENSATION DECLARATION 40 1 hereby a an under penally of perjury ata of the following dedaradom: 1 have rend will nommen a Cenifia¢o(Consent to self-imu¢for Worlds Compere sation,an paovidcd far by Section 370 of the labor,Code,for tW Pon(...of Ne work for which this permit is issued. O I have and will maintain Workces Compensation bamboos.as required by Secvon 370 of the tabor Co ic,far the performance of the wark for which this permit is sued. My Workce,Campcmatian lmursnce ajncr�vfd I' number[am�:�(yn/ Carrier:��QIt��Q I(/�N '¢'oltry No.:BAl�Tva a.a� CERTIFICATE OF EKEMPIION FROM WORKERS' COMPENSATION INSURANCE rhos second reed not bacomplamd if the permit Is fm ooe hundred did.($10) less.) I certify Net in the puformancc of the work for which this permit is Want,I shall am employ any person in any mortar so as at Waome subject in lie Woakcri Compensation Laws of California,Data Applicant NOTICE TO APPLICANT:IL after making his Ccnificam of Exemption,you should become subject N on,Worker's Comienntion provisions of the labor Code.you a= .J O forthwith comply with such provisions m nu Permit shall h assured revoked. „�..'� CONSTRUCTION LENDING AGENCY [-+ Ihmahyaffirm and thcrt iso eta.dnn lendingagcxy far nc perfmmvmmof (Yi the,work far which this Permit is issued(Sec.3097.Ch,C.) �W Q Let&,',Name z Lenders Address Q Q I cenify Net 1 have mad Nis application and sum that the&hove information is F^ correct.I agree to comply with all city and county ordimtaea and sum laws relating to Q Ubuilding consouction,and hereby aunarlac MPrescnutocs o(dos city to enter upon the r W shove-mcmiuned p.,,Iy far imMu.n pugwses. Dy (We)agree to save,indemnify and kap harmless use City of Concert mo.Saint fn liabilioenjudgments,costs and expenses which may in any way seems against saidCity U Z, in enscqumec,of the granting of this permit. e ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURC EGUI.ATIO a.s—� ,{/- FII• ,Re-roofs Signazum of ApplicorVCom DO Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will tha applicant or forum Wilding occupe.Chapter on,9.1 orhandlet Healat an mamdal m defined by Ne Cupertino Municipal Code.Chapmr 9.12,and the HcaIN and Safety Code.Section 25532(a)7 ON. All roofs shall be inspected prior to any roofing material being installed. �Ym Will thea Ream or future Wilding aavpace use ipmet or deice which If a roof is installed without first obtaining an inspection, agree I a ree to remove PP rquv .mit hanado s air contaminants as defined by the Bay Area Air Quality Management allnew materials for inspection. District? ❑Yes ONu 1 have maJ One hms mammals requirements under Chapter 6.95 of the Califon nu llalth&Safety Cao,S¢mm 25505.25533 and 25534.lundcrsan lNal if ft Wilding does not Currently hale a mnans that it is my responsibility N notify the acupma of the m 'remndts hlhrecces a mnceafaCeNTmamo(Ce `) Signature of Applicant Date Owner or orthori'reJ.gem 7^ � 'O - All roof coverings to be Class "B"or better - Dam' Community Development r 10300 Torre Avenue N Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 IOUPEkTINO Building Department JOB ADDRESS: PERMIT # 6607000 OWNER'SNAME: 1<jV(jj<o PHONE #4-laji - -7 GENERAL CONTRA OR: FAX # I am not using any subcontractors: d Signature Date Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical . Excavation Fencing Flooring: Carpeting • Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO em 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32649013 . 00 DATE ISSUED. . . . . . . : 07/03/2006 RECEIPT # . . . . . . . . . : 35099 REFERENCE ID # . . . : 06070007 SITE ADDRESS . . . . . : 10651 STOKES AV SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : UYEHATA KIYOKO K ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . , RECEIVED FROM . : TOWN & COUNTRY PERMT CONTRACTOR MARK C GOOD LIC # 23097 COMPANY . . . . . . . . . . : SEARS HOME IMPROVEMENT ADDRESS . . . . . . . . . . : 283 E. AIRWAY BLVD. CITY/STATE/ZIP . . . : LIVERMORE, CA 94550 TELEPHONE . . . . . . . . : (925) 245-2000 •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---- ---- - - ---------- ---------- BENERGY PERMIT FEE 255 . 96 122 . 86 0 . 00 122 . 86 0 . 00 BPERMFEE VALUATION 17, 973 . 00 255 . 96 0 . 00 255 . 96 0 . 00 BSEISMICRE VALUATION 17, 973 . 00 1 . 80 0 . 00 1 . 80 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 380 . 62 0 . 00 380 . 62 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 380 . 62 1114 TOTAL RECEIPT 380 . 62 ST CITY OF CUPERTINO © Cool CITY OF PERMIT APPLICATION FORM CUPERTINO • IAPN# 3a� - Y9 - C) 3 Date: 0, _ 30 06 i Building Address: Mailing Address (if different from building address): 1 o I, - S M tF5 to OF CvPf ;r, 9s-Di Owner's Name: Phone#: t yo ka U Ycrfq Contractor: License #: S E 1/E E 7 al 1 8- 1 i Contact: Phone: 9.-tv-02 ys-. 100 Cupertino Business License#: Fax: ;, a —olUl Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ 1 Job Description: ,N STAt_L q-764 uwyL siollv6 leevr— LFFT d HT !N Cl GyR Ui5 Residential W t 182 LF SC4 Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: i Cost of Project: / Occupancy Group: 3. 12 Type of Construction: 7 Please check this box if the project is a • second-story addition: ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other A liances MECHANICAL BBLDGFEE Bld 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> 1.75MBtu 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— ner BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of 3- t}CCS- CITY OF CUPERTINO CITYOF PERMIT APPLICATION FORM CUPEkTINO • Quantity Fee ID Fee Description Fee Group 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 BPERMF'EE 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 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> I OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL kf WBREMSIGGNIJS HOOD Installation of Hood MECHANICAL ISC Misc A aratus ELECTRICAL RAPP Rem Non-Res A liance ELECTRICAL LE Pole/Platform Fixture ELECTRICAL WER Power Device/A aratus ELECTRICAL CEPT Rent] Switch & Outlets ELECTRICAL LOCA Relocation of Hood MECHANICAL PALT R air/Alter Heating MECHANICAL SAPP Remodel Res Appliance ELECTRICAL NAD Rmdl Si s Add Branch ELECTRICAL GNS Remodel signs, Marquee ELECTRICAL 2of3 (G - CITY OF CUPERTINO NOF PERMIT APPLICATION FORM CUPEkTINO MkQuantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting 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 Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Ternp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/ Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Change BUILDING • 3 of 3