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03050154 (2) CITY OF CUPERTINO # n .yg, . , :; ` BUILDING DIVISION PERMIT CQ NTRACTQWINFQILMt1TIC, BUILDING ADDRESS: LION R CRASE CONSTRUCTION I I!MITNo03050154 21060 TUT-TTA ( T OWNER'S NAME: 164 GILMAN AVE P°gMI"'b"!Fn 0/2003 PAO MING KUO ONE: (408) 370-1485 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLOC ELECT PLUMB MECH u p p LICENSED CONTRACTOR'S DECLARATION 1 hereby in,.that I am licensed under provision.of Chapter 9(commcncing FIN p��eWr�C,['IPtIOn with Scmio OM1 of Dlvision3 of Ne Bun, dProrcasium Codc.end myliccnm la N In full forte e fey. 1 ��z ucenm rel C Lle.I 3'e. 7 TUFF SHED n qqqq Date — <'- - Carolw JUN 2 5 2003 tp ARCHITECI'SDECLARATION Y uu.�5)5 nu my pie n 1 Ye9lttl,u pat lie records DyU h0 LkcnWd Pmrcssianal BUILDING 5Q Oat I am exempt from mDECLARATION wY Yi/ 9 a 1 hereby,(firm(Section nl 1 1. exempt(rum tae Convenor§License Law for Ne iOO fallowingmason. (anion8131.5,Busiter. and ProRaium Cadre:Any city mammy $m which mquset•pertain ac consweLalcor.impmw,h Permits are a signedr any mucmat < pdorwiuissumtt,aim ant to Be theapplicanto for Co Permit to Nc=Lawdnatemcnt p O (comma angwitpumuantwthepmviviomnfNcConasinims ndPrel law(Chapwr9 Sq.Ft. Floor Area $4NblD)iMion Y z❑eeg kat he is exempth Sectionfom and O Basis f r the the alleged eta and on.Anynn.Code)or a.. that he u exempt therefrom end Ne burls for the alleged cxemptlan.Any violation of Section 7031.5 by any applicant for a permit ubjects the applicant an n civil penally of 3MMMi6i8er00 Occupancy Type not mom One Ove hundred dollar.(5500). ❑I,as owner of the property,army employees with wager"doW sole cumpemnlon, willdo the work and the suunum H not intended maffned forsmc(Sec.704q Business e 1 dI05 eCt100S and Pchosemu Code:The ConuaemLadote n Lim. w not apply e m.1 of 102 — PIERS IERS p pmpeny who builds or improves thereog and who does.uch work himmlfor through his ownemphymit,provided thatioch lmpmwmmts am not intended in offered for sets.B, 103 — UFER howeveq the building or improvement is mid within one year of completion,the owner. ' builder will have the burden or proving Nat he did not build or Improve for purpose or 104 - REBAR sale'). 105 - ANCHOR BOLTS ❑I.as ownerver do property.am exclusively contracting with licensed comaxims to 106 - SEWER & WATER com morel the project(See.7044,Business and Professional Cotler)The Convacers U. cent.Taw dote not apply w an owner of property who huilEsnr Improves thereon,and, 202 — UNDERFLOOR PLUMBING contractswho for such projectsprojectswith aeonuacwr(s)licensed pursuant in the Contractile,License Law. 203 - UNDERFLOOR MECHANICAL O l am exempt under Sec. .B&P C for this ream. 204 - UNDERFLOOR FRAME owner Data 205 - UNDERFLOOR INSULATION WORKERS COMPENSATION DECLARATION 301 - ROUGH PLUMBING Icatchy arm under Ne"y"'perjury uncertain fmlewing dacluad. 302 — TUB & OR SHOWER Ihaw endw111mainmune CeNOcemorC..ttouif-luumfur War esCompcm 303 — ROUGH MECHANICAL on,u provided far by Section 37W of the labor Coda.far the performance or the ort for which this Permit is issued. 304 — ROUGH ELECTRICAL ❑1 have end will maintain Wwkcr's Compensadon Inmrance,as required by Schon 305 — FRAME 3700 of the labor Code,for the performmec of on,work far hich this permit is Issued. My Worker's Compensation insurance,a. Po a. l' bcr are: 306 — HOLDOWNS are j Policy .: 'Cc,"7r29- 26t;3 307 - INSULATION CERTIFICATE OF EXEM PEON FROM WORKERS' COMPENSATION INSURANCE 308 - SHEETROCK reels motion lined non he completed it the permit is for one hundred dollars(Slisp) 309 — EXTERIOR LATH 310 - INTERIOR LATH 1 certify that in the performance of we work for which this permit is issued.I Nell not 311 - SCRATCH COAT employ any pmmn in my manner m as to become subject to de WorkaW Commoomflon Lawn of California.Data 313 - ROOF NAIL Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you shnuW 501 - FINAL ELECTRICAL ENERGY become subject to the Worker's Compensation provisions of the Labor Cade,you mute 502 - FINAL PLUMBING ENERGY ,JO forthwith comply with such provisiam or Nu permit shall be deemed revoked. CONST RUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY Iherchyam.them there is a connotation lending agency for the lerfamanceur 504 - FINAL BUILDING ENE a? the work for which this Permit isBoaed(See.3lm,Civ.C.) Lender's 505 - FINAL ELECTRICAL W A Name az Lender.Addrrs. 506 - GAS TEST U0 I certify that 1 have read this application and sum Oxidic above[of..it..is 507 — FINAL PLUMBING 15,E correct.I agree to comply with all city and county ordinances and sum laws relating w O SV' building construction,and hereby euthodmapmmnutivcsofthucity toem il,xanW FINAL MECHANICAL W .hove-mcntaomd property for inspection pugieses O9 FIN (We)agree to save,indemnify and keep harmless the City of Cupertino against Let Babilodinjudgments,casts and expenses which may in any way acme agarnst said City I Nt�i U in consequence of the granting of this permit. rr'�� APPLICANT UNDERSTANDS AND WILL COMPLY WITH L NON POINT Issued by:5 WORKS Date SOURCE REGULATIONS. —3a '2 Re-roofs Si eofAppIimm1Conusemr r Data HAZAR SMATERIALSDISCLOSURE Type of Roof Will the applicant ar future building omuprat more,or handle hamdous macdal as de0nod by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(.)7 ❑Yes Btlt4o All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building oceupom um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove inItrict? hrrsrdnuir malmo moans as&rmcd by the Bay Area Air Quality Management all new materials for inspection. ❑Yesus I have mad the hanNnors mncrials reyuircmcnts undcrchaplcrb.95 of the Calif., ria Health&Safety Cade,Sectors,V5505.25533 aod25534.1 understand thuifthe building it.nom cunemly have.tenon,that it is my m.ponsihi'tY w notify dm occupmt or the requi¢mcntsp whhap be mph.orwissumce ora Ce oma ampmcr. Signature of Appl icant Date J—3o_f ow mnodveya n. Dam All roof coverings to be Class"B"or better ams, AY OF CUPERTINO CUCITY OF O PERMIT APPLICATION FORM 03 N# Date: s'-2.9-03 Building Address: 1 vet G� Owner's-Name: Phone Contract r: License #: o-r" 2. cg- n p- Contact I ��li a4 Cupertino Business License#: Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job escription: Residential E] u Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: a�D Occupancy Group: Type of Construction: r SQuantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee gBUILDING 1 of 3 �� Q �s' Gt3L. IX4 2 GA t:,XINECTtR PLATE (MIN j 2�4 iTRiGiIRu SP 74' f. 1 4 iYl .l —2)4 t.n(hi' - f TF RAFTERS 0 24' OC. iGNH v L } u LR T'<AWwG /j i!T•p1 BUILDING AULKE— -- ---___.—. 2X4 SPACE. rEC 6 3 2 (-A. CONNECTOR _ _ _ _ _ _ 1 --- -- -iRE0U1RCD FOR 12 W ! - - _ - - - - - -- _ - _z BUILDING SIZE - - - t - - - G" TREAIED WOOD OR GALVA, W,D_rH: �, 7'-0 \` -- - - ISTFEL FOUNDATION., LFNGTIA: - 0C BLE --� ry , f' PF: ETAI - B OR F-417. HEIGHT: 2X4 TOP PLATE - - - — - - - - - - - - -' / --- - ' X L - ROOF LIVE LOAD: 4(J PAF 1)2' APA RAIVO ! - - - - - - .- - - I f DESIvN r+1NGL 0%,J BS MAX EXP. n[YURATEMP SIDING I _ _ ! ROOF PiTCH, A742+ ON CEN�TERTUDS F -- _ _ _ - ^_-- _- - - _- - dE TAIL SHEETS kFt?IiIREI? - - - _ i TiJD,h THIMifER - M4' APA P,AU TOI,iGUE k GO r� pfj 6 0 Typ' VWOi]d -RE: DETAILS F-48 OR F-4C T Ij 6' TREATED WJOO OR GALVANIZED SM FOUNDATKM! x 4 SOLE PLATE 4B 2X4 SOLE PLATE -RE: DETAILS F- OR F-4( 2 / —� ? ) NADTH 12' M f ¢F—$FIFA HIr4G Ex^l EIXiyE APA STWICTURA�L,, 1 OR II LE W',TH PANfl TH;CKNkS - 15/'2 SPAN RA11Ni ,4 16 LONG DIM, PERPENU!GILAR P FRAMWG 3 CROSS SECT1+Oh1 FLOOR PLAN . - - W.T.S - - . - - N.T.S. - NOTES! 1. PROVIDE RAMI GUTTERS AND 00101ty :*OUTS FOR !NITS >400 fT.2 1R)IF R)IF RAFTERS i S I"ACK ON FRAMING I. ULE CONST CT SCHEDULE 2, AL1 CONSTRUCTION TO BE PER 19117 U.B.C. UNLESS ��T++ER+M';E NOTETt DOOR RAKEWALL 3 WOOD FR.A"G NAiLW/ 6d 4 20 YEAR ROOFING SHINGLES SHINGLES FIBERGLASS B. ALL FRAMNC MEMBERS SHALL BE SPRUCE-FINE-FUR ';Tl it GRAY x----15 W ROOFING FELT OR BFTTER MIEN THE F01-I001IKG DESIGN VALUES if rt = 25 PSI i Fv ?0 PS1 - DOUBLE 2X4 TOP PLATE Fc = 675 P9 PARALLEL J -STYLE V METAL FLASHING E 1,20U,OW PS f G k!?( EATMING All BF PER 5( IE E S.'A:'" R LAr.X T (AFA CJNO 1i. MET DRIP ! J 0. €XTERiCR 1sAll SFj ATHING 9fkLL BF RA 'MP�NAI;D !O FRAµMG NAM"6d GALY. _j MM-SHANK Al c - AT EMS, AT 12' AT INOMED,AFF vdFORT'i. 2X4 NC WALL FRAMING E- NAILING SCHEDULE 112' APA RATED N 24, ON CENTER - STUD TO TOP PLATE 2-IFI UURATEYP SIDING 4 r ---2a4 BALL FRAMWO 0 24' G.C. SILO TO NLL PLATE 2-ttd TO E TXJUBLE 20 BUILT UP URL PLATE SPLICE 16d A� 16' 1X4 FORESTRIM HEADER / UK. HEADER f6d AT ifi' I i 4. RcbFtFhG HtADER 10 STUD 6-9d i --6' STEEL TEE HINGE A 20 YEAR FIBtR;LASS SHINGLES 4060 DOOR ( - B. 15 fb ROOFING FT LT J(X4 WIJOD TRIM 1/2' APA RATED C. TYPE D METAL FLASHING AND _TRIP EDLfS P.F,)IHRED A,t NILS j°w OF G TI<RS ANN ILIURATEMP SIDING DOWN SPOUTS RE RE FOR UNITS LARGER THAN 400 S . 5. GENERAL A. ERECTION -EDURES SHALL CONFORM TO OSHA STANLAWS BUUAR SHALL STEEL DOOR PROTFC.T L ADJA("T PR!)PERTY, STRUCTURES, STREETS ifflUTiES, ETC. LATiY16" TREATED WUL)D OR GALVANIZED IS REFUh IRE FOR :'*TTY OF BUILDIN( DUPING GGwSikULMA PRONUE 1 IPG OR BRAGNG AS P,EOUIRED AND PER GDVERNINS-�- REOULATkJNS- - S?EEL FUUNOAIION G '�' a UNIT 1S PI V;LD WITHIN 3 FT. OF PROPERTY UI*-. A 1 HF tTRE WALL -RE: DETAILS F-48 OR F-4C. � � I BE REQ(uRED 7. N GIUTTE:RS ANF: REGb FOR ALL !!NITS LARGER T4A1N 41.x' SG ?T. S• F MA E A SCHEDULE TO BE PER 1957 UBC BY (oQFpFES IG,L,a� - Op ALL .jcxv 4 FRONT ELEVA11ON 2 SfC� ELEVA D APPR.OV£ is No.45 6W.T S ;= :_<< Y 30 ZOOS IN ACCORDANCE WITH THE Cff OB E j zs aU t ,'tt, ; E W CUPERTIN ES ORDINAWGM sl cna \'r, ' L � BY DATE 9T�FC3t1F�Qi<� j -• 11r(iT PROJECT N(Y. ?5$5 TI TLE : This se cii ? n L Vs+i1 1 k� I r - :, , all times and Is un 'PLO"' yL Y a jcgas o-�aTferadbW - - DATF� .wn 2002 CBE AlVS w tten permission from ii RICHARD EKED B3r WEINGARDT FiWAMu BY: HP i h� ,ty of Cupertino. CONSULTANTS DATE 00 T, , ,n -nd specifications - D*CKF0 BY, JO De P mit or to be an , , . - .r-V provision, REF. Uwc:: DATE Rznch Shed B c. � �'. ATY OF CUPERTINO • CITY PERMIT APPLICATION FORM CUPEkTINO Ouantity Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamil Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINI'ERCEP 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 HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C-Unit> 10,000 cfm MECHANICAL BREMAMIAN A/C Units <= 10,000 cfin 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 BREMINHOOD Installation of Hood MECHANICAL BREN MISC Misc Apparatus ELECTRICAL BRENE%4 PP Rem Non-Res Apgliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2of3 alOCITYOF CUPERTINP PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch&Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Sips, 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 Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING • 3 of 3 CITY OF CUPERTINP CITY OF PERMIT APPLICATION FORM CUPEI�TINO Quantity Fee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch& Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Sips Add Branch ELECTRICAL BREMSIGNS Remodel Sips,Marquee ELECTRICAL BREMTHEATR Theatrical Ligting 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 Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3 CqTY OF CUPERTINO cuPE0TiNo PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTWE Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING MIXTURE 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 Pipe PLUMBING BPWHEATER Water HeaterNent 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 Fumace> 1 OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2 of 3 Jon R. Crase Construction, Inc. .0e Lu 164 Gilman Avenue, Suite A SHEETNO. 1t`Ln TOY14101 OW CAMPBELL, CA 95008 (408) 370.1485 CALCULATED BIL ` DATE FAX (408) 370.0238 CHECKED BY DATE Lic. 4*611547 SCALE : i GRENOLA DR , : ��"t Illli't 1 T�L.OT PLA Ai-- . . �'�t 1� : ... �] M ;.. . MAY 8 0 1.2083 B I .. ......... . _ Zu ; i Aso � Q I t+LQ Pd.As1N�1 izxiz.. CHCTKEII BY, .. a..3 OATF .Q.' .... : FL G 1 U't ! 1 NOBS$ . .. r { ... I i ...j.. B( 1 a ....-� ' I 1............_ . . L . ,. ,10 (00 .-1 C : , I i ... h C`T L !A . ' '_...... 1 '. r . I LL _. i... ! KCA4�ALI%9.h1A.�n.K.n CITY OF CUPERTINO '�x�wa BUILDINGDIVISION PERMIT CONT.RACTORINFORMATION•�- .il,,, ,;tygg, x ai�� mss a!✓3'1[ud- .;C ti;3#t� '' BUILDING ADDRESS: JON R CRASE CONSTRUCTION I eMITN003050154 Ell's NAME: 164 GILMAN AVE PERMIT 96'f Fn0/2003. O MING KUO V7 PRONE: (408) 370-1485 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH0 �00 LICENSED CONTRACTOR'S DECLARATION I Wreby affIrm Nn 1 em licensed under provisions of Chapter 9(commencing lob DOSCrIptlOn with Sectio 000 of Divlslon3orlhe Busl rad Profculan.CDdc.and my lleenso B TT Va Pu [,p"vo, n m mu mreea reg S TUFF SHED ZJ� Oatenm CI R . 1 Ganoaera JUN 2 .5 2003 W ARCHITECT'SO TION 3 ]1 nu my planu pu tic records �WWO Licensed Pnrfesalovl BUILDING MNER-BUILDER DECLARATION I I hereby mill.that I am exempt from the Canuaaor's License Lew for the 0O following recon.(Section 70313.Business and Predicament Case:My city or county ZQ� which requires a permit to construct,alter,improve.demolW,or repair my structure Sex prior w its iuumcc.alsu requirettW applicant for such Permit Ole a signed statement —�< Net he is licensed pursuant to the provisions of the Comracm s License Law(Chapter 9 Sq. Ft. Floor Area $41ftgtion (commencing with Section 7000)of Division 3 of(be Business and Profusions Code)or .. Ihrt be 4 m exempt Ibemrraand Ole huts for Ore alleged exemption.Any violadon of Section 7031.5 by any applicant for a permit subjects the applicant in a civil penalty of not mart than rive wholmd dollar(SSW). er Occupancy Type ❑I.uownerafthepmMly.mmyemployeeswiNmgau NeGmlemmpenudon, will do the wok.and themunum tsnol invaded urolfered fnsale(Sec.7041,Business — and Profession.Codc:The Contractor's License law does nm apply to an owner of 102 — PIERS e 1 d Inspections property who builds or improves themon,end who does such work himself or through his own employees,provided thatsuch Improvements an not Intended or offered for sole.If. 103 — UFER however.the building or Improvement in mid within one year of completion,dee owner. builder will have tau truden of proving that be did not Wild or Improve far purpose of 104 — REBAR sale')' 105 - ANCHOR BOLTS ❑1,as owner or the property,am exclusively commeing with licensed co.=an.to construct te,project(Sec.706a.Business and Profusion,Code)The Comnctor'a Ll- 1O6 — SEWER & WATER came Law does not pply to an owner of property who Wilde or improv Comes.and 202 — UNDERFLOOR PLUMBING who Contracts for such projects with a comrmmRe)licensed pursuant In due Comrmmes 203 - UNDERFLOOR MECHANICAL License Lew. ❑l are exempt under Sec. ,B&PC for this maser 204 - UNDERFLOOR FRAME car Date 205 - UNDERFLOOR INSULATION WORKER'S COMPENSATION DECLARATION 301 - ROUGH I hran erebya under penalty of perjury one H PLUMBING of the following declarations: 302 — TUB H OR SHOWER I have and will malnan a Cerdficam ofCommnt m wIf-insum far Waftez Compem felon,as Provided for by Section 3700 of the labor Code.for the Performance or the 303 - ROUGH MECHANICAL work for which this permit is issued. 304 - ROUGH ELECTRICAL ❑1 have and will maintain Worker's Compensation Insuranu.as required by Section 3700 of the labor Cock,for the performance of the work far hush this Permit is Issued. 305 — FRAME My Worker's C�omlIpe��mauon Insurance carrier and Puy berare: 306 — HOLDOWNS artie Ti't—'4 O Polity .: (OG7TZ1-2MU307 - INSULATION CERTIFICCOMPENSATION TINSURANCE ON FROM WORKERS' 308 — SHEETROCK (Thbseelon need not W completed ifthe Formal,iaforouchundrrd dollars(SIM) 309 - EXTERIOR LATH orku.) 310 - INTERIOR LATH 1 ccnify that In the mrormenc=or the work for which this permit is issued,i shell nun 311 - SCRATCH COAT employ any person In any mmu erm u m become subject to the Wcolms'Compensallon laws.(Califoroim Dau 313 - ROOF NAIL Applicant NOTICE TO APPLICANT%Ir.after making this Ccniflcaw of Exemption,you should 501 - FINAL ELECTRICAL ENERGY Wmme subkct total Worker's Compensation provisions of the labor Cod=.you muss 502 - FINAL PLUMBING ENERGY OZ forthwith comply with such provisions or Nis Permit mall be deemed revoked. zo CONSTRUCTION LENDING AGENCY 503 — FINAL MECHANICAL ENERGY [tiff IWrcby alfom h.,them iseeonsuuctinn lending agency for the performance or 504 FINAL BUILDING ENE C' > the wok for which this Permit tsissued(Sec.3097,Civ.C.) 505 - FINAL ELECTRICAL W Q Lender's Name 7 Z Landee Add. 506 - GAS TEST �— U O I cent,that I have mad this application and.ute Ihn Ibc a Wve infa medusa i. 507 — FINAL PLUMBING U.F correct.T agree m comply with all city and county ordinances and ante laws relating to OV building construction,andherebyautholsnrepresentativofthiscitytoenterupondre FINAL MECHANICAL r W above-mentioned property for impection purposes O9 FIN LL (We)agree Io ma,indemnify tadharmthus keep less City of Cupertino against tiro liabilities,judgments.cuts and expenses which may in my way acru ce against said City I NG U 7 in consequence of the Swung of this permit. '7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH L NON-POINT Issued by:5 WORKS Date SOURCE REGULATIONS. -3a Re-roofs . 9 Si of AppliunUCort m, Date HAZA S MATERIALS DISCLOSURE Type of Roof Will the epplinm at future Wilding occupant store or handle hazardous material as defined by Ne Cupertino Municipal Code.Chapter 9.12,and the Nealth and Safety •.e.Saedon 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes Po -v. - Will the applicant or future building occupant old equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit Will air contaminants as dcOncd by the Bay Arts Air Quality Management all new materials for inspection. District? ❑Yes Vusu I have mad the huardous materials requiremona under Chapter 6.95 of the Califor- nia Health&Safety Cade,Section 75505,25533 and 75534,1 undersand that if the Wilding dans not c.mc ily hue a=an4 Net II is my MSNM hi'ty w notify tW occupant of the requimmen"ichm be Ipriorwissuance oraCc area Occupancy. - Signature of Applicant Date 5-�- Dam All roof coverings to be Class"B"or better 0 authorize m