05010078 (2) CITY OF CUPERTINO � _ "haKat c«
BUILDING DIVISION PER* CONTJUC"'I�QRIIt\�1114w 1�N
"o-
BUILDING ADDRESS: CUPERTINO KITCHEN DESIGNS 1111114105010078
OWNER'S NAME: PERMIT ISSUE DATE
TO
RY NO.
12 12005
NE: SANITACONTROL NO.
(408) 2S7-4900
ARCHITECTIENGINEE
a 2 7-
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
no, LICENSED CONTRACTOR'S DECLARATION = O O O
wF 1 co by affirm in.,1 am Rmnscd umWrNmvisians a(aside,9(commercial Job Description
i`� with 5emd�n]gflU)of Divitlon3of Ne�ul.'..F��F dPmfcssivas Code.and myli<evcls
r� infiirmrl(Merr«L
Lica /o�py� 3 BATHRM REMODEL
�qb mass r3ffJC.
i�c m Cu
to I..A"y o-4—,,,
' ARCHnECrS DPpIARATIDN
(understand my plans shall the wed Ys publieracruch
TION
C Licensed Professional
OWNER-BUILDER DECLARATION
s0 I hereby Affirm(Scc Ned 1 1. exempt Prem the fesionc,ofs e:Any c Law for the
i e O followhich m reason.(Scour 3(r L5, t,Wux.s and nve.de tins Cod,:Any city or county
L m tci which requites a Permit re enwruc,,alter or fmve,h Permit t fire a si,saygned amostuucomem
X prior its issuance,also
uantrequires lW applicant for suchosion' Limm Law sammcm
mxtWucmnudpurstion7 )provisions or of the the Business umaulaw(Cbapmr9 Sq.FC Floor Area Valuation
(co��$ that M is exam t Scmion7and th Division rofthccged cssand
on.An vi Code)of
.-
that he u exempt therefrom and Is baso for Uma alleged emmpuon.Any violation of
Section 703 LS by any applicant for a permit subjects the applicant to a civil penalty of 3 2Aa1,B poi rr0 0 Occupancy Type
not mom man five hundred dose(53 L P Y YP
El I,as owner of the property,or my employees with wages as Meir sole compensation,
will do the work and tae smrnure is notinurWed oroRcrcd for sale(Sec.7044,Business
and Prolie cions Cade:The C.no acmh License Law does not apply to an owner of Required Inspections
property.W builds.,improves thcreon,and who doessteh warkhimsel(or,luo nigh his
awn employees,provided that such improvements am not intended oruRered forsale.If.
however,the building or improvement is sold within one year o(completon,the owner-
builder will have is burden of Proving that he did not Wild or improve for purpose of
sale.).
❑J,as owne,of the property,am exclusively c.ownt r,with licensed ronannors or
co awn the pmjcen(Sec.71W4,Business and Professions Code:)Tie Conlncmr's U.
cewe law docs not apply M m owner of prapeny who Wilds or improves tmcmon,and.
who contacts for such projects with a con ractor(s)licensed pursuant to the Committees
License Law.
❑ I nn exempt nder Sec B k P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affurn under penalty of perjury one of the following declarations:
❑1 hew,and will maintain a Certificate of Conant m self-insure for Worian sCompen-
s pian,as provided for by Section 37M of the Labor Code,for the performance of the
work for which this permit is issued.
i�fsive and will maintain W.rker'a Compensation Insurance,as required by Section
3700 of the labor Code,for the performame of Is work for which this permit u issued.
My orkda Cnm esalhon Insurance ca ,r and P licy number art:
'er. itin FIC ,mr� NOMWORt4/O —2c17'
CERTIFIC OMPE S INSURANCE
old,
WORKERS'
COMPENSATION INSURANCE
(Thu=am need not W completed if the permit is far-.ne hundred dollars(5100)
tela)
1 comity mat in the performance of the work for which this Permit is issued,1 shall not
mnployanyperson in any manner so as to become subject o the Worem Compensation
Laws of California.Dam -
Applicant
NOTICE TO APPLICANT:IL atter making this Cenifieac,of Exemption,you should
become subject to the Worker's Compensation previsions of the Labor Code,you mum
.7. z forthwith comply with such provisions or this permit shall W deemed mvokcd.
Z O CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency lar the Performance of
Qi the work for which this permit is issued(Sce.3097,Civ.C.)
W Lender's Name
z Lender's Address
V Q 1 minty mat 1 have mad this application and sum that the above information is
cotrecL 1 agmen m comply with all city and county oNinencrsand item laws rtlaling m r...
�U building construction,and hereby au,horim mirmumztives or this city to enter upon de
above-mentioned pma,my for inspection pu pumc&
(We)agree to nave.iedcmmty and keep harmless the City or Cupertino against
(/) liabilities,Judgments.casts and expenses which may in any way accrue againusaid City
V t7� in consequence of me granting of this permit.
APPLICA UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE '•�D WILL
LYLL C
')
Re-roofs
agnamrt of ApplicanVCanROO //// ate
HAZARDOUSµA4R1ALS DISCLOSURE Type of Roof
Will the applicantm ruwm bus ding occupant store or handle havardow material
as defined by the Cupertino Municipal Cork.Chapter 9.12.and me Health and Safety
Conn.Section zss3zfan❑Ycx �"� All roofs shall be inspected prior to any roofing material being installed.
h,rv.
O If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or future building occupant vu equipment or devices which
miI srardous air contaminants as dcrined by(be Bay Area Air Quality Management all new materials for inspection.
District'
❑Yea NNu
1 have mad the hwolow materials requirements under Chapmr6.95 of the Califon
at.Health k SafetyCod,,Secdmu 25505.25533 and 25534.1 undersand mat ifthe Wilding
docs not currently haat a erne L that it is my responsibility an modify the occupant of the
requimmcnm which and,tic met priori issunne,or a Cenifcate of Occu r Signature of Applicant Date
lee ZlIf
OA'ficr or amhodred agent ,Date All roof coverings to be Class"B" or better
CITY OF CUPERTINO
m 1 of 1 PERMIT RECEIPT OPERATOR: conniew
COPY # 3
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . . 32613034 . 00
DATE ISSUED. . . . . . . : 01/12/2005
RECEIPT # . . . . . . . . . :28268
REFERENCE ID # . . . : 05010078
SITE ADDRESS . . . . . : 10427 VISTA KNOLL BLVD
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : TOM & DORIS DEFRANCO
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1039
RECEIVED FROM . . . . : CUPERTINO KITCHEN DE
CONTRACTOR . . . . . . . : REID, BILL LIC # 14708
COMPANY CUPERTINO KITCHEN DESIGNS
ADDRESS . . . . . . . . . . : 10562 S DE ANZA BLV
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
• TELEPHONE . . . . . . . . : (408) 257-4900
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- --------- ------------- ---- ------ ------- - - - ---------- --------- - ----------
BPERMFEE VALUATION 20, 000 . 00 277 . 56 0 . 00 277 . 56 0 . 00
BPLANCHK PERMIT FEE 277 . 56 370 . 40 0 . 00 370 . 40 0 . 00
BPREPIPE NO OF FIXTURE 3 . 00 27 . 00 0 . 00 27 . 00 0 . 00
BPSEWER SEWER SYSTEM 1 . 00 21 . 58 0 . 00 21 . 58 0 . 00
BPSPRINK NO OF SPRINKL 1 . 00 13 . 19 0 . 00 13 . 19 0 . 00
BPSTORM PER DRAIN 1 . 00 9 . 00 0 . 00 9 . 00 0 . 00
BPVENT UNITS 1 . 00 10 . 79 0 . 00 10 . 79 0 . 00
BPWATER UNIT 1 . 00 9 . 00 0 . 00 9 . 00 0 . 00
BENERGY PERMIT FEE 277 . 56 133 . 23 0 . 00 133 . 23 0 . 00
BREMFIXT NO. FIXTURES 9 . 00 10 . 80 0 . 00 10 . 80 0 . 00
PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
BREMPOLE NO. FIXTURES 2 . 00 2 .40 0 . 00 2 .40 0 . 00
BREMPOWER POWER UNITS 4 . 00 101 . 93 0 . 00 101 . 93 0 . 00
BREMRECEPT NO. OUTLETS 6 . 00 7 . 20 0 . 00 7 . 20 0 . 00
BREMVENFAN NO UNITS 1 . 00 45 . 39 0 . 00 45 . 39 0 . 00
BREMVENSYS NO UNITS 1 . 00 10 . 26 0 . 00 10 . 26 0 . 00
BSEISMICRE VALUATION 20, 000 . 00 2 . 00 0 . 00 2 . 00 0 . 00
EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
MPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 1166 . 84 0 . 00 1166 . 84 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
�CK -- - 1166 . 84 35497
TOTAL RECEIPT 1166 . 84
Zl CITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM S
CUPERT[NO
APN # 3 Z / 13
0.3 Date: 1 15 10
Building Address: �(IS?*T �00II O*I.Mailing Address (if/different from building address):
Owner's Name: 1 awl Phone#: 4.y g
Contractor: ¢� >tivl p k� �.eh bei ��. License #:
Contact: vl Phone: ¢p$,'177-17G Cupertino Business License#:
Fax:4p f3-2S'7- D ) 4-7o8
Building Permit Info: g01g-rary" RP-Wp Oji
Bldg 0--' Elect Plumb Fri Mech---
Job Description:
Residential I� Commercial ❑
Sq.Ft. Floor Area: l,� 0 e� �+ $/Sq.Ft.:
Cost of Project: -4 2�0/ p e o Occupancy Gro
Type of Construction: r Please check this a project is a
second-story addition: ❑
Project Size: Standard ❑ Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu , MECHANICAL
BBOILER3 Boiler> 500K to FM Btu MECHANICAL
BBOILER4 Boiler> IM 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 Ener y Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
1 of
h G,
CITY OF- CITY OF CUPERTIN#
PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
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
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pb1g 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 rinkler/Backflo 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 cfin MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation ofFumace MECHANICAL
BREMFURNOV Relo Fumace> l 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
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT. Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heatin MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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G 4ITY OF CUPERTINO
CITYOF PERMIT APPLICATION FORM
CUPERTINO
Quantity 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
BS WIM 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 Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Change BUILDING
•
3of3
DEC-06-2005 06:12 MARK THOMAS CUP 4082535173 P.01i01
MR $AN IIAq�.AI
s
DISTRICT MANAGER-ENGINEER BOARD OF DIRECTORS
MARK TWOMAS&COMPANY,INC. " � �' WILLIAM A.BOSWORTH
DAVID E.ROSS DR.JOSEPH F.BROWN
DISTRICT COUNSEL �s b� JOHN M.GATTO
ATKINSON•FARASYN,LLP lget 1 S H6� �9 CURTIS S.HARRISON
HAROLD S.TOPPEL 20833 STEVENS CREEK BOULEVARD,SUITE 104 WENDELL H.KERR,JR.
CUPERTINO,CALIFORNIA 950142154
(408)253-7071 PHONE • (408)2535173 FAX
�RECEIV]F<',�;I
DEC 5 2005 I
BY:
File: CuSD—MOP
Building Dept. —Cupertino
City of Cupertino
Attn.: Building Department
10300 Torre Ave.
Cupertino,CA 95014-3202
Subject: Residential RemodeUAdditions
. Name: Defranco
Address: 10427 Vista Knoll Blvd
APN: 326-13-034
Permit No.05010108
■ Videotape and Property Line Cleanout inspected.
No additional condid'ons/requirementsb - the District
Inspector: George Santos ..........................................�5
Date: ...12-5-2005..............:.... Sanitary Sewer Location:
cc: Home owner :3 C
SUPPIYING SANITARY SEWERAGE Swim FOR: CITY OF CUPERIINo, PORTIONS OF THE CITIES Of SARVOCA, SUNHYYALE, Las ALIDS ANa SURROUNDING UNIN(ORPORAIED AREAS
W w W.cup Orrin os a n i tut Ydlsuic r.r o m
TOTAL P.01