02100193 (3) CITY OF CUPERTINOry
BUILDING DIVISIONpET 'GONTRAGTOR INFO
JONvit v
e.x•, .t,`,r t.ax�.. .. s-'3
Bm D CT
B . K. DEVELOPMENT CORP . PERMITNO2100193
OWOR'SK,%ME:DEVELOPMENT CORP . APPLICATIPi!)S B�T 2002
ONE: SANITARY NO. CONTROL NO,
ARCHITECT/ENGINEER: BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
�00 LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under pmaisions of Chaptsr 9(commencingREVI.S'I ON (SID TI1Q�D JI'b 1 UCCO
with Section 7(M),f Division Sof the Bmineasmd Professions Code,ud my license is
in full form and effect. IN HOUSE USE ONLY, NO NEW PERMIT ISSUED
r0 ) Lrcen=clms-s Contractor
ORIG. 401100131
F ni; Dam ComracCL
ARCHITECTS DECLARATION
1 understand my plata shell be used as public rmdNs
n�LLOo J/
r Licensed Professional
j OWNER-BUILDER DECLARATION 7—`illJ�
u�0 1 botchy affirm that 1 1. exempt from tbe Convenor's License Lew for the
0 0 following recon.(Section]m mm Business and Improve,
derions Cede:Any city or mummy
a64$ which rtquimx n permit re c�res the on.improse,d[mnl'ub,or repair any amscoure
mown
F ZYY+ thiormi¢iensed issuance,alsorequires pro isionnl(or Contractor's
tobleasLaw(Chapter
tsmmem
FF€o (co menccensed Forward to the of Diviousafof Comramorx Lianselso(C mO)or Sq. Ft.Floor Area 3139S1d11[tion
N $ thamm is exewiNSauromad of Diviaionr ofdmBusiness and Professions Any
Code)or
— Nos he is comps-therefrom and the baso for the alleged exemption.Any violation of '
s�ecdon 7031.5 by any applicant for a permit subjects the applicant to a dull penally of
not mom than five hundred dollars($500). be Occupancy Type
❑I.Mmurofinepmpcny,mmyemplayemwimwgasuN irulecomPemdon,
will da ase work,and the swcium is nos intended m offered for We(Sm.7W.Bminen
and Professions Code:The Contractors License Law does not apply to an owner of 102 - PIERS equired Inspections
property who Wilds orimporns thereon.and whodaessmh work,himselforthrough his
own employee,provided that such improvements Are not intended oroRcred for We.If. 103 — LIFER
however.the building or Improvement is sold within oro year ofcomyletion,the owner- 104 — REBAR
builder will have the burden of proving Nat W did wt Wild or improve for purpose of
ale) 105 - ANCHOR BOLTS
01,As owner of Ne propeny,am exclusively contracting with licensed conranon to 106 - SEWER & WATER
construct the project(Sec.7004,Business and Profealons Code:)The Contractors Li.
cense Law does not apply to in Owner or property who Wilds or finaprom domon,and 202 - UNDERFLOOR PLUMBING
who contracts for such projects with a contrutor(s)licensed pursuant to the Connectors
Lkenselaw. 203 - UNDERFLOOR MECHANICAL
❑l am exempt under Sec. ,B&P C forthis reason 204 - UNDERFLOOR FRAME
Owner Date 205 - UNDERFLOOR INSULATION
WORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING
I hereby afrsrm under penalty of perjury one of Ne following declarations: 302 — TUB & OR SHOWER
a Ihave and will maintain a CenifConsent caw of Conseno aelf-imom for Workers Compen.
station,as provided for by Section 3700 of the Labor Code,for the performance of tW 303 - ROUGH MECHANICAL
wonmrwhichthispermivaissued. 304 - ROUGH ELECTRICAL
❑ I have and will maintain Workers Compensation Insurance,as required by Section 305 — FRAME
37W of the Labor Cottle.for do,performance of Ne work for which this permit is issued.
My Worker,Compensation l...carrier and Polity number err: 306 — HOLDOWNS
Caroler: Policy No, 307 - INSULATION
cERnPICOMPENSATIOP`INSURANcsoRKERs 308 - SHEETROCK
This amnon need not he complcmd ifthe Permit is mrone hundred reliant($100) 309 — EXTERIOR LATH
lona') 310 - INTERIOR LATH
I unify Nes in sbe performance of he work for which this Permit is issued,I shall not 311 - SCRATCH COAT
employ any person in any mannerso as m become subject to the Worker,'Compensation
Laws of CalRomla.Dats 313 - ROOF NAIL
Applicant
NOTICE TO APPLICANT.If,after making this Cenifcaw of Exemption,you should 501 - FINAL ELECTRICAL ENERGY
O,Zbecome subject to the Worker's Compensation provisions of the labor Code,you must 502 - FINAL PLUMBING ENERGY
foMwith comply with such 1mvixions or Nis permit shall he darned revoked.
0 503 - FINAL MECHANICAL ENERGY
CONSTRUCTION LENDING AGENCY
F"N'a
I hereby affirm met there Is a construction lending Agency for the N'llumnince.1' 504 - FINAL BUILDING ENERGY
a �
dim W Q for which
chthis pm i,issued(sec.3097.Cit.e.)
Lder'sName 505 - FINAL ELECTRICAL
ud sAaa ,jz
506 - GAS TEST
J p I cenify that l have raw this application and xtsts that the shove information is 507 - FINAL PLUMBING
correct I agree in comply with all city and county ordinances and state laws relating to 5 FINAL MECHANICAL
Q building connection,and hereby authorise mpracntatives oflhiscity to enter upon me
W above-mentioned property for inspection purposes- 09 FIN GRADE, lI
FCy'a (We)agree m ave,indemnify and keep harmless the City of Cupertino against
a,y y liabilities,judgments,casts and expenses which may in any way acemc against said City 5 F N L G
V z A APPLICANT
NDERf thA TAN of mit Permit 4V&APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by51 ORKS Date
SOURCE REGULATIONS.
Re-roofs 603 - OF BATTENS
Signal..of Applic _HAZARDOUS MATERIALS DISCLOSURE um Date 1ypeof%Of4 - ROOF IN-PROGRESS
Will the applicant or future Wilding occupant store Or handle havallous material
As defined by the Cupertino Municipal Code.Chapter 9.12.and the Health'and Safety
Code. e ❑No
25532(a)?)1
Oyer All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant sea equipment or devicas which If a roof is installed without first obtaining an inspection,I agree to remove
it haramous air contaminants as dcrtned by one Bay Amo Air Quality Management all new materials for inspection.
❑Yes ❑No
It ave read the haardous materials nquimments under Chapter 6.95 of the Califor-
niaHcalth&Safely Cade,S dom25 5,2533md25534.1uMcrsundth ifft Wilding
don not curmndy haus a tenant thus it ts my MSPoruiHlity tu WUry me occupat of Ne
requirements which muss be met prior to issuance ora CcnlOcate of Occupancy. Signature Of Applicant Date
Owner or amthmixed agent Dam All roof coverings to be Class "B" or better
MARVIN D. KIRKEBY
• 3249 STEVENS CREEK BLVD. #101
SAN JOSE, CA 95117 Q
(408) 984-0331
OCT 1 6 2002
June 24, 2002
Job No. 20033
Building Department
10300 Torre Avenue
Cupertino, CA 95014
Re: 1070 Wallin Ct., Lot 6, Tract No. 9335
Gentlemen;
Per Section 7014 of the Uniform Building Code, we have inspected the rough grading for
the subject lot and hereby state that it is in substantial conformity with the approved
grading plan. Finished building pad was measured to be with 0.1 feet, plus or minus, of
• the approved design grades.
If further information is required please contact the undersigned.
p�OFESS/pyo
truly, �Q`�� N 0 �9 �L
. �fT/`yG SSP 11 2
� m
arvin D. Kirkeby * Exp, 343 /05 x
Registered Civil Engineer
Lr CIVIC-
9TF OF A\.'F
•
MARVIN D.KIRKEBY
• 3249 STEVENS CREEK BLVD. #101
SAN JOSE, CA 95117
(408) 984-0331
June 24, 2002
Job No. 20033
i
Building Department
10300 Torre Avenue
Cupertino, CA 95014
Re: 1070 Wallin Ct., Lot 6,Tract No. 9335
Gentlemen;
Please be advised that I have inspected the subject lot and hereby state that the building
j pad conforms to the approved plan and the basement setback location and elevation
conform to the approved site plans.
• If further information is required please contact the undersigned.
i
ours truly, / Q�OFESSl0,y�
� i �
L2 o0.1 ` a
Marvin D. Kirkeby 4001
Exp. 9 IMS
Registered Civil Engineer
� s9fF OF Cad\F�Q�\p
•
MARVIN D. KIRKEBY
• 3249 STEVENS CREEK BLVD. #101
SAN JOSE, CA 95117
(408) 984-0331
June 24, 2002
Job No. 20033
Building Department
10300 Torre Avenue
Cupertino, CA 95014
Re: 1070 Wallin Ct., Lot 6, Tract No. 9335
Gentlemen;
Per Section 7014 of the Uniform Building Code, we have inspected the rough grading for
the subject lot and hereby state that it is in substantial conformity with the approved
grading plan. Finished building pad was measured to be with 0.1 feet, plus or minus, of
• the approved design grades.
If further information is required please contact the undersigned.
4Marvin
trulyJe'b�y r QQ,OFES&
D.
D. W No.14001
Registered Civil Engineer * Exp. 9191/05
'rl CIVIC
A
OF CA��F�Q
0 •
CITY OF CUPERTINO
.m 1 of 2 PERMIT RECEIPT OPERATOR: conniew
COPY # 3
Sec : Twp: Rng :: Sub: Blk: Lot :
APN . . . . . . . . . 36218011 . 00
DATE ISSUED. . . . . . . : 10/30/2002
RECEIPT # . . . . . . . . . : 20223
REFERENCE ID # . . . : 02100193
SITE ADDRESS . . . . . : 1070 WALLIN CT
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : B . K. DEVELOPMENT CORP .
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95016
RECEIVED FROM B. K. DEVELOPMENT
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY B . K. DEVELOPMENT CORP.
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95016
TELEPHONE . . . . . . . . :
SEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- ------ --- -- - - --------- - ------- -- -- - ------ - ------ - - - - ----- - ---- --- - - -----
13PLANCKREP HOURS 4 . 00 222 . 00 0 . 00 222 . 00 0 . 00
---------- -- - - ------ -- - ------- - ---------
TOTAL PERMIT 222 . 00 0 . 00 222 . 00 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
101 FOUNDATION 102 PIERS
103 UFER 104 REBAR
105 ANCHOR BOLTS 106 SEWER & WATER
202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL
204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION
-301 ROUGH PLUMBING 302 TUB & OR SHOWER
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
305 FRAME 306 HOLDOWNS
. 307 INSULATION 308 SHEETROCK
309 EXTERIOR LATH 310 INTERIOR LATH
311 SCRATCH COAT 313 ROOF NAIL
501 FINAL ELECTRICAL ENERGY 502 FINAL PLUMBING ENERGY
503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERGY
505 FINAL ELECTRICAL 506 GAS TEST
507 FINAL PLUMBING 508 FINAL MECHANICAL
509 FINAL GRADE 510 FINAL PLANNING
514 FINAL PUBLIC WORKS 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
•
'J
CITY OF CUPERTITO <.
CUo 13
4PEkTiNQ PERMIT APPLICATION FORM
APN# Date:
/o Zgl
7Building.Address:1076 &W�/ i✓wner's ,e/ Phone#:
41eg-: X73- E7
ContractqLy License#:
it/�}i✓ ��� 1—�L �9
Contact: 3�oi
Phone#:
f�2�i9ii/ �{ GL 5��8-
Applicant/Contractor: 87D- S-,;>-741Fax #:
Building Permit Info:
-Bldg Elect Plumb Mech
Job Description-
Residential:
Sq-Ft. Floor Area: r al:
Archit ngineer: Valuation:
TiCO iZrSSi ✓tomJ/ ' I✓
Typeo onstruction: Occupancy.Gro
uanti Fee ID Fee Descri tion Fee Group
BAPPLOTHER Other Ap2liances MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXB Con. Tax for.B Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax-Resi/Mobile BUILDING
BELEC1000 Elec 600V<= 1000A ELECTRICAL
bLLEC1U01 Elec600V>.1000A ELECTRICAL
BELEC200 Elec Svcs 600V<=200A ELECTRICAL
• BENERGY Ener BUILDING
BENERGYADD ' Ener Add Multi BUILDING
BINVESTIGA InVeSti ation fee BUILDING
BMITIGATC Comm. Housin Mit. Fee BUILDING
BMITIGATR , Res. Hous:- Mit Fee
BMNEWMULTI BUILDING
New Multi-Famil Res MECHANICAL
BNEwMULTI New Multi-famil Res• ELECTRICAL
BNUCOMME New Comm Electric, ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
Tyle Z
��
vl'of3 '.•' • ,. ��z3
11,E 6 v6f 21 2 .