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05070192 (2) CITY OF CUPERTINO " ` BUILDING DIVISION PERb _ �,CON,TRACCIR TIN, QRMQ_N BUILDING ADDRESS: PERMIT NO.05070192 10943 WILKINSON AV 10 EWS NAME: PERMIT ISSUE DATE SPIELMAN MARVIN AND BARBA n7/2S /2 05 PHONE: SANITARY NO. CONTROL NO. ARCHITECTMNGINEER: BUILDING PERMIT INFO BLOC ELECT PLUMB MECH +Op LICENSED CONTRACTOR'S DECLARATION Job Description u G I hereby affrm Nat 1 am licensed under provisions of Chapter 9(commencing - U with Section 7")of Division 3 afore Businasand Profusiarm Code. dmyliccnsc is p "z' in full far.Ind Re �� KITCHEN D %e1 j(/]�lIL `S OWER REPLACEMENT j 2 License Claza .�1 0 G a Lie.M "J / {�,1 J(�i> I�.3,�In PI y❑ Dam Contractor u u WWIfII]'�MC\ ARCHITECTS DECLARATION ;>U 1 undervand my plans shall W used as publi��`��� `l (` koH Licensed Professional -AN 2006 S OWNER-BUILDER DECLARATION <� 1 hen,hy affirm that 1 am exempt from Na Contractor's License Law for the n p o following reason.(Section 7W 1.5,Business and Profession Code:Any city or county RN fi gI pl �t pa p y� 2 5 which myuires a permit to contract,alter,improve,demolish m repair any struclure Ij t'n !I N A fY prior ht its issuance.also mquiresthe applicant for such permit to rile asigned stammcat y s 1` �' z< chat he is licensed pursuant to the pravisiom of dm Cantraewr's License Low(Chape,9 Sq.Ft. Float AreaLtl �- Valuation y'r•� (commencing with Section 701 of Division 3 of the B usinesa and Professions Code)or y that M is exempt themfrom and the basis far dos alleged exemption.Any vim.don of Section 7031.5 by any applicant for a permit subjects the applicmno a civil penalty of 3r Occupancy Type not mom than fin hundred dollars($500). ❑1,as ownu of ttie propcny,or my employees wib wage u d¢ir sole compensation, will do the work,and Neswcwre is not intended or offered Tarsale(Sec.7044,Business and Profoesions Code:The Contractors License taw does not apply to an owner of Required Inspections propen y who bui Ids are improves common.and who docs such work himsr3 f o r through his wn employees,provided chat such improvements are net amended.,offered forest..if, however.Ne building or improvement is sold within one you of completion,Ne owner- builder will have she burden of proving bat he did not Wild or improve far purpose of Wk.). Q I,as owner of an property.am exclusively contracting with licensed contractors to ' construct the pmjccs(See.7044.Business and Professions Cade:)The Conamars Li- cense Law docs not apply to an owner of propcny who Wilds or improves thereon,and who contracts for such projects with a constacsor(s)licensed pursuam to be Contractor's License Law. ❑1 am e..mpc under Sec. .B @ P C for this on Date WORKER'S COMPENSATION DECLARATION 1 hereby of arm under penalty of perjury one of the following declarations: ❑1 hem and will maintain a CaniOease of Corrector self-intim for WorkereCamper. sation,as provided for by Section 3700 of the labor Code,for Ne performance of the work for which this pcman is issued. ❑1 have and will maintain Worker's Compensation Insurance,es myui.d by Section 3700 of the tabor Codc,for dm performance of the work for which bis permit is issued. My Workers Compensation Invaronez carrier and Policy nuurnhrap-, Camaag e � . P 6 C rC �P q FICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE QTis section need not W completed ifthe permit is fm one hundred dollars($1010 nr less.) 1 certify that in be performm¢c of de work far which this permit in;issued.l shall not employ any person in any manner so u In become subject to the Workers'Compensation Laws of California.Data Applicant NOTICE TO APPLICANT:If.after making this C.Illfeme of Exemption,you should become subject a the Workers Comperaetion provisions of done Labor Cod,you muse ,JO foMwish comply with such provisions or this permit shall W deemed mwkcd. z Vy CONSTRUCTION LENDING AGENCY E1 hereby affirm that there is a coesttupthm lending agency Tore the performance of > the work for which this permit is issued(Sec.3097,Co.C.) W 0 Lenders Name z Lenders Address a V Q 1 ccnee tom 1 ham read this application and sue bat be above information is 0 U corms.1 agree m comply with all city and county oNinnnoes and slate laws relatingupthe�(J building construction,and hereby forimpmhonpuMo csentativesaf this city mentor upon be r above-(We)a cd gree to amysave find mpeNon keep es (We)agree to save,indemnify and keep harmless be City of Cupertino against F'Z liabilities,judgments,costsandof this Permit. may in anyway acerae against said Ciq U z A consequence of UNDERSTANDS of chis permit. 1) 60 rti APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. B 29,-V— Signawr p eanV ontracmr Dam Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type Of Roof Will be applicant or fume building uccap..,wane or handle havallous material as dcfinca by he Cupertino Municipal Code,Chapmr 9.13,and the Health and Safety c,Station 15532(a)7 ❑Yes ON. All roofs shall be inspected prior to any roofing material being installed. Will be applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit haxordaus air contaminants n defined by the Bay Arca Air Quality Management DistrictT all new materials for inspection. ❑Yes ON. Iban mad thohvardeus materials25505,25533 Ind under Chaper695o the Caldinr- / © � 0 rias not ur Safety Cale,Rectenant shat it i my mad15534.1 undersand that illW Wilding Jos ams currently base a tenant that it my mspomihility rem notify bda<upant of IL nequircmena which must melp�iyyrr to lssaanecorac mfeamorwrapm,cy. Signature of Applicant Date >cS P �6C[ C2�/r/J HGF S G ermaubarlvndagem D„e All roof coverings to be Class "B”or better 0 0 CITY OF CUPERTINO 1 of 1 PERMIT RECEIPT OPERATOR: quem COPY # 5 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35613028.00 DATE ISSUED. . . . . . . : 07/28/2005 RECEIPT #. . . . . . . . . : 30567 REFERENCE ID # . . . : 05070192 SITE ADDRESS . . . . . : 10943 WILKINSON AV SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER SPIELMAN MARVIN AND BARBARA ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4774 RECEIVED FROM . . . . : BOBS CONTRACTOR . . . . . . . : LIC # COMPANY . . . . . . . . . . : ADDRESS . . . . . . . . . . : CITY/STATE/ZfP . . . . , TELEPHONE . . . . . . . . : • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 1.00 34.86 0.00 34.86 0.00 BPERMFEE VALUATION 25, 000.00 331.56 0.00 331.56 0.00 BELEC200 METERS 1.00 29.43 0.00 29.43 0.00 BPINTERCEP NO OF INTERCE 1.00 17.99 0.00 17.99 0.00 MPERMFEE SQUARE FEET 200.00 16.00 0.00 16.00 0.00 BSEISMICRE VALUATION 25,000.00 2.50 0.00 2.50 0.00 BUSLIC FLAT RATE 1. 00 102.00 0. 00 102.00 0.00 EPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 " ---------- ---------- ---------- ---------- TOTAL PERMIT 572.71 0.00 572.71 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ OTHER 572.71 MASTERCARD TOTAL RECEIPT 572.71 • P W JV � boa t H -- 218'–LU is Z 89e �-� 25Z__---_45.. .I 173" y0 W.—V—21" —� Ld :— 24" —/ / W 03'.. 3.e.= 33" kZN Y F)4 – 33" --' QW21'36 DW36S-L� \ LU N W F HW -SL ro I ; n _=NN. . • h ° �1 ai LL> LL I o o A w \ t! LUL 1 3 0 • WQ�a N j LLr mall l% O �� 7i0 VaI 'am Nm F LL- LU W U` U t i F-U 7o ZOQ h ZZ, " m _ � LUO z Qco,! . ym o a D m 0QN V LL iU 1Z4E0£ HD <WLU � N Y o N j 9E0£M9£O£M m'o m i N 2 N iLL :f 09 _ �-1_—� .•8�Z1Z9£M -�k � l ,,:ZZ — m � m ZZ .. 9E OFFICE egpy 1793 Lafayette St., S• 200 Santa Clara, California 95050 I}c h E n Phone (408) 248-4050 Fax (408) 248-4060 Jn Web www.KitchenGatteries.com c;l� ELECTRICAL INSTALLATION NOTES Marvin & Barbara Spielman • 'Wilkinson Ave Cupertino, CA 95014 101 —single pole for fluorescent recessed cans, mounted 21" away from exterior wall 1013—fluorescent 3-way located in eating area. 102—switch/dimmer for incandescent recessed cans mounted 21"away from the walls. 1023—incandescent 3-way located in eating area. 103 - switch/dimmer for incandescent fixtures over the table 104 - switch for fluorescent undercabinet—buffet area 105—switch for halogen "puck" inside cabinet. 12v Class 2 60w transformer location subject to job conditions. Suggested location top shelf of wall cabinet. Unit must not be buried in insulation or in wall. 106—switch for garbage disposal use. 107 -switch for fluorescent undercabinet—main countertop area. • Special Installation Notes N1 - 15a receptacle for refrigerator and freezer use. See manufacturers specifications for proper installation and height for these units. N2 — 15a receptacle for microwave/hood combination use. See manufacturers specifications for proper installation and height for this unit. N3 - 240-208/120 VAC, 60hz for range/oven use. See manufacturers specifications! N4 - receptacle for electric cooktop. See manufacturers specifications for proper installation for this unit. N5 - 15a receptacle for dishwasher use. See manufacturers specifications for proper installation for this unit. N6— 15a receptacle for garbage disposal. See manufacturers specifications for proper installation for this unit. • your dream kitchen . starts here 218" 55 92 70" Q 24.DISH ISH � f0y 0 lot / � M - --------�— �... LLQ s� IJP — — -! OZ-Zd32j 9£ log �I 0 iZ1 - 1 29s =zz „z�s I r tC Lq 4e _ OS ��o / 9Z O CITY OF CUPERTIN# CUP OF TYO PERMIT APPLICATION FORM APN # 3 5� ` 13 -029 Date: /;7 z8 , c� Building Address: Mailing Address (if different from building address): O ` So eAT, v 04 S / Owner's Name: Phone#: 6 aA Apia i ' Ie_b Contractor: License#: Cont t: Phone: 6C6),2XYS22S Cupertino Business License#: a, -' C4J-1 6> Fax: 0 31SZ;Z3q Building Permit Info: 7AE 45VV 5VU'461GPr—V �Cc e%hce 0A,,.4( Ad—,q/e—&- Bldg ❑ Elect ® Plumb ® Mech 12 Job Description: Residential ® Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: X00 1 Cost of Project: c9" Occupancy Group: Type of Construction: — Please check this box if the project is a second-story addition: ❑ Project Size: Standard ❑ -- - _Lare ❑ Maior ❑ 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 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 Investi ation fee BUILDING 1 of 3 CITY OF CUPERTIN(* CUPEI�TINO PERMIT APPLICATION FORM QuantityFee 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 BldgPermit 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 rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER InstaWAlter Water Pie PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRI AN 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> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res A liance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/A aratus ELECTRICAL BREMRECEPT Rept], Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL AbL BREMREPALT Repair/Alter Heating MECHANICAL Iry BREMRESAPP Remodel Res A liance ELECTRICAL 2 of 3 ;��`�� OITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEI,TINO 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 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 41W EPERMITFEE Elec Permit Issuance ELECTRICAL p U MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERNHTFEE 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 • 3of3 CITY OF CUPERTINO a <' ` e'0 BUILDING DIVISION PERMIT kCONTRACTOR INFORMATION BUILDING ADDRESS: PERMIT NO.0 5 0 7 019 2 10943 WILKINSON AV ER'S NAME: PERMIT LSUE DATE SPIELMAN MARVIN AND BARB 2005 PHONE: SANITARY NO, CONTROL NO. ARCHITECDENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH +Op LICENSED CONTRACTOR'S DECLARATION U I heroby affirm Nat 1 am licensed under provisions of Chapter 9(commencing Job Description with Section RIIgB or Division 3 of the Business and Profession Code,and my license is in full force and e • 51-Y061 KITCHEN RMDL, TILE/SHOWER REPLACEMENT j}a z Liccve Cress :J Fp Dam Contractor 'pry ARCHITECT'S DECLDELL ARATION e(-s I understand my plans shacoed u puM1lic y4� ll be_� "�i`f0 Incensed Pmfcssionel 3 OWNER-BUILDER DECLARATION ZQ C 1 mors affirm Net 11. exempt from N.Canlns CO License Law for the p O following moron.Permit 1 ]IDL;Business and Profession Code:Any city as county u29 which its requires a permit se toms;Me alts.improve.h Permit t fie a sig any .cutructure, $25000 °z„ priarmiss issuance.also requires Ne applicant for inch permitmfileasigned mtemem m, Oat las islicensed pursuant mNeprovisions ofthe Contractor's License,Law(OwincT9 Sq.FL Floor Area Valuation x (commencing with Section]DDB)of Division 3 of NC Business and Professions Codi or y $ Nat he is exempt therefrom and the has¢for Nc alleged exemption.Any violadon of Section 7031.5 by any applicant for a permit subjects Ne applicant 10 a civil penally of not mom than me hundred donor($50B). r Occupancy Type ❑1,u owner of the property,or my employcu with wage n their wlc compevalion, will do the work,and Ne structure Is notimanded of.Bered forwle(Sec.7Os4,Buelirss and Professions Cade:The Contractormm Contractors Liece Law dors not apply an owner of Required Inspections property who Wildeorimprov Nercon.andwho dMssuch werkhimseJfor through his awn employers,provided Nat such improvements are not intended oroRcrd forests.If. however,the building or improvement is mid within one year of completion,the owner. builder will have the burden of proving that he did not Wild or improve for purpose of tile.). ❑I,as Owner of the property am exclusively...tiefir,with licensed contracmn to ®� construct the projm(Sec.]044.Business and Professions Cade:)The Contractor's Li cense Law does not apply u,in owner of property who Wilde or Improves Norton,add who concocts for such projects with a canuactods)licensed puumnt in the Contractor's License law. ❑1 am exempt under Sec. B 6:P C for Nis mason / DauA' or WORKERS COMPENSATION DECLARATION r 1 hereby will ai under penalty or e of one of the following dalaeeuons: �/ ❑inner. as and will maintains rom 33au of the Labsent r Code, for Wmkcr's Cruice of th- 81Aine,,for for by Section 3]00 of the Labor Code.for the performance of iW work for which this permits orker ❑1 have and will maintain he pcof rmance of the w Insunna,h re,his Per by Section ss u d, 3]00 of Nc labor Code.for the prance can..of d work for which this permit is issued. My Worker's Compensation Insurance eartier and Policy number arc: Cmrismes6r 1160V - CERfIFlC OMPE SATIONNSURAN WORKERS' COMPENSATION INSURANCE (Ihusettion need not W completed!Btis Permit is forum hundred dollars(SI00) or less.) I anifv Nat in the performance of On work for which this permit is issued.I shall not Morin;any person in any summer an as in become subjttuo the WorkertCompensation lawn of California.Dau Applicant NOTICE TO APPLICANT:If,afsr making this Cenifiam of Exemption,you should become subject to the Worker's Compensation provision of flus labor Code,you most .Jz forthwith comply with inch provisions or this permit shall W named waked. Z O CONSTRUCTION LENDING AGENCY (-+ I hereby affirm Nat there is a construction lending agency for the performance of C(. Ne work for which this permit is issued(Sec.3097,Civ.C.) CQ Lender's Name . Z)z Lemicrf Add. U Q I comly Nal T have read this application and sus Nat On above information is correct.1 agree to comply with all city and county ordinances and sum laws relating to U Wilding construction.and hereby authorns representatives of Ois city to enter upon the r W aWvedmenudgm property for inspection expenses which may a F 0. (We)agree to Yve Indemnify and loop harmleII the City of Cupertino against TTI lieconeo,mence of the gratsing expenses which cosyin any way¢true against said City U Z his crunit. APPLICANfeUNDERSTANDSOf tAND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS��) 29 IV— Re-roofs Signaler p¢andConuacmr Dau HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will IW applicant or future Wilding ocemp tit gore or handle hanrdous mamtud dcfrnd by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety C.Section 25532(a)7 . ❑Tea 0 N All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupam use equipment Or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit M1arard ors air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? P ❑Yes ON. Ihavemad Nehua ousmaurialsmquimmenmunder Chapmr6.95offtCalifor- !� niaH.Il aSafctyCoda SccE..25505.25533wd25534.Iundmsund Nmiftbe Wildingr+-- docs not cmmmly ham a u enk Nat his my responsibility to notify the uc.upent of C J tequiremcnu winch mug be mt pmss.nceaa comfit=oSignature of Applicant Date� a�a. aS©s own—cr car autboricd seen. Data All roof coverings to be Class "B"or better i>