08030097 (3) MY OF CUPERTLNIO
BUILDING DIVISION c N7rR'EICT0R�INF0, TIO
Buu..g1f3 SS' 'F RESTON DR BART & IRIS GACH 08030097
OWNER'S NAME: PERMIT ISSUE DAM
BART & IRIS GACH 10332 CRESTON DR 03/18/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
-BLDG ELEL7 PLUMB MECH
l� 0 (�
eros LICENSED CONTRACTOR'S DECLARATION UOD
U 1 hereby affirm Nu 1 w licenced under Provitions of Chapter 9(commenei� Job Description
wild Srcum 10(10)ofDivision 3 of the Business We Profutima Code,and my license is CHG 2 PRNG SKTS TO 3PRNG & GRND REPLC
iq? Ucc.0. Lk.g SWTCHS,LIKE4
nf0W Dau ARCHITECTSDECLARa7TON LIKE WNDW RPLCMNT
j¢< i undrnund mY Plans shall Ic used as publk records
WG
, U
g G LIccn¢d Ra(cstioval .
'' 3
OWNER-BUILDER DECLARATION
0 I,nonny from Nat 11.exempt from Nc Conrns;Co Lkmx law for me
0 O rollowing mason.(Swum Tin 1.5.Business and Ndfesdam Code:Any city Or county
$ W Eich wilds a Permit m crosanct.alta.improve.demolish,or repair any sunnew. '
prior as its i..M.earn requires She.poicam for arch Pewit to rile.egne'Iau¢ment
<
in.W is paved pumam mNc provisions of the,contractors uaone LAW(Chapter 9 Sq.Ft. FIOOr Area cC Valuation
�$ (commencing wills SecuonTODD)of Division 3 of Ne Business and Professions Cade)or yJol]0
Q r3 9 Nal be is exmpl lbuefmm and the basis for the alkgod caueption Any vioWioo of
Section 703IJ by airy appliances fora premie mbj=t e applicant to a civil Penalty Of
. ,
Number Occupancy Type
old mre than rive hundred dollamWI, 32637042q
w
win da Ne work and the swnuR a mlNunGd afoffered(made(See.7014.Bua.ay.•
'
and Prefessons Casio: e TCamncmrs Licnue Law does Out appy to an mncr of Required Inspections
property rho builds or improves afternoon.and whuddeusuNwark hi rse fortMugh his
owrn wploya,proNeW Nat w.."Impmvrmenu>R not inmndnd m oRurd(male B.
bwevv.Ne building adden ovcmuu scall did rex)ear of mmpkum.lW awrcof .
balder will have She burden of provNg that K did Out Wild m improve for punprnce of
vk). '
1.as owner M and property.w sclusively computing With fl contwoetms in
commrct ue project(Sec.10th.Business and Profestiov Cade)The CoO.e.U.
sate law dors not appy in an owner a prOPOVY who builds or improves thereon.and,
wmymranvacu for Sabi projceu witha marcut(s)licensed'moos.in the Conuces" .
Law
�1 erntan;Oyofunder Sec B s P C fm dos ma+on
Owmr�✓tit1 Due- 11 /O
le
WQ IYERS COMPE`15ATON OECLSRATON
' I hwbY!(nrm under pevaltY a perjury m o!Ne falbw;ng declarationsS
❑Ibsve and WiR mdnuinaCerWiesl,of Camentm cell-imam fm wahcraCumpan '
word,.es provided for
wmSmrioo 7]00 of th Lobar Code,for 1W perfowarto:of Ne
art for which this pewit is issued '
❑I have and Will mdoWn Workers Comper ation Insuranco,as squired by Section
3700 of the Lobar Cock,for the perfdwancs of Ne work far which thad pewit is issued
My Waduurs Compenvuon Iwraom carrier and Policy number tic -
Cadier. Polley No_
CERTIFICATE OF EXEMMON FROM WORKERS
COMPENSATION INSURANCE -
0-,j.seal.posed ran he pit"-a the pewit is for cote hundred dOBas(SI00)
or less)
I aunty that in 1W performance Of the waHt for which Shia Permit a Was.I shall not
cmpbyanypcoaninanymarman'
de Wadpaa'Compussum
tawsarCaifamiaDa ' gKKcom
Applicant \ w
NOTICE TO APPLICANT:If,enUmapin,this Certificate of Eawptlon,you speaks
Wonme sub)=to She Worker's CmnmaatiOm P.W.Of the,LaWr COde yrnu moa
O forthwith comply with such Provisions or this permit Shall W doomed revolted.
e .
Z p 1 CONS'TIRUCTION LENDING AGENCY
[+— 1 hotels,andm She Here is a construction lending agent'for the Performance of
D: 7 the wish for which this Permit is issued(Sec 3097,Civ.C.)
1 Lenders Name
= Z t<ndcrs Adamv .
U O I unify dist T in.read this appiiudon and ml,the the above information a
Iy cortcca 1 agree in comply wish all city and cmnty mdi,an¢s and sue laws reaung to
C) building constructions.aod hereby auNmics reryracnuuves of Na city in mterupno Ne
LO shove-crenuomd property for LSpen;on purydses.
Qw (We)agree to ave,indemnify and keep harmless six City of Cu,crurm against
(A hieb;liugjudgmenu,teas and eapmces which may to any Way Secrete against said Cy
I.
U? APPPLICAN`UNDEunsocc.r the RSTANDS ANDS AN.1 of this D WILL COMPLY WIT1/ALL NON-POINT Issued by: Date
SOURCE REGULATIONS. ,/
V '. ' Q ✓jja-t, lItFIO' Re-roofs
STignalum of 'canuConun
arnr Dau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will use applicant Or future Wilding nsuprM wen Or haMke baardou malmia
as defired by the Copernican Municipal Cade.Chapter 9.1;and de Holth and Safety
Code.Section 253307 All roofs shall be inspected prior to any roofing material being installed.
C]Y. ON.
Will the applicamorfuture building eaupamOn,equipmmtcar ded. Which If a roof is installed without first obtaining an inspection,_I agree to remove
con,ha aNnm air enriamimoa as denned by J¢Bay Alda Air Quality M..gwmt all new materials for inspection.
District?
0 yes t34.
1 have mal the haareausmacriaa requircmens under C1cmuS&95 of Ne Calif..
Code.Sovas73301.95577and25S3a.ImtlavaM Shnifdrc
building
'Inca ml emrendy pave a alum.Naz Il a on espensarld'm mury Ne oavpmt a the
raquimmc which rer.Wmet 'rmia at�anecairicamofaeupmeY. Signature of Applicant Date
-f All roof coverings to be Class'n:a'or better
Owneror mNOrbcd ot- Dom' .
CITY OF CUPERTINO
5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32637042 . 00
DATE ISSUED. . . . . . . : 03/18/2008
RECEIPT # . . . . . . . . . : BS000004188
REFERENCE ID # . . . : 08030097
SITE ADDRESS . . . . . : 10332 CRESTON DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : BART & IRIS GACH
ADDRESS . . . . . . . . . . : 10332 CRESTON DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : IRIS J GACH
CONTRACTOR . . . . . . . . LIC # *OWNER*
COMPANY . . . . . . . . . . : BART & IRIS GACH
ADDRESS . . . . . . . . . . : 10332 CRESTON DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE . . . . . . . . :
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
------=--- ----------- --------- ---------- ---------- ---------- ---------
1BSEISMICR VALUATION 5, 000. 00 0. 50 0 . 00 0. 50 0. 00
1ELCPLNCK HOURS 1. 00 122 ..38 0 . 00 122 .38 0. 00
lEPERMITFE FLAT RATE 1. 00 40.79 0 . 00 40.79 0. 00
1TRAVDOC FLAT RATE 1. 00 40.79 0•. 00 40.79 0. 00
1WINREP EACH 8 1. 00 367 . 00 0 . 00 367 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT : 571.46 0 . 00 571 .46 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 571 . 46 VISA
---------------
TOTAL RECEIPT 571 . 46
0oP03 009 7
GCa�,
CITY OF CUPERTINO
CUPEkTiNO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # Date:
�2G�-37.- e�i2 : Gv ��i��aS� •
Building Address-
1 CO3;I_
ddress:1CO3:z &Z�)-) l�iG
dL,P. C/)-' jS;Tly
Mailing Address (if different from building address):
Owner's Name: G�� Phone #: yCb' 7.26'1'[)24:
Contractor: Phone:
Fax:
Contractor License #:
Cupertino Business License#:
Contact: Phone:
Fax:
Residential Commercial ❑
Job Descripti/os�: c1la-Ae., t,��� jCc{_E� �Z d�2tmt7 �pldrnc:� CL/aG?
VL kv' Lek; WivdaL0 k&F a"-iYtv_vtA
Building Permit Info:
Bldg ❑ Elect 14� Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1 FR, I IFR ❑ 11, 11), V 1HR ❑ 11, 111, 1V V-N-p- 3
Valuation: Square Footage:
Project Size: { Standard VLarge ❑ Major 0
li
NI
aj rt-Y+ a`1Zt�uiNE
�`; f � � _ k' s.r� r`'°,.4j�yi��'�,'iaC�t`--s'��.�y. •��,X�c+� �-4�s� wN.• n et•..R� -�•.
�` � = RESL�DENTIAL�PROJEC�=T�COUER�SHE-E�T'
Assessor's Parcel Number:II 3 7(JY 2
Name of owner. P?0,cC rt (IIIS (t -Y'1
Project address.
_ r ,t>
Contact person. AGI C,V1f�I Phone. `�(� Lt D D
Fax.
Net square footage of lot.
Existing Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
Are there at least two 10'foot by 20 foot clear spaces inside the garage? Y N k)I1�k-
Is privacy protection planting required for the project? Y
5 .
On what floor(s) is work being done? I-
Brief description of work. fL7I/anpylryr> ' Ii)IY1Cow-,
�Vtr>yi 5o 'LT cr�a (-s iv a Int r [rtr�,mt ,1 (� t fl,l��r• It Qt S-Lt
Code editions:2008 CBC (Y - N)2008 CFC (Y - N)2008 CMC (Y- N)
2008 CPC (Y - N)2008 NEC (Y - N)
%PPROVE®
Effective 1/1/08 IN ACCORDANCE WITH THE CITY 06 i
CUPERTINO CODES AND ORDINANCES 1�
-)ATS '/ I4AR IS 7000
3IGNED � or.�
This set of plans and Specifications &11157 I�y
tie kept on the job at ap times and it is m
! lawful to make any changes or alleram 14 _--. -•
an same withnut wnttenV etm.ssiun 1 €
ti the building Dept., Ny a Cupe Imo.
the stamping OT be ed tp anip n sperwca 1 OFFICE COPY
I' ,1 it iHALL NOT be he d t 1 pa nln t 1 U.
— 3pproval of the violau�n c! ai; pr.,vlslll
1 I . if any City Ordinance or Stale Law
1 I Plan Review Process Work Book Page-8-Revised 1/1/08
I
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