07060238 7777777777�—
CITY OF CUPERTINO
BUILDING DlvlsloN PERMIT
PERMIT NO.
BUILDING ADDRESS:
22442 WALNUT CL PATTY ARAKAKI 07060238
PERMIT ISSUE DATE
OWNER'S NAME:
PATTY ARAKAKI
SANiTARY NO. CONTROL NO.
IE:
BUILDING PERMIT INFO
ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH
p p LICENSED CONTRACTOR'S DECLARATION Job Description
v
P 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing
z w with Section 7000)of Division 3 of the Business and Professions Code,and my license is
REPLACE FURNACE IN EA. UNIT & CONVERT 1/2 BATH TO
y in full force and effect.
�? License Class Lic.N LAUNDRY ROOM. NO STRUCTRL & NO LIGHTING.
p DateContractor
E ARCHITECTS DECLARATION
i a< 1 understand my plans shall be used as public records
ryU
U.ti Licensed Professional
a
OWNER-BUILDER DECLARATION
3< 1 hereby affirm that 1 am exempt from the Contractor's License Law for the
p o following reason.(Section 7031.5,Business and Professions Code:Any city or county
which requires a permit to construct.alter,improve,dcmttlish,or repair any structure
t prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation
?a that he is licensed pursuant to the provisions o(the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area
4 H( commencing with Section 7000)of Division 3 of the Business and Professions Code)or $1000
that he is exempt therefrom and the basis for the alleged exemption.Any violation of pN Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 35703035`�'p U Number
not more than five hundred dollars($SW).
0 I,as owner of the property,or my employees with wages as their sole compensation.
will do the work.and the structure is not intended or offered for sale(Sec.7044.Business Required Inspections
and Professions Code:The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for salm ff.
however.the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
§rn4 I,as owner of the property.am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Contractors Li-
cense Law does not apply to an owner of property who builds or improves thereon.and.
who contracts for such projects with a contractor(s)licensed pursuant to the contractors
License Law.
0 I am exempt under Sec. B&P C for this reason
Owner "�" D. t/ Z
WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
v I have and will maintain a Certificate of Consent to self-insure for Workers Compen-
sation,as provided for by Section 3700 of the Labor Code.for the performance of the
work for which this permit is issued.
0 I have and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
My Workers Compensation insurance carrier and Policy number arc:
Carrier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars($10M
or less.)
I certify that in the performance of the work for which this permit is issued.I shall not
employ any person in any mapnFr so as me subject to the Workcrs'Compensation
Laws of Califomi� 'ale
Applicant
NOTICE TO APP CANT:If,alter making this Certificate of Exemption,you should
become subject to the Workers Compensation provisions of the Labor Code.you must
Z forthwith comply with such provisions or this permit shall be deemed revoked.
z. CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of -
> the work for which this permit is issued(Sec.3097,Civ.C.)
W Q Lender's Name
Lender's Address
I certify that 1 have read this application and state that the above information is
CUL.F information correct.I agree to comply with all city and county ordinances and state laws relating to
U building construction,and hereby authorize representatives of this city to enter upon the
W ahovc-mcnuioncd property for inspection purposes.
G3. (We)agree to save,indemnify and keep harmless the City of Cupertino against
liabilities,judgments,costs and expenses which may in any way accrue against said City +�
U Z in consequence of the granting of this permit. Date (r�
►- APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b'r:
SOUR ZE REGULATIONS.
(_J Z�1dO4 Re-roofs
Signature of Applicant/Contractor Date
HAZARDOUS MATERIALS DISCLOSURE Type of'.ZOof
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code,Section 25532(a)? All roof:,shall be inspected prior to any roofing material being installed.
0 Yes f j4o
If a roof is installed without first obtaining air inspection,I agree to remove
Will the applicant or future building occupant use equipment or dcvias which
emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new I naterials for inspection.
District?
0 Yes Wo
I have read the hazardous materials requirements underChapter 6.95 of theCalifor-
nia Health&Safety Codc,Sections 25505,25533 and 25534.1 understand that if the building
does not currently have a tenant,that it is my responsibility to notify the occupant of the -
��
require is w ich mus metQ;ncc of a Certificate of 0ccyV—tTl1 pancy. Signatur-,of Applicant Date
Y lL Iy All roof coverings to be Class"B" or better
Owner or authorized agent Date
CITY OF CUPERTINO
5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Bl{: Lot:
APN 35703035 .00
DATE ISSUED. . . . . . . : 06/27/2007
RECEIPT #. . . . . . . . . : BS000001812
REFERENCE ID # . . . : 07060238
SITE ADDRESS 22442 WALNUT CL
SUBDIVISION . . . . . . : _.
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER PATTY ARAKAKI
ADDRESS . . . . . . . . . . .
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2742
RECEIVED FROM . . . . : DCN ISAMU TOKUNAGA
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY PATTY ARAKAKI
ADDRESS . . . . . . . . . . .
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2742
TELEPHONE . . . . . . . . .
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- --------
BENERGY PERMIT FEE 83 .16 39 .92 0. 00 39 .92 0. 00
BPERMFEE VALUATION 1, 000. 00 83 .16 0. 00 83 .16 0. 00
BPWATER UNIT 1. 00 9 .00 0. 00 9 .00 0. 00
BSEISMICRE VALUATION 1, 000. 00 .0.50 0. 00 0.50 0. 00
PPERMITFEE FLAT RATE 1. 00 38 .37 0. 00 38 .37 0. 00
- --------- ---------- ---------- ----------
TOTAL PERMIT 170.95 0. 00 170.95 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 170.95 #774
---------------
TOTAL RECEIPT 170.95
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ----------------------------- -------- ---------
301 ROUGH PLUMBING 303 ROUGH MECHANICAL
304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL
507 FINAL PLUMBING 508 FINAL MECHANICAL
CITY OF C'UPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
.CPN# Date:
351 -0 3 - 035- 00 -o
Building Address: Mailing Address (if different from building address):
n 94 4a 5. i,00--t n u-l- G r(-( W-(-i on o . z
Owner's Name: Phone#:
Paff Ara-kA-ki 408,1 5-.)-12- 408"-&00--x-346
Contractor: License #:
JOL 0A,1 All &:340
Contact: Phone: 40d- -6 I-!1 T5 Cupertino Business License#:
Fax:
Building Permit Info:
Bldg ® Elect ❑ .dumb ❑ Mech ❑
Job Description: 0 Repla-e i a r e.* �n earh u� t �� co yr yZ bd to i razry, . o
Residential ® O"`« U°5d") Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: �- Occupancy Group:
to vi a-YN-- --'�
Type of Construction: Please check this box if the project is a
second-story addition:
?roject Size: Standard ® Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Bailer<= 100,000 Btu MECHANICAL
BBOILER2 Her> 100K to 500K Btu MECHANICAL
BBOILER3 Boller> 500K to 1M Btu MECHANICAL
BBOILER4 Boil,-r> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ir d/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 flee 600V> 1000A ELECTRICAL
BELEC200 Ele c Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
�k �u rvAc es io l� ;✓�s llt�: pk4 v►e, Cbh PG�-JAA 0 3,4 TO nJ"TU WK
1 of 3
CITY OF CUPERTINO
MY of PERMIT APPLICATION FORM
CUPEkTINO
Quantit Fee ID Fee Descri tion Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Coram. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIME Ir spection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pb1g Fixture PLUMBING
BPGAS Ga;Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Phan 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 Sprinkler/Backflo PLUMBING
BPSTORM ;itorm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT A It of Drain &Vent PLUMBING
/ BPWATER Install/Alter Water Pi a PLUMBING
BPWHEATER Neater Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER AJC Unit> 10,000 cfrn MECHANICAL
BREMAIRHAN AJC Units<= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Re]o Furnace> I OK btu MECHANICAL
BREMHEAT :3eater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rerz Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Po-A er Device/Apparatus ELECTRICAL
BREMRECEPT Re itl, Switch_.& Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
of 3
CITY OF CUPERTINO
cuP�Y��o PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BREMSIGNAD RmJl Signs Add Branch ELECTRICAL
BREMSIGNS Rerr-odel Signs, Marquee ELECTRICAL
BREMTHEATR. Theatrical Lighting Fix ELECTRICAL
_ BREMVENFAN Ve at 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 Tem orary 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 Mechanical sq. foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG PI.robing Fee sq foot PLUMBING
PLLONGRNGC Plannin LR Comme/Multi-Fam PLANNING
PLLONGRNGR Plannin Long Range Residential PLANNING
3 of 3
June 26, 2007
22442 Walnut Circle, Cupertino
Re-convert half-bath to laundry room
Formerly a laundry room next to the kitchen, this room was converted to a half-bath by
the previous owners.
Current plan: convert the room back to a lamdry room. All plumbing and electrical from
original laundry room still exist.
The ceiling exhaust fan will remain as well as the current light fixture.
The toilet plumbing will be converted to a drain for the washer machine.
The exhaust for the dryer will be ducted outside (below the window).
lei ACCORDANCE C)VjEU
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Ct1PEl�TINU ,
BWITH THE CITY Or
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ORDINANCES
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Community Development
10300 Torre Avenue
` Cupertino CA 95014
Telephone(408)777-3228
Clllf OF Fax(408)777-3333
`;UPEkTiNO
Buildi�n De artment
JOB ADDRESS: PERMIT# .
Qa43g 5, L ars,►-L4 C,�rcle 0�7 U��2-�
OWNER'S NAME: F^01 A n-kb k-; PHONE # a S-"-SN 2-
GENERAL
GENERAL CONTRACTOR: Jkk_ FAX #
I am not using any subcontractors:
is Z+to 4-
Signature Date
Please check applicable subcontractors and complete the following information
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Date
Owner/Contractor Signature