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07110154 CITY OF CUPERTINO �t �����*���'���;, : BUILDING D;VISION PERMIT �'����' ;. .: ;; <. �; . < ,.:> . pERM1T NO. Bui���c�+�r�REs�RAKE CT BATHROOPIS BY REMODELING 0'7110154 . pIItMIT ISSUE DATE iNER'S NAME: . THOMPSON CHARLES F AND KAY E 1422 SAItATOGA AVE 11/28/2007 SAMTARY NO. CONTROL NO. PHONE: �4OH� 37�3 BUILDING PERMCI'INFO ARCHI'IECClENGINEER: BLDG ELECT PLUMB MECH � � 0 � n p Q LICENSED CONTRAC7'OR'S DECLARA710N IOU DCSCi1�7t10R ,� V C I hcrcby sffirm Uu� I am licenscd undcr provisions of Chap�cr 9(commencing Z Z � with Scc6on 70(xp of Di 'sion 3 oCthc Busincss and Protcssions Codc, and my lic� is HALL BA` ['H REMODE L �� y in full force an d e f f ��� Q� � � Z Licenac Clasa �n�racwr = �,,, ❑ Dam � � � ARCHII'ECI'S DECLARATION I undcrsunJ my plans shall bc uscd u public rernrda �yv `a y Lir.ensed Pn�fcssional OWNER-HUILDER DECLARATION � `� �►krcby ulTirm thal 1 am cxcmpt Gum �hc Con�ractor's Liccnsc Law Cor thc i p O following rcason. (SccGon 7031.5. Business and Profcssions Cak: Any ciry or county .� ,°, Pi which mquires a pemiit to consuuc4 e��r. �P��. �molich. or repair any svucw�c y Z y prior to i�s issuancc. also requires thc applican� for such permit to file a signcd sta�ement S Ft. Floor Area Valuation < that hc is limnscd pursuant lo lhc �xovisions aC ihc ConUactor's Liccnse [ew (Chaptcr 9 $19 6 8 0 Y t z -� $(commcncing wi�h Section 7000) of Division 3 of thc Busincss and Profcasions Cadc) or y�.. that Ae is ex�mpt the�e[rom and ihe bssis �or the sllcgcd exempuon. Any violatiun o[ Number Occupancy Type Section 7031.3 by any applicant [or a pem�it subjecu the applicant to a civil penalty of 316 3 2 015 � not mote �han five hundmd dollars (5500� � I. u owner a[ tlie property. ac my employces with wsges u the'v solc compensadon, wi11 do the wodc, and ihe swawe is not intended or oReeed for aak (See. 7044 susiness Required Inspections and P�o[essions Code: The Conuacmr'a License Law dors not'PP�Y e��"ner of property who builds or improves thercon, and who das such work himaelf or throngh hia own emplayccs. Prmided that such improvemen�s ue not intended or ofCcred for sala I[. however, ihe building � imp�uvement ia sold within one year oC compleuon. the ow��- builder will have the barden o[ proving �hat he did not build or improvc Cor purpose of sak.). 0 I, as owner o( the propeny, sm acclusively conuuting with Iicenaed rnntract�s to consuuct the p�oject (Sec. 7044. Business and Pcofessions Code:)llie Coatnctor's Li- cense Law does no� spply w m owner o( propeny who builds or improves U+enon, �nd . who conuacu [or sucd projects with a conuactor(s) Iicenxd purswnt io ihe Convacars Licente [.aw• I am exempt under Sec. , B& P C for thia resson wner Date WORKER'S COMPENSATION DECLARA't'ION I hereby aflirm under penalty o[ peryury one o[ the fo0owing dalaraGons: ❑ I hsre and will mainuin a Cenif cate o( Consent lo ulf-imwe for Worke�s Compen- sation, as provided for by Secuon 3700 of the Iabor Code, for �he performancc of �hc work (or which Ihis pertnit is issued. have and will mainlain Worker's Campensation Insurana, as icquired 6y Scction , 00 oC ihe Labor Codc, for �he pecformance o( work for which �his permi� is isued My Workds Co Tpenau' esu cartier d Poli num �� �Y � �� ol'�cy No.: '� CERTIFICA OF EXEMP'fION FROM WORKERS' . COMPENSATlONINSURANCfi (ILis section need not bc completed if t4e pecmit is for anc hunNed �ilus (S I00) . nr Icss) I cenify that in thc performance o( �hc work for which �his pertnit is issued, I shall not unploy any person in any manner so as m become subject to ihe Worlcen' Compensation Laws of Califamia. Da�c Applicant N077CE TO APPL.ICAM: If, aticr making �his Ccrtificatc of Exemp6on, you shoulJ become subject to the Worlcer'a Compensetion provisiona of �he Labor Code, you muu � O foMwilh comply with such provisions or this permil shall6c dcemcd revoked. z �"� CONSIRUCfION LENDWG AGENCY [...� �-�+ I hero6y �rtn Uut �here is a constcuction knding agency Cor the performance uf a, � tlu work (ar which �his permit is iu�rcd (Scc. 3097� Civ. C.) . W Q I.endets Namc � z L.enders Address V � 1 certify ihat 1 have resd ihis applicuion and statc thu thc abow infamauun is w F cortec� I zgrce w comply wi�h all city and counry oniinentts and sute laws relaGng w 0 U buildins consuuction, and hereby authori�e represenuGvcs of this ci�y to cnter upon ihc � W aAove-mentioncd propeny (or inspection purposes a (�ye) agree w save, indcmnify and kecp f�am�less ihe City a( Cupertino against �,H„� � liabilitiu,judgmcnls, cosu and expenscs which may in any wey accruc against seid Cily ��� V z in consequence oC U�e granting of ihis permiG Date ` � � APPLICANT UNDERSTAND WILL COMPLY WITH ALL NON-POINT Issued b:r SOURCE REGULATfO �� � Re-roof; � . _- Signaturo of A canUConuactor ��� T of Koof HAZARDOUS MATERIALS D[SCLOSURE YP w11 the applicant rn futurc building occupant storc or handle harardous matcrial :fincd by thc Cupenino Municipal Codc. Chaptcr 9.12. and thc Hcalth and Sal'cty .�. Scction 25532(a)? All roof,� shall be inspected prior to any roofing material being installed. � �"° If a roof is installed without first obtaining an inspection, I agree to remove Wil� the applicant or Culurc building occupant use equipment or devices which cmit harardous air con�aminanu u dcfincd by thc Bay Area Air Qualiry Managcmcnt all new ; naterials for inspection. ����� �y� No I havc rcad �he hv matcrials requi�cmcnu unJcr Chap�cr 6.95 of tlu Califor- nia Hcal�h & Safcty Codc, 'oaa ZSSDS, 25533 anJ 25534.1 undcrsl�nd ihet �C �hc b���ding docs no� curtcn�ly ha an4 ��� �s mY �P�^�hiliry m noufy thc � �� � Date rcyuircmcn�s wh�c bc mei pcior to issuancc ot a ccnirua�c otj�cu � Signatur e of Applicant �� All roof coverings to be Class "B" or better Owncr of author'ved agcm ��� �: � _ . � . � �o. � - t + y�s� � � e � � � !1 �^ � � a # . - �. . . �. , . .,.- _.. 'L < , _ . _ � _. CUPE TlNO Assessor's Parcel Number: Name of owner. ���� � ��, � �� Project address. � /� � � � °���-���� �� � �/ �x� �^- ne. °-� � `� �� �� ��` U� Contact person./�e� v Pho Fax. Net square footage of lot. ���� � E�istin� Proposed Square footage: First floor: f�-.�c---- Second floor: _� Garage: _,�.— , TOTAL: Are there at 1 east two 10 foot by 20 foot clear spaces inside the garage? � N Is privacy protection planting reQuired for the �►roject? N On wha.t floor(s) is work being done? rp ,.— �� � � ` �� `-� `�� C �� � `���`'c�Z Brief description of work. , � �� , � n �' �,� �, � � Zooi cFC ��2ooi cMC �� Code editions: 2001 CBC ��2001 NF C �'� 200I CPC � � Effective 11/1/02 � - � ,� s � � ,� so ,; � �� . ,o� Plan Review Process Work Book Page -8-Revised 8/22/OS _ iA ��•..�" �r � l.✓. ' • �tx �'3��'�'-Y'�t��1l�S � ���.. � - � ����� rr.r.-- a , b b� R�mode�i� Spec;ic�iists IO -• /�— n� 142Z SARATOGA AVE. • SAN JOSE, CA 95129 � r �— C�� TELEPHONE (4O8) 378-6700 CON"FRACTORS LLC. 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CUPEf�TlNO Assessor's Parcel Number: �,G',�,�.� �► ��� � ..� Name of owner. Project address. /� /� � � � ���-����e�-e �� � �/ �x� �- one. °-� �S �� �� [ S� U� Contact person. j��� v Ph Fax. Net square footage of lot. ���-��� � E� istin� Proposed Square footage: First floor: � Second floor: _��' � Garage: �.- , TOTAL: Are there at least two 10 foot by 20 foot clear spaces inside the garage? N Is privacy protection planting required for the ��roj ect? N On what floor(s) is work being done? c ���� 1 � - ,��/-�� �� ��.��c� �'``J � l i� Brief description of work. � ��� , � � �� ' � ,- Zooi cFC ��2ooi cMC �� "� Code editions: 2001 CBC �� 2001 NE C �'� 2001 CPC � � T' , .:: :� �Z�� �� �"'� hy � a �;�� CI�CY OP� , � ��CE `NI�1 �yCE9 � Effective 11/1/02 � ,;� F�CG�`'�� � Q���t�a �tfP�.��ltd�J ' �OD�S A ��-2�� � �r,�E�'���____��� s �� ,...._-..—°" ""— tll�y;iS ` k .�--� �t - ,�.c�,;ca� u �-1 ' r i�-. 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F i " � _ � D � '_� � __• � �� � � 1 ` � ` ° ' � i � a . , � 4 s � 1 t ,_... �,. " � .�- � � �"'.. a i% �.._...�..� i J a I.� : ) - � „e _ .��, �, � �.,. ._t-�. �-�--� � , ,. ' � � � � � � i � , 3 i � � � � S � • ..�... t ' �"� w�-�v � t---~ f - � � i , - t i � � � �. � _.� L��� �. � � � � � � # � . � c :. . i 1 F - ..�.r._ ' ��� _ _ _ � : F , - � � � - , � y � ' _� . � �� i/oi�-y CITY OF ��UPERTINO ;� ����` ADDITIOrJ/REMODEL .�.� CUPE�TINO PERMIT APPI,ICATION FORM APN # .3 ! � ,3 02� � `J . � Q Date: f/ ���/d � Buildin Ad�ess� � �- � «�� �� � Mailing Address (if different from building address): Ow�er' �I'�1 � ��. ��� � Phone # � � ) � � � /' , ��„� � �/ Contractor: Phone #: �� p�� J��6 � 6 ��l-Cd/``,�'�-8-�-r� � �C � ���r,' F . Fax #: Contractor License #: � � � U�� Cupertino Business License #: v`1 0� � 3 Contact: � Phone #: ('� �� J � �,��j � � /� l� " QL� ��'`'�— Fax #; Building Perniit Info: Bldg. Elect Plumb. ]_ Me . Hillside ❑ Job ription: ' What is being added? What is being remodeled? � /�� r� l ���`��� . / �/ Residential Remodel Includes Re-Roof Yes ❑ No ❑ If yes list number of squares Remodel Includes Structural: Yes ❑ No ❑ Square Footage: Addition: Remodel � � � � Garage: Porch: Deck: Other: Type of Construction (Usage Class): Occupancy Type: 1 FR, 11FR ❑ 11, 111, V-1HR ❑ 1 l, 111, 1�� V-N � Valuation: � Please check this box if the project is a �_�?��� �/, � �� • � second-sto addition ❑ Green Building Check list must be completed an�3 Green Building Points Achieved: attached to the plans. ***For Office Use Only*** Over-the-Counter ❑ CITY OF C UPERTINO ADDITON/REMODEL FEE SC]E3EDULE Quantity if A licable Fee ID Fee Descri tion Fee Grou Permit T e PATMOBF Atmospheric Vacuum PLUMBING � PCESS Cesspool PLUMBING PPRSEWG Ea. Private Sewage PLUMBING Disposal System PRSEWER Sewers PLUMBING ' BPSPRINK Lawn PLUMBING SprinklerBackflow BPWSVCS Main Water Service PLUMBING BSEISMICRE Seismic Residential BUILDING DECKWOOD Each BUILDING DECKRAIL Each BUILDING � GARDTW<=1K Wood Frame up to BUILDING 1,000 SF GARDTM<=1K Masonry up to 1,000 BUILDING SF PATIOWOOD Wood Frame up to 30 � BUILDING . SF PATIOMETAL Metal Frame up to 30�) BUILDING. � SF PATIOOTHER Other Frame up to 30() BUILDING SF � Additional Patio Each BUILDING 300 SF PATIOENCLW Enclosed Wood up to BUILDING 300 SF � PATIOENCLM Enclosed Metal up to BUILDING 300 SF PATIOENCLO Other Enclosed Patio BUILDING up to 300 5F • Additional Enclosed BUILDING Each 300 SF REROOFRES Residential Re-roof BUILDING Each 100 SF REMRESKITN Kitchen Remodel up to BUILDING 300 SF REMRESBATH Bath Remodel up to BUILDING 2 of 3 CITY OF CUPERTINO 2 ITEMS OF 2 PERMI'� RECEIPT OPER�ITOR: patq COPY # : 1 5ec: Twp: Rng: Sub: Bl:c: Lot: APN ......... 31�32015.00 DATE ISSUED.......: 11/28/2007 RECEIPT #.......... BS)00003344 REFERENCE ID # ...: 07L10154 SITE ADDRESS .....: 19742 DRAKE CT SUBDIVISION ....... CITY .............. CUPERTINO IMPACT AREA ....... OWNER ............: TH�MPSON CHARLES F AND KAY E ADDRESS ..........: 19742 DRAKE CT CITY/STATE/ZIP ...: CUPERTINO CA, 95014-2432 RECEIVED FROM ....: BOL�TIFACIO ALCANICES CONTR.ACTOR .......: JOZO CAR.AN LIC # 24223 COMPANY ..........: BATHROOMS BY REMODELING ADDRESS ..........: 1422 SAR.ATOGA AVE CITY/STATE/ZIP ...: SAI�T JOSE, CA 95129 TELEPHONE ........: (408)378 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ---------- ------ 1BSEISMICR VALUATION 19,680.00 2.00 0.00 2.00 0.00 1REMRESBAT SQ FEET 45.00 551.00 0.00 551.00 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 553.00 0.00 553.00 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ------------------ CHECK 553.00 #5598 --------------- TOTAL RECEIPT : 553.00