06090253 CITY OF MPERTINO
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BUILDIN6DIVISION PERMIT 1
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BUILDING ADDRESS: CALIFORNIA SKYLIGHTS PERMIT NO.06090253
10366 A PERWT]SSU DATE
OWNERS NAME:
MURNA EHRLICH 2250C
SANITARY NO. CONrRol,NO.
E
(408) 866-6759
BD1LnwG PERMIT INFO
A0.CHITFIT/ENGINEER:
BLDG ELECT PWMB MECH
0
1m, LICENSED CONTRACTORS DELI-ARATION Job Description beehy Nom dda 1 w li¢mdd
uer p,r Ooa,of Chapter 9(macin{
mm
N Sedmr 7ODM or Dirlmn 3 of the Budms and lea"Oml+Code,id my firma 4
N iME nfauforcc denea INSTALL SKYLIGHT AT. LOFT LOCATION
)nz IAccn,cclass Lr.[—�$ suiejE7
it�< °� ARCHTIECTS DECIMATI N S V/G ffT
W U l udvcad my PIr^+i1W l be uspehlid u c reorN
-OG Lkrnad PmkW
OWNER-BUILDER DECLARATION
co TON gf
aC 1 hereby M.dr I m eBcroptusw two Ne Cmudd Cd Lsen c Law rte Nc 6
0 o following mimn.(Sadm](1313,Busrcss and Pmrnsiom Code:Any cxY or counre,
f$tea which is 4 a Pemit rc celwnc4 w improv,he ii,a ..ic rnr suunum
- «b i4.d 7 also m to dic the odoicaof for sOccoo rtit=�I Ek-Li. chit r 9 Valuation
e4Heevd pwsuin m NC a Di,lokor de cm.ncior',Lina Vw(aifnm9 Sq.Ft.Floor Area
5 $ (c,heb nL with Section]0007 of pvWno3 the
r1 deed—Pd-
ru O16Of
�S _ ttw id h carob macrmm rod or Per I.tle alleged c mPdm.Aoy d Prodon or
oot m 70.11.7 M arrykun ippilant for i permit wbfeau the ippbtau b i rdvll p�Y Of r Occupancy Type
cot mom thm 0w kedmd dN4ra(S5f10).
C L u—of the property.or my—N.Y.whh F.u dei mlc mmP tools
w01 do the wart-.,m the hna mmnded 0, Bind Wole(set.' .B'oroet Required Inspections
aM Prufe,amis Code The Cordd a ,Lsms LOw des bot"OY m ro owoe or
pmPrtr who bundsm impvu Nemo.and whadoca such wet himslfefhmugh hu
,owcmplaoms. thaIo.b wpr Wdwivartoe hie ehdacOemL fe We.B.
hridder Nebo oo[orvoPa`®em 4mIded1ol asyesrOr ni fo.ft
;d aaoe-
bddewJlhi,a rh hmden MpmHni N,IKdd ml briW Or lmpmw for pvp®.d _.
ule.7.
❑I.u mmu d Ile property. tm coch, Y lY coaorllot wIN 00cood ITtlYlO1,b
pn,^ae ds pi(sec 7014,Burinea W Prate dleao Cade)The cmurzMi U.
ame U.doe ml ipWy to-owns of Paperty,who builtl,or impro,n Neem.and.
who cmoru fe such pmj,=with a mnuewrr/)Bcrnxd pm to do C®o.maf, .
❑Inco eaempr undo Sea ,Bh PCTs th4 masai
wmer Oue
WORKERS COMPFNSAT]ON DECLARATION
I hembY iQlm under pmdRy of pejmy me d the falbwing dmlarulme
I bswid wxl miinwo iCmifusa(Comem W ,di-macefmWatctiCampcn-
ndaa.r proWdnd for by setdon 3N0 of the Libor Code fm the perfmmroce of Ne
rwk fe.lich th4 perml14 idued.
C 1 bid rad will mv..W rk eo CaarPmwdn IRRv .o rNikd by Seed- .
1700 of thc 1�Cadc,ran de Prformoec of the work fm which N41-4 u"""d
My Warkffr Ceopm,dm inmvla 'e id Policy number rte:
Grtic:�Poliy No_ /aLF 7�oS-o
CERTIFlCATEOF Pr1ON FR OM WORKERS'
COMPENSATION INSURANCE
(ITh cNm sed cot be ceop4ad If the permx 4 for oro hodml donna(5100)
or a )
I eerdfy die io the Prformiice a the work fa whit W,permit u Word.I skit our
mpla,,,y Pmon N aay mmmr to u n became aubjOct to the W.AW ComPenvdm
U.of Califorri Doc
Appli®I
NOTICE TO APPLICANT:If.afar wkin{04 Ccniricoe of Eacmpliao.You,boo d
bewm,ubjce to the WarktYs Comp dm proriueo M the ubm Code-yod muR
,JO fanhviN comply with such imMbdom a N4 pe Odt Hill be deemed le,ahtC.
ZN CONSTRUCTION LENDING AGENCY
E-w^ thereby rinrm thu Nss 4a mnnnxiinn coding ages,for the'iormrne of
r�> th,wart for which this permit b laud(See.3091.CO.C)
Ip1 Q Lc 'N.
L< el',Aft.
U Ow1 certify the I haw red W,ippliorim.,a swe tha the ibow inform,dm 4
f- carrctt I i[ec to comply w'ab 01 city rid county ordi.id,um Inn m4dn1 W
U buifiini cva m,ad bereby autharirz re,r nm6 .f On city to corer uN.Nc
r C alnw-..doed lmPnr fee xoi ccd.porposcs.
(We)iile to Lw,vdcmNry and htsp h ]eod,the CITY of CVPcolm aguna
E" h xdiham jdgtmm,.cmu ad-Pero wrich miY d m,nY acvuc agaiusl old Coy
U Z io crosWymrce aide{roweg orN4 pmol,
^ APPLICANT UNDERSTANDS AND WI MPLY WITH ALL NON-POINT Issued by: Dale 7i GC
SOUR UTIONS. "
` Re-roofs
SipKum ofAfirflcodd
V inlrialor
H o SAATERIAUDISCLOSURE Type of Roof
WRI the tppi l ar forme building aeupmt nee a hadke noodarmoo-"•
m deGocd by de Cupte loo Mooterrd Cock.Cho 9.17,rd the Rcddr r,1 Safmy
Code.Scaim 25532(.)7 dNa All roofs shall be inspected prior to any roofing material being installed.
CYa
WiR the gWlicrdf or rotor,balding acrncant quipmel a dc,d¢s whim If a roof is installed without first obtaining an inspection,I agree to remove
emit o,, d air cmdiddrun4 a Joined by Inc Bay Ares Air QuililY Mmiimew all new materials for inspection.
DwrkR
0Ya [J NV
I hieread N,hoodoos mrerlils mBdimmmfsudjrcb icr&95oftheCaiifor-
wH IIb h SdayCodome
,S ]3505.27533 rd 25534.1 ,deroold thnIfac builticg
Jmi mta� n,w.ema.thr itbmy ny to mart de«,opao or de
t,.lwn,m wb uvbcmclpriorwbsr oracmdrteseora-mp.ay. Signature of Applicant Date
4 —4 dc `� i All roof coverings to be Class"B"or better
Ou crarnr a tdaicnl Oaa
Community Development
• 10300 Torre Avenue
ii I Cupertino CA 95014
" Telephone(408)777-3228
CITY OF Fax(408)777-3333
*UPEI�TINO
Building Department
JOB ADDRESS: PERMIT #
r O6 d �O 2 S--:?
OWNER'S NAME: Al PHONE # 6
GENERAL CONTRACT R d FAX #
I am not using any subcontractors: /a >-7
In 6
Si tune 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
•
Owner/Contractor Signature Date
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CITY OF CUPERTINO
em 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34245038 . 00
DATE ISSUED. . . . . . . : 09/27/2006
RECEIPT # . . . . . . . . . : 36221
REFERENCE ID # . . . : 06090253
SITE ADDRESS . . . . . : 10366 AVENIDA LA
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MURNA EHRLICH
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : CALIFORNIA SKYLIGHTS
CONTRACTOR . . . . . . . : TERRY KIYAMA LIC # 26844
COMPANY . . . . . . . . . . : CALIFORNIA SKYLIGHTS
ADDRESS . . . . . . . . . . : 2250C PARAGON DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95131
TELEPHONE . . . . . . . . : (408) 866-6759
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, 148 . 00 83 . 16 0 . 00 83 . 16 0 . 00
BSEISMICRE VALUATION 1, 148 . 00 0 . 50 0 . 00 0 . 50 0 . 00
--- ------- --------- - ---------- --------- -
TOTAL PERMIT ': 123 . 58 0 . 00 123 . 58 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
--- -- - - -- -------- ------ ------ ------- ------
OTHER 123 . 58 VISA
TOTAL RECEIPT 123 . 58
•
d CITY OF CUPERTINO DxeV?Oc253
CITY Or PERMIT APPLICATION FORM
CUPERTINO
Ak
IRVN# Date:
-4-5 -036 OCT.
Building Address: Mailing Address (if different from building address):
C a
Owner's Name: Phone4:
p 040)
Contractor: License #:
Contact: Phone:CgoB 712--734'f Cupertino Business Lie e#:
Fax:
Building Permit Info:
Bldg C" Elect ❑ Plumb ❑ Mech ❑
Job Description: L O� 'aca on .
/0,5T,1-CLL
Residential C /0,5 _ S 4 tf - ��
Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy Group:
Type of Construction: Please check this box if the project is a
second-story addition: ❑
ro'ect Size: Standard ❑ Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILER1 Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK 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 <_ I OOOA ELECTRICAL
BELEC1001 Elec 600V > I OOOA ELECTRICAL
BELEC200 Elec Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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G - CITY OF CUPERTINO
C TYOF PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee 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 Bldg Permit 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 Sto m/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain & Vent PLUMBING
BPWATER Install/Alter Water Pipe PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BRENWRHAN 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 Fumace> I OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heat in MECHANICAL
BREMRESAPP Remodel Res Ap liance ELECTRICAL
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CITY OF CUPERTINO
CUPEI�TIN
TO PERMIT APPLICATION FORM
Quanti Fee ID Fee Description
Fee Grou
BREMSIGNAD
Rmdl Si s Add Branch ELECTRICAL
BREMSIGNS Remodel Si s, Mar uee ELECTRICAL
BREMTHEATR Theatrical Li tin Fix ELECTRICAL
BREMVENFAN Vent Fan Sin le 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
T
BTEMP em ora Power ELECTRICAL
BTEMPPERM Tem ora Bld Permit BUILDING
BTEMPSVCS Tem Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical s foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MEC
HANICAL
M
PERMITFEE Mech Permit Issuance
MECHANICAL
PPERMITFEE
Plumbin Permit Issue PLUMBING
PPLBG Plumbin Pee sq foot PLUMBING
PLLONGRNGC Plan in LR Comme/Multi-Fam PLANNING
PLLONGRNGR Plaunin Lon Ran a Residential PLANNING
ZADDCHG Address Chane 11 BUILDING
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