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05120019 (3) CITY OF CUPERTINO '4KIN tsOBUILDING DIVISION P fi� - M . � Q BUILDING ADDRESS: PERMIT N0.0 512 0 0 19 .1.658 JAMES TOWN DR PERMITLSSUE DATR JULIE & MIKE ST. CLAIR 12/05/2005 PHONE: SANITARY NO. CONTROL N0, ARCHITECr7ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH X00 LICENSED CONTRACTORS DECLARATION Job Description I hereby afr.Nat 1 am licensed under provision of Chopmr 9(commencing with Sermon 70110)ofDivlaion J of the Busirua&Od Profession Cade and roy license u mfull mmeand.Dem /1yp 373 KITCHEN REMODEL (NO. STRUCTURE CHANGES) bZ License Class I> LinN � p Dau_JJ_^ Cunuxtor 4V1F4 7`RNf7AI - �ARCHITECrS DECLARATION I undem,and my plans shall M used a public records g u. Licensed Professional 50 OWNER-BUILDER DECLARATION I hereby.firm Net 1 1 exempt from tM Contractors Licence Law for tM O O following mason.(Section 7(13 L4 Business and PmRvium Code:Any city m county $45000 5$Iii which rtyulrm a permit b emuwe4 alar,improve,demolish,ar mPWr ay awnum ' NO prior to its issuance.also requires On applicant for Such Permit to file a signed moment Valuation G that M is licensed punuam t.Na proviaiom.f the Contractor',U.S.law(Chapter Y SQ. Ft.Floor Area $ (commencing with Section 7000).1'Division 3 or the Business and Professions Cme)or that M is exempt therefrom and the basis for due alleged eampdon.Any violatfon of Section 7031.5 by any applicant for a permit subjects the applicant b a civil Penalty of r Occupancy Type not more Nan Rw hundred dollars($500). ❑Lo he wCak the pro perty,mmyomployea withwages r Weir Sul.7044.Rathon, ,will do the work,C d e s o Como mosot Li caromded Law ed s an,apply 7044,Bulinus Required Inspections pmNand ny who obu Code:The Convertor'+Liana Law dace ret apply lf an owner is Q p mancinwyces.provided that sathumomand ements oenot ch tom icark himadfor through his .Sun ver,m Wilding War such Improvements mid wit in ne you off mploutueorcd for onmar- builder,me Wilding brimprow...injhat he withinoneWildorImproedogtheowwr- builder will haw the burden of proving that he did not Wild car Improve for purpose of co 1,u owner of Uro pmpcny,704,Business mand cofessi ng with licensed cnnlnnosa i. 3I eoawm rhe project(sec.n an werofand profession Wild. Code:)TheContractorstho ton.LI- ceme law dont not apply to in owner of property wise Wilda rsSmpmws tMmon.and / who contracts for such Or.jeeu with a contractor(s)licenced punuem m tM Contnnoh 0� Lice.Law. lam ucmptunder See. i; b / 130 �B&PCfor cele moon Dau or WORKERS COMPENSATION DECLARATION 1 Mreby arum under penalty of perjury one of On fallowing dalaatiom: ❑l haw and will maintain a Cerdli ate of Consent maelf-imum for Worked'sCompen- union,u provided for by Section 3700 of the labor Code.for We Performance of this work for which this Permit is issued. ❑1 ban and will maintain Workers Compensation Insurance,as mquired by Section 3700.1 the labor Code,for the perf.....of On work for which this permit is Wood. My Worke s Con IearW and Policy number am: Carle Poliry No.: CERTIFICATE OF EXEMPTION FROM WO RICE S COMPENSATION INSURANCE (Thin section need not be complcted if the Permit lsror.nc hundred dollarst$100) .r less.) I csrvfy that in the performance of the work for which this Permit Is Issued,l WII not employ any person in any manner nab coma uh2 to OkWorkerif Compensation Laws of Califon Dau APPlicar I a NOTICE TGAPPLICANT.If wirrAfrakirri this CCAUreMe or Exeemmption.you should become&Object In the Worker's ComPensaion provisions or me labor Code,you mug .J O forthwith comply with Such provisions or this permit shall W deemed invoked. r y CONST RUCTION LENDING AGENCY [—t I hereby slDtm that then lasconsl.d..lending agency for the performance of gY,> On work for which thin permit Is Issued(Sec.3097.Civ.C.) G.Q. Lenders Name QLenders Addma V Q 1 cenify that I haw read this application and sub Net ton aWw hurmal.d..I. i,, Correa I agree to comply with all city and county ordinances and auto law,totaling to Q U building construction.and hereby authorbe mpscsenutins of his city to enter upon the Uabove-menti.red propeny for hopectian puriwes. 17 (We)ag.10 save,indemnify and keep terminal the City of Cupertino against q) Imbilida,judgments.costs and expemm which may in any way aceme against aid City U in eomequena of the granting of this permit. .. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOU RE LATIONS � � ��,��, .— f L—S'�S Re-roofs Sign re of ApplicaUCOnuacbr Dam HAZARDOUS MATERIALS DISCLOSURE Type Of Roof Will the applicant or future building Occupant store or handle hmmdous manurial defined by the Cupertino Municipal Code.Chapter 9.11.and this Health and Safely . a.Section 25532( ? �(('''' All roofs shall be inspected prior to any roofing material being installed. []Yes mNb Will the applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove cmll horardous air contaminants an deMcd by the Bay Area Air Quality Management all new materials for inspection. Disulct4 C pros �t�u I haw mad the hmumms materials requirements under Chapter 6.95 of the Califon —y iia HcalW&Safety C.de,SCcu.os Vi5B5,15533and7553a,lundcrstandmtM W � atlfilding dom not et rcmm ly haw.unl Nat it 4 my rmsihil ponity m notry du occepmt of tM r L � realm laic mngWnetpd.dmi+&Oatuc.r.Ltrtirm+te.rQeup. ey. Signature ofApplicant Date � ��5 All roof coverings to be Class"B" or better Owner tar..mono<d agent Dale i MUM - w i l � id xr�ia riY 141W.#i .f ..d�.}J a�. r�,.�t ry� «4- is-. �t+}{UF �.iE c4a"a 4 • - �i x X6R-s;S AhE 5s rL s '�3 E x- 1d' L 5 '�' RESIDENT-1 Iff OJECT,COVER SHEET f� f v? SVM T,F ,4 UIITYO A� Fv^ i - 1q� f+ ac181PR Y- riN ni*b. r.E 1 h w'tr,tx9�� �.4'Y'y* r s� f CUPE3�TIN0 1F- I I , r an$146s NIF, Assessor's Parcel Number: Name of owner. Project address. L--- - - y'5 8& 7- 72-660) Contact person. JU0 'C Phone. 4/1 S ' Z 37- / 15 5 Fax. qv 5 - 537 - q1 Iy Net square footage of lot. Existing Proposed Square footage: First floor: Second floor: Garage: TOTAL: O • Are there at least two 10 foot by 20 foot clear spaces inside the garage? l_/ N Is privacy protection planting required for the project? Y N On what floor(s) is work being done? r Guh/ Brief description of work. �C✓��C��F' ki �C�cN 6- tejrJ�uJ (•��W�l� J��acS / ZFAPJ4 e en v Code editions: 2001 CBC (Y -N)2001 CFC (Y -N)2001 CMC . (Y-N) 2001 CPC (Y -N)2001 NEC (Y - N) LL .J3 IS rn d iI u 'Effective ll/1/02 NQS 9hG7-)-,)z&L DEC 05 2005 1 Plan Review Process Work Book Page-8-Revised 4/28/04 i.l -1 wpos—W- e -R Alt IP ca up `,.,.""i�gi .gyp'}—y- n' ''�»�'g' °��a ",G' S:� ♦ ��� �n("b�l'�.,� • �� � �a .RESIsN�Th L�PRO �C-� COs s� SH°EE�T� �� CUPEI�TINO le Assessor's Parcel 1Number: tP t0 LGO�/ Name of owner. J V 2 f �1 � 7L 1 CJO-1 V-- Project Project address. W A �— ��- y�5 8(0�' 7ZrnnB Contact person. ` mo e Phone. S - Z 3 (- Fax. t'-Fax. zV/5 - 5137 - Z/1f?i Net square footage of lot. Existing Proposed Square footage: First floor: Second floor: Garage: TOTAL: O • Are there at least two 10 foot by 20 foot clear spaces inside the garage? C N Is privacy protection planting required for the project? Y N On what floor(s) is work being done? I Brief description of work. 1� �✓��G��P K i �Gl1eK 6-a� � (00u Ta-Nr W� ( -Jv-fa-S e� —�' ert e�c u Code editions: 2001 CBC (Y -N)2001 CFC (Y -N)2001 CMC . (Y-N) 2001 CPC (Y -N)2001 NEC (Y - N) Effective 11/1/02 /V6 w RECEIVED • DEC 0 5 2005 Plan Review Process Work Book Page-8-Revised 4/28/04 CITY OF CUPERT CUP 7Y OV IT APPLICATIONWRM 11 N# 3 /O 063 Date: 1 Z - CS Building Address: Mailing Address (if different from building address): 1658 J Owner's Name: Phone#:4,�o b' -3 6 6 - 18.9 2- ST, C(a)v, Contractor: License#: NOEL GOr)(DAJA/ �"o373 B Cj Contact: C- v15 Phone: N1S•z3Y-/3s3 Cupertino Business License#: /VoF L X67-77,68Fax: 4/1S 7- yit�- Building Permit Info: Bldg Elect zi Plumb Mech ❑ Job Description.- -TV sn2u LTV 044- C ka K[•eco Residential G e K Commercial ❑ Sq.Ft. Floor Area: q.Ft.: Cost of proiect: Occupancy Grouro: Type of Construction: Please check this box if the project is a second-story addition: ❑ ro'ect Size: Standard Laze ❑ Major ❑ Quant ity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BB01 LERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBQILER3. 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 Investigation fee BUILDING 1 of 3 h ✓ CITY OF CUPERTIN CUPEi�TINO MzT APPLICATIO�RM QuantityFee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMTTIGATC Comm. Housing Mit. Fee BUILDING BNUCOMNM 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 Pblg Fixture PLUMBING BPGAS Gas Pioing 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 rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 c$n MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFIIRN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECHANICAL BREWMAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood IITECHANICAL BREMMLSC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMR.ECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Ap liance ELECTRICAL 2 of 3 Cft OF CUPERTINO CUPEI�TINO PERMIT APPLICATION FORM QuantityFee ID Fee Description Fee Group 13REMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS I Remodel Signs, Marquee ELECTRICAL BREMTHEATR I Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems AfECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISAIICOM Seismic Commercial BUILDING BSEISAHCRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMY Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Per BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL j9 MPERMFEE Mechanicals . foot MECHANICAL MPERMI'TFEE Mech Permit Issuance MECHANICAL O PPERMTTFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Commel Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Chane BUIDDING • 3of3