30327APPLICANTTO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
CITY OF CUPERTINCO BUILDING - ELECTRFCAL
BU • ,DI PPLICAT ON/ RMIT PLUMBING -MECHANICAL.
0• � ItUlIA1NC, PROJECT IDF,NTIFICATIs3N
BUIL LNG ADDRESS: - SANCAF
14 IE -
O ER'S NAME: PBONP Il CU CTOR'S NAJME; LICpjO NIC
L Fv S
RCHII ECTIENGx� INC'rR) LINN O: ADDRESS: ❑
CO((A�'CI✓Tv PHONE:
Consultant Fees Paid by Applicant (Initial) BIL�DGr
1 IQ`
I hereby afBrtn that I am licensed under provisions of Chapter 9 (commencing
Opt with Section ]000)af Divisiun3uf the Business and Pndewi as_Cn dtny?enscis
Wr in full force and "'M ( r
f.. U fk]] Li«nx s Lic. #
N<It Date Convector
F, D y L XRnFLEC7SDECLARATlON
= Z � G 1 understand my plans stall be used as public records
Fs $: LL1 Licensed Pmfuvsional
0�OWNER-BU ILDER DECLARATION
K I hereby affirm that 1 am exempt from the Contruanr's License I,aw franc
O
La') following mason. (Seximn 70315, Business and Professions Cale: Any city or county
3 r
t .4 which requires a permit of construct, alta improve, demolish, or repair any small..lion our in issuance, nlw requires rhe applicant for such Permit o lite a signed smRmem
Nat he is licensed pursuant o the provisions of the Communes License Law (Chaper9
so0 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
d oy that he is eaempt therefrom and the basis for the alleged exemption. Any violation of
ySection703L5 byany applicant forapermit subjectstheapplicanttoacivil penaltyof
aAnot more than rive hundred dollars ($500).
❑I, as owneref Ne property, or my employees with wages use their sole compensation,
will do Ne work, and the structure is not intended or offered for sale (See "TMJ. Business
W and Professions Code: The Contractor's License Law does not apply in an owner of
�' .. property who builds or improves thereon. and who dues such work himself of through
his own employees, provided that such improvements are not intended or offered for
aale. If, howesee. the building or improvemem is sold within one yearofcompletion, the
owner -builder will have On burden of proving that he did nm build m improve for pur-
r, pose of o la.).
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to
construct the pmjccl (Sec. 7044, Business and Professions Code:) The Contractor's Li-
canse Law does not apply o an owner of property w to buildi or impooes thereon. and QTY.
who contracts for such projects with acontractur(s) licensed pursuant to the Contractors
License law.
❑Into exempt under Su. ,B& P C for this me as.
Owner Dom
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under Penalty of perjury one of the fallowing declarations:
I have and will mainmi Section 37M of C e Labor Code, sure a pert r -mance of the
walkf ox provides for by Ss N,w 3]00 of the LoMn Cale, for the perfonvonce of the
work for which this permit is issue].
❑Ihave and will maintain Workers Compensation Insurance, required by Section
W of the Labor Cededow
Code. for the pnnce of the workk for for whichh this permit is Inoue].
My
Worke'n Campenmtinn s ante artier and PNicy number oR:
Cartier. Policy No.:
CCRTIFI 'ATE f E%EMPN INSURANCE WORKERS'
COMPUNSATIONINSURANANCIi
(Dmiasection aM na becomPlaeJ time, permit is (Drone hundred Mllnm 3I00)
or le .)
I certify that in the performance of the work for which this permit is issuN, I shall
not employ any person in any manner -Lo bS\erm bject to thekers Compcn-
O z salm Laws o{Cplifomu.O s
z APPlicont LL -�� ^
y NOTICE T" (CANT: a0c eking t m m sat¢ o � em plmn. you should
a 5 become subject to the Worker's Compensation provisions of the Labor Cade, you must
W r� forthwith comply with such Provisions or this permit shell he deemed revoked.
a
CONSTRUCTION LENDING AGENCYagency
V 0 (hereby affirm that there isaronswmion lending agency for Performance of
W (✓ the work for which this permit is issued (sec. 3091, Civ. C.)
O ULender. Name
Lenders Address
04 1 anify that I have read Nis app - inn and stat but the above information is
V) correct. 1 agree to comply with all city and county ordinances and slate laws relating to QTY.
U z building construction, and hereby authorize representatives ofthis city to enter upon the
w+ above-mentioned property for inspection purposes. '
We) agree to save, indemnify and keep hamJess the City of Cupertino against
liabilities,judgments, costs and expenses which may in any way accrue agaitnt said City
in consequence of the granting of this Permit.
APPLICANT ll DERSTANDS AND WILL COMPLY WITH AL1. NON.POINT
SPIZECE REf'UI1ATIONS.
-a •-.....V"HAZARDOUS MATERIALS DISCLOSURE
W II me applicant or future built ingrecupant store or handle hazardous material
as defin2 by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety
Coda, Scaion 25532(0)]
❑ Yes . *N'
Wil(the applicant or future building occupant use equipment or devices which
emit hazardous if conmrnmems as defined by the Bay Area Air Quality Management
Dis rict^
Dyes TfYr y\
I have tend the hamrdous maaid.), rryuiiemcnls under Chapter 6,95 of the Cali -
Forms Health & Safety Cale, Sections 25505, 25533 and 25534.1 understand that if the
building does not currently have o tenant dim it is my resPmnsihility to ratify th<ascupent
ELECTRIC PERMIT
PERMIT ISSUANCE
APPLIANCES - RESIDENTIAL
PANELS
UP TO 200 AMPS
SIGNS ELECTRICAL
SPECIAL CIRCUPGMISC.
TEMP. METER OR POLE INST.
POWER DEVICES
SWIMMING POOL ELECTRIC
OUTLETS - SWITCHES - FIXTURES
SQ PT.
PLUMBING PERMIT
PERMIT ISSUANCE
ALTER- DRAIN & VENT- WATER (EA)
BACK FLOW PROTECT. DEVICE
DRAINS- FLOOR. ROOF, AREA, COND,
FIXTURES -PER TRAP
GAS - EA. S) STEM.I INC. 4 OUTLETS
GAS - EA. SYSTEM OVER 4 (EA)
GRE.ASMNDUSTRL WASTE INTERCEPTOR
GREASETRAP
SEWER -SANITARY -STORM F.A. 200 FT.
WATER HEATER WNENTELECTR
WATER SYSTEM/TREATING
WATER SERVICE
NEW RESIDENTIAI, PLMB. SQ. FT.
MECHANICAL PERMIT
PERMITISSUANCE
ALTER OR ADD TO MUCH.
AIR HANDLING UNIT (TO 10.000 CFM)
AIR HANDLING UNIT (OVER 10.000 CFM)
EXHAUST HOOD (WMUCT)
HEATING UNIT TO 100IX0 BTU)
HCXGNG UNIT (OVER 100,000 BTU)
VENTILATION FAN (SINGLE RESID)
BOILER -COMP (3HP OR 100,0W BTU)
BOILER- COMP (OVER 100,0(0 BTU)
AIR CONDITIONER
NCW RESIDENTIAL MECH. SQ. FT.
OFFICE
FEE
FEE
30327
APPLICATION SUBMITTAL. DATE
COpOItOL#
.DING PERMIT INFO
iLECf PLUMB MUCH
A ❑
JOB DESCRIPTION
RESIDENTIAL
❑SFDWL
❑KITCHEN REMODEL
❑ADDITION
❑PLUMBING RE -PIPE
❑MULTI -UNIT
E3 STRUCTURAL
MODIFICATION
❑ INTERIOR
❑CHIMNEY REPAIR
IMPROVEMENT
❑ BATH REMODEUREPAIR ❑DEMOLITION
[]OTHER
COMMERCIAL:
El NEW BLDG/ADDITION ❑DEMOLITION
❑TFasNANT .OFOODSERVICE
FLOOR AREA ESQ. FT.
YNLUNIIV IV
20va-
BUILDING DIVISION PEES
PLANCHECK FEE
ENERGY FEE
GRADING ME
SOILS FEE
YAIU
Data Receipt#
TOTAL:
BUILDING FEE �
FEE SLIISMIC17ER - A
ELECTRIC FEE
PLUMBING FEE
MECHANICALEEE
CONSTRUCTIONTAX
HOUSING MITIGATION FEF,
PAID `#
Date Recempt#
TOTAL:
DEVINE CONSTRUCTION
P.O. Box 7452
Menlo Park, CA 94025
(415) 329-1187
Contractor's License Number 355706
APPLICATION FOR BUILDING PERMIT
CUPERTINO BUILDING DEPARTMENT
Devine Construction will supply the labor and materials for the renovation of the condominium
unit for Mr. and Mrs. Jerry Brush, located at #514 F #9 at the Forum in Cupertino, CA. as
specified below.
CATEGORY
1.CARPENTRY:
A. Rehang the hall bathroom door to swing inward in to the
bathroom.
B. Install two T.V. outlets in the living room.
C. Frame and sheetrock the door opening into the living room from
bedroom #2.
0 2. ROUGH PLUMBING:
Supply one new Waterworld shower head and one hand, held shower for the master
bathroom shower. This includes following:
#1 Shower head # bosh 14b
#1 hand held shower head with hose. #hohso8b
#1 shower head diverter-HANS GROEHE .#28719.93
3. DRYWALL: Supply the labor and material to install the sheetrock and
match the existing drywall texture of the unit. The walls and the ceilings in the
following rooms will be finished to a smooth wall surface for the application of
wallpaper or paint. The kitchen, master bathroom, hall bathroom, and the master
bedroom. The wall patching in bedroom one at the living room and the closets
where the new shelving was installed, will be textured to match the existing textrure.
RECEVED
OFFICECgpy Page AUG 2 1996
BLDG. INSPECTION DEPARTMENT
CITY OF CUPERTINO
L, 1!bI
4. PAINT:
Supply and paint with Benjamin Moore paint as follows:
All of the walls, interior doors, their wood casings, and crown mouldings will
recieve two coats of paint. The new bookshelves, and the television cabinet will
recieve four coats of oil based enamel paint. The wood work mentioned above
will recieve oil based enamel paint and the walls will recieve two coats of latex
paint. The walls that are wallpapered will recieve two coats of oil based paint
as requested by the wallpaper hanger. Also included is the interior of the rear
entry door whisch will match the new color of the interior trim.
5. HARDWOOD FLOORING:
Supply and install 1/2" thick by 2" wide tongue and groove red oak flooring,
which will be glued down to the existing subflooring. It will extend from
the front door in the entry hallway into the kitchen and the kitchen utility room.
The hardwood will stop at the the beginning of the living room on one side, and
the beginning of the bedroom hallway on the other side. This also includes tucking
and rolling the carpet under the edges of the hardwood at the ending points
mentioned above.
6. MISC. CABINETS: Supply and build paint grade cabinets made of birch
wood, with raised panel doors, and Europen hinges as follows:
A. Two bookshelve cabinets in the living that are approximately 30 inches
wide by nine feet high.
B. Bedroom 92 television cabinet that is designed to fit
into the corner of the bedroom.
C. Installation of the cabinets.
8. SHOWER DOOR AND MIRRORS:
A. Shower door: One custom made clear tempered glass door for the
master bath shower.
B. Mirrors: Supply and install on mirror on the back of each bathroom door,
the approximate size of the mirrors are two feet wide by six feet high.
Please note that there are no structural changes being made, in terms of moving or resupporting
walls. All of the changes being made are cosmetic upgrades. Please feel free to call me if you
have any questions.
STaee
y,
Douvine
Devineruction
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