03070080 CITYOF CUPERTINO k '°'^ '•" r ,; 1" '� ''� '" �„;
ISUILDING DIVISION PERMTI' CONTRACTQR INk'ORMATION s
BUILDING ADDRESS: PERMIT"03070080
003O7O080
NnRNR MR
OWNER'S NAME: PERMIT ISSUE DATE
i
NE: SANITARY NO. CONTROL N0,
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
Sm BO ELECT PLUMB MECH
O
a00 LICENSED CONTRACTOR'S DECLARATION
�uF 1 hereby affirm that 1 am licensed under previsions of Chapter 9(commencing lob Description
iW with Seorce 7IXH0uf Division]of the Business and Professions Code,and mylicenx is FINAL
��
<„ imm�m eanderr=et. NEW SOLAKUBE r ■rte
? License Class Like.N
=_o DateContractor
W ARCH7..CTS DECLARATION SEP 1 6 2003
991
< 1 understood my plans shall k used as public records
"coci
Liecnud Professional
3 OWNER-BUILDER DECLARATION
3 BUILDING
A<I 1 hcrcM1y affirm that I am exempt from the Contractor's License Law fur the
0 C, fullowing maser.(Scene.7031.5.Business and Professions Codc:Any city or County
$(i which requires a permit to eonsvun,alter,improve,demolish.or repair any structure
_Zt prior to out issuance.also requires the applicant front permit toilets dgnedsurament
@s`o that he is licensed pursuant to the pmvisioaofthe Contractor's License Law(Chapter 9 Sq. Ft. Floor Area Valuation
it (commencing with Section 7000)of Division J of the Business and Professions Cale)ur
i $ Not he is exempt therefrom and Ne bssis for the alleged exemption,Any violation of 32344008 . 00
Section 7031.5 by any applicant for a permit subjects enc applicant to a civil penalty of aneccu APN Number O-Type
not more Nan five hundred dollars(5500). p y yp
❑I,as owner of dre propeol m my employers with wages ad their sok compensation,
will do the work.and the swcmm is not intended or offered for sale(Sec.701 Business lul —
and Professions Codc:The Contractor's License Law docs nos apply to an owner of 102 -
property who his
PIERS d Inspections
builds or impmvu Merton,and whodea such work himsellorthmugA
ownered.yca,provided thatsuch improvemenaare notinrendedero0erad forsale.If, 103 — UFER
however,Ne 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 104 — REBAR
a1c')' 105 - ANCHOR BOLTS
1,as owner of the propen,,am excleaively contracting with licensed convenors t9
construct the project(sec.7044,Restricts and Profusions Code:)The Convacwr's Lb 106 — SEWER & WATER
caste Law dors be,apply tom owner of property who builds or improve thereon and
, 202 - UNDERFLOOR PLUMBING
who contracts for such projects with a contranor(s)licensed pursuant to dm Convenor's
License Law. 203 - UNDERFLOOR MECHANICAL
❑l m=x=m BaPcmr Hrt 204 - UNDERFLOOR FRAME
w" WORKE0.S COMPENSATION A " « 205 - UNDERFLOOR INSULATION
I hereby affirm under penalty of perjury one of the following declarations: 3 01 — ROUGH PLUMBING
have and will maintain a Ccnifcate of Convert o self-iamb for Workers Compcm 302 — TUB & OR SHOWER
sation,ss provided for by Section 3700 of Come hbor Code.far the pcdo...of enc 303 - ROUGH MECHANICAL
work for and Cola permit istraded.
orker 304 - ROUGH ELECTRICAL
❑1 have and will maintain Worker's Compel the w rkboxersocc.whi h required by$cairn
nae ofthc Labor Cook,for the pertormance of the work for which this Permit is issued. 305 — FRAME
My Worker's Compensation Insurance carrier and Policy number art: 306 — HOLDOWNS
Carrier. PolicCERTIFICATE OF EXEMPTION FROM ROM WORKERS307 — INSULATION
COMPENSATION INSURANCE 308 - SHEETROCK
or lbsx)Osie reeao"dead not ho Completed if ti"permit is forotm hundred dollars(SIt10) 309 — EXTERIOR LATH
1 unify that in the performance of the work for which this permit is issued.1 shall not 3 10 — INTERIOR LATH
employ any person in any mother 91as to become subjecIto the Workeri Compensation 311 - SCRATCH COAT
An of California.Dare 313 ROOF NAIL
NOnCECEIt.
TO APPLICANTtheWorker
aftermakingCope Ceninsof of Exemption.yooumot 501 - FINAL ELECTRICAL ENERGY
become subject m the Worker's Compensation provisions of reed Cnde,you must
� Z mnnwith comply with such provisions or this permit ahallWdeemed revoked. 502 - FINAL PLUMBING ENERGY
Zo CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
F N—' I hereby affirm that there its Contraction lending agency for the performance of 504 - FINAL BUILDING ENERGY
C Ne work for which this pennn is issued(Sec.1097,Co,C.)
ow nderaNme 505 - FINAL ELECTRICAL
z Lender'sAddmss 506 - GAS TEST
U O 1 certify that I have mad this application and tam that dm above information po niton is 507 - 'FINAL PLUMBING
U.0 U building 1 agree to comply with all city and county eNinarttta and Cram laws relating e
>,U) building eononcelnn,and hembyeclionpurpoesemativcsofNisciytoenter upon the FIN MECjWNW
CAL
� above-mcntinncd prepcny for inspcnion purposes.F N (WC)agree to save,indemnify and keep harmless the City of Cupertino against 0 9 F I 1
liabilities, cosuand eapdnusmit- may in any way accme against said City C,
V Z incoaes,judg ethe granting Of this which
^ APPLICANT UND RSTANDS AND WILL COMPLY WITH ALL NOP01 Issued by:5 ORKS Dale
SOUR U ATIO
atareo li , m� Re-roofs
HAZARDOUS MATE0.IALS DISCLOSURE Type of Roof
Will the applicann per furore W ilding occupant score Dr handle hvmdous maicnal
as defined by the Cupertino Municipal Code.Chapter 9.11,and the Health and Safety
Calc,SEl yesection 25531(a)? k/ All roofs shall be inspected prior to any roofing material being installed.
Wal the applicant or/future building occupant use equipmentIf a roof is installed without first obtainingan inspection,I agree to remove
haaanfi us air contaminants az debited by the Bay Arca AirQualiry Ma agement p
,rid,? - all new materials for inspection.
❑Year
1 have mad the hanniousmatefials mqumements under Chapter 6.95 of the Califon.
ria Health k Safety Code,Sections 255)5.25533 and25534.1underamnd Nat ifthc Wilding
Jin not aventlI h t,that it is my responsibility m boor he,.gf nt of Co.
dodo ¢ mon be prion.issu of cttlficam of eupan .
Signature of Applicant Date
owneror out ens g.t D, All roof coverings to be Class"B"or better
CITY OF CUPERTINO CO1�'TRACTORINF'ORM �
BUILDING DIVISION PERM MW, _iT
BUILDING ADDRESS: PERMIT N003070080
OWNER'S NAME: PERMIT SUE DATE
SANITARY NO. CONTROL NO.
BUILDING PERMIT INFO
ARCHfTERYENGINEER: BLDG ELECT PLUMB MECH
0 0 0 0
p LICENSED CONTRACTOR'S DECLARATION Job Description
C 1 Mmby aMo.But 1 sum licensed under pm`huoru of Clupler 9 recommencing
p �INALED
tJ with Scotian 7")of Division 3 of the Bu4xss and prorusium Code.and my litems,is
H imfall forme dcffem NEW SOLATUBE
i Licame Class Lic.I
p Data Contractor SEP '16,2003
ARCHITECTS DECLARATION
-+ 1 understand my plans Nall be used as public msmds
Licensed Professional BUILDING OWNER-BUILDERDECLARATION
F I hereby olfirm that I am exempt from the Contractor's License law far the
0 following moon.(Section EDIS,Business and Profcuiuns Code:Any city of county
9 which requites a permit to construct.slur.improve,demalkah,at repair any structure
ly prior m its issuance.also ccqubes,the applicant for such Permit tople a signedsuument
A that he is licensed pursuant athcprovisionsoftheCotiuou'slimuseLa (Chapter 9 Sq. Ft. Floor Area Valuation
,$ (commencing with Section 7")of Division 3orfBusiness and Prafossions Code)of 32344008 . 00
.— Nat w u exempt thcrefrom and the basis far the alleged exemption.Any violation of
Secdon?031.5by."appliant far a p,.i,subjects the applicant m a civil anally of APN Number Occupancy Type
not moa Nat Bre hundred dollars
I,as owner of the property,or my employees with wage as Jci,seta comperuadon,
will da the work,and the structure is nor immodad or offered for safe(Scc.70,14,Business — d Inspections
and proThuta
professions Cade: e Comrfa Litmus law dean not apply re an owrau of 102 — PIERS
p
propcny,who builds or imp.Burson.and who does a scb work himself or thmagh his
ownamIA.Imees.provided tea such impmvemrena
enu as invaded oroRared forsale.If. 103 — UFER
however,the building or improwmat is sold within can Sea of completion.the owar-
Wiwer will haw the earthen or proving wt M did net wild or improve for purposes,of 104 - REBAR
""' 105 - ANCHOR BOLTS
.as owner of the property.am exclusively contracting with licensed convacmer as
10 6 — SEWER & WATER
ccrostmct the pmjch(Sec?014.Baines and Professions CodTh
e:) e Conuaclori LL
camse Law does am apply an an owner of property who Wilft of improves thicance.and. 202 — UNDERFLOOR PLUMBING
Lhaome Law each Projects with aeonuacte,(s)lianxd pursue¢mthe ConvuuYs 203 — UNDERFLOOR MECHANICAL
Clan aam .B@PCfm a 204 — UNDERFLOOR FRAME
-2naLog�t te « 205 — UNDERFLOOR INSULATION
WORKERS COMPENSATION D N
I hereby affirm under penalty,of perjury ata of the fallowing drrdaretiao: 301 — ROUGH PLUMBING
.vasad will maintain a Certificate of Consent to self-insure for Wml¢ts Campy- 302 — TUB & OR SHOWER
,.a,as provided for by Secdon 3700 of the IJWr Code.for the performance of the 303 — ROUGH MECHANICAL
work for which this permit is issued. 304 — ROUGH ELECTRICAL
❑1 bee and will maintain Warkcts Compensation Insurance,as scquimd by Secdon
37W of the Labor Cade.for the performance of the work for which this Permit is issucci. 305 — FRAME -
MyWorkcriCnmpensadonlnsursncecarrierandPolityountam: 306 — HOLDOWNS
Carrier. PolicyNo.; 307 — INSULATION
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE 308 - SHEETROCK
(Thu section need an,W completed if the permft is for arc hundred ddlasa(SI W) 309 - EXTERIOR LATH
¢leas.) 310 — INTERIOR LATH
I certify,that in the perfmmmen of ties work for which this permh 4 isseea,l shall eat 3 11 - SCRATCH COAT
employ any person in any manu ueevma another so bsubject tithe Workers'Compcnvum
Law 3 of CaliAmar Date 313 — ROOF NAIL
A" am
NOTICE TO APPLICANT.If,after making this Ccrulmaw or Exernpmet.you should 501 — FINAL ELECTRICAL ENERGY
became subject In use Worker's Compenauan provisions of the IaWr Code,you most
Z romwth nmpyWim hpro anserm penntr halves mdm.atm. 502 — FINAL PLUMBING ENERGY
= , CONSTRUCTION LENDING AGENCY
503 — FINAL MECHANICAL ENERGY
I Wroby aRsm mat dart iia construction leMingagancy far the pcfmmauear 504 — FINAL BUILDING ENERGY
Jte work for which mu permituIssued(Sec.1095,Civ.C.)
LcMcfs Namc 505 — FINAL ELECTRICAL
z Icnde,SAddscs 506 — GAS TEST
0 1 unify mat I have rod this application antl state that f above infoonaiun is 507 — FINAL PLUMBING
E4 coreccL 1 agree to comply with all city and county meinsu as and sum,laws telmng m
V building conswction.and hereby aumorimrepresenuuvesofthis city to enter upon the FIN MECHAN CAL
U shove-mcntiancof pmpeny for inspection proponent.
gy (We)agree th save,indemnify and kap harmless the City of Cuperdno against 0 9 F I
fn
liabilities.Fragments.cots and eaaoms which may in my way ueru against said City 5 NG
Z in consequence of the granting of this anniL
^' APPLICAM UND STANDS AND WILL COMPLY WITH ALL NO -POINTtR
d by:5 WORKS Date
SOUR U TIO
�� 6ofs
ammo L HAZARDOUS MATERIALS DISCLOSURE Dan, of Roof
WillJu applicant or future wilding occupant smm or handle havdoos material
as defined by the Cuanina MunicFal Cade,Chapter 9AZ and the Hcadth and Safety
de. er:ss3z(a)?
OYns All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future
future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
t hmardrus air comamianu as defined by the Bay Arca Air Quality Maugham all new materials for inspection.
Wim?
❑Ynsu
I have mad the hoardwsmateriaH,yuirotunu underchmur S,Y5 orthe Caurno.
nu Haal"Safcty Code.Seetiau25505.25533aW 53a.luMcma ifrM Wilding
docs not nmcndy x Jut it u my msponsibiln,te ndifY oceupot of the
royuimif..an piarur of a Signature of Applicant Date
owner or aathariu s t Da All roof coverings to be Class "B"or better
Re:COPY:[Fwd:Sun Tunnel request]
r
Subject: Re: COPY: [Fwd: Sun Tunnel request]
Date: Fri, 8 Nov 2002 15:31:44 EST
.Froin: Soaresbb@aol.com
To: benedett@ihot.com
CC: bsoares@communitymanagement.com
Hi Tom:
The board of directors approved the installation of the Sun Tunnel skylight
subject to the following:
1. A licensed contractor professionally installs the skylight.
2. Any necessary City of Cupertino permits are obtained. ,
3. Davey Roofing 510-293-9300 needs to inspect and approve the roof before
- and after the installation, so the roof warranty is maintained.
4. The skylight can only be installed on the sloped shingle portion of the
roof.
5. You are responsible for any damage, repairs or maintenance caused by the
skylight installation, including leakage around the skylight.
Thank you for submitting your architectural request to the Board of
Directors.
Bob Soares
Cupertino Countrywood Association Manager
RECEIVI
• JUL 12003
•
l oC 1
11/11/02 9:17 AN
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COpER1LNu :r ,,�i�il ,i�ANGES
DATA._
SIGNED—
This
, ,—
This set c. ans and specrfi� MUST
be kept u, the jab at
aia
s and it is un
lalawful to melee any clngesor
on same without written permialterations
ssion from
the buildingDept., City of Cupertino,
The stamping of this plan and specifications
SHALL NOT be held to permit or.to be art
approval of the violation of any p[oYiai"
9t any. City. Ocdinanta oL St3ita lalo6
•
log
s(tc+?erZ n�ro l
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{ JUL 120
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Of
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This ::, ac ','US)
n .p• ii is ,.�n
18Mw. to r. ,. ,., ,;.i is or nlierri. w
on same c Ui ;, r.:,,en pt,mission fror
the building Dept., City of Cupertino.
The stamping of this plan and specifications
• 31IwI NOT be hcld to permit or to be ar
appruval of the violation of any provisions
of any City ordinance or State Lar.
II •
GC = CITY OF CUPERTINO 09 0 7 0 80
CITY°F PERMIT APPLICATION FORM
CUPERTINO
APN # 2,� 2 _ Date:
Building Address: ✓/ �" n n
V06,;t �Re ,[!G l CJpe,6&A7 Cd SU/
Owner's N Ph e#:
o C EDS rf o& asps 3s3s
Contractor: License#:
Te A gS-A tva �u c �ol� G3 70-!�9�f
Contact: Ph ne#:
u NA os_ 90?0 - //00
A can ontractor: Fax #:
Building Pe it Info:
Bldg Elect Plumb Mech
Job Des ' tion:
ential: //,^, .. 11
�W Co rc5;a1:
Sq.Ft. Floor Area: 1 $/Sq. t.:
33S Sd
Architect/Engineer: Valuation: --
Type of Construction: Occupancy G oup:
Ahk
, RAmG '
Quantity Fee IDFee Descri tion Fee Group
BAPPLOTHER Other Appliances 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=Multi
BUILDING
BELEC1000 Elec 600ELECTRICAL
BELEC1001 Elec 600ELECTRICAL
BELEC200 Elec SvcELECTRICAL
BENERGY EnerBUILDING
BENERGYADD Ener ABUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm.-Housing Mit. Fee BUILDING
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BNEWMULTI New Multi-family Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
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