03020042 r
CITY OF CUPERTINO ` i g ' : , , -i;rci ±�,, •> •s
BUILDING DIVISION PERMIT CQNTRACTOWINFPRI
BUILDING ADDRESS:
880 HYDE AV VANNI BROTHERS CONSTRUCTIO PERMIT NO.
OWNER'S NAME: 914 HYDE AVE APPLICATION SUB DATE
CHARLOTTE M LUDEMANN 02/12/2003
rHONE: 408 T253-7028 SANITARY NO. CONTROL NO.
ARCHf1ECDENGINEER:
BUILDING PERMIT INFO
BLDG EIJ:CT PLUMB MECH
w00 LICENSED CONTRd orderSDECLARATION
0 0 0 0
U C 1 hereby affirm Nat I am licensed under provisions of,Cocks 9(commencing - Job DO p[19p
with llto=lOW)of DivisionJorthe Busim_v and Prafemons Code,and my license is
o in Lfeumrcaand effect. KITCHEN REMODEL B1 NNNIII pm
00 n 0 Licence Class Lie.M
oZ-0 prem Convenor
F�4~4'j ARCHDECLARATION MAR 0 5 2003
O 6 V I undersand my plant shrill
lt W W used az public records
uai3 u•t�, Licensed Professional
Fu,03 OWNER-BUILDER DECLARATION BUILDING
1 hth
ce
ereby from at I am exempt from rhe Cunvacmrs License Law for the
00 following moon.(Section 7031.5.Business and Professions Code:Any city or county
a. $tai which equiru a permit to.omUpel,alter,improve.thrombsh,or mpair any su acusle
FI< prior in its issuance.also requires the applicant for such pelmil to file a signed statement
That he is licensed pursuant o me provisions or the Contractors License Low(Charm,9 Sq. Ft. Floor Area $24V6Ip[ion
of (commencing with Section 7")Of Division 3 of Ne Business and Professions Cose)or
y 3$
first M Of exempt therefrom and the basis for Ne alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of
not in=then Bw hundred dollars($500). - Occupancy Type
D I.ssownerof Nepropony.ormyemployeeswithwegesuthe'vwlecomperwdon,
will dothework.andthestrucmeisnotimmsided oroBced forsale(Sce.1044,Business —
and Professions Cade:The Conwcm102 —
r's License Law does not apply to an owner of PIER S equired Inspections
'property who buildsor improves themon,and who doessuch work himsefor through his
ownemployces,provided Jut such improvements ate not intended or offered forsale.If, 103 — LIFER
however,Ne building or improvement is sold within one year of completion,Ne owner-
builder will haw the burden of Proving that he did not build or improve for purpose of 104 - REBAR
ask.).
105 - ANCHOR BOLTS
I,uctOwner ofthe ct(Sm.70y.Bam usiness
immorprofessors
Cudk:)eueContra ssmeto 106 - SEWER & WATER
couwm the project(Sec.1044,Business and Profcssioru Code:)Thi,Contractor's Li-
faselewdoesnotapplytoanownerofpropenywhoWildsorimprovesdumun.add 202 UNDERFLOOR PLUMBING
who contracts for such projects with a mnuactor(s)licensed pursuant to the Contractor's
cum1a
0 203 — UNDERFLOOR MECHANICAL
Tem exempt under Sec. ,BRPC for this coon 204 — UNDERFLOOR FRAME
Ovo � � Lr�gmON— -/L-0j 205 — UNDERFLOOR INSULATION
WORKER'S COMP NSATION DEC
TherebyaffirmunderPenaltyOfperjuryoneofthefounwingde,.rations: 301 - ROUGH PLUMBING
D l haw and will maintain a Cemificau of Consent ultimure forw.rm's Comped. 302 — TUB & OR SHOWER
salion,as provided for by Section 37W of the Labor Code.for the performance of the 3 03 — ROUGHwork MECHANICAL
C1Iha whichthis
maintain
ok issued. 304 — ROUGH ELECTRICAL
❑1 haw and will maintain Workers Compensation work
for hi h tis required by Section
My of the Labor Code,
nsatifor n rhepeRomcance add Policy
for which Nis permit is issued. 305 — FRAME
My Worker's Compensation lrtsunnce eartiermd Policy number am: 306 — HOLDOWNS
carver: P 307 — INSULATION
CERTIFICATE OF EXEMPTION
ION FRORO M WORKERS'
COMPENSATION INSURANCE 308 — SHEETROCK
or lett)(lhis section need not be completed if Re permit is for one hundred dollars(SI W) 309 — EXTERIOR LATH
1 eenify,that in the performance of the work for which this permit is issued,I shall not - 3 10 — INTERIOR LATH
employ any person in any manner so as re become subject to the Workers Compensation 311 — SCRATCH COAT
Laws of Califgmia.Data
Applicant 313 — ROOF NAIL
NOTICE TO APPLICANT:If,after making this Certificate of Exemption.you should 501 — FINAL ELECTRICAL ENERGY
become subject to the Workers Compensation Provisions of the L mor Code,you must
0 fimthwith comply with such pmvisinn.orthis permit hall Wdecmedmvnked. 502 — FINAL PLUMBING ENERGY
y
CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY
F IWrebyaffirm thalthem isacouvunimlending agency for fire performanceuf 504 - FINAL BUILDING ENERGY
the work for which This permit is issued(Sec.3891,Civ.C) 5 Q 5
ave q Units,',Name — FINAL ELECTRICAL
D z Under'Address 506 — GAS TEST
Ug 1certifyNalThave read this tyaddcounand sumthundabove information is FINAL PLUMBING
{f. (~ comm.l agree to comply with all city and county ordinances and sum laws elating to 507
p U Wilding construction.and hereby authod,emprescoadwsOfthis atytnenlr,upon he %09FIN
NAL MECHANICAL
Fyshout-meinioned Property for inspection purposes.
(Wq agree resew,indemnify and keep harmless the City of Cupcnina against isconsequnceof ecostsand ex pisremiichmayinanywayaccmcagainnsaidCityn. Gmconscyucncc of the graining of perces whiURAPPLICANT UNDERS SANDS AND WILL COMPLY WITH ALL NON-POINT Issued byWORKS Dat
icte0lpxO'4" R-11- Re-roofs
gnalue of ApplicanUConlector Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding occupant store or handle harud.0 material
as defined by the Cupertino Municipal Code.Chapter 9.12,and Ne Health and Safety
Cod..Section 25532(a)?
41 Dy. Pis All roofs shall be inspected prior to any roofing material being installed.
Will the applicant Of future Wildingoccupanl use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as defined by Ne Bay Arca Air Quality Management all new materials for inspection.
District?
Dy. I(.'u
I have mad the h romfous mameials requirements under Chapter 6.95 of the califor-
niaHealth S,Safety Code,Savmu 25505.25533 and 15534.1 undersand that if lM Wilding
does not currently haw a tenant.that it is my reapmeibilily m notify the acupml of the
requirements which most bei ,
�e me,prior m nompree of a Certificate of Gee
upancy,
—tet "d'�"� "- z-i2-a3 Signature ofApplicant Date
O crorauthoriwdagent te All roof coverings to be Class "B"or better
00F
CITY OF CUPERTINO
CUPEI�TINO PERMIT APPLICATION FORM 03 a ao �
•
APN# �7 Date:
Building Addre s:
Owner's Name: Phone#:
C-havlo e_. AA _ Lv, 0g — z5-7- 3110
Contractor: 7 License #:
\/0 h n i Y'ro 5 • Corn S+Y u C' D rl — 0Z 5 3 7•z q P
Contact: Cupertino Business Lice*e#:
ChOr � v�' 'L Lk �ernAv� r,
Building Permit Info:
Bldg Elect Plumb
/ Mech ❑
Jobescription: ��? /
Residential Commercial ❑
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Project: .�eZ Occupancy Group:y �y'0
Type of Construction: ^
1
QuantitV Fee ID Fee Description Fee Group
BAPPLOTHER OtherAppliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILERS F— Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/ uasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V<= IOOOA ELECTRICAL
BELEC1001 Elec 600V > IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V <=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm. housing Mit. Fee BUILDING
I of ¢ 9 7-9
u
Ln
cn
u
0
0
H a
H
'(03
T J
J u ..
cn .
0
• Z
_—
z
(may_ It� Z
I
� O
i
N E
U 0
Z 0
-...__.... -------8sIn m z
U) to <
v I'M SE < toz m:
I Lij
UES rcal ?nm u no a
'0 J 0
O
l y 3 4h
O m
'-' O
O
LJ I_J 1_J LJ LJ
ti
bMv T29N
� S o^
00
00i O m ~ 1 0 0
u m
I I 4k /p / m
N,�>f>><�FI.0 H r"E
IN ACCORC�P w 'H THE CTY OR N
• DI IANCES
IF ol�00000000
i i 7
N [ \Ts — — --
r. O < t N _ _ U
GN .[_ _
m ILL ;P plans I. matins MUST 0
e 4 pt mI the j' a at III mics nd it is un —i 00000000
_ awf Ito makes ly cl in, as or alterations
In I ime withal . w,i en permssion from
ctim hno. L \
+' m .
D-
N ,n 'nd s ,eciIlea.i�ms w vvvvNNNN
— O Jnr t NOl he hod t 13 mlt ,( I, t nil
m , m „d IFVill Ir
N r , gal of the vl la, n v an D
y N LOLO1D10fD(O1D1D
1 , I , xmmmrnm
mmm
,,. I
N1 '� i
of
4h m 1 — ! l� 1't mJ JJ L
I I
1 I 1 U 010000000
a mmmmmmmm
_ LJ LJ
ofxmw
wwww
I_ 1 aan_a
a w
»>0
EWMW
DM<M 0000
mxwm
Z<m<>««
m mmOOOO
+J Y
OZO ««Z<<<<
-+
c rl-+I—«r-rr
Ocnlnlnalnlnlncn
z1k—+NmV'117101 m
DATE:
_ JOB:
WOOD CI_. ASSIC rl PHONE:
i
Im
oP� i
rrn _
u 6 zuu-
r.•
t�-
B
I _
r ..,..Tv na
CtlPERTO D SES ANS ORDINAftCh
I
GATE_ a
• Ftns s ;t of P' t s an, specific ations m in
be ke it on t .e job t all timf ;and it is P .:
__`� M Au t , ,a changes tr alteral o!�
Iwit! ut written pe mission Iola
1.-----
he braiding leEClty of "uyew,w. .. .. _.
D ,
2 3o hr ��mpiap of this,ptan an�j speuficaHon9,
4��l NOT q'Ad to TU-.MR or to be al; !
vr; a,< the vio)alion of any provisiot6l i ..
;.. n e n, or State law,
_ _ I