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03110098TCY OF CUPERTINO ss. + '_ '' �,; k :CH BUILDING DIVISION PERMIT ,as CONTkXCT0kjNF0RMATION '._` -DING au1LDINc nDDRess: SEARS HOME IMPROVEMENT PERMRNO0311009B OWNER'S NAME: IJGHMAN PATRICIA R 2R; E. AIRWAY RT.Vn PERMITISSUEDATE 11/19/2003 E: - SANITARY NO. CONTROL NO. 925 245-2000 ARCHM-C /HNGINEER: BUILDING PERMIT INFO BLDGEIEC! PLUMB MECH O O O O LICENSED CONTRACTOR'S DECLARATION Job Description 1 hereby affirm Thal I em licensed under provisions of Chapter 9 (commencing P with Section 7M)) of Division 3 of the BusingayInd Professimu Cade, and my license is License fall denten JC/ aI i SIDING UPGRADE Licensee _Lick D�y Contractor CHI'RLTS DRATION IundcrstandmyplansshallMuscdaYYpuhlicrccom, I Licensed Prafessiunal - OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law fur the allowing reason. (Section 7031.5, Business and Professions Code: Any city or county which mquim a Permit as consbun, alta, improve, demolish, or repair any structure prior to its issuance, also mquims the applicam for such Permit to file a signed statement that he is licensed pursuant to the Previsions of the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section 70dad at Division 3 or the Business and Professions Code) or that he ie exempt therefrom end not basis far the alleged ascription, Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil pemlry of - 3 aIRN tD BiBer 00 Occupancy Type P Y---- nm mom than five hundred dollan($500). - 0 I, as owner ofthe property, or my employees with wages As their sale eompensiahm, will do the work, and thasod clum is not intended or offered for sale (Sec. 7614. Business and Professions Code: The Conunmes Lia. Law does not apply m an Owner Of - Required Inspections property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements arc not intended interfered forsele. If. however, the building or improvement Is Bold within one year of completion, the owner builder will have the burden of proving that he did not build or sermon for purpose of . . ulcJ. co 1, as Owner ora the property, . Business exclusively contracting with licensed attract is . comwct Ne Code:) The Contractor's not (See. es cense Law does not apply to an owner of prapeny who W iltls or impmvn thereon, roti , o an wneorand property who Wilds rad D who coram is for such projects with o contractor(s) licensed pursuant to the Contractor's A f Licence Law. O l am exempt under Sec. , B h P C for this mason (a �0p Q,/1/ Owner Date V WORKER'S COMPENSATION DECLARATION _ _ 'N Ihereby affirm under penalty of perjury arc of the following daluetionc I have and will maintain a Certificate, of Cmesenuo self -hours, for Workc6 Compere .. . scion, u provided for by Section 37M of the Lamor Code, for Ne Performance of the We, for which this permit is issued. ❑ I have and will maintain Workers Compensation Insurance, As required by Section 37W of the Labor Code, for the performance of Ne work far which this Permit is Issued. My Wor/Ikeri Cone, creh mn,Inlsurance carrier cy number art: IWP C crhlhE0.TY awA2.ISMro CERTICERTI IDEM,N FROM WORKERS' O 2, COMPENSATIO�s' INSURANCE (TTISsectitm treed not W completed if the permit is forme hundred dollars ($100) ar Icas.) 1 certify that in the performance of the work for which this Permit is arced, l shall not employ any person in any manner sat as he became subjacuo the Workers' Compeuation Laws of California. Data - Applicant NOTICE TO APPLICANT: If, after making this Car le of Exemption, you should become subject to the Worker's Catamoution provisions of the unto Code, you mast forthwith comply with such provisions or this Permit hall W deemed revoked. CONSTRUCTION LENDING AGENCY I hereby effirte that there its construction lending agency for the performance of Ne work fur which this permit is issued (Sec. 3097. Civ. C.) Lender's Name Lenders Address 1 tt.ify that 1 have read this application and scale that the above information is correct. I agree to comply with all city and county ordinances and stale laws relating to building convection, and hereby authorise representatives of this city to enter upon Ne show mentioned pmperty for inspection purposes. (We) agree to on. indemnify ad keep humlw the City of Cupertino against liabilities, judgments. costs and expenses which may in any way account against aid City / 6i 7 in consequence, of the granting of this Permit. G/ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date SOURC PikGULATION Re -roofs Type of Roof G S' rte of pplicaHAZA cm Data HAZARDOUSMATERIALSDISCLOSURE Will the applicam or forum Wilding sceupan Bore or handle huutlous materiel occupant As defined by the Cupertino Municipal, Code, Chapter 9.12, end the Health and Safely Cede, Section 25532(')7 Yea All roofs shall be'ins inspected prior to an roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment ordaviacs which d ha'rarama air aantaminsnts as defiaed by the Bay Area Air Quality Management all new materials for inspection. istrmrr ❑Yes No I have mad the huardousmamdals rryuircmenu under Chaper6.95 of Oc Califon nice Rulth&Safety Code.Savon255f15.25533.d25534.lunder damifmWilding' does not currently has a teren , Nat it is my responsibility m notify the oeeupant of Oc mquir emwhc an onto suaneaofacamream fOcaupuey. Signature of Applicant Date 1 1 ` u All roof coverings to be Class "B" or better 0 or authariacd agent Date IesZ GO IUt, El_ 7q )wu 10 Do 3$� -zC1 aFFc V :)2 z �p C JC yF 7 ti 6 CI'T'Y OF CUPERTINO �- BUILDING DIVISION - PERM CONTRACTOR INFORMA�►N: . Ta.,f`--6Pera 1, eR�a,. ".�¢',M„Piry 3�w"+v94, BmIP LONG ADDRESS: SEARS HOME IMPROVEMENT PERMITNO03110098 'HER '$ NAME: PERMIT ISSUE DATE 3 PHONE: SANITARY NO. CONTROL NO. (925)245-2000 ARCHITECT'/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTORS DECLARATION Job Description viaions of Chapter 9 (comencing 1 hereby affirm Thal I am licensed under pmm with Section 70M) of Division 3 or the Busing"rad Prorcuium Codt and my license Is imm�m derreel JC/ al 7 SIDING UPGRADE License Lic.p' D Contractor CHITECTS D6Qt.ARATION �akt P�tjagyak Q� 1 undersand my plum shell Ix eyed, Imblie mmods Licensed Professional OWNER -BUILDER DECLARATION . I hereby Affirm that 1 me exempt from the Contractor's License Lew for the following moon. ($cellon 7031.5, Business and POnAmrsiona Chalk: Any city or county which RQa11C[ a permit I,, emastram, aItm. Improve. demolish, or Rpa1f any IINLIYm prior to its ISNancc. also recrums the applicant for such Permit to file a signed turamucnl Sq. Ft. Floor Area Valuation that he is licensed pursuant n the provisions or the Contractors Llan. law lChapmr9 (commencing with Section 7wrid or Division 3 of the Business and Profession. Code) or that he is exempt therefrom and she buss for the alleged exemption. Any violation or 3AgNM&ElCr00 Occupancy Type _. Section 7031.5 by any applicant for a permit ubjceu the applicant to a civil Penalty Of not more than five hundred dollars (SSW), 0 I, u owner of the property, m my employees with wages as their sole compensation. Required Inspections will do the work. and theswnufe is not immaded prepents mrl.1.(Sec. 7064, Business sod Proposal.. Code: The Commerce. Lt. Law docs nut apply m an owner of q P Property whobuilds of improves Hereon, and who does such work himself orthrough his own employees, provided that such impawmen s see not Intended ororrcmd for sale. If. however, the building or improvement is sold within one year or completion, the owner - builder will have the burden of Proving that he did not Wild or Improve for purpose of ..In.). ❑ 1 I, as owner of the confessions contractors i. exclusivelyeand - Cir ;i The coEasn the project (Sec. o an Business and Pmresoom Cade:) The Con mcoana Li. See. 704, . B sense law coca not apply 0 an owner of property who builds or improve the.mnfud,who / contracts fontmth projects with a conlncwr(s) licensed pursuant o the CammctoM1 Licence law. ❑Tem exempt undo Sec. .B,YPCfor this moon Z/�\ mer Dau 2 v WORKERS COMPENSATION DECLARATION I hereby ellitm under penally of perjury one or the following declarations: .... ,_ ❑ I hue and will maintain a Certificate of Consent to se Wasum for Worker's Comma. u0on, as provided for by Section 3700 of the laWI Code, In, but peffemed a of the . . work for which this permit is iuuc6 ❑ I have and will maintain Wurker's Compensation Insurance, u recruited by Section 3700 of the labor Code, for the porf.mame. of to work for which his permit is Issued, My Worker's Compensatlon lnsues�atmae� c.1omer cy number am: - rht4E0.TY Mtfl V/I .Pot eJA*:1- D9ro 1 v CERTI ON FROM WORKERS' Q 2 COMPENSATIO INSURANCE (This section need not he completed if lK permit is far one WnJreddollam (SIM) . nr leu) I certify that in the perrmmance of the work rot which this permit u issued. I shall nut employ any person in any manner so as to become subject o the Workers Compemallon Laws or C.I&mdia. Dale Applicant NOTICE TO APPLICANT. If, After making this Cenificue of Exemption, you should became subject to the Worker's Compensation provisions of the labor Code, you must ' forthwith comply with such provisions or this perfrilshtil be seemed mvnked. CONSTRUCTION LENDING AGENCY 1Mr thi thet Them isaeo tl0lending agency for tire Pcrfurmana of which (Sec. ' BIC Work for which Ihl9 pCrlllll S IS[Ycd ($Ce. 3Di7. Cu. C.) Lendcls Namc Lenders Address I ceniry that l have read this application and store that the above information is ' torten. I sgrce to comply with all city and county ordinances and state laws misting, to Wilding construction. and hereby authorize repruenu ivu of this city to enter upon the I ahovemenaoned properly rot inspection Pmposma. (We) agree to sew, Indemni ry and keep harmless the City of Cupertino against / i liabilities, judgments. costs and expenses which may in any way aceree against said City in or th. Starting of I APPLICANT cUNDERSTANDS IAND WILL COMPLY WITH ALL NON -POINT Issued by: Date G SOURC EGULATION Re -roofs a S' na of pplicanUComw Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding txeupml care or handle heardom material or de0ned by the Cupertino Municipal Code, Chapter 9.12. and the Health and Safety ode, Section 25532ta)? / All roofs shall be inspected prior to any roofing material being installed. ❑Yes �Au a roof is installed without first obtaining an inspection, I agree to remove Will the applicant at roam beading Occupant use equipment of devices whichIf colt huardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. ' District? ❑Yes Nu I have mad the hnaaNtrosmacriais les rummcnts..&,Chapmr 6,95 of the Carter. . nig HcalN&Safety C9M,So-:dum25505,255J7 wd255J4.l understand Nal iftM Wilding' J. not atmmly haw . atom, that it is my esp ars dity to notify line nee.mnt or me my anrsWhmnmtA Earl. aaaannCLrd`c,`pfOe Pang Signature of Applicant Date All roof coverings to be Class "B" or better o aramh� nriedagenl Dam Nov 18 03 10:42a SERRS HOME PRO (9251245-2016 P.1 (, Hoare Home bnprnvement Products ' LPohcoandea +'Z �R�f� P.O. Bo52290 Uann 62-2290 California Jcenae N 21379 S t 4 f A.l1 (r Nemo �Plhme: ua p ,,JdR�.sy�er Address: Ciry: at: Lp:—f""`"7— Wye, the owlets of mo premiseo described below, In"Inalter referral to ae'Pu a offer to cathect with Some Home Improvement Producln haelneaermfmredtoa to furnish, dell"r,ond arrange for Installation of all matadals necessary to lnpmx the wooden, located at (Sts,0 01ela) (reg) Aging to the following epecigcallonm NOT INCLUDED INCLUDED SPECIFICATIONS PREP9RA7j0 1. ® ❑ Obtain at weal Permits and Inurences. 2. (91 ❑ Inspect wrlecae in work area - mroul loose wood, replace moan cul waodF5818 rletUee3�y YOM • area e)wJudhg roof, decking or reaare, tmeWrel members. 7T 9. Cl i0omow Edklnp 1. Fir W('Nkk, areae. Lamtlan: d n work area a nxassary. 9. I p old INW 11 wnnN; 7, I fla a a dad%ft '3T 1/4"exhudotl pdyt rmishI einn.(circle one) CUBTUM TRIM: a. Cl Custom Vyw-Nod Wummum lakn spasm; Cour: 9. Cl Remove and reaaadJdaposo of edsarlp gu". to. ❑ Cover seed nn.e of home with '4m I -an N'k NNapl taboo oroos noted �-,( Bert/ Bettor l Good l Oftr�d WIC 11, q� ❑ Custom Vynb osd aluminum flexor he rM: r - ) V1 .,,,.,,,• `,� Location: 12. L ❑ Jump/Mod w5ndowrtrL"callam ,,, " 13. •`j[J\ ❑ Customvtom W wlndawshiY gaheadam wan WN1.a-' A I 1r1nrS�w 10 g 14. �Qn Romma and reinstall edxtlng WWorm wlndowowniIr� M. 15. u'+� Custom wrap door taking, won Vyw-10ad dumin Loa on: is. ❑ Custom wrap garage door singl dwble h Vyn-fum:_ n. Remm6 and reinaMY slam door sa,, 1 _ _ _ T aEr of plans rr� :iNC II la A9llSi: ts. jl��r Daae comer Poste: Cok,c-JI rCp.YJ'fe _. ar-., .. ..tl0 (tom f 19. ry ❑ CIIP Yon - _ alO1NO: 20. `/$7\' ❑ Insall (Good DO.' Sol a p:( Iii undP Suit 'P tenT�ga� TYP Hod.. / COj.O on itis.. . fl... oil PORCH 21. ❑ Poroh Lows p Color. SYSTEMS 22. ❑ Patch pmn: - t11e subarea u�diap I ret '_Ov 23. Patch boom I'fi(�atlonl CLEAN Up: 24. ® ❑ Caen up and nmoval W Wt job MWM dWne: � CLEAN. 26. ® ❑ Each job Is mnr-shipped o maid delay,. Remove a) a AWlatifA A topermit or, to be all •WARIMNTIER: 20. D ❑ Manunkureya wermnry sam upon conlpkgum aooreval of the violation of any (1faY1IIW TIME FOR COMPLETION OF WORK Cmeadar Rud owaromw wort within aPplodmalsly Meth/ (20) days from the dale shown herein and we be sut.mmhay comphNd within faly4w(45) days ma nMq• dNooa esdmatad ownseon an Is shown ARu.dnztokorongdmeIs; lL e�rAppredmde co pnibn was, m '!L— OS — 0 3 In the awed of sues future to sept detiwry, of goads or porawnw os, 0 "Maes eovamd wndn, the Corwo or shall ba walled Io and Buyw groes b ADDDIONAL PROVISIONS AND WARRANnES ARE STATED ON REVERSE AND ARE PART OF THIS CONTRACT. Please read the fallowing gold typo and Inlual o(orwpondbg On). Verbal underatwuDngo and agr fft with repnaaantettve shelf not be binding. All understanding* and agreamenta must be Bet both in writing In [hie Contract. Pur,heaorinitkk: The TOTAL PRICE far so Labor a Matonal0 (indulins rry oppllwhle discount) Is $ Centred Pdbe S Down Payment a oil State Sala,Tex�',�i%)S Balance Payable8 dfnpowal.) -- iTotaicmtwpdco $ Tbnnw Credit Cl (Subleot In the opprmal of the Credit Dopmwam) Cash X(Flral payment payable to lnataper upon comple lob) Funded by: Bank. —., ^• AC a i7Lj / / /Z 2✓ /Gr�i cr i v 10%Prohrrad Cuafalmr Wecount(PCD)awardadfor erryluoro provamntPMduWepurahaus.Currenlpaing AVWlatlefOrO (I)Y=— It this Is a proof tMMCdM, the atimament for Credit ts contained in a eep8rela dam, rowhichle Ilag omteo heroin by rotannce and meds ape rt hors0l. Me the malWgrad ere hereby wmoraing Seam Home Impmmmaru Proads to wady ntl rev mylwr oradn rarnd with a Inds,pkMem ttotla reporting agony and mines Mom from WI IIah1Ny Incurred from Intah m or IN WITNESS WHEREOF PunbaOor(s)aevs hwwma tigadthelr name(s)MI' duyW 209,1end ecklnwladpll rocalpt W a hue wpy d misConan and uniess ors iw rpw--, N b untlarkootl th e mwwr is reedy for tMa work o begin. Purchaser hes the right to require Contractor to have a payment and performance hand. ' THIS MESSAGE APPLIES TO DOOR•TUDOOR SALES ONLY. You Purohesn(s) may cancel this transaction any Ons Rd" to midnight o1 the thlyd t y o r the hI8 (r§ons colon. Ste accompanying notice of eancaaation form for an esplaing this right 2 rt or/LrG-dY/`d� so.N,..b I,,,.m u,.s4r uw puen.w(o no.wa asksta w emn. fi Tn'a9F.rlglvrMalM' Ida, Orb INer pat, ACCfPrf00 :aaYwNa Iwe.nlNmeknpavemeMPNdudl ode or ply, • ITY OF CUPERTINO JCt PERMIT APPLICATION FORM 63 //Oa98' APN # y �' Fee Group Date: Building Address/' MECHANICAL BBLDGFEE , 193,7 LAMAP, Mx0F BBOILERI Owner's Name: MECHANICAL BBOILER2 Phone #: TA i A v 66 NM q AJ BBOILER3 Y0 - 253 - 6753 Contractor: BBOILER4 Boiler> 1M to 1.75 M Btu License #: SEAP,t- Boiler > 1.75M Btu MECHANICAL a 13"1 Contact: BUILDING BCONSTAX Cupertino Business Lice #: "'r. 9,,.4 esoul BCONSTAXBQ Con. Tax for BQ Zone a3b ilding P rmit Info: Hotel and Motel BUILDING BI X/ Elect ❑ Plumb ❑ Mech ❑ escription:7 Elec 600V <= IOOOA ELECTRICAL BELEC1001 Elec 600V > 1 OOOA Residential ❑ U J BELEC200 Elec Svcs 600V <= 200A Commercial ❑ Sq.Ft. Floor Area: 1P —Zrz BUILDING $/Sq.Ft.: Cost of Project: s BINVESTIGA Occupancy Group: BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING ype of Construction: OF Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI 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 <= IOOOA ELECTRICAL BELEC1001 Elec 600V > 1 OOOA 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 1 of 3 CITY o _CUPERTINO OITY OF CUPERTINO 0 PERMIT APPLICATION FORM WL yQuantity Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi -Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUNMTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interce for 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 Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAMHAN 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 Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC - Misc Apparatus ELECTRICAL BRENUSJ PP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL �Q CITY OF CUPEkTINO WITY OF CUPERTINO* PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmd] Sips Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL . BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL 13REMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING k]no c3