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02080021 (3) CITYBUILDINGID DIVISION PEOT CONTRACTOR MOR V ION: BUILDING ADDRESS: PERP NO. 7728 OBSIDIAN CT KAVENY JOHN J AND DIANE W 02080021 APPLICATION SUB DATE MEW: JOHN J AND DIANE W 08/06/2002 PHONE: SANTDLRY NO. CONTROL NO. .O.eeZ° ARCHITECT/ENGINEER: BUILDING PERMR INFO Lk�w BLDG ELECT PLUMB MECH Z y 2 LICENSED CONTRACTOR'S DECLARATION - Job De ion FI B�„Iv ALE ° -° I harm,oRrm that 1 am licenud under provisions of CTaper 9(comment g ADD BAY WINDOW (DINING RM) ttyy with ati n7000)of Division Jof Ne Businesafnd Professions Code.andmylicense ,a xi u in see and eRmt, c\A'/ aoT6 ass OCT 1 0 2002 Conwc�p 3 a ARCHITECTS DECl/peRA�oN t °5 I understad my plans shall k uu4 assd�bbb r S o O Licensed professional BUILDING OWNER-BUILDER DECLARATION I hereby,.(Sera that 1 am exempt s an Ne Conions Ca Licame,c law Tor county I_?D following roar .(Sinton]OJ str Business end Improve, demolish, Cade:Any city structure county $1 ej Q Q W F° whim requims a permit ro comwct.alar,improve,demolish,or rep'v wy i --ofiiia]Ov twei&ttroplb5(y athle?tirtonfro'(0mi0'0h}opakaartD<ivboiusroiotsonTJofrotfhteheah lQkugseidndceasseetBMkp0Pomni.feAuWniyonvsioClpaotidoen) 1 36s-Q_i,4bt0@9uo;r6.'O�ra_.•:�'�:'�1 i.: ValuationpNakmgLm m any applicant far a pemtit subject the applicanuo a civil penmry :arnwmartt.mrmabunarcdaauas(ssodJ. 101AP`tNY�ATION -'"' Occupancy Type ❑Lu owner of the property.or my employm with wagesutcir cele compensation. 102 PIERS - -will Eo me want:and the'awcmrc is not intended or offered for agile(Sm.70,14,' - - - -"- - t Busiiesi aM Proteaana Cade:The conuumr'a Liceve Law does rat appq to an 103 — UFER Required Inspections'"" ^' owter of property Who Wilda or improve thaean-and who does such wart himself 104 — REBAR 05 throw h his own employees.provided Nat such improvemenu are not intended or _ _ .. __. __. .. '1bRc¢d orale:ILhowever,the buildingofimprovementisSold witidone yEarof IGS - ANCHOR completion,Ne owner-Wilder will have the burden of proving that he did trot Wild or improve Tae harpooner sak.l. 106 - SEWER & WATER __._.. ..._..------..__.......__.- - _. .. ._... .... - ---- dl.uowner o(tk PropertY.ameadusivdy contracting with liccnscd convecmrsm — :+ - - consumer the protect(Sm.704,1.Business and Proressiom Coded The Cortramr's 203 — UNDERFLOOR MECHAN'ICAL'`;=" Limme law docs not apply to an owner of property who Wilds m improve Ncrem. -and.wha mntr¢u for.auch,mieu wit.a.cnmractor(e)Bmnsed.pursuant.m.Ne. ._ _..__. _2 04- _.. UNDERF-LOOR-- F'RAME_._ ea iA.'s License Law aemptunder Sec. rB&PCfor Nia rtason 205 - UNDERFLOOR' INSUliATION g OZ . 301 - ROUGH PLUMBING ORI I'SC SATION C RATION 302 — TUB & OR SHOWER thereby Rw u r vlt of t f tk followin dakntiana: _ ys pe. ._y paj ryamo g 303 ROUGH MECHANICAL = ❑ 1 have and will mamam a CeitlOme or consent to self-insure for Workers 304 - ROUGH ELECTRICAL Campemaion.•u Provided for by Section 37M or to IaWr Code, for to - - - perfomiuLm ar to wa ,far whipn ria permit is i::pee. 305 - FRAME Ol ha6ciai will'tainuin Worker's Compensation Insurance.Pas required by Section 306 - HOLDOWNS '. TW of to L.Wr Code.fbr to performance of the work for which this pewit is307 — INSULATION rsiuW MY Wo kers Compensat on Insurance caner eM P 1 cY k tie: ._ . 3,08,.. . SVEETROCK':_:, --_...-'----_...\'.....i. .._....._.. _.. Comer 1 +' Policy Na.; t' s [{CERTIFICATION OF EKEMPTION MOM WORKERS �. 1`309 'i 'EXTERIOR �liATH .= -L!:L COMPENSATION INSURANCE=' : ;._.. . sass _ ,r ..,... . ._ _. ,L-"(rhiz semioh need not IN complcrcd if the permit is fm one hundred dollars 311 _ ' SCRATCH COAT ,..1"....t ,,;r . _ . .. ..._.. . . 313 -ROOF AIL - - - 1certify tat in to peAoimance of to work foi which tis permit is ivum,1 N - �iballhooationyanyf manner gopat a e,iPblmt to to Worker' 501 _ FINAL ELUMBI G. ENERGY-_: CoPPmppps t n canto t � � ' C 5Q2...__. FINAL .PLUMBING.. ENERGY tN TO PL A ILakrty ngtNSCe ' ofFaemgon;youshould 503 - FINAL MECHANICAL' ENERGY 'bin ubl note Workers Comps at p ionsofthfaW Cade,youmust 0 forthwith 'ply wit such provisions t peritShallkam demand oke. 504 - FINAL BUILDING..,ENERGY ___ za ... _ _ ..sttnn ,: .,. ''. CONSTRurnoNLENDING AGENCY 505 - FINAL ELECTRICAL E+.> ,.." Y g agency a.. ,, ... "1 hereby c for dr, 506 - GAS TEST r 'or the work roe which this pewit is issued(sec.JDLZ civ.C.1 t<tda's Name _._:...,:_a., ....__ . ... ._..____. _.. LeMcr'x Addrcu � ^�' 507 FINAli PLUMBING AL U'O I ccnify tat I have mod this.pplication and na¢tknhc stye information le 508 - FINAL ME CHAN I C Tr.Fro cosi<ct.1 agree to comply,w N ell city ad county on ioonces and sate laws misting 509 - FINAL GRADE O.V mWildingconawnian,aridhertbyeutorisertpmssnuwesaftiscitymcntaupon 510 - FINAL PLANNING �r W taa=rmrtianed pmpmy for inspection purposes.. ,_. y M)agree m,eve inderviify and keep hamksa the Cityof Cuatiino against PPI!) - FINAL UB C WORKS PPI!) iiabilitie,judgmenu,costs Wpa . rses which may in any way an ce against said U'Z City in somal...a of the gm ung of to permit. �` V4�_1v APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL YON-POIXT' Issued b Date OU RCE R[ ' T NS. D y' casco ApplicartuConwctor'; 't '_Dow Re-roofs / HAZARDOUS MATERI� CLOSURE - , Will Ne applic t rfim2 Wildingoccupantsmre or handl haaamrmatenal _-_Typeof.Roof ._ _.. . .... _ _ .._... .......__<.._..... u ';=y to C Pcmno M NciJgJ Code Chapter 9.13 and to Heath and Safety ,. r. All,ro fs shall be Inspected prior to any roofing mater al being installed. ,_-_ .•_ Will ba,eppl ant or future building occupant use equipment or devices which If a roof is insfalled without first obtaining an inspection;'-I agree to remove ft •cwt haavdaus ab o um a is m fined by to Bay Are Air Quality Management Dirt t f all new materials for,inspection. Applicant.understands and will com_ply with .oee _ l �°rvo all non-point source i'eg'Ie ons, , 'L 1 huve'rtad.te haeardoua rata is regbireinenu under Chapee 6.65 of he [:Lfiramia Health&Surety Code.Sectiona25505,25533 and 25574.1 undenurd tat -ifte Wilding does not mmentlyhaveamnnnt,that n is my resyaelbility to ratify the occupant a the requirements which must k met prior m issuance of a Certificate of °.°.-Y': Signature of Applicant Date ,uNo gat soar,. Dae All roof coverings to be Class"B" or better CITY OF CUPERTINO 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp : Rng: Sub: Blk: Lot : APN . . . . . . . . : 36218027 . 00 DATE ISSUED. . . . . . . : 08/06/2002 RECEIPT 4 . . . . . . . . . : 19320 REFERENCE ID # . . . : 02080021 SITE ADDRESS . . . . . : 7728 OBSIDIAN CT SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . : OWNER . . . . . . . . . . . . : KAVENY JOHN J AND DIANE W ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4111 RECEIVED FROM . . . . : JOHN KAVENY CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : KAVENY JOHN J AND DIANE W ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4111 ' TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - - -------- --- - --------- --- - - ----- -- -------- - - - - - - --- - - - ---- BPERMFEE VALUATION 1, 500 . 00 77 . 00 0 . 00 77 . 00 0 . 00 BENERGY PERMIT FEE 77 . 00 23 . 10 0 . 00 23 . 10 0 . 00 BPLANCHK PERMIT FEE 77 . 00 65 . 45 0 . 00 65 . 45 0 . 00 EPERMITFEE FLAT RATE 1 . 00 35 . 52 0 . 00 35 . 52 0 . 00 BREMRECEPT NO. OUTLETS 1 . 00 1 . 11 0 . 00 1 . 11 0 . 00 BSEISMICRE VALUATION 1 , 500 . 00 0 . 50 0 . 00 0 . 50 0 . 00 ------- - - - ---------- - - - - - ----- -- - - ------ TOTAL PERMIT 202 . 68 0 . 00 202 . 68 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ---------------- - -------- - --- - -- - - ----- CHECK 202 . 68 6717 -_---------- TOTAL RECEIPT 202 . 68 r� PITY: OF CUPERO- CITY OF PERMIT APPLICATION FORM 0Z UPERTINO APN # 362 2 Date: Building Addres Own_er's Nam Phone#: 2JO Contractor: License#: owner Contact: Phone#: Applicant/Contractor: Fax#: ing Permit Info: Bld Elect Plumb Mech Job Description: Residential: A tp Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: Architecl/Engineer: Valuation: e of Construction: Occupancy Group: r / Quanti Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/COmm/ uasi BUILDING BCONSTAXB Con. Tax for B Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= IOOOA ELECTRICAL BELE 1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. HousingMit. Fee BUILDING BMITIGATR Res. HousingMit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BNEWMULTI New Multi-familr Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING 3L° lof3 Z 0 2 ' (� aCITY OF CUPEF�' INO- �'iY°F PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BNUMULTI New Multi-family Res PLUMBING 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 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 HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN 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> 10K btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP I Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 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 Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs,Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL 2of3 • 4 SIVA CITY OF CUPER4ifNO' CITY OF PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSF&2FAM Single & 2 Family BUILDING BSFNA Single Family New Add BUILDING BSPECIAL Special Inspection 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 Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75 M Btu MECHANICAL 3 of 3 Plot: 7728 Obsidian Court, Cupertino Parcel: 36218 027 TR 5711 Lot 11 0 2 FFBy 6 AU Olt . . . . . . . . . . . L4 1 z 7G. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . SUBMITTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A=24x105 = 2520 B=(76x79)/2 = 3002 C=37x64 = 2368 D=(12x52)/2 = 312 E=(84)d5)/2 = 630 TOTAL LOT 8,832 SqFt z 4- Building: 2,907 Lot: 8,832 Lot Coverage: 32.9% FA&) r Y d � 38' 27' / sT FLUUG2 -7 6 40' ...................... ......................: ............... ........................................................ ................................................................ ............................................................. �a. ............................................................. SUBMIT, 1 • ....... fl #1 - 0 6 200 2 J -- ` ovi'i n YF m o m bw ti. C� V/ , 'J Gd � [UdN O W 9 ^' ` C� @ �. ;, z o TaN' 3 �o C N m YUU = N M S r o � F S t ,. Y4 tka 306 �i )r �•; t gs'Nb�.l — �-L,- "w""';', ' ra� �y1 ,:;P1 O 0. �F., y 't' i FV �•�'f Al ^ r T73'�L4 t y ay '"t v�j`� �r t�h .h�" F4,P F' cfi bvsi� e3�vr, rs��na <* ,�'+�,� tg.�I f> ; .. .n r '.�".• isN � � �i � � ,�'? ���A.°� °tea .. 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