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03090231 CITY OF CUPERTINO '^d� - nuu.nlrvc DIVISION PRRMIT C�1N7.RA TnR INPQI2MMAT10 ,. BUILDING ADDRESS: PERMIT NO03090231 3090231 OWNER'S NAME: PERMIT ISSUE DATE SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 imp LICENSED CONTRACTOR'S DECLARATION i d C 1 hereby airrm that 1 am licensed under provisions of Chapter v(commencing lob Description .S2w with Section 7000)of Division 3 of the Bus smnd Professions Code,andmylicenxis °`°"` a° FINALED iq: u.ttxC a lGu .a�i TERMITE REPAIR Dam Contra° CONTRACTOR: O.M.C. BUILDING ARCHITECTS DECL ATION � U Iunderomminly,hirm.MllMuxdasTu foments, OCT 16 2003 o. G Licnnscd Pmlcasnnnal OWNER-BUILDER DECLARATION or <S 1 hereby Maso affirm thin 1 our.sumps from the Cosional o License Law Tar the BUILDING.00 fallowing reason.(Secant ]IDIS.Business and w.the um Code:Any tiny or county fm which requires a permit re cores the elteq int cant forsu h permit t or repair ed structure thione itsissuance.pursuant toircs thovisiapposofthe,Centocor', kensle a.Law etammcm 3—� that he inciagsd pursuant the of Division of the Canusinesss Liccnxlaw(Chapmr9 Sy. Ft. Floor Area Valual 500 E $ that a is exempt Section]and the basis r th me alleged axe and Proon.AIIlaO Ctti6a of — Natio is exempt Ncrtfmm and Ne bur far be alleged u.mant to Any it Penalty of Section 7031.5 n any applicant fora permit subjects the applicant to a civil penalty of 3 MD1100cir 0 0 Occupancy Type not more Nan five hundred dollars(5300). ❑I,azownerof the property, mmyomploym withwagesaz Nei(sale 044,8 ,roes, will dothewmk.ands:The tutois not intended o Law dfor rOut apply 7044,Business RC uired Inspections and Professions C&orimpr C,Morena,License Lew dao nos apply O r t owner or p own employes,proeed that Sucercomantlwha awssuctende himffered through his 101 - FOUNDATION awn ver,M employees,provided or i pr vemech ntpromments within myonot n off orocompletion, the owner. 102 — PIERS, however,Ne building or improvement is said a within one yet of comm a for N.owner- builder .will have dm burden of proving Nal he did not Wild or improve for purpox of 103 - UFER sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to 104' - REBAR construct the Project(Sec.70",Business and Professions Carl The Contractor's Li- 105 — ANCHOR BOLTS. wme law does not apply to an owner of property who Wilds or improves themon,and ho comneb for such projects with a consncmr(s)liunsed pursuant to Ne Conlmctoh, 106 — SEWER & WATER Law. 202 - UNDERFLOOR PLUMBING am caempt under Sec. ,0&P C fm this reason 203 - UNDERFLOOR MECHANICAL Owner Data WORKER'S COMPENSATIONDEC RATTION 204 - UNDERFLOOR FRAME I hereby afnsm under penalty,of perjury one or Ne following declarations: 205 - UNDERFLOOR INSULATION I have and will mainwi n a Certificate of Consent to self-insure temo r Worker'.comn. 301 — ROUGH PLUMBING ,.lion,u provided for by Section TIDO of Ne labor Code,for Ne purformmxo of the 302 - TUB & OR SHOWER work for which this permit is issued. ❑1 have and will maintain Worker's Compensmion Insurance,As required by Sectio 3 03 - ROUGH MECHANICAL 3700 of M.Ube,Code,for the ordormance of the work for which this permit is issued. 304 - ROUGH ELECTRICAL My WorkcrY Campensuion lnsunnce carticrand Punic nambcrare: 305 - FRAME CERTIFICATE OF EXEMPT' 1 ROMWOEKERS306 — HOLDOWNS COMPENSATION INSURANCE 307 - INSULATION (Thissx,inn need nolhecompleled ifsk rhordisfaroachundmddolla(s($100) 308 - SHEETROCK fir less.) I certify Nat he performance of the work ter which this permit is issued.I shall nut 3 09 — EXTERIOR LATH Laws of Cali sXm enc mulo�aigr�yijecZa Workers Compen,ation 310 - INTERIOR LATH - Applic rat 311 - SCRATCH COAT N0T1 E0 P ICA : B.r making this Certificate of Exemption,you should u 313 - ROOF NAIL beco hje I to the Worker's Cam pemation provisions of the Labor Code,you must `( forthwith comply with such provisions or this Permit shall ht deemed revoked, 501 — FINAL ELECTRICAL ENERGY ZO CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY .N. I herby rEhmNat Here is a construction lendin Is issued(Sec.J(H],Civ.CJ x ti the work ter which this gagcncy Ter the Performance of 503 - FINAL MECHANICAL ENERGY +.1 Lender's Name permit — � C] Lna<r,Aaa� 504 FINAL BUILDING ENERGY � Z 505 - FINAL ELECTRICAL p 1 certify that I have read this application and sure that and above information mining is 506 GAS TEST y correct.1 agree 10 comply with all city and county ordinances and stain laws relating la D CF.7 building construction,and hereby autheim mmosentathes of this city m color upon the FIN PLUMB G N above-mentioned property for tmpcction purposes. (Wc)a me to true,indemnify and keep harmless the City of Cupertino against 0$ F I L h liabiliticcj cols.costs andapun.which may in any way eccmu ageinn,aid City 5 ;)7 in conxyu c of the gmmi of this Turin. "�^^.• APPLICA TUN ERST 5 AN WILL COMPLY WITH ALL NON-POINT Issued by: ING Date st;�u E cu ION 514 NAL PUBLIC WORKS --- Re-roofs Signature o Ap HAZARDOUS rtara or Ore HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Ncapplicantor fMoor building..C1uP mh.mhandle be Ad az defined by the Cupertino MuI,Code,CTetler 9.12,and Ne Hnllh and S.rety ' Code,Section 25532A)? All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future bu,,,,,,111111'IdingOccupant Me cyuiparent or devices which If a roof is installed without first obtaining an inspection, I agree to remove 11 auris homrdnus ash conmmi' nap 6 ayBCfind by the Bay Arca Air Quality Management rl all new materials for inspection. . h ❑Yes No I have M. th.havardnus materials requirements under Chapter 6.95 of the Cali foo- Ma Heal &Safety Cale.Secduse 25505.25333 And 8534.1 undcrsuad Net if the Wilding aces not neny ha Nat ie is my ropvmiml'tty to and n c«cupmt or Ne require ih tstW IpniunnissunnccnfacroiOcatcora`74 Signature of Applicant Date 29 All roof coverings to be Class"B" or better aumorived ogee Date WOOD DESTROYING&TS AND ORGANISMS INSPECTIOfIEPORT Building No. Street,City,Zip Data of Inspection No.of Pages • 10290 Denison Avenue, Cupertino, CA, 95014 09/18/03 12 THRASHER TERMITE& PEST CONTROL 17427 Farley Road West Lits Gatos, CA 95030-3308 Ph:(408)3549944 Fax:(408)395-7934 W Firm Registration No. PR 0240 Repon No. 25411 Eaerow o. 989283 _ Ordered y: Property Owner/Party o ntanat; epon Sen Coldwell Banker-Pat Ireland Jessie Ruark Chicago Title 221 Los Gatos-Saratoga Road c/o Pat Ireland 888 8 ossom Hill Road Los Gatos CA 95030 CA San Jose CA 95123 Trisha Dye Alain Pinel-Jane Scully 187 S.San Antonio Rd.Ste 1 Los Altos CA 94022 COMPLETE REPORT 29. LIMITED REPORT 0 SUPPLEMENTAL REPORT 0 REINSPECTION REPORT 0 G.paal ...nptmn: Inspection Tag Posted: One every wood tremed single family residence with wood senator. Subarea Other Tilde Posted: None noted An inspection as been -ado o the vtmcture e shown on the diagram ,n accordance with the StructuralPast ontoct. Detached porches, do,..had step., detached decks and any other structures not on the diagram were not inspected. Subterranean Termites 29 Drywood Termites 29 FunguslDryrot M Other Findings 99 Further Inspection ❑ If any of above be...are checked,it irMicates that there ware visible problem.in accessible areas. Reed the report for details on checked items. DIRBRRf1 NOT OFFICE COPY TO SCALE 11 H iie 11F SA • ... _.. _ __ sees 11J 111 3q .SC-SP1.B .1C 1R-1B IC_1B S 9C 1 1 F \So 4B ;,An SOR SH � IE 10 go SEP 2 9 2003 SOB IE IR I I K 11F 28 2C IF SH ID I I L T SOC 3R 4R 4 1 IF ISR � ' I18 110 11F BS BC SSREIR BB 110 SSB • 11C 1113 11E FGONT j Inepaoted By Dean R. Misner license No. OPR 10780 Signature You ere entitled to obtain copies of all report.end completion poute.on the propany..paned to the Stmotural Past �� [ yu�eing two veer.. To innoln copies contact:structural Poe control pars,tale Hews Awnw,Suite 1B.Sacramento,calif nnle 95.26 �( grip GG Hors: oa...mo.or in.bl........inp In..bew span.1nuld as directed to this manager of the company. UnindsooA{�aC n I I F1 RY e.d.mail may be shamed Is m.Stnm,..a pea Untrol seem a Im e1 set egos.IBadI 7pg et ee a,w u CUPERTI ANCES )ATE SICNEG � —_ —_ This s l,a:c: rntl specifications MUST 17 ao kepi cn tnf: job at all times and it is un ' ( � ialyfol ti: c!e!m any changes or alterations • i on same m!t;uili tvniten permission from rte bui:ding Dept., City of Cepeltino. rhe starnpma rt this plan and specifications 34ALL NOT be held to permit or to be ar, 1pproval of the violation of any provisions ,f anv City Ordinance or State Law. 2nd PAGE OF STANDARD OEC71ON REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/18/03 25411 BUILDING NO. STREET, CITY, STATE, ZIP INSPECTION DATE REPORT NO. • NoTiat The structural Pest control Hoard encourages competitive business practices among registered companies_ Reports on this structure prepared by various registered companies should list the same findings (i.e. termite infestations, termite damage, fungus damage, etc.). However, recommendations to correct these findings may vary frost company to company. Therefore, you have a right to seek a second opinion. NOTE: This property was not inspected for the presence or absence of health related molds or fungi. By California law we are neither qualified, authorized nor licensed to inspect for health related molds or fungi. If you desire information about the presence or absence of health related molds, you should contact an industrial hygienist. The following areas were not inspected, as indicated in Section #1990 paragraph (J) of the Structural Pest Control Act and Rules and Regulations: Furnished interiors, inaccessible attics, insulated attics, and portions thereof; the interior of hollow walls; spaces between a floor or porch deck and the ceiling or soffit below; stall shwas over finished ceilings; such structural segments as ports cocheres, enclosed bay windows, buttresses and similar areas to which there is no access without defacing or tearing out lumber, masonry and finished work, built-in cabinet work; floor beneath coverings, areas where storage oorditicns or locks make inspection impractical. A further inspection is recommended at any/all inaccessible areas, please contact our office for any additional information. THRASHER TERMTIE AND PEST CONTROL is not a'licensed roofing firm. If any interested party desires further information, a licensed roofer should be consulted. NOTE: IF RE23EST'ED BY THE PERSON OIZDFRING THIS REPORT, A REIDEPECrICV OF THE S1RC1Cp'DRE WILL BE K%DE. THIS REQUEST MUST BE WITHIN MR b WINS OF THE NATE • OF THIS REPORT AND MERE WILL BE A FEE. . This-is a'separated report and is defined as Section 1 and Section- 2 conditions that are evident as of the date of this inspection. SECTION 1 - Infestations, infections and/or related conditions. The findings listed below contain items where there is evidence of active infestation, infection or conditions that have resulted in or from infestation or infection found on the date of this inspection. =ION 2 - Adverse conditions where no infestations or infections were noted at this tine. The findings listed below contain conditions deemed likely to lead to infestation or infection, but where no visible evidence of such was found on the date of this inspection. Our company cannot assume any responsibility for conditions existing in these areas unless an authorization for repair, replacement or further inspection of these areas is made in writing. g,N E THRASHER TERMITE&PEST CONTROL--License No.PR 0240 SEP P % Q 2003 1 3rd PAGE OF STANDARD JECTION REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/1 B/03 25411 BUILDING NO. STREET, CITY, STATE, ZIP INSPECTION DATE REPORT NO. • ROTE: ME IDCl'mim SOREMM OF 170E ROOF WILL NOT BE INSPECIM. IF YOU 4IIW TBE MM TIGI'IIOEl9S OF TBE ROOF =MUM=, YOU -W= CMM= A ROOFING Ocun rOR 1•R0 TS LICENSED BY TE Q'II7IF 1W'S MM LICE 46 BOARD. SUBSTRUCTURE AREA: Item lA: FINDING: Evidence of drywood termite activity was noted at the subarea. These infestations appear to extend into inaccessible areas. REQMME2ID TIGN: Fumigate the entire structure with a lethal gas for conglete, La f all drywvod termite infestations. aaaaaa a is a section 1 Item aaaaaa In the performance of the above recamlendation, we propose to use the chemical Vikane (Sulfuryl F7ouride), along with the chemical Chloropicrin. NOTE: We can provide the Nylofume bags that are necessary for storing £ori and medicine during the fumigation process. These bags are available at no additional charge to our custamere. Please call our office and we will make them available for pick-up. NOTE: There WILL be preparation work that must be conpleted prior to the performance of the structural fumigation. The preparation work is the responsibility of the homeowner. If interested, we can provide a quote for the prep work through a company that specializes in this service. She cost to complete the prep work varies for each particular structure depending on the ammmmt of work that is required. our firm does not mark up this prep work bid, we pass the same quote on to our customer. Please feel free to call our office if you have any further questions or if you are interested in obtaining a fume prep quote. NOTICE: The charge for service that this company subcontracts to another person or entity may include the campany,s charges for arranging and administering such services that are in addition to the direct costs associated with paying the subcontractors. Item 1B: ADDITIONAL REoa4 mAITON: Remove and/or nask all accessible drywcod termite pellets found at aaaaa This is a Section I Item)****** Item IC: FINDING: Drywood termite damage was noted to the rim joist in the substructure area. RFKCMEMATION7: Break open the stucco and remElve the damaged rim joist and check for concealed damage. If no additional damage is found we will install new rim joist where removed. Install new paper and wire and restucco as close as practical. If additional damage is found, a Supplemental Report will be issued. aaaaaa This is a Section 1 Item aaaaaa THRASHER TERMITE&PEST CONTROL...License No.PR 0240 7SEP2 'I'VE � 9;.2003 BY: 4th PAGE OF STANDARD OCTION REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/18/03 25411 BUILDING NO. STREET, CITY, STATE, ZIP INSPECTION DATE REPORT NO. • SUBSTRUCTURE AREA: Item ID: FINDING: Evidence of subterranean termite activity was Emoted at the substructure. The termites are originating at the Subarea soil. REOU44 NOMCN: Scrape down and destroy all accessible mud shelter tubes found at the subarea frandng. The Subarea soil will be trenched, at the affected areas, and then treated using chemicals toxic to subterranean termites for Control of Satre. Upon completion of the chemical treatment, all treated areas will be backfilled over top with soil. A series of holes will be drilled at the perimeter of the garage and porches. The holes will be injected with chemicals toxic to subterranean termites and then plugged with cement. Finally, we will rod the exterior soil at the entire perimeter of the structure and treat the soil using the same toxic chemical to create a complete chemical barrier'against subterranean termite activity. NOTE: The owner must clear the storage at the perimeter of the garage,. approximately two feet away from the walls, prior to this treatment. «r+«** This is a Section 1 Item **««** In the performance of the above recommendation, we propose to use the chemical Termidor (Fipronil). NOTES ALL CARE WILL BE TAKEN TO AVOID POSSIBLE DAWM TO ANY HIDDER PIPES _ IN THE CONCF= BLAB OR WALLS. HOWSM, IF SUCH D XNM DOES OOCUR OUR MM WILL ASSUME NO RESPCNSIBI= FOR SAM. WE W31L ASSIST THE H30090M BY CMMC.TINS THE PROPER TRADES TO REPAIR TEE DAMAGED PIPE(S) . THE H3o141DR IS EF9�SIDLE POR ALL 88PIDL4E9 THAT ARM AS A RESULT OF ANY LAMM PIM- THE HOMEOWNER SEIDERSTANDS TH73 C@IDITION AND AGREES TO ALL L.TEA1T.IW By SIGd•M OM WORK AUTHDRIYATTON AGZMM NT. PLEASE PEEL FREE TO CALL OUR OFFICE IF YOU HAVE ANY QUESTIONS. Item IE: FINDIM: Subterranean termite damage was noted to the 2"x6" tongue and groove subfloor at the area indicated on our diagram. • RECa+3gENmt'IGN: Pull up the parkey floor at the family roan and kitchen area. Pull up the carpet at the livliig"room. Remove-and replace the- damaged' - subfloor and replace with new materials. Upon completion, the carpet will be layed back into place. No stretching and/or rekickicg is included in our bid. «+++«* This is a Section 1'Item ****** Item 1F: FINDIM: Subterranean termite damage was noted to the 4"x6" support girders at the substructure area. RECUi+ESIDATION: Remove, replace and resupport the 4"x6" girder with new materials. Items #lE and #1F should be Conpleted at the same titre. This is a Section 1 Item **«*«« JITP C F.7 Cf 2 9 2003 THRASHER TERMITE&PEST CONTROL--License No.PR 0 BY: • 5th PAGE OF STANDARD•EC ION REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/18/03 25411 BUILDING NO. STREET, CITY, STATE, ZIP INSPECTION DATE REPORT ND. SUBSTRUCTURE AREA: Item 1G: A®ITICNAL RECOFOOMATION: Hardwood floor trades IIust be enployed to repair/replace the parkay flooring after we have completed our phase of the work, as outlined in items #1E and #1F. **r*** This is a section 1 Item ****** Item 1H: FINDING: Cellulose debris was noted on the subarea soil. Evidence of subterranean termite activity was noted in the debris. REMIAE IDATION: Remove all cellulose debris and dispose of it properly. we will then trench and treat the soil at the affected area with chemicals toxic to subterranean termites for control of Belle. Ulan canpletion of the chemical treatment, all treated areas will be back filled over top with soil. The cost to complete this item is included along with item #lD. - ****** This is a Section 1 Item ****** STALL SHOWER: Item 2A: NOiE: A standard water test was performed at the master bathroom stall shower. This revealed no visible evidence of leakage at this time. The haneovmer is advised to maintain the shower as necessary. rrr*****x* Information Item ++++++*xrr item 2B: NOTE: Others have installed a new paneled stall shower. All interested parties should be aware that Thrasher Termite and Pest Control will assume no responsibility for work completed by others. rr+rr++xrr Information Item +++++++**+ Item 2C: FINDING: The master bathroom window is set low in the paneled wall. This may create an excessive moisture condition. RECUgAE=ICN: The hareovmer is advised to install a shower curtain at the window to help minimize the moisture condition at this area. . • rrrrrr This is a Section 2 Item xxxxxr FOUNDATIONS: Item 3A: FINDING: minor vertical cracks were noted at the fourdatiem. This condition may lead to moisture intrusion at the subarea, and/or infestation by subterranean termites. RFA0M4D ATICN: The houeowner is advised to engage the services of the appropriate licensed tradesperson for further information regarding this finding. ****** This is a section 2 Item ****** PORCHES--STEPS:. - Item 4A: F12MING: The wood siding is eribedded into the front brick porch. RECCNENDATION: Trim the siding up out of the brick and fill the void with concrete. ++xxr+ This is a Section 2 Item ++++x+ JItJ[�CRI V ED THRASHER TERMITE&PEST CONTROL—LiCern,e No.PR 0240 SEP 2 8 2003 BY: • 6th PAGE OF STANDARD OECTION REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/18/03 25411 BUILDING NO. STREET, CITY, STATE, ZIP INSPECTION DATE REPORT NO. • PORCHES-STEPS: Item 4B: FIMING: Cracks and voids were noted at the side porch. REca4m ATION: Seal these areas as part of routine maintenance. ++**++ This is a Section 2 Item ***+*• 1 ATTIC: Item 7A: NOTE: A limited inspection was lade of the attic area due to insulation. We inspected the attic as practical. However, we will assume no responsibility for any inaccessible area that has not been inspected by our firm. ***arr+xar Information Item **xrr*arra GARAGES: Item BA: FINDING: Evidence of drywod termite activity Was noted at the garage. These infestations appear to extend into inaccessible areas. REC»FUMATICN: Fumigate the entire structure with a lethal gas, see item #IA. xarrr* This is a Section 1 Item xaaa+a Item BE: ADDITIONAL RECU44EaIDATiCN: Remove and/or mask all accessible drywood termite pellets found at the garage framing. The cost to complete this item is included along with item #1B. **r*** This is a Section 1 Item r*aa*a Item SC: FINDING: Evidence of subterranean termite activity was found at the garage of the garage. The termites are entering at a void between the concrete slab and the footing. PMM4IIDATION: Scrape down and destroy all accessible mud shelter tubes found at the garage framing. A series of holes will be drilled at the entire . perimeter of the garage slab. These holes will be injected with chemicals toxic. to subterranean termites for control of sane. Upon cmlpletion of the chemical treatmeiLf, all holes will 'be' -plugged with cement. NOTE:- Th owner must clear the storage at the perimeter of the garage prior to our performance of this chemical treatment. The cost to complete t item is included along with item #1D. arrr*a ibis is a Section 1 Item ar*xax DECKS--PATIOS: Item 9A: FINDING: Evidence of drywood termite activity was noted at the patio roam. These infestations appear to extend into inaccessible areas. RELUMMENMT'ICN: Fumigate the entire structure with a lethal gas, see item #1A. *aara* This is a Section 1 Item *arae R-MCEEVrT"D SEP 2 9 2003 THRASHER TERMITE&PEST CONTROL--License No.PR 0240 BY: 7th PAGE OF STANDARD,OCTION REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/18/03 25411 • BUILDING NO. STREET, CITY, STATE, ZIP INSPECTION DATE REPORT NO. DECKS--PATIOS: Item 913: ADDITIONAL REC34SIDA GN: Remove and/or mask all accessible drywvod termite pellets found at the patio room. The cost to coplete this item is included along with item #1B. ***•** This is a Section 1 Item ***••• Item 9C: F=ING: Drywood termite damage was noted to the 4" x 4" post and framing at the patio room. REMW IMATICN: Remove the damage as necessary and replace with new materials. ***•*• This is a Section 1 Item *+**rr Item 91): ADDITIONAL RE0GM4M=ICN: Trades must be employed to rescreen the patio roam after we have completed our phase of the repairs. a*♦*aa This is a Section 1 Item •***rr OTHER-INTERIOR: Item 1OA: FINDEZ: An excessive moisture condition was noted at the hall bathroom floor. Moisture has entered causing fungus damage to the floor covering underlayment. Concealed damage may exist. RECOMTiQIDATION: Remove the vanity. Remove the complete existing vinyl floor covering and floor underlayment to check for oonceeled damage. If No further damage is found, we will install new floor underlaynent and new vinyl floor covering throughout the bathroom floor. The toilet will be reset on a new wax seal, properly bolted. If any further damage is found, a Supplemental Report will be issued with our additional findings and cost. *a as*a This is a Section 1 Item ****•• Item 1OB: ADDITIONAL - RECCI+mmTIgV:_The same vanity will be reinstalled after the completion of the floor repairs. The drain and plumbing will then "be reconnected: NOTE: The bid to reinstall this vanity is based on 1 to 1 1/2 hours of labor. Additional costs will be incurred if further plumbing repairs and/or additional plumbing parts are required. aaa++* This is a Section 1 Item *a**** Item 10C: FINDING: An excessive moisture condition was noted at the misster bathroom r covering floor. Moisture has entered causing fungus damage to the floounderlayment. Concealed damage may exist. RFStT+bIIS,=CN: Remove the complete existing vinyl floor covering and floor underlayment to check for concealed damage. If no further damage is food, we will install new floor underlayment and new vinyl floor covering throughout the bathroom floor. The toilet will be reset on a new unix seal, properly bolted. If any further damage is found, a Supplemental Report will be issued with our additional findings and cost. **+*** This is a Section 1 Item +rr*r* THRASHER TERMITE&PEST CONTROL•—License No.PR 0240 SEP 2 9 2003 By: 8th PAGE OF STANDARD OC71ON REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/18/03 25411 BUILDING ND. STREET, CITY, STATE, ZIP INSPECTION DATE REPORT NO. • OTHER--EXTERIOR: Item IIA: FINDIM: Evidence of drywood termite activity was noted at the exterior. These infestations appear to extend into inaccessible areas. REC31,02ID GN: Fumdgate the entire structure with a lethal gas, see item #1A. +xarrx This is a Section 1 Item ++xrxx Item 1133: AMMONAL RECCM•MMATION; Remove and/or vacuum all accessible drywood termite pellets found at the exterior, as practical. The cost to complete this item is included along with item #1B. ****** This is a Section 1 Item ****** Item 11C: FINDING: Drynood termite damage was noted at the front of the structure. Damage exists to the 1^xa^ V-rustic roof eaves. Concealed damage may be revealed. RENM+,IDATION: Remove the roof covering as necessary. Remove his found, wood members and check for concealed damage. If no further damage we will replace with new materials. The repaired areas will be primer painted only. If any further damage is found during the course of these repairs, a Supplemental Report will be issued with our additional findings and cost. NOTE: The eave wood members will be braced and/or reinforced as necessary. Thrasher Termite & Pest Control will attempt to maintain the original cosmetic appearance of the eaves, however, when performing partial repairs this is not always practical. We cannot guarantee an exact match of the existing materials and/or sizes. ****** This is a Section 1 Item ****** Item 11D: ADDITIONAL lace time REC3449MATIa1: A licensed roofer must be employed to repair/rep . . ._ . roof covering we removed while ovmpleting our phase of the roof work, as outlined in the item above. _ +x+r** This is a Section 1 Item Item 11E: NOTE: There is heavy plant growth at some areas around the exterior of the structure. This does limit our inspection. We inspected the exterior as practical, however, we will assume no responsibility for any inaccessible area that has not been inspected by our firm. +ra+rx+++x Informlation Item x+r+rxrr+x Item 11F: FnMING: The exterior paint was noted to be weathered. RSO:w SIDAT'ICN: The appropriate, licensed tradesperson should be erployed to seal and/or paint the exterior of the structure as needed. x+ria+ This is a Section 2 Item ****** SEN 2 9 2003 THRASHER TERMITE&PEST CONTROL—License No.PR 0240 Bx,--- 9th PAGE OF STANDARD OCTION REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/19/03 25411 BUILDING NO. STREET, CITY, STATE, TIP INSPECTION DATE REPORT NO. • OTHER--EXTERIOR: Item 11G: FILING: Cracks were noted at the exterior stucco. This appears to be from past settling. REcag4amATICdi: Trades should be enployed to check and seal/paint as necessary. ***xx* This is a Section 2 Item *x*x*x Item 1W: FINDING: Leaks were, noted at the sprinkler valve. RRCO1jM,IDATIDI7: A licensed plurber should be enployed to check and eliminate all leakage as needed. ****** This is a section 2 Item ***++* Item III: FILING: Fungus aril fungus damage were noted at the 1Nxe* V-rustic roof eaves. Concealed damage may be. revealed. REc34NIQIDATION: Remove the roof covering as necessary. Remove the damaged wood members and check for concealed damage. If no further damage is found, we will replace with new materials, The repaired areas will be priner painted only. If any further damage is found dlrring the course of these repairs, a Supplemental Report will be issued with our additional findings _ and cost. NOTE: The save wood members will be braced and/or reinforced as necessary. Thrasher Termite & Pest Control will attempt to maintain the original cosmetic appearance of the eaves, however, when performing partial repairs this is not always practical. We cannot guarantee an exact notch of the existing materials and/or sizes. **+*** This is a Section 1 Item ****** Item 11J: ADDITICNAL RECOM ENDATION: A licensed roofer must be ESTployed to repair/replace the roof covering we renuved while conpletinlg our phase of the roof work, as • outlined in the item above. *****x This is a Section 1 Item ****xx Item 11K: FILING: The repairs outlined in items #1C, #3E and #1F will reTAre a —3. building permit. RECcmr4a CN: Our firm will obtain and purchase the necessary building _-)p� permit. Please refer to the note at the end of this report for additional information regarding the permit process. ****** This is a Section 1 Item ****** Item 1x.L: pnmLNG: Thrasher Termite and Pest Control is not a licensed roofing contractor. RECCtM D=ION: A licensed roofer should be enployed to check all areas of the roof covering and furnish any further information regarding the LBY: condition and the life of the roof.This is a Section 2 Item9 2003 THRASHER TERMITE&PEST CONTROL--LiPrnAe No.PR 0240 • 10th PAGE OF STANDARD OCTION REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/18/03 25411 BUILDING NO. STREET, CITY, STATE, ZIP INSPECTION DATE REPORT N0. • NOTE: There are some Section 1 items outlined in this report that do not have a bid associated with the repairs. Please feel free to call our office if you have any questions, and/or if you would like an estimate for sore Of these "Will Bid- items. FOR ALL OF YOUR JOB SCBED M G NEEDS PLEASE CUT, A9 AT (408) 354-9944. NMMI CURRENTLY IT IS 'TAKING APPRMMOITHLY 19A WEEKS TO SCHEDULE WURZ . (DEPENDING ON THE SIZE OF THE JOB) AND APPRaMATEMY 5 TO 10 WORIC 4a DAYS TO SCI IREZ AN ITISPECI•IDV. SOME EXC7pTjMM CAN BES YIS GOW MW OF OF THTIM. PIRA TARR 'TILS nM 0@IIIDERATSQDTPIAMMG Cl� ESCROW. THANK YOU. NOTE: Tne standard virryl floor covering allowance is based On $0.89 per square foot. If a Imre expelsive virryl is chosen there will be an upgrade charge. This charge will simply be the difference between aur standard allowance, and the cost of the upgraded vinyl, nultiplied by the nurber of square feet needed. The cost for the upgrade will be collected by the vinyl store at the time the vinyl is chosen. Our vinyl allowance includes anythirg up to and including $0.89 per square foot. If a less expensive vinyl is chosen there will be no refund. NOTE: Unless otherwise specified we will install silver cap metal at the perimeter of the floor when the vinyl is coved, and we will install an off-white rubber base when the virryl is a flat lay. Please call our office if you have any further questions. NOTE, We work with S¢G Discount Outlet at 505 S. Market St, San Jose, CA 95M. Thair Phone npzber is 292-8971. NOPE: A local city building permit Tray need to be on file to .complete some of the repairs outlined in this inspection report. If Thrasher Termite and Pest Control is eTrployed to perform the repairs we will obtain the necessary • permit. If the local building department requires any additional plans, drawings or modifications (i.e. structural, plumbing, electrical, framing, engineering, etc.) the cost to obtain these services is not included in- our- bid. It may be necessary for the owner and/or the agent to meet the building department inspector when needed, however we will inform the owner and/Or agent of the scheduled appointments as they became necessary. We will try to reg�ardii.ngg thde as e building perm t,pplease feelfree to give our office questions l. NOTE: The local building department may require the installation of smoke detectors in order to carply with State Fire Regulations. Upon request, we will install new battery operated smoke detectors at the required locations. This will incur a charge of $25.00 per unit. �- ��✓�IL b ILi1LJ' SEP 2 9 2003 B Y: THRASHER TERMITE&PEST CONTROL---License No.PR 0240 • 11th - PAGE OF STANDARD OCTION REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/18/03 25411 BUILDING NO. STREET, CITY, STATE, ZIP INSPECTION DATE REPORT NO. • Ia7I'E: If others are.going to cemplete any of the repairs, as outlined in this report, they MUST have our firm perform a reinspection during the course of their repairs. This reinspection must be nide after ALL, damage is removed but prior to the installation of any new materials. We cannot be responsible for certifying the property if these guidelines are not followed. Allow 2 to 3 days lead time when scheduling a reinspection. There is a $125.00 fee for this reinspection service. Please don't hesitate to call our office if there are any further Questions. =Y: THRASHER TERMITE&PEST CONTROL—License No.PR 0249 • 12th - PAGE OF STANDARD OCTION REPORT ON PROPERTY AT: • 10290 Denison Avenue, Cupertino, CA, 95014 09/18/03 25411 BUILDING NO. STREET, CITY, STATE, IIP INSPECTION DATE REPORT NO. • OCCUPANTS CHEMICAL NOTICE THRASHER TERMITE AND PEST CONTROL will use pesticide chemicals) specified below for the control of wood destroying pests or organisms in locations identified in the Structural Pest Control report No'IIxiClted above. (1) The Pest(s) to be Controlled: SUBTERRANEAN TERMITES _ FUNGUS or DRY ROT _ BEETLES Ix DRYNOOD TERMITES _ OTHER (2) The pesticidets) proposed to be used and the active ingredient(s). ' A. TERMIDOR: Active ingredients: Fipronil _ B. DRAGNET:- Active ingredi arta: Permethrin X C. 'VIKANE: Active ingredients: Sulfuryl Flouride It Chloropicrin _ D. CY-KICK: Active ingredients; Cyfluthrin _ E. TIM SON: Active ingredients: Disodl un Octaborate Tetrehydrate _ F. PREMISE: Active ingredients: Imidacloprid _ G. OTHER: Active ingredients: (3) "State Lau requires that you be given the following information: CAUTION-PESTICIDES ARE TONIC CHEMICALS. Structural Pest Control Operators are licensed and regulated by the Structural Pest Control Board, andapply pesticides which are registered and approved for use by the California Department of Food and Agriculture and the United States Environmental Protection Agency. Registration is granted when the State finds that booed on existing scientific evidence there are no appreciable risks if proper use conditions are followed or that the risks are outweighed by the benefits. The degree of risk de WKIS Upon the degree of exposure, so exposure should be minimized. "If within 24 hours following application you experience symptom similar to cm aeasonai Ill nese comparable to the flu, contact your physician or poison control center and your peat operator Im adiately. (This statement Shall be modified to Include any other symptoms of over exposure which are not typical of influenza.)" For further information, contact any of the following: Thrasher Termite and Pest Control..................(408) 354.9944 Med-Net Customer Hot Line.........................1(800) 655-7262 County Public Health Department....................(408) 918-3400 • Courson ConAgriculture Car Commissioner....................(408) 918-4600 - _ - PPicon Control Center......oner...................1(800) 876-4766 gtructurel Pest Control_ 1430 Howe Avenue, Sacramento, CA 95825 .........1(800) 737-8188 Persona with respiratory or allergic conditions, or others who may be concerned about their health relative to this chemical treatment, should contact their physician concerning occupancy during and after chemical treatment prior to signing this NOTICE. NO CHEMICAL APPLICATION WILL BE PERFORMED UNTIL SUCH TIME THAT THIS NOTICE IS RETURNED, HAVING READ THE INSTRUCTIONS, I, THE UNDERSIGNED, WILL ACCEPT RESPONSIBILITY FOR ALL THE AFOREMENTIONED. ' DINER/OCCUPANT DATE OWNER/OCCUPANT DATE i SEN 2 9 2003 ' . �3Y:_ THRASHER TERMITE&PEST CONTROL—License No.PR 0240 i THRASHER TERMITE&PEST Cor-* Page 1 of 2 17427 Farley Road West LoN Gains,CA 95030-3308 ph:(408)354.9944 Fax: (408)395.7934 • WORK AUTHORIZATION CONTRACT Address.1 Pr.p.rty: 10290 Denison Avenue, Cupertino, CA, 95014 Inspection Data: 09/18/2003 Repan R: 25411 Tide Co.&Escrow R: Chicago Title, Escrow At 989283 SECTION 1SECTION 2 FURTHER INSPECTION —T!'Ntt a^A 'j[AIT —IA: 6 1655.00 11C: 6 210.00 2C: Owner --p IS: 6 125.00 11D: Roofer u,,& 3A: Tratlea I P pif, RI K'1. '1C: Will Bid 111: s 275.00 4A: Will Bid - S�,iT°T•� 1E: Will Bid 5.00 11 K: s o. 00 W 11 F: Trades _.v 1F: 6 875.OD Qq.p 110: Trades ..o r 1G: Tratlea p IIH: Tratlea — �Irp.. 1H: Sea tl11) r 11L: Roofer ,- y4 BA: See RIA BB: See 813 BC: Sea N1D BA: Sea RIA 9B: See NIB act p»c 9C: 6 W.DO iC 9D: Trade. 1 OA: 6 Sell D0 — 108: 0 150.00 10C: $ 500.00 11 A: See NIA 1IS: See N18 We AmhorW the FoRc)wLes, We Audited.his Followins We Authorize the Follawins Section I Immc ro he Per(nrmcd. Section 2lt..I.be perforead. Immo for FUM.,InFoed... s 7360 OD+ Sea Above Proposed Cost Fur.lnap: None Proposed Com Section 1: Proposed Cos[Section 2: P • otal:an Fee: 1 200.00 Total:inspection s 7560.00+ MOLD DISCLAIMER There may be health related I....a ..satiated vIth the structural repairs reflected in the inspection report referenced by this York Authorization Contract. These health issues Include out are net limited to she possible rel seas of said aperes during the course of repair.. ve are not qualified to end do net render any.pinion concerning such health issues or am special precautions. Any quest fans concerning hlelth issues or any special precautlona to be taken prior to or during the course of such repairs should be directed to a Certified Ioduatrlel Hygienist before em such repairs are undertaken. BY EXECUTING THIS 00RK AUTHORIZATION CONTRACT, CUSTOMER ACKNWLEDGES THAT HE OR SHE HAS BEEN ADVISED OF THE FOREGOING AND HAS I have road this work authorization contract and WDO Inpectlon report It refers to. SIGNED WORK AUTHORIZATION CONTRACT MUST BE RECEIVED BEFORE WORK WILL BE SCHEDULED. I have road and understand the terms of this work authorization contract and hereby agree to all terms thereof. APPROVED AND READ BY: DATE ACCEPTED MIR: DATE THRASHER TERMITE&PEST CONTROL iL SEP 2 9 2003 • BY: THRASHER TERMITE& PEST CON& Page 2 of 2 17427 Farley Road West Los Gatos,CA 95030-3308 Ph:(408)354-9944 Fax:(408)395.7934 • WORK AUTHORIZATION CONTRACT Address of Property: 10290 Denison Avenue, Cupertino, CA, 95014 Inspection one: 09/18/2003 Report a: 25411 Title Co.A,Escrow a: Chicago Title, Escrow # 989283 TERMS AND CONDITIONS. A LIEN WILL BE FILED ON THE PROPERTY e0 DAYS AFTER NOTICE OF COMPLETION IS ISSUED. THE LIEN WILL BE RELEASED ONCE THE BILL 15 PAID. It is understood that these corrections are reconmanded on the heels of visibly determined surface examination. In the course of Work being Performed an the basis Of this contract, conditions may be revealed which were not evident at the time of inspection. This contract is limit ad to that which Wes visible at ted time of inspection and of that, only these parograph(s) herein apeelfied and cmtractod for. We assure m responsibility for concealed or inaccessible damage or Infestation that was not observed by us without excavation or.opening timbers, wells, floors, callings, @mv i ng furnishing., storage, eta We shall not be liable for any demepe resulting from probing, cuttl n0, Opening, removal or otherwise, of timbers, walls, floors, ceiling. or other parts of the building inspected. Our liability for damegea b/ reason of error or ami o taro In the Inspection Report shalt m limited to the cost of the inspection and report. If additi mel work should be required by the City or County Building Inspector, such work wilt not We performed under this contract. THRASHER TERMITE AND PEST CONTROL AGREES TO FURNISH ALL LABOR, MATERIALS, SUBCONTRACTORS (if required)', and compensation insurance to complete the repairs as accepted above. THRASHER TERMITE AND PEST CONTROL AGREES TO USE ALL DUE CAUTION IN THE PERFORMANCE OF OUR WORK, but In no Way WILL we be held roaponsibte for damage to property, planta, or animal life caused by the use of chemica Ls, Bas or oqulpint in conjunction with these repairs. It is agreed that the contract price shall be paid to THRASHER TERMITE AND PEST CONTROL upon ratite of completion. It is understood that service charge. of 1.5% Per month on the unpaid balance, or 18%Per @neon, wilt be charged an overdue accounts end if suit is filed for collection of delinquent accounts the cust Peter agrees to pay ail litigation costs. At least one signed copy of this contract mut be returned to THRASHER TERMITE AND PEST CONTROL before work is started. This contract must be signed by THRASHER TERMITE AND PEST CONTROL'S representative to be valid. NOTICE TO PROPERTY OWNERS : (Section 7018 of the California Contractors License Lew, Business S Professonel Code Div. 3, Chep. 9 Provides under the Nechanic's Lien Lew any Structural Past Control Operator who contracts to do work for you, any contractor A laborer, supplier Or other person who helps to Improve your property, but is not paid for his work or supplies has s right to enforce a claim against your property. This means that, after a court hearing, your property couttl be cold by e court officer and the prat ends of the sale used to satisfy the Imebtednass. This can happen even if you have paid you contractor in full, if the subcantreetor, laborers, or suppli are rem ins unpaid. THRASHER TERMITE AND PEST CONTROL GUARANTEES CHEMICAL TREATMENT AND STRUCTURAL REPAIRS FDR 1 YEAR FROM THE DATE OF COMPLETION. WE GUARANTEE GLASS AND FLOOR COVERING REPAIRS FOR THIRTY (30) DAYS FROM THE DATE OF COMPLETION. WE CANNOT GUARANTEE WORK COMPLETED BY • THE OWNER AND/OR THEIR AGENTS. ANY TYPE OF GUARANTEE SHOULD BE OBTAINED FROM THE PERSONS) MAKING THE REPAIRS. NOTE: ALL CARE WILL BE TAKEN TO AVOID DAMAGE TO HIDDEN PIPES IN THE CONCRETE SLAB OR WALLS._ HOWEVER, IF SUCH DAMAGE DOES OCCUR WE WILL ASSUME NO RESPONSIBILITY FOR SAME. WE WILL ASSIST THE HOMEOWNER BY CONTACTING THE PROPER TRADES TO REPAIR THE DAMAGED PIPE(S). THE HOMEOWNER IS RESPONSIBLE FOR ALL EXPENSES THAT ARISES AS A RESULT OF DAMAGED PIPES. THE HOMEOWNER UNDERSTANDS THIS CONDITION AND AGREES TO ALL LIABILITY BY SIGNING THE WORK AUTHORIZATION CONTRACT. PLEASE CALL OUR OFFICE IF YOU HAVE ANY FURTHER QUESTIONS. M� T V';D SEP 2 9 2003 BY:_ -____- THRASHER TERMITE&PEST CONTROL--License No.PR 0240 • r THRASHER TERMITE&PEST CONTROL 17427 Farley Road West • Los Gato(408)3 4- 944 Fax: Ph:(408)3549944 Fnz; (408)395.7934 DATE REPORT a ESCROW s PROPERTY LOCATION 09/22103 25411 989283 10290 Denison Avenue,Cupertino 95014 TO: Chicago Title 686 Blossom Hill Road San Jose,CA 95123 ATTN: Trisha Dye 09/18/2003 INSPECTION FEE 0 200.00 BALANCE DUE 0 200.00 • RETURN THIS COPY WITH REMITTANCE DUE AND PAYABLE WITHIN 1D DAYS 1.5% per month charged on oil pest due accounts. This is an emuel percentege rote of 1a% (Interest charged pvrsuent to the Robinson-potman Act) NOTICE: "Under the Mechenics'Lien low, any contractor, subcontractor, loborer, supplier or other person who helps to inprove your property but is not paid for his work or supplies, hes the right to enforce o claim against your property. This means that after a court hearing, your property could be said by a court officer and the proceeds of the sale usetl to satisfy the indebtedross. This can happen even if you have paid your own contractor in full, if the subcontractor, laborer, or supplier regains unpaid." THANK YOU FOR YOUR BUSINESS �cTi;jl` j�<jd SEP 2 8 2003 BY: ___—__ • ma C*Y OF CUPERTINO 07 0 03 l CUCITY OF o PERMIT APPLICATION FORM �� l APN# _ Zj Date: Building Address: 16090 Demi-se)a u Owner's Name: Phone#: O 1 - Contractor: License #: 0- H .1- - c 16Z33 Contact: Cupertino Business License#: B ' ding P rmit Info: Bldg ct ❑ Plumb El Mech ❑ escription: Residential ommercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: Occupancy Gro r �i Type of Construction: S -R r Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILER1 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> 1.75M 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 <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A 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 e� z33( t X33 ( 3 1 of CIOY OF CUPERTINO CITY PERMIT APPLICATION FORM CUPERTINO Quantity 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 BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTHAE 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 Repipe 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 din 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> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2 of 3 D CITY OF CUPERTUO CUPEkTINo 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 Rmdl Signs Add Branch ELECTRICAL BREMSIGNS, Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res 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 MPERIv9EE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Pl.umbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chan e BUILDING • 3 of 3 CITY OF CUPEWFINO roes h 7 � °- nun.)nnc Drvlslon PERMIT . CON:TRACT INFORMATION:. BUILDING ADDRESS: PERMIT NO03090231 03090231 F.R'I NAME: PERMIT ISSUE DATE PHONE: SANITARY NO. CONTROL 10. ARCHITBC(ENGINEER: BUILDING PERMIT INFO BLDG ELELT PLUMB MECH X00 LICENSED CONTRACTOR'S DECLARATION I C 1 hereby affirm that 1 am licensed under provisions n(CM1apmr 9(commencing Job Description with Section M%«)of Division 3 of the Busi and Pmfcasinns Code..nd my license is u In full f and Cffcc lG.u.« TERMITE REPAIR ' ir., DateEcam^ CONTRACTOR: O.M.C. BUILDING ARCHIT[LTS OEC( ATION RUIundcrsund my plans shallMtree !records ao� Licensed Professional . OWNER-BUILDER DECLARATION I<E I hereby rearm the I am exempt from the Contractors License Law for the a O following reason.(Section 703 IS.Business and Professions Cci Any city o,county e m which requires a permit to construct,alter,improve.demnlish,or repair any structure prior as its issuance,alto requir"the applicant for such permit to rile a signed statement < that he is licensed pursuantintheprovisionsoftheCommctu'sLicenseLaw(Chapter9 Sq. Ft. Floor Area Valua[ 500 IreFm (commencing with Section 7")of Division 3 of he Business and Professions Code)or that he is exempt hemfrom and the basis for Ne alleged cxlmp u..Any violation or Section 7031.5 by an,applicant for a Permit subjects the applicant to a civil Penalty of 3p�)� gt�er00 Occupancy Type not more Nan five hundred doll..($500). I,as owner of the property,or my employees with wag"as their sole compensation, will do the..k,and the structure isnot intended or offered forsam(Sec.7054,Business Rid I and Prolamin a Code:The Convumr.LicenseRequired nseCIIODS Law docs not apply to an owner of p progeny who holies or improves thereon,and who doenuch work himmlfor through his 101 - FOUNDAT ON awn employees,provided that such improvements arc not intended or offered for sale.If. 102 — PIERS however,the building or improvement is sold within one year of completion,the owner. badder will have the burden of proving man he did not Wild or improve for purpose of 103 — UFER sale')' 104 - REBAR 1,as owner of the property,am exclusively contracting with licensed contractors to construct Ne pri(Sec.7000,Business and Professions Cade:)The Counselors U. 105 — ANCHOR BOLTS, ecnse taw does not apply to anowner of pomany who Wilds or improves hereon,and, who contracts for such projects with a conuacmKO licensed pursuant to he Contractor. 106 — SEWER & WATER IU saw. 202 - UNDERFLOOR PLUMBING em exempt under Sec. Bk P C for this reason 203 - UNDERFLOOR MECHANICAL Data r WORKER'S COMPENSATION DECLARATION 204 - UNDERFLOOR FRAME Ihereby AM. nor,Penalty ofp,J.,one ofthe following ded.,.none: 205 - UNDERFLOOR INSULATION ❑(haw and will maintain a Certificate of Consent to self-insure for Worker.Cumpom 301 — ROUGH PLUMBING cation,as provided for by Semicon 3700 of the LAW,Code,for he performance or the 302 — TUB & OR SHOWER work for which this Permit is issued. ❑ I have and will maintain Worker's Compensation Insurance,as required by Section 3 03 - ROUGH MECHANICAL 3700 of he Labor Code,for he performance of the work for which this permit is issued. 304 — ROUGH ELECTRICAL - My Worker's Compencailon Insurance cams!(and Polite numk,..: 3 05 - FRAME CERTIFICATE OF EXE 01 OM WORKERS' 306 — HOEDOWNS COMPENSATION INSURANCE 307 - INSULATION This section need not W completed if the Permit Is foomm hundred dollars($IN)) 308 - SHEETROCK or leas.) 1 ceniry Nat he performance of the work for which this permit is he..d,1 shall no, 3 09 - EXTERIOR LATH !.`Ploy any m nuc vnas n grq upj.cu t Wmkeo'Com�em.orn 310 — INTERIOR LATH Lawanrcali - 311 - SCRATCH COAT' Applic m NOT( E O tP ICA this Certificate of Exemption, should been hjco he Workers Compensation previsions of he labor Code,youroust 313 - ROOF NAIL forthwith comply with such provisions or this Permit hall W deemed revoked. 501 — FINAL ELECTRICAL ENERGY z� CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY I hereby affirm but there is a constructinn lending agency lnnhe performance of 503 - FINAL MECHANICAL ENERGY Yd 7 he work fur which his permit Is issued(Sec.3097,Civ.C.) y C Le. uder'a Name 504 - FINAL BUILDING ENERGY Lenders Addrose p I certify that T have read this application and state Nal the above information is 505 - FINAL ELECTRICAL y cmrtn.I agree to comply with all city and county ordinances and sum laws relating to 506 — GAS TEST Vbuilding construction,and hereby authorize orpresemutivesuf Nis city reenter upon the grNFIN PLUMB G ✓ shove-memioncd u s,"for inspection keepha. / (Wc)a me In save,indemnify and keep harmless he City of Cupestino against 0 B F I L / to E.1,11blesj embi arccspcnses which may in any way accrue agaiustsaidCity 5 ;)Z in eonseq c of the grams of this (mit. APPLICA UN ERST S A WILL COMPLY WITH ALL NON-POINT Issued bY:5 ING Date E GU ION Re-roofs 514 NAL PUBLIC WORKS Signawrco CanUConl or Dau HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hanrdum material As dufrncd by he Cupertino Mume I Code,Chapter 9.12,and the Health and Safety .section 25532(.)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes Will be applicant or future mg occupant use cyuipmcm or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit ha.mmis air!enures nu cfincJ by he Bey Arta Ai,Quality Management all new materials for inspection. District? ❑Yes AN. )on injivs materials requirements under Chapter 6.95 of the Califon rias. to4myrtoday.morcdoes msena ,hm it u my 2aplruibility m notify cupant nr Ne requirek tprionnion.or.Cenirica¢ofOc an Signature of Applicant Date caner authorised agent Date All roof coverings to be Class"B"or better