04040168 CITY OF C1JPEWHNO d''i x*a}w'ai4as-« �• ' " ee +'7-r� "^�Sr
BUILDIN'C DIVISION PERMIT �CON1=I2AC�"T0121NT„®RMATION '.
BUILDING ADDRESS: ARTISTIC KITCHEN DESIGN PERMIT N004040168
10533 ESQUIRE 2T.
OWNER'S NAME; PERMITISSUEDAIE
CHUCK & ELLEN HAAS 131 E. EL 7/2004
HONE: SANITARY NO. CONTROL NO.
(650) 390-9615
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELF,CT PLUMB MECH
°00 LICENSED CONTRACTOR'S DECLARATION
e C 1 hereby arfirm that am rccnwd under prnProfess of Cnapler)anmmensi it Job Description
SzUul with SCC11on]I ))of DivisinnJorlhc Buainc.+ Prorcssinnx coca.and my license is
jaimraum divest. GG KITCHEN REMODEL
Lic n' us,T}3 Lic.p �cS��c to 7')
n 1-p Dal i l�jll
l D—f�Caur__K„tom_
S4IJ` ARCIIITECTS DECL TION 9a51bN
a'a 1 understand my lunatics he used aipu rc records
,,u
a G Licensed Professional
i y a OWNER-BUILDER DECLARATION
<$ I hereby affirm that 1 am exempt from the Cnnlracloh Licenu Low for the
00 fallowing reason.(Section 71131.5,Business and Professions Code:Any coy m county
Sm which requires a permit it,construct.alter,improve,demnlish,or repair any structure
it prian!its isoanee.also requires the applicanl forsuch parmit m Ble a signed statement
a that he is licamed„uretam more provisions ofthc Conlranori License law(Chapler9 Sq. Ft. Floor Area Valuation j
yI=n (commeneingwith Section 7003)ofI)MMon 3ofac Business and Pmfcxaions Code)nr
y $ Nal he is exempt therefrom and the basis for thc aH.Epul cxcmptipn.Any violation of
Section 703 L5 by any applicant for a permit objects the applicant to a civil Penalty or 3W#;4438kBcr00 Occupancy Type
not mom than five hundred dot me x6500), P Y YP
1,as owner of the property.or my employees with wages as their sole compensation,
will drlhewod.and the mm�ureisnot immndedoroffered wdo for sale(See to an Business � p s��� q P
and„refusions Code:The Canmcmrs License Law docs nota man owner ss �p��®■{ Required Inspections
property who builds or improves thereon,and who does such work himself or thmugh his
wn employees,provided thriven improvements are not in¢nded oroRered Basic.If.
however,the building or improvement is sold within one yearof completion,the owner
builder will have nine burden of Proving Nal he did not Wild or improve for purpose of
salf.01. Owner JAN 2 0 2005
❑Lasrot the Progeny,, exclusivelyend confessions with Miens C ur contractors to
Cause ct thproject(See.](WA,Boniness and Profusions ds Or I The Conoauor's U.
n
Cause taw dace net apply I.an owner orproperty win
ca milds or improves memos.and.
woo conuacu for such projects With a mnfeanor(s)littnsed pursuam m Nc Contractor's
License Law.
❑l am nempt under See. B 6 P C for this reson BUILDING
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following Contortions:
J l have and will maintain a Cenirieam of Consent to self-insum for Worker's Comped.
cation.as provided for by Section 3700 of the labor Code.for We performance of the
work for which this permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,as required by Section
700IX((��t of me uM1 de,f the pertormance of me wort fur which Nis Permit isissueJ. '
,. O n co minsunna conic antl Policy number art
amcr.
CE IFICATE OFE%EMtyOIQFROM WOR RS'
COMPENSATIONINSURANCE
tion nccJ Ihccompincd it @c p[rmil is furans dred enlhrs(sl(MB
arlea:) -
1 ernify that in the Performance or the work for which this Permit is issued.1 shall not
employ any person in any manner an as of become subjectto She Workers Compensation
Laws or California.Data
Applicant
NOTICE TO APPLICANT:If,alter making this Ccnilica¢of Exemption,you should
Become subject to the Worker's Compensation provisions of the labor Code,you must
z footwith comply with such provisions or this p cion Ishall he deemed revoked.
z O CONSTRUCTION LENDING AGENCY
F” l hereby allure that there is a construction lending agency for the Performance of
CL Ne work for which this permit is issued(See.3097.Civ.C.)
W Q Lord r'c Namc
z Lender's Address
U
I)O I ccniry m that 1 have this application and sunt that Ne shove information is
W mum
t' ,1 agree comply with
all city and county Ordinances Os and slam laws totaling m
OU buildingConstruction,iopand herebyins authorize representatives of Nis City menmr upon the
,r G alwvc-(We)agre to saveery for inspection keep proposes.
(We)agree to save,indemnify and kith harmless the City or Cupertinoagainst
F' N liabilities,judgment,eusts and expenses which may in eny way accrue againsLeaid City
U inconwquenceef Negranlingafthispermit.
'—' APPLICANT NDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SO RCER LAT
no 3
RC-r00fS
rX1111/211c,
of pylic UConmoor Data
/ 1{AZARDOUS MATERIALS DISCLOSURE Type of Roof ,
IN plicam ur fulurc bulldog acupam score or handle haraNum ma¢rial
as Ja( cd by the Cupertino Munni Cudc.Chapter 9,13,and the Health and Safety
Code.Section
r. Sc e 35532(¢)?
❑Ys Na All roofs shall be inspected prior to any roofing material being installed.
Will mea applicant or future building Occupant use equipment ar devices whim If a roof is installed without first obtaining an inspection,I agree to remove
pP s panArea Air
solIf id? usair mnmminantsudIndbythe Bay ArcaAirQuality Managcmem all new materials for inspection.
❑Yes 1
1 have read Ne hadandm smaterials requirements umfer .Chapmr 6.95 of the Califor.
ria HealthY Safety Code,Sec ions 35315,25533 and 25534.1 untlersmnd that if the building
docs not Coglyhatenant,Nal itis my responsibility m nnthy the occupant of Nc
rgdromou5t be tpdortoissueroraccmecaeoramPaney. Signature of Applicant Date
yyit Dale All roof coverings to be Class "B” or better
3��.
Community Development
10300 Torre Avenue
4'✓' (yX� Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
1PEKTINO
Building Department
JOB ADDRESS: 0 S 3 3E—sa U t ez pe-.. PERMIT # 0 (� D
OWNER'S N te, 16 PHONE yM• 714 .038 7
GENERAL CONTRACTOR: p,.-Tisrv-- FAX # 390 9 sa
404e,-t 4gyap Pg4i41
I am not using any subcontrac ors:
Signature Date
Pfease check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
d'
Co •actor Signature � Dat
1
�j
152"
72" 80"
® r- 18"-}—30"--13. 42'�—30"—}—29'—
33' .{.- 18'-.III-V--36' 30'--7I —27"
N W183W30364I1 _1(� I100DI8,II ` BBMW3038�/
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30B18-
, I W 24UR3090B
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'IyPERTINO
BUILDING DIEPA CUT BACK WALL TO 28'. - �—r-1-
WINDOWS COME DOWN TO
N B LT H
_ m NO CHANGES
m
O � AN ES
m
m CABINETRY
N
� n N NO CHANGES
o REMODEL KITCHEN
_ n UPGRADE KITCHEN ELECTRICAL F 2
`h (N)CABINETS
n (N)GRANITE COUNTERS
N
(N)TILE SPLASH o O
(N)APPLIANCES
(N)WOOD FLOOR
-�– } (N)FLUORESCENT UNDERCABINET LIGHTS------- ' —1—l-
�� I (N)PONY WALLS `.`^�( t,0
Vt
�cyci •-'
sl!V% T
�9i' — 1251 w U%
_ err ) d SP . es and it15� �
"1—
at all Cm oc, @icy°n<i
' •� r5^ ., , Ra"^nY & pecmiSScoll
on s OdptWC °f a d s0 ecfica�o0�
---She sm 'c eldpto P o� y Pto —
HAu N�.�a violaaan l6�
(N)30"W X 42" HIGH PONY WALL (N)9517�2L'LV ` br"PbO�I '�3{J/1LQ� --------- r �-
B.-t anY
KITCHEN REMODEL FOR MR. AND MRS. HAAS
10533 ESQUIRE PL
CUPERTINO, CA 95014
All dint.iory tiu dcsignatiov givrn arc Artistic Kiwhrn This is an original design and must not be Duigncd:3/32004
subj«t to verification onjob site and 131 E.EI Carnino Real relcaae or copied urdcss applicable Poe lis Printed:4/23/2004
adjustment to fit job conditions. Mt.Vicw, CA 94040 born paid orjob order placed.
650-390-9615
Designer Ed BeAlow
HAAS KITCHEN DESIGN I CAB Drawing 0: 1 Scale:0 5/16"- 1
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152"
® -f- 16' -�— 30" —.J. 42" —.7.— 30" 29" 2i
I33 33'I'
384"--
— 33' 18' y-7. 36" 30" —� 27" — 2 f
I II II II 41>•—•
—1— - 20�-t_ 21'
F_�7��HOD-6
r1
N
l
`0 S RANGE N
\ o
4-
u
(E)
m O AIR SWITCH REFUILT
RIGERATOR
NO CHANGES
P N (E)kPAAB� N~ V tl 1 \
NETRY
N NO CHANGES— n
�,�it 14C
ALL RECESSED LIGHTING IS EXISTING��Y 11 yr v�pp�1�pp T SPf��� N
m ' NO CHANGES TO BE MADE TO IT
2-(N)SMALL APPLIANCE CIRCUITS
-r 3-(N) FLUORESCENT UNOERCABINET=LIGHTS
1-(N) MICRO CIRCUIT --------- _L
\ 1-(N)DISHWASHER/DISPOSAL CIRCUIT
�."✓) ry 1- (N)220 LINE FOR RANGE N
(N) 110 OUTLETS ON BACK SIDE OF PONY WALLS ^:
i
_ ALL EXPOSED KITCHEN PLUGS TO BE GFCI OUTLETS AL
i
011 nnfNn
------------------------------
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(N)42" H X 30"W PONY WALL (N)36" H X 95 1/2"PONY WALL
(E)STEP DOWN TO FAMILY ROOM
ELECTRICAL DETAIL
All dimensions size desilptations given we Artistic Kitchen This is an original dcaign and must not be Designed:4/23/2004
subject to verification on job site and 131 E.EI Camino Real released or copied unless applicable fee has Printed:4/23/2004
adjustment to filjob conditions. Mt.View, CA 94040 been paid orjob order placed.
650-390-9615
Designer Ed Bwd.o
HAAS ELECTRICAL DESIGN CAB I Drawing a: 1 Scale:0 5/16"- 1'
CITY OF CUPERTINO
CUP kTCITY OF
O PERMIT APPLICATION FORM
APN # 3 �- Date: L-/
Building Address: Mailing Address (Jif different from building address):
/0533 ZSQUiPZcr L
Owner's Name: Phone #:
CAU-)rL E11e-r- S q08 - 7o�O - 03 8 7
Contractor: License #: �/6 G 7$
53-03
Contact: p Phone: 6S0 - Cupertino Business License#:
J6e— �v � DTItC�} Fax:
Building Permit Info:
Bldg � Elect ET�— Plumb Mec
Job Description: �B��s �G,� ie—
Residential \„ Commercial ❑
Sq.Ft. Floor Area: $ o i $/Sq.Ft.:
Cost of Project: c7oe� , rouOccupancy p: r-.
20�
Type of Construction' check this box if the project is a
second-story addition: ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> l OOK to 500K Btu MECHANICAL
BB0ILER3 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 > I 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
Z �
1 of t 7. 5 6
arm, CITY OF CUPERTINO
CUPEYTITY OF PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
/ BPFIXTURE Pblg Future PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
T 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 Heater/Vent 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> IOK 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
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
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amCITY OF CUPERTINO
If v CITY OF PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee ID Fee Description Fee Group
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 Swinuning 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
3 of 3