03100204 CNTI2AC
ITY OF CUPERTINO
BUILDING DIVISION PERMIT COTnR INFORMATIQW
Bu1LDINGADDRESS: JEREMY & LAURA YAEKEL PERMIT NQ.03100204
0670 MARTINWOOD WY
.R'S NAME: PERMIT ISSUE DATE
JEREMY & LAURA YAEKEL 10/29/2003
ONE: SANITARY NO. CONTROL NO.
ARCHITEC tENGINEER: BUILDING PERMIT INFO
BLDG ELECf PLUMB MECH
ivo LICENSED CONTRACTOR'S DECLARATION G� O O O
1 hereby arirm mal]am licensed under provisions of Chapter 9(commencing Job Descrip(1!(}s
£� with section INS)or Division Sof the Business and Professions Code,and my license is �w4Y tYf1 b nom®
j tEmmu tome eneerren. KITCHEN REMODEL _ ^- „
License Class Lit.M
;,_ca Dam.Contractor
2 s 1 understand my plans shall nc used DECLARATIONas erds
U
�O ZOOy
n
w t; Licensed Professional
0,5 OWNER-BUILDER DECLARATION BullNG
<f 1 hereby affirm that 1 am exempt from the Convectors License Law for the
00 following reason.(Section 71n 1.5,Business and Professions Code:Any city it county
5 which requires a permit to construct,altar,improve,demolish,of repair any structure
$22000
prior to its issuance.also requires the applicant for such permit to rile a signed statement
that he is licensed pursuance the provisions of the Contractor's Liecnm Law(Charier 9 Sq.Ft. Floor Area Valuation
2 $ (commencing with Section 7")ofDivision 3ofthe Business and Professions Cndc)or 36935036 . 00
Jd the,he is exempt therefrom and Ne basis for me alleged exemption.Any violaunn of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy T e
not mom thanfvehundreddollars($500). panC y yp
❑Las owner ofthe property,ormycmploycea with wages u their sale compensation,
will do the work,and the strunure is not intended or offered for aale(Sec.7044,Business
and Profusion&Code:The Contractor's License Law does not apply to an owner of Required Inspections
property who builds or improver thereon,and who does such work himself or through his
awn employees,provided mat such improwmenu are not boosted or offered for sale.If.
however,Ne building or improvement is sold within one year of completion,me owner,
builder will have Ne burden of proving Nat he did not build or improve for purpose of
sale.).
❑1,as owner of Ne property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Cotle:)The Convenor's Li
come law does not apply to an owner of property who builds or improver thereon,and
who contracts for such projects with o corbactor(s)licensed pursuant to dm Contractor's
License Law.
❑I tunder Sec. ,B&P C for Mia reason
k
/ oa
WOKE C PENSATION DECLARADPfl
1 hereby affirm under penalty of perjury one of Ne following declarations:
❑I have and will maintain a Cenificak of Consent to self-insure for Worker's Compem
smum a provided for by Section 3700 of the Labor Code,for the performance of the
work for which Nix permit m issued.
❑1 haft and will maintain Worker's Compensation Insurance,s,required by Section
3700 or,
f Ne Labor Code,for Ne performance tribes work for which this permit is issued. '
My Workers Compensation Insurance carrier and Policy number am:
Cartier: Policy No.: _
CERTIFICATE OF EXEM MON FROM WORKERS'
COMPENSATION INSURANCE
(This section need not he completed if the permit it reform hundred dollars(Sla))
or less.)
1 certify that in The performance of the work for which this permit is issued.I shall not
employ any person in any manner n u in become subject to the Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:IL alter making this Cenricate of Exemption,you should
become subject to the Worker's Compensation provisions of the labor Code,you must
� Q forthwith comply with such provisions or this permit he deemed mauled.
ti h CONSTRUCTION LENDING AGENCY
I hereby affirm That there it a construction lending agency for the performance of
X 7 thc work for which this permit is issued(Sec.3097.Civ.C.)
Z] Q Lender's Name
z Lender's Address
Q I certify Net 1 have reed this city
and coup and rink Net the above information is
F cording Iagrceocomply
and with all city and countyordinariesand skk laws entre upon the
U building construction,and hereby authome repreacnmtives of this city to corer ups the
01 above-mentioned pmostlyest for ie penes whrposer.
r
(Wo)agree to save,indemnify ad keep harmless the City of Cupertino against
h7 Iioembesjnam of the goading
aintl Of this expenses they in any wayaccmc against mid City
,7 A PLICA ncc of the granting of this permit. / L
'^• APPLICANT NDERSTANDS AND WILL COMPLY WITH ALL NONPOINT Issued by: Date
SOUSE! OCLATIONS.
�3 Re-roofs
S' of Applicant nt orDOUSData
AZ MATERIALS "toren E Type of Roof
Will the applicant of future building occupant store or handle ha�ousdSafety material
Bnetl by the Cupenine Municipal Code,Chapter 9.11,and the Health and Safely
Section 15532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes f .
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit han dour air contaminants a defined by the Bay Arca Air Quality Management all new materials for inspection.
District?
0Yes o
I have mad the haaaNnus materials re mbernanu under Chapkr6.95 of the Califor. J
ria HcalN&Safety Code,Sectors]5505,15533 and 75534.Iundcrstnd Nat if the building
dues not currently haw a tenant.Net i,is my femoral hility to oouly tbe occupant of Me
requi which most bemetpri issumccnf cNica,ofUocupmc Sign'"re ofApplic Date
where mnHzeta / Q2� All roof coverings to be Class "B"or better
r
CITY OF CUPERTINO
BUILDING DIVISIONPER - C0NTRACT0R TNk,Oi N ;
BUILDING ADDRESS: JEREMY & LAURA YAEKEL PERMITNO.03100204
10670 MARTINWOOD WY
NER'S NAME: PERMIT ISSUE DATE
JEREMY & LAURA YAEKEL 10/29/2003
PHONE: ) SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: - BUILDING PERMIT INFO
OO ELO PLUMB M CHCH
agZ, LICENSED CONTRACTOR'S DECLARATION
U I hereby,affirm that I am licmucd under provisions of Chapter 9(commencing Job Description
with Section 7").f Division 3.f the Business and PmEssiums Code,and my he...is
± in toll O.A.nd effect, KITCHEN REMODEL w ®
,n4 License Class Lie.N FIN Q.1
F O Dam Contractor ///��_'111
eeH) ARCHITECTS DECLARATION
8 I understand my plans shall he used as public records APR 2 3 2004
l
a.W to Licensed Professional
g OWNER-BUILDER DECLARATION
<P 1 hereby affirm that 1 am exempt from the Contractor's License Law for the
` B�'�DI�fGi
�
❑D following reason.(Section 7031.5,Business and Pmfcssimer Code:Any city or county 4 m E which requires a Permit to construct,alter,improve,demolish,or repair any Structure $22000
u;< prior to its issuance,also requires the applicant for such permit to file a Signed.natement
:rD on 3 that he is licensed pursuant to the provisions of the Contractor's License Low(Chapter 9
3 Sq.FL Floor Area Valuation
(commencing with Section 7")of Divisiof the Business and Professions Code)or
that be is exempt themfmm and me basis for the alleged exemption.Any violation of 36935036 . 00
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APNNumber Occupancy Type
not more man five hundred dollars($500).
P Y YP
❑1,as owner of the property,or my employees with wages as mcir.Mlc compensation,
will do the work,end theswctum is not intended or offered for set.(Sec.7044,Business Required Inspections
and Professions Code:Thnse Contractor's License Law dean not apply to an owner of q P
property who builds Or improves thereon,and who does such work himself orgeough his
own employees,provided that such improvements arc not intended or offered for sale.IL
however,me building or improvement is sold within one year of completion.the owner-
builder will have Ne burden of proving mat he did not build or improve for purpose of
sale.).
❑1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(See.76W,Business and Profusions Code:)The Contractors Li.
cense Law does not apply to an owner of property who builds or improves thereon,and
who contracts for such projects wit a con ractor(s)licensed pursuant o dm Contractor's
License law. -
❑1 funder Scc. ,B&P C far this rcazon
/ ZJ v3
WO KE�t' CO PENSATIONDECLARATI
1 hereby affirm under penalty of perjury one of Ne following declarations:
❑IhaveandwillmaintainaCertificateofConsenttoself-insureforWorkchCumpen-
Milan,as provided for by Section 3700 of the Labor Code.for the performance of the
work for which this permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,as required by Section
3700 of me Labor Cotle,for me performance of be work for which this permit is issued.
My Worker's Compensation Insurance carrier and Policy number arc:
Camel. Polity No.: _
CERTIFICATE OF EXEM MON FROM WORKERS'
COMPENSATION INSURANCE
(This section need not he completed if the permit is for one hundred dollars($1 Nil
em.
I certify mat in the performance of the work for which this permit is issued.l shall not
employ any Person in any manner so as to become subject o the Workers Compensation
Laws of California.Dem
Applicant
NOTICE TO APPLICANT:if,alta making this CeniOcatc of Exemption,you should
become subject to The Worker's Compensation previsions of the Labor Code,you must
0 forthwith comply with such provisions or this permit shall M deemed mvokad.
ti CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency I'or the performance of
Y.7 the work for which this permit is issued(Sec.3097.Civ.C. -
1 Q Under's Name
Z Lcndcr's Address
1 certify mat 1 have mad this application and state that he above information is
correct.1 agree to comply with all city and county ordinances and state laws relating W
D V building construction,and hereby authorim representatives of this city to enter upon the
NU aWn-racnro
tiuned property for inspection purposes.
ti (We)after,to save,indemnify and keep harmless The City of Cupertino against
N liabilities,judgments,costs and expenses which may in any way accrue against said City
,Z in consequence of the grouting of this permit (�
'-' APPLICANT.ttNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date '
SOURCj<REGOLATIONS.
S Re-roofs
Si ebf AppbcanV��dm)ac or Date
=1ZffND0US MATERIALS DISCLO E Type of Roof
Will the applicant or future building occupant store or handle hazrduua material
0 defined by the Cupertino Municipal,Code.Chapter 9.12,and the Health and Safety
rude,Section 25532A)? ,],�
Yea 0 All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it havardous air commminanis as defined by the Bay Arta Air Quality Management
District? all new materials for inspection.
C]yes ;E�No
I have mv1 the hexaNnus materials requirements under Chapter 6.95 of the Califor. y
nia Heath&Safety Code,Sections 25505,25533 and 25534.1 undctsmad mat if me building
does not currently have a tenant that It is my res mwihility to madly the«cup.,of me
rcyui whichmustbemetpat pryyisMmrviceof erircaeoroccupancy, Slgn'6rreOfApplhcc ,' Date
or.A�lh ,�,ad As .1 All roof coverings to be Class "B" or better
wncru thori'rnJ aF m - part
CE D
RE 9 003
0OCT
APPr--,C3VED
IN ACCORDANCE WIT N THE CITY 06
CUPERTIN ODES A DINANCES
DATE 1
SIGNE 2
This at p1l Us
' an�be a to at ail tjmed REHR 17 ERATOR
H$U (
1 law Ito m l e an Changes or atteral g
Jon ame wit o '
ue '
� ' DISHaL
-
SHA � ,.
LL NOT be held tope ( waste
approval of.the violation of any qp
All
'f any City Ordinance or State La
156
i
SINK 2
1 . SINK 1
RANGE
HOME PHONEo 408 - 777 - 0647 YAEKEL
CELL PHONE , 408 -839- 5015 —tx0/27/03
KITCHEN REMODEL.
117
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• 155 RWFC BPP9
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W2136 BPPS
L 21
DISH. 54
24"
77
BD15
SUB-0
42"
•
AN dimensions&size designations This is an original design and must 72600BDE scale: 1/2"=1'
Design: 07/26/03 Dwg no.
given are sub THE 9 ie Date : OB/02I03
g subject to verification on I HOME DEPOT not hereleased
as been
id orj
job site aad adjustment to fit job applicable fee has been paid or job
conditions. order placed. Designer
kat
•
A a `
N
w �
El
•
_ Note:This drawing is an artistic THE 72600BDE Dwg no.
Interpretation of the general HOME DEPOT
appearance of the floor plan. It Is
not meant to be an exact rendition.
A o 1N
Q9 I �
waq
U
U k r _
ISLAND ISO- VtC-W
J
® ®
Note:This Brewing Is an artistic THE 72600BOE Dwg no.
interpretation of the general HOME DEPOT
appearance of the floor plan.It is
not meant to be an exact rendition.
l
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0
53 21 3/ 48 27 —�
12 i
26
53491 0 0
• 96
84
53
343i4i
43t-- 42 3 21 ---G3 9 / 36 36 —�
I
I
c
All dimensions&size designations THE This is an original design and must 726"'DE Scale 3/8"=1' Dwg no.
given are subject to verifcatlon on HOME DEPOT not be released or copied unless esigner
job site acid adjustment to fit job applicable lee has been paid or job
conditions. order placed. WaIVC Line# 1
Q
Cr)
C=)
U 117 '
g2711--/— 9 7 -- 36 --�9 21 —f 12 7Gi
\ T 6
6
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48 49} }
• 96
84
53 0
1344
36 36 Zvi- 9 21 —f 12 7lX
•
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1,
All dimensions&size designations THE This Is an original design and must 72600BDE Scale:1/2"=1' Dwg no.
given are subject to verification on not be released or copied unless esi ner
,job site and adjustment to fit job HOME DEPOT applicable fee has been paid or job L..
conditions. order placed. Wall/C Line# 2
- *CITY OF CUPERTIN*
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
APN# r c� Date:/0/Z9 03
Building Address: Mailing Address (if different from building address):
Iwo o,4z-r11v4jooD a✓�4Y
Owner's Name: Phone#:
T6R6-My e ZAUM /t //Of -P39 -Ko/3
Contractor: License#:
SEL
Contact: Phone:q0g •839-5013 Cupertino Business License#:
7e Amy Fax: Z59-663 -4;3(/6
Buil i Permit Info:
Bid ❑ Elect El Plumb ElMech El
Job Description:
Residential ❑ ft--06W — o cia
Sq.Ft. Floor Area: Is/Sq. .:
Cost of Project: tU7 Occupancy Gro p: i
(�f
Type of Constructi . Please 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
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
X362(
1 of3
Sorne CITY OF CUPERTINO*
CITY OF 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
BOVERTIIvIE 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 Cbeck 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 cfm MECHANICAL
BREMAIR.HAN A/C Units <= 10,000 cfin 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
BREMPOWER Power Device/Apparatus ELECTRICAL
2 of 3
SamOITY OF CUPERTINO
CUP TYOF O PERMIT APPLICATION FORM
ua Fee ID Fee Description Fee Group
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
BREMSIGNAD Rmdl Sips Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL i
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
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issuance PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
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