06090041 CITY OF CUPERTINO v
BUILDING DIVISION PERMIT G(SNT=RACCQI2TNFUIYMA"I'=IQN .�-
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BUILDING ADDRESS: PERMIT NO.06090041
10933 NORTHFIELD S
OWNER'S NAME: PERMIT WUEDATE
JOANNE FRANKLIN 6
E: SANITARY NO. CONTROL NO.
ARCHITECLENGINEER: BUILDING PERMIT INFO
9LDG� ELECT lm PLUMB MECH
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00z LICENSED CONTRACTOR'S DECLARATION Job Description
I"1 I betcby affirm Nat 1 am Ikcmed umkr pmvkdmu of Chapter 9(cro mcncing p
with Scedon 70(10)of Division 3 of ma Busnamand Prefeuimu Code,andmy Ikenso is
inrmllrarteaneerrec �� DECK REPAIR LIKE FOR LIKE WILL NOT COMPROMISE
Lpullf Iw Lt.M
contranor sAr-st STRUCTURE.
QQ ARCHnECi•S DECLARA N
I 2 I and to a re lana shall he usod as public records
16
•p5 LicewdP fwianel
.7 Oat I am exempt
from
m Ce Contractor's
ON
f I herthy.(firm on 11. sump'from Nc Corrector's :A n c taw for the
.O o fallowing rtaon.(Samoan 71m 1.5,Business and vee.de tea cock:Any city or mouton.9 which requires a permit m cum s the slur.Mprove,tlemulah,m roamg any urument
_ met he i u i licensed
p slant to Me Nprovisions o Ma far such Coop tor'a ce a siLaw(Chaps em
i (comma cingwiitpSesoar7001))ofDvsio o oftheBuiness LicmucLaw(Chapler9 Sq.Ft. Floor Area Valuation
(commencing heisegp(therion70W)n( basis n3memoegdnexepton.Anand yaviCodc)w $3500
Nat he u eaemP'Nertfmm and the baso for role alleged exemption.Any Noutiun of
Section 7031-5 by any applies'fele perms Waimea On applken,re a advll penalty ar APN Number Occupancy Type
not more Nan five hundred dollars(SSW).
❑T,as..,of the property.ar my croPloy.with wages as mail to compemnko,
will dome work and me mtueurt u not intended eloffered fel We(Sec.7041,Business
ens property
who
carie:The wsthimme,Llaw law dues a'apply lf an.war of Required Inspections
Own employ b,ilosorimpmven himpr werMul whs Messuc tendo him elforpared Waugh bk
ownemployees,providedOat rsuchim Is mid nu am not intended compared for We.If,
builder,Ncbulkingelderoprnmtg sokwithin aneyw orcompktiformeowner-
=]a.)(will love the burden of proving Wt k did rot build el improve for pmrpaa of /
❑1,AS owner of me Property am eachminty connecting with Ikeaed Coomctors u
None
construct IN project apply
to n Bminw and property
wh loos Coda:)Th Conueme,U.
cave law cora not apply u an owner of property who build or impacts Norton,ad.
who
iom
contracts for such Oalecu Comm a Commercials)licensed pursuant as Ne Contractors
Le"Larm law.
0 lam eaemp'under See .BkPCfor this rtason
Owner Dau
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury,ane of the following declare lov:
1 have and will malreln aa
a CaNOu of Coenter self-Insure farwortcr's Compcn-
aaoon,u pmvidcd fel by S=n 3700 of the label Code.for the perfotmamce of man
work for which this permit is issued.
❑I have and will maintain Worker's Compensation Issuance,an required by Section
37W of me labor Coes,for the performance or me work for which not permit is limed.
My Worker's Compound bio ee artier and Policy number are:
Caller: Policy No.:
CERTIFICATES0 p EXEMP17ON FROM WAR?,
COMPENSATION INSURANCE
(INs action need not he completed if me Is foror hundred dollars 5100)
err less.)
I cenify the,in the Performance of me work(ter which mis permit is Wood.I shall No
employ any person In any manersa as in became subject in W Workers'Compewuon
Laws of California.Date
Appllam
NOTICE TO APPLICANT:IL after making ria Certificate of Exemption,you should
become subject le the Worker's Compensation provisions of Nc Labor Code,you most
0z forthwith Comply with such provisions or this permit shall be deemed revoked.
z^ CONSTRUCTION LENDING AGENCY
[—m I herthy affirm mat Neu lea coamocOm lending agency for one performance.!
FL > the work for which this permit Is issued(Sec.3097,Civ.CJ
W�0 Lenders Name
z Lender'.Add.
V Q 1 cenify mat I have iced Nis applieuion and show Out Ne oleic information is
D. (~•' conch.l agree to comply with all city and county ordinances and rule laws miming to
�lJ building consmrunion.and herby mOmim rcparcnutivcsof Nis city to enter upon Nc
r Cal shove-menti.ned progeny for iapecd.n purpler.
(~P. (We)arca a save,indemnify and keep harmless me Cary of Cupenino against
y liabilitia,judgmcnu.cosu an,expcmn which to;"
in an ey ecu against mid City
U Z in cowgmurce of me grand.,of m permit.
^•m APPLICANT UNDERSTANDS D WILL C WITH L NON-POINT Issued by: Date
SOURCE REGULATIONS. to a/bo(-
W Re-roofs
�'✓�
Signuurt o(AppllanmyConmr.0 Date
HAZARDOUS MATERIA DISCLOSURE Type of Roof
WIII hocapplicamrfuluo lldingecou assamorhandlchanrdousmamcrial
u defined by tie Cope Nno Mimi
poi Code. epter 9.12.and the Hcalm and Safety
CWC.seamen 29532(a)?
❑Ya No All roofs shall be inspected prior to any roofing material being installed.
Will the spPlican'ar future building occupant tea equipment el devices which If a roof is installed without first obtaining an inspection,I agree to remove
cool hoo dons air cmuminsou dere d by Na Bay Amo All Quality Management all new materials for inspection.
District?
❑Ya Nu
IhaVC rtml Ne harvdim maurialsmquim4m ,4rClupterd.95o(NeCalilel-
niaHcalmkSafctyCaoc,Sati x5505.3-5537 annand thulfNe builJing
dao not cormedy how a Con Nat It is my msDuty the eecup rn of me
rtyulrtrrcnuwhich mum a pd nairra,naaof(kapancySignature Of Applicant Dale
Owner anumori' tlegcn' f Dam
All roof coverings to be Class"B"or better
• 2006-09-06
To City of Cupertino,
Description of water damaged deck and damaged peaces being replaced, I will be
removing all water damaged pieces and replacing back to existing the joists will be
replaced with the same size board with pressure treated wood, some of the joist that
cantilever out need replace and I will replace like for like except using pressure treated
wood I will pull the hole board out not splice.
Greg Feist
Bay Area Enterprise
408-238-5043
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CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31637020 . 00
DATE ISSUED. . . . . . . : 09/06/2006
RECEIPT 4 . . . . . . . . . : 35934
REFERENCE ID # . . . : 06090041
SITE ADDRESS . . . . . : 10933 NORTHFIELD SQ
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : JOANNE FRANKLIN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : GREG FEIST
CONTRACTOR . . . . . . . : LIC #
COMPANY . . . . . . . . . . :
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
TELEPHONE . . . . . . . . :
*EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 3, 500 . 00 104 . 76 0 . 00 104 . 76 0 . 00
BSEISMICRE VALUATION 3 , 500 . 00 0 . 50 0 . 00 0 . 50 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 210 . 26 0 . 00 210 . 26 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ---- -------- ------------------
OTHER 210 . 26 MASTERCARD
TOTAL RECEIPT 210 . 26
•
CITY OF CUPERTINO Wb(]
Or PERMIT APPLICATION FORM
CUPEkTINO
N# 31(o 3762- p Date: 9_ —0& -
Building Address: / Mailing Address (if different from building address):
t7 3 / °Qr'T�t �r Cl • S C/�' O
Owner's Name: Phone#: yo$ _ SO
i- o. r�nK rtt -Z 30e
Contractor: License #:
F 9/7 9/ 77
Contact: Phone: Cupertino Business License#:
t--P- Ftr `S Fax:
Building PPe t Info:
BldgL+1 Elect ❑ Plumb ❑ Mech ❑
Job Description: / /, kc a ✓gyp< cr n a l cHr�� A,rC
Residential Ld da-'e"' k- G w Commercial ❑
Sq.Ft. Floor Area: Y�`����Seep, Sq.Ft.:
Cost of Project: � Occupancy GGrro_u-22:
s
3 0-0 S
Type of Construction: Please check this box if the project is a
&,--c kG ✓ second-story addition: ❑
ro'ect Size: Standard ❑ Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
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> 1.75M 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 Elee 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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CITY OF CUPERTINO
CUPEf�TINO PERMIT APPLICATION FORM
QuantityFee ID Fee Description Fee Grou •
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
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 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 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> 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
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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C CITY OF CUPERTINO
CUPEf�F PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
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 Insection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Chane BUILDING
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