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03050087 CITY OF CUPERTINO d� '. . st ,�' � " s BUILDING DIVISION PERMIT CONT=RACTOR TIVE MAT_xON g BUILDING ADDRESS: PERMIT NO. THE BEEDLE FAMILY 03050087 0 A PERMITISSUBDATS 05/20/2003 EAMILY SANITARY NO. CONTROL NO. ARCHITECDBNGINBERi BUILDING PERMIT INFO BLDG ELECT] PLUMB MECH I 300 LICENSED CON aACD]R'S DECLARAT ON 70b a Crl tl rd 1 hereby eMan that 1 am Ilavtud under provisions of Chapter 9(Commencing q p. with Soetiun7000)or Division 5aftha Business and PmreWnoCarlo,and my licenm is �J 1—_! jn In full to=and Affem TERMIT REP License Clue Lia 0 S Dale Contractor ARCHITECTS DECLARATION 1 understand my piens ahall he umd As public accords --- �yga� 5O Licensed Pmfedoml OWNER-BUILDER DECLARATION t� 1 hereby anirm that 1 emmexempt from the Canaactofs Licence Law for tits Po following mann.(Section W31-5,Bmineas and Professions Code:Any city m county which requires a permit m Construct,alter,Improve,demolish,or repair any umctum �jprior in its lung=.alga roquima the applicant fm such permit to file u+gned Mnsmant gg¢yFp that M is licensed purmanl la the provision of tha Contractor's Llan.Law(Chapter 9 Sq.Ft.Floor Area Vat a eon eu LS$ (commencingwith Section 7000)ofDivision 3ofthe BuslnandProfession.Code)or $3 It Nu he is exanpt Bxmfrom and the basis for Bte alleged exemption.Any violation of Section 7071.5 by any applicant fm a permit mbjects rite applicant be a civil penalty of Type remore ore Nra an w hundred dollars(M), 3'6Zi ly Q7'3� 00 Occasp arcy '7 ❑I.an mvner of the property.or my employes with wagtaas their sole Compensation. will do Ihewmk end the stmctute Is notinnsnded malrVed rorasns(Sec.704,seems and Professions Code:The Conttulaes License Law dos not apply or an owner or 101 - FOUNDIKM(DM Inspections properly whobuild.arlmprovesthereon,andwho doessuchwakhlmseiforthmugh his 102 - PIERS ownemployea,provided that inch improvements Are not intended orortered fmasle.B. however,the building or lmpmvemem is seid within one you ofcompletioa the owner- 103 — UFER Wilder will have tie burden of proving that he did not build or improv for purpose of 104 - REBAR sale.). 01,a owner of the property.am exclusively contracting with licensed contminr,to 105 - ANCHOR BOLTS canwct the project(See.7044.Business and Profession Cade:)The Consort L4 106 — SEWER & WATER cense law data not apply In m owner of property who builds or Improves Marmon,and who contracts for such projects with.eonwctor(n)licensed pursuant to the Contrac7oee 202 - UNDERFLOOR PLUMBING LieeneeLaw. 203 - UNDERFLOOR MECHANICAL Dlam a1Pl0Xndd{Sec -� .B&PCfnr rid.reuan 0we6 Nd 204 - UNDERFLOOR FRAME 205 - UNDERFLOOR INSULATION I hereby Arm under Nulty of perjury ane of the following emigrations: 301 — ROUGH PLUMBING An ve and will maintain aCenlnateof Content to self-inum fmwarkch Compen- 302 — TUB be OR SHOWER 1937.1 n,u provided for by section 7700 of the labor Code,far the periormmen of IN k far which gas permit Is Wood. 303 - ROUGH MECHANICAL hawendwill mainWnWmkeesCompenadonInsurance,arequiredbySection 304 - ROUGH ELECTRICAL 0 of tie labor Code.for the perfarmatea Arden work forwhlch this permit M Wood. 305 — FRAME Workmen Compensation Insurance carder and Polity number am:er: Pol+ryNo.: 306 - HOEDOWNS CERTIFICATE OF EXEMPTION FROM WORKERS' 307 — INSULATION COMPENSATION INSURANCE 308 - SHEETROCK mien mdsaectimnecd nmhacomplemu lDha permit tsfmone hundred dollars($100) 309 - EXTERIOR LATH I conify that In th in Fame of the work for which this permit I,is ued.l shall not 310 — INTERIOR LATH empioyayperwn in a 17 g,lobeto wbjmlfalbe Workegram).-My 'Can eaa0 311 - SCRATCH COAT Lawwf calif I o e Nom t 313 - ROOF NAIL NGfI APP .a sur making this Ce cd e a Egempttan.you shout bmomeI bjeclmNeWorker'sCompensationpews,IofWefahorCook,youmuu 501 - FINAL ELECTRICAL ENERGY OZO forthwith comply with such Provisions;m this Perron shall be tleemed mwokee. 502 - FINAL PLUMBING ENERGY �r CONSTRUCTION LENDING AOE.NCY 503 - FINAL MECHANICAL ENERGY I haraby.M.Nat there is amtutmctim lending agency inn the poformancC of x0 the rwhimthis pemb,umd(sm.w9,Civ.c.) 504 - FINAL BUILDING ENERGY y A Leader'aAllm 505 - FINAL ELECTRICAL =Z Lender's Addrces ;,)p 1 certify that 1 lave read this application and man that tie eban Infomeadon Is 506 - GAS TEST correct.1 aim 10 comply with all city and county ordinances and suns laws relsting 10 507 - FINAL PLUMBING off{.....tt building construction,and hereby authorim representatives of this City to Amar uptm tins 0 - FIN L MEC ICAL W above-mentioned property for inspection purposes (We)agree m ave,Indemnify and lamp harming,the City of Cupertino agaimt 0 9 FI �W Ilabiltties,judgments,costs and expmuta which may in any gay accmo againlssid City APPLInconICANT UNDERSTAuebracofthe NDS AIND WIL COMPLY WITH ALL NON-POINT Issued by: 5 NG Date SOURC -BULATI NS. _ sd4 C Re-roofs App r H=MOUS MATERIALS DISCLOSURE As ons Type of Roof Will the applicant of future building mcupem atom or handle haardom material An denned by tine Cupertino Municipal Codc,Chapter 9.12,and the Health and Safely Code.section 25551(g)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yta �ilo WIII the applicant or(alum building oceupanl um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove r harardnu.air cmuardaina u cicfrncd by the Bey Arca Air Quality Mangcnam all new materials for inspection. rict7 I ❑Yes tpiu I have mW the haardmts malerialsmelulmmenu under Clamorti.95 ofthe cghfor. nim Health&$afdy COdC.&cutw25505.25577au155N.iunderaladdwtfdw building does not currently hew a anal,this t Is my responsibility m notify tie WCUmm M the mqui Act mathemI miss cora Cc aaarOccopmcy. Signature of Applicant Date -d Dans All roof coverings to be Class"B"or better a OWNER-BUILDER VERIFICATION 1. (Check one) I or my immediate family (parent, spouse or child) will perform: A. All the work authorized by this permit B. _ A portion of the work C. _ None of the work If B or C is checked,com Tete 2 -i'VED 2. A state licensed contractor will be hired to do: MAY 2 0 2003 A. _ All of the work B. _ A portion of the work (complete secti - ow -- Contractor Address/City Phone # State License # Type of work to be erformed • 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or portions of the authorized work. I understand that I may be an employer (see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. Person/Firm Address/City Phone Number Type of work to be erformed ................................................................................................................................................................ I declare under penalty of perjury that the above is and corr t. I ave read and understand the Owner-Builder Information(reverse J' Qi D Property Owner's Signature: LR . 9WJob Addres Any changes to the information provided on this form shall be submitted to the City of Cupertino Build Department. zat CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO ll N# / Date: 7 1 Building Address: 3pa P` /(L,,,w �J/ P Owner's Nam • ,ly Phoone Contractor: V I ' License#: Contact: Cupertino Business License#: Bui] rmit Info: ldgW Elect ❑ Plumb ❑ Mech ❑ ob ' es pti : I , . I • ❑ vY` y ommercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: Occupancy Gr p: Type of Construction: Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> IM 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 1of3 aTwYoCITY OF CUPERTINO PERMIT APPLICATION FORM CUPEkTINO 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 Multifamil 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 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 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 Pipe PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection.Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units<= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFD{T 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 CITY OF CUPERTINO , CITY OF PERMIT APPLICATION FORM CUPEI,TINO 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 MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane 13UILDING 3 of 3 CITY OF CUPERTINO �m 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp : Rng: Sub: Blk: Lot : APN . . . . . . . . . 36619079 . 00 DATE ISSUED. . . . . . . : 05/20/2003 RECEIPT # . . . . . . . . . : 21893 REFERENCE ID # . . . : 03050087 SITE ADDRESS . . . . . : 7330 RAINBOW DR. SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : THE BEEDLE FAMILY ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : THE BEEDLE FAMILY CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : THE BEEDLE FAMILY ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- -------- -- ------ ---- --- - ------ BPERMFEE VALUATION 3 , 000 . 00 77 . 00 0 . 00 77 . 00 0 . 00 BPLANCHK PERMIT FEE 77 . 00 65 .45 0 . 00 65 .45 0 . 00 BSEISMICRE VALUATION 3 , 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 ---------- ---------- ---------- -------- -- TOTAL PERMIT 142 . 95 0 . 00 142 . 95 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER - ---------------- ------------ ------------------ CHECK 142 . 95 2878 TOTAL RECEIPT 142 . 95