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