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CONTRACTOR INFORAVION:
PE T
BUBDING ADDRESS:
10341 TONITA WY
PERMIT NO.
02080066
MVMNORMAN E AND VIRGIL G
APPLICATION UB DATE
0813/2002
PHONE:
SANITARY NO. CONTROL NO.
ARCHITECT/ENGMER: <
BULLDING PERMIT INFO'
BLDG ELECT PLUMB MECH
u u 1 '- r-3
LICENSED CONTRACTOR'S DECLARATION
Ihon by thmlam dsiner Chapn9(commecense
rl�
Job D@SC•1L.G`fy
[ DALED
pend proanof
with Section 7000) of of
Division Business end professions Code, and my license
TERMITE
REPAIR
DLacon lass caro effece
Nil affect.
ata Glass Como
AUG 2 2 2002
ARCHITECrS DECLARATION
1 understand my plaza shall be used as Public rcrnNs
BUILDING
Liecroad professional
OWNER -BUILDER DECLARATION
1 hereby M. on 1 1. uemp, from me Gonioma C s Liceme Law forme
following reason. (Section IS. Business and ioit Code: My city or county
$11000
which co
m construct. alter. improve, clu repair YScruchom
s a'ast5apenin,
.. pdormirscenadpumw minutes , Nissn'emmb,Of
ait.i'
i rc(Ch:piem
oment
- - - - - — -- _
*peapplinsoff !Con toiuoicen
that 6 sHe provisionna the C s Licenu Law (Chaps 9
ending
p� ,A,.�
.,," ., +. p C.-1�yyL.'k[Q590 zea,.• •• t 7' z
Valuation
Min Secuonom
er with e Burin Codd
o of me Business and
t'� , ..
;Y) v � •�
or tat io i70 cm t therefrom and the basis far m< aIle
or and the basis mptiprofessions.Av
Law tion, An
P g' p Y violation
Sec
of Section lone man iv mydredd i(35cmm wbjecra the applicant toacivil penalty
a
. or not mat mw me hundred sonars (ssoo).
`O
AQN
101 PbrAMATION
Occupancy YP
Occu ane Type
1, as owner of me property, tar my employees wish wages as Neir sole compenel item
102 -
PIERS
will do the work, and Use structure is not intended or offered for sale (Sm. 7W4,'
Business mil professions Cade: The Contractor's License Law docs trot apply to an
103 -
UFER Required Inspections '
owner of property Who Wilds or improve Merton, and who does such work himself
104 -
REBAR
of throw h his own employees. provided that such improvements an not intended or
-offered
- -
- ... ..... .. - .
far tile. H. however. me Wdding o provcment i. wm Within ane rest of
105' -
ANCHOR BOLTS ,
eompledon, the owner builde I have rdcn of amving that he did amt Wild or
mvrnveff s
106 -
SEWER & WATER
d( "pC�' 1
1, a caner ihEp y, am exclusively contrutin8 with hanud mnrtactors m
z
202 '-
UNDERFLOOR PLUMBING' _._ ... _.... . . .
omuuct the project (sec. 7W, Business and Professions Codc:) The Convector's
203 -
UNDERFLOOR MECHANICAL• -
License law docs not apply man owner of property Who W ills ua impasses thereon.
_and raco cs such pnieLn wim a LomnLmdn BLemea-parsuan, m.me
_..2 04 -
-UNDERFLOOR FRAME'
Licer L
Contractor's Li<enu Law.
❑lam <ae der —' C for this reawn
n�NS>A_Q�TjlzOECLA
205 -
UNDERFLOOR''INSULATION
ZP
oweC� to 7l//(dZ
301 -
ROUGH PLUMBING
TION
302 -
TUB & OR SHOWER
I M1ereby.ffnm under penalty of pcq ormefoRowingdecluatinns:
303 -
ROUGH MECHANICAL
❑ 1 have end will meinnin a Cenificate of Consent in self -insure far Worker',
304 -
ROUGH ELECTRICAL
Compensation, a5 provided for by section 3700 of the Labor Code, for the
305 -
FRAME
prfomance of the work for which this permit is Issued.
C I have md'will maintain Worker's Campanian.. lmmoriee, as required by Section
306 -
HOLDOWNS
37W of the LaWr Cade, for the Performance of the work for which this permit is
307 -
INSULATION
issued. My Workefs.. Companwtion Insurance carrier and Polity number are:
... .. .�_. _.... _
308 ,-
SHE$TROCiC -
PalfayNo.:
CERTIFICATION OF MEMPTION FROM WQRKERS'
', r''. 30.9 `-''EXTERIOR'.
LATH '-
COMPENSATIONwgURANCE _
- --3-10: -
INTERIOR -LATH' - -
fmi, aatmh need oat W Completed irme pem,it it reran! Wwrcd ammrs
311 -
SCRATCH COAT
(51001 n, Ie,s.l
313 -
ROOF NAIL _.
IccaUry tMiid me ce of me work IQ, qqhiah is prm"'su:ued,I
shall "'employ any p�o ???999 �pE u p m me Work,
501 -
FINAL ELECTRICAL' ENERGY'
,
502 -
FINAL PLUMBING ENERGY
,.Coalea�a // TAT _
N L utir.'6 �rmildisCcniicmeo1E.aempdan.You should
503 -
.. _
FINAL MECHANICAL ENERGY '
n.
We e s 63cct m me Woheh Compensmion provisions of the Labor Cadc, you man
rannwimLomply with wLh provismnS ar thir pemdt ,n.0 be deemea rtvoked.
504 -
FINAL BUILDING ENERGY
CorismucnONLENDING AGENCY
505 -
FINAL ELECTRICAL
I Mrcby affirm mat mem is a construction lending agency for me performance
506 -
GAS TEST
of me work for which this permit k issued (Sec. 3W7, Civ. C.)
UNd _. _. . ..._.... ..._
507 -
FINAL PLUMBING. . ._. .. Q
roS, -
Ianaer.Address
50
FINAL MECHANICAL
I certify that I have reed this application and state moi me above information is
5 -
I NAL GRADE
neer. I agree to roan. a wihM1 all city and county ordinances and state laws enter
suvu of oris city wenter upon
upog
thWilding conawmpropedy
5 0 -
INCL NG
to, inspection uposes.
pmpeny forifydkpurposes.
me sbo(We)
agree to
(We) ugmeetosave,indemnifyandkeephmayintheCityofCupertinoagainst
51 -
INCL B RKS
liabilities. judgments, eases and upenus may in my way acme against said
City
City in consequence of the moon thls �
pe.
APPLICANTUNDERSTAND wILLe IPLY WITH ALL NDNPOIjIT
ouRc�Reet' rlq"s///
Issued b Y
Dale
�a /3 0
,
sIg rA I. anvLT3EmLtor /e
Re -roofs
H RDOUS MATERIALS DISCLOSURE
Will the applicam or Noure Wilding occuPsm awe or MMI. huallous material
Type of Roof
_ _ -- - _ • _ .. _.
derided by the Cupertino Municipal Code, Chapter 9.13, and the Health and Safety
• .'•
.•
�`.
Code, Section 35532(.)^ - _ ..
o re,' `}/,(A'No
All roofs shall
: • ` •, i •
be inspected prior to any roofing material being installed..
Will the applicant or Noire Wilding occupant on aquipment or devices which
If a roof is installed without first obtaining an inspection; I agree to remove
emit hamrdous nor contaminants as dirtied by the Bay Area Air Quality Management
Disnicn
all new materials
for inspection. Applicant understands. and will comply, with
o Y<ao
all non -point source regulations. .
I have rtad the hu ous m_annals requirements under Chapter 6.95 of the
Celifomia Health d5 Safety Code, Seaiom 25505.25573 and 25534. I understand that
if me Wilding does not cmrtndy haul a ten t, s is my responsibility w notify the
acupant of the requirson ¢h must be to of CeniR a c of
ey/pnor issuance a
Occupant
/
Signature of Applicant
Date _
All roof coverings to be Class rB" or better
arta a Data/
OFFICE
FROM : TRPS TERMITE
3rd PAGE OF STANDARD INSPECTION REPORT ON PROPERTY AT:
103.11 TONITA WAY. CUPERTINO, CA, 95014
BUILDING NO. STREET, CITY, STATE, ZIP
r1UU. J. GYJCJGJ • JI:JIII 1 1 Y
PHONE NO. 4082595900
06/06/02 264978
INSPECTION DATE REPORT NO.
SUBSTRUCTURE AREAS:
Item 1J: Per Item #1D of our original report, subterranean termite and fungus damage
noted to rim joist.
RE0"MMA.TICN: Replace dwreged Hood (approx. 20'). Restucco to match as
besc practical. No painting included.
****** This is a Section 1 Item ******
•
This property was not inspected for the presence or absence of health
related rrolds or fungi. By California law we are neither qualified,
authorized nor licensed to inspect for health related molds or fungi. If you
desire information about the presence or absence of health related rrolds,
you should contact an industrial hygienist.
NCITE: A PERMIT IS REQUIRED FRCM THE VOCAL BUILDING DEPT. PRIOR TO CZNvIENCING
THE WORK RFMT0,XOED IN ITEM # 1J. IF THEY REQUIRE ANY CfMGES OR ADDITICtJAL
WORK MOND THAT SPECIFIED HEREIN, THERE MAY BE ADDITIaML CI -M GES ABOVE THE
AT I%aIED BID. IF ST -10M DEPECIt]RS ARE REQUIRED, WE WILL SUPPLY AND INSTALL
STANDARD, BATEERY OPERATED UNITS FOR A CHARGE OF $25.00 EACH.
REFER TO ATTACHED WORK AVINCILIZATICPi FOR BID BRE XDOW.
PLEASE CAIS, IF WE CAN BE OF FURTHER SERVICE.... THANK YOU.
SUBMITTAL
OFFEE CON
Ir'l «
COItDAfr^,F N/Iry �yc C
rTy a/�ANr r DIPINJO S
L' Lopt on the/ob at specifications P0871 I to make all lir
as and 't
on sal
me anY changes is un.
t e buadingDept, C'dten permissiOI7 ns
LL
stamp,n of Y of Cupertin0. om N Ua h1 plan and S cificab
SHn Oi
aoprovaI at the violation of mit or to be �s
any CifY Ordinance or Stele �W. visions
TAPS TERMITE AND PEST SPECIALISTS, INC. -- License No. PR 0227
1
CITY OF
CUPERTINO
Ask
CITY OF CUPERTINO
PERMIT APPLICATION FORM koc()goo( )b
Quantity Fee ID
APN #
Date:
42
BAPPLOTHER
Building Address:
f G � // iU �✓' i7/i Gs'9 � �'U'Ofs£'Ti y o
MECHANICAL
Owner's Name:
Phone #:
BUILDING
BCONSTAX
Ind/Off/Comm/Quasi
BUILDING
Contractor:
License #:
BUILDING
TA�J TC/l L1/TC
a Pr<' �tiG6
BUILDING
Contact:
l�A�� C>�/�.z��✓<
Phone #:
BUILDING
Applicant/Contractor:
Fax #:
ELECTRICAL
Buildi Permit Info:
Elec 600V > 1000A
Bldg Elect Plumb Mech
Job
BELEC200
scription:^ _`
V" I
ELECTRICAL
Residential: l � Co e
Energy
Sq.Ft. Floor Area:
$/f q1t.:
Energy Add Multi
BUILDING
Valuation:
Architect/Engineer:
BUILDING
BMITIGATC
Occupancy Grdu?�
Type of Construction:
BMITIGATR
Res. Housing Mit Fee
BUILDING
Quantity Fee ID
Fee Description
Fee Group
BAPPLOTHER
Other A liances
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
BMITIGATR
Res. Housing Mit Fee
BUILDING
BMNEWMULTI
New Multi -Family Res
MECHANICAL
BNEWMULTI
New Multi -family Res
ELECTRICAL
BNUCOMME
New Comm Electric
ELECTRICAL
BNUCOMMM
New Comm Mechanical
MECHANICAL
BNUCOMMP
I New Comm Plumb
PLUMBING
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