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14060005CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10488 RAMPART AVE I CONTRACTOR: REASONABLE ROOFING I PERMIT NO: 14060005 OWNER'S NAME: CHIANG PETER AND ALICE 1 794 W MAGILL AVE I DATE ISSUED: 06/02/2014 1 OWNER'S PHONE: 6507663745 ❑ LICENSED CONTRACTOR'S DECLARATION License Clas 3 Lie. # 5 z Contractor ' ? DateV L I hereby affirm that I am 1'cens 4und a prov isions of Chapter 9 (commencing with Section 7 00) sion 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self - insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this p it. Additionally, the applicant understands and will comply with all n n -p i t sour ulations per the Cupertino Municipal Code Section 9 18. Signatu Date ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self - insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 918. Signature. Date FRESNO, CA 93704 l PHONE NO: (559) 417 -6988 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ RE -ROOF 28 SQ - TEAR OFF INSTALL 7/16 OSB, PLYWOOD Sq. Ft Floor Area: I Valuation: $10000 APN Number: 36925010 00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN OF PERMIT ISSUANCE OR 180 DAYS OM LAST CALLED INSPE T ON Issued by: Date: RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaini g an i ection, I agree to remove all ne materials for inspection. Signature of Applic Date: ALL ROOF COV G O BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cu ertmo Municipal Code, Chapter .12 and the Health &Safety Code, Sec 'on 505 5 3, an 34. Owner or authorized agen DateW C CO �TIOENDJNGAGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional REROOF PERMIT APPLICATION D COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION �0 . 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 O (408) 777 -3228 • FAX (408) 777 -3333 • building a.cupertino.org CUPERTINO PROJECT ADDRESS APN # OWNERNAME CA s � PHONE STREET ADDRESS • v ` ( CITY, STATE, ZIP [ /I FAX CONTACT NAME PH NE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER- BUILDER ❑ ^.OWNER AGENT ❑ ;CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ��� ❑ TENANT CONTRACTOR NAME 1 COMPANY NAME r LICENSE NUMBE15 LICENSE TYPE BiS. ( /LLL ' Oi E-MAIL �/ ,,� _ {I 1 � f N � � FAX , STREET ADDRESS ^ CITY, STATE, ZIP (,+ ��L PHO� ARCHITECT/ENGINEER NAME LICENSE NUMBER �o J BUS. LTC. # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF j l SFD or Duplex ❑ Multi - Family ROOF AREA: VALUATION: - /�� STRUCTURE: El Commercial C� /D 1.� EXISTING ROOF TYPE:. ❑ BUILT -UP ROOF ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE/REPLACE IaYES IFNO, PLYWOOD ❑ '' /," 12I PLYWD (@-OSB PITCH: ROOF ❑ NO # LAYERS! THICIa1ESS: ❑ 5/8" TYPE: ❑ COX ' i 2 CLASS: A PROPOSED ROOF TYPE: ❑ BUILT -UP ROOF O'ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER ICC -IS REPORT # DESCRIPTION OF WORIC j -� / �4 < < of approval from HOA. Provide Planning approval to verify if there any restrictions. Provide copy of Manufacturers Installation Specifications. Provide signed copy of Cupertino's Tear -Off Policy. ReroofApp_2011.doc revised 03116111 CITY OF CUPERTINO W-N-470 FFF, FNTIMATOR — RITILDING DIVISION I&'ADDRESS: 10488 rampart ave DATE: 06/02/2014 REVIEWED BY: Mendez Plan Chccl,: Fce: APN: I BP#: EVALUATION: 1$10,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re-roof PRIMARY SFD or Duplex USE: I PENTAMATION PERMIT TYPE: 1SFDWLR00F WORK re-roof 28 sq - tear off install 7/16 osb, plywood SCOPE FEE ID ROOF AREA (s.f.) 1REROOFFRES 2,800 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, tire, sanitary sewer utstrtct,,3cnoot manta!/ the Dent for addnl info. FEE ITEMS (&e Resolution 11-053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Chccl,: Fce: L PC Fec L Permit Fee: $448.00 h_/Fleu Permit Fee., (7onsirn(.1;on TIX., '1(jinillistrali"v Work Without Permit? Yes (j) No $0.00 �1(yw87wecl Plannirlg Fees: TrSwel Documentalion Fees: Strong Motion Fee: IBSEISAHCR $1.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 RONNE now . $45000 $0.00 TOTAL FEE: I I- - -, - $450.00 Revised: 04/01/2014 Address • SMOKE / CARBON M6XIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building0- cupertino.org FILE J161- IIL nr/,4" t__ PURPOSE This affidavit is a self - certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single - family and multi- family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above - referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have read and agree tqlcomply with the d conditions of this statement O e s) Name: % Si na re. . ..........., .............................. Dana!!... ... /... ... Signature .................................... ............................... Lic.# ....... ............................... Date: ................... Smoke and CO form.doc revised 03118114 l REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT-SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255 (408) 777 -3228 FAX (408) 777 -3333 • building(a)cupertino.org PROJECT ADDRESS APN # OWNERNAME `7' � PHONKS 1 ` 3-7 / -MAIL STREET ADDRESS ( C b A �� CITY, STATE, ZIP FAX CONTRACTOR NAME c_ A % ' JJ v� LICENSE NUMBER 5�3, LICENSE TYPE 4 BUS. LIC. # COMPANY NAME d `� d 5 C� E -MAIL � 3U�4 - A � FAX STREET ADDRESS n CITY, STATE, ZIP �` a� PHONE I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re -roof project shall comply with all applicable provisions of the 2013 California Codes. 2. An inspection request can be scheduled up to one business day before the requested inspection date. Please schedule inspections online or call (408) 777 -3228 from 7:30- 3:30pm (Mon - Thurs) or 7:30 - 2:30pm (Friday) to schedule inspection. For Tear -Off and Nailing Inspections, you must also call on the day of the inspection only after that phase of the work is completed. The building inspector will be available within one hour. The hours for this service are: 7:30- 10:30am and 12:30 -3:30 (Mon - Thurs) and 7:30- 10:30am and 12:30 -2:30 (Friday). Final Inspections will be given a two hour window. 3. Tear -Off Inspection, is required. Any and all dry- rotted wood shall be replaced prior to this inspection. Unless new plywood roof sheathing is proposed throughout, all the nails /fasteners shall be either completely knocked -down or removed prior to this inspection. 4. If plywood is installed, a-plywood Nailing Inspection is required. 5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the building inspector. Any roofing which is applied without first obtaining an approved inspection will require the removal of all new material down to the sheathing so a proper inspection can be performed. 6. A Final Inspection and approval shall be obtained from the building inspector when the re- roofing is completed. To receive a final sign -off, the following items will be verified: a. Flat roofs shall have a minimum of I/" per foot of slope and demonstrate there is no ponding. b. Listings from approved testing agencies for all pre - manufactured products used shall be available on -site to review at the time of the inspection. c. Proper spark arrestor installation, vents painted, gutter /downspouts installed, debris removed. 7. NOTE: If you call for a tear -off or plywood nailing inspection and the work is not complete, you will be charged a re- inspection fee. The re- inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's behalf. I understand and agree to comply with the re -roof policy stated above. I also understand that smoke detectors and carbon monoxid detectors are required to be installed in accordance with Sec7;7; 4 and R315 of the 2013 California Residential Code. i/ Signature of Applicant/Aizent: / Date: ( / ReroofPolicy_2014.doc revised 01 115114 CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 21481 ELM CT I CONTRACTOR: /+ - / PERMIT NO: 14060014 1 eANSA-VC_ ,0,1 OWNER'S NAME: MAHROUYAN REZA AND AZAR DATE ISSUED: 06/03/2014 I OWNER'S PHONE: 4085157428 I , 1 PHONE NO: I LICENSED CONTRACTOR'S DECLARATION License Class_ Lic' #r' ��- Contractor �1 1 [�Si - ,? L!/�nDate 6 ' l I hereby affirm that I am licensed under the provisi s of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self - insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I ave d will maintain Worker's Compensation Insur e, as ro 'ded f by Section 3700 of the Labor Code, for the performance a wo fo which his permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City, of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comrip with all no -point source regulations per he Cupertino Municipal Code, Section 9.18. Signatur Date 6` ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self - insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL E] REPAIR WATER DAMAGE IN (E) SHOWER IN MASTER BATHROOM fl�, \ ID Ft Floor Area: ' W I Valuation: $3500 APN Number: 36201021.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 1 R LLED INSPECTION. Date: RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined b V the Bay Area Air Quality Management District I will maintain compliance witl the pertino Municipal Code, Chapter 9.12 and the Health &Safety Code, Se ti s 25505, 25533AVA n 534. Owner or authorized agent: k D ate: 6 not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION O COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 ` O (408) 777 -3228 • FAX (408) 777 -3333 • building(a�cupertino.org \V\ f-1 r—I n tnwt /TILCL"'T, nuTf- THAT PFRMTTfi IJ NEW UUNS I KUU I IUIN LJ AIJL/111U1v u t�Laaay.aay.. u • - --- PROJECT ADDRESS t1 Q� C APN # OWNER NAME M a h ro a 8 `A PHONE /yF oU � 1 � _ 6R /�� E -MAIL ro at„ `.Ou a -v\ / / fl DO` Ci `I STREET ADDRESS Q 1 �l Nh �r'� CITY, STATE, ZIP ' ` [� ('V l0 CA \ q r 0, 1� FAX CONTACT NAME e � `�Y , �O � �1.. PHONE `_ 08) y, j- (v� cT V / h j L E- MAILII /T � �� ro U STREET ADDRESS CITY, STATE`, ZIP FAX ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER -:� LICENSE TYPE BUS. LIC # t,J A • 9N I z .�;;COjvIPANY NAME E -MAIL FAX 9 CL STtE ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUM R BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP HONE DESCRIPTION OF WORK � f-a-lti �t� 1. 0— �f EXISTING USE PROPOSED USE CONSTRTYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) �j EXISTG NEW FL R DEMO TOTAL NET AREA 10.61- .- AREA AREA AREA BATHROOM KITCHEN OTHER REMODEL AREA v REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑ NO ADDITION? []NO PRE - APPLICATION E] YES IF YES, PROVIDE COPY OF APPROVAL LETTER IS THE BLDG AN ❑ S EICHLER HOME? OTAL VALUATION: PLANNING APPL # ❑ NO PLANNING Li ,. By my signature below, I certify to each of the following: I am the property owner or a prized agen on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating t b 'Iding construction. I aut rize representatives of Cupertino to enter the above - entified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFO ATION REQUIRED �it'cHECltxa�E - * . , ,' ; {ROU i iNG slPti , New SFD or Multifamily dwellings: Apply for demolition permit forOVER THE coUNTER ;BUIIDINGPLAP(REYIEW existing building(s). Demolition permit is required prior to issuance of building��� permit for new building. ExPxESS,' ❑ rLANNI�GrLANREYIEwS � Commercial Bldgs: Provide a completed Hazardous Materials Disclosure mil] # sTivnARD f 0 ruBLlc woRxs ' t _ form if any Hazardous Materis are being used as part of this project. IN zARE ❑ : -FIRE DEP'!; a 1 Copy of Planning Approval Letter or Meetin g with Planning prior to w') h ©SANITARY sEwERVISTRrcT _ so submittal of Building Permit application.y E a�I Viµ. xrt T�, . x �...: a�. , .� , ❑;�.E1�TVIRONMENTAI. HEALTH, z BldgApp_2011.doc revised 06121111 -rt; OW L ,� CITY OF CUPERTINO I FFF. FCTIMATOR — BUILDING DIVISION 19, ADDRESS: 21481 elm ct DATE: 06/03/2014 REVIEWED BY: MELISSA UNITS APN: 362 01 021 BP #: "VALUATION: 1$3,500 *PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: p # PENTAMATION 1RPFIX PERMIT TYPE: WORK I REPAIR WATER DAMAGE IN E SHOWER IN MASTER BATHROOM SCOPE APPLIANCE / EQUIP TYPE FEE ID QTY /FEE QTY UNITS BP FEES Fixture set on One Trap 1BPFIxTURE 1 # $10 1'c>r7nit I�'�e>. PME Unit Fee: $10.00 PME Permit Fee: $47.00 i.'(viz o`ac'tion lira Administrative Fee: ]ADMIN $44.00 Work Without Permit? 0 Yes 0 No $0.00 TOTALS: A Travel Documentation Fee: ITRAVDOC $10.00 Strong Motion Fee: 1BSEISMICR S1ech. Pharr Check k Plumb. Plan Check 0.0 hrs $0.00 I;lec. _P/o, Chee a Llr>rlr. Petntit Fee: Plumb. Permit Fee: IPPERMIT / >lec term =t 1"'e, r11/1,11,1h, fnsf'. Other Plumb Insp. 0.0 hrs $47.00 Oilwr 1,lec. hsla hap1 1° e� Phinrb. Insp. Fee: 1_a61c. Inch Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Fiammng, vuotic WorKs, rare, Namrary fewer vistricr, acnooi r_ t:. FEE ITEMS (&e Resolution 11 -053 Eff.' 711113) FEE QTY /FEE SC JJMS Plan Check PME Plan Check: $0.00 1'c>r7nit I�'�e>. PME Unit Fee: $10.00 PME Permit Fee: $47.00 i.'(viz o`ac'tion lira Administrative Fee: ]ADMIN $44.00 Work Without Permit? 0 Yes 0 No $0.00 ,''hh *(,f,R,V P)trrxrdnr ,, Fees: A Travel Documentation Fee: ITRAVDOC $47.00 Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $149.50 $0.00 TOTAL FEE:" $149.50 Revised: 04/01/2014 �. 214-0 1 L-- I Ct C u e lrt 'ru 501+ S cvel : 96-? A 112 W VAl"62. pA-W-1c-= i N /1A &-5 Tt-YL S06 W c2 . COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION - CUPERTINO APPROVED This set of plans and specifications MUST be kept at the Job site during construction. It is unlawful to make any changes or alterations on same, or to deviate therefrom, without approval from the Building Official. The stamping of this plan and specifications SHALL NOT be held to permit or to be an rmial nf tha ioiation of any pro " y C' ate Law. PERMIT NO. f�.4 u 0 e 1) ej }emu v "0A 41 o r^ J c� P Rvn ER 'Idlr /A(6 � 9 O��a W '` e rt'n ant k66 � 00W rbbA roow r I r� Kbow J j a Y-A q e v �y nor) ,m J C JUN 02 2014 BY