Loading...
05090227 CITY OF CUPERTINO PER -✓ �"rx�F7 * '•F�t 74• " �� fa' "+'" BUILDING DIVISION AP 5, Li " BUILDING ADDRESS: KITCHENS BY MEYER PERMIT 110.05090227 11140 CHADWICK PT, ER'S NAME: _ PERMIT ISSUE DATE LAURA. PETERS 278 CASTRO 05 P NE: SANITARY NO. CONTROL NO. (415) 968-8318 ARCHITECT/ENGINEER; BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 app LICENSED CONTRACTOR'S DECLARATION - Job Description �i I hereby at on del 1 am licensed under provisions of Chapter 9(commencing withsmdon70I10)of Division Sof de Business end Pro(cseinns Cole, rad mylkense is n� In mu farmandof �q 1 REMODEL BATH/REMOVE , NON LOAD BEARING j Z License Lk.p Date Cuntr¢tor ARCHITELTS DEC TIO V 5y 1 understand my plans shill be used of public records 0 ak.cf Licensed Pmfessitnal 5 OWNER-BUILDER DECLARATION Contractor's ON s� I hereby affirm that 1 ore exempt from Ja ConlrecYs License Lew for the 9aO following reuon..(Section 7031.5,Business and Professions Code:Any city Or county : $16654 j$� which requires a penail ro construct,ab or,improve,demolish.lir repair any structure y prior In its issuance.abut requires the applicant for such permit to rile a signed statement Valuation EAG that he is licensedpussuonttotheprovisionsoftheConuacmrfLicenselaw(Chapter9 Sq.F[.Floor Area $ (commencing with Section 7")of Division 3 of the Bushoummd Professions Code)or .. 'bat he is exempt darefrom and Uta basis for the alleged exemption.Any violation of Section 7031.5 by any applicant far a permit subjects the applicant to s civil penalty of r Occupancy Type not more than five hundred dollars(5300). , ❑1,a owner of the property,or my employees with wages as their aide compensation, will do the work and immucture is not intended oraffmad for sale(Sm.7044,Business Required Inspections and Profeulrns Cc&:The Convector's License law.does not apply m an owner of q P property who builds or improves thereon,and who dassuch work himself or through his own employees,previded did much improvements ere not intended suffered for sale,if. however,the building or Improvement is sold within one year of completion,the owner- � builder will have the burden of proving that he did not build or Improve for purpose of soled. ❑1.is tweet of the Sao,7 am exclusively convecting with licensedcontractorsto cense La the project(Sec.7W4,wner of and Profusions CadeI The Contraction's rad tenet Law does not apply loan owner of property who sed r m improves centro,and who contact for such projects wIN aconkecmr(s)licensed pursuant to doe Convedofa / License Law. / EJ 14M exempt undo Sea .B&PCfor this Tenon er Data a/. WORKER'S COMPENSATION DECLARATION GV 1 hereby affirm under penalty of perjury one of the following declarations: I haft and will maintain aCeNBam of Comenuo selGinsum fm Warker'aCompen- satlon,u provided for by Section 3700 of the labor Code,for the performance of the work for which this Permit is issued. ❑I hive and will maintain Wmker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the Performance of the work for which this permit is Iliad. My Worker's Compensation Insurance artier and Policy number'm�e:��a-� Cartier. A P 09 10I• Polity No.Y6,G{.6 ' CERTIFICATE OF EXEMPTION FROM WORKERS' . COMPENSATION INSURANCE ('Nis section need not hccompleted]film permit isforanc hundred dollars($100) arlcsL) I certify that in the performance of the work for which this permit is issued,l shall not employ any person in any manner so as in become subject to the Workers'Compensation I.of California.Data Applicant NOTICE TO APPLICANT:If,after making this Cmdrreata of Exemption,you should become subject In the Worker's Compensation previsions or the Labor Code,you mum .7. O forthwith comply with such provisions or this permit shall be deemed revoked. z y CONSTRUCTION LENDING AGENCY [r I hereby affirm that more is a construction lending agency Wr the performance of fY,7 the work for which this permit is issued(Sm.3097,Cih,C.) W�Q Lender's Name m1- z Lender's Address 1 certify that 1 have read this application and auto that the about Information is LL corset I agree to comply with all city and county ordinances and sum law.rehomg to building construction,and hereby mchones reprtsmuniWS of this city to enter upon the LL7 above-mentioned Property for inspection purposes. a (Wee)agree to save,indemnify and keep harmless the City of Cupertino against U rAdabilideejudgments,costs and expenses which may in my way seems againstnid City APPLIin CANTeof the UNDERSTANDSof d/y��I�9}yaNNN'''IIIDrWILL COMPLY WITH ALL NON-POINT Issued by: Date SOUR�1'gREGUI-A'TJIJhjS= ��1.��.1?s//,,�� Re-roofs Signature of Applicant/Contracmr Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building cecupam store or handle hazardous material as&rind by the Cupertino Municipal Cade.Chapter 9.12,and the Health and Safely a de.Section 25532p)? All roofs shall be inspected prior to any roofing material being installed. ❑Yu ff will the applicant or stare banding necapam use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hanodaus air contaminants as defined by he Bay Ama Air Quality Management all new materials for inspection. Disvict7 ❑Yee IQr+t I have mad Lh.W.dnus materials roquiremem;under Chapur6.95 of cc Califon ria Hcaic&SafayCodc,Sonans 35505,8533 and 25534.1 understand thatif the building does not cumemiy have a tenant,that It is m spun Wyao.nodl'y the occupant of the requirements whichm bete p nti aril cerunata of Occupancy. Signature of Applicant Date �Xw + All roof coverings to be Class"B"or better Owner m uucofiaed ager Dmc CITY OF CUPERTINO 1 of 2 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35617080 . 00 DATE ISSUED. . . . . . . : 09/30/2005 RECEIPT # . . . . . . . . . : 31442 REFERENCE ID # . . . : 05090227 SITE ADDRESS . . . . . : 11140 CHADWICK PL SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : LAURA PETERS ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4705 RECEIVED FROM . . . . : KITCHEN BY MEYER CONTRACTOR . . . . . . . : MEYER, ROMOND P LIC # 19637 COMPANY . . . . . . . . . . : KITCHENS BY MEYER ADDRESS . . . . . . . . . . : 278 CASTRO ST CITY/STATE/ZIP . . . : MOUNTAIN VIEW, CA 94040 TELEPHONE . . . . . . . . : (415) 968-8318 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 16, 654 . 00 245 . 16 0 . 00 245 . 16 0 . 00 BPFIXTURE UNITS 3 . 00 27 . 00 0 . 00 27 . 00 0 . 00 BREMFIXT NO. FIXTURES 4 . 00 4 . 80 0 . 00 4 . 80 0 . 00 BENERGY PERMIT FEE 245 . 16 117 . 68 0 . 00 117 . 68 0 . 00 BREMRECEPT NO. OUTLETS 6 . 00 7 . 20 0 . 00 7 . 20 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 BREMVENFAN NO UNITS 1 . 00 45 . 39 0 . 00 45 . 39 0 . 00 BSEISMICRE VALUATION 16, 654 . 00 1 . 70 0 . 00 1 . 70 0 . 00 EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 MPERMITFEE FLAT RATE 1. 00 38 . 37 0 . 00 38 . 37 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 564 . 04 0 . 00 564 . 04 0 . 00 CITY OF CUPERTINO o2 2 uPER,T irvo PERMIT APPLICATION FORM ° s APN# Date: Building Address: Owner's Name: hone#: S - q10 Contractor: icense#: Contact: Phone#: O o4 11fP00 App icant/Contractor: ax#: _Building Permit Into: Bldg Elect Plumb Mech �C Job Description rAl /L1Mdv++!W A(�n /.qO �d�✓,tisq Residential: r 7���r Commercial: Sq.Ft.Floor Area: $/Sq.Ft.: Architect/Engineer:' Valuation: 442 h�3 e of Construction: Occulfancy Group: Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX hid/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' BMrFIGATC 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 1 of3 � � 6Y ITY OF CUPERTINq CUPEI�TINO PET APPLICATION FORM QuantityFee ID. Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMIvIE 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 rinMerBackflo 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 BREMAIRIIAN 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 2 of 3 OITY OF CUPERTINO COPE o PERMIT APPLICATION FORM QuantityFee 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 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 EPERMUTFEE 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 • 3of3 YQ s y V � ooz O \O 2 W_ W CS n aam \ Z U N • O cc o W O.2 WLU UJ W U J N LL a ~ Z J J d S LLJ CO LU Oui AU-¢ K� V7 z .a m `• •O �•�• \ Q F Q O z 2 n �J C,' y ui CL o •� �N � N OI a ,\ r� s -.3 U) ^1 — 3 . F `, r 0 b IL p cj • 3 W � Q O � � � V U NZF Q O LL O Q V F z - F a LL z Wf � yNj W 0 > N N O LL N F a � U • W Z Z N II Q �m a Z N N W Q ..1 ZwrF- . 2 CD Z LLJ CD J WOO a > z00 cr r 0 _ � z Z N o b LOU w N a 2 N trW Q d W d Q O� a K ¢ N Z S � y ocz Z W W Q d m R t Z L) • O Q 3 = o wUJ UJ WU Q Q LL J Z ujw d W Rf UCJ .9 tl OWv ¢ V, „ A 3 Zmam > �a0Qo .� " FFZ Cc YL3 0 S }� NyLLJ JO w � Na Aw � Oa ` OQ U — y er v o � U 0 0 N 3 vt ash W • — �: `� a a W � aw Q, O \ � V U (nzF BOLl — LL � O Z U F C7LLZ HR f W WL N LL fn F Q U • w 0 n 0 j Q 2 in En 0 ZwH1_ W cc F Q m Z wOZOO J W � U J acro ° z C o 2 N W (g O O 3� ¢ w w ¢ a wa O Q X Z CITY OF CUPERTINO 7.b »^ azi.xai ,e : BUILDING DIVISION PERMIT kCO1VTI2AC7 R I,Nk`URMATION NO ADDRESS: KITCHENS BY MEYER PERM"I'D'0 5 0 9 0 2 2 7 140 CHADWICK PT, ER'S NAME: PERMT715517E DATE , LAURA PETERS 276 CASTRO 5 SANITARY NO. CONTROL NO. (415) 968-8318 ARCHITECTrrENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 �oo LICENSED CONTACTORS DECLARATION 4 Job Description I beroby afficen Nat 1 am licensed under provisions of Chapter 9(commcncin{ P with Smtion7O(X))o(Division3.f Lh.BatiR,and Prorcui..Code, detyimcomis n iunifull forceand e r Lim Oq REMODEL BATH/REMOVE .NON LOAD BEARING 7 Z Dam ConhmTIO DEC mf ARCHITECT'S Q I undeeund my piens shall M used u public recnrds 5 U 4Ot; Licensed Prorcssional 3 OWNER-BUILDERseptfrom DECLARATION the COO hereby affirm (Section n 1 am cxcmpt from d r ConuasCo Liecnu Law for p O fallowing moan. eitt703 1.5. t,aker. and ve,demolish. Cake Any city or county COO (Vi which mqus u•e,also to cmgrmt alms bnprow,d fennit,"repair my Bnmtum $16654 S" prior msl issuance,also requires Neapplicant tfarsochhe Cor permit misteasignedgalomem that(comms licensed pursuant an the of Divisor of the ComrOur'a Ucensolaw(Chaptm9 Sq.Ft.Floor Area Valuation Ila that pt armor 70nd of basis f rth al Business edexemption.Any vi Cade)or a.. Nat he h exempt Nemfmcn mtl Ne buts for the alleged exemption.Any NahOun of Section 7031.5 by my applicant for.permit subjects the applicant to a civil penalty of r U Occupancy Type not mare than five buedmd dollars(5500). ❑I,as owner of the property,or my employees wish wages as deh Ole compensation. will do the work and thago,noe is not intended or offered ror aak(See.7044,Business Re uired Ins ections and Profeulons Code:The Conummri License Law.dam set apply m an owner of q P property who builds or improves thermn.and who doea such work himselr ar Nrou{h his own employees,provided or I shmmch rat is mid wit arc not Intended mmfeed for names. however.the building the or Improvement is halo within one year of mprave for the owned builder will have Nc wrdm of paving Out k ala Out wild or improve for purpose of ale.). ❑1,as owner of the property am inclusively connecting with Immeed canuacmn in contract the pmjea(Sec.7044,Business and Professional Code:)The Commodes Lb mane Lew dam not apply m an owner of property who builds or improves Whom,and, whence Lace for such projeeu with acmuacm(s)Iisonuant licensed pumthe Communes License Law, ❑lam exempt unties See. ,BkPCfor this msmn r Date C7� WORKER'S COMPENSATION DECLARATION 1 Welty affirm under penalty of perjury one of the following declaedorss: hero and will meinuin aCeNOmm of Co..,a sel6imme for Workers Comped- union,as provided for by Section 3700 of the labor Cade,for Ran performance of the work for which this permit is issued. ❑1 have and will maintain Worker's Compensation Imuunce,u mquied by Section 3700 cruise,Lab"Code,for the performance of the work forwhkh this Ismailia Issued My Workeeg Compensation Insurance mrtier and Policy number am; Cartier. `b r 19 P,I Policy Na. f CERTIFICATE OF EAEMMON FROM WORKERS' COMPENSATION INSURANCE (This warm need Out becomplemd If the permit H fmmehundmAtloRan({Ig17 or less.) I certify that in she performance of the work For which this permit Is issued,I shall not employ any person in my mamerm as se become subject in the Work of Compenudon Laws of California,Data Applicant NOTICE TO APPLICANT:If.after making this Cer inmlo of Exemption.you should become subject m the Workers Compensation provisions of Ute Labor Code,you mug ,J O forthwith comply with such provisions or this permit shall be accused mused. 'Z� CONSTRUCTION LENDING AGENCY [..r I hereby africm NU Nee las comtuctimr lending agency for the perfarmmctof tYishe work fur which Nis pemit la Issued see.3097,Civ.C.) lenders Name0. , Z) z Leaders Add. V Q 1 sorrily that 1 Mw mad this application and sute that the above Information Is ly F correct.I qme an Comply with all City ad county on inancea and sum laws misting k QU building consecution,and hereby authorize eprmufflOM of NU City m color upnn the above-mcndorud property fur impecu"purposes^y py (We)agree to save,indemnify and keep harmless Ne City of Cripcnino against M limniities,judgmenu.com and expenses which may in my way mcee against aid City U Z in cortsrguence of rhe granting of Nu Kam11. APPLICANT UNDERSTANDS 6ND WILL COMPLY WITH ALL NON-POINT Issued by:9 Date sOUR�REGUI-A �������� .Re-roofs Sigmture Of ApplimnUContracmr Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or roam building accupanrstore or baralm haurdous material as dcnned by 0te Cupminu Municipal Code.Chapter 9.11 and the HceIN and Safety Scdtim zss3ur. / All roofs shall be inspected prior to any roofing material being installed. CYes 1,7tvu Will the applicant or future wilding am pam am equipmcal or covers which If a roof is installed without first obtaining an inspection,I agree to remove It wrndnns air conuminadu u deRncd by the Bay Am&Air Quality Management all new materials for inspection. District? —/ ❑Yes 11+u I haw mad the hmardrmsmamrials requirements under Chapter6.95ofshe Califoo- niaHmldr&Safcty Code,Sodom 25505,25533and 25534.I undem out thetlfft wilding dam rant curmnly hew a inane tiw It k or wify de asupant of the requirements which h{eo sets , a a Ccnfruam of Occupancy. Signature of Applicant Date o�raraue� -Do. All roof coverings to be Class "B"or better