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05090222r« noc w E ;z _amu F— Dma ca0 xoG EC �m�Os EEC Esc O2 z CITY OF CUPERTINO BUILDING DIVISION PERMIT C IN FORMATION -- , BUILDING ADDRESS: PERMIT NO.0 5 0 9 0 2 2 2 1 OW NER'S NAME: PERMIT LSEUE DATE ANN & RENO DIBONO 2005 NE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION lob Description 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing P wire Senian 7akl)arorvision3orthe Busineaaand Proreaanpns copde.�arnd yhc.nml.s . in full from and ffe TERMIT REPAIR BALCONY (2ND -STORY) License Class Lk. ro f12— Iaf Or Dam ��con awe CONTRA.: THRASHER TERMITE r&PEST' CONTROL (41776 ARCHI'TECT'S DE LLA ION X M_ , r Njl �� 1 undcrsunJ my plans shall W used as public records N'Ra/k� IJ tl �j .ya:i . Licensed Prefe.minol OWNER -BUILDER DECLARATION Ys cense Law for the 1 hcrchy aTrm Not I am cacmpt from the CmuractaLi ��zr Zp05 following reason. (Section 7031.5. Business and Profeadom Cote: Any city or county which requires a permit to consumer. alter, improve, demolish. or repair any structure poor m its issuance, also requires the applicant for such permit to file a signed statement that lee is licensed urmant 1. the rovisions of the contractors ueeroe Law (Chapter 9 S Ft. Floor Area �I, �(H q 16L yy j� �� a L(��—�J�(��J Valu Lb6000 (commencing withSection 7") of Division 3 of the Business and Promsiom Cole) or , that he u exempt thcmfmm and the basis for the alleged exemption. Any violation of APN Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of not mom Nan five hundred dollars(6500). 35604042.00 ❑ Las owner.! the propcny,amy cmPlaYcca with wagasu Heir sale compensation, e Required Inspections willdo the warkmd the structure u not intended oronered for safe (Sec. 7044. Busirtess and Profrssm. Code: The Conuacmis License Law dose ret apply m an owner of q P property who buildsor improves Neuron, and whodoca such work himself or through his own empl.ycex, provided that Inch improve cnu are not intended oro0end for sale. If. however, the Wilding or improvement is sold within one year of completion, Use owner builder will have she burden of proving that he did not Wild or improve for purpose of sak). p 1, as owner of the property, am exclusively contracting with licensed contractors to consumer the project (Sec. 7W, Business and Professions Cade:) The Contractor's Li. cense Law docs not apply in an owner of property who Wilds or improves thereon, and who contracts for such pmjecu with a contractor(s) licensed pursuant in the Consommes Lac. law. ❑ 1 am exempt under Sec. . B h P C for this mason Owner Dam WORKERS COMPENSATION DECLARATION I hereby, affirm under penalty of perjury one of the following declarations: I haveand will mainuina Ccnlfiemeof Coosenuoxlf-insum for Workees Compcm . ration, As provided for by Section 37W of dm labor Code. for the performance, of the Into k for which this permit is issued. 1 ban and will maintain workefs Compensation Inmrana, as required by Section 37 the Labor Code, for the performance of the work for which this permit is issued. Insurance ca�rrier boom: My Workers Compensationend policyn O Lamer:l 11 I E f' 0M4/Policy No.: CERTIFICATE OF EXEMP ION FROM WORKERS' COMPENSATION INSURANCE ('this acnion need not W completed if the permit is foronchundrtd dollars(SIM) or I ss.) 1 CCm(y Nat in the performance of the work for which this permit is issued. I shall not employ any person in any manner m as; or become subject o the Warkers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If. after making this Certificate of Exemption, you should become robject m the Workers Compensation provisions of the labor Code, you must , forthwith comply with such provisions or this permit shall k deemed masked. CONSTRUCTION LENDING AGENCY I hereby thi Nu there is a construction lending agency I'm the perfurmanec of which d(See ' too which this pcmrit is issued (Sec. 44191, Civ. C.) Lenderk(ur Lenders Lender's Address 1 cenify that I haus read this application and sum that the above information is ' ' comet. 1 agree to comply with all city and county ordinances and rune laws relating to building construction, and hereby amhorim rearcroutivn of this City to enter upon the 1 mo vomemi...I property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cotentin. against j liabilities. judgments, casts and experves which may in any way accnm againetsaid City in eonmeacice of the granting of this permit. APPLIC UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT y B Issued by: Date / �—�s� � SO R EGUL ON /' • �_ OS� /(�f/f - Re -roofs L t nal sof Applicam/C.ntractor Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant Or future building occupant ram or handle hazardous moron.) az defined by the Cupertino Municipal Code, Chapter 9.12. antl the Health and Safety ole. ea 25532(a)7 All roofs shall be inspected prior to any roofing material being installed. ❑Ycr 0 /gyp\ If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future Wilding occupant ase equipment or devices which it hazardous air contaminants as dcfncd by he Bay Area Air Quality Management all new materials for inspection. DistricO Q Yeso 1 have read thc hmardsmsmamnalstequircntcnu under Chapter 695 of the Califor niaHeolthhSafc"Code, Sccuam255(15.25533wd25534.lun&m=dNatif Ne, Wilding dorms nm mendy have a tensor Nat it is my ressibility to nouly thc.eeupam of the utwich rc nm ri n, lam olaCerdhcamofOccupancy. Signature of Applicant Date __30 05— All roof coverings to be Class "B" or better r m authorize) agcm Dam F CITY F UPERTIN0 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Department JOB ADDRESS': PERMIT # OWNER'S NAME: Nft9 R.9N0 D%TSoNo PHONE# p$ 3-5Y-44 GENERAL CONTRACTOR: FAX # ct 08" 3 `ls - 7 ` 3 4r Fe -ST_ ON-rj"1 � I am not sing any subcontractors: alej Signature Date Please check applicable subcontractors and complete the following information: Owner/ Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/ Contractor Signature Date WOOD DESTROYING PESTS AND ORGANISMS INSPECTION REPORT Building No. Street, City, Zip Date of Inspection No. of Pages 10675 Clubhouse Lane, Cupertino, CA, 95014 08/11 /05 9 THRASHER TERMITE & PEST CONTROL 17427 Farley Road West Los Gatos, CA 95030-3308 Ph: (408) 354-9944 Fax: (408) 395-7934 Firm Registration No. PR 0240 Report No. 29574 Escrow No. Ordered By: Property Owner/Party of Interest: Report Sent To: Anna & Reno DiBono Anna & Reno DiBono Anna & Reno DiBono 10675 Clubhouse Lane 10675 Clubhouse Lane 10675 Clubhouse Lane Cupertino CA 95014 Cupertino CA 95014 Cupertino CA 95014 COMPLETE REPORT LIMITED REPORT ❑ SUPPLEMENTAL REPORT ❑ REINSPECTION REPORT ❑ General Description: Inspection ag Posted: A two story, wood framed, single family residence with wood and stucco Garage exterior. Other Tags Posted: None noted An inspection has been made of the structure(s) shown on the diagram in accordance with the Structural Pest Control Act. Detached porches, detached steps, detached decks and any other structures not on the diagram were not inspected. Subterranean Termites 29 Drywood Termites N Fungus/Dryrot 29 Other Findings 29 Further Inspection DQ If any of above boxes are checked, it indicates that there in were visible problems accessible areas. Read the report for details on checked items. • DIAGRAM NOT TO SCALE 9c 96 ---------- i 9P. 9C if 3A 10 —9 IE 1082A IE SOA 7A 18 SB 10E Q IB I SOD 1E 3A IA 7A ICID BA BB /B C T sFA U �u F"R^NT Inspected By Scott Martin License No. OPR 9412Signature V You are entitled to obtain copies of all reports and completion notices on this property reported to the Structural Peat Control Board during the preceeding two years. To obtain copies contact :Structural Peat Control Board, 1418 Howe Avenue, Suite 18, Sacramento, Coliforms 95825.3204. NOTE: Questions or problems concerning the above report should be directed to the manager of the company. Unresolved questions or problems with services performed may be directed to the Structural Pest Control Board at (916) 561-8708, (800) 737-8188 or www.poGtboard.ca.gov. 43M-41 (Rev. 10/01) 6th PAGE OF STANDARD INSPECTION REPORT ON PROPERTY AT: ti 10675 Clubhouse Lane, Cupertino, CA, 95014 08/11/05 29574 BUILDING NO. STREET, CITY, STATE, ZIP INSPECTION DATE REPORT NO. IECKS--PATIOS: Item 9A: FUMING: Evidence of drywood termite activity was noted at the balcony joists. RECOMMEMATION: Fumigate the entire structure with a lethal gas, see item #1C. ****** This is a Section 1 Item ****** Item 913: FUMING: Drywood termite pellets and/or swarmers were noted at the balcony. RE I IDM=ION: Remave and/or mask all accessible drywvod termite pellets and/or swarmers as necessary, see item #1D. ****** This is a Section 1 Item ****** Item 9C: FINDING: Diywvod termite damage and fungus damage were noted at the rear balcony cantilevered joists and decking materials. REC MMMATION: Reconstruct the entire balcony, replacing all visibly damaged materials. NOTE: Approximately three of the cantilevered joists must be replaced in their entirety (extending into the structure approximately twice the length that they cantilever from the exterior wall). Sections of the exterior stucco must be repaired to accomodate joist replacement. Our bid (if given) includes installing metal flashing over the tops of all joists and upgrading the existing railing for code -compliance. This is a permit -required item. ****** This is a Section 1 Item ****** OTHER --INTERIOR: Item 10A: FUMING: Cracks were noted at the kitchen counter top tiles. Cracks were also noted at the grout joints. [i RECOhIlNIDATION: Replace all cracked tiles and regrout as needed. ****** This is a Section 2 Item ****** Item 1013: FINDING: The floor underlayment appears to be slightly soft adjacent to the dinette sliding glass door. The vinyl floor covering appears to be loose adjacent to the kitchen dishwasher. Concealed adverse conditions may exist. REroNII�CATION: FURTHER INSPECTION recomrnded. Pull back the floor coverings adjacent to the dinette sliding glass door and dishwasher to allow for Further Inspection. Perform a Further Inspection and issue a Supplemental Report on any findings. NOTE: Damage to the vinyl floor coverings may result from this Further Inspection. Our bid does not include replacement of the vinyl floor covering. ****** Unknown Further Inspection Rec wended ****** THRASHER TERMITE & PEST CONTROL --- License No. PR 0240 ZION- CITY OF CUPERTINO 3 c0P,'-) m- Ae---fl CITY OF CUPERTINO v . 2 2 PERMIT APPLICATION FORM U� �-- L-A 1 of N # 3 5-& D L� 0 `f a— Date: q - 30 - 05 Building Address: /C --� s _ Mailing Address (if different from building address): Ow er's Name: i Phone Co ractor:t r►t ' real., j5 F_ =s License v V Contact: Phonet wd 1 J'_1 Fax. VJ6 35�- 717 Cupertino Business License#: i -7 % uilding Permit Info:'; Bldg [ Elect ❑ Plumb ❑ Mech ❑ Job Description:Z-»-cw a �L-bLAw -re . ' � Residential t9 2EPLA-C-E LIVE FolLI4i MAf•AAtSCommercial ❑ 2L�� ?�•9zc�/� e1N�9rOK Sq.Ft. Floor Area: au st-Z5— $/Sq.Ft.: Cost of Project: J 0J. 000.00 Occupancy Group: 3 Type of Construction: U Please check this box if the project is a second -story addition: ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILER1 Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler > 1M 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 L-A 1 of r 1 CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM Quanti Fee ID Fee Description Fee Group BNUCOMME 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 BPINI'ERCEP 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 rinklerBackflo 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 cfrn MECHANICAL BREMAIRHAN 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 > I 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 BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL 2 of 3 CITY OF CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group 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 Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3 1 a