02040120 (2) CITY OF CUPERTINO '� , -
BUILDING DIVISION PERMI CONTRACTOR I1vFORMAT T:
ti ..BUILDING ADDRESS: •` o'.i —_PERMIT NO.
10565 E ESTATES DR SEARS HOME IMPROVEMENT 02040120
ONT'ER'S NAME: jjAIE�
ED COLE 283 E . AIRWAY BLVD. APP�14� U�LUU2
PHONE:
(925) 245-2000 SANITARY NO. CONTROL NO.
B p00 WR
CHIIELT/ENGINEER: _ BUILDING PERMIT INFO
iBLDG ELECT PLUMB MECH
-�Z LICENSED CONTRACTOR'S DECLARATION ]�b
�`c Ihereby affirm then l am licensed under pro sign.of chapter 9(commencing INSTALL WINDOWS Description
ith Sects 7000)af Diririon 3 ofthc Business Professions Code.and my license
c f=
51'
s in fu Meted t.
J < Licenx lass(-�3' Lir.a
.
Z
c F Da S DEC In ✓ fM1s/C Ih
ARCHITECT'S DECLARATION
O 5 1 understand my plans shall be,used az publir records
!}
s p O
Licensed Professional /
fix that I a-BUILDER DECLARATION
I hereby retur affirm that 1 am exempt from the Contractor's Co License taw for the
_E a following return.(Benson 7031.5,Business and Professions Code:Any city or caunry �� $7700
F i-G which requires a permit to ronawct,idler,improv,,demolish.Or repair my structure
0 pilar a,issuance,B l.ort requires eY licum for such II IO file a signed statement.
s.3 (cthnenhe isg withthe'fromandtheiti.for theelBuorsLicenx Law(ChapterCod) "Vluatio-- -
re that sang wehsvnefromi 0)afD iasisaOf tthe Business and processions vi COdc) t'. ,3``619 SE19.o3!�iF<D ' \ ! - ValUatlOn
mvtvons of O,Contract
.. ... .......... ........,......
rommcn'
'ee apphatibn.Any violation `
Of Slrtivn 70J 1,5 by any eDplicom for o permil subjects
the opplicam�o a rivi)prnalry-
'Of ran MOM then five hundred dollar.(SSW). l OAPN NPITMDAT I ON Occupancy Type
1.0 1.as owner of the property,Amy employees%ith wages az their sole compensation. 102 - PIERS
wil'dathe work.and the su i is nou Wended or oVertd for sale TSec.7W.. l
'Buss leis and Professions Code:The Contractor's License Law does not apply to an O3 - UFERRequired Inspections
owner of property w O builds a improves O mil,and who does such work hirruelf_ 10 4 - REBAR
or througM1 his own employees.provided the(.such impm�ememx ere not in¢ntled or
laHirrd for sale.IL however.the Wilding or imProvemenl is sold within one year of _
I O5'--- ANCHOR BOLTS.. .... ,. - -
completion,the ownerwildrr will have the burden o!proving that he did not build or .. -
a.
improve ra Purpose orsilr.y. 106 - SEWER & WATER
--_ '---' -. . _.. . ...__
❑I,ssowmn Oflhe n.am«rw.m�i'�onlmain "i _ .._ 202 .--.-UNDERFLOOR' -
- : Mope Y Y 8 with licenud contractors to ----; --PLUMBING--
construct the project(Sec.7044.Business and Prafeasims Code:)The Com cam's
License Law does not apply to an ownet ofpropcnywho Wilds or(mpmv¢thermn, 203 - UNDERFLOOR MECHANICAL
.:
and who lmnlmcu for such projects.with a comma,lons).licensed pursuant Ila the.' 2 O4 -UNDERFLOOR- FRAME , .. .
-
commnW.urmxuw. ....._......_..._._.
c ❑IamucmptuMirSd.'t BAPCfair lhis xasoa 205 - UNDERFLOOR:-INSULATION
Data - 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
I hereby e)Brm°ndexPrtwlY of per ury anei of m,rnnawing decimation: - 303 - ROUGH MECHANICAL
j. I have ldrd win mainuin•Ccnifidem of Cotaxno m alt-insure fa worker's 304 - ROUGH ELECTRICAL
mpvution, as provided fa by Sternum 3700 of the Labor Code, for the
rrormance of die work fur which this permit is issued. 3 05 - FRAME
- - 01 but ad will miinuin Wsi Compensation lnsunnce,ix Mi by 5mtion u306 - HOEDOWNS
37000 of the Labor Care,for tai P-1-11 of thc'work'for which N.permit;: 3 0 7 - INSULATION
ekefs Compcnlauon Ins ace center and Polxy nu bcr ve: '
D My Wo
c,r�t l 2 c/AWc-� �/ . .308., - SHEETROCK- t
Poo�19a i I
. cE ExEMPnON M MwORKERS 3 0 9" `=` 'E`X'I'] RI OR••LATH
COMPENSATION WSURANCE
310 INTER-INTER - LATH
m) 'loon nttd notwcam Inca if the A --^
P Permit rs for one handled dollars
f5100)alr.r) 311 = SCRATCH COAT
Icemlythat inthe parriamm a,ofthe workr hicn .. . 313. ^ ROOF...NAIL .
oaOawyp .1ariener o permit iuord,)CmanimioCifr .Data Io become subject
,.r.._.- ... ... _._.._..,.._.
to Or workers, 501 - FINAL EL'EC'TRICAL��ENERGY
Ap,hicuNOTCm_ . . : .... ...502 ...- FINAL .PLUMBING._ENERGY.,_-.__.._.
pe provisions ofth La
O _ P permnshillb,fEscmplion,youshould 503 - FINAL MECHANICAL ENERGY
forthwith coin with s c Labor Cada you mum '
r APPLIc F aeemedre°°"ra. 504 - FINAL BUILDING ENERG'
r I M1ertby ifBmi thn Nuc is a comwct D NGlenAGENCY•c -- -
y: CONSTRU.... LENDINGa505 - FINAL ELECTRICAL
Z become subjcn m Ne WarEdld Com archon
ncYtatheperfammce GAS TEST
a(the work me Which this p,mtit is issued(Sec.3097;Ci¢C.) 5 0 6 - `
.... ... .. .
7Z I<oduYAddrtss' .. _ ._ . . .... ._. _. ._
507 ' FINAL PLUMBING
1 ceruty Nat I love react this application and nem Net the iwve information is 508 FINAL MECHANICAL
7F tromp.l agrtetq comply with ell city end must ordinances and soon I.,Mlning 509 - FINAL GRADE
11, towBdingmmwld propddy farpauthbrire tepteunuuvu of this city to court upon
,+.A. the ew(we)iiianee property mrinspedk pumosea, 510 - FINAL PLANNING
. ( (s,j.d, u.Cas)nrustexymdkeepM1eNy'hsCiryofClPuunoaguw 514 FINAL PU LIC WORKS (/
h' liabilities,jud uatice cora and vpensaz which may in any way acme egairut laid
Z City i omcquence of Ne yranm)lot this pv*ui -
APPLICAfi7 UNbE N 5 AI: WILL COMPLY\ITrH ALL:NON. r
/
Z�(/ L� Issued by: Date v
Slgaetue.,APPheanVCbnhauen Re-roofs
HAZARDbUS MATERIALS DISCLOSURE
bon 152 ViFduaruar future bablat accupaid nae dr hari hewdbos muvial
.s aernee br dx eapcninn Mardciped end nett 9.Iz.and ler Head,ma scary Type of Roof . . . _
Code:Semon 8332 p7, ... .. .. ..
❑Yes f) o
All roofs shall be inspected prior to any roofing material being installed.-.. .
WdI the eppbo,. a Wilding m u cq promo o devices which If a roof is installed without fust obtaining an inspection,I agree to remove
QYaz d<rMty the Bay Arte An Quality MmeBcmam
all new materials for inspection. Applicant understands and will comply with
cwt hewdous a roma len ss
Damn .. : .: .. .
o t
all non-point source regulations: .
'I ba a read Ne h bus malcri reqs mens undv Chaplet li 95 of the "
m mildin althdo ffi Safetymem Cade,ave Seem 25533 end25534 1 undersandthat
If OeTNlle g Eon not cutrtmly ha a Icnan,than t is Tory,re)pgnsrb,luy t tmOry the -'
0 of Ne igen a rapil hitch most ba ala poor,m also.ca M Ce iBrete of
oto ppp
Oc cY -
�Q SGIZ z .. Signature of Applicant Date
a n rrrea gml Data All roof coverings to be Class "B"or better
' OFFICE. .. ...
U4/ZZ/02 Oe:1Z FAA 406 775 0034 EL TORO GLASS to003
'v
6
BACK
F FICE
®py G° Ga APR:2 2 2002
KtF+en Kr +
(3eLroo�
qy3/y x-3 �
• l,owerr nG -
RIC 7
• A PR--Oven
IN ACCORDA ;1:_,WITH THE CITY )F
CUPERTINO )c;£ AND 0 INANCES
DATE D-1�
• ,• �, SfGNED � _ r
�• v srmhi!eGrna"Ou3T-he
O ksm rx f e joo
"nes ene it is unlnv-fiai to .,
make any Chfljr altarnons on same
without tter, Perm-cion 1110M1110M tim building
' Living j`A a 5{••C!`�ePt. Ciq,or Cu�nfri�:
I?oom f3edroogri' starnpmg of this`uiar end s zoic+t!i0nn
4U- NOT be-ha!a•to fErma a, a, , ri
#wn ana.^.wa! of rho vic!at , of sny 0ro,,sa-1s ;!
FR
OLS i - rhe nrd_nanC,.+r r�t^Law
r
i
baddrem 115 5
OFFICE
20" CLEAR I� 34 C NEM I " ?R 2 2 2002
MINIMUM �-
- e
SLE
AREA 41'CLEAR
•'' OPFJrABLE-- 24"
5.7 So. FT. AREA
CLEAR
f�IPAr�0.lM
5.7 So. FT. MINIMUM
II�IAUM • •.
MINWI N SIZE MIVMLIM SIZEW DON
WNDOWFCR FOR2�CLEAF►FEx+�
2T CLEM WOTM
IN ACM-9DA CP .Vi' HE CITY OF
CU;)Fr l lNf :UC£S% .J OHCINANGES
ow- $ILL NEKiHT' nnTE V
/I, IE0-
iand ;n u;ii!cahaj3 •.4:157 be
� t,got on trre lob at i9 times am it rF unlavlul to
m8o any changes or ,^.Itr-,r.;ticntr on sante
'�dhnul wnttar, fwnissiRGDqie bwlding
r trip. starnpmg,of this Olen and specificminns
.SHAD. NOT be hald to pernur o! a> oe an
approval of the violation of any, prcv,sons of
m.Lity Or
inanro or State Lt+ry
_MINIMUM SIZED RESCUE OR ESCAPE
WINDOWS FROM SLEEPING ROOMS
Sec. 1204
_ sy
CITY OF CUPERTINO Zn p�
CITY OF PERMIT APPLICATION FORM
CUPERTINO
• APN# Date:
6 a5-- ot3 zz CJz
Building Address:
(o S E. E-57;'17-6-5
Owner's
-5i --
Owner's Name: Phone#:
ED Ctl �E o�'- as - 2
Contractor:_ License#:
S9 S P VEMcn./%'?Co puc,%r /NC /02
Contact: Phone#:
DA,/<' o ER -s 3t- r- 36?- i2oo
Applicant/Contractor: Fax #:
I
lding rmit Info:g Elect Mech
scription:idential: //V S i ;�\::=Iumb
LV fnIf)n, Commercial:
Sq.Ft. Floor Area: $/Sq.Ft.:
Architect/Engineer: Valuati
Type of Construction: Occu eup-
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other�Appliances MECHANICAL
BBOILERl 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
BBOILERS
Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXB Con. Tax for BQ one BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V<= IOOOA ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
ELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Enerpv BUILDING
BENERGYADD Ener y Add Multi BUILDING
BINVESTIGA Investi ation fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
• BMITIGATR Res. Housing Mit Fee BUILDING
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