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03010198 (4) CITY OF CUPERTINO -.€* ••A, k; ' BUILDING DIVISIONPERMIT , CONTRAGTORIN)E'ORMATI IF BUILDING ADDRESS: REED ARTHUR M AND JEANNE K TRUNO. 10990 MARIA ROSA WAY O xlNER'S NAME: APPLICATION SUB DATE REED ARTHUR M AND JEANNE K U 01/30/2003 TONE: SANITARY NO. CONTROL NO. ARCHITECDENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH �00 LICENSED CONTRACTOR'S DECLARATION G Job DeSCr 1e I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section 7000)ofDivision 3 of Ne Business and Professions Code,and my license is Z�= Lierns from and err"'' SHEAR WALL IN FM RM Data Class Cmdr MAR - 4 2003 0 F Dam T'S DECLARATION ES ARCHITECT'S DECLARATION _ 1 understand my plans'hall be used a9 guhlic records o. Licensed Professional BUILDING LLO OWNER-BUILDER DECLARATION u�<S 1 hereby affirm that 1 am exempt from the Contractors License Law for the i—p0 following mason.(Section 7031,5,Business and Professions Code:Any city orcouncy 2 which requires a permit to construct,Sher,improve,demolish,err repair any Structure prior to its issuance,also requires the applicant foramen permiuo File saignedstalement 0 that he is licensed pursuant o the provisions niche Contractor's Limmo Law(Chapter 9 Sq. Ft.Floor Area tion $ (commencing with Section 7")of Division Sof the Business and Professions Code)or i Nat he is exempt therefrom and the basis for Be,alleged exemption.Any violation of Section 7031.5byany applicant for a permit subjects Ne applicant to a civil penalty of �p not more Nan five hundred dollars($500). ¢ Occupancye 0 1,as owner of the progeny,or my employees with wages u their sole compensation, will do the work,and the swcmre is not intended or offered for sale(Sec.7044,Business tOt FOUNIDA; 015 — and Professions Code:The Contractors Lt..Law does not apply to an owner of egwred Inspections progeny who builds or improves thereon,and who dorthrough s such work himselfor rough his 102 - PIERS own employees,provided that such improvements arc not intended or offered for sale.If, 103 — UFER 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 104 - REBAR C]1. ❑ aowner of the property, mm exclusively contracting with licensed 105 - ANCHOR BOLTS constructdcontractors to 106 - SEWER & WATER construct the project(Sec.]044,,Business usineand Professionss Code:)The Contractor's Li. cenx law does no apply to a a owner of property is Mrilds orimproves theraon.and 202 — UNDERFLOOR PLUMBING wh,comrac rsuc prpjecrscvs raglm ice sed Pursuant so the Convenor:' 203 — UNDERFLOOR MECHANICAL ens l Iam empt n ce B&PCfordai, an 204 - UNDERFLOOR FRAME °w WORKER'S COMPENSATIO DECIAI -so 205 - UNDERFLOOR INSULATION R I �/I hereby affirm under penalty ofperjury one ofthe following declarations: 301 — ROUGH PLUMBING - IhaveandwillmaintainaCardBeamofCorsemmelf-insure for worker's camper- 302 — TUB & OR SHOWER cation,as provided for by Section 37W of the labor Code,for the performance of the 303 - ROUGH MECHANICAL work err which this permit is issued. 3 04 - ROUGH ELECTRICAL ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3 0 5 — FRAME 3700 of Ne labor Code,far the performance of Ne work for which this permit is luted. My Workers Compensation Insurance carrier and Policy number are: 306 — HOLDOWNS Carrier: PolicyFROM 307 - INSULATION CERTIFICATE OF EXEMPTION FROM WORKERS' COM PENSATION INSURANCE 308 - SHEETROCK or leas.) rI'his Section need not ilicraoideted if the Permit is for one hundred dollars 1$IBI) 309 - EXTERIOR LATH 310 - INTERIOR LATH 1 cenify Nel in an ich th' ger it is issued,1 shall not employ any sane `ry nn w c Workcrs'Compcnsation 311 - SCRATCH COAT Lawi of mmi 313 - ROOF NAIL App 501 - FINAL ELECTRICAL ENERGY NOT 0 o t A :I[Compensation pr Certificate of of Exemption,you should Wo, c hjccl y the Worker's Compensation provisions of the hear vodc,'ynu must O ,Z mrmwhhenmplywhnstmProvisions nrthis permitsnallbedeemed revaked. 502 - FINAL PLUMBING ENERGY 'z�.'O - CONSTRUCTION LENDING AGENCY 503 - FINAL MECHANICAL ENERGY H I hereby affirion that there is 4 construction leading agency for the performance of 504 - FINAL BUILDING ENERGY x > Lenders far Namewhich Nis permittsissued(Sec.J09],CieC.) 505 - FINAL ELECTRICAL W0. Lender's Name Dz Leader's Address 506 - GAS TEST U'O 1 certify that I have read this application and sum that the above information is 507 - FINAL PLUMBING [✓ti correct.I agree to comply with all city and roomy ordinances and Stam laws relating to building emnswclion.and hereby authorise reproordstives of this cit mcmeru O U tho FINAL MECHANICAL above-mentioned progeny,for inspection gurpoxs O9 IM01— tn H a (We)agree to save,indemnify and keep harmless the City of Cupertino against H Bad lilies,judgments,costs and expenses ich may to any way see...gainsl said Ci ty 5 G U z in can a the a 'n his r t. E" APP CA ST DS D ILL COMPLY WITH ALL NON POINT Issued by!1 - WORKS Date S RC U ION . Re-roofs IF Si at c of AppReant/Contractor ala HAZARDOUS MATERIALS DISCLOSURE Type Of Roof Will the applicant or future building Occupant store or handle vamrux material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety `vele.Section 25532(a)] All roofs shall be inspected prior to an roofing material beim ❑res '�ofrn P P y g g installed. Will the applicant orfuturebuilding accupanl sax equipment Or devices which If a roof is installed without first obtaining an inspection,I agree to remove ich haradnus air contaminants as de0ned by the Bay Area Air Quality Management all new materials for inspection. Oistrin9 ❑Ycs I havcm c thentanus materials requimmmou under Chapter 695oftoo Califor- nisHealth cry tions 3 534.1 understand Nu if the building tiros not aread sae 11N it is to Idly to notify the rocuparl of the rcgtie cataw al melp rto iSa a fa CCNncale of elft � Signature of Applicant Date or aathorized ageml D,m All roof coverings to be Class "B"or better CITY OF CUPERTINO 1� 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # 3 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35618003 . 00 DATE ISSUED. . . . . . . : 01/30/2003 RECEIPT #. . . . . . . . . : 21013 REFERENCE ID # . . . : 03010198 SITE ADDRESS . . . . . : 10990 MARIA ROSA WAY SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : REED ARTHUR M AND JEANNE K TRU ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4720 RECEIVED FROM . . . . : ARTHUR REED CONTRACTOR . . . . . . . . LIC # *OWNER* COMPANY . . . . . . . . . . : REED ARTHUR M AND JEANNE K TRU ADDRESS . . . . . .. . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4720 TELEPHONE . . . . . . . . : 0E ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 200 . 00 77 . 00 0 . 00 77 . 00 0 . 00 BPLANCHK PERMIT FEE 1 . 00 62 .25 0 . 00 62 . 25 0 . 00 BSEISMICRE VALUATION 200 . 00 0 . 50 0 . 00 0 . 50 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 139 . 75 0 . 00 139 . 75 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 139 . 75 4683 TOTAL RECEIPT 139 . 75 • S11CITY OF CUPERTINO 03 CITY OF CUPEkTINO PERMIT APPLICATION FORM • APN# �� / J {�✓ �d Dateb Building Address: . u Owner' Name: Phone#: 23;1", 1 4nS-2,&-7-. 349 Contractor: License#: Contact: Phone#: Applicant/Contractor: Fax #: DJobD Permit Info: Elect Plumb Mech cripti��on:ial: N1/J iL: t�1 u f Y1now1 WALC /8 S lM' omme c3a1: Sq.Ft. Floor Area: $/Sq.Ft.:, Architect/Engineer: Valuation. i T eyp of Construction: Occupancy Gro Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances 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 I New Comm Electric ELECTRICAL BNUCOMMM I New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING 1 of R ,rte • • F � CITY OF CUPERTINO c'Ty PERMIT APPLICATION FORM •' CUPEf�T1NO uanti Fee ID Fee Description Fee Group BNUMULTI New Multi-family Res PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmos heric 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 rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING • BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterNent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units<= 10,000 cfm MECHANICAL .BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT -LightingFixtures 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 Sips Add Branch ELECTRICAL • I BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR I Theatrical Li ting Fix ELECTRICAL 2 of 3 0 . r� CITY OF CUPERTINO CITYOF PERMIT APPLICATION FORM . CU PEkTINO Quantity Fee ID Fee Description Fee Group BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSF&2FAM Single &2 Family BUILDING BSFNA Single Family New Add BUILDING BSPECIAL Special hisection BUILDING BSWIM Swinuning 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 BBOILERI 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> 1.75 M Btu MECHANICAL • 3 of 3 14— A- ---- -_ D � I i^ZNt1V ; Si-1 U �'f.C:LI� �2c�vvt 1 KISS 6a L J/k. L(_ Cil Mi , f� InrJ S �t.Ir�tJ�t� GbX PLSr .�l�t✓�_ 1 ' n _ - SAN 301003 t By, APPROVE[) -- TN ACCQRDA CE WITH THEXY OR I CUPERTIN� ES AND 0 INANCES DATE SIGNED f Thi, set o plans and "specifications MUST ' be kept on the job at all times and it is un e, + I r' lawful to make any ehahaes or alterations L�dJC� `vl At IA- X534 G 4( on same without writNh permission from _ the building Dept:; WV gf Cupertino. IOC ° Cl I°�—Cj 7 � The stamping of thig plah and specifications 7_ � SHALL NOT be 4r 4 to permit or to be an approval of•tttti Wliltion Of any provisions ant+ taw ^;"4'nance or State Law.