04020081 (3) CITY OF CUPERTINO
BUILDING DIVISION PERM A + Ol[2�.C1�()Yti' ORtAI BUILDING ADDRESS; ARGONAUT WINDOW & DOOR 1E11IT"°04020081
76-30 WATERFORD ET?
OWNER'S NAME: PERMITL'SUEDATE
DAN & LIL
ONE: SANITARY NO. CONTROL NO.
(408) 996-9670 1
ARCHITECT/13NOINE!ER
08 996-
ARCHITECf/ENGINEER: BUILDING PERMIT INFO
BLD° ELECT PLUMB MECH
p
aIOO LICENSED CONTRACTOR'S DECLARATION Job Description
I hereby affirm that I am Rcemed under previsions of Chapter 9(commencing
�m wIN Section 7").lDiA.ion30f%c Business and Professions Code,and my license is
in full fom.and.ffect. REPLACE WINDOWS
j � LicenseClass Lie.p
rap Dan_Connector
ARCHITECT'S DECLARATION
1 undersand my plans shall W used as public records tial
j:d Licensed Professional
OWNER-BUILDER DECLARATIONurate
I hereby affirm Nal 11. exempt from Ne Cnntas Cc :Any c Lew fordo /
00 following reason. FBL3,Business and Professions Cod.:Any city or county
which mqulms a Permit to eonswm,alter,improve,demolish,or repair any structure
FZ,t< poor to its issuanm,also requires the applicant forsuch permit to file asigde .munnum
g3ththatWisliccnsadpursutnto1WProvisimuoftheContractor'sLianselaw(Chapn,9 Sq.Ft.Floor Area Valuanon
g (commencing with Section7dp)of Division 3 of the Business and Professions Code)ur
y 9 that he is exempt Macaroon and Ne hada for the alleged redemption.Any violation of
Section 7031.5 by any applicant for a permit subjects thc applicant to a civil penalty of 3 Ci�NH'Qu erO 0 Occupancy Type
oat mart Nan ftw hundred dollen($500).
❑I.as owner of the property,or my cnploycns wish wages m their sole compensation,
will do the work,and the structure is not brocaded or offered for sale(See.7044,Business
and Professions Cad.:The communes Licenn Law does and apply to an owner of Required Inspections
a property who builds or Improves lhereon,and whodoes such work himself at thmugh his
own employcns,provided mal such improvements am not intended ora@red forale.If,
however,the building or improvement is sold within one year of completion,the owner.
builder will have me burden of proving that he did not Wild or Improve for purpose of
sale.).
1.as owner of the property,am exclusively contracting with licensed contncmn to
mtru ,do,project(Sec,7044,auction.and Professions Cade:)The Contractor's Lt.
cause law does not apply in an owner of progeny who Wilds or improvm thereo,and,
who contracts for such projects with aconwnar(s)licensed pursuant to the Contractors
License Law.
❑Isee em y L Our Sea ,B&P_C for this reason
WORKER'S COM AT10N DECLARA0 a. Te _�oT '
1 hereby affirm under intensity of perjury ane of the followNogCatiom:
1 have and will maintain a Genetical.ofcme em m self-insure for Worker's Coupon.
sedan.an provided for by Section 3700 of dm labor Code,for the performance of dm
work for which this permit is issued.
❑1 have and will maintain Worker's Compensation Insurame.as required by Section
3700 of the Labor Code.for the performance of the work for which this permit is handed,
My Worker's Compensation Insurance artier and Policy number am:
Cartier. Polity No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
('Bels semlon used not W completed if the permit In foram hundred doll.ISI W)
Sr lrssJ
I c.nify that in the performance of the work for which this permit is Issued.I shall not
employ any person in any manner an as to become subject u the Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPL3CANP.If,afwr making this Cenifiatc of.Exemption,you should
become subject to the Worker's Compensation previsions of the Labor Code,you meat
7�O forthwith comply with such provisions or this permit shall W deemed;coked.
a ti CONSTRUCTION LENDING AGENCY
[—c thereby affirm Nat Nem is a construction lending agency for the Performance of
Ci r�-t the work for which this permit is issued(Sec,309'i,Civ.C.)
aQ Lenders Name
iti. z Lenders Address
(.)Q I ttnlry that I bow mad We application and state that the aWw informationis
0 banding I.gra n comply with all city and county ordinances and sate laws relatingng m
lr.'J abowngconswdiroentl henbyauNorimnoses. Civet of this city to enter spun Nc ,
W shove-(We)age Properly forimnify an keep es.
gy (Wc)egret Io saw,indemnify and keep harmless Un City of Cupertino against
t..t`,i liabilities,judgmenu,costs and expenses which may In my way acrnn against said City VT
in
of the greasing of
C)^
APPL
ICANT eUNDERSTANDS AND.WILL COMPLY WITH ALL NON-POINT Issued by: Date
E E REGULATIONS.
V Re-roofs
room
ofApplican Co cur Ditto
room 0
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding omupanl Ston or handle haardaus material
ex defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety
Code.Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes .
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
0 haalloua air contaminants m defined by Ne Bay Arca Air Quality Management all new materials for Inspection.
District?
❑Yes M1HNo
I have read the ha andoesess____mamrials nqum.crosm dc,Chapnr6.9S.fdo Califor-
dexatntcdrSntlyho aSecants25505,25533end25534.1 to rail teach cure of the dors not currently haw a u:nend that it is my responsibility co notify the acupant of Ne
rdquitemcn wlchmastbeme(Prim,nim.anb..(.CcnigcateafOcapanay Signature of Applicant Date
a 6� All roof coverings to be Class"B"or better
Ownc rm1'Smiacd agcot 0
CITY CITY OF CUPERTINC*
CITY OF PERMIT APPLICATION FORM
f�TINO
CUPE
APN# Date
r b :� G v
Building Address:
E2
Owner's Name: Phone#:
D AO L L/ L -E/�lE 40 - 20
Contractor: License#:
R6ONHU 604 rod '- 72. 5
Contact: ��11 '' Cupertino Business License#:
� VtRil.// �� vR �, S 'foSG83-oS-92
Building-Permit Info:
o .
Bld Elect ❑ Plumb ❑ Mech ❑
Job -esc ption: fep(ace e_ xr:s7 w,-:-doc� S
ResidentialeLA� "in cTo r Commercial ❑
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of project: r 70 Occupancy Group: .—
Type of Constructio
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot 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> 1.75M 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 > IOOOA ELECTRICAL 00 Elec Svcs 600V<=200A ELECTRICAL
GY Ener BUILDING
EBEBNERGYADD EnergyAdd Multi BUILDING
Investi ation fee BUILDING
ATC Comm. Housin Mit. Fee BUILDING
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( - *CITY OF CUPERTINCS
CUP TYOF O PERMIT APPLICATION FORM
QuantityFee ID Fee Description Fee Group
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL
BNEWMULTI Multifamily Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BNUMULTI New Multifamily Res 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 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 Heater/Vent 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 Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Fumace> 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
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IRCITY OF CUPERTINO*
CUP TY OF O PERMIT APPLICATION FORM
QuantityFee ID Fee Description Fee Group
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 Sips, 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
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issuance PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
BMISCELL Building Mise Fees BUILDING
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IN ACCORDA nE WITH THE CITY I '
G1IEERTINO C11SMrV
DATE,_„ _ „l_ 4- GARAGE
SIGNED—
This
IGNED _This set of Ian am specifications ii us
be kept on the at all times and it is u, \
Ige,L -fA£iS ny chal'ONOsitR'OOM / Ci
on same with( : writtenrr;11-;1r f— e�rtsr
the building De t, City of AT11'J. dt• ' ` `� D
ThIII'.
mping c this plan and speeii(ra ion, /s—
�sh NOT be ^" Hermit nr tobeapal of the violation of a r�orjrxo'City Ordinance or State