00110145OF
CITY GDIVONILLD
CONTRACTOR INFORMATION:
Iti PERMIT
PD I LOT NG ADDRESS,
I'ERMI'r NO.
ANEV AU
Al I EN ,'rAYly
4143110145
ow£M i'S NAME: -
APPLICA'T'ION SUB DATE
11/30/2000
azµSTONE_STONEAI,IE
IONI?. -
SANITARY NO. CONI SOL NO.
ARCI II'I'F.0 UF.NGINEEIR
BUILDING PEItMI'I' INhU
NLDO [71.17 T PLUMEp1ECH
L_I I__I I_I LI
IJCENSED CON9'RACIOR'S DECLARATION
Job Description
Hereby ollI IN flat I la Iicelviced Honerrplovi bloat Chapter 9 (cummenaiag
will Sermon II1fN11 of Dlvisicn}ndNCllunin,,,l IVlq(y� Ju t.
alo9yS:c� ,cel
-'in VIII Inrec .utlda .Y S
nre clan. l ,� Lic.Ny
�_
INSTALL ONE SET OF CHANNEL LETTER SIGN
Dale _ _'1 Cantlaeher
G/ ARCMrLCrS DECLARAT ION
I undel'.Tnnd ay plans droll he u.d to rabbit recon.
Lionod F ... i,,ianal
OWNER -BUILDER IN CLARAI'ION
I hereby Winn tha 1 as cxmopt fnnn if,,, Cralnmltr, I.icca,c Law for the
INllowing.uton. lSwian 9031,5. 19rctne,.. Im I Pmfe..on. Code: Any city m county
MITI C tpernllto o lmcT. Ifter, i lnpm ,dolali,h, p
oal iry a5l Pecarc
pian, n, itGswFace, viva cattle, the applionl fnsucl' per nil file a signed ,aaca
a
Sq. Ft. Floor Area
Valuation
OWlTel,fiat.edpu:.amliie
all to mecoelrnr,nr. uceno, Law(Chapter 9
(,Iwish See
rmon 9001) l Division 3 of the it. Pal Prole ., Code)
,.Ilia,ing he lr exen.,1 Ommf l) Ind the Nn.i. bur the alleged oxmnprl n. Any wiolada i
ill, —a -Ali
of ScuGun 913 L5 by vny .gq,lmunl fora Pa'm11 xulgmts Ilia upplcwu to o civil pcnT.lry
et INatalie flanlive hun(tied d.la,($500).
A13NNumber
Occupancy Type
13 1, nCthe p,opwy III ay elnpluytt will. .vag-othe,,olc tao,,,n,; 1,.
will do he work, and the.Imaure i, not animated ,),. Berea Il.. eWc..Sec. 9Md,
BONIN... and Poce,.l,)n, Coale: The Co.aoa,lor:, Liacn.e Law dee. Ilot apply To an
~J - •� -
Required Inspections
"open, Who hailde a mPrn c. theroon, tad who dot Ouch wad hooted
;,of
IF...ogh I , tellemployee,. Fa„ided that ,Lell mato v lFPI-Lm act ietended rte
1 t�:1 '— FOUNDATION
0
ullervd ler,aTlc IL how r, doe Nodding a cpm ere k sold wi0en one ye. nr
�hualiN
imn.phe. I.Iben "hnuder w.0 hme 11'. ho aglbnlI Il hni1do,
for
1. 1..11'ER
prov. Paprn of .ahel.
Yl,i
104 — REHAR
01.,1, owner of pro,ioil ... holoehy Cantrowdoel Will ncet.d coonaaa., it)
t the pa,,iecl (see 7044. ltv, . and Pmle,sln.I, Cocc) T at C.......
ilec a eof,,,)party
j 1,75 — ANCH1�I'd HOLTS
Law doe an apply m all a who bulli, or i.npa,vc thereon,
nnd'who eolaawl, To, .neh ,Yglm�T will a eanbmclor(s) licen,cd pnnannt to the
.!;414' ROUGH ELECTRICAL
CoWritelar s License Law.
❑ l al.. exlapt I]No Sec. ,[I& P C Ice l],I, mu.m.
505 — FINAL ELECTRICAL
Owner Dat,
514 — FINIAL PUBLIC WORKS
WORKER'S COMPENSATION Il17CIARAl'ION
I achy afrmll old penahr of perinryaae 01 the fnlltea, dutlamtonv,
V /^1
GUN A LEM
e d will mainain n Certfi of Cttwm m .ell-In.wdct
�1 haw:ro Fee for Wos
Ceeplo len, T. pmaded 1'ur by Section 3900 of the Labor Code, for the
p1ra-leneenflln wad l'or which thispcmdl0...td.
OCT 0 9 2001
❑II rlln.i lyckef'Cml 't as a.- 1' dbySceiinn
i7
9911(1 f Th I li II , a fol 1, q yT� . Pit h,
lou"L My m ri�'rtl 1't S✓iY
s
la�^�qq..��..('�
BUIL®gN
Curncc Policy Nc.IN�
CEIYI'114CACOMPEN
ATIO INSURANF�-O.�MYKI?RS'
COMPENSATION INSURANCE
Tri 1, .cetiun n,cd nal bcunndiced if the pet'miI i, f,)nat headed dollar,
J�
($10(11.111x.)
U
1'Nadl y 111,11 in the I'll TO of the wol'k NaI' which this )..roil 11 "all).
,hall ao enadoy any p y ON ION h)t ill the Worker.
Cot 1 I La,O ofCII Date
Apl 1
NO TOAPII APPLICANT II II - ' ll YI 'Ind1. yna.hould
ha II t tl l It
k C ol n,al P n,afll I '1 Code, y[ n..1
ali
l
fall w lh co nply w'Ili ., d p .virion, nr thl. Prrmlt.,11oll be deetneJ revoked.
CONS 'I'RUC HON LENDING AGENCY
I herehy alfirai IoW Ilat a ota. ....lending lgcncy Innh, pedom.ancc
A the work lin which Thi, per alt i, olued (Set. 3097, Civ. C.)
1_cader. Nmne
ender'. Addm,.
1let' 1, Ila I lave lead 11.11 rygilicolinu un"al .11uc Ihn. I hcahove infortnolion TO
an
nt. I Cote to comply wish Ill city clod evenly orilne, laed nae laws m talft
o naddiegeon.mmtoe. and hereby anlhurioc relaeseaali .sol dacity to eller trial
the.dmve-llealiond properly Or inrpmren pulpa
1 Wel rice Ia,ave iodea lily and keep lar Jc.s the City of Caperton egainl
Habil ilio,...tlgn.ene,, enols and cxpcn,v, wlEel may In :my wuy uccruc ngainrl miA
Cny in ttm,taum Cie alba gaoling of Ildx )total.
AT LICA I UNI ASTAND.' AND WILL COMPLY WITH LL N -POINT
/ 1/J
/� _
SOU t , 11 T NS. — Y3t7�"�
Issued by: Datt
Re -roofs
Slgnas ph Oaf ,)ntraetar Dane
Vat/
AItDODS MATILRIAI.S UISCLOSURIT
Wil(lie app1.I,,"ILot mbrdhdiny«IIIb,.nl,loe.rhnadmhamm.uxaatedal
Type of' Root'
o dtlind by the Ctpenino Municipal Colo. Chapin 1) 12, and 0.e Headh and SaLly
Code Section 25532110?
ElY" El No
All roofs shall be inspected prior to any roofing material being installed.
Will FIC ap,dCaatornanebraragteel.panl all eati1"Fea n1 de, Ill, whin.
11'a roof is installed without first obtaining an inspection, I agree to remove
mhhamlooll Ill coceltal nB lin ddinul by the Wy, Area Air QIOIll, lMwganem
all new materials for inspection. Applicant understands and will comply with
V"°`loYF, FJ No
allnon-point source regulations.
I htrve rola the Iazmduu. .uulenad. I..... call undo, Chaplet 695 of the
CaliO,miu Ilc,iIl &Solely Gale, Seaians 255115, 25533 and 25534. 1 undnstund let
If.hc building do" nut nw"Fl, h Pe o anon.. ILa it i, at, cspan.i ladity m nullfy the
ccnpam the r . hmh cwt hu .nut prior m na.. cc 1 n CeniOwle nl'
ncactl W
nevi°T
I13o
.Dale
Signature of Applicant Date
All roof coverings to be Class rB" or better
Dwoce nr cat No„A I
V / OFFICE
CITY OF CUPERTINO
It 1 of 1 BUILDING PERMIT RECEIPT OPERATOR: nancyc
COPY # : 2
Sec: Twp: Rug: Sub: Blk: Lot:36934001.00
DATE ISSUED.......: 11/30/2000
RECEIPT #.........: 14144
REFERENCE ID (( ...: 00110145
SITE ADDRESS .. — 10709 S BLANEY AV
SUBDIVISION ......:
CITY .............: CUPERTINO
IMPACT AREA .......
OWNER ............: INSTRINSIC VENTURES INC
ADDRESS ..........:
CITY/STATE/ZIP ...: MENLO PARK CA, CA 94025
TOTAL RECEIPT : 57.72
VOICE ID DESCRIPTION
101 FOUNDATION
104 RESAR
304 ROUGH ELECTRICAL
514 FINAL PUBLIC WORKS
VOICE ID DESCRIPTION
103 LIFER
105 ANCHOR BOLTS
505 FINAL ELECTRICAL
RECEIVED FROM ....:
TIM 0
CONTRACTOR .......:
ALLEN LIN LSC # 22174
COMPANY ..........:
ALLEN SIGNS
ADDRESS ..........:
1982 STONE AVE
CITY/STATE/ZIP ...:
SAN JOSE, CA 95129
TELEPHONE ........:
(408)280-6500
FEE IO
UNIT QUANTITY
AMOUNT PD -TO -DT
THIS RED
NEW HAL
----------
FREMSIGNE
------------- ----------
NO SIGNS/MARQ 1.00
---------- ---------- --------------------
22.20 0.00
22.20
0.00
EPERMITFEE
FLAT RATE 1.00
35.52 0.00
35.52
0.00
'I BERMIT
---------- ---------- ----------
57.72 0.00
57.72
----------
0.00
METHOD OF
PAYMENT AMOUNT
NUMBER
-----------------
OTHER
------------
57.72
------------------
VISA
TOTAL RECEIPT : 57.72
VOICE ID DESCRIPTION
101 FOUNDATION
104 RESAR
304 ROUGH ELECTRICAL
514 FINAL PUBLIC WORKS
VOICE ID DESCRIPTION
103 LIFER
105 ANCHOR BOLTS
505 FINAL ELECTRICAL