00100152 CITYOF,CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION <"s - -
BUILDINGADDRES3: "' - " PERNITI NO.
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.OWNER'S PWi1® + • APPLICATION SUMDA r
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❑ONE: SANITARY NO. - CONTROL NO.
ARCHITECr/ENGINEEk: - 'x-�' BUILDING PERMIT INFO
BLDG ELECT "PLUMB 'MECH
m?y -
Lrmthat UCONTRA(;dk5U[ena ol'ClON
I ne ebr mrnn that 1 ma licensed I p � �ar cl npter v man,n,enemg . � - ,Job,Descriptio_n '
G�CIy 'wllh Section]lldll)o[Dlvisian3ofine Business and lProfessians Codc,und my license s
at sifa laic tall cl alse at`CV C 5( 'Lax '/ o l FMf' POWER: POLE ,
3 Dat it e c Canv tnor ,
ARCH I'1 OI S DECLARATION
� `- - -
��°, I understand my plans shill be used a,public recoms.Aewtrd$bI4S
r
s, O O LirensW PrnR;cvionul _ t
o OWNER BUILDER DECLARATION. e
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roll 1 h by II 1 I x pl f the C I'a lthe 6 a �II o n903158 an vndP fCWe A Iy ca e `
CYC which e b y mal col l ah p d de '
fh, p I Y i sc
3p3q psi t I el spe 1 1 p
or ' tl hpII
molllicensedp II tl pkin [ah tma LicenseL& CII 9I
Sq
Ft. Floor Area ,.
SectionVAllatlOH(eommemDivisiona the Business aP desoursCode)
thin Isesemptmand anrad the basis f 11heaII gd xompuoAny .
minums
o[S { 90315hy y
qr toaremanrven ta '' bie ' APN-Number- Occuppecywill ,
❑Ion, In,
ork.andthe is
intended
on offered
no locomr,.'7pv,' -
Bus d th 6 d Ila 'tut I t 1 d If d f fS ]oan -
Bu d l f i Code:Th .. nl 'I I 1 d apply a n t " egHlred Inspections
' owner ofp p ,y Whobail. p lomcon,and who dicie,melf workhimself
'
nr lh gh h'. .ply p ddd t. l ' p I is d l- _
• If drrtale.If.ha thebuilding -improvements la inn yearf < 3VJ4 ROUGH -ELECTRICAL
umplel on,the aw ter h I I will have m burden f proving that he did not build or.
`mprovemrpurpexeor.ale,). 50J. — 'FINAL ELECTRICAL Elsi
❑1,1owner.1 hepmpem.air esda,ivelycompacting wiollicensed eotdmchn . - `545 — -FINAL.�ELECTR GAL "
comar,the project,(Sce,9044 Business d Porfessim.,Coale:)The C t actor, - _ "
mcast,Law chs,, ppl,on con.acrof,.perly whit,hand,,,, , :,hereof "
Cdl b ll' t fL h P 1 s:with t caps) ed p um m the
Ell ps oder S E&P C f this reason
Owner bac
'
WORKER'S COMt I NSA910N DECLARATION '
1 he by affirof under p ally. f perjuly one ofeh fill Ig d dnraumt
/�- - - - ' 0.
7 1 heve and will maintain a CcIR,re f&p,crl in mll mare fnr Woder,
bnapensnlion. as provided for by Seelian 3100 of te h [,;,hot Code, far the
pe"rrormance oflhe work For which this penult is issued'
❑shave and will aminluln Worker',Cuaa,ca itiI,a Insumnw,u,reyuired'by Section
3900 of the Labor Code,I,), he perfunnnnce of the work for wbieh this pnmil is -
'is,avd.MyW ker',C P :fan insurance carrier and policy b ?
Carr er'. PorcY No. S �: are
I CETIFICATIO FEXF,MPI'IONFROMWORKERS' - a -
COMPENSAI'IONINSURANCL. _
(This secdan need not be emnpleted if the pemnif is for one hundmA Jnllum
($100)or len.) -
� r
linty that in thepe,!fImmaarcofth work on, ch III,pcill` issued1
chola t ,soy avyp : y nn .rs:t because,abi to Ola Workers
Compensation Lowsof Cnifnmim Dale < '
Applicant. - -
NOTICETOAPPLICANT11,after mukiug mis Ce[tl0catenf 8xemption:Yon should
beton esub)ettm meA4 k :C p t p n. of the Labor Cade yonmast
I'mhvflh comply with Inch ptvvisinall er tl a,pemft-,hull be deemed mvakw: .
,^nom CONSTRUCTION LENDING AGENCY `
I limcby'am,'him fiisa-Inarrammin lending agency for the perfonneme is - -
W,r of th A f ti h m i,c oma iv ,sued IS 309] C v C)
Q Leme N
.0 z Lei I Address
O
Icgreetocom rehall city
a Ivd Ol mesh h f 's r - _ t• ,
QC) to t 1 y t ply dlabyinah p ordinances dslate tyt ling
'V to Id g ruined and M1 forinsulho p ,coni ves Itl(s eltymenler upon _ -
G: The ab n i d property Indemnify I p P : •^ x
Q r (M') gr I .. fIc,c Ikeep I I..the angCityway
fCmrt said - ' v .a, . -
r Vi Cit In e. J J& l' e 1 p s F b naY in.mY Y'' g Inns 1 „
V � City segs engin of m gmnung of Ihispe m I '
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT, Issued by:
-=JDate
SOU L REGULAT ONSy: D 3-6n
m2 e... Jhnwll Date
signmure of AP0lic
HAZARDOUS
- I Re-roofs
HAZARDOUS MArCR1ALS, Rw ciSIIRF _
wnmeeCeemnrfmarii,Id age,Chan,tareon glen :lt dicier1 Type of Roof
a,del rcdby the Cupen'nn Muncpnl Crdc Chapmr 9.12 and the Health and Safny "
Code'Stanton 2553Mn)P -
°Ve ElNo ' - - - - All roofs shall be inspected prior to'any roofing mat eriahbeing Installed.
Wil the a t or rulers building oec,cal n,e e,mpmsm or devices wbieh If a roof is installed without first obtaining an inspection, I agree to remove
emi
mit haeuNnue air conlnimum,as defrod by dao Bay Area Y,Quality Managcmeni _
oiariI " all new materials for inspection. Applicant understands and will comply with
❑Yes' ❑No - - -
all n'on-point source regulations. '
flame ae td sheInced nn -'l 4 his wW Ch'pt 695 aof,lhe�
Cal fnmaHealsh&Svl ty Codc;Senioa,255116255J3 and 255i4.l utdmsmnd that -[if1hebadldingdoesnotcm.endy hnvev icamit clam it is my responuibilitymnolify she. -
occupant of thc'rnryiremem,which nmst ba mea prior to issuance of a Cenidinle of - '- "
O
,a's,
. v n
(j
Signature of Applicant, Date,
own raranmora ageae ,. All roof coverings to be Class'"B" or better'
OFFICE:
CITY OF CUPERTINO
Item 2 of 2 BUILDING PERMIT RECEIPT OPERATOR: karenb
. COPY a 1
Sec: Twp: Rng: Sub: Elk: Lot:36217002.00
DATE ISSUED. . . . . . . : 10/23/2000 -
RECEIPT q. . . . . . . . . : 13804
REFERENCE ID # . . . : 00100152
SITE ADDRESS . . . . .: 9800 CREERLINE DRIVE
SUBDIVISION .......
CITY . . . . .........: CUPERTINO -
IMPACT AREA .......
OWNER ............: L&D
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
RECEIVED FROM .. ..: ALAN
CONTRACTOR .. . . ... : LIC N 21563 _
COMPANY . . . . . . . .. . : ACME & SONS,SANITATION/ELECTRI
ADDRESS . . . . . . . . . . : 1880 S. 7TH ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . :' (408)275-2263
FEE IO UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW HAL
__________ _____________ __________ __________ __________ __________ __________
EPERMITFEE FLAT RATE 1.00 35.52 0.00 35.52 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 35.52 0.00 35.52 0.00
1 OF PAYMENT AMOUNT NUMBER
40---_ ---
CHECK 71.04 37318
TOTAL RECEIPT 71.04
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
z
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL