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05010161CITY OF CUPERTINO'.-s� "=! BUILDING DIVISION pglt CONTRACTORINFOR QN BUILDING ADDRESS: NUNES ELECTRIC CORP PERMITND05010161 OWNER'S NAME: a UNITED NATIONAL BANK 104R(; T)OUrT4TF.RTV AVE PERMIT ISSUE DATE I NE: -0 SANITARY N0. CONTROL NO. (408)776-0599 ARCHITECTA NGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description o I hereby affirm Nal I am beamed under provisions of Chapter 9 (commencing P with Senion 7") of Division J of the Business and Profession, Code, and my license is in tort tome am or ea ADD RECET./RELOCATE LITS LDiac¢cns�Class—J��__tr41"4"5-1 ' Conr see��RCCDECLARATION ITETS I undcoomd my plans shall m used as Public records Licensed Professional OWNER BUILDER DECLARATION I hereby affirm Nat I am exempt from the Contractor's License Law far the following nnasm. (Section 7031.5, Business and Pmfasimu Code: Any city As cWmy which rcyuims a Permit In coast.,. alto,, improve, demolish, or repair any structure prior to its issuance, also require the apPlmant for such permit to rile a signed u2monent that he is licensed pursuant to the provisions or the Conloomori License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section 7000) M Division J of the Business and Pr dleari ons Code) to that he is exempt thcmfrom and the basis far the alleged exemption. Any violation of 326fl'NeL[ial*et00 Occupancy Type Section 7031.5 by arty applicant for a permit subjects the ALPHA= to a civil penalty of not marc than fire hundred dollars ($500). 1, As awns, of use pmperty, or my ..play. with wages az their sola compensation, Required Inspections Will do Ne work, and the suuctum is not intended or offered for sale (Sec. ]044, Business and Profcssione Code: The Contractor's License Law docs not apply to an owner of pmperty who builds or improves Neuron, and who work himself or his ncmPloyce,provided are offered t. arcnot intended or such imps in finthe completion, r. h r improvement is sold widid of year of completion, owncry the pr mid within under the builder will have Ne burticn of proving that he did not Wild or improve for purpose of have b pu sale]. ❑ h az owner or , am confessions with licensed contractors U. consumer the i The Connector's a Seen Business mr's not (Sec. ]t U4, Business and Professions / ds or therms, nd cave law docs not applyje ts owner of pmpcdy who builds or improves Neuron, and es who contacts for such projects with a convacmr(s) licensed pursuam to the Convaaofs License Law. ❑ I am exempt under Sec. . B & P C for this rcuon / Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under Penalty of perjury ane of Ne following declarations: I]Dom and will maintain a CeNfiexm of arrasnuo sell-insumfor Worker's Campen- server, as pmvided far by Section 7700 of the Labor Code, for do performance of the work for which this pnrmil is issued. ❑ 1 have and will maintain Worker's Compensation Insurance, az mquimd by Section l]00 of the tabor Code, for Ne performance o! Ne work fnrwhich this yermit is issue]. ' My Workcra Compenstionh lnsunncc carrier and Policy��Miuundam art: [[ Carrier. 7,�—Ai l Policy No.:4 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section tried nal be completed if the permit is Imam hundred dollars ($400) or Less.) 1 ecnify in., in the performancc of the work for which this permit is issued. I shall nut employ any Parson in any manner so a in become subjecuo lM Workers Compcvadon Laws of California. Dam Applicant NOTICE TO APPLICANT: If, after making this Cenificam of Exemption, you should became subject to Ne Worker's Compensation previsions of the tabor Code, you most forthwith comply with such provisions or this Permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1hereby affirm thmthere isac(s agency for the performance of . .innlending thework far which this permit is issuedd(Sec. 709]. Civ. C.) Lendcfs Name Lender's AJdmss I certify that 1 has, read this application and state that fee above information is ' correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby author m midesenatives or this city to enter upon the ahovc-mentioned property for inspection purposes. OA) agree to save, indcmni fy and keep harmless the City a( Cupartma against j Liabilities, judgments, costs and expenses which may in any way accrue against mid City in eansequcnce of the grams all of this Permit. APPLICANT UNDERSTANDS ANP WILL COMPLY WITH ALL NON-POINT Issued by: Date SOU EREGULATIO Re-roofs Type of Roof ignaturc of ApplinHAZARDOUS MATERIALS DISCLOSURE Date Will the applicant or future building occupant store or handle haiarduus material az declined by the Cupertino Municipal Code. Chapter 9.12. and the Health and Safety Castle. All roofs shall be inspected prior to any roofing material being installed. P Y g 0Yeazssgz(a)? ❑Yea �a P g If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which mit haaardous air contaminants m dcrined by the Bay Area Air Quality Management all new materials for inspection. D'svia? � [I Yea L9^/ o 1 have read the haardrmsmamrials¢yuimments under CTapmr6.95 of the Califon nia Health & Safety Codc, Sccdons 25505.25513 and 25574.1 undcmand that KNc la ildmg does not currently have a tenant, that it is my fes ainshility b notify the IXCupant of the rail mcnuw��hlcsmast reptvtp�Uissuance ofaeemBcamorOccupancy. Signature of Applicant Date c`'"'"x`� 9� � All roof coverings to be Class "B" or better r,(/t//+/ I$wner � ser authoriu0 agent omA,m` Dale ..q w lo: wi RVIR I.UOIRV..I tU1V -� JV�tOJJ1 APPROV TMD a ,+�oA�� CUPEF7 col s use oho DATEsntea Thw eet d 39.Y urd cmc MUST be kept on = Pb a' a ares aM a 15 UNOM b make aSY cr"" s or arterRh" on without µInert pem+-NW tom Rw bA*W* tfept., LtiN d cupert:rta The etarr,rr9 d ttwe p1wKd « SHALL NOT be he. b peind ID bo I approval of to videtion of " Poo" a aM CRY asft LaW /Ov N -yam ,zu l� diol Urtr�ed.- Nail Ora� 150n(< N� es •��ec'FPi � Co r j' 776 0,01?9- w� -�..:_ .M6T. NON -ANG WALL -4rorlNG V/AUUT. WALL- - ALL � -- --1 Ch . f++� OW bv� ats-mi(s FOWEIZ- 17S -k/ hrt Of to r� . /7- RECEIVED 2 7 2005 may: OFFICE COSY 6 I�L1.9'tl Wi l4 LL/GCO� lU:Y� RIII�L W.I�IR1LI lUV Y �4J'fb�Jil .. NO. 45B /Ov N -yam ,zu l� diol Urtr�ed.- Nail Ora� 150n(< N� es •��ec'FPi � Co r j' 776 0,01?9- w� -�..:_ .M6T. NON -ANG WALL -4rorlNG V/AUUT. WALL- - ALL � -- --1 Ch . f++� OW bv� ats-mi(s FOWEIZ- 17S -k/ hrt Of to r� . /7- RECEIVED 2 7 2005 may: OFFICE COSY 6 CITY OF CUPERTINO Qem 1 of 1 PERMIT RECEIPT OPERATOR: conniew COPY # : 3 Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 32634074.00 DATE ISSUED.......: 01/27/2005 RECEIPT #......... 28403 REFERENCE ID # ...: 05010161 SITE ADDRESS .....: 10001 N DE ANZA BLVD # 101 SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ...... OWNER ............: UNITED NATIONAL BANK ADDRESS ..........: CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: NUNES ELECTRIC CORPO CONTRACTOR .......: STEPHEN L NUNES LIC # 25416 COMPANY ..........: NUNES ELECTRIC CORP ADDRESS ..........: 10486 DOUGHTERTY AVE CITY/STATE/ZIP ...: MORGAN HILL, CA 95037 TF.T.7PWnM7 (4npA 77r-nc;qq I L J FEE ID UNIT ---------- QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ------------- BPERMFEE VALUATION ---------- 2,000.00 -------------------- 83.16 0.00 -------------------- 83.16 0.00 BREMFIXT NO. FIXTURES 20.00 24.00 0.00 24.00 0.00 BENERGY PERMIT FEE 83.16 39.92 0.00 39.92 0.00 BREMRECEPT NO. OUTLETS 20.00 24.00 0.00 24.00 0.00 EPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 BSEISMICOM VALUATION 2,000.00 0.63 0.00 0.63 0.00 ELECTRIC SQUARE FEET 1,000.00 80.00 0.00 80.00 0.00 TOTAL PERMIT 290.08 0.00 290.08 0.00 MFTHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ CHECK 290.08 ------------------ 15356 TOTAL RECEIPT 290.08 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- 304 ROUGH ELECTRICAL _------- 501 ____-------________--------_ FINAL ELECTRICAL ENERGY 505 FINAL ELECTRICAL 0 I' �,«bp- cFf Tof CUPE(�TINO CITY OF CUPERTINO PERMIT APPLICATION FORM �s--Gl°i6J APN # 320 z D Date: /— ;?7_ O r Bui1�nDAddress: �� Iv,' U /D'Mailing Address (if different from building address): n nZ 2 Owner's Name: fed ( k Phone #: r gildna cc Boiler <= 100,000 Btu Contractor:License BBOILER2 u 0 e c r- MECHANICAL Contacl: . Phone:408 7 Cupertino Business License#: Steve P) Fax: 0 8 / 97 5/ Building Permit Info: ao .0 1 QA -Bldg ❑ Elect Plumb ❑ Mech ❑ Job Description: t-eef, t Residential ElA� �S) 4 I.1 •Ars (ReIeoaf Commercial GP-` Sq.Ft. Floor Area: f _ $/Sq.Ft.: Cost of Project: e` Occupancy Group: Type of Construction: Please check this box if the project is a Ind/Off/Comm/Quasi second -story addition: ❑ Project Size: Standard ❑ Large ❑ Major ❑ Con. Tax for BQ Zone Quantit • Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOTLER3 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 > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 9P3 ;� aq 0. 1 i CITY OF CUPERTINO CITY OF CUPERTIN S PERMIT APPLICATION FORM Quantity Fee 1D Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g 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 rinklerBackflo 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 Z BREMFLYT _ Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > 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 ,20 BREMRECEPT Rept], Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 SEA- CITY OF CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM • 3 of 3 Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmd] Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL 13REMTHEATR Theatrical Lighting Fix ELECTRICAL% BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISAIICOM 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 Mechanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fees foot PLUMBING ZADDCHG Address Change BUILDING • 3 of 3