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02030073�1 — CITY OF CUPERTINO BUILDING DIVISION PERMIT ,,CONTRACTOR INFORMATI r h, e:i•V' r BUILDING ADDRESS: PERMIT NO. 10200 S DE ANZA BLVD HOWARD WRIGHT CONSTRUCT ON CO. 02030073 OWNER'S NAME: APPLICATION SUB DATE PORTAL SOFTWARE PIER 9, THE EMBARCADERO 03/14/2002 HONE: (206)447-7672 SANITARY NO. CONTROL NO. ZO ARCHITECDENGINEER: _ BUILDING PERMIT INFO BLDG ELECT PLUMB MECH -t I'-1 L-) L_J i LICENSED CONTRACTOR'S DECLARATION I hereby of! lost f am licensed under provisions of Chapter 9lcommencing Job Description p w ihSeed.7001ofDivision 3ofthegvliness°rWProfession, Code,and mylicense is in fop force TENANT IMPROVEMENT -ADD ONE WALL end eR r !'-, b Litt l Lia M b J ➢ate C n ter n O _EARA ON A rstatd 1v</ my arts shall blit raards �gaaxITELTS^B Licensed Professional OM k DECLARATION :n I hereby dirm Nm 1 me exempt from the Contractor's License Law Radar VV < following reason. (Section 7031.5, Business and Professions Code: Any city or county o vthich $3500 requires a permit to consumer, alcor, improve, demolish, or repair any structure prior to us issuance, also requims the applic°nrfar such Permit to file a signed statement. .that be is licensed punuav( to the provisions of the Contractors License Law (Chapter 9 (commedcin8 with Senian7000)of Division 3 oft he Business ins Professions Code) i :'3 �ltj_} ',[IU Va1LLBhOR or or that he is exempt tberefrom and the basis for lie alleged exemption. Any violation .of Section 7031.5 by any applicanttfor a permit subjects the applicant m a civil prosily of not more than rive hundred dollars(S500). 1 a�LV 10l1`N N�N`T} rrDATION •' Occupancy Type ❑I, as moss, of the property. tar my employs. with wages me their sole eomparatice. _ will do the work, and Ne atmnuR'is not intended or offered for tele (See. 0094, 103 - UFER Required Inspections Business and Professions Code: The Contractor's License Low does not apply to an ..all of property Who builds or impro eta thereon, and who does such work himself or through his own employees, provided that such improvements am not intended or 104 - RE BAR offered for sole.'Ir, however; the building or irr,rai mens Is sold 'within one year of completion, the owneo-builder will have the burden of proving that he did not build or 105 - ANCHOR BOLTS ' improverorparposeofa°le.). 106 - SEWER & WATER Q,4 .1 owner of the ponpeuy am exeiasivdy ton,.ting with licensed concrete ran, 202 — UNDERFLOOR PLUMBING""' ' construer the project (Sec. ?044, Business and Professions Cade:) The Contractor's License. Law does not apply to an owver of property who Wilds or improv.thereon 203 - UNDERFLOOR MECHANICAL: . md.who comets for,such projects with a eontmmar(s) licensed. pursuant to Ne. ContmnaraucenseLaw. , 204' _'UNDERFLOOR, FRAME ..__.... . ..... .... . . Cleme.emptunderSee. - ,,B&PCforth..sarm 205 - UNDERFLOOR INSULATION ` owner' Data WORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING 302 - TUB & OR SHOWER I hereby aRnn under penalty 303 - ROUGH MECHANICAL I have and will maiein a Cenificvm of Connor to self -insure for Workeh of Cosentteoollowingdee for Compensation, a provided[orforfar by Section 1900 of the labor Code, for the 3 04 - ROUGH ELECTRICAL Performance arms work for which mire permit is issuer. 3 05 — FRAME 01 neve and will'maintain worker's compensation Insurance. 19 required by section 3 0 6 - HOLDOWNS 3700 of the Labor Code. for the performance of the work for which his permit is issued. Mr Worker's Compensation Insurance canter and Policy number are: 307 - INSULATION c.rt;e,' ..FaficyNa.: L�+lg2JA.. ... - 308',-.SHEETROCK= - - ......, .... .. .. IPICAnON OFEKENIMON FROµ WORKERS' ' 309 ^-'"'EXTERIOR LATH COMPENSATIONINSURANCE _.... _.....310, ;- INTERIOR'L'ATH"" (Thiaaecfiannewndbeaompinedihhrpermhiafor one hundm4donan (6100) or less.) 311 - SCRATCH COAT ' . 1 on9fy that in the performance of �tia work for which this pemut is usued,1 313 - ROOF -NAIL shall red employ any person in any manna so as to become subject to he Workers- Compensation501 Compensation Laws of California. Due — FINAL ELECTRICAL ENERGY Apph.nt 1 NOTICE TO APPLICA,YT: If, after making this Cenifi.m of Exemption, you should 502 - FINAL PLUMBING ENERGY become subject to the Workers Compemation provisions of the Labor Code, you must 503 - FINAL MECHANICAL ENERGY forthwith comply with such provisions or this pnrnit shell be deemed revoked. 504 - FINAL BUILDING ENERGY CONSTRUCTION LENDING AGENCY . : 16crtby .Ifirm that then is s consw,lbm lending dgcncy for the perfolmance 505 - FINAL ELECTRICAL of he work for which this permit Is issued (Sec. 3097, Civ, C.)' 506 - GAS TEST Lnder'a Ndme Lender i Address 507 - FINAL PLUMBING I Certify that l have mad this application and state that the above information is 508 — FINAL MECHANICAL comet 1 agree to comply with all city and county ordinances and state laws salting m to building construction, and hereby Wtheriae representatives of this city to cnmr upon 5 0 9 - FINAL GRADE the move -mentioned property for inspection purposes. SIO - FINAL PLANNING - (We) agree to save, indemnify and keep harmless the City of Cupertino against ^ t liabilities. judgments, costs and expenses which may in any way acme against card 514 - F INA PU IC WORKS City in consequence of the granting of this permit. APPLICkNT UNDERSTANDS WILL COMPLY WITH AL{{f///NNNON 111 SOURCE REGU TION q /`'� Issued by: Date 1, /ate Stgnawrc of AppltenJCo J . Re -roofs / HAZARDOUS MATERIALS DISCLOSU ' wll the applicant or future building occupant store or hmNe hvudws mstrsinl Type of Roof . m defined by the Cupertino Municipal Code, Chapter 9.12. and he Health and Safety ' Code. Section 255321.1? • s , Dyt6 'and, a' All.roofs shall be inspected prior to any roofing material being installed. _ Willtheapplicant orlamm building occupant am equipment err device, which emit hoaardo. air contaminants m defined by the Bay Arta Air Quality Management If a roof is installed without first obtaining an inspection, I agree to remove rict? Oycx aft all new materials for inspection. Applicant understands and will comply with .' all non -point source regulations. 1 have mad the ha4ardous materials requirements under Chapter 6.95 of he Califomis Health & Safety Code. Serum, 25505, 25533 and 25534. 1 understand that . if the building docs netcurrently have uenant. that it is my responsibility to notify the occupant of the mquiremenn whit at be met prior t�is.xii(e�, ni0cam of Occupancy. // Signature of Applicant Date All roof coverings to be Class "B" or,better o nerprauthona--? Data .. OFFICE CI OF SIIONNOPERMIT BUILDI C DIIVIS CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO, 10200 S DE ANZA BLVD HOWARD WRIGHT CONSTRUCTION CO. 02030073 WNER'S NAME: APPLICATION SUB DATE ORTAL SOFTWARE PIER 9, THE EMBARCADERO 03/14/2002 SANITARY NO. CONTROL NO. HONE: (206)447-7672 ARCHI=tENGINEER:. .. ... - BUILDING PERMIT INFO BLDG ELECT PLUMB MECII LJ CJ I__j L__I LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing Job Descri IIDn p c RithSecdon]BOB)ofDivi.mn3nnnma,sindPacifeaion,Code .andmyh«nse TENANT IMPROVEMENT -ADD ONE WALL ful1l force and elf 1. LiccnkJC_ L a nam ar_ ITECI" CuARAT0N 9`as g' n mm�d m .,.hall Nie records rLicensed Pm4onal ,si ' O\1 'r f, DECLARATION �QOry "1 I 1 hereby .(hest thin 1 evempt from the Qmtm, Low fnr the LiAny 1. Coo s following massa, (Semon ]03 L5 Business end improve, da o li Coils: Any city or county ] which requires a men alms improve, demolish, ri repair any mrecmn $3500 e. also pnsnou also req a the applicant for such Permit mrile asigned! statement the 1L'p1NG he tlpnuan t - of the Commcmrs Lcen¢Lawons [�y�I(� q�r,� ��Z Valuation co (commencing Irommac g as thSeao ]0t )of Code) Bllod ( h °y S-;3 U} ,,,'tUV s•4. •. '�� or that h theDivision'rafihc mardmri An, rotation li and the bass fns the tl exemption. Any vin zany n 7031.5eaab subjects -"nf Section ]031.5 by any applicant for a pcmnit mbjttrt the applicant to a civil Penalty int th natty .of nor man Than me handled dollars (Map. 10 �pN ")�TbFDAT I ON i•" Occupancy Type 01, as Owner ofthc Is peny,ormy anployees wi th wagcsas thairsole compensation. _ PTFiRq will do the work, and the structure is not intended or offered for sale (Sec. 'l06a, - Susinesz and Proressiuns Code. The Contractor's License Law dce.s not apply m an 10 3 - UFER Required Inspections' icaner or property who builds or improves thereon• and who does such work himself t through ms own employee,. provided thin such improvements are not intended ar 104 - REBAR offe- compile for isle If. how - t0 building., eb top y ssW within one year of � completion, the uwn<r bu lderwll have the burden ofpmv ng that he did not build or �� -" '- " 1 0 O " O - -.. _.... ..._.....__ - _... . 105 — ANCHOR BOLTS improve far purpose of tole.). 106 - SEWER & WATER _... ...... _. _...._.o -Ol,ae,thas, a.mOTheComamsto __._.._ 202 — "UNDERFLOOR PLUMBING "i:': -- " rjecp(Seertya4,Busiessaconracssionsliracmed License the project (Sec. ]04f, Business and Professions who b Code:) The ves trxmr's uLvvImlwdoes an thereon, .• -' 203 — UNDERFLOOR MECHANICAL'' _and.wM10 contracts (slouch pmjcax with.a camnctorts) liccnud. pursuant m one. ricasfapuchpmjctswthacormwems)Bmaeimprapanttome m .. 2 04 _ UNDERFLOOR FRAME- 0, exemptunderSee , ❑Iamaaempranderstt1.. ,B&Pcro1.rtmsnanoa 205 — UNDERFLOORS INSULATION ' Own``" ' Dole ' 301 — ROUGH PLUMBING WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER I hereby af,. order pclanr Of pcpmy a no Of. the following decrosti... 303 - ROUGH MECHANICAL C 1 nava and will mamted n cby Sem Of Coolant7Woto snr-ineare for Worker's Comps,ormmtioo one pravidad lar by Section J]00 0( the Labor code. for the 3 04 — ROUGH ELECTRICAL pertmmanee elle walk res wmdn drie permit ie issued, 305 - FRAME 01 M1me and will {nnintimm Worker's Compensmion Inmmnce. as required by Section 3 06 — HOLDOWNS 3]00 of the Labor Code: for the performance of the work mor which this permit is "mad .MyW k t . 's Ca pe 1nneecamerandPolcy foundation, 307 INSULATION Ca PhcrNo.'b%�i2JA .. 30;8`;"'-4 SHEETROCK. . TIPICATIONOFF%EMPiIONPROM WORKERS' 309, EXTERIOR "LA'TH' COMPENSATION INSURANCE -, r "' " (Th a need not hea completed rine permit is for one hundred dollars 3.1.0..,.,.._._INTERIOR LATH—— _ ... SISHonem.) 311 — SCRATCH COAT I certify that the part. rine walk for m p<rmr'-.aad,1 .. _.'..- "'313 `- 'ROOF—NAIL' :riawhich"- II t ploy any on Y annual binrothewnrkcrs sComhall semplnima lawn ofCaliforniaPerson i: Dad 501 - FINAL ELECTRICAL'ENERGY APPI can,. "` • - NOTICETOAPPLICAN 1:11. after ma4:ing this Cenihcam of Evatimuon. you should _. ...".502 — FINAL PLUMBING ENERGY. .... Nacome subject lathe Worker's Cion,maxur provisions or the Labor Code, you must 503 - FINAL MECHANICAL ENERGY " forthwithri ply such'erprovisions'this pamaint shallbedeemed revoked,.504 'CONSTRUCTION r. FINAL BUILDING ' ENERGY, 1'"t • LENDING AGENCY " I he by alrmi 0 t th< wno le d'ng'agency fo th performance _.._ .. 505 — FINAL ELECTRICAL rine rkrartinehtinspeunntoissaadSec. 3097.civ,e.) -' -- 6 506 - GAS TEST_ . lender's Name ...: __ .. ,. _ ..-_ ....:. ..: _� .__,• ... .:_ ... a`r'nAadra.•;• _ _ _ _ .. _ ._ 507 — FINAL PLUMBING . tcampy that Ihave mail this application and state that the above information is 508 — FINAL MECHANICAL' Conrad. I agree to comply with all city and county ordinances and state laws rala m ing building comforeii,cm and hereby authorize representatives of this city to enter upon 509 - FINAL GRADE ,heabovr.memddnedpropenyfarmsprcdonpurposes. (We) agree m snOr, indemnify and keep harmless the City 6f Cu ii nino'agvnst 510 — FINAL PLANNING liabilities, judgments, costs and expenses which may in any way ammc aganst mid 514 - F INA PU I (_' WORKS City in evnsultia ee of the graining of this painful. APPLICANT UNDERSTANDS' WILL COMPLY WITH ALION POINT SOURCE REGU TION /� Issued by: Date signator`of Appncanvco7ltswcm�� ' • "' ',Ula�it Re -roofs HAZARDOUS MATERIALS LOSUI DISC" ' Will the ppfcaut to farm, bd Id' g occuparat ire or mindki haticandmis nominal Type Of Roof yp as def ed by to C pent Municipal Code.Chapter9.12. and m Health d Safety Catlb, Seen.. 2553200", .. . ' ` - -" • a - 0 Y � .., r i'` - All roofs, shall be mspec[edpnor to any w ll doh 1,0 ...r f t refined id' g rpt q i n e � Winn th d tut r bythBay A A Quit Ity Management roofing material being -installed. ___ If a roof Is installed without first obtaining an inspection Pagree to remove ,'""CY all new materials for inspection Applicant understands and will cont I with p' Y. all non -point source regulations.-. I have red the n do trdals q `mems under Ch pier 6.95 of the " - California Health & Safety Code Sections 25505 25533 and 25534.1 understandthat if the building doe not cu tly have a tenant, that t . my responsibility to notify the occupant f theq innatim hi si be p et m issu -' 1 a C nihcam of 9 actipanity, j' - Signature of Applicant Date Al] roof coverings to be Class "B" or, better wrelmhmrze '�Y--'-u„e o11 f 0 0 r. 3N. A 7- L W I J22:aO 20 El jew �41 lc�ol 7- L W I J22:aO 20 El jew 117-e0mv- • CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM 62 0300123 APN # U1 I Date: Buie drfs: 6 �e Other Appliances MECHANICAL 2 Bldg Permits . foot Owner's Name: �j Torte BBOILER1 Pho a #: Oi.( 10B —, 7Z —2 Zy Contractor: ' , Q(- License #: Contact: Svzh Phone #: iY--2-03 'Applicant/Contractor- MECHANICAL Fax #: rmit Info: MECHANICAL BCONSTAX g Elect Plumb Mechtion: Ind/Off/Comm/ uasi . BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING l: r14� I W ei Cotqt.: Sq.Ft. Floor Area: BUILDING $/ I Constax— Resi/Mobile BUILDING BELEC1000 Architect/Engineer: ELECTRICAL Valuation: Elec 600V > 1000A ELECTRICAL BELEC200 Type of Construction: ELECTRICAL Occupancy Group: Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILER1 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/ uasi . BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR I 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. FeeI BUILDING 1 of 3