00010131 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE SALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING.ELECTRICAL. PERMIT NO ^
BUILDING DIVISION APPLICATIONIPERMIT PLUMBING-MECHANICAL 50001 `
BUILDING PROJECT IDENTIFICATION
BUILDINUADDRE,SS: ( SANITARY NO. APPLICATION SUBMITTAL DATE
`� N 1
X
R5 NAME , !1 aI PHONE: RACCOII'1NMME: ' LIC NO:sl C S.�J
Mp -•7 Fored E4q 0,5 NIC CONN ROL N
ARCHITE 'NGINEER: EJC NO: ADDRESS n/� n�a ,p� ❑
Daq / S• K✓V M1i� ICN WI r
CONTAM PHONE: BUILDING PERMIT INFO
18 ❑ Consultant F¢P9 Paid by Applicant(Initial) IILDG ELECT PLUMB MLCH
tn- EJ
LICENSED CONTRACTOR'S DECLARATION QTy ELECTRIC PERMIT FEE
1 benbY affirm mm 1 am Iicenad under Provision.M Cmamef 9(mmmrncing _ JOB DESCRIPTION
wog rh Scction](XNOol Diviaiun 3affe Buvir.Ysaml ProfieNiom Cove,amlmy l'aenw an RESIDENTIAL_
1- - .� PERMrtISSUANCE
F-ly full tura serer effect. ❑SFUWI. ❑KIT'CHfJJ REMODEL
QVU Lna"'se Cm`s Ix'N APPLIANCES-RISIDENIAL ❑ADDITION Bi'ttlhNBfNG RE-PIPE
F-Zul Dale
vF1QD aw Comnome
ARCIITECFS IiCL
AAIONPANELS
❑MULTI-UNIT ❑STRUCTURAL
MODIFICATION
C)O`tfjz IUMcnnrd mY Elam shall be ulzdw PuhlicrmNs UP TO 2(X1 AMPS
pZ-� ❑IhTIiR10R El CHIMNEY REPAIR
F-�1�' LIcenwl PArk"i eal 201-1100AMPS [MI'ROVILMEN7 C]SWIMMING POOfS
�yf' OWNER-BUILDER DECLARATIONOVRRI00AMP ❑BATHREXI0DE1JREPAIR ❑DEMOLITION
yyx C C Q 1 hereby affirm that 1 am exemM from the Gmx
trwr's License Law for the
W O d V following rwwm.(Scotia 90313,Baainci oM Profesaiom Code:Any city or county. SIGNS ELECTRICAL ❑OTHER
3 LL which requires a Permit In eonstmcl.aver,improve,demolish,Or repaif any structure
(,ry C)� , prior to itv islaance,almrc9uiru Brapliboom fOrsueh Permit to fiM le asignuvcmrnl SPECIAI.CIRCUDDMISC.
(yY I hat he is licensed pu.at ,,the lrcililimil of lac Comacmf's Uceme Law(CEupmr9
�� (comn¢tcing wit,Seemn 7000WDivision Softk Busiwvs mW Professions Cak)or TEMP,METER OR POLE IN31'. COMMERCIAL'
a a e a that M is eeemlN Ihercfnm atter the basis far the,allegal eamr A nn,Any vidlmrvm of NEW BLDG/ADDI'I'ION ❑DEMO[.]'I'ION
�N Soetion 7031.3 by any applicant for a permit aabjeeU lk applicant to a Civil perlithy of POWER DEVICES ❑TENANT ❑FOOD SERVICE
.F. y to acre than five hundred dnllus(5510). IMPROVEMENT
�Q (] I,as were el lbe prsgcny,yr my emplgas with wagesmlh[ir cede anmpernatilm. SWIMMING POOL ELECTRIC
fF0 will dothcworA.and the smcwrc i,as imendcd Or offoM file.elelSec.9M4.Huvioe, ❑OTIIF.R
C Nnd Prof..Code:The ns
Cior amor's License Law docs napply w x wmer of pURET'S�SWITCHES-Fl%TURES
pr,reny wNr builds or imlxovo Rxmrim,atter who drcn such wart himwlfa I mar,h
his osvn emrby.,pmvidal that ouch arprom—not an ud arerdM ne offered fa NEW RESIDENTIAL ELE:CfR SQ FT.
Lrilc.1[Mwarr.Re huildingailnpmvcrrcnl is urlJ within late ycmu(canplainn,the .PC TOR AREA SISQ.PC.
owlenbuider will have the blaJen U proving LIOU he did m timer a imPfolc fa fact
Pout Ofsnlc.).
n 1,ss Domer M the pr,peny am elall..iwAy comncung with licensed canmaetwa to 'TIJfAfL
nmatucl the projtwt(Sr.9(HT nueinca and Pmfeevi(nv CIdoO The Cunmech>rs U-
eLio, a not appy in-saver Of Nater wln builds or imlaovn dercon.serer QTY, PLUMBING PERMIT FEE
a who,amnia,B.rmcbmPrI,.Ohaama,IO1,)IlccnrN pmwmnn,the Canracmr'I
nLiamc Law.ImrcscmNlmdcr SePERMIT ISSUANCE.
1 o. ,H&PChrfiarcaron
1 ALTER-DRAIN&VENT-WATER(EA) VALUATION
Owrcr Dam
i WORKERS COMPENSATION DECLARATION RACK FLOW PROTECT.DEVICE
I Imrtby alfimt ualcr penalty of perjury arc n(tM following Je:laralionc,
I have"will naruna in a Conificwe ofComoa to self-court for Warlies Canprn- DRAINS-FLOOR,RODE AREA,GOND. STORIES..... T1'I'E CONSfRUCI'ION
w ,as NuviJal far by S2IIan J)(NI,f IhC IWMr Ude,f,a Ih,pctlim a,wa of Abe
watt dtispmtdl is usucd. e9 FIXTURES-PPR TRAP
El"ha,c.on will maintain Wmkar's Co o,manian I2wnmc,rev neImsal by Section
r 370)Ofde Labor Cni fa the profanlateeditbe were for which Jlu Permit issued GAS-EA.SYSTEM-1 INC.J OUTLET'S OCC,GROUP C3 �N
CMy urio sCanpc in ymncca 'cr�cYtN0 nulrlMxwc�s47 GAS-EA.SYSTEM OVER 4(FA) J\ Cp T ?
CERTl19CA IF. EX RNIPTION FROM WORKERS' GREASF7INDUSHt1.WASTE 1NItiRCEPIOR d
COMPENSATION INSURANCE BUILDING DIVISION FRES _
(IN,rection netelmv hceomplctM flMpcmut is facmenvabMdallma(SI(XE GR[?ASE TRAP
a Ices.) PLANCIIECK FEE
IanifytMl in lneperfnmtarceot dew,rk forwhich lhispermit riouM,IvhOl SEWER-SANITARY-STORM EA.200 FL
m employ.,Penson in Any manor w m to tecwte subjem m the Wakcrs'Canlrn. ENERGY FRIT
O 2 i.riem,Lit"of Calif—iia Dam WATER HEATER WNENTUELEM GRADING FEEZ 2 AMficamtt
NOIICE'1O AI'1'LICANT.U.eller making this Caraflc Oc rel Eaentlrian,you nhuuld WATER SYSTEMTREATING
rfw = became whjav la ate Woke,Ctmmemation pmvida
sn ,t yo Mbar Code, ma nom.
_ SOILS FIJI
funhwiN comply with each rmvixiov a lois pennil Jell be JeemCd rtwNCM. . WATER SERVICE
LLI
D
7 Z CONS TRUCI[ON LENDING AOPCY NEW RESIDENTIAL PLJ,IIL SQ.PT, PAID Doc RecciNN
U Thereby aR IMOh[r<iaacm.unniao kMing age yfa the rcH,rrrumx of
dm work❑m which thin pcmtit is isatd(.Sae,:RN, Civ.CJ - TOTAL
Q LeMcrs Name
I.rnAYn AJdnxr 'D)l'A L:
1 comfy that 1 h t,eerier This cep BaItarc mrd state telae the aNwe infamntioo is BUILDING FEE
rn arM1Tl.l agmcwrontrlY wiN all my amt amnty rxJirinrres aper mmelawv nlalingm QTY. MECHANICAL PERMIT FEE
U Z buildingc,nwtction.and bemby amhairc relaeentafivel ofihis city to enter rpm the SEISMIC F'[E
abavc-mentialM pmpany for inspecNm WNvaes. PERMIT ISSUANCE.
(We)agree Io save.Imkmnify,aml loop hnrrnl¢s II¢City of CaPenina against ELECBIC FIJI
Ilobilities,jWgmenu,co.and expo which may in any way xxme apirot said City ALTER OR ADD TO MECH.
inmrria, aofthc eon yg Mt rode. PLUMBING FEE
APPLICANT UN 'NAND D WItL COMPLY WITH ALL NON-POINT SIR HANDLING UNIT ITO 10.000 CFM) MECHANICAL FEE
R E NS.
9.7w+-� AIR HANDLING UNIT(OVFJt 10.00I CFM) CONSTRUCTION TAX
Sigwun of pplicanJCo ra C Kl Enen EXHAUST HOOD(WMUCI) HOUSING MITIGATION IFF.
HNIARIIOUS MATERIALS DISCLOSURE
Will the aprlicanl w Imon,briding rccupant use a hmalk havud0us material HEATING UNIT CFO 100.000 BTO)
m defrcd by the Cdpem.Munirilvl Core.Cbvptcr 9.12,and the If ailth and Safety
Code,Swoon 8532(io" HEATING UNIT(OVER I00,000 BTU)
E3 Yaa ❑NO PAID
Vf?M'IL\TION FAN(SINGLE RFS11p Ihm Ranp N
Will the aprlicanl Or fulum building tccul net use etm,Pmenl Or devices which BOILER-COMP DIIP OR 10TAM B'IM)
cit
om6aarJaus air commem.as dcfin�by de Bay Area Air Qua ity Marlagcnrnl TOTAL:
DnIrIn9 BOILER-COM P(OV ER I(X10)(i BTU)
❑Yes ❑No
I hive brad de bac cni Vs maree als reyainmer.under Chahar 6.95 of de Cali- AIR CONDITIONER ISSUANCE DATE
Roma Health&Saar C .Smi� 25515,25533 all 2553x.1 underslard that if Ina NEW RESIDENTW.MECII. SQ.FI'.
Bim,cllesro ova .mate..my mvrmainilitr to ltadfY de aarpaat 27— 2-
C 1 Ian ma mer prix II,is..ri,j7c-iQne of Oari'le,
e xaw 'vad ugant / C Uetc TOTA1' ISSUED BY: ` 40
OFFICE
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
L ^ . CITY OF CUPERTINO
iBUILDING PERMIT INVOICE OPERATOR: karenb
Sec: Twp: Rng: Sub: Elk: Lot:32643057.00
INVOICE DATE......: 01/27/2000
REFERENCE ID # ...: 00010131
SITE ADDRESS ..... : 10675 GRAPNEL PL
SUBDIVISION .......
CITY ............. : CUPERTINO
IMPACT AREA ...... .
OWNER ............: DEL ROSARIO EDGARDO M AND REME
ADDRESS .. ........ :
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-1319
CONTRACTOR .......: CARDIA, FRANK L LIC # 612
COMPANY ..........: CUPERTINO PLUMBING
ADDRESS ..........: 10297 S DE ANZA BLV
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
TELEPHONE ........: (408)283-0618
FEE DESCRIPTION CHK TOTAL FEE PAID-T'0-DATE BALANCE DUE
--------------- --- --------- ------------ -----------
BPFIKTURE P 8.33 0.00 8.33
PPERMITFEE P 35.52 0.00 35.52
--------- ------------ -----------
43.85 0.00 43.85
ID DESCRIPTION VOICE ID DESCRIPTION
........ ............................ ........ ............................
202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING
502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING
APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE SALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING.ELECTRICAL. PERMIT NO ^
BUILDING DIVISION APPLICATIONIPERMIT PLUMBING-MECHANICAL 50001 `
BUILDING PROJECT IDENTIFICATION
BUILDINUADDRE,SS: ( SANITARY NO. APPLICATION SUBMITTAL DATE
`� N 1
X
R5 NAME , !1 aI PHONE: RACCOII'1NMME: ' LIC NO:sl C S.�J
Mp -•7 Fored E4q 0,5 NIC CONN ROL N
ARCHITE 'NGINEER: EJC NO: ADDRESS n/� n�a ,p� ❑
Daq / S• K✓V M1i� ICN WI r
CONTAM PHONE: BUILDING PERMIT INFO
18 ❑ Consultant F¢P9 Paid by Applicant(Initial) IILDG ELECT PLUMB MLCH
tn- EJ
LICENSED CONTRACTOR'S DECLARATION QTy ELECTRIC PERMIT FEE
1 benbY affirm mm 1 am Iicenad under Provision.M Cmamef 9(mmmrncing _ JOB DESCRIPTION
wog rh Scction](XNOol Diviaiun 3affe Buvir.Ysaml ProfieNiom Cove,amlmy l'aenw an RESIDENTIAL_
1- - .� PERMrtISSUANCE
F-ly full tura serer effect. ❑SFUWI. ❑KIT'CHfJJ REMODEL
QVU Lna"'se Cm`s Ix'N APPLIANCES-RISIDENIAL ❑ADDITION Bi'ttlhNBfNG RE-PIPE
F-Zul Dale
vF1QD aw Comnome
ARCIITECFS IiCL
AAIONPANELS
❑MULTI-UNIT ❑STRUCTURAL
MODIFICATION
C)O`tfjz IUMcnnrd mY Elam shall be ulzdw PuhlicrmNs UP TO 2(X1 AMPS
pZ-� ❑IhTIiR10R El CHIMNEY REPAIR
F-�1�' LIcenwl PArk"i eal 201-1100AMPS [MI'ROVILMEN7 C]SWIMMING POOfS
�yf' OWNER-BUILDER DECLARATIONOVRRI00AMP ❑BATHREXI0DE1JREPAIR ❑DEMOLITION
yyx C C Q 1 hereby affirm that 1 am exemM from the Gmx
trwr's License Law for the
W O d V following rwwm.(Scotia 90313,Baainci oM Profesaiom Code:Any city or county. SIGNS ELECTRICAL ❑OTHER
3 LL which requires a Permit In eonstmcl.aver,improve,demolish,Or repaif any structure
(,ry C)� , prior to itv islaance,almrc9uiru Brapliboom fOrsueh Permit to fiM le asignuvcmrnl SPECIAI.CIRCUDDMISC.
(yY I hat he is licensed pu.at ,,the lrcililimil of lac Comacmf's Uceme Law(CEupmr9
�� (comn¢tcing wit,Seemn 7000WDivision Softk Busiwvs mW Professions Cak)or TEMP,METER OR POLE IN31'. COMMERCIAL'
a a e a that M is eeemlN Ihercfnm atter the basis far the,allegal eamr A nn,Any vidlmrvm of NEW BLDG/ADDI'I'ION ❑DEMO[.]'I'ION
�N Soetion 7031.3 by any applicant for a permit aabjeeU lk applicant to a Civil perlithy of POWER DEVICES ❑TENANT ❑FOOD SERVICE
.F. y to acre than five hundred dnllus(5510). IMPROVEMENT
�Q (] I,as were el lbt prsgcny,yr my emplgas with wagesmlh[ir cede anmpernatilm. SWIMMING POOL ELECTRIC
fF0 will dothcworA.and the smcwrc i,as imendcd Or offoM file.elelSec.9M4.Huvioe, ❑OTIIF.R
C Nnd Prof..Code:The ns
Cior amor's License Law docs napply w x wmer of pURET'S�SWITCHES-Fl%TURES
pr,reny wNr builds or imlxovo Rxmrim,atter who drcn such wart himwlfa I mar,h
his osvn emrby.,pmvidal that ouch arprom—not an ud arerdM ne offered fa NEW RESIDENTIAL ELE:CfR SQ FT.
Lrilc.1[Mwarr.Re huildingailnpmvcrrcnl is urlJ within late ycmu(canplainn,the .PC TOR AREA SISQ.PC.
owlenbuider will have the blaJen U proving LIOU he did m timer a imPfolc fa fact
Pout Ofsnlc.).
n 1,ss Domer M the pr,peny am elall..iwAy comncung with licensed canmaetwa to 'TIJfAfL
nmatucl the projtwt(Sr.9(HT nueinca and Pmfeevi(nv CIdoO The Cunmech>rs U-
eLio, a not appy in-saver Of Nater wln builds or imlaovn dercon.serer QTY, PLUMBING PERMIT FEE
a who,amnia,B.rmcbmPrI,.Ohaama,IO1,)IlccnrN pmwmnn,the Canracmr'I
nLiamc Law.ImrcscmNlmdcr SePERMIT ISSUANCE.
1 o. ,H&PChrfiarcaron
1 ALTER-DRAIN&VENT-WATER(EA) VALUATION
Owrcr Dam
i WORKERS COMPENSATION DECLARATION RACK FLOW PROTECT.DEVICE
I Imrtby alfimt ualcr penalty of perjury arc n(tM following Je:laralionc,
I have"will naruna in a Conificwe ofComoa to self-court for Warlies Canprn- DRAINS-FLOOR,RODE AREA,GOND. STORIES..... T1'I'E CONSfRUCI'ION
w ,as NuviJal far by S2IIan J)(NI,f IhC IWMr Ude,f,a Ih,pctlim a,wa of Abe
watt dtispmtdl is usucd. e9 FIXTURES-PPR TRAP
El"ha,c.on will maintain Wmkar's Co o,manian I2wnmc,rev neImsal by Section
r 370)Ofde Labor Cni fa the profanlateeditbe were for which Jlu Permit issued GAS-EA.SYSTEM-1 INC.J OUTLET'S OCC,GROUP C3 �N
CMy urio sCanpc in ymncca 'cr�cYtN0 nulrlMxwc�s47 GAS-EA.SYSTEM OVER 4(FA) J\ Cp T ?
CERTl19CA IF. EX RNIPTION FROM WORKERS' GREASF7INDUSHt1.WASTE 1NItiRCEPIOR d
COMPENSATION INSURANCE BUILDING DIVISION FRES _
(IN,rection netelmv hceomplctM flMpcmut is facmenvabMdallma(SI(XE GR[?ASE TRAP
a Ices.) PLANCIIECK FEE
IanifytMl in lneperfnmtarceot dew,rk forwhich lhispermit riouM,IvhOl SEWER-SANITARY-STORM EA.200 FL
m employ.,Penson in Any manor w m to tecwte subjem m the Wakcrs'Canlrn. ENERGY FRIT
O 2 i.riem,Lit"of Calif—iia Dam WATER HEATER WNENTUELEM GRADING FEEZ 2 AMficamtt
NOIICE'1O AI'1'LICANT.U.eller making this Caraflc Oc rel Eaentlrian,you nhuuld WATER SYSTEMTREATING
rfw = became whjav la ate Woke,Ctmmemation pmvida
sn ,t yo Mbar Code, ma nom.
_ SOILS FIJI
funhwiN comply with each rmvixiov a lois pennil Jell be JeemCd rtwNCM. . WATER SERVICE
LLI
D
7 Z CONS TRUCI[ON LENDING AOPCY NEW RESIDENTIAL PLJ,IIL SQ.PT, PAID Doc RecciNN
U Thereby aR IMOh[r<iaacm.unniao kMing age yfa the rcH,rrrumx of
dm work❑m which thin pcmtit is isatd(.Sae,:RN, Civ.CJ - TOTAL
Q LeMcrs Name
I.rnAYn AJdnxr 'D)l'A L:
1 comfy that 1 h t,eerier This cep BaItarc mrd state telae the aNwe infamntioo is BUILDING FEE
rn arM1Tl.l agmcwrontrlY wiN all my amt amnty rxJirinrres aper mmelawv nlalingm QTY. MECHANICAL PERMIT FEE
U Z buildingc,nwtction.and bemby amhairc relaeentafivel ofihis city to enter rpm the SEISMIC F'[E
abavc-mentialM pmpany for inspecNm WNvaes. PERMIT ISSUANCE.
(We)agree Io save.Imkmnify,aml loop hnrrnl¢s II¢City of CaPenina against ELECBIC FIJI
Ilobilities,jWgmenu,co.and expo which may in any way xxme apirot said City ALTER OR ADD TO MECH.
inmrria, aofthc eon yg Mt rode. PLUMBING FEE
APPLICANT UN 'NAND D WItL COMPLY WITH ALL NON-POINT SIR HANDLING UNIT ITO 10.000 CFM) MECHANICAL FEE
R E NS.
9.7w+-� AIR HANDLING UNIT(OVFJt 10.00I CFM) CONSTRUCTION TAX
Sigwun of pplicanJCo ra C Kl Enen EXHAUST HOOD(WMUCI) HOUSING MITIGATION IFF.
HNIARIIOUS MATERIALS DISCLOSURE
Will the aprlicanl w Imon,briding rccupant use a hmalk havud0us material HEATING UNIT CFO 100.000 BTO)
m defrcd by the Cdpem.Munirilvl Core.Cbvptcr 9.12,and the If ailth and Safety
Code,Swoon 8532(io" HEATING UNIT(OVER I00,000 BTU)
E3 Yaa ❑NO PAID
Vf?M'IL\TION FAN(SINGLE RFS11p Ihm Ranp N
Will the aprlicanl Or fulum building tccul net use etm,Pmenl Or devices which BOILER-COMP DIIP OR 10TAM B'IM)
cit
om6aarJaus air commem.as dcfin�by de Bay Area Air Qua ity Marlagcnrnl TOTAL:
DnIrIn9 BOILER-COM P(OV ER I(X10)(i BTU)
❑Yes ❑No
I hive brad de bac cni Vs maree als reyainmer.under Chahar 6.95 of de Cali- AIR CONDITIONER ISSUANCE DATE
Roma Health&Saar C .Smi� 25515,25533 all 2553x.1 underslard that if Ina NEW RESIDENTW.MECII. SQ.FI'.
Bim,cllesro ova .mate..my mvrmainilitr to ltadfY de aarpaat 27— 2-
C 1 Ian ma mer prix II,is..ri,j7c-iQne of Oari'le,
e xaw 'vad ugant / C Uetc TOTA1' ISSUED BY: ` 40
OFFICE
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
L ^ . CITY OF CUPERTINO
iBUILDING PERMIT INVOICE OPERATOR: karenb
Sec: Twp: Rng: Sub: Elk: Lot:32643057.00
INVOICE DATE......: 01/27/2000
REFERENCE ID # ...: 00010131
SITE ADDRESS ..... : 10675 GRAPNEL PL
SUBDIVISION .......
CITY ............. : CUPERTINO
IMPACT AREA ...... .
OWNER ............: DEL ROSARIO EDGARDO M AND REME
ADDRESS .. ........ :
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-1319
CONTRACTOR .......: CARDIA, FRANK L LIC # 612
COMPANY ..........: CUPERTINO PLUMBING
ADDRESS ..........: 10297 S DE ANZA BLV
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
TELEPHONE ........: (408)283-0618
FEE DESCRIPTION CHK TOTAL FEE PAID-T'0-DATE BALANCE DUE
--------------- --- --------- ------------ -----------
BPFIKTURE P 8.33 0.00 8.33
PPERMITFEE P 35.52 0.00 35.52
--------- ------------ -----------
43.85 0.00 43.85
ID DESCRIPTION VOICE ID DESCRIPTION
........ ............................ ........ ............................
202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING
502 FINAL PLUMBING ENERGY 507 FINAL PLUMBING