99100076 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECTRICAL RMIT N�
BUILDIW DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL _ S0001
ILDI
WNG PROJECT['IDENTIFICATION I:.'
BUILDING ADDRESS: / SANITARY NO. APPLICAI ION SUBMITTAL DATE
2,2218 +jAMMoNj WAY fupz cow) 95o14 LOT I
OWNERS NAME PHON CONTRAC.TOR'S"NAME. LIC NO:
tWONTACL
fi0161ZIfr1lCa2DUP �oSgf�'17.030 O'BelEnl G¢P !09'1513.8 N/c oNTaol.0
ITECUENGINE4'14. LIC NO: ADDRESS: ❑
,CAA5r/�M IjE r_& 2440 13 COVOIRATE.' Zlo �qF
PHONE: BUILDING PERMIT,INFO
GAmy A6LES 419/1714.- 1474 ❑ Consultant Fees Paid by Applicant(Initial) BLUG C PLUMB MECH
❑ ❑ ❑
LICENSED CONTRACTOR'S DECLARATION QTY EIJsCTRIC PERMIT. - FEE
1 hereby affirm that I am licensed under provisions of chapter 9(commencing JOB DESCRIPTION
CWZ with Sreaotf/(XX))o(Dbdsion3ofdhe Business and Pmfessions Cmla,andmy license is RESIDENTIAL;
o PERMIT'ISSUANCE
CSF
if) form CRem. p �91 S13 ❑SFDWL ❑KIT CHEN REMODEL
t U V License Class o Lic.p
rF t Dmc le'•t�--I Cnntrm- r--��-_ APPLIANCES-RFSIDEM'IN. ❑ADDITION El PLUMBING RE-PIPE
FDva ARCHITECTS DECI,ARA'I'ION PANELS ❑Mundt'[-UNIT ❑S'rRUCfURAI.
Zo�,Z, I understand my plans shall be used as public merrdv MODIFICATION
OZ CUPTO200AMPS [_1 INTERIOR ❑CHIMNEY REPAIR
ice
M Lned sNofeaionol 201-IIMMIAMPS IMPROVEMENT I]SWIM MING POOLS
OWNER-BUILDER DECLARATION OVER IlN1UAMYS ❑BATA REh10DE1JREPAIR [I DEMOLITION
W st 1 hereby allirm that 1 an exempt front the Contractors License Law for Nm
a 0 u following reason,(Section 7031.5.Business and Professions Code:Any city or county SIGNS ELECTRICAL ElOI'I IER
a W h which rcgoirex a permll m<uneunet,alter,innpmve,demnl xh,lir mpuir any swemm
prior to its issuance.also mature,the applicant for such permit to file a signed statement SPECIAL CIRCUGUMISC.
E y', that lie is licensed pursn.nt to the provisions of the Contractor',License Law(Chapter 9
(commencing with SecJon 9000),dDivision3ol'the Business and Pr ofessions Code)or 1'I7M I I M I:TEIt OR POLE INS'L COMMERCIAL:
6 p,m y Nal he is exempt therefrom and the basis for the alleged exemption.Any violation of ❑NIiW BLDG/ADDITION ❑DEMOLITION
k t4 Section 7031.5 by any npplicnnt I.,.permit subjects the applicant to.civil penally of POWER DEVICES in TIiNANT Cl FOOD SERVICE
1-.. not more than five hundred dollars FEW).
F Z Y IMPROVI:MENI'
6� 0Las othe wok.the property,ormyemptende wiNwages mstheir sok<ompe.,inc,, SWIMMING POOL ELECTRIC
_ will do the wmk,Cand e Its,Cont is turs License Livened does of a(Sripply to int Business I�OTIIhR
13 w and Prakssions Code:'Ihc Commdor'x License Law Jas not apply m an owner of OUTLE't5-SWIrCHISS-14XTURES - - 'T/j
property who builds or improves thereon,and who does such work himself lir through
his own employees,provided that such improvcmenB are and intended or offered lot NEW RESIDBMTIAI,P .�aC
Made.IL however,the building or Improvement is sold wintertime yearofmmpletion,the1 SQ.FL FT.
FLOOR AREA 8/SQ.F
mer-builder will have(lie burden of proving that he did nal bided w
lir innpne for per-
m
owl .aIIh p 71A.m exch s vny c nl ting N I W n n t L �. � �
nsv IIh p j t(Se c.]044.Bus nesse and f .l n.CdeJ Th Contractors I' - t - -
c ce Law does n n .ply to anownarol propcny Who b Id improve,theorem. d QTy.- I PLUMBIN sP FEE v
who tactsfor Wch projects w'IhaumVnlf(s) runsedlon 01
111 the Connector's ''
License low v ' �ot
I.ca,c. plunder Sea. .B&P C for Nremora
ora PERM11'1. UANCG,,�
AA w e w
, AhT611-DRAIN&ViiI
..
OwnerDate
VALUATION
WOIt KIiR'SCOMI'IiNSATIONDHCLARATION HACK i6QW.,PROTE(.T+'IU
hereby nRrm under penalty of perjury one of the following deductions:
I have and will maintain a Certificate of Cons<m toself-in.snre for Workers Compen- DRAIN.60L a .AREA,CONU' S'I ORI65 'IYPIi CONSTRUCTION
limn,as provider fur by Section 3900or tire Labor Code,for the,erfornnmce ol'the
work for which this permit is issued. FIXI'URE?-PER TRAP
1 have and will maintain Worker's Compensation Insurance,as required by Section
3900 ofihe labor Code.for the performance of the work for which Nis permit is issued. GAS-IiA.SYS'I EM.I INC.4 Off[LETS DEC.GROUT' At
My Worker's Compensation Insurance cancer and Policy number me:
turner: Funny Nn.: GAS-EA.SYSTEM-OVER 41EA1
u
CERTIFICATE OF EX MVI'ION FROM WORKERSGREASFIINDUSTRt.WAS'1'12 INTERCEPT OR
COMPENSATION INSURANCE BUILDING DIVISION PF;ES
('Ibis section need not to completed if the permit is Port line hundred dancers($100) GREASETRAP or less.) ITL 'I KFE6
[certify that in life pednnnancu ofihc work for which this permit is issued,lnhall SEWBII-SAN['I'ARY-S9'OItM A.2nD IT.
not employ any person in any ms m annerxo abeome mbPot to Ne Workers'Compcn- liNER(i Ilili
C Z ration Laws of California.Dam WATER HEATER W/VENEUELECTR GRADING LEE 2 Applicant(
h NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should WATER SYS'PEMOKEATiNG
become subject m the Worker,Compcnialum provisions ul'the Lahor Gale,you must SOILS FEE
W forthwith comply with such provisions or this Permit shall be deemed revoked. WATER SERVICE
Q
CL,
U z CONS'I'RUC'I'ION LENDING AGENCY NEW RESIDENTIAL PLMB. SQ.Ira PAID V 0 IM1ereby aiRmuhauhcrc ire constriction lending agency for the pefom
rmnce of Dote Remi...Of
D•
(~ the work for which this permit is imaotl(Scu.3097,Cos.CJ
Lender's Name 'I OTA L:
V Lender',Address TOTAL:
6W6 I coolly firstll mind IPI' n J:I I ManN h f 'r - 1 -. BUILDING FEE
h Correct Iag mortality With all city d indications' d state Pminingt QTY. I, MECFIANICAI.PERMIT .FF:IS '
U building construction,and h by mmh,67n representatives o -f this city m enter,o the t SEISMIC FEE
ebov<-memioned property for inspection purposes. PERMIT ISSUANCIi
(We)agree m,nee,indemnify and keep he nd,o,the City of Cupetino li,itst L'LIiCTRIC FY.E
liabilities,judgments,costa and expenses which may in any way income against said City ALTER OR ADD TO MECI I.
in PLUMBING FEEcon¢Ruenee of Jun granting mf This pefmit.
APPLICANT'UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10,000CENG
SOl CE ULAJ�{TN$ _ M1IECIIANIGL FIT.
AIR HANDLING UNIT(OVER I I).(KKICFM) CONSTRUCTION TAX
Signature od AppliVcan-VCoM1mrusc�torr Date EXHAUST HOOD(WMUC D HOUSING M iTIGA'110N FEE
HAZARDOUS MATERIALS DISCLOSURE
Will Ne epplicant lir fuwre huilding occupron xtme lir handle lorome s not"i.l I[EATING UNIT(TO 100.000 BTU)
m defined by the Cuptimen Municipal Code,Chapter 9.12,and the Health and Safety
Code.Section 25532(a)'t HEATING UNIT(OVER I00.00D BTU)
❑Yes ❑No VENTILATION FAN(SINGLE RE.SID) PAID
Date Re<eiplN
Will he applicantmons a budding by the If,lire.Air uiou mdMatimwhich
mit hamrJnm ter ntmamiwnts m defined by the Boy Amo Air Quality Mmagement BOILEN-COMP(311P OR 100.000 BTU) TOT 1L: 1
tslnct9 BOILER-COME(OVER 100,000 BTU)
E]Yce El No
I hove mudfleb .tonus nataiuds.teryitmarms order Chapter 6.95 of the Call- AIRCONDHIONER ISSUANC17 DATE
fomite Deader
&Safely Codc.Somans]5505.25533 and 25534.1 nnderstand Nat ifthe NEW RESIDENTIAL MECIL SQ.Pr,
In
ilding Jaw ,I cancer bso on an,that it nanny responsibility to unlity'he<rcapva
ofih rents met prinrmissuunceol'ac'mil teal().a,: Y.
10-14-CM
Owner lir authorisedagent Date TOTAL: ISSUED BY:
OFFICE
FEB.23.2000 7:48AM BR--q1 KCENCAS FOULK N0.302 P.2/2
Brian Kangas Foulk
Engineers • Surveyors • Planners
• February 22,2000
19990104-50
Gary Ables
O'Brien Group
23505 Oak Valley Road
Cupertino,CA 9SO14
Subject: Oak Valley_Foundation Verlfleation
Dear Gary,
On February S,2000 we performed a field survey of the location of the foundation form for the building being
constructed on Lot 1-01 of the Oak Valley project in.Cupertino.
11te results of that wavey clearly show that the location of the foundation form of the building,s in
conformance with the setback line of the lot
This letter is intended to provide you with the verification of that unit per our survey. If there ere any other
questions concerning that location,please do not hesitate to call.
Sincerely,
• BRIAN KANGAS FO=
eah 1`
iN
` 8R.IOM h 81160
ey A.Bil 6141 F7N x191;02 4 r Dated
project Manager Nr. W.0141
Survey Department d� pf 0g dr