00010083 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY 000 loo
I- NE
TY OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO.
BUILDING DIVISION
APPLICATION/PERMIT PLUMBING-MECHANICAL,
BUILDING PROJECT IUEN'TIFICATION
ILDINGADDRESS: SANITARY NO. APPLICATION SUBMITTAL DATE
zo W 'SNA PHONE: CONTRACTOR'S NAME: LIC NO:11.7 N/C CONTROI 0
,CIi1DiCfRiNGIM1'ER: LIC NO: AIo51. 444 Asv��J-W.CA 44 -01 �
CONTACT: PHONE: BUILDING PERMIT INFO
❑ Consultant Fees Paid by Applicant(Initial) BLDV ELECT PLUMB MECH
❑ ❑
LICENSEDCONTRACfOR'SDECLARATION QTY. ELECTRIC PERMIT FEE
I hereby affirm that I am fidcnxed under provisions of chapter 9ldommencing JOB DESCRIPTION
C
FZ with Seaion]INXI)orllivisinn3of the Business and ProfessionsCWe,anJm liccrsscis
OO in full force and eB t. y PERMIT ISSUANCE RESIDENTIAL
QUU hiceret Cl zs 45 Lic.p 147 ❑SFDWL ❑KITCHEN REMODEL
rFi,60. Date Contractor APPLIANCES-RESIDENTIAL ❑ADDITION ❑PLUMBING RE-PIPE
ARCIiI'ECT:SDECIA AI'ION PANELS' ❑MULTI-UNIT [I STRUCTURAL
Z O y z 1 understand my plans shall be used as public act MODIFICATION
ONTO UP'FO 21X1 AMPS El INTERIOR ❑CHIMNEY REPAIR
F_Zu] LucnxJ PmPossional 201-IfKKIAMPS IMPROVEMENT SWIMMING POOLS
OWNER BUILDER DECLARATION QVfiR IINIUAMI'S
Q 1 hereby affirbs,Thal 1 am exempt from the Cnnacane,License Law far the ❑BATH REMODEL EPAIR ❑DEMOLITION
ad
3 t4 F'WUfollowing reawn.(Section]0315.Basins and Pmficroa os Code:Any city or mm�tr SIGNS ELECfRICAI. El OTHER
which mgmtex a permit h,construct,alter,improve,demolish.or repair any%mnure
Qi prim.it,icmanee.akw event applicant for,mch permit to fileasgnNstalemem `—
ra SPECIAL CIRCUIT/MISC.
}� hoc he is licensed pursuant ht the provisions of he Convucn,rs License Law(Chapnr9
O (m,mmvenang with Section](g0)of Division 3 oftbe Business and Professions Cock)., TEMP METER OR PDLE INST COMMERCIAL
d a o C mal he is exempt heacbmin and the hosts for the alleged exemption.Any violation of ❑NEW BLDG/ADDITION ❑DEMOLITION
[.;w Section]031.5 by any applicant for a permit%objects the applicant to a civil penalty of _ POWER UE ICES
nm marc,ban five hundred dollar.(SSW). ❑TENANT El FOOD SERVICE
=Q 01.a,owner of'he pnspeny,army employer,with wagecas theirxale coupe mation, SWIMMINCp ELECTRIC IMPROVEMENT
yFo x'illdo the wml,,mal the suucturvisnotildradedoroRemiforsale(Sec.90W.Holiness ❑OTHER
W 3 m and Poole¢iom Code:The Coulmcmrs Limn%c Law does not apply a un owner of OUTLETS- HES-FIXTURES
property who builds or improres duce on,and who docs melt work himself or through
his own employees,provided that inch improvement,are an muao1cd or nfftmJ for NEW RESIDENT ECTR SQ FI'.
sale.IL however,he building m unprovemenlcoold within one year ofcompletion,he SQ.FT.FLOOR AREA VSQ.FT
owner-builder will have the burden of proving That he did net build or improve for pur-
pn%c m ale.).
❑h as owner of the propeny,am exclusively contracting with licensed contractors to TOTAL:
n..mO the pmjca(Sec.]IH4,Rosiness untl Pmfessiom Code:)She Caniructor'%Li-
censelawdoes not apply to an ownerofpmlosmy who buildsor improvesthcnon.and QTY. PLUMBING PERMIT EE
whocommas furwN,projects will,a comm lens)licensed pursuant v,the Contractors
License Law.
❑ I on exempt under Sec. ,B&1'C fonbls reason PERMIT ISSUANCE
ALTER-DRAIN&VENT-WATER TEA)
neo Date VALUATION
mmile,WORKERS COMI'ENSAry me DECLARAHONwile, BACK FLOW PROTECT.DEVICE �^1
Ihcnby nl maintbsdcr penailyaf ofCoaoneofthcfollowing Workertions: V 'JQ7
❑Ihays andwill maintainstion 37Mfi,mv of the Lahr t to Code.forte Workm'xce of
DRAINS-FLOOR.RWEAREA,COND. STORIES TYPE CONSTRUCTION
ration, r hick his
for by Section 3]00 of the hlwr Code,for the Performance of he
Is or which this permit is isued. FIXTURES-PER TRAP
9I
have and will maintain Worker's Carce.f e w Insurance, h his ort by Section
J]1Nl of the laM,r�pCeMseW.for he up�erf-rm�afnce of the work for which this pem,it is iswcd GAS-EA.SYSTF.M-I INC.40UTLIiTS OCC.GROUP APN
Mr WorkLw'.sF ,pen W 1 ., metarml
Policy acy n •.ice
Carrier: �n1 C1.K "aV hf� GAS-EA.SYSTEM-OVER 4(EA) / Q
CERTIFICATE OF EXEMIMON FROM WORKERS'
COMPENSATION INSURANCE GREASMNDUSTRL WASTE INTERCEPTOR
(This rection need not be completed if ihc Permit is for one hunJmd dollars(S 11111) BUILDING DIVISION FEES
or le".) GREASE TRAP PLANCHECK FEE
1cenify hocin the parformance of the wadfar which Ibis held is ers' lshall
,tempi" any person in any manner so nsmberome subjectmthe Workcri Co.,.-CSEWER-SANITARY-STORM F.A.200 FI'. ENERGY FEE
rZ
,an..nansvz of California.Dine
z O Applicant WATER HEATER WNIiNT/ELGCTk GRADING FEE
kN-1 NOTICE TO APPLICANT:If,after making this Cenifica,e of Exemption,you should WATER SYSTEM(TREATING
abecome subject e,the Worker's C.... a anion pmvlxioro of the tabor Code,you must SOILS FEE
W forthwith comply with such provisions or his permit shall be deemed invoked.
0 WATER SERVICE
fo
Z) z CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLA1B. SQ,FT. PAID '
V (hereby affirm hoc mere isamnalmaion lending agency fi,nhe perL,rmantt of Date RecciptN--1
the work fur which mo permit is ism.If(Sec.3197.Co,C.1 r�'L
u" U Lobsters Name
"I Lenders Address TOTAL: 1\ ` TC'Al:�
a. 1 cenify that 1 have read his application and state thin the above information is
r'BUILD W G FEF.V
Tr, conedtgcomon)mmmply wiltysufall fiand d presenmmana%find niece hw,rtupon the QTY. MECHANICAL PERMIT FEE
V z building amoned,pu and herebyauthodmmoses, ivewf his city mentor upon the (SEISM 2
aMrcmce)agree
foremnify an keep ha FERMI I'ISSUANCE
(Welogrctn,save,andemmfyandkeep harmless the City of Cupenitmagainst ELECTRIC FEE U
invaiocs,jace letm.cotes and of this sant, may in any wayaccmc against said City ALTER OR AILD TO MECH.
vnCANTeoe thegrTAN SthisDWil. (PLUMBING FEE
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10.0W CPM)
SOURCE REG ATIONS. ,-s ' / /1 MLCHANJICAI;,FEE�
p� JL+,aj� 1/ 14/QQ AIR HANDLING UNIT(OVER 10,0W CFM) CONS'TRUC'TION TAX
Signature al AppbcardCommcmr stere EXHAUST HOOD(WRIUCT)
HA]/rRDOUS MATERIALS DISCLOSURE HOUSING MITIGATION FEE
Will the applicant()rfuture building occupant stare arbitrable formalous material HEATING UNIT(TO 100.001)BTU)
as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code.Section 25532mo! HEATING UNIT(OVER HOLM BTU)
C]yes
�Y. VENTILATION FAN SINGLE HESIUI PAID
Will the irca applicant m as a building occupaB use ea Air Qu m devices which Dam Receipt M
emit hauNouv air dnnlaminanu as defined by the Buy Arca Air Quality Manugemcnt BOILER-COMP(3HP OR I00.I0)B'TU) _
Ilivlricl'
Fl Yes do BOILER-COMP(OVER 110,000 BTU) TOTA X
I have read the h afdam materials nquiinmenn under Chapter 6,95 ofthe C.E. AIR CONDITIONER
fomia Health&Safety Code,Sections 25505,25533 Imd 25534.1 undervwnd mut dine ISSUtJNC- DATE
building hcwotc,yrk tly have t Lhm it is my nspnnsibility to notify me arupvn NEW RESIUEM1TIgI.MECH. SQ.FTpN�,-('I
of myuiremenWr ea,r;nr to i,xnandt ora etnirettf�/Ddec ante. I/ e7^ liV L/
vx•�uw71V%- /1 yrtp
Owner or aulhonecJagent i Dn TOTAL:
ISSUED BY:
7 OFFICE
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
• BUILDING PERMIT INVOICE OPERATOR: christya
Sec: Twp: Rng: Sub: Elk: Lot:32610063.00
INVOICE DATE...... : 01/14/2000
REFERENCE ID # ... : 00010083
SITE ADDRESS .....: 20620 HOMESTEAD RD
SUBDIVISION .. .....
CITY ....... . . ....: CUPERTINO
IMPACT AREA .......
OWNER .... ........: BANK OF AMERICA
ADDRESS .. . .......:
CITY/STATE/ZIP ...: SAN JOSE CA, CA 95116-2018
CONTRACTOR . . .....: STERN, CHARLES LIC # 20786
COMPANY .... . . ....: ARROW SIGN CO
ADDRESS .... . . . ...: 1051 46TH AVE
CITY/STATE/ZIP ...: OAKLAND, CA 94601
TELEPHONE (510)533-7693
FEE DESCRIPTION CNK TOTAL FEE PAID-TO-DATE BALANCE DUE
--------------- --- --------- ------------ -----------
BPERMFEE P 77.00 0.00 77.00
BPLANCHK A 65.45 0.00 65.45
BREMSIGNS P 22.20 0.00 22.20 '
BUSLIC P 90.00 0.00 90.00 -
EPERMITFEE P 35.52 0.00 35.52
• ---290 17 --------0.00 -----290.17
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
101 FOUNDATION 103 UFER
104 REBAR 105 ANCHOR BOLTS
304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL
514 FINAL PUBLIC WORKS
•
America.
• 111
Bankof • Y
20620 HOMESTEAD R
City:ETP�R�INO
t P � State:CA
PLOT
, Zip:95014
CHECKED BY
IATE 13 61)C,
PLANI
DATE
Rim Ip
Accounting No(s):
151625 ATM
�D =j APPROVED AS NOTED
REVISE AND REWBANT
TITU
I � a. 1 4 v•1 ..- • .• .�� Wei, � �
BRANDING REVIEW STATUS
Pi cl"c(4�:1rJ y_�nicnt SP,cre'rfs I�r-���
Signage Recommendations
• Accounting No:151625
HOMESTEAD SQUARE-20620 HOMESTEAD RD CUPERTINO,C01 95014
Sign No:01 . Existing Signage
Height:28"
Width: 10'0" ..
Depth:
Overall above
grade:12ft _. '..ut'>v "'x*".:,
Illuminated: Yes '
Double face: No
Comments: Singie Faced Lighted Box
Sign Product: D3
Proposed Signage /F lu.Ul"tII1kPP eA1911JE �&,j
y
_
Description: 10'-1'x 1'-6"Horizontal Wall ..,
Required Site Work • •+y „
Electrical: None xry 1az+`: m'%•
------
Landscaping: None
Wall Repair: None
Comments: Replace Only_-_______
A-1
Location •
Tracking No:T0001 65
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