99090175 APPLICANT TO FILL+IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CP SITY OF CUPF,RTI�J BUILDING-ELECTRICAL T XGtERMIT NO.
BUILDING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL tJJ
BUILDING PROJECT IDENTIFICATION
BUILDING ADDRSANITARY NO. APPLICATION SUBMITTAL.DATE
Llk
OWNER'S NAME: l r, PHONE: NTRACTOR'S NAME: LIC NO:
�"' I`��• a S lo-1 3'�YuC}T Q'1C6 N/C CONTROL IT
CHI /F,N,GINEER LICNO: V 9�
ADDRESS ❑
i kR C�2v� cors
CONTACT: PHONE. BUILDING PERMIT INFO
2� ❑ Consultant Fees Paid by Applicant(Initial) BL ELECT_ PLPLUMBME❑CH
7Q 0 J'A
LICENSED CONTRACTOR'S DECLARATION QTY ELECTRIC PERMIT FEE
1 hereby affirm that I am licensed under provisions of Chapter 9 W (commencing
JOB DESCRIPTION D'z with Section nXgp ofDmruan rite Business and Profensirns Code,and mylicenuRESIDENTIAL
WW-i- in full force and eRed. ^ p PERMIT ISSUANCE
QUO I,iceme Clas Liap M1�l� ❑SFDWI, E3 KITCHEN REMODF.1.
Fzw ).it ]p�L/ Cnnvnctor �k P APPLIANCES-RESIDENTIAL ❑ADDITION El PLUMBING RE-PIPIT
AI RCppTCT'S ULCLABATION
'Mon IundcrsmnJm I PANELS ❑MULTIUNIT []STRUCTURAL
Z O on_ y plans shall la used as public e, MODIFICATION
Oz� UP T0200AM111'S
1=NFW Licensed Professional ❑INTERIOR El CHIMNEY REPAIR
Q I 20140W AhIPS
OWNERBUILDERULON ❑IMPROVEMENT SWIMMING POOLS
C Q I hereby infirm that 1 am exempt form the Contractor's License Law for the OVER IOW AMPS ❑BATH RHMODEL/REPAIR ❑DEMOLITION
�gq�S50
CO following.,.T.(Section 7031.5.Business and Freebooters Code:Any city ca,00my SIGNS ELECTRICAL ❑OTHIiR
which requims a permit m vonstrteu,aha,intpoor,eemnhxn,ur re,ed any uruare
n
42
prim'to its i0uaner.also requires the applicant for such permit to rile u signed xtarement SPECIAL CIRCUIT/MISE.
Eby that he,licensed pursuant to the previsions(if the Contractor's License Law(Chapter 9
1+f�00 (commencing with Section7")of Division 3ofthe Businessind Professions Coee)or TEMP METER OR POLE(NST. COMMERCIAL
ado 5 that he is exempt therefrom and be basis for the alleged exemption.Any violation of
X^D• Section 1031.5 by eny applicanTfnrapennit svbjec¢me applicam Toacivil penally rf PoWER DEVICES El NEW BLDG/ADDITION ❑DEMOLITION
1�-,z donot more than fee hundred dollars($500). ❑TENANT' ❑FOOD SERVICE
Q ❑Lan owner of the pnspcny.onny cmpinyvcswith wagcsauneirsrleasmpensatinn, SWIMMING POOL ELF,CTRIC IMPROVEMENT
willdo The work,and thcxtrucmrc isnot lmendedorefteomf for xalc(Sec.1144,Business THBR
a3 m and Prof sirens Code:'I he Contractor's 1 iecnxe Law docs Pill apply w an owner of OIITLE'FS-SWITCHES-FIXTURES
property who builds er improves thereon,and who dies such work himself or through
his own employees,provided that such improvements are not intended or offered for NEW RESIDENTIAL ELECTR SQ FT
sale.IL however,the building or improvento is sold within oneyearofcompletion,the SO.IT.FLOOR AREA VSQ.Fr.
ser-builder will have the burden of proving that he did not Wild or improve for pur-
pose of al'.),
❑ I,as owner of the property,am uddivdvuly contracting with licensed contractors be TOTAL:
construct The protect(Ne,744,Bavnesn ane Professions Crnc:)'Doe Contras"',fi
lvdiw Law doennm apply loan cos" f property who builds or inpieves memos,;tial QTY. PLUMBING PERMIT FEF:
Lecnvet.awts fursuch projects with omntm0nr(s)licensed pursuant tome Contractor's t . . '''���•'ryyy
❑l am exempt antler Sec. ,B&P C for this reason PERMIT ISSUANCE
i41 ��� C III
ser One
ALTER-DRAIN&VENT'-WATER TEA) VALUATION II/I�
�._ .
WORKER'$COMPENSATION UECLARA'1ION K d
I nems Tenn rrmaor 2 8 1999
yn penalty til'penury one of the following Acclarmioav JLD
Ihavo and will rnaimaina Cenifewe nr Cnn,cenuo wlGinxurc liar Workers Compere- ) B ) �J STORIES T'YPR CONSLTRUCTION
x"oh.as provided ea by Section 3100 of the Labor Code,for the performance of the
work for which this permit is issued. FIXT ES T
❑1 have and will maintain Worker's Compenrution Inmmace,as"aired by Section I V
3900 ufthe Labor Code.for the performance nithe work for which this permit is issued. GAS YSTEM -OCC:GROUP--"—• �7ApN�
My WildL[ Con�pcnvtin InsvruTTFF r and Policy bcr
Carrier�T�� N�ll carticPolicy No.��_«3D
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE ST - R
A This section need nm be completed if the permit is for one hundred dollars(SRM R IILDING DIV151pN FEES
or less.) PLANCHECK FEE
I cenify that in the perfornance ofthe work forwhich this permit is issued,l shall 200 FT.
SEWER-SANITARY-STORM EA.
not employ any peon in any manner so as to become subject e Workers'Compere- ENERGY FEE
Zzrsttth
nation Laws of Caliherio.Dae
+� Applicant WATER HEATER WNENT/ELECTR
Z GRADING FRE
N NOTICE TO APo The Work If,afteCorer perking this vi sionnvte of E abortion.you should WATER SVSTIiM/1'REA'1'ING
a bccmtithem cTto The Workers Coons or
ermiit shal ofthe tued revoke you most SOILS NEIi
1 Q forthwith comply with such przrvinirm'rr this permit shall be dccnud revoked.
WATER SERVICE
oz CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMB. SQ.FT. PAID
V Ihcrcby affirm thatthere is acomTruaion lending agency fnnhe performance of Date Recei p
sr the work for which this permit nosiest(Sec 3101 Ci,C.)
Lenders Name
O Lender's Address TOTAL: T TAL:
F a I cenify that I hava read this applicarinn and state that the ahnvc information is BUILDING TER
V) correct.1 we to comply with all city and county ordinances and xmte few,mlding m QTY_ MECHANICAL PERMIT FEE
U sZ building construction.and hereby authorize reprusentatiersofthis city Tuenter upon the SEISMIC FEE
shove-mentioned progeny for inspection purpwes. PERMIT ISSUANCE
(We)agree positive.indemnify and keep harmth
less e City of Cupenino again ELECTRIC PER
liabilities.judgments.cosh and expenses which may in any way accrue against said City ALTER OR ADD TO MF.CH.
m consequence of the granting of mos pend PLUMBING FEE
APPLICANT UNDERR NDS ANP ILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10,000 CFM)
SOURCE REG NS. MECHANICAL FEE
,/ AIR HANDLING UNIr(OVER 10)001 CFM) CONSTRUCTION TAX
ill Sign rfIlucector Date EXHAUST HOOD(W/DUCT')
WUS MATERIALS DISCLOSURE HOUSING MITIGATION FEE
Willuture building occupied ord or handle hmallous ma¢rial HEATING UNIT(TO 100,000 BTU)
defined bMunicipal Code,Chapter 9.12.and the Health and SafetyCode.SectioHEATING UNO'(OVER 100,000 BTU)
�YcsNo
VENTILATION PAN(SINGLE RESID) PAID
/ Will the applicant or future building occupant use equipment or devices which BOILER Date Receipt p
.cit hazaNuun air nmmmirunu as defined by The Bay Area Air Quality Management COMP(3HP OR 100,000 BTU)
District9
E]Yet L]No BOILER-COMP(OVER U10,000 BTU) TOTAL:
IM1ave rtaJ the hazZSe,,,.n,
nircmenl undtt Chap¢rfi.95 of the Cali- AIR COND1110M1'HR
lirmia Health&Sarcry Cr255.3 and 2s534.I unJcmm�A mar dmc �ISSUAQNCE UATE
buJdingencsis Toyresponnini lay,u nr..lythorecipam NIiW RESIU-N'I[Al.MECH. SQ.FT. � n / ^- Qy1l the quire robissuance of a CenirwTe ofCccupencr. ( C
Owner uthodzed ag Ume TOTAL: ISSUED BY: �Q
OFFICE
01i13120ao 12: 00 FROM JAMES CHEN: C•E. :=.E. TO 446e5le P.01
James C.Chen,G.B..S.E.
00
P.U.Sox 20302
COO San Jose,CA 95160
(408) 268-0612
January 12,2000
City of Cupertino
10300 Torre Ave,
Cupertino,(,'.A. 95014
RE: Lot 1
19503 Howard Ct•
Cupertino,California
Our Job Nu. 9905
Dear p>_vpeetor•.
I visited the jot,site on V IV2000 to perform the observation inspection7andsadsBod
aming
c eonctruction.All works are complied with the Plan and Specitkadon sho me.
.£you rave any questions in regarding to this subject,please don't hesitate w call me.
Vory=Iy yours. cOpROfE33/py,
�4
V I
ti
James C. Chen,C.F,., S.E. #�9
Sd WdtIT :£0 0002 zT 'uer BTSe 9bt+ e05 'ON 3NOHd S3HIDOSSe = W H WOJd
NOV-06-60 06:16PM FRO"IG CREEK LUMBER WAT30NVILE 6317611634 T-239 P.01/21 F-660
WFA
Certificate of Conformance
Certificate 053742
THIS IS TO CERTIFY that the glued laminated timber products identified with a collective mark of
Engineered NACad Eyet"a (Oft)were manufactured in accordance with the applicable standards
and associated speaficationis indicated below:
ANSI Standard A190.1.1992, For Waod Products-Structural Glued
Lamatated Timber
NER-456 Glued l_arninated Timber Combinations And"GAP'
Computer Program For Determining Design Strauss
AITC 117-93-Manuta=nng-Standard Spacificallons For 9
Glued laminated Timber Of Softwood Species
IT 16 HEREBY CERTIFIED that the APA EWOMWemarked structural glued lam ted timber members
were produced In a manufacturing facility suosct to regular audits in accord with the ItngMsaned
Wood Systems (EWE) Cuality Assuranoo Program. Routine audita include inspection of me
manufacturing process and mivadon of tris in-plant GA program with adequate sampling to verify
conformance in industry standards for lumber grade and glualine bond quality.
See Astaetraunt 01 dated 11-02-1999
-�0
Wopie
a �R 1111111N
Fn by
at SFAL �_ G.Williamson
Exec Vice Preskim
Er7aWEEneD VMD iy$MMS e.teem rAMWM of of Ok-ME FAMEWW10;Z A==TOM
70112"M Im Sno.P.D.em 11700•T�L WA 2011-0700
T�aiYlulc(24A"saw-Fu mamw-9471 KI R60
NOV-05-66 05:IIN FROM-BIG CREEK LUMBER WATSONVILE 8317611634 T-235 P.02/21 F-660
AjolmmEWS
�l
Attachment N ber 1
TC CERTIFICATE OF CONFORMANCE W. 0:5 3-7 Ya HATED 0�—�^ 9
jug Name ?A/lr C jQa-:K abs.
Jaawcmn CUAQL7PA C &-J4
cwmmaraarmrne 95g1.v aaqp iC - ab-/S�S9 Mrgrsomxno
The fallowing idendfiea ate mernbere and gives the basic specifications that were used an MIS i0W
Lumber Spedow 09497-V= X•es-iot! 60""4S F M-
w"Alcom auff" In Comrntutiml �1SO A,p�,O,r�,,da,� Camber
a/1,6 5-149X /Ot�j elt—pok "" _ 'gra,
132. tho 6J/B+ xb'/a-" OyF✓4 Wtr7 -h#' 33ZOi2-
1g2 I/s/ s%b .xjjw- 0;?yF04/ kilo AWch Who Z.
/.3 4/- //3s Tye r �i" ayP3hf c.rP �c� 3sc�'r�
�-
C.a
_�oR6rA
fqmpuy Mill au ontra J r
Goo
moi\