00040139DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING A^•DrD---RESS:
�,/ .LV Frps IT1E "OpJsf 1�JS�J WIN d.O l.�{i Is.1 Q
DWNE SNAME:
1iONc: 't�Pl.
:R ���ly��so
C.Y Y.IIN$G1 .l i�G V-500 -7
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 sm licensed under provisions of Chapter 9 (commeain,
wiNSa[io ]000)efDivi'ion 3 of rhe Busi«sand Pros<uioiu Cade, and'm liccnm is
In run rorce w erc«t. 59984 to
Liave Clack �--�kZ—Lie,. x
I undersand my pluu Shall W used as public remolds
L,camed professional
OW NEB-BUMDER DECLARATION
I hereby affnn that 1 sum exempt from We Consracmnes License Law for the
following recon. (Section 7031.5. Business and Pmf.mons Calle: Any city a county
which tapsmes a permit in construct, Sher, improve, &=Jim. or repair my swcmr ,
prim to its ixSuaoe. W. revuimes the appEcam fasuch permit to file a xigred statcmem
that he is licensed punumt to She provisions of the Contravenes License Law (Clsspter 9
(commencing with Section 7000).f Division J older Business and Prefteslou Cade) or
that he is exempt therefrom W the basis for rise alleged exemption. Any Ailment of
Semon 7031.5 by an, applicant fora permit Subjects the applicant m a civil penalty of
not more, than rive hundred dollen (3500).
I, ser owner of Ne progeny, or mY emPloY«x with wugea. Neireole compenastion,
will do the work, and the mucron limit intended or offend for Nn (Sec.7W, Business
and Profined. Code: The Convector's License law dors hot apply to m owner a
preptrY who W ildx or implies. thereon, and who it. such work himself er through
his own employees, provided this such impmvemenu am nm intended or ofterd for
We. If, however, the Wilding in improvement IS Sold within one yearofcompluior, die
owneeW ilder will have de, When of proving that he did Inst Wild or impeve for For-
Cl
or-
of role.).
co I, o owner of she progeny, am exclusively profession, wish licensed dentode. U. o. La the project pp ]UN. Business of rope Professions build. or the Convanm. Li-
cense Law peas nut applyje sat owner of progeny wee sers imao.. Neeson, and
who mummer for such projects with a conuac,or(q licenced pursuant to the Contractors
License law.
El I om eaempturcerSec. - .B R P C forthlan.wn
Owner Dam
WORKER', COMPENSATION DECLARATION
I hereby efffrts under Firmly of perjory oa of the following declarations:
1 hear and will for by aCcni 37M of Gomenol Code, for tfor irlker'sCompene
worn, as provided for by Sector J]00 of the LeWr Code, (m Na perfomun« of she
work for which this permit isokae
❑ 1 have and will ode, fon Wnrker'e efteCompensation week
for hies required by Section
J]00of the Libor Code, for the adortmme,e of the work fm which this permit is issued.
My Wo 1Compeyulie Insurance Cartier and Policy syn
Carrier yas Sw471 E Policy Noir Sif ry��l
CEBTIFTCATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
MIS Section random W completed ifNepremit is fororchu�eddollnn (SI00)
or
1 trolly them in On perfmmantt of Ne work for which this Fermi, is iwued, l Shall
of torploy any peno;n any mnnnar so u m Wcome nub,.tto the Workers'Compen-
Sallon Laws of Cmiilmou. Date
Applicant
NOTICE TO APPLICANT: If, after making Nie Cenificav of Exemption, you Should
hecomt subject to the Workels Compensation provisions of the Labor Code, you moat
foMw;th comply with Such provimons or this permit shad! W decreed revoked.
I hereby affirm W, Here u u connmedon lending agency for the perfemmnce of
the work for which this permit issued (Sec. 3097, Civ. C.)
Leader S Name
Lender's Address
I unify that i have read this appli.tio and mute that tie above information is
Somali. 1 agem to comply with all city and county mi inances and slate lows muting,.
building umswetio. and hereby mtbearim reprea.wives of thus city to enter upon to
above-mtmioed property for inspection purporea.
(We) agree in sive, indemnify, and keep homeless ,he City of CupeAno agmat
liabilities. judgments. coma and expenses which may in my way seems, against Said City
1nsequeoc<of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL CO MPLY Wll'H ALL NON.IKHNT
I Pbi!mDUS MATERIALS DISCLOSURE
Will de applicmt or future Wilding scup rte store orhandle harar ftem material
ns defined by the Cupertino Municipal Code, Chapter 9.12, and She H WN end Safety
Code, Section 25532(0]
E] Yes
Will the epplicmt or fumm Wilding excupmt use equipment or devices which
emit Woundous air commitments ex defined by Be Bay Arcs Ah Quality Management
❑Y. [I No
this he]<rdous maerials mquimmenu under Chaga 6.95 of d,c Cali -
fey Code. Sections 25505.25533 nM 2f53o.1 unbnsood that if Be
mmudy have, a %xiseq, dead it is my responsibility tonmif, to accupod
PERMIT N0.
c00`�0d 3q
W , o
El 1 99/e,,
{,/'`�{—� s1l /�r�-� v//�. Job.r((D��escription C � �/
(�P �F c
�,Srt wG �s� : �I�_Cf e05-ana.0 �Fh �
Area Valuation
1 . 'a M 11.1.10 0
Re -roofs
Type of Roof
10j 9�73. OR
All roofs shall be inspected prior to an yy roofing material being
installed. If a roof is Installed without first obtaining an inspection
I agree to remove all new materials for inspection. Applicant
understands and will comply with all non point source regulations.
Signature of Applicant
OFFICE
All roof
Date
to be Class `B" or better
IfEIOi 1 of 1
CITY OF CUPERTINO
BUILDING PERMIT RECEIPT
Sec: Twp: Rng: Sub: Elk: Lot:31602106.00
DATE ISSUED.......: 04/21/2000
RECEIPT #.........: 12063
REFERENCE ID # ...: 00040139
SITE ADDRESS .....: 2 INFINITE LP
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: christya
COPY # : 1
OWNER ............: CUPERTINO GATEWAY PARTNERS
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014
RECEIVED FROM ....:
TIM
QUANTITY
CONTRACTOR .......:
NOBLER, PETER C
LIC # 13302
COMPANY ..........:
DPR CONSTRUCTION
INC
ADDRESS ..........:
555 TWIN DOLPHIN
DR
CITY/STATE/ZIP ...:
REDWOOD CITY, CA
94065
TELEPHONE ........:
(650)592-4800
0.00
FEE ID
UNIT
QUANTITY
AMOUNT
----------
0.00
----------
BPERMFEE
-------------
VALUATION
----------
1000,000.00
49.98
4109.00
TURF
UNITS
6.00
0.00
49.98
0.00
.9OCHX
PERMIT FEE
4,109.00
3492.65
B FIXT
NO. FIXTURES
72.00
0.00
57.04
87.19
HENERGY
PERMIT FEE
4,109.00
1232.70
0.00
EREMRECEPT
NO. OUTLETS
117.00
927.96
87.19
PPERMITFEE
FLAT RATE
1.00
0.00
35.52
0.00
BREMREPALT
NO UNITS
76.00
927.96
ESEISMICOM
VALUATION
1000,000.00
210.00
EPERMITFEE
FLAT RATE
1.00
35.52
MP£RMITFEE
FLAT RATE
1.00
35.52
TOTAL PERMIT :
METHOD OF PAYMENT
-----------------
CHECX
TOTAL RECEIPT
10273.08
AMOUNT
-----
4725.35 62107
-•v-v4725 35
PD -TO -DT THIS REC NEW HAL
0.00
0.00
4109.00
0.00
0.00
49.98
0.00
3492.65
0.00
0.00
0.00
57.04
0.00
1232.70
0.00
0.00
0.00
87.19
0.00
0.00
35.52
0.00
0.00
927.96
0.00
0.00
210.00
0.00
0.00
35.52
0.00
0.00
35.52
NUMBER
0.00 4725.35 5547.73