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99080025
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY (0 2002vo CITY OF CUPERTINO t BUILDING-ELECTRICAL PE BUILDING DIVISION APPLICATIONIPERMIT PLUMBING-MECHANICAL +i 'BUILDINGPROJECTIDENTIFICATION BUILDING ADDRESS: - SANITARY NO. APPLICATION SUBMITTAL DATE o `Z!j til c r Lo a, s PJ 3 OWIJI,R'SNAM-. PHONE. CONTRACTOR'S NAME: LIC NO: Ask r� N/C ONTIOL If R ITICIENCINEER. r .I N : ADDRESS: ❑ L C CONFACT, PHONE BUILDINGPERMITINFO Z! �y ❑,Consultant Fees Paid by Applicant(Initial) BLDPI ELECT PLUMB MECFf_ V t . _ ... L ^KL . ❑ Ppm( LICENSED CONTRACTORS DECI ATION QTY.? '. 'ELECTRIC PERMIT FEE /"— p I hereby affirm that 1 am licensed under p . of Chapter el(commencing _ JOB DESCRIPTION Wpz with Section 71100)ofDrvson3oRhe Basilicas and Professions Code,and an,license is RESIDENTIAL,In full force and effect, PERMIT ISSUANCE. ❑SFDWL -� El KITCHEN REMODEL �pU License Class Or lac.#' APPLIANCES-RESIDENTIAL C1 ADDITION L1 PLUMBING RE-PIPE Nzj Dale Ireftor F5y Cf 1" DECLARATION PANELS [_1 MULTI-UNIT El STRUCTURAL O mZ ret to b ublin reemms MODIFICATION OZq Li se Pr es mal UP T0200AMPS El INTERIOR L1 CHIMNEY REPAIR 201-IOMAMPS IMPROVEMENT E]SWIMMING POOLS �� OWNER-H LDER DECLARATION OVER 1000 AMPS ❑BATH REMODEUREPAIR El DEMOLITION I ereby affirm that I a xe opt from the Contractor's License Law far the a6 U following reason.(Seriun 1031..,Bosinexs and Professions Cede:Any city or county SIGNS BLECTRICAI. ❑OTHER 0.F Imich requires a remit to ennsWcl,alter,Improve,demolish,or repair any structure Prior to itsissuance.also requires,the applicantfor such Permit t Ile a agred statement SPECIAL CIRCUIT/MISC. - y that he islicensed p un a the provisions of the C t l r'x Licence Low(Chapter9 X00 (commencing with Section 1000) fDivision3 of the❑ ss dProfessions Code)or TEMP.METER OR POLE INS'L 0.y e eG that h x pt dr of -t d thefork f thealleged excitation,Any violation of - ❑ LDG/AI3D7� ON WX 4N. Section 1031.5 by any applicant for a permit subjects the applicant m a civil penalty of POWER DEVICES N7 lJ�. ODS' 1 E F i+ not more than five handled dollars P3500) GVEMENT C�do (] 1.as owner of rhe pmprny,or my ebtployces with wages al,iheirsale comperomion, SWIMMINGPCULELECTRIC' dd will do the work,and the structure is not intended or offered for sale(See.]MHER 4,Business q W 14 and Professions Code:The Contractor's License Law does nut apply to an owner of 5L GOTTEN S-SWITCHES-FIXTURES S ' ' �i property who builds or intpnrves taarem,and who does such work himself or through �t his own employees,provided that such improvements rare not intended or offered fo NEW RESIDENTIAL ELECT SQ FT. sale.If,however the building or improvement is sold within one year ofcamplehom Ota fT SQ.FR FLOOR AREA SSQ.FT. colanc r will have the burden of proving that 1a did not build or improve for par- Y pose lm1c). ❑ 1,as owner of the p o,ext am exclusively contracting wan I' n. d c nam t rs m TOTAL constructll p ) t(SC 1(144,Business dr' f:.' Cd! C t I sl. .y cense Le dent pply to un nxnerot pct pe ly h bu'IJ 'mpr m and QTY `PLUMBING PERMIT tPEE who facts for such projects with a commercials)Icensed pursuant m the Contractors t License Law. PERMII'IS NCH EDI am exempt under Sec. ,B&P C for this reason Owner Dote ALTER-DRAIN&VENT-WATER(EA) VAVALIIAT10N WORKERS COMPENSATION DECLARATION BACK FLOW PROTECT.DEVICE �J DA© I hemby affirm under penalty of prim or,one of the follnwing dedrun ions: I have and will maintain a Certificate of Con.sentto self-insure for Worker's Compen- DRAINS-FLOOR,ROOF,AREA,COND STORIES TYPE CONSTRUCTION anon,as provided for by Section 3100 of the Labor Cade,Initial,perfomaance of the 1r work far which this permit is issued. FIXTURES-HER'TRAP ,. /�f ❑I have and will maintain Workers Compensation Insurance,as required by Section - 3100nfthe Labor Col,for the Performance of the work for which this permit is issued. GAS-EA.SYSTEM-IIN OUTLETS OCC.GROUP APN My Worker's Compensation Insurance carrierPolicy number are: Carrico Policy and GAS-EA.SYST' -0VER4(EA) CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE GREASUlPi WAS TE INTERCEPTOR BUILDI GDIV7510NF2E$ (Thissecdon need not be completed lithe permit is fomite hundred dollars ISIou) GRC ETRAP - others.)e PLANCHECK FEE I certify Bazin tire colommuccafthe work for whll,ths permit is issued,i shall SOWER-SANITARY-STORM BA 200 FT. not employ any person in any manner so as to become subject to the Wm1wG'Compen- ENERGY FEE. Z Nation Laws of California.Date O Applicant WATER HEATER WNENTIELECTR GRADING FEE tiNOTICE TO APPLICANT:If,after making this Carifieate at Exemption,you should WATERSYSTEMITRFATING N , become subject to the Worker's Compensation provisions of the Labor Code,you must SOILS FEE WQ forthwith camply with such nevi mour this permit shall Is,deemed revoked. WATERSCRVICE CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PI,MB. SQ.OT PAID U O thereby affirm that there is a construction lending agency for the perfornmovs,of Date Receipt the work for which his permh o issued(Sec.3097,Civ.C.) O VLender's Name TOTAL'. (11 Lend r Address TOTAL: I rify,hB1have Idsapplication and stare It., he aboveiratti r - , .i' t BUILDING FEE h correct,1 g t ply with II city and county aMinances and site law.rll gto QTy MECI{ANLCALPERMIT- FEE',: UZ abodengcame stmcdonand hereby zeffuse, wl vea of th'sety to eater upon the SEISMIC BB above-Oste) n agree to save, for inspection an keep ha PERMIT ISSUANCE ELECTRIC FEE (we)agree m save,indemnity and keep harmless the City of accord sagmaid City liubilities,judgmemrs,costs and expenses which may in any way accrue against said City ALTER OR ADD'1'OMECH. PLUMBING FEE n comeyuence of this permit. Allf, ,RSH 'AND WILL COMPLY WITH A.L Nf -POINT AIR HANDLING UNIT(TO 14000 CFM) SO ' R MECHANICAL FEE 6 3 AIR HANDLING UNIT(OVER 10,000 CFM) CONSTRUCTION TAX Signor eo AppliMalf unit n Dat EXHAUST HOOD OYMUCT) HOUSING MITIGATION HE IIAZAR OUS MATERIALS DISCLOSU E Will flare nemil.r tum budding ocupam Hort or handle hazardous nmmrial HEATINGUNIT(TOIOo,00on'IV) as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Cade,Section 25532m)1 HEATING UNIT(OVER 104000 BTU) ❑Yes Na PAID VENTILATION PAN(SINGLE RP.SID) Date Receipt# Will the applicant o tutu a building occupant use equipment or devices which BOILER-COMP(3HP OR 100,000 E'I'I1) _ ii hauxnious air contama,mmdclined by the Buy Area Air Quality Management TOTAL: rict[I BOILER-COMP(0VER 100,0011 BTU) ❑Ves No I haverendthe hazy do matedals requirements under Chapterfi95 or the Cali- AIR CONDITIONER ' ISSUANCE DATE`^, fomia Healt &Sa1M ode, e s 25505,25533 and 25534.1 dors rad aha if the NHW RESIDERTIALMECH. SQ.Ff. huildingd ¢ lyh t am,Na it is my responsibility nasi the occupant lJ nfthu t tet arm issuance ofa ey. ' Owner if thorized agem D TOTAL: ISSUED BY: r *� OFFICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO BUILDING PERMIT INVOICE OPERATOR: chnistya Sec: Twp: Rng: Sub: Blk: Lot:31602107.00 INVOICE DATE. .....: 08/03/1999 REFERENCE IO N ...: 99080025 SITE ADDRESS .....: 2 INFINITE LP SUBDIVISION . .. .. . . - CITY .......... ... : CUPERTINO IMPACT AREA ...... . OWNER ............: CUPERTINO GATEWAY PARTNERS ._ ADDRESS ...........: CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014 " CONTRACTOR . . .. .... LIC N COMPANY ..........: ADDRESS . .........: CITY/STATE/ZIP ... , TELEPHONE ........: FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE --------------- --- --------- ------------ ----------- BENERGY A 62.10 0.00 62.10 BPERMFEE P 207.00 0.00 207.00 BPGAS P 4.44 0.00 4.44 BPLANCHK A 175.95 0.00 175.95 BPREPIPE P 8.33 0.00 8.33 RRR P 14.43 0.00 14.43 FE CEPT P 34.93 0.00 34.93 PALT P 158.73 0.00 158.73 BSEISMICOM P 3.15 0.00 3.15 EPERMITFEE P 35.52 0.00 35.52 MPERMITFEE P 35.52 0.00 35.52 --------- ------------ ----------- 740.10 0.00 740.10 1 ��G INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO BUILDING PERMIT INVOICE OPERATOR: chrietya Sec: Twp: Rug: Sub: Blk: Lot:31602107.00 INVOICE DATE......: 08/03/1999 REFERENCE ID N ...: 99080025 SITE ADDRESS .....: 2 INFINITE LP SUBDIVISION ....... CITY .......... . . .: CUPERTINO IMPACT AREA . ...... OWNER ........... . : CUPERTINO GATEWAY PARTNERS < ADDRESS .......... S}f CITY/STATE/ZIP ... : CUPERTINO CA, CA 95014 1 ' •+ CONTRACTOR ....... : LIC fl COMPANY ..........: ' ADDRESS ..........: CITY/STATE/ZIP .... , TELEPHONE ........: VOICE ID DESCRIPTION VOICE IO DESCRIPTION ............................ ........ ............................ 101 FOUNDATION 102 PIERS 103 -UFFR 104 REBAR 105 ANCHOR BOLTS 106 SEWER 6 WATER UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION ROUGH PLUMBING 302 TUB E OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 306 HOLDOWNS 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 313 ROOF NAIL 501 FINAL ELECTRICAL ENERGY 502 FINAL PLUMBING ENERGY 503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERGY 505 FINAL ELECTRICAL 506 GAS TEST ' 507 FINAL PLUMBING 508 FINAL MECHANICAL t09 FINAL GRADE 510 FINAL PLANNING 514 FINAL PUBLIC WORKS 1 •