99090019 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY L CYT'
iu,'i.DIN
OF CUPEwrINO BUILDING-ELECTRICAL PERMITNO.
DIKiDIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL.�QURESS , SANITARY NO. API'-LLIIC ION. BMITTALDATE
got
S NAMIi /V PIIONIi: CO ACT N LIC NO:
N/C ONTR LM
t 'f .'/'NGINEER: LIC O DD S ❑
CONI'nC'1': P no'n BUILDING PERMIT INFO
(�-� ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT PLUMB MECH
LICENSED CONTRA R f<1 AI1Ar10N 't
(herchy ulfrm mad am liwnsWu p fChvpmr9(annmepnn QTY.,, CLI?CTRIG PERMIT'S ,,'FEE
e t _ t . . , JOB DESCRIPTION
won with Section 7")ofDivuon3ofineBus and Profession,Code amdmy license is - RESIDENTIAL
FSO in full fnce.nd effect. P[RMII'ISSUANCE
a U V license Class u ❑SFT)WL ❑KITCHEN REMODEL
vFiQa Dom mmnor
APPLIANCES ❑ADDITION ❑PLUMBING RE-PIPE
AR SDEPANELSCLARATION ❑MULTI-UNIT 0STRUCTURAL
O~nK a uhlic records MODIFICATION
Z-p UP TO 200 AMPS El INTERIOR El CHIMNEY REPAIR
awl"j Lice sJ +fie conal 201-1000AMPS IMPROVEMENT SWIMMING POOLS
-9 OWNS - ILDERm the Comouni OVER 1000AMPS ❑BATH REMODEUREPAIR ❑DEMOLITION
C Q 1 herchy affirm that 1 am exempt from the CamrmTm'n License Law fon the
V (D U following reason(Section 7031.5,Business and Professions Code:Any city or county SIGNS ELICTRICAL ❑OTFJER
which reunites u permit to consvum,.lter,Improve,demolish,or repair any structure
tooriiy prior m Its issusher.also requires the applicant forcuch permitIn filen signed statement SPECIAL CIRCUIT/MISC.
.CqW�pC "ohneb"ve eA pursuanua iheprovisions of the Comnwmr'x Lienmsc Lnw(Chtirycr9 COMMERCIAL:� d� (commencing wiOm Section 7000)of Division 3afthe liminess unit Pmtr,sia.,Cale)ar TAMP,MET ER OR POLE
shut be Is exempt therefrom and the basis for me alleged exemption.Any violation of EIV BLDG/ADDITION ❑DIiMOLITION
iy( Y• Secliun 7031.5 by any applicant for apcm+it salomis the applicant)a civil penalty of POWER DEVICI:9
ANT ❑FOOD SERVICE
not more than live hundred dollen,(4500). 1 IMPROVEMENT
=ZC ❑ L,asownerofthepmpeny,ormyemployeeswlthwagosastheirso].compensation. SWIMMING POOL ELEC rRIC
wLl do the wed,and the structure is ern intendednr mffercd ferrule(See......Business ❑OTHER
and Promovions Cade:The Caaractars License Law does ant uppiy to as owner of OUTLETS-SWITCHES-FIXTURES
property who builds or amproves thereon and who does such work himself or through
his own empinyea,provided that such improvements am nm intended or offered for NEW RESIDFMIAL ELECTR
aide.If.however.the building or improvement is sold within one yemofcompleuon,the SQ.FT.FLOOR AREA ESQ.FT.
awrc-hmlder will have the burden of proving that he did not build or improve for pur-
❑1,as owner of the property,am exclusively convecting with licensed contractors to p
consumer the project(Sec.7000,Business and Pmlesxinnx C,-..,I—Commemr's Li- - - - ote - x-S
least Law does not apply to an owner of property who builds nr imFrove llumoommd 'QTY. PLUMBING PERMITFEE
who contracts for such projects with a contructar(s)licen.sed pursuant no the Contractor's
Limns.Law. P13RMI1'ISSUANCE O
❑ I ion exempt under Sec. ,B&P C for this reason
ALTER-DRAIN&VENT-WATER(EA) VALUATIOy�'
nar Dam (JU
WORKER'SCOMPENSATIONDI3CLARATION BACK FLOW PROTECT.DEVICE
I hereby affirm under penalty of perjury one of the following declarations:
❑(have proxid l for by
a tion 3700 of the LaI or Code.fumhe erform ante of the DRAINS-FLOOR,ROOF,AREA,CONI. STORIES TYPE CONSTRUCTION
satins,as provided for by Smdon 3]1X1 of the Labor Cale,for the performance of the
work far which this permit is issue. FIXTURES-PER TRAP — -I
❑1 have end will mainmin Wmkers Compensation Insurance,as hectored by Section J
ItA
37Mcifthe Labor Code,forme prommushar.fthe work for whichdr,pe mm,is issued. GAS-1?A.SYSTEM I INC.4 OUTLETS OCC.GROUP APN
MyWo ors Insurance lnxunce<arittand Policy number am:
rhirr.
Policy No.: GAS-IiA.SYS'f1iM-OVERJ(EA) L/ /
CERTIFICATE OF EXEMPTION FROM WORKERS' GREASI%INDUSTRI.WAS RCEPfOR
COMPENSATION INSURANCE QDIVi9FP.RN
(Ibis section need not be completed i f the permit is forme hundred dollmrs(5100) GREASETRAP
or less.) PL ECK
Icmify that in the performance ofthe work for which this permit is issued,i shall SEWER-SAN RV-STORM EA.200 FT.
not employ any person in tiny manner so as to become subject to the Workers'Compcn- EN FEE
Z salon Lows or Colilbrnin.Dote
WATEklJIIAI'IiR WNF.NT/ELECTR
z O Appllmmt - G G�GL{`P 1 1999
rN•t N amnio:object
o'h e W k IL after making this si,io cute of Exemption,you should W R SYST EMnEHA1 INC
a become subject as the Workers Compensation provisions of the labor Code,you moa SUN If FEE
� (nnhwith comply with such provisions or this permit shall to decmcJ rcvaked. WATER SIikVICI?
A y
UO CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMB. SQ.PT. PA
I hereby affirm that hen is a constmction lending agency for performance of ate them#
F the work for which this permit is ixsued(See.3097,Civ,C.)
Q Lenders Name TOTAL:
V Lenders Address TOTAL:
Fy I certify that 1 have read this application and some than the al.we information is BUILDING FEE
to roomer.I agora to comply with all city and county ordinances and state laws misting to QTY. MECHANICAL PERMIT' FEE
V z buildingconshartion.and modayauthorim mpresmmativexafmhis city mentor upon the SEISMIC FEE
uhnve-mentioned property for inspection purposes. PERMIT ISSUANCE
(We)agree to save,indemnify and keep harmless the City of Cupertino against ELECTRIC FEE
Iiuhiliticajudgmcnts,ensI vat lex cores which may in any way me corns,sold City ALTER OR ADD'1'0 MACH.
msoqu-ncc if uyrgnor th spermia PLUMBING PEE
APPLI fU ) 9 US NDWILLCOMPLY W I'H .h NON-POINT AIR HANDLING ON]T(DO 10,000 CFM) MECHANICAL ME
SOU K 0
AIR HAN DIANG UN I'1'(OVER 10,000 CPM)
2 CONSTRUCTION TAX
o ApplirmumCom act Date EXHAUSTHOOD(W'/DUCT) HOUSING MITIGATION FEE
HA R US MATERIALS DISCI. SU
Will the applies there building accupam Hare or handle hazmil..,end HEATING UNI'1'('1'0100,000 BU)
T
as defined by the Cu Muni al Cale,Chapter 9.12,and the Health and Safety
Code,Section 25532( . o HEA'T'ING UNIT(OVER 100,0X1 BTU)
❑YCx VENTILATION PAN(SINGLE RE,SID) PAID .'
Date Receipt#
Will the applicant m future building occupant use equipment or devices which
emit hmmdous air contaminants as defined by the Buy Area Air Quality Management BOILER-COMP DHP OR 100,000 BTU)
DixlricYt TOTAL: J
Yes BOILER-COMP(OVER 100,0X1 BTU)
I h,m mad the ham o - mmeow un l,,hy `�11111AIZIOF`a
e C.li- AIR CONDTI'IONER
I qui ISSUANCE DATE
f nnia Head, , far,C e, ac .25. 5,25533 and 25534if the NEW RESIDIN'1'IAL MECU SQ.IT.
buildingd n re am at it is my teslsmsihilal me ti
0 oro a or cd agerTOTAL: ISSUED BY, 2f&V
OFFICE
i 1
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
• BUILDING PERMIT INVOICE OPERATOR: christya
Sec: Twp: Rng: Sub: Elk: Lot:31602107.00
INVOICE DATE......: 09/02/1999
REFERENCE ID # ...: 99090019
SITE ADDRESS .....: 3 INFINITE LP
SUBDIVISION . ......
CITY ........ . .. ..: CUPERTINO
IMPACT AREA . ......
OWNER . . . .........: CUPERTINO GATEWAY PARTNERS
ADDRESS ..........:
CITY/STATE/ZIP ... : CUPERTINO CA, CA 95014
CONTRACTOR .......: RUSSELL, DAVID J LIC # 5655
COMPANY ..........: SOUTHBAY CONSTRUCTION
ADDRESS ..........: 511 DIVISION STREET
CITY/STATE/ZIP ...: CAMPBELL, CA 95008
TELEPHONE .. ......: (408)379-0400
FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE
_______________ --- --------- ---- ______---__
BENERGY A 32.10 0.00 32.10
BPERMFEE P 107.00 0.00 107.00
BPLANCHK A 90.95 0.00 90.95
BREMRECEPT P 8.88 0.00 8.88
HR EPALT P 24.42 0.00 24.42
7ICOM P 1.05 0.00 1.05
ITFEE P 35.52 0.00 35.52 "
MPERMITFEE P 35.52 0.00 35.52
_________ ____________ ___________
335.44 0.00 335.44
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
........ ............................ ........ ............................
101 FOUNDATION 102 PIERS
103 LIFER 104 REBAR
105 ANCHOR BOLTS 106 SEWER & WATER
202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL
204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION
301 ROUGH PLUMBING 302 TUB & 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
CITY OF CUPERTINO
I� 1 of 1 BUILDING PERMIT RECEIPT OPERATOR: chriatya
COPY # 1
Sec: Twp: RnB: Sub: Elk: Lot:31602107.00
DATE ISSUED.......: 09/02/1999
RECEIPT q.... .....: 9972
REFERENCE ID N ...: 99090019
SITE ADDRESS .....: 3 INFINITE LP
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA . ......
OWNER .. ..........: CUPERTINO GATEWAY PARTNERS
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014
RECEIVED FROM ....: JOBS
CONTRACTOR ....... : RUSSELL, DAVID J LIC # 5655
COMPANY ..........: SOUTHBAY CONSTRUCTION
ADDRESS ..........: 511 DIVISION STREET
CITY/STATE/ZIP ...: CAMPBELL, CA 95008
TELEPHONE ... . ....: (408)379-0400
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 5,000.00 107.00 0.00 107.00 0.00
BP CHK PERMIT FEE 107.00 90.95 0.00 90.95 0.00
MM,Y PERMIT FEE 107.00 32.10 0.00 32.10 0.00
CEPT NO. OUTLETS 8.00 8.88 0.00 8.88 0.00
MPERMITFEE FLAT RATE 1.00 35.52 0.00 35.52 0.00
BREMREPALT NO UNITS 2.00 24.42 0.00 24.42 0.00 .
BSEISMICOM VALUATION 5,000.00 1.05 0.00 1.05 0.00
EPERMITFEE FLAT RATE 1.00 35.52 0.00 35.52 0.00
___ ----- ---------- ----------
TOTAL PERMIT 335.44 0.00 335.44 0.00
METHOD OF PAYMENT AMOUNT NUMBER
_________________ ____________ __________________
CHECK 335.44 6622
----------
TOTAL RECEIPT 335.44
• CITY OF CUPERTINO
Item 1 of 2 BUILDING PERMIT RECEIPT OPERATOR: christya
COPY N 1
Sec: Twp: Rng: Sub: Blk: Lot:31602107.00
DATE ISSUED....... : 09/02/1999
RECEIPT q......... : 9972
REFERENCE IO k ...: 99090019
SITE ADDRESS . ....: 3 INFINITE LP
SUBDIVISION .. .....
CITY ........ . ....: CUPERTINO
IMPACT AREA .......
OWNER ...... ......: CUPERTINO GATEWAY PARTNERS
ADDRESS ... . . .....:
CITY/STATE/ZIP . ..: CUPERTINO CA, CA 95014
RECEIVED FROM ....: JOES
CONTRACTOR .......: RUSSELL, DAVID J LIC k 5655
COMPANY ..........: SOUTHBAY CONSTRUCTION
ADDRESS ......... . : 511 DIVISION STREET
CITY/STATE/ZIP ... : CAMPBELL, CA 95008
TELEPHONE ........ : (408)379-0400
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
*ID DESCRIPTION VOICE ID DESCRIPTION
............................ ........ ............................
101 FOUNDATION 102 PIERS '
103 UFER 104 REBAR
105 ANCHOR BOLTS 106 SEWER & WATER
202 UNDERFLOOR PLUMBING - 203 UNDERFLOOR MECHANICAL
204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION
301 ROUGH PLUMBING 302 TUB & 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