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00020148CITY OF CUPERTINO . BUILDING DIVISION PERMIT PERMITNO. 00 06( 6 I g nUILDINGAUARE.S�)� \/ �•s ��/yk •��' (�T SANITARY NO. AP PLICATION SUBMITTAL DATE + p /`•'�C ✓2�6'. CONTROL# OWNER'S NAME:. Won taws of California. Disc l has 61 O G'[ 1 N/C -' ❑ - PI,ONLr 0 � ; J•... ARCHITECTIENGINEER '� A;' +t ';•jew-BULDINO PlEhi PINFO aq." `o 3Z— q foMwith comply with such provisions or this permit shall W deemed revoked. � CONSTRUCTION LENDING AGENCY ' - I hcaby afErir lhal thou is a c nimclon lending age g forth. perfomwce of I ' a -O s- Cw LICENSED CONTRACTORS DECLARATION 1 hembyaffirm that, 1 am li,coued under pmvleions of Chapter 9 (occormenums with Sation'f00D)ofDrvisronl.lthe Buaimaeand Rofaiovfode,and�lianseis " //''�� ///'''�� JoliElpscription /' � _ �! /)/J-��/ /,(til? i w mNll fmceand Liam Class L¢ M Z /V/ / /(`JifLyl/7 E u y Dam�g Convacmr 1„ g m y ARCHITECTS DECLARATION - $Efv� y 11 undentW my pals shall be uaei u Public rands r'1 building building conswNon. and hereby authorice representatives; ofthis city to enter upon Ne Urn used Pm(G661anel above-mentioned property for inspection purposes.. - (We) egret m uvejrdemnify and kap harmlea. the City of Cupertino against OWNER .DER DECLARATION • U C Z Q ' i hereby effmn I am exempt from the Connectors Lice ., Law for the ., ❑ following.d.. suction ]031.4 Business,t,and y c on Cade: Any city a county [r Rt Sy.. Floor Area p' Valuation• 4 improve, demolish, m repairany Swann which mquima.per.monn:wGh alta,improm,h Mor she permit to iensedpalur fm sahpcmtil,Lice.Law(Chso. ^Ft. —. is oviabscsnr 9 to the Convenors law lCNpra 9 shu he is lianud pursuant to she Pmvuionns `.•� l + HAZARDOUS MATERIALS DISCLOSURE I of nd Pmfi thatWisesgwith Section ]unB)afbasisnlartheBualanandon.AnionsChair) donof that he is exempt thcm(rom end she bowie for the alleged exemption. Any violetlon of APN Number, Oc an p Re -roofs Section ]031.5 by any apple., fm E permit subjects the applicant m • civil penalty of O l 1 m male than five hundred dollars ($300). ❑ La}owner of Ne propeny,mmy employers wish wagesurheir sole compemauon. _ ' RB(iUlre(I IRspectlons ' -will do the work, and theswcma is nor inhaled moBend for sMe(Sec.]Ue4, Buuneu - 'v end Prefeaalons Cade: The Convamrt License law does na apply to an war of installed without first obtining an -inspection properly who builds or improve, thereon, and who does such work himself or through " ' his awn employees, Provided than such improvements ace nor boarded a oftcmd for .. " ith all non point source regulations. We. If,however, da building of lch'.'emcntls said within nae yevof completion. the fmrua Health Ar Safety,Cade, Settions 25505.25533 nod ]5534.1 understand that if me 1 t" - owner -Wilder will have LLL mandon of proving that he did am build or improve for w- building docs roe cu currently have..nt, this it is my mverify spsnabiloy m tc i — ` �� - ❑ 1. u owner of the Property, am..clusivey cono-acung wish licensed contramn 1. ' construct the project (Sec. TON, Entice. and Pmdallinna Cede:) The Contrarora Li- �, r " class law docs out apply to anownarcfpmperty who builda or improves thereon, and •• ' whochrum cts fa such pmjaa wish. conwcmrto licenud ponuam to she Contrechat" All roof coverings to be Class or better Licence Law. ( OFFICE .. Ism aemptulall'Bec." .BBPCilm thi osm. . , .. t Owner Dam " WORKER'S COMPENSATION DECLARATION ' I hereby eflirm under penalty of pr j., was of the fallowing dealnnlma: - z of Ce Workers Compel- will rfar ❑on, etut. - ' send ration, ea provided fa by Section 3]00 of the labor Code, fm the prrfomena arms by 3700 LalbooCocle, far the " work for whish thv permit is issued • ❑ I have and will mnna n Worker's Compensation Insurance, ea mqurred by Section ))(IOof iM labor Code, fm the peHarmentt of do work forwluch this'ndn 1. 1 ... ed. MY l Compensation 11... r• vam and Policy r 1, Policy /rTI�'EI{1IItl[� 1A LEOp Cif mpnlON FROM W (This secsina m edwt becompl ool tithe permit is fm ooehundmddollan (3100) m less.) lecrifythalinttiepafamnanceofthewalk for which this permit is issued, l shall + p not employ any person in any manar w as se become subject to the Workers' Comprn- Won taws of California. Disc Applicant '. SUFFICE TO APPLICANT: If, after making this Cenificale of Exemption, you should , " Wcome subject to dm Workers Compensation provisions of the labor Cade, yw must foMwith comply with such provisions or this permit shall W deemed revoked. CONSTRUCTION LENDING AGENCY ' 0 I hcaby afErir lhal thou is a c nimclon lending age g forth. perfomwce of I Z r�. ,the work fm which this pemrir is issued (ga. J09I. Civ. CJ - - e " Lenders Name Under' Addmaa " .. L17 1 cemy this 1 have read this applialirm and stere Jul the above information is dI... l agree to comply with all city uad county assimilates and nam laws misting to r'1 building building conswNon. and hereby authorice representatives; ofthis city to enter upon Ne , above-mentioned property for inspection purposes.. - (We) egret m uvejrdemnify and kap harmlea. the City of Cupertino against U liabilities, jWgmems, some and expemes which may in any wry seerve against said City t - ^yr W in consequence of the grousing of this permit. [r Rt APPLICANT IJNIiL'ItSTANDS AND .11 COM1�I.V WITH ALLNON-PoIM' V tiOURCE 1lL. � z -17 -Db 9gon5rsnar _ Data ' + HAZARDOUS MATERIALS DISCLOSURE WIIl she.pelicans or future Wilding acupnvannemlosedle hazeNaus mmmial Re -roofs as; defmW by the Cupertino Municipal Code. Chapel 9.11. and the Heald, and Safety Type Roof Coda, Section 25532(.)?.. of Will the applicant or future Wilding occupant use equipment or devices which All roofs shall be inspected 'prior to any roofing,material being installed., 111"a, roof is emit nowdousairconaminsneasdefinedbytheBayArea AirQualityManagement installed without first obtining an -inspection °`b "• ' o Na ,,, ❑Yea I'a ree to remove all new materials for inspection. Applicant - f _ "I have rad the hrsardous hatinals re docmen.a under Cha der 6.95 Write Cali- u it com ith all non point source regulations. ' fmrua Health Ar Safety,Cade, Settions 25505.25533 nod ]5534.1 understand that if me 1 t" - building docs roe cu currently have..nt, this it is my mverify spsnabiloy m tc i — ` �� - of the mquhemems which most h me prim m is . . of a CW ilea of Ottupenry. Signature of ApplicantDate " Downer or euthorizedagem Da Date, "B" All roof coverings to be Class or better OFFICE .. CITY OF CUPERTINO • 1 of 1 BUILDING PERMIT RECEIPT OPERATOR: karenb COPY # : 1 Sec:. Twp: Rng: Sub: Elk: Lot:37511006.00 DATE ISSUED.......: 02/17/2000 RECEIPT q.........: 11476 REFERENCE ID A ...: 00020148 SITE ADDRESS .....: 10148 JUDY AVE SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... 0NNE R ............: SOHONI ADDRESS ..........: CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: CHUCK CONTRACTOR .......: WADE, DON LIC # 18388 COMPANY ..........: DON WADE ELECTRIC CO ADDRESS ...... ....: 16320 HARWOOD RD CITY/STATE/ZIP ...: LOS GATOS, CA 95032 TELEPHONE ........: (408)377-2323 FEE ID UNIT QUANTITY ------------- AMOUNT PD -TO -DT THIS REC NEW HAL ----------- ---------- BELEC200 METERS 1.00 ------------------- 22.20 0.00 -------------------- 22.20 0.00 EPERMITPEE FLAT RATE 1.00 35.52 0.00 35.52 0.00 PERMIT ---------- ---------- 57.72 0.00 ---------- ---------- 57.72 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ CHECK 57.72 ------------------ 3480 ............ TOTAL RECEIPT 57.72 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ........ ............................ 304 ROUGH ELECTRICAL ........ ............................ 501 FINAL ELECTRICAL ENERGY 505 FINAL ELECTRICAL (0 is J ` - Qty. i/ Applicable Fee 10 Fee Description Fee Group �SPERMFEE IBLOG PERMIT FEES 7BUILDWG IBCONSTAX 1CONSTRUCTION TAX IBUILDING BENERGY (ENERGY IbUILUINU BENERGYAOD (ENERGY ADD MULTI IGUILDING BOVERTIMEINSPECTION OVERTIME BUILDING BTEMPPERM ITEMPORARY BLDG PERMIT IBUILDING BMITIGAT HOUSING MITIGATION FEE ISUILDING SPLANCHK PLAN CHECK FEE BUILDING BPLANCKADO PLAN CHECK ADO MULTI BUILDING BPLANCKREP PLAN CHECK REPEAT FEE BUILDING BREINSPECT REINSPECTION FEE BUILDING BSCBLVD SCB SPECIFIC PLAN BUILDING BSEISMICOM SEISMIC COMMERCIAL BUILDING BSEISMICRE SEISMIC FEE RES BUILDING BSPECIAL SPECIAL INSPECTION BUILDING SSWIM SWIMMING POOL BUILDING ZADDCHG ADDRESS CHANGE ISUILDING EPERMITFEE JELEC PERMIT ISSUANCE ELECTRICAL SELEC1000 ELEC 600V <=1000A ELECTRICAL BELEC1001 ELEC 600V >1000A ELECTRICAL BELEC200 ELECT SVCS 600V <=200A ELECTRICAL BNEWMULTI MULTIFAMILY RES ELECTRICAL BREMBUSWAY REMODEL BUSWAYS ELECTRICAL BREMFIXT LIGHTING FIXTURES ELECTRICAL BREMMISC MISC APPARATUS ELECTRICAL BREMNRAPP REM NON -RES APPLIANCE ELECTRICAL BREMPOLE POLE/PLATFORM FIXTURE ELECTRICAL BREMPOWER POWER OEVICE/APPARATUS ELECTRICAL BREMRECEPT RCPTL,SWITCH &OUTLETS ELECTRICAL SREMRESAPP REMODEL RES APPLIANCE ELECTRICAL BREMSIGNAD RMDL SIGNS ADD BRANCH ELECTRICAL BREMSIGNS REMODEL SIGNS, MARQUEE ELECTRICAL BREMTHEATR THEATRICAL LGHTNG FIX ELECTRICAL BSF&2FAM SINGLE & 2 FAMILY ELECTRICAL BTEMP TEMPORARY POWER ELECTRICAL BTEMPSVCS TEMP DIST SVCS ELECTRICAL MPERMITFEE IMEPH PERMIT ISSUANCE IMECHANICALI SAPPLOTHER OTHER APPLIANCES MECHANICAL SBOILERI BOILER <= 100,000 BTU MECHANICAL BSOILER2 BOILER >100KTOSOOK BTU MECHANICAL BBOILER3 BOILER >500K TO 1M BTU MECHANICAL SBOILER4 BOILER>1M TO 1.75M BTU MECHANICAL SBOILERS BOILER> 1.75M BTU MECHANICAL BREMAPPLI APPLIANCE INSTALL MECHANICAL BREMHEAT HEATER INSTALLATION MECHANICAL BREMVENFAN VENT FAN SINGLE DUCT MECHANICAL BMNEWMULTI NEW MULTI -FAMILY RES MECHANICAL SMNEWSF&2F NEW SF&2F RES SLOGS MECHANICAL k oft Revised 9110/99 V