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08030185 CITY OF CUPERTINOrt �aq��vurs^ sl&. �7'g� y'�,g' �Ta - BUILDWGDIVISION PERMIT WQ of�, �31R1Y-g RTQ - BuaOtaQlApIt"EINDA VISTA PL A PERFECT CLIMATE PEn08030185 LR'SS NAME; 1s PERMIT ISSUE DAM U MARTIN 8375 BRENTWOOD BLVD STE B 03/31/2008 NE: SANITARY NO. CONTROL NO. ARCHTfECT2NGINEER: AC REPLACMNT, 4 TON BLDG BUILDING ELECTPERMITPLUMB MECH 0 0 0 0 Do LICENSED CONTRACTORS DECLARATION - Ib Description rI I hereby affirm WOeSCTIp t I am licensed under provisions,of Chapter 9(commencing i with Section 7")ofDi,sien 3af the Bummat and Pmfeuium Code.andmylismac is p H in full tome aha sffe Z Defense CI CO hector r WgPa . e �CrS DECLARATION U V y 1 undemmmJ my plans shall W used u public mcoNs 5Gt; Licensed Professional OWNER-BUILDER DECLARATION f I bo.,y a?rex that 1 em exempt from the Contmctor's License Law far the i.pa o following meson.(Section 7031.5.Business and Pmfeatom Cole:Any city or county m which requires a permit to condoms,alter,improve,demolish,or mpair any smucture prior or its issuance.also requires the applicant rorsuch permit to file a signed ntstmemi � that he is licensed pursuant to the provisions of Ne Connector's License Law(Chapter 9 Sq.Ft. FIOOC Area Valuation $ (commencing with Section 7")ofDivision 3 of the Busineaand Prormonions Code)or that he t&e¢mpt therefrom and me but&for W alleged exemption.Any vlolauon of Section 7031.5 by any applicant for a permit abjecu the applicant m a civil penalty of AFN Number Occupancy Type not mote than five hundred dollar(55001 0 1,u owner of the property,or my employ es with wages at their sok compensation, will do the work.and the structure is net intended aroffemd for sale(Sec.7044,Business Required Inspections and Professions Code:The Committees Liatue Law doer not apply to ownee ns an r of Q p property who bui Ida m im proves Ummun,and who does such work himsel r m through his awncmploywa,provided that such impmwmcrts mc not inmrded oro@red fern ale.If. however.the building or improvement LL sold within oro year of completion,the owner, Wilder will haw me burden of proving dot he did not build or improve for purpose of sale.). 0 1,as owner arms props",am exclusively conosedng with licensed convectors to comwet me project(Sec.7W.Business and P ultaslam Code:)The Commome.Lt. codes law does not apply to an owner or proper,who Wilda or impmvn 0mmon,and who contracts for such projects with a comractor(s)licensed pursuant to the Commctoh Lleense Law. ❑lam exempt undv See ,B&PC for this moon t Date WORKER'S COMPENSATION DECLARATION ereby affirm under penalty of perjury m e of the following declarations: and will maintain•Cerufreeteof Consent to self-Imam for W.ftesCampus- provided for by Secuon 3700 of the labor Code,for the performance of the which this permit is issued. and will ons.for Workers Compensation Insure hi h his perm by Section ssu d. e labor Code,fw me performance of the work for wMch this permit isluued.Co prommon Insurance carter and Policy umber are/Gan[.. Policy lt6.fea eyo?_600 i& CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (Thu modest need not k completed if tiro permit Is feature hurled dollen(5100) or leas.) 1 certify met in the performance of the work for which this Permit is tauN.l shall not employ any person in any mammr so as to became subject o the Workers'CompemNon Laws of California.Date Applicant NOTICE TO APPUCAN1%If.after making this Certifies a of Exemption,yen should become subject to the Worker's Compensation previsions of the tabor Code,you mount .J Q raMwith comply with such provisions or this permit mall bo deemed rooked. ,Zn CONSTRUCTION LENDING AGENCY I heath trims that men is a construction lending e E~ Y { genryfar the performance of !Yi the duh for which this permit LL issued(Sec.3097,Civ.C.) [q 0 LeName 0 z lernme,ndeh Address U 0 1 cu ify sen 1 have nand this application and sum mu the above information is common.I agree in comply with all city and county oNinancea and scam laws mating to .0 buildingconstruction,and hereby authoum representatives of this city to enter upon he W thou.-mentioned property for Inspection purposes (Ws)agree to save,indemnify and keep harmless the City of Cupertino against l.i IZI Iiabilttlq,Judgments,costs and expenses which may in any way accrue against aid City in of the U^+ APPLwneCUNDERSTANDS ANrounfing of this D WILL COMPLY WITH ALL NON-POINT Issued by: Date ( O� s I GULA3o z2 L Py mR 3— Dam Re-roofs Signature,of Apt antic Oele OUS MATERIAL ISCLOSURE Type of Roof Will the applicant or future building oecupand atom or handle hanrt ours material U defined by the Cupertino Municipal Code.Chapter 9.13,and the Health and Safety .sectionEl Y.25532(1)? All roofs shall be inspected prior to any roofing material being installed. El Y. /�Q�Noj Will the applican or r( m building occupant um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove i be ardoue air conmtnimmus u defined by the Bay Area Air Quality Management all new materials for inspection. .strict? 0 Yes I have mad the braid mrf�als requirements under Chapter 6.95ofmcCalifw- alth&SafeiyCode Seem ns25505,25533 and 35534.1 undersand metifthe Wilding nm current w a tenant that it u my maponsihility m nodfy dm occupant of thc mmcna mnbcmel or eof.CertificateofOemianey. Signature of Applicant Date � ° "�3 P Dow All roof coverings to be Class'W'or better Owner or authorised agent ' CITY OF CUPERTINO 6 ITEMS OF 16 PERMIT RECEIPT OPERATOR: patg COPY # 1 ® Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35608011 . 00 DATE ISSUED. . . . . . . : 03/31/2008 RECEIPT #. . . . . . . . . : BS000004316 REFERENCE ID # . . . : 08030185 SITE ADDRESS . . . . . : 22126 LINDA VISTA PL SUBDIVISION . . . . . . : CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : KU MARTIN ADDRESS . . . . . . . . . . : 22126 LINDA VISTA PL CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : EDWARD A GREGORY CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144 COMPANY . . . . . . . . . . : A PERFECT CLIMATE ADDRESS . . . . . . . . . . : 8375 BRENTWOOD BLVD STE B CITY/STATE/ZIP . . . : BRENTWOOD, CA 94513 TELEPHONE . . . . . . . . : (408) 861 9545 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---- 1BSEISMICR VALUATION 5, 854 . 00 0. 60 0. 00 0. 60 0. 00 ® 1EPERMITFE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00 1MPERMITFE FLAT RATE 1. 00 40.79 0. 00 40 .79 0. 00 1MRRAA UNITS 1. 00 61 .19 0. 00 61.19 0. 00 IPPERMITFE FLAT RATE 1. 00 40 .79 0. 00 - 40.79 0. 00 1TRAVDOC FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00 ------- ------- ---------- ---------- TOTAL PERMIT 224'. 95 0. 00 224 .95 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 ------ ------ - 505 FINAL ELECTRICAL . 507 FINAL PLUMBING 508 FINAL MECHANICAL I INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO PERMIT INVOICE OPERATOR: patg Sec: Twp: Rng: Sub: Blk: Lot: . APN . . . . . . . . : 35608011 . 00 INVOICE DATE. . . . . . : 03/31/2008 REFERENCE ID # . . . : 08030185 SITE ADDRESS . ... . . : 22126 LINDA VISTA PL SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT. AREA . . . . . . . OWNER . . . . . . . . . . . . : KU MARTIN ADDRESS . . . . . . . . . . : 22126 LINDA VISTA PL CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144 COMPANY . . . . . . . . . . : A PERFECT CLIMATE ADDRESS . . . . . . . . . . : 8375 BRENTWOOD BLVD STE B CITY/STATE/ZIP . . . : BRENTWOOD, CA 94513 TELEPHONE . . . . . . . . : (408) 861 9545 FEE DESCRIPTION DUE FOR -- AMOUNT DUE ------PAID BALANCE --------------------------- -------------- ---------- ---------- SEISMIC RESIDENTIAL PRINTING PERMIT 0 . 60 0. 00 0 . 60 ELEC PERMIT ISSUANCE PRINTING PERMIT 40 .79 0. 00 40.79 MECH PERMIT ISSUANCE PRINTING PERMIT 40 .79 0. 00 40.79 RES MECH REPAIR/ALT/ADD PRINTING PERMIT 61 .19 0. 00 61.19 • PLUMBNG PERMIT ISSUE PRINTING PERMIT 40 .79 0. 00 40 .79 TRAVEL & DOCUMENTATION FEE PRINTING PERMIT 40 .79 0. 00 40 .79 --------- ---------- ---------- 224 . 95 0. 00 224 . 95 . VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- ------ --------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL Single Famil GreenPoint Checklist dam: Build It Gre Y f� Et7 The GreenPoint Checklist is based on ra the various green features sol green Into the home and is the �/ )� Smart Soluirorc From the Ground Up basis for the GreenPoint Rated program.A home can be of ategor green if b fulfills0),Indoor prerequisites, /�/�// c 4• Hams at lease 50 poems,and meets the minimum points per category.Energy list of Indoor Alr CusPoi Health(5),Resources(6),antl Water(B).Please cromad Build It Green for a list of qualified GraenPoine ——I Raters If you are interested in pursuing third-party verification. The green building practices listed below are described in the New Home Construction Green Building •`•- ' Guidelines,available at www.bul dilginunoro. • PROJECT e • 4 MUIR A'fiI1'E.' — - Pdmis Available Per MaBsurd 1.Protel Topsoil and Inform Disruption of Esisdng Plants B Trees ❑ a Protect Topsoil from Erosion and Reuse after Construction 0 1 ❑ to LJmfl and Defrosts Construction Foo¢mnt lar Maximum Protection. 0 2 Deconstruct Inmead of Demolishing Existing Buildings Do Site 0 3 3.Recyele Job She Construction Wast(Including Green Waste) ❑ a Minimum 50%Wast Diversion by WagM fRecycArg or Reuse)-Required 0 R ❑ b.Minimum 65%Dfniz on by Weight(Recycling or Reuse) 0 2 ❑ c.Minimum BO%Diversion by Weight(Recycling or Reuse) 0 4.Use Recycled Content Aggregate(Minimum 25%) ❑ a.Walkway and Driveway 0 1 ❑ b.Roadway Base ------' D 1 I Total Point Available In Site=12 0 B.FOUNDA710N _ Prime Available Per Measure 1.Replace Portland Cement in Concrete with Recycled Flyash or Slag —❑ a.Minimum 20%Fyashw Slag 0 -- ❑ b.Minimum 25%Flyash or Slag 0 1 2.Use Frost-Protctd Shallow Foundation in Cold Arm(C.E.C.Climate Zone 16) 0 - 3 a.Use Radon Resistant Construction On At-Risk Locations Only) - 0 f 1 4,Design and Build Structural Pest Controls ❑ a.Install Termbe Shields A Separate All Exterior Wood-te-Concrete Connections by Metal or Plastic FastnaraD'rvider 0 1 b.All New Plant Have Tmnk,Base,or Stem Located Al Least 3fi Inches hom Fountlation 0 1 Total Point Available in Foundadon=B 0 C.LANDSCAPING.. -" - '• Points Available Per Measure t.Construct Resopecies sial y Ca Hcepes --_ ❑ e.No Invasive Species IJnetl by Cel-IPC Are Planted 0 ❑ b.No Plant Spacies Will Require Hedging p El c.75%of Plants Are DmugM-tolerant Celifomla Natives,Mediterranean,or Omer Appropriate Species D 3 2 Use Fire-Safe Landscaping Techni uele 0 1 3.Minimize Turf Areas in Landscape Installed by Builder ❑ a All Turf Will Have a Water Requirement Less than or Equal to Teo Fescue(50.6 plant factor) 0 i 2 • ❑ b.Tud Shall Not Be Installed an Slopes Exceeding 10%or in Areas Less then B Feet Wide 0 2 ❑ c.Turf is 533%of Landscaped Area(total2 points) 0 2 ❑ J.Turf Is 510%of Landscaped Area(told 4 point) 0 i ( I i 2 El 4,Plant Shade Trace 0 3 S.Group Plant by Water Needs(H dratemin 0 2 6.Install High-Efficiancy Irrigation Systeme ❑ a,System Uses Only Low-Flow Drip,Bubblers,or Low4low Sprinklers 0 2 ❑ b.System Has Smah Controllers 0 7.Incorporate Two Inches of Compost in the Top B to 121nehas of Soil D 3 6.Muleh All Planting Is to the Greater of 2 Inches of Local Water Ordinance Requirement 0 2 B.Use 50%Salvagetl or Recycled-Content Materials for 50%of Non-Plant Landscape Elements 0 1 LJ 10,Reduce Light Pollution by Shielding Flnures and/or Directing Light Downward 0 1 Total Points Avalable in Landarapor,g=31 0 D.STRUCTURAL FRAME R BUILDING ENVELOPE Points Available Per Measure, 1.Apply Optima Value Engineering - — _ ❑ a Place Ratters and Studs at 24-Inch On Center Framing 0 ❑ b.Size Door and Window Headers for two 0 1 ❑ c,Use Only Jack and Cripple Studs Required for Load 0 "-�- 2.Use Engineered Lumber ❑ a.Beams and Header 0 _ I _.L ❑ c.Insulated Engineered ers 0 El c.Wood bJoist W or Webb TrusHeases for Floor 0 ❑ d.Wood l-Joist for Roof Rafter 0 ---T —�— �_—_ ❑ a.Engineered or Finger-Jointed Studs for Vertical Applications 0 ❑ I.Oriented Stand Board for Subtloor 0 T— 1 ❑ g.Oriented Strand Board for Wall and Root Sheathing 0 -'� 1 ].Use F Dimensional Lu Wood — I ❑ a.Dimensional Lumber,Studs and Timber.Minimum 40% ❑ b.Dimensions Lumbaq Studs and Timber.Minimum 70% 0 I 2 ❑ c.Pena Products:Minimum 4D% 0 1 _ ❑ d.Panel Products:Minimum 70% 0 1 • 02D07 Build It Green .Single Family GmenPolnt Checklist 2007 Version Page 1 of 4 AMAMI& 4 @ 1 a 4.Use Solid Well Systeme!Includes SIP&,ICFs,&Any Nor-Sfick Frame Assembly) ❑ a.'101311 0 2 ❑ h.Walls 0 2 2 ❑ c.Roofs 0 2— 2 S.Reduce Pollution Entering the Home from the Garage ❑ e.Tightly Seel the Air Bamer between Garage and Living Area 0 1 ❑ b.Install Garage Exhaust Fan OR Build a Detached Garage 0 1 a.Desi n Enn Hrols on Trueses 7e%of Attic Insulation Height at Outside Edge of Exterior Wal 0 1 I I 7.Dwl n Roof Trunw to ACCOmmodal&Ductwork 0 1 i Lj 0.Use Recycled-Courant Steel Studs for goof InWOr Well Framing 0 1 I LJ a.Thermal Maw Walde:564neh Drywall on All Interior Wells or Walls Weighing more then 401Weu.fL 0 1 I 10.Install Overhangs and Outows ❑ s.MWmum 16-Inch Overhangs and Gulden D ❑ b.Minimum 244nch Overhangs and Dollen 0 Total Points Available M Structural Buncling Freme and Envelops.3B 0 E.EXTERIOR FINISH Prints Available Per Maidstone t.Use Re tied-Content(No Virgin Pleads)or FSC-Certified Wood Decidn 0 - 2 —2.Install a Rein Screen Well System 0 1 1 2 3.Use Dumble and Noncombustible Siding Materiels 0 1 1 4.Select Durable and Noncombustible Roofing Materiels 0 1 2 1 Total Points Available in Exterior Rush•7 0 F.INSULATION Points Available Per Measure 1.Install Insulation with 75%Recycled Content ❑ a.Walls endlor Floom 0 ! 1 2 Install Insulation that u Low-Emitt ng(Credited Section 01350) ❑ n Web and/or Floor 0 ❑ b.Catin 0 1 J.Inspect Duality of Insulation Installation before Applying Drywall 0 1 I Total Palms Available in Initiation•5 0 O.PLUMBING Points Available Per Measure 1.Distribute Domestic Hot Watw Efficiently(Maximum 7 Points). ❑ e.Insulate Hat Water Pipes from Water Heater to Klfchen 0 ❑ b.Insulate All Hot Water Pipes 0 ❑ c.Use Engineered Parallel Piping 0 ❑ it.Use Engineered Parallel Piping with Demand Controlled Circulation Loop 0 I __ ❑ e.Use Structured Plumbing with Demand Controlled Circulation Loop 0 ❑ f.Use Central Core Plumbing 0 1 r 1 I 2 ❑ 2lnstall Only High Efficiency Tollem(Dual-Flush or 51.28 U D I ! ! 4 Total Palmer Available In Plumbing=Tocol 12 0 H.HEATING VENTHATION&AIN CONDITIONING Paul Available Par Hassam 1.Design and Install HVAC System to ACCA Manuel J,D,and S Recommendations 0 4 ! I 2 Install Sealed Combustion Units ❑ A.Furnaces 0 1 2 ❑ b.Water Neaten 0 2 1 77 3.Install Zoned,Hydronic Radian Heating with Slab Edge Insulation 0 1 1 4.Install High Efficiency Air Conditioning with Environmentally Responsible Refrigerants 0 '1 1 5.Design and Install Effective Ductwork ❑ a.Install HVAC Unit and Ductwork within Conditioned Space 0 3 _ ❑ b.Use Duct Mastic on All Duct Jolms and Seams 0 1 ❑ c.Install Ductwork under Attic Iwulatio i(Buried Duch) 0 1 ❑ d.Prenure Balance the Ductwork System 0 ❑ e.Protect Duct during Construction and Clean All Duca before Occupancy 0 1 1 _ e.Install High Effidancy HVAC Filter(MERV W) 0 1 ❑ 7.Dont Install Fireplace or Install Sealed Gas Firsplam with ENolansy Rating Not Less Than OT% 0 1 using CSA Standards r 0.Install Effective Exhaust Systems In Bathroom and Kitchens ❑ a.Install ENERGY STAR Bathroom Faro Vented to the Outside 0 _! 1 ❑ b.All Bathroom Fans Are on Timer or Humldistal 0 1 ❑ c.Install Kitchen Range Hood Vented to the Outside 0 1 a.Install Mechanical Ventilation System for Cooling(Maximum 4 Points) ❑ a.Install ENERGY STAR Calling Fens S Light Kits In Living Ames&Badmoms 0 _L 1 ❑ b.,Install Whole House Fan vAlh Variable Speeds 0 _ ( 1_ C.Automatically Controlled Integrated System 0 2 —� ❑ d.Automatically Controlled integrated System with Variable Speed Control 0 10.Install Mechanical Fresh Air Ventilation System(Maximum J Points) ❑ e.Any Whole Howe Ventilation System That Meets ASHRAE 522 0 __ _I I 2 ❑ b.install Air-to-Ab Heal Exchanges that meats ASHRAE 522 0 I 1 2 11.Install Carbon Monoxide Alarms) 0 ! 1 Total Points Available In Heeling,VenNetion and Air Condficnin •30 0 02007 Build It Green Sinqla FamRv GreenPolnl ChecMist 2DO7 Version Pan 2 of 4 fill CITY OF CUPERTINO FURNACE/AC SCUPEOF kTINO PERMIT APPLICATION FORM APN# _� Date: :3- 3 Building Address: P z 2 6 L ; de Owner's Name: // Phone #: Contractor: �erIlCe Phone#: yay- Vi6!- 9rsr� I Fax#: Ya` ?- 6V- 9S `16, Contractor License#: Cupertino Business License#: -- Contact: A 4e - S 9 , .11q Phone #: yds-� 9 Fax #: Voe l 9 SYJ Building Permit Info: Elect &- Plumb [T' Mechl . Residential Commercial ❑. Job Descriptions Td�l For Residential Installations: Attic ❑ Ist floor 2nd floor ❑ Adhere to minimum setback re uirement For Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: 5 P S Y Type of Construction (Usage Class): Strapped ❑ On Platform ❑ Bonded 0 New Location ❑ Replacement Valuation: Green Building: Must attach Green Building Check list to this application 2 CITY OF CUPERTINO OF FURNACE/AC CUPEf�TINO FEE SCHEDULE e Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC 1MCRAA Commercial-Repair/Alteration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system,incl installation_of_controls_regulatcd b_y_this code. 1MCREPALT Commercial for the repair of alt/add to M ea heating appliance,refrigeration unit,cooling unit,VAV boxes, absorption unit or ea heathing, cooling absorption,or evaporative cooling sys, incl install of controls regulated by this code. 1MCSUSHTR Commercial InstalI/Relocate ea M suspended heater,recessed wall htr, or floor mounted unit heater. 1PGASCOM Commerical for ea gas piping System P 1-4 outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1MCAPPVNT Commercial for the install/relocate/ or M replacement of ea appliance vent installed & riot incl in an appliance pen-nit. 1BSEISMICO Commercial Seismic B 1MRRAA Residential Repair/Alteration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system,incl installation of controls regulated by this code. 1MRSUSHTR Residential Install/Relocate ea M suspended heater,recessed wall htr, or floor mounted unit heater. 1 MRAPPVNT Residential for the install/relocate/ or M replacement of ea appliance vent install &not incl in an appl permit. CITY OF CUPERTINO FURNACE/AC :cUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FLRN/AC 1PGASRES Residential for ea gas piping system of P 1-4 Outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1BSEISMICR Residential Seismic B 1MECPLNCK Mechanical Plan Check M 1MFR=<100 Furnace Syst<=100k BTU install or M relocate ea forced-air/gravity type furnace/burner, incl,ducts/vents attached to such appliance up to and include 100,000 Btu/11 1MFRN>100 Furnace Syst> 100k BTU install or M relocate ea forced-air/gravity type furnace/burner, incl ducts/vents attached to such appliance over 100,000 Btu/h 1EPERMITFEE Electric Permit Fee , E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit P 1TRAVDOC Travel Documentation B 1BUSLIC Business License B i CITY OF CUPERTINO 0FURNACE/AC CUPEf �TINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group AIR FURN/AC CONDITIONING IBCAIRHAN Commercial A/C Units <= l0k CFM B 1MCRAA Commercial Mech Repair/alt/add M 1BSEISMICO Seismic Commercial B 1PGASCOM Commerical for ca gas piping System P 1-4 outlets 1PG7ASRES -Resid-entiaFfor ea gas pipin�—ern —P— --- of 1-4 Outlets 1BPGAS For each gas piping system of 5 or P more per outlet. Comm/Resid 1BREMAIRHAN Residential A/C units <= 10k CFM B 1NUU AA Residential Mech Repair/alt/add M / 1BSEISMICR Seismic Residential B 1EPERMITFEE Electric Permit E /I 1MPERMITFEE Mechanical Permit M / 1PPERMITFEE Plumbing Permit P 1TRAVDOC Travel Documentation B 1 1BUSLIC Business License B O Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 0 CITY OF Fax(408)777-3333 UPE�TINO Build'n De artment • JOB ADDRESS: // /! / / �/J/ PERMIT # 0 U 0 3 p/ O 5 `ZZ/ Z �j �C G+9 VcS�9 r ( — e— S'6 OWNER'S NAME: 1V1,7 r /I k (/ PHONE # GENERAL CONTRACTOR: e ; ,q Q to I FAX # p e- 0/- q!-,-yb I am not using any subcontractors: rii , b Li�Lpa, �j-yl-D Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing e� � C m e -Z Roofing Septic Tank Sheet Metal Sheet Rock Tile 3-31-op Owner/Contractor Signaffire Date