03120056CITY OF CUPERTINO£
BUILDING DIVISION PERMIT�TQ�Xg121VIATONa
-
BUILDING ADDRESS:
PERMIT NOT 3 12 0 0 5 6
PERMTMUEDATE
k�LE:EW:AI—H0N
:
SANITARY OL NO.
ARCHITEC IENO1NEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
lob Description
1 hcmby affirm that 1 am lic.nsed under previsions of Chapter 9 (commencing
with Section 70W).fDivision 3 ofthc Business and Profmares Codc,and my license is
C'w, A ■'tea®
in funfo=anderfem.
Llceae Claes Lle.lf
ADD BEAM/REPAIR r e�/fat�,! G`a�
DateCOmonckr
ARCHITECTS DECLARATION
JAN 0 6 2004
I understand my plans shall W used u public mento.
BUILDING
Licensed Profesvenal
OWNER-BUILDER DECLARATION
I hereby of ron Nat 1 am exempt from the Comucmrs License Law for the
following mann. (Section 7031.5. Business and Professions Cade: Any city or county
which requires a permit to construct. alter, improve, demolish. or repair any structure
prior to its issuoace, aim requires da applicant for such permit to III.. signed akmment
Law(Chapter 9
Sq. Ft. Floor Area
Valuat on
that he is licensed pursuant to the provisions of me Contractor's License
(commencing with Section 7000) of Division 3 of the Business and Professions Coca) or
that he Is exempt therefrom and the basic for the alleged exemption. Any violation of
3 24iP1`1$40rr0 0
Occupancy Type
Section 7031.5 by any applicant for a permit Subjects Ne applicant r0 a civil penalty of
not more than five hundred dollars (SSW).
❑ 1, u owner of tis property. m my employees with wagu as their mho rompenution,
Required Inspections
will do the work, and timmuchure isnotimemind oroQemd Russia (Sec. 7044, Business
and Professions Code: The Commences License Law does not apply m an owner of
q p
property who builds or im proves thereon, and who does such work himself or through his
awn employes, provided Nat such improvements arc natinkrWed... Bered far uk. If.
however, the Wilding or improvement is sold within on year of compledon, the mom,
builder will have the human of proving Net he did not Wild or improve for purpom of
ark.).
L as owner of 0te proper, am exclusively contracting with licensed contractors k
as
Omer me pmjem (Sec. 7044, Business and Profusions Cade:) The Contractor's L4
celu<law dean not apply k an owner of pmpeny who Wilda or imprews thereon, and
who mum for such projects with a conuactor(s) licensed pursuant to the Contractor's
Lkema Law.
pruner an. ,B k PC fm mere an
-'
O net Dek g�
WORT R' COME ONDECLA TION
I hereby affnm under penalty of perjury one of dte following declarations:
I have and will maintain a CeniOcak of Content to self-Lours for WorkeriCompen-
andon. as provided for by Section 3700 of the Labs Code. for the perromtance of the
work for which this permit is issued.
0 1 have and will maintain Worke's Compensation Iauruce, a required by Section
3700 of the labor Code, for the performance of the work for which this Permit is issued.
My Workers Compensation Insurance carrier and Policy number am:
Cartier. Policy N..:
CERTIFICATE OF 11 EMP ION FROM WORKERS'
COMPENSATION INSURANCE
Mia section need nm W completed tribe ponant Is farm. hundred dollars WWI
ter lass.)
I certify that in the performancc of thO .,it for which this permit is mound, I shall at
employanypeoewu"na4p} anan u ymner to become subject m the Workers'Compensation
Laws Of Callfor Ah,
Appikant
N APPLICANT: If. Carr making this cisioes of of Exemption. you should
me Workers Compensation Labor Code, you retia
bac objectcomp steal ofd
e
forthwith comply with such Provisions or this permit shell Wdcemed revoked.
y o Permit
CONSTRUCTION LENDINGAGENCY
1 hereby mBthi Net mem is lending agency for IW performance or
s ed (Sm.30
' de dark for which Nla permit Is iuocd (Sec. J097, Civ. C.)
lender's N
Lender's Address
I certify that I have mad this application and sum mer the above Information is
correct. I agree In comply with all city and county ordinances and some laws relating to
building construction, and hereby authorire mprommadives of this city to Omar upon Rte
above-mentioned Properly for inspection Purposes.
(Wc) agree In save, indemnify and keep harmless the City of Cupertino against
i liabilities, judgments. casts and expenses which may in any way scene against mid City
fW
of lh11 permit. APPUNDS WILL COMPLY WITH ALL NON-POINT
' in caTCq
APU
Issued by: Date
Re-roofs
Type of Roof
Jl O
S a.. ofA icanUConuac Da
HAZARDOUS MATERIALS DISCLOSURE
will NO....care ser fuwre building occupant amrc or hendlO hoard... material
as defined by Ne Cupertino Municipal Code, Chapter 9.12. and the Health and Safety
Code, season zs532(a)7
Ycaa
All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or fuwrc building oceupant use equipment or devices which
it hat rdnus air c.marl sons u defined by the Bay Am. Air Quality Management
all new materials for inspection.
[Wrier?
0 Yes X.
I have mW the hawndous materials requirements under Chapter 6.95 of me Califor.
nia Hcal" arerycode Seca 505,25533and25534.lun&.=dthairthebuilding
does n ear nt ha neat, th u my sponsihility k notify the .neap., of the
c ich a met wisuanceef.crniRcaa Occupancy
ignature of Applicant Date
iI lr
roof coverings to be Class "B" or better
.doer ter amm.,ed a,an, D.16All
CITY OFCUPERTINO
9�
BUILDING DIVISION PE'•"'P�
j.n,«
y
PERMIT NO 03120056
VUILD
.
BDING ADDRESS:
OWNER'S NAME:
PERMIT LSSUEDATE
LEE WAI-HON
io.
E:
SANITARY NO.
ARCHITECAENGINEER:
,.
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
ip
LICENSED CONTRACTOR'S DECLARATION
- Job D sen tion
��ra
i
1 homey a10= that 1 am licensed under provisions of Chapter 9 (commeming
pr �m
WALED
:{
with Semlon 7(1110) of Division 3 of Ne Beat. eM Profcahms Code, and my license u
41W
r
iiy
infmlloommlcffoxt.
Lim..Cleo Lic.g
ADD BEAM/REPAIR
Iz
o
s 2004
Dam Contractor�,
j
I
ARCHITECTS DECLARATION
1 understood my plana mall Its used as public records
IJCCnsetl PNfCaBlanel
0.A'L®�G
BUILDING
lye
OWNER -BU ILDER DECLARATION
,eJ
1 hereby affirm that 1 am aampt from gm Camnmmis U—se Law for the
j o
fallowing maven. (Section 703 1.5, Business and PNfusuum Code: Any city or ..my
a
which requites a permit to WeAmM elies. improve, demolish, or repair any stracwm
;re
prim m its issuance. also requires the applicant feosuch permit to fleasignW atommem
Law
Sq. Ft. Floor Area
Valua On
<<
that he isnmmudrammemmthcprovisiamarthe conuacmrsLh<nsefchomer9
S
with hamfon 7000) of basis far the al a edmamtl Ps. An, m l d. of
slut he h exempt therefrom and the bob fm the alleged exempgam Any violation of
that be I. stamps
3 2400fulitTetO O Occupancy Type
Somear 70313 by arty apphunt for a permit Subjects we applicant te e civil penalty of
not mom than five hundred dollars MSM.
.
p I, u owner ofthe propeny, mmy Cmployca with wgm m their Nle compentogan,
will do thewark,and dmsbuemm b nainanded aronored f=sakfSec. 7044, Bummse
Required Inspections
e
and PNfessions Code Muc Consensuses License Law does not apply w an owner of
q P
•
'propenywhe builds=Improves drum=. and who doessuchwerkhimselfmllwugbhis
ownemFlosoms, provided that such Improvements are notimende i connoted forms, If.
however. Ne buildingor improvement u sold within arc year of completion. the owner -
builder will have the burden of proving that he did not build or improve for purpose of
tole.).
I, u avar of the p upesty, em mmmawly contacting with licensed cnnuectors m
corm the project (Sec. 7009, Bmimss and Piefessi=s Cndw) The Cmuacmr's LI -
come law tl=s not apply he an muni of property whe builds or improves gum=. and.
who contracts for such projects with a cenlramer(s) Rkenmd pursuant he the Consomme,
Lt.. law.
❑ lam as btun msec. .B&PCfo,this.m
p - Dau t/
OR R' COMB ONDECLA TION
I hereby all irm under penally of perjury one of the following declarations:
'
have and will maintain a Cendieab of Consent he sal Nunnto for Workarl Compen.
tion• as provided for by Session 3700 of the labor Cade, for the performance of the
work for which this permit is issued.
❑ 1 haw and wilt maintain Workm's Compensation Insurance, as required by Section
3700 of the Labor Code• for the performance of the wark for which this permit is intend.
My Worker's Compensation Incmame rimier and Policy number are:
Cartier. Polley No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thbscollen need not be completed d1be fe=IOsfmmmhundeaddollan (5100)
s"
or luta)
I cenify that in the perfarnmco of the work for which this permit is Wood, I shall not
employanypcoowwnn+uIpynymmmrmawbecomesubjectto Ncwor)mri Compcmadon
Laws of
Laws of COlifamYCDam
N APPLICANT. If, ager making Nle Certificate of Eacmption, you shouw
he ubjc. APPdm Werkels Core don tian provisions of the labor Code, you met
Z
lorthwith comply with such provisions m this Permit shall he deemed mmked.
ON LENDING
CONSTRUCTION
endingAGENCY
iia c lending Renry for the performance of
1 hereby aRi= Net girt ria
i
ed (Sm.
dm work fm which this permit b issued (Sec. 709], Ch. CJ
Loola Name
Lemler's Address
,G
O
1 tardily that 1 haw mad this applimd= and stat: that the above information Is
F
Mrspe I Allmomm w comply with all Gly etl county etl au¢ taws relating
t.:
e
hereby authodmrposes tuiwa of this city to enter upon the
building representatives;
fee Inspection
LT(
y
ahave-mentioned purposes
shove -mento ages,
(We) egme m cove, indemnify and keep harmless gal City of Cupertino against
ow,
liabilities, which may in my my ac=re against aid City
judgments, emu and expennes
of the re tingofthisprmit.
AR ANDS WILL COMPLY WITH ALL NON -POINT
inFEUN
/
Issued by: DateSUg
TI NS. '
Re -roofs
mumof Ap mard Comms .192
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will the applicant or fuwm building mcupmtsmre or handle haardom motorial
defmnad by the Cupertino Municipal Code, Chapter 9.12. and the Health and Safety
;1mici?
e, section 255320)7 S��S,,,sss
Cl Y. I,� o
All roofs shall be inspected prior to any roofing material being installed.
'' \\ '
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building =upon, use equipment or devices which
It hazardous air co aminanto m dcfmncd by she Bay Ams Air Quality Management
all new materials for inspection.
❑Yes o
1 have mad the b cardmsmamrialsmquimmcnts under Chapurd.95 of the Califor-
altodc Sunoco 25505.25573 and25534.1undemundthuiflhc building
nuHcalth��Ic,,%
does n c nmi, u rn mspomihility w notify Ux occupant of Me
h a met wissnemxanCenifama Ocmpmxy
ignature of Applicant Date
Al
"B"
All roof coverings to be Class or better
Owner or autharucd egcnl pa
v
QTY OF
CUPEkTINO
kITY OF CUPERTINO* /
PERMIT APPLICATION FORM ( L o L S�6
W
Iof3
APN #
�,
Date:
(
`
0 3
Building Address:
W;3 --t
Owner's Name:
w A 1- >J
LE -c
Phone #:
Contractor:License
#:
Contact:
Cupertino Business License#:
Building Permit Info:
Bld Elect ❑
Job escription:
Residential JN
Plumb ❑ Mech
Commercial ❑
❑
Sq.Ft. Floor Area:
$/Sq.Ft.:
Cost of Project:
Occupancy Gro
^�
IML
Type of Construction:
Quantity
Fee ID
Fee Description
Fee Group
BAPPLOTHER
Other Appliances
MECHANICAL
BBLDGFEE
Bldg Permits . foot
BUILDING
BBOILER1
Boiler <= 100,000 Btu
MECHANICAL
BBOILER2
Boiler > I OOK to 500K Btu
MECHANICAL
BBOILER3
Boiler > 500K to 1M Btu
MECHANICAL
BBOILER4
Boiler> 1M to 1.75 M Btu
MECHANICAL
BBOILER5
Boiler > 1.75M Btu
MECHANICAL
BCONSTAX
Construction Tax
BUILDING
BCONSTAX
Ind/Off/Comm/Quasi
BUILDING
BCONSTAXBQ
Con. Tax for BQ Zone
BUILDING
BCONSTAXH
Hotel and Motel
BUILDING
BCONSTAXR
Constax — Resi/Mobile
BUILDING
BELEC1000
Elec 600V <= IOOOA
ELECTRICAL
BELEC1001
Elec 600V > IOOOA
ELECTRICAL
BELEC200
Elcc Svcs 600V <= 200A
ELECTRICAL
BENERGY
Energy
BUILDING
BENERGYADD
Energy Add Multi
BUILDING
BINVESTIGA
Investigation fee
BUILDING
BMITIGATC
Comm. Housing Mit. Fee
BUILDING
W
Iof3
a"Eg
CIN OF
CUPERTINO
SITY OF CUPERTINO 10
PERMIT APPLICATION FORM
Quantity Fee ID
Fee Description
Fee Group
BMITIGATR
Res. Housing Mit Fee
BUILDING
BMNEWMULTI
New Multi -Family Res
MECHANICAL
BMNEWSF&2F
New Sf&2F Res Bldgs
MECHANICAL
BNEWMULTI
Multifamily Res
ELECTRICAL
BNUCOMME
New Comm Electric
ELECTRICAL
BNUCOMMM
New Comm Mechanical
MECHANICAL
BNUCOMMP
New Comm Plumb
PLUMBING
BNUMULTI
New Multifamily Res
PLUMBING
BNUSFD
New Single Family Res
BUILDING
BOVERTIME
Inspection Overtime
BUILDING
BPBACKFLOW
Atmospheric Vacuum
PLUMBING
BPCESSPOOL
Cesspool
PLUMBING
BPERMFEE
Bldg Permit Fees
BUILDING
BPFIXTURE
Pblg Fixture
PLUMBING
BPGAS
Gas Piping System Fee
PLUMBING
BPINTERCEP
Ind Waste Interceptor
PLUMBING
BPLANCHK
Plan Check Fee
BUILDING
'BPLANCKADD
Plan Check Add Multi
BUILDING
BPLANCKREP
Plan Check Repeat Fee
BUILDING
BPREPIPE
RepipeOfFixtures
PLUMBING
BPSEWAGE
Sewage Disposal
PLUMBING
BPSEWER
Sewers
PLUMBING
BPSPRINK
Lawn S rinklerBackflo
PLUMBING
BPSTORM
Storm/Rain Water
PLUMBING
BPTRAP
Kitchen Trap
PLUMBING
BPVENT
Alt of Drain & Vent
PLUMBING
BPWATER
Install/Alter Water Pie
PLUMBING
BPWHEATER
Water HeaterNent
PLUMBING
BPWSVCS
Main Water Service
PLUMBING
BREINSPECT
Reinspection Fee
BUILDING
BREMACOVER
A/C Unit > 10,000 cfm
MECHANICAL
BREMAIRHAN
A/C Units <= 10,000 cfm
MECHANICAL
BREMAPPLI
Appliance Install
MECHANICAL
BREMBUSWAY
Remodel Busways
ELECTRICAL
BREMFIXT
Lighting Fixtures
ELECTRICAL
BREMFURN
Relocation of Furnace
MECHANICAL
BREMFURNOV
Relo Fumace > l OK btu
MECHANICAL
BREMHEAT
Heater Installation
MECHANICAL
BREMINHOOD
Installation of Hood
MECHANICAL
BREMMISC
Misc Apparatus
ELECTRICAL
BREMNRAPP
Rem Non -Res Appliance
ELECTRICAL
BREMPOLE
Pole/Platform Fixture
ELECTRICAL
Is
2 of 3
aITYI
CUPERTINO
WITY OF CUPERTINO*
PERMIT APPLICATION FORM
Quantity Fee ID
Fee Description
Fee Group
BREMPOWER
Power Device/Apparatus
ELECTRICAL
BREMRECEPT
Rc tl, Switch & Outlets
ELECTRICAL
BREMRELOCA
Relocation of Hood
MECHANICAL
BREMREPALT
Repair/Alter Heating
MECHANICAL
BREMRESAPP
Remodel Res Appliance
ELECTRICAL
BREMSIGNAD
Rmdl Signs Add Branch
ELECTRICAL
BREMSIGNS '
Remodel Signs, Marquee
ELECTRICAL
BREMTHEATR
Theatrical Lighting Fix
ELECTRICAL
BREMVENFAN
Vent Fan Single Duct
MECHANICAL
BREMVENSYS
Ventilation Systems
MECHANICAL
BSCBLVD
Scb Specific Plan
BUILDING
BSEISMICOM
Seismic Commercial
BUILDING
BSEISMICRE
Seismic Fee Res
BUILDING
BSPECIAL
Special Insection
BUILDING
BSWIM
Swimming Pool
BUILDING
BTENT
Temporary Power
ELECTRICAL
BTEMPPERM
Temporary Bldg Permit
BUILDING
BTEMPSVCS
Temp Dist Svcs
ELECTRICAL
BUSLIC
Business License
BUILDING
ELECTRIC
Electrical sq foot
ELECTRICAL
EPERMITFEE
Elec Permit Issuance
ELECTRICAL
MPERMFEE
Mechanicals . foot
MECHANICAL
MPERMITFEE
Mech Permit Issuance
MECHANICAL
PPERMITFEE
Plumbing Permit Issuance
PLUMBING
PPLBG
Plumbing Fee sq foot
PLUMBING
ZADDCHG
Address Chane
BUILDING
•
3 of 3
rr
16
IN
MSEngineering Consultive Structural Eneineerzne Services
PO BOX 2385 SARATOGA, CA. 95070 (408) 927-9686 (FAX) (408) 927-9684
NEW G.„,GF a10E COPY
APPROVED WAI HON LEE RESIDENCE
)RDANCE WITH THE CITYOR
;IGNED�1 M1.11
chis set u. pan . ai specifcationsMT
ue kept on the job at all times and it Is un
lawful to make any changes or alterations
.m same without written permission bort:
.he building Dept., City of Cupetfno.
rhe stampi% of this plan and epedrdift
;HAU NOT be held to permit of #, • fX
approval at go vfopNao of
ARV OM Oidium do Stab to
NOEL AVE
CUPERTINO, CA
DECEMBER 08, 2003
CALCULATED BY � DME l 2--,6
CHECKED BY DATE
l!
Iu
CALCULATED BY � DME l 2--,6
CHECKED BY DATE
MAHMOUD SANATKANI, P.E.
Consulting Civil Engineer
P.O. Box 2585
SARATOGA, CA 95070.0585
OATE
DATE
? T 7' ... s.caueo ........
CDB )a j9 Oi-1,Ave—P iA PQ*-�ii,Q_
MAHMOUD SANATKANI, P.E. SHEET NO. OF 3
Consulting Civil Engineer Q
P.O. Box 2585 CALC NATE99V Vim'— DATE 1, Z
SARATOGA, CA 95070.0585
CHECKED By DATE
.. ... ........ ...... - .._ .. ...:
l` �Dvf�
bfi L-
w
0
MAHMOUD SANATKANI, P.E.
Consulting Civil Engineer
P.O. Box 2585
SARATOGA, CA 95070.0585
SHEET
CALCULATED BV DATE
DATE
E
•
Ll. Join to sill Or girder, toenail
2. IIridSing to joist toena0 cart eM
3. I"x6'(25 mmx752 mm)mb0oorwkssmischjoist, face nail
4. Wider than k' x 6' i?5 men x 152 awn) mbnow to each join, face nail
5. ?" (51 mm) mbFloor ro join wgudet: blurt and 6rce tail
6. Sole piateto joist or bloel;ing-typical face nm7
Sole plate ro join w Working, arblatxd wall panes
7. Top plate to sttxl, eM nml
8. Smd io sole plate '
9. Double studs- face nail
' 10. Doubled top plates. typical fate nab
Double top plmes, kap splice
S k. Bkocking lshveen joists w rafters m tap plate, toenail
12. Rim joist to top plate, toenail
] 3. Top Plates, laps and mtetsections, face nail
14. Continuous header, two pieces
15. Ceiling joists m plate, toenail
16. Continuous header to stud, toenail
17. Ceiling joists, laps over partitions, face nail
10, Ceiling joists topandlel rafters, face roll
19. Rafter to plate, toenail
.., 1 ate P13m. falx reit
23. Built-up comer surds
24. Built-up girder and beams
25_2'(51 mm) plank
26. Wood saue,,d p
SuWlour- roof x
'I,' and less
l
I /e" -l$4"
5-"t)s mm)or
6 n1
28. FK IIdBdnng
t!_ (13 mm)
'-sI3_' (20 mm)
29. Imedw paneling
i/a (6.4 mm)
1/8" M5 mm)
:ommon o� ;,,
3-8d
2-8d
2-8d
3-8d
2-16d
16d m 16" (406 mm) o.c.
3-16d per 16" (406 mm)
2-16d
4-$d, ttrnail w? -76d, end oaf!
l6d 11124' (6 10 mm) 0,,
16d at 16` (406 mm) oc.
8-164
3-8d
8d at 6'(152 mm) ox -
2 l6d -
'16d
16d at 16�)��, cash edge
3 8d
4 8d
3-16d
}16d
3.8d
2-&1
tail 2-8d
fact nail 3_8d
k6d W 24" (6l0 mm) ac.
20d m 32" (813 mm) ac. at top ami
bora`w and staggmd 2_2W
cads and a each mkiee
Mumg(io fr—mgl'. (1 inch =!SA mml
6d3
8d4 or 6dS
SO
clavmtnt ito hamingk (1 inch 25A mm) ldd4 nr 8d5
60
eds
�- llW4 w 3d5 i
6db
SO
No. 11 gas
6d4
No. t6 ga 9
No. 11 pad
Sd4
No. 16 ga.9
,)dao
6d11
I except where otherwise stated.
patvsceare C8 m'Cches 1 inencs (305 runtl In intemuditite suppony except 6 inches
�ar wa4 refer S( _l9 mm) m tame. Fur nailing of vvOW snnelm, panel and
•
•
or casing. - - - -- to croon 2314-3. Nails for wall sheathing may be common. box
4Common w deformed shank. _
4Common,
SDefotmcd shank.
'FUSIO sion-t aced 3 siding or casing nails conforming to the requrtemems of Satipn 2;25.1.
Fasicims spaced 3 inches (76 mm)on eemrerm extedwedges and 6 iltdaa(152 mm)on cenlerat intermediate sip -
pons.
aCorrosion-resistuii loo[ng nails utth'/a6_mch-diametc (I! mm) bead and i lh-inch (38 mm) length
'or nch
(13 mm) sheathing and I°)y-inch (44 mm) length fw�5!i°-;mit f20mm) sheathingconfoiming to the ttxpailrnrelns . •
of
ion 2335.1.
9Cormsio greslsan151(38twri)ten aI?iw4(limm)cownand ails-inch(29mm)lrngtirlwt/S-inch(13mm)
shenthhn awl
ndlt
2325.[. 8d+/32-(ricla(20mm)s6eathiagconfotming todactegaitemeittsofSeclion
s.
16
` inmherwippmtsemadcedj.tCasi orfitrahlw[bet Miitchest508rata)ifsmtmgdtaxrsinthelongdirectkonofthepanel.unless
..w:... -._ spaced 6 inches (152 mm) an pane edges, l2 inches (305 mml at
o
�m 1 of
1
CITY OF CUPERTINO
PERMIT RECEIPT
0.00
Sec: Twp: Rng:
Sub:
Blk: Lot:
4,000.00
APN ........:
0.00
32647045.00
0.00
DATE ISSUED.......:
4,000.00
12/11/2003
0.00
RECEIPT #.........:
0.00
24015
97.00
REFERENCE ID #
...:
03120056
0.00
SITE ADDRESS .....:
10332 NOEL AV
-----
0.00
SUBDIVISION ......
------
0.00
METHOD OF PAYMENT
AMOUNT
CITY .............:
CUPERTINO
IMPACT AREA .......
209.05
------------------
------------------
VISA
OWNER ............:
LEE WAI-HON
209.05
ADDRESS ..........:
CITY/STATE/ZIP
...:
CUPERTINO CA,
RECEIVED FROM
....:
WAIHON LEE
CONTRACTOR .......:
LIC #
COMPANY ..........:
ADDRESS ..........:
CITY/STATE/ZIP
...:
,
TELEPHONE
Ll
OPERATOR:' conniew
COPY # : 3
95014-1231
0 -EE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
BENERGY PERMIT FEE
97.00
29.10
0.00
29.10
0.00
BPERMFEE VALUATION
4,000.00
97.00
0.00
97.00
0.00
BSEISMICRE VALUATION
4,000.00
0.50
0.00
0.50
0.00
13PLANCHK PERMIT FEE
97.00
82.45
0.00
82.45
0.00
TOTAL PERMIT
---------- ----------
209.05
-----
0.00
209.05
------
0.00
METHOD OF PAYMENT
AMOUNT
NUMBER
----------------- ------------
OTHER
OTHER
209.05
------------------
------------------
VISA
TOTAL RECEIPT
209.05
Is