NO PERMIT NUMBER ................. .. _
I is HULLOING PROJECT IDEN'1'IPIGAI lDM1
NUI LDINGADDRIiSS: SAN]'IAR\'No. APPLICNION SUBMITFAL DAT
OW -R;c NAME. /k pIIONF.: CO SITACTORSNAMINAMP' LIC N6. 20
(i/!Tf rY /rA/r�.f.�w eFsJAJ (fJb �SI-LAIC A ��0—AJI NIC CONTROL#
'RCHI'IECf/I;NGINEE _ Cpd�/� IC NO. q AD) F.'S: // /] /� ❑
'TACT': I-IPHONL. Hl11LDING PERMIT INFO
niM/9 Gu/y '<rya' 753 ❑ Consultant Fees Paid byApplicant(Initial) BIAG CT PLUMB 6.CII
[? — ❑ ❑ ❑
LICENSED CONTRAC'TORIS DECLARATION QTY ELECTRIC PERMIT FEF,
I hereby amrm,lint 1 art.licensed ander tsonkimn.m(Chapter 9 connnemtng JOB DESCRIPTION
0 wiln Section 9000)of Position 30 the Boston,,and P'of nems Code,und my liumx.n RESIDENTIAL
WCC PERMIT ISSUANCE
FU iamithmecunden,11Q_f ❑SFDWI. ❑KITCHEN REMODEL
aUU Lecnse Clues Lick 4+--- APPLIANCES ❑,ADDITION El PLUMBING RI.-PIPE
tidy Du1c TSDECL
ARCHITECTS DECLARATION PANELS [j MULTI-UNIT 0 S RUCTURAI.
zCN7, Tun morn n I I MODIFICATION
y plant.hull he usul as�suhlic rw, �pPtiAN UPT0200AMPS
O Z.^ P INTERIOR ❑CHIMNIiY REPAIR
1, mn:cJ pmlecwon' 201-I00pAMpS IMPROVEMENT �tAvIMMING POOLS
OWNER,BUILDER DECLARATION
CY' r-I OVER 1000 AMPS ❑BA'I'II REMODLLIRF;I'Allt (]UGM(Ihff10N
C d M1cmby.(torn onnt I 1 i cxmnpt,,an the Chien,Co eAn, Love for the
�y(C d C following reason.(Section]nor 5,9usincs,and Yroressimw G,de:Any city m wuntY SIGNS ELECTRIC ❑D'DIER
{Y 4l\tj whivM1 reyu.rcn u Rani,m e mwd,vltn,improve,demolish.nr mount any s ourtme
^, Cun d prior[ t cls 4 h ppI ' If 'hp It flsignedaramen SPLCIALCI TtAISC.
�yNjR 'J 'hath licensed p pursuant Il p It Contractors,1 c L (Chapter9
��'�� (aonmcncngwNSeclo t 9000)dDviknn 3 of the Bu"nux and( I ,xi :Code) FEMP ER OR rrrsp',IN T. COMMERCIAL.
WE
e y Nm be o exempt thetef r nt unJ'bc basis for the alleged ronnp'ion.Any violation of r�' ❑NEW BLDG/ADDITION ❑DIiMOIJ riON
W^y
Section 703i5 hyany applicant'is,,Parent...bytio be upplicanlm aJ,HTLcnuhv or 'OW OFVICESry
rotor than five hundred dollars($500). E]
]OTHER ❑IbGD SIiRVICIi
.F..z.i+ IMPROVEMENT
d ❑ Lac ownurofthe propeny,onny cntployccx with wages es their sole unnpclu;niun, S 1dMING POOLv LECTRIC
will do the Bork,and the comma is not intended or offered for svle(See 70,14,Bcsin,' ❑OTHIiR
a 3 m ;rod 11 lemon.Code The Conni s Llcen.e Law does be,apply m an owner UTLI! s-1 -S-FI%TURLF eI
ZZ
property who budds ar Improves thereon,and who disc.wch work h.naelr or thmugn
his own cntployccx,provided that such Improvements am not intended or n0e,ad lar d C,
LW RE. IiNT1AL HLECTR SQ
sins.If,however,the buildingar irnprovn em iv hold withinare year ofcoundatlon,.6c F SQ.TTI'.FLOOR ARCA $ISQ.ITL'r
cr-builder will have the burden of proving that he did not build or improve for pur-
powner
a ml srfv.h
❑ I,as nwncf nnhe pmpcnY,am exclumvcly contracting won teemed unmm�ar.w IYI'1'
mxt a,the pmjecl(Sea 7044,Business and Prof tions Cndc:)The Contmemrx L,-
wLse Lew docs nol apply to an owner ofpmpeny who build,or impmccs thereon,and QTY. PLUMBING PERMIT F
r,conloobfiersuebp jemmor to The Contractor'.
License Law, PERMIT'ISSUANCE
C]I..n euouln under So,, .B&P C for thi,ma.un
ANTER-DRAIN&VENT-WA'fYk(EA) VALUA'T'ION
Owner Doc
N'ORKLRSCOyefrarAT10N' iffene RATION BACK FLOW'PRIRECT UF:VICG
1 hereby uuinn under pm,dty of Rrp.ry one of the fallowing Jmlara'io1u:
I huvvvndwillmnin'uin a Certificate of Conscnnn xcl6lnmrc for Worker's Compert DRAINS- ( r .A '"TORIES 'fYPIi CONS'I'RUC'I'IM
kax provided for by Sava 3700 of the Labor Code,far the pnhmnunm,of,hc Iqlow
l ti h F.pent t d. PIX LURES ,R'
'KI h d I int W k :C n1p i 1 ranee learned by Sen on
3701 of the Labor Code.f di I f ince ftb weak I,,,which this permit is ia,ed GAS EA SYSTLM I INC. V .GROUP N'N�
Myw k frctgn3 'rtic JP Y�,th' ,��q.; OAS EA.SYSTE VER
Cartier, /FN'ALV Policy No.� 1,.. -'^ ( i.1%
�t
CLRTIFICA'rE OF EXEMPTION FROM WORKERS' GRF,ASFIINUUS'rk TtiRCL DR J
COMPENSATION INSURANCE LNG UI VISI(1N FEES
(This section need not be completed EON,permit is forma,hundred dollars($100) GREASETRA
or I...) 1 lY1.AN HECK I'lifi
Iccnily Thin The prninmmrcc nfrN:worklois whicM1,h..Rani, "'med. SEWER-.SAN '
net aridnyanry in nun inanymannassons to Femme nub l m the Workers'Con,;Iyo -^'BNERGY�,FE
O z vu'ion Luwx n' inniu.Data JOS A WATLR HEATH WNHNT/ELI!GIR -
zO Mich, lcanDl�r,noel
NOTICFTOAPI .«1rCl�tvking this Certificate of Exemption,you should WATER SYSTEM/IRFAI'ING
F^ y hecunm.ubjcet to m .ken mann poar,iun.al the Lahr Gda,you rnu.t SUIT Eli � Q
{a✓•7 G onbwithcnmply wi,h,Iah pro,momof This permit shut be deemed revoked. WATER SERVICE If UV I
Q
CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLIAB. SQ.FI. PAID
= z Iherchya(lirm Thai here iscnnsvvcuun lcnJrng agency fill he Performance pl Dom IttteiplM
•w0 Thcworkfmwhidt Xj1y .t is ixxn3(Scc3(YJ9.C,aC.I Dt
P Lender's Name l�' ) O
U Lender's Addren TOTAL:
'7. {Lj - BUILDING PLIi
.1 I,cony Than I have rem @is appl.cunnn and s,a,,Than the above informaum,is
Fri crnc'.I agree to comply ant all city undeaanty,nrdmancea and dart law,mlm,ng m QTY, MECHANICAL PERMIT FEE
V 7Z.. build.ngwmrrec, i,and herby authors.yrcaunmtiva.olthivchy m,mmrtE.n'hc SEISMIC FLU
above-mentioned property for Inspection purposes. PERMIT ISSUANCE F,LEC'IRIC FEE
(We)art In save, nlm nidi,and keep hefmle,,the City of Criterion.ugmma
Imh.litics.judgments.a,.cr.and expenna.which may.n any say ocerueagaina said Gt)' ALTER OR ADD TO MECH.
PLUMBING FEE
in consequence c of the RSIAgranting(if this Rrnti'.
APPLICANTON ULATO'rANDS AND WILh COMPLY WI'T'H ALL NON-POINT AIR HANDLING UNII'('IO III,IN11 CFh1) MECIIANICAI.PEE
SOUHCIi R[GUhATIONS.
AI R HA N DLING UN IT(OVER 111.011)CFM) CONSTRUCTION'
Signalur Pman Dare EXHAUST HOOD(WMUCT) HOUSING MITI ( 'Lf:
AZARU S MATERIALS DISCLOSURE
Voll The applicant or t a lose building ommpant Nom or handle buandure mmeriul HEATING UNI T(TO 10NIlIlI It FIJ)
uv
d1fined by the Cupertino Municipal Gulp,ClwPrer 9 12,and the Health and Sahay
Code.Section 2553200^. HEALING ON[P(OVER I UI sli)BTU)
[D Yes MNo VENTILATION PAN(SINGLE RRSID) PAID
Doc Rc<cipt
r 00.11 the appliaml nr lumen building pcaup➢nT me eyvipmrnT or devi ra wblah BUTLER-COhIP(3HP UR IIN),nW B'IUI (�
w haeurtlaus yr conmmman.s as defined by the Has Arca Air Quulny Mawgemcm
st°ell
BOILER-COME(OVER 100,000 BTU)
❑Yes E]No
I have fendthe hazardous nationals rcgnircn.cnts under Chapter G95of,he Cal.- AIR CONDITIONER ISSUANCE DATE.
lom.a,doe,m Sde'y Cale,, tiom25XL5,o,dy and 2smili 1 u rmilytd m:m dthc
NEW RESIDENTIAL.MECH. SQ.PL 1/F,
building docs not curtfactu hvvq mnant.IM1M it i.v my rcxponlihilityler nmify the txavpamf (/
I,he¢smirsmonlx wM1luh m' lJ', etprior b,isuane.cfn Cenir.w of Dearman,
Owns ors Uatc TOTAL ISSUED BY
OFFICE
CITY OF CUPERTINO
1 Of 1 BUILDING PERMIT RECEIPT OPERATOR: chrietya
COPY W 1
Sec: Twp: Rng: Sub: Blk: Lot:31606033.00
DATE ISSUED....... : 10/11/1999
RECEIPT N......... : 10290
REFERENCE ID # ... : 99100021
SITE ADDRESS .....: 19055 PRUNERIDGE AV
SUBDIVISION .......
CITY .......... . ..: CUPERTINO
IMPACT AREA ..... . .
OWNER ............ : HEWLETT PACKARD
ADDRESS .......... :
CITY/STATE/ZIP ... . ,
RECEIVED FROM .... : TIM
CONTRACTOR ....... : LIC N
COMPANY ......... . :
ADDRESS .......... :
CITY/STATE/ZIP ... .
TELEPHONE ........ :
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---- ---------- ---------- ---------- ---______-
BPERMFEE VALUATION 51000.00 107.00 0.00 107.00 0.00
BPLANCHK PERMIT FEE 107.00 90.95 0.00 90.95 0.00
BSEISMICOM VALUATION 5,000.00 1.05 0.00 1.05 0.00
le PERMIT : 199.00 0.00 199.00 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ --------
CHECK 199.00 874
TOTAL RECEIPT a 199.00
CITY OF CUPERTINO
Stem 1 of 2 BUILDING PERMIT RECEIPT OPERATOR: christya
COPY # 1
Sec: Twp: Rng: Sub: Elk: Lot:31606033.00
DATE ISSUED.... . . ..: 10/11/1999
RECEIPT k..... . . . . : 10290
REFERENCE ID # ... : 99100021
SITE ADDRESS .....: 19055 PRUNERIDGE AV
SUBDIVISION .......
CITY ...... . ......: CUPERTINO
IMPACT AREA . ......
OWNER ...... ......: HEWLETT PACKARD
ADDRESS ..... .....:
CITY/STATE/ZIP . . . .
RECEIVED FROM .... : TIM
CONTRACTOR ....... : LIC #
COMPANY .......... :
ADDRESS .......... :
CITY/STATE/ZIP .... ,
TELEPHONE ........ :
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL
VOICE ID DESCRIPTION VOICE IO DESCRIPTION
........ ........ ............................
101 FOUNDATION 102 PIERS .
103 UFER 104 REBAR
105 ANCHOR BOLTS 106 SEWER & WATER
202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL
46 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION
ROUGH PLUMBING 302 TUB & OR SHOWER
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
509 FINAL GRADE 510 FINAL PLANNING
514 FINAL PUBLIC WORKS
•