06090112 CITY OF CUPERTINO
BUILDING DIVISION PERMIT kco'
BUILDING ADDRESS: ICOM MECHANICAL INC PERMITNO.06090112
19320 PRUNERIDGE AV
OWNER'S NAME: PERMIT ISSUE DATE
APPLE COMPUTER 477 BURKE STREET
NE: SANITARY NO. CONTROL NO.
(408) 792-2292
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
oo LICENSED CONTRACTOR'S DECLARATION lob Description
I hereby affirm Ihe,1 sem licensed under provision,of Chapter 9(ammancing
' with Section 7000)ai'Division 3ofthe Business tad Profession Cade,and my lkense is
h�a in full form andAffaM NATURAL GAS PRESSURE TEST FOR EXISTING COMMERCI
j g Z License CI Lk.N -Z \
it Dalo��Commeter BUILDING
ARCHrmcr3 DECLARATION
i 1 understand my plans shall he used AS public retards
sLL
Licensed Profassional
3 OWNER-BUILDER DECLARATION
I<� 1 hereby airirm that I at Attempt from the Contractor's License law for the
.p o following mann.($.On 703 1.5,Business and Professions
Code:Any city Or county
I$ii which rryuI.A Permit in consuu0.alar,improve.demolish,m oemir any aEucturo
_zY Erin Wits issuance.Also"AquimuNeapplianl for Such parillofilealignedsukment Valuatiol�
G Nathe u licensed pdrmant to Um provision of the Conuacter's Limine taw(Chapwr 9 Sq.Ft. Floor Area 500
` h
�$ (commencing with Section 7000)of Division 3 of due,Business Prafeuinm Code)Or
WE a u exempt therefrom and It,basis for the Wetted eampUon My violation of
Section 70313 by arty applicant for a permit objects the Applkut m a civil penalty Of APN Number Occupancy Type
not mare then f va hundred dAlw (SM. 31606050 . 00
❑I.u owry of tie property,army wploym wW wa{es as twksole campewtmh.
wnimthewark.and the auuctureisnatmlAndedmart<md raraale(sec.roe4.Buothasa
Required Inspections
end Pmfeuiau Cade:The Commences License Law don rorc
Act apply to u awr of 9 P
pmpeny who bunds mimpmwath n,sed who doessuch workbimaelfor thmagh hu
own employar provided thmsuah improvements at notinunaed naRerM for ASIA,If.
however,the Wilding or Improvement is mid within ode Kar of temPotian,the owner.
builder Mn law the humbeo of proving that he did rot build a improve for pury of
sale.).
D 1,AS owner of the property,Am esclu vely comocung with Hamed comractms m
contact the project(See 70th.Business and Pmfession Cadet The Cmlrvsors U.
cattle law docs not apply As An awrom of Property wed bunds Of improves tartan.ad.
vho contracts,fou Such project with with acanwcmr4)Hamsu
Hamad mutant
to the Contoemrs
License Law.
D lames BIsPCfm l$
Gwnf ��Dae
�WORKERT GMPENSATION DECLARATION
I hereby bra under pmWty or Pe7uy one of to following declam ovir
1 how and will maintain Acenifimw of Consent malf.touro fa Workers Campers.
scion,as Provided far by Section 37,0 of Ne Labor Cam.far the pufammua of the
wort for which this Permit is issued.
D 1 haw and will maintain Worsi CompamaUan loonna,As required by Section
3700 of the Lobar Code,for the parfarmance of to wort for which this permit is issued.
My Warkefs Compensation hhmtana esuim and Polity number are:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
mus faction new at becomplewd ifft Permit is forme hundraddellsn($100)
mina.)
I of tfy toot in tin performance of the work for which this Permit is laded,)WII not
employ anyperson in any At a a bject an the Wolens'Cmnpatiadom
law,ofC Dam
NOTIC�Pe the :IL alum making thin visiam of u Exemption.C d.y thaw:IL atom making Inpr visit,catc of FLabor Coda.
.y Ahuust
became a a ml y it Workers Compensation Pmviaiav m the a nor Cede,you mol
�O foMwith comply with such provision or Nie Permit a rimmed mesad.
„ztCA CONSTRUCTION LENDING AGENCY
[r Ibereby affirm that Here is a cmumuction Lending agency for the performance of
fYr > the work fur which this permit is tuned(Sec.3097,Civ.C.)
W Q Lenders Name
z Lenders Address
V C) L certify that 1 haw read Nis appneulan and Miss dot rhe Abuw information is
LL (✓ comet.l agree m comply with all city tad county ominucn and slaw laws re1W ng lA
pU building conswction,and hereby Milton.ramscmmtva fir his city m Eric'uPno the
W show-mentioned property for fuPcction pugmses.
(WE)agree to taw,indermi ry tad San hamless the City or Cupertino against
tiy IiebilitieLjudgmenu.cons end expenses which may in any we natuagalmtsstd Cihy
t.)z i!�tt
mit.
rt, ILL COMPLY WITH ALL NON.POINT Issuedby: Date
Re-roofs
gnmum of ApolhawlCosersexaOr Dam type of Roof
HAZARDOUS MATERIALS DISCLOSURE
WIII to applicant or future building occuputaafc orhandl.huudous mammal
M;defuhad by the Cupentno Municipal Cade.Chapter 9.13,and the Hoalth tad Safely
Cam,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
Q yea DNa
Will the appllcut or future building accupant WEA atilpmcnt Or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hmaNnua air anumimnu As deRrcd by be Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes C1 No
I have mad the hnramas materials roquireo nu under Chapter 6.95 of the Califor.
nia Health&SafelyCode.Section 25505,25533 and 25534.1 oukr aid that if the building
Jan not anently how•wont,Net It is my rponihitay m notify the occupant fir the
Mintramc .wnicn tametpriarloi Ae araceninmwaraapancr. Signature of Applicant Date
r awhariz I D All roof coverings to be Class "B"or better
CITY OF CUPERTINO
!m 2 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31606050 . 00
DATE ISSUED. . . . . . . : 09/15/2006
RECEIPT # . . . . . . . . . : 36051
REFERENCE ID # . . . : 06090112
SITE ADDRESS . . . . . : 19320 PRUNERIDGE AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : APPLE COMPUTER
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . :
RECEIVED FROM . . . . : CHRIS DANIEL
CONTRACTOR . . . . . . . : DON ISAACSON LIC # 21800
COMPANY . . . . . . . . . . : ICOM' MECHANICAL INC
ADDRESS . . . . . . . . . . : 477 BURKE STREET
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 792-2292
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 500 . 00 83 . 16 0 . 00 83 . 16 0 . 00
BPFIXTURE UNITS 1 . 00 9 . 00 0 . 00 9 . 00 0 . 00
PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
BSEISMICOM VALUATION 500 . 00 0 . 63 0 . 00 0 . 63 0 . 00
---------- ---------- ---------- ----- -----
TOTAL PERMIT 131 . 16 0 . 00 131 . 16 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 262 . 32 AMEX
TOTAL RECEIPT 262 . 32
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
106 SEWER & WATER 202 UNDERFLOOR PLUMBING
301 ROUGH PLUMBING 302 TUB & OR SHOWER
502 FINAL PLUMBING ENERGY 506 GAS TEST
507 FINAL PLUMBING
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Community Development
10300 Torre Avenue
4 Cupertino CA 95014
Telephone(408)777-3228
Cl OF Fax(408)777-3333
4UPEI,TINO
Building De artment
JOB ADDRESS: PERMIT #
2a .�2 - .4 ,t GYo T6/(2
OWNER'S NAME: .0 1 PHONE # D -
GENERAL CONTRACTOR: F # 7 -
I am not using any subcontractors: oz/Fe d
gr6ture 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
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
• Q /j
Owner Co actor Signature Da e
eXI2IS 2)A-USG L
CITY OF CUPERTINO
CUPEftF PERMIT APPLICATION FORM
T
PN# l0uilding Address: Mailing Address (if different from building address):
wner's ame: Phone #:
L �i7 -8B6S"
Contractor: License#:
Contact: // Phone: 118 'J$2-2Zob Cupertino Business License#:
Fax: o&,7?--Y949 D
Building Permit Info: L
1U,J1uX 4a - 4457 ` gslkicr� ��sT �pR ��irri us L�o��i�0���ro
Bldg ❑ Elect ❑ Plumb Mech ❑ N
Job Description:
Residential ❑ Commercial
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project SO mo Occupancy Group:n
O t�
Type of Construction: Please check this box if the project is a
second story addition: ❑
ro'ect Size, Standard ❑ Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILERS 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> I OOOA ELECTRICAL
BELEC200 Elec Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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CITY OF CUPERTINO
CUPER,TINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee 'BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pb1g 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 Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinkler/Backflo 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 din MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> 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
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Ap liance ELECTRICAL
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z
CITY OF CUPERTINO
aCQ F
CUPEQ NO PERMIT APPLICATION FORM
• uanti Fee ID Fee Descri tiou
BREMSIGNAD Fee Group
Rmdl Si s Add Branch ELECTRICAL
BREMSIGNS Remodel Si s, Mar uee ELECTRICAL
BREMTHEATR Theatrical Li htin Fix ELECTRICAL
BREMVENFAN Vent Fan Sin le Duct MECHANICAL
BREMVENSYS Ventilation S stems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL S ecialIns ection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP emporary Power ELECTRICAL
BTEMPPERM Tem ora Bld Permit BUILDING
BTEMPSVCS Tem Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical s foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
/ PPERMITFEE Plumbin Permit Issue PLUMBING
PPLBG Plumbin Fee s foot PLUMBING
PLLONGRNGC Plan in LR Comme'Multi-Fam PLANNING
PLLONGRNGR Plannin Lon Ran a Residential PLANNING
ZADDCHG Address Chan e BUILDING
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