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00010095 APP LI NT TO FILL IN INFORMATION WITHIN RED LINES-USE fSALL POINT PEN ONLY - CITY VFZI)YERTINO BUILDING-ELECTRICAL PERMITNO. BUI INC DIVISIO O APPLICATION/PERMIT PLUMBING-MECHANICAL it BUII,DING PROJECT IIIENT'IFICATION - BUILUIN, DRESS: / P 1 SANITARY NO. APPLICATION SUBMITTAL DATE osoo Al. S+ellg 1\OA� Q✓111,10 �Qr2Vn D 'NER'S�'�(kA11H�:/ PHONE: CONRAC W NAME: LIC NO: hlNaUaf,AY..L L'Xt At IISDL X64$ n1.` a S+ ,� N/c CONTROL A f:'\\awn Nc OOk LTC No -/i k (<J/Cs olK 'f� RK 51+, rs� ❑ CONTACT: PHONE: t BUILDING PERMIT INFO [;ti. Krx (C-4c �,Sa-a6�8 ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT LOMB MECH ❑ ❑ ❑ LICENSED CONTRACTOR'S DECLARATION QTY ELECTRIC PERMIT FEF, I orrery a0irm ma Ind Rcenrw ander provixianx or Chapter n(commencing . . JOB DESCRIPTION �pZO with Section 7000o1Division 3ofthe Bnsinessand Professions Cade,and my license is RESIDENTIAL: H W Oy in fall idea and elfmt PERMIT ISSUANCE - 1U� License Class Lie.» ❑SFDWL ❑KITCHEN REMODEL Fab Dae Conaacor APPLIANCES-RESIDENTIAL []ADDITION ❑PLUMBING RE-PIPE .r p ARCHITECTS DECLARATION PANELS ❑MULFTUNIT El STRUCTURAL Z o iA�, 1 undemrmd my duirs mull he used es publie m....ds MODIFICATION Oz`30 UP1021X1 AMPS [I INTERIOR ❑CHIMNEY REPAIR Fa��W Licensed Prifewimnal 201-10NAMPS IMPROVEMENT L]SWIMMING POOLS CYF� OWNER-BUILDER fora he Cm ION OVER IWOAMPS ❑BATH REMODEUREPAIR ❑DEMOLITION 3 R:W 6 1 hereby.(Rim That 1 tm exempt fnun the Csniohs o eAnyLicense Law for the W H fallowing rector.(Section JW I.S,Business and Profeasinnr Code:Any city or county SIGNS ELECTRICAL OTHER y which requires a permit to construct,altar,improve,demolish,or nepalr any soueture prior to its ismnow.0a,rcquircsrhe applicant lar such permit m Elea xlgnedstatemcnt SPECIALCIRCUIT/MISC. F } that he is licensed marmnto he provisions of the Coal.mrs License Law(CWpmr9 O_ hourea ncimg with Section J1X10)ol Division 3 of the Business and Professions Gde)nr 'I'EMP.MIN It It OR POLE INST, COMMERCIAL, G c m That he is exempt themtmm o I the basis for the allegN exemption.Any dilation of - ❑NEW BLDC/ADDITION ED DEMOLITION W Section J031.5 by any applicant for a permit subjects the applicant m a civil penalty of POWER DEVICES �s�<N�•• ^m ytcnANT ❑FOOD SERVICE S^zQnot more mm five hundred!dollars($500). IMPROVENHINT ❑Lmownerk.addsopenyormy employees withwogchrcalei(See70m.Buturnn, SWIMMING POOL ELECTRIC '3f will Pathe work.and the 1 C...cisnots License awdoe a n,ar$ec,toan,wnwrss ❑OTHER anderty who Code The G,mtnereo License Lawdoesnotapply tolf ownerof 011'1'LETS-SWITCHES-PIXTU S popery mpl hail,s or improver thereon,and who does wcM1 work himself or though 1 his sun employees,provided that such Impnwew ore or intended or o9ered for NEW RESIDENTIALlil.li(TR S 10 sale.IChowevec the building orimprom veem is sold old within one year of completion,the SQ.PT.FLOOR AREA $ISQ.14. er-bol rwill lmoe the harden til'pravingthatheJiJnrnhuildarintprovaforpur- se ra owner of the property,am exclusively contracting with licensed contractors in TOTAL: wnamr'I the pmjeel lSec.JMi,#minus anJ Ikofenimnx Ctde)'Iho Contmaors Li- - sel.awdoelnotapplymattawnerofpn)periywhobuilJxornnprovonlhemom,rad QTY. PLUMBING PERMIT' PBEi onmmts forsnch proleets whB a eonmumm(s)Iicenmd pursuan m the Cmmrunnri e,a Law' PERMIT ISSUANCE l Iance,ennamader Sec}.. , .B&1'C far this reason w `^I X00 ALTER-DRAIN&VENT'-WA'T'ER(HA) ♦♦♦ ``` VALUATION WORKER'S COMPINSATION DECLARATION BACK FLOW PROTECT.DEVICE Iherebyallinnunderpenaltyofperjury(me of the following declamdmi / OO ❑I have and will maintain a Cenificate of Consent to self-insure for Workers Com r DRAINS-FLOOR,ROOF,AREA,CONTI. .pilon,is provided for by Section 3JW ol'the labor Cods,P n ST'ORIE, TYPE CONSTRUCTION work for which this permit is issued. I L ❑1 have and will maintain Worker's Compensation Insurers 3JWofthe lmMrcode,forthe perfarmane some work to"w ,pc sueMAILMAII' DEC.GROUP --tt APN / My Worker's Compensation Insurance carrier and Policy number are: 32 3 1 Carrier: Policy No. S sit CERTIFICATE OF EXEMPTION FROM W ORKE D COMPENSATION INSURANCE A "T CGPTOR (Ihissecrion need nrn be completed lithe permit is fnnmehu ($1 BUILDING DIVISIQN FEliS or less,) GREASE TItAI' PLANCH ECK FEE I certify that intheperfornincenfrhewnrkforwhich t t ,1. ffft not employ any person in any manner so as to become subje E E ENERGY FEE O z sation Lawsof Cplifomia.Date z 0 Applicant R F gi-TE FEE r1 l NOT ICH 10 APPLICANF.Hour,making this Cenificae ml'Exemption,you should HER SYS'I'EM/HREATING a , become suhjecl to the Worker's Con,wevation provisions of the labor Code,you mart E forthwith comply with,ach provision.,this permit shall be deemed revoked. WAFER SERVICE az CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLNIB. SQ ET, UQ thereby affirm that there is u constmmimn lendingagency for the performance of Date Receipt» .y the work for which this permit is issued(Seo.3119].Civ.CJ 0 U Lenders Name .�- �'IVTAI:!Lenders Address TOTALI renify thn I hive read till upplleabn and'me that theabove Information Ix �E�.\ I In)V) correct.l agme to comply with all city and county ordinances and state laws relating toQTY. MECHANICALPERMIT 'FEEz building conswction,and hereby authorize representatives of this city to enter upon theEEabove-mentioned properly far inspection purposes.(We)agreem save,mdeneri fy arid kcap Bamlexathe Ciy of Cupen ino p,vano PERMIT ISSUANCE �Gliahil lams,judgments,costs and expenses which may in any way arrow against said City ALTER OR ADD TO M ECH.in consequence of the granting of this permitC FEEAPPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10,000 CFM)SOURCE REGULATIONS. ICAL I'EE�� AIR HANDLINGUNI1'(OVER I0,000CPM) C'PION'TAR-`- -� t nature of Appl'earraCroaddror Dare EXHAUST HOOD(WMUCH) HOUSING MITIGATION FEE IAZARDOUS MATERIALS DISCLOSURE WiII themlilicunr m faun building corruptor sone or huddle hazardous material IWATI NO ON I HTO 1rXfNX)BTU) did ed by the Cupertino Municipal Cade,Chapter 9.12,and the Health and Safety 'e,Section 25532hol HEATING UNIT(OVER 100.00)BTU) ❑Yes VINa VENTILATION FAN(SINGLE RFSID) PAID Date Receipt# Will the applicunt or from Building rampant use en or devices whim BOILER (3HP OR U0,000 BTU) It it hueaNuus mit contaminantscontaminantsnants as Defined M1y the Ruy ArcAir QuaAir Quality Management TOTAL: sWa? E]Yes No - 0BTU)BOILER 100,00�j , I hove real the hurnNcus mmeriuls requircmems unJer Chapmrfi45 of the Celi- AIRCONDI'HONER ISSUANCE DATE fort Health&Safety Cale,Sediom25505.25533ard 25534.1 coderundthat if Ne NEW RESIDENTIAL MECH, SQ.PT. Wilding fres net anemly have a wind�,Pis it is my responsibility to notify the occupant ( !!! e rc�wm emacs Pan Le rneI C ss once of a Cenfiicate of Occupancy. D e T+ -4 -gen Dam TOTAL: ISSUED BY: - _ OFFICE 481 e abundant Life x F ♦B BEMGLV OFez- F far R �i5 Abundant Life ASSEMBLY OF GOD r � tY S 3+ �Z g. ME t DOUBLE SIDED, 114M I/NATFD OROUND SIGN m � CO/CRFRh To manufacture and Install one double-sided,illuminated ✓08 S/TE.• ground sign.Sign to be constructed out of twenty-four gauge Abundant We Church sheet metal and illuminated with fluorescent tube.The faces 10100 N. Stelling Road �. to be 3H6- white lexan with vinyl graphics applied.The base pCupertino, CA 95014 SIDE VIEW will be tex-coated and painted to match building colors.The S011th Bay $I�nB reviel will be painted black.The cabinet will be paintedto DESIBI match building colors. South Bay Signs DATE.• iiiiNU Complete Sign Solution! Phone: (108) 363-8600 January 7, 2000 UWE SBSittiawLeom Fax: (406) 363496t 00470WER IRRADDAL: 412 Blossom Hill Rd. San lose, CA 9923 William Hooke General Manager South Bay Signs ]bur Complete Sign Solution! f Phone:(408)363-8600 E-Mail:SBSlgns®aol.com Fax:(408)363-1961 412 Blossom Hill Rd. San Jose,I 95123 r. Abundant Life 3_ATnE . ASSEMBLY OF GOD7-7 tiTF,L�( 20© -- --- V Sy d' ", n Sf } t{ir Ili J vpF rt �A 1 i LO � X ��t:i M - } r By �, y r7•'' p!�'f5 �r �i p 'S { Ao .} w f< f F a � Cf L11, M^,r [1.'J :'V Olt J of '` 11,1z" {AI I'afr7 •- '' r ILA 1 1 : INVOICE TNVO10E INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO - BUILDING PERMIT INVOICE OPERATOR: karenb Sec: Twp: Rng: Sub: Blk: LOC:32631019.00 � INVOICE DATE...... : 01/19/2000 REFERENCE ID # ... : 00010095 SITE ADDRESS .. . . . : 10100 N STELLING RD SUBDIVISION .. . .. . . CITY . ............ : CUPERTINO IMPACT AREA ...... . OWNER ABUNDANT LIFE ASSEMBLY ADDRESS . . ........ : CITY/STATE/ZIP ...: CUPERTINO CA, 95014-5711 CONTRACTOR ....... : LIC # COMPANY ..........: ADDRESS . ... ....... CITY/STATE/ZIP ... . , TELEPHONE ........: FEE DESCRIPTION CNK TOTAL FEE PAID-TO-DATE BALANCE DUE --------------- --- --------- ------------ ----------- BPLANCHK A 62.25 0.00 62.25 BREMSIGNS P 22.20 0.00 22.20 BUSLIC P 90.00 0.00 90.00 EPERMITFEE P 35.52 0.00 35.52 --------- ------------ ----------- 209.97 0,00 209.97 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ........ ........ ............................ 10FOUNDATION 103 UFER 1094 REBAR 105 ANCHOR BOLTS 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 514 FINAL PUBLIC WORKS