99080082 PPPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO.
BUILDING DIVISION APPLICATIONIPERMIT PLUMBING-MECHANICAL
BUILDING PROJECT IDENTIFICATION I , ; ,,
BUILDING ADDRESS: SANITARY NO. I APPLICATION SUBMITTAL DATE
S L
OwNER'S I PHONE: CONTRACI'OR:S `AMI?: LIC NO:
AllotsU G 5 1 —O O 7 <(> : '(ds / 7'a 7 NIC CONTROL N
CHITEC11ENGINEE : LIC NO: ADDRESS: ❑
P0 6V
CONTACT: PHONE: - BUILDING PGRMIT INFO
❑ Consultant Feu Paid by Applicant(Initial) BLDG ELECT PLUMB MECH
❑ Com ❑ ❑
LICENSED CONTRACTORS DECLARATION QTY ELECIRICPERMIT 'FEE".
O Z I hetehy atlirm Thal 1 ass licensed u d p as of Chapter 9(tammenring �., JOB DESCRIPTION
agg with Section TIDO)ofDvision 3 of the Business and Professions Cod and mylmusais RESIDENTIAL
F OZ in fit l fare and thin ,� 'J j PERMIT ISSUANCfi
QUU Limnse Class C- /C Lic.x C� ❑SPDWh [I KITCHEN REMODEL.
vFi6W Dace Cmano nr < rr ible" APPLIANCES-RESIDENTIAL ❑ADDITION ❑PLUMBING RE-PIPE
Z psen ARCHITECTS DECLARATION PANELS ❑MULT'1-UNIT ❑STRUCTURAL
y 4 I understand my plans shall he used as public nand, MODIFICATION
OZ—O UP 10 200 AMPS El INTERIOR ❑CHIMNEY REPAIR
F141sj Licensed Professional 201-1000AMPS IMPROVEMENT 'SWIMMING POOLS
OWNER-BUILDER Ce Contractor's
OVER 100JAMPS El REMODE EPAIR ODEMO41T1ON
Y a /
O W Q 1 hereby ef0rm that I am exempt from the Commcmr's License Law for the (t C�C
W 3 y0.,F following mm.a(Section 9031.5,Rosiness and Professions Code:Any city.,,,,our, SIGNS ELECTRICAL ❑OTHER
which requires a permit to construct,alter,improve,demolish,or repair any structure
frVI0 priortonsis,mmm,alsoreclimstheapplimnlfmsttchpenniunfile„ ,malmecemeot SPECIAL CIRCUIT/MISC.
fly that he is licensed pursuant to the previsions ofihe Conaamors License Law(Chapter 9
1+100 (aomnlcnaing with Section]000)of Division 3 of the Bminexx:md Prof c..ma,Code)or TEMP.M ETER OR POLE INSI. COMMERCIAL:
a K c that he is exempt therefrom and the basis for the alleged exemption.Any violation of W BLDG/ADDfrION ❑DEMOLITION
Section 7031.5 by any applicam for a permit subjects the applicam to n civil penalty of POWER DEVICES ❑ fiNANT ❑FOOD SERVICE
t more than five hundred dollars($500y,
1 SWIMMING POOL ELECTRIC
SSD PROVEMIiNT Las owner.(the property,.r my employees with wages as their sole compensminn,
F will do the work,and thegmewreis tet mmnded nndfereJ forxale(Sec.9044,Business ❑OTHER
Wy”—m and Professions Code:The Cmitmetors License Law does out apply to an owner of OUTLETS-SWITCHES-FI FS
property who builds or improves thereon.and who does mach work himself nr throughoe
his own employees,provided That such improvements art not intended or offered for NEW RESIDEN3lAL FLEC SQ FT.
sola 11,h.wmu,lhn hulldiri aImprovement is sold within ane year at completion,the JF
ownerbuilder will have the burden of proving that he did not build or improve for pur- 0 F
pose of sale.),
El as owner of the pmperty,am exclusively contracting with licensed enntmctors to TDI D
construct the project(Sec,7(M4,Business and Professions Code:)The Contractor's Li- --
mroxeawdoesnotapplytoanownerof property who builds a improves thereon.and QTY. ' ,PLUMBING PERMIT I E ' AUG 1 U 1 ��
who contracts for such projects with a contra ctogs)licensed pursuant the Contractor's s u
License Law. PERMIT ISSUANCE
I am exempt under See. ,B&P C for this reason
ALTER- RAIN&VEN3'-WATER EA) VALUATION
Owner Date
WORKER'S COMPENSATION DECLARATION BACK PLO I'ROTI;CL DIeViCli
1 hereby affirm under Penalty of pe jury one of the following d¢lamtinus:
I have and wi 11,,minim a a Cliificate of Consent m set f-insure for Worker's Cotnpen- DRAINS )R,ROOF,AREA,GQND' STORIES TYPE CONSTRUCTION
stele,,,as provided for by Section 3700 of the labor Code,for the performance of the
work for which this Permit is issued. FIXTURES-PHR RAP
❑I have and will 51amid.Worker's Compensation hamranre.as remoter by Section
3700ofth -ode,for the performance,,Tike work for which this pemlit is issued. GAS-EA.SYSTEM- INC.4 OUTLETS OCC, ApN
MyW Compemly I uranmcarocranJ P.licynamMram: -1` N
Or Policy No.: GAS-FA.SYSTI?M-OV 4TA)
iRTIFICAT F EXEMPTION FROM WORKERS'
C PENSATION INSURANCE GREASMNDUSTRLWAST 'GRCEPTOR
(Thixwe innneed not bacmu,I,,ed if lhepernlil is l ensue hindredd,11ho,18100) u o e „BUIL NG DIVISION PEES
or less.) GRIiASI!TRAP PLANCHF.CK FEE
Lenity that in the perlim prem of the work tit wh di this permit ix Ixsued.I shall
not nplo any ymanna so axmbeconm subjectmthe Workcr%C.m SEWER-SANTFAR -S'TORMEA. WET.
Y Pcn- ENERGY FEE
ten laws of ifomia.Dt
C)
O A licam M� WATER IIEATF IVENI'IELECfR
Pp GRADING FEE
ICE TO APP,( NT:IL afte making this Cimi0cme of Exemption,you should WAFER SY EM/TRHATING
F become subject to the Workers Compensation provisions of the Lehr Code,you must SOILS FEE
forthwith comply with such provisions or this permit shall he deemed revoked WATE :ERVICE
Z CONSTRUCTION LENDING AGENCY N Rr:SIDF.NI'IAI.PLMO. SQ.IT. PAID
Ihercby xfhnn lhul lhaci onsvumion landing agency forlhe perinrmunce of Dam ReeeiplN
w H the work for which this permit is issued(Sea.307.Civ.C.)
Larder's Nu;na TOTAL:
W Lander,Addtem TOTAL:
Fty I certify but 1 huvo read This Implianti.n and stem It alawe infonnml so isBUILDING FEE
' rn correct.l agree to comply with all city and county ordinances and state laws relating to QTY. MECHANICAL PERMIT 1 ' FEC
C.7 huildiag construction,and hereby authorize representatives of this city m enterupon the SEISMIC EEE
above mentioned property for inspection purposes. PERM SUANCE
(We)agree to save,indemnify and keep hnnNess the City of Cupertino against ELECTRIC FEE 3
liabilities,judgments,costs and expenses which may in any way accrue against said City gI:TEH OR UT'O MF.CH.
in consequence of the granting of this permit. ` PLUMBING FEE
APPLICAN UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING NIT'(TO IO,WO CFM)
SOURCE JULATIONS. MECHANICAL FEE
AIR HA N ]NO If '(OVER 10,000 CP
60
i / CONSTRUCTION TAX
Signa l'A canOConmly r Dem EXHAUST ODfW/D T) HOUSING MfI1CAT1ON NL'E
HAZAXIIS MATERIALS DISCLOSURE
Will theappliwnt or future building uecupartmore.r handlehnzardous material HEATING UNIT OI00,tMH1 )
as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Code,Section 25532(x)? HEATING UNIT(OVER I .BOOR )
❑Yes No VENTILATION PAN INGLE HOW) PAID .-
Date Recciplp
Will the applicant or furore building by the B use equipment li devices which BOILER-CO (3HP OR 100,000 BTU)
it hazardous air contaminants as defined by the Bay Area Air Quality Management TOTAL:
shin? BOILER OMP(OVER 1000F() TU)
❑Yes ❑No
(have rwJ the ha u materials requirements under Chapter 6.95 of the Cali- AI ONDITIONEN ISSUANCE DATE
forma Heald;& - rale,Secoun,255115,25593 and 25534.1 understand Thal d the E\V RESIDENTIAL MECH. SQ.ET.
buildin of currently have a talent,that it is my responsibility to notify the occupant
of meats wIt ��poor,,i,tatim of.Ccnifinnc of Occupancy.
orizsxl agent Date TOTAL: ISSUED BY:
OFFICE
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
• BUILDING PERMIT INVOICE OPERATOR: chrietya
Sec: Twp: Rng: Sub: Elk: Lot:37542036.00
INVOICE DATE......: 08/11/1999
REFERENCE ID # ...: 99080082
SITE ADDRESS .....: .747 STENDHAL LA
SUBDIVISION ... .. ..
CITY ............. : CUPERTINO
IMPACT AREA . . .. . . .
OWNER ............ : WOLGEST, STEVE
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-4658
CONTRACTOR .......: LIC #
COMPANY . .........:
ADDRESS ..........:
CITY/STATE/ZIP .... ,
TELEPHONE ........:
FEE DESCRIPTION CNK TOTAL FEE PAID-TO-DATE BALANCE DUE
--------------- --- --------- ------------ -----------
BREMRECEPT P 1.11 0.00 1.11
EPERMITFEE P 35.52 0.00 35.52
--------- ------------ -----------
36.63 0.00 36.63
VOICE ID DESCRIPTION VOICE ID .DESCRIP. 0.. ...... _
ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
i'
•
CITY OF CUPERTINO
I• 1 of 1 BUILDING PERMIT RECEIPT OPERATOR: christya
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:37542036.00
DATE ISSUED.......: 08/11/1999
RECEIPT #. .. . .....: 9793
REFERENCE ID # ...: 99080082
SITE ADDRESS .....: 747 STENDHAL LA
SUBDIVISION . . . .. . .
CITY ..... . .. . .... : CUPERTINO
IMPACT AREA ...... .
OWNER ............. WOLGEST, STEVE
ADDRESS ...........
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-4658
RECEIVED FROM .... : JOES
CONTRACTOR .......: LIC #
COMPANY . .........:
ADDRESS ..........:
CITY/STATE/ZIP .... ,
TELEPHONE ........:
FEE IO UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BREMRECEPT NO. OUTLETS 1.00 1.11 0.00 1.11 0.00
EPERMITFEE FLAT RATE 1.00 35.52 0.00 35.52 0.00
-------- ---------- ----------
T.PERMIT : 36.63 0.00 36.63 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 36.63 6107
............
TOTAL RECEIPT 36.63
VOICE IO DESCRIPTION VOICE ID DESCRIPTION
........ ............................ ........ ............................
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
•