03070142 CI'PY OF CVPERTINO �,`�'% l " '" z a]�f'.ffv k.',
BUILDING DIVISION - PERMIT
COO NCRACTOR INFORMA.TIgN: alp
.�°s3uS�z•.dwAF:fl £ "&x ° " 4s4rtx?�'kYvu.!
BUILDINO ADDRESS: JOHN SUTTI & ASSOC. INC. PERMITNo03070142
OWNER'S NAME: ,500 AIRPORT BLVD. #110 PIRMIT ISSUE DATE
wgm P. Fnnnq MARKET
IS: SANITARY N0. CONTROL NO.
' (650) 34.3-4244
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT' PLUMB MECH
0
uo0 LICENSED CONTRACTOR'S DECLARATION
YmF 1 hereby iffrm that I am liceued under provisions of Chapter 9(commencing Job Description
<Zm with Section tf Division Sof the Businux and Pru&ssinm Cnd,,and mylicenee is
"� in full Tt1 ..cftb
ff
>qg LicenrLm.♦ REVISION--IN HOUSE USE ONLY
Zi- Dao convector NO NEW PERMIT ISSUED ORIG. #02080065
S DECLARATION ,
hJl sed as public rtcnrtls REVISION--SKYLIGHT #03030076/03050133 COUNTER
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io dP7dp...I
1
1 DECLARATNI hethe e t.sero (rum NCmonra LicenreLaw for the
p0 following on 703 . usi ss and Pmfeuioes Cade.Any city m county
mwhich rtyum co nrvn.s tea improve,demolish,or repair any structure
prions its re res the applicant far such permit re Glc a signed statement
thalhcialknthepmviameannhecnmaemraL'u¢n sw(cn.prer9 Sq.Ft. Floor Area Valuation
(commencion7U)of Division 3 of the Business and Professions Cade)of
that be is exempt hc„from and lie baso for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of APN Number Occupancy Type
not mor,Nan five hundred dollars(8500).
01,as owner ofthe propcny,or my employees with wages as half sole compensation, 35908027. 00
will do the wark,.ad the structure,is not intended maffered fonsle(Sec.7Da4,Business Required Inspections
and Professions Code:The Contractor',License Law does not apply m come,er of q p
property who build,or improves thereon,and who does such work himsdfor Untaught his A
however W,uilding or i pr vemch nt isaemenlsin..inandecmonerW far mle.IL 101 — FOUNDATION
.wee mpthebuildingdetoosu improvement oro tro dcompletion,the mvner.
builder will have the bonen of proving that be did not build or improve for purpose of 102 — PIERS
ulc1. f
1,as ruownerofthe ctproperty,ameulusand contacting with:)Theedconmante.,1. 103 — OFER
construct the pmlcm(Sec.7044,Business and Profusions Code)The Canwcmr'e U. 104 — REBAR
""
elaw0 apply to an owner ofpcepeny who Wilds or improv mereon,and,
who comnca an mjec herb)licensed puauam to one Contractor. 105 - ANCHOR BOLTS
Lme"„uw.f 106 SEWER & WATER
❑1 am ue pt der ,B&P for thisrevert
.11-1103 202 - UNDERFLOOR PLUMBING
Own` WOR Co N DELLAg 7ATOION 203 - UNDERFLOOR MECHANICAL
1 embyeffmnunde It of duty one ofth ingdeelantmns: 204 — UNDERFLOOR FRAME
a and will meinain CcsitiateofConuma.lulf-asuamrworkchCompem 205 — UNDERFLOOR INSULATION
provided for by Tam 3700 of the ISWr Cnde,for the performance of the 3 01 - ROUGH PLUMBING
work for ich his pc I is ounce.
❑I have an ant,in WorkuY Compensation lnsunna,u taloned by Sectio" 302 — TUB & OR SHOWER
37M of the L,Wr Coals.far m,perfamane,of me work far which Box permit 1,Teal 303 - ROUGH MECHANICAL
My Worker's Compensation msuaem,carrier and Policy number am: 304 — ROUGH ELECTRICAL
Caller: Policy Na.: _
CERTIFICATE OF EXEMPTION FROM WORK ERS' 305 — FRAME
COMPENSATION INSURANCE 306 - HOLDOWNS
(Iblssocdan need notMcomptewduthepetmitisforanehundmddoilm(Eulln 307 - INSULATION
nr Ics,.)
I certify last in the perfnori of me work for which his manit is hated,1 shall oat 3 08 - SHEETROCK
employ any pawn in any manner so as h become subject tobc workers'Compensation 309 — EXTERIOR LATH
Laws of California,Date
Applicant 310 - INTERIOR LATH
NOTICE TO APPLICANT:IL after making this Cenifo¢of Exemption,you should 311 - SCRATCH COAT
become subject to he Worker'.Compensation provisions of he IaWr Code,you must
.JZ forthwith rnaply with each ,.vision,or thi,Permit mol he d,cmed revoked. 313 — ROOF NAIL
'z0 CONSTRUCTIONLENDINGAGENCY 501 - FINAL ELECTRICAL ENERGY
.F ^ therehya(faro21Nh i'.conswninnlendingagencylnnheperformanceof 502 - FINAL PLUMBING ENERGY
Cli the work fur which thin Permit is based(Sec.3W7,Co.C.)
wp l<ode,tName 503 - FINAL MECHANICAL ENERGY
z Leader'.Addrca 504 - FINAL BUILDING ENERGY
U o I certify that l have read this application and atm do he above information is 505 - FINAL ELECTRICAL
Iy F comma.I agree to comply with til city and county ordinances and sate Ins,Pelting to
L]V build0A4j
n,end hereby authoram representatives of osis city to upon he GAMetfI
.1nopi far inspection purposes.n save,indemnify and keep humlcu the City of Cupertino against Q 7 F Ifn liablcn apcnses which may in any way accom against said City S AL
C)z in cac r tinge permit.
^ APPE ANDS A WILL COMPLY WITH ALL NONPOINT Issued by:5 Date 411�1
VI n s. kill 5 NAL PLANNING
Re-roofs 5�4 - INAL PUBLIC WORKS
It amr fAPPb r a
Hs n OU h M RIMS DISCLOSURE Type of Roo
Willlifet e Cu or fu bu' We Chira,ort nr handle Health and acrid '
as Med by the 32 iso Man ode,Chapar 9.12,roti Inc Hcetlh and Safety
C e.Scedonzss32 )7 All roofs shall be inspected prior to any roofing material being installed.
' �Ycs No
al applicantorfu to Wilding occupanluseequipment atdevices which If a roof is installed without first obtaining an inspection,I agree to remove
he",nus all Camaro nava u food by the Bay Area Air Quality Management - all new materials for inspection.
in7
❑Yes
"a 'mad cha>m s varialsayvircmcna under Chaparfi95 of the Celifnry
nie l'et", Safc dens 25515,25533 and 25534,htmlcrs d!dim if the building
dose hot to yIa aen 4tht' is my r,slounlity b,nobl y the can tnI he
reyuimmc is s me sumccofa Nficase focuanc Signature of Applicant Date
wnet a, atnoris agent ale All roof coverings to be Class "B" or better
QC5,y f 9' Boz 8� 6s
(��- CITY OF CUPERTINO
CUP TYOF O PERMIT APPLICATION FORM
PN # �.� �c Date: 7 I1 D 3
i
Building Address: I Mailing Address (if different from building address):
201R.30 lw
Owner's Name: Phone#: 650 -3' "3>—+L4-4
5O _39"3_+L4-4
Contractor: License#: Sq-S33
aG
Contact: Phone: 0-6 Cupertino Business License#:
Fax:
Building Permit Info:
Bldg 9' Elect Plumb Mech ❑
Job Description:
Residential ❑ Commercial
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Project - Occupancy Group
b`irl�U�"
Type of Cons n• Please check thisprd ect is a
second-story addition: ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to IM 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<= 1000A ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
2253 �
1 of 0. d
#- /3�
CITY OF CUPERTINO
Cl OF PERMIT APPLICATION FORM
CUPERTINO
Quantity Fee ID Fee Description Fee Group
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMCTLTI 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
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 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
BREN ABUiAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BRENUI RN Relocation of Fumace 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
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IRTY"0
- CITY OF CUPERTINO
PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee ID Fee Description Fee Group
BREMRECEPT Rc tl Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
BREMSIGNAD Rmdl Sips Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR Theatrical Ligbting 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 Inspection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP 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
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