00010007 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY 01006 4—
CITY OF CUPEMPINO BUILDING-ELECTRICAL
BUILDING DIVISION APPLICATION/PERMIT PLUMB NO-MECHANICAL
BUILDING PROJECTIDENTIFICATION
BUILDING ADDRESS: SANITARY NO. APPLICATION UBMITTAL DATE
Cv 4int Ca•95014 -3 Zo
O1WNEB'. NAME: 1'HON C(:QIppRACTOR'S NAME: LIC NO:
•` S u.- 52e-4.1,947 JU _J NIC CUMROLp
ARC ITECI'/ENGINEER: I.ICNO: ,AAD�ES� �h�r- / c �� ❑
C(O�/N�TA/CIT':'rs p �,n Q�1PHHONE: Ga/n,I BUILDING PERMIT INFO
IL li,LL Y. O q� 0334 ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT PLUMB MECH
❑ ❑ ❑ le
LICENSED CONTRACTORS DECLARATION QTY. ELECTRIC PERMIT - FLEE
1 hereby of inn that I am deviated under provisions of chapter 9(commencing JOB DESCRIPTION
WOO with Secction 7000)of Division 3 ofthe Business and Professions Code,and my license is RESIDENTIAL'
F in full force unJ eRvn �l ^ PERMIT'ISSUANCE:
CLO /���Q�� ❑SFDWL El KITCHEN REMODEL
4 V U Liean llnas Lic.p
yGi Ume./- ,nx/ [j Conwctnr� APPLIANCES-RFSIDHNFIAL ❑ADDITION El PLUMBING REYPIPE
a'I '7 e RCHITECTS DECLARATION ❑MULFLUNIT ❑STRUCTURAL
E y PANELS
ZOyZ understand
my plans shellodused public records MODIFICATION
OZ�O lr Qa pU V UP TO 200 AMPS un ❑INTERIOR ❑CHIMNCY REPAIR
aF��; 1.141m'essmnul 201-IIXO AMPS IMPROVEMENT []SWIMMING POOLS
C
OWNER-BUILDER DECLARA'110N
CG Q 1 hereby amffirm Thal I am exempt from the Com.emev Liccnxe I.uw count OVER IIIfM)AMPS ❑BATH REMODEV/RE�PAIIR ,O DEMOLITION
x1x O G U following anna(Section 7831.5,Business and Professions Code:Any city or county SIGNS ELECTRICAL ❑OTHER ---e�r V/ Y •/ '
W LLO ya which requires a Permit to emotma,aIle,,improve,Avnmh,h,nr repair any ro name
prior to its issuance,also requires the applicant for such pen and In File a signed duration SPECIAL CIRCUIT/MISC.
aQ� that he is beensedpursunm to the provisions of Nc Cnntmcmr's Liccnac l.uw(Chupta9
W OO main eneing wish Secdnn]O(Np ofDivlslon3nf the❑acinus nnJ Pndcminnt Cn 1.)nr TEMP.ME 1 R Olt TOLL:INST. COMMERCIAL:
a e that he ix es,and headman and the basis fur the alleged cxcrnptin i.Any violation nl' ❑NEW BLDG/ADDITION ❑DEMOLITION
P IN Section]W l5 by any applicant ro,a permit subjecaa the applicunuoa civil penally of POWER DEVICES []TENANT ❑FOOD SfiRVICG
not more than rive hundred dollars($500),
F Z Y IMPROVEMENT
Q E] Lothewrk,the pestrac,o,isnot mendeswi0ered frlhci(See 7044.Businon, SWIMMING POOL ELECTRIC
will�O and Jn the work,and Code,
a Cont a tot s License Law dos out a(Sly to an Business ❑OTHER
and property
h.b Codon i.p Contractor's License Law Jaen nm apply to if owner of OUTLETS-SWITCHIS-FI%TITRES
6 3 his ,am who hail,,or improves thereon,and who does inch weak himself or through
his own employeesprovided but such improare not intended o,offered for NEW RESIDENTIAL ELF.CTR SQ FT.
tale,IL however.the
building or impmvemrntis sold sold w within one year nfwmplerion.the SQ.FT.FLOOR AREA LSQ.FT.
marambuildcr will have the burden of proving that be did not build or improve for pur-
pnu of sale.),
❑I,as owner of the property,am exclusively contracting with licensed contractors to TOTAL:
construct the project(Sec.]BiQ Business and Professions Ctule:)The Contractor's Li-
censeLawdnaernapplymanownerofpropenywhobuildsorimprovesthereon,and QTY, PLUMBING PERMIT FETE
who coneams f or such projects with a contractor(,)licensed pursuant to the Commcam s
License I.e.. PERMIT ISSUANCE
El I nm axnnpt under,Nee. ,13&PC Im his reason
do
Dnle
ALTAR-DRAIN k V17NT-WATER(EA) VALUATION
O
WOR KERS COMPENSATION DECLA RATION BACK ITOW PROTECT DEVICE
wner � � „^
1 hereby affirm under penalty of perjury ons of the fallowing dedita tioup V
Cl I have and will mainmina CeniBcanot Consent to self-inshrm far Workers Crmpen- DRAINS-FLOOR,ROOF.AREA.COND. STO ES TYPE CONSTRUCTION
sanium as provided for by Section 37M of the Labor Code,for the performance of the
work for which this permit is issued. FIXTURES-PER TRAP
❑1 have and will mainmin Worker's Compensation Insurance,as required by Scants
3100 of the Latha Code,for performance of the work for which this pemmit is issued. GAS-PA.SYSTEM.I INC.4 OUTLETS OCC GROUP /L/s'�7APN
My Wnr$p�G m naubn Inxuranc,cainimitnd MicyAuymW yry,A,L I I GAS-EA.SYSTEM OVER 4(G) V 13n O J
Came, =1l Policy Noll
C1ERf11BCATEOP •XEMFI'[ON FROM WOR KHRS' GRF.ASPJINDUSTRI.WASTE O
COMPENSATION INSURANCE BUILDING DIVISION FEES
(Thisuction need nom he completed if the peril is forone hundred dollars S 100) GR17ASE'IRAP
or less.) - PLANCHECK FEE
I eanify that in the pe,fo..numeof Newark far Much la,permit is issued,Lshall SEWER-SANITARY-B'TORM P.200 IT
nm employ any pemmh in uny maernnso as m became tghjeel In Lha Worker,Camper- ENERGY PEE
,Z tutu..Lawsol'California.Date WATER HHAI'1711 WIVENT/F.LEC R
7Q O Applicant GRADING FEE
q y NOTICE TO APPLICANT,If,atter making this Certificate of ftxcmption,you should WATER SYSTEMG BEATING
a became suhiecl to the Worker's Compensation provisions of the I.ahor Cale,you must SOILS ME ,
hear In comply with such t
provisions ortho pe it shall he deuimd revoked. WATER SERVICE
Q Q
U z CONSTRUCTION LENDINGAGENCY NEW RESIDENTIAL PLMN. SQ.FT. {"��.. PAID Dam Receipt#
V O I for
rwhich muhermit i isacartwetianlending agency for the perfatance of
4. P: the workLadd,A forwhich this Permit is issued(Sec.3097.Civ.C.) 1!1) 1,\ ' I1� AL:
lender s Name I
LU17 IxnJerI Address TOTAL: )L/ - IJ
1 certify that I have read this application and nate that the uMwe infonnetion is _ AIUILDING FEE 'nl
V) nhnect.l agree mnrmply with all city and enemy ordinances rnAstam lows relating to QTY MECIIANICALPERMIT I( EI
V ,'Z, building connruminn,and hetaby authorize repreunmtivns nl this city nmemer upon the r MIC
SE
abnvomandnred pnrperty far iia aninn pmpnmt. PERMIT ISSUANC13
(We)agree m save,indemnify and keep hatless the City nI"Cupertino against ELLCfRIC FEE
liuhiliou,,pa gmento costs:md expenses which may in any way accrue against nuiJ CimyALTER O
msnlucnce of the grnming of this R ADP'fO MECH. „.•JJ i. PLUMBING PEE
me
p nt.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO ID,OINI CPM)
SOURCE HEGIIIiTIONS. MECHANICAL;F`._
/�✓1 i� i�JJn [ Aff^ Ia119-Al AIR HANDLING ONI'T(OVER IB,"CFM) CONSTRUCTION TAX
Signature ol'Apppliicca`n CCon-I•mc�mrS-t' —1/i�,C.[VV Dam EXHAUST HOOD(W/DUCT) HOUSING MITIGATION FEE
HAZARDOUS MATERIALS DISCLOSURE
Will lheapplicamminch,building occupant nano,handle hmmdaus mmenal HEATING UNI"I'(TO 100.000 BTU)
as defined by she Cupenino Municipal Code,Chapter 9.12,and the health and Safety
Code,Section 25532(W HEATING UNIT OVER 100,00.9 BTU)
❑Yc, [IN. VENTILATION FAN(SINGLE R'ESID) PAID
Dote Receip>
Will the applicant or Tulare building occupant use equipment of devices Which
hit hoariest,air comaminalns as defined by the Bay Area Air Quality Management BOILER-COMP f3HP OR 100,000 BTU)
TOT
UistricR
❑Yet 7 N BOILER-COMP(OVER 110,000 BTU)
AIR CONDITIONER
I blvd read Lha Code,Se mars 255sil,requirements nndn Chapter ota aline Calf. — =ANnnnCsssP��,,DATE?
Rnnlu Hmdlh ra Safety Code,eunoias 255(15,25533 and 25534. mmdusmnd that if Imo NEW RHSIOI?NTIAI.MI!CH. SQ.PT. / 0
huilJing Aswx nal currently hove a mnun6 that it is my Iu,pnnnihiliry In nmify the acupam
of ihemgal ascots which tort Ipn min I'a Cc if fc tontOcc y.
'Aoenp �yr�o/�� t�I �g9
Ow Ihoved agent ry �ule TOTAL:
ISSUED BY:
OFFICE
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
• BUILDING PERMIT INVOICE OPERATOR: karenb ,
Sec: Twp; Rug: Sub: Blk: Loe:36204035.00
INVOICE DATE. . . . ..: 01/04/2000
REFERENCE ID N . . . : 00010007
SITE ADDRESS ..... : 7990 WOODLARK WY
SUBDIVISION . . .. .. .
CITY .... . ........: CUPERTINO
IMPACT AREA .. .... .
OWNER ....... . ....: LYDIA SHO-HUI GO
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-4937
CONTRACTOR .. . . . ..: ALLEN SENNERT LIC N 21614
COMPANY ......... . : SUPREME AIR SYSTEMS
ADDRESS ......... . : 520 MCGLINCEY LANE #15
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE ........ : (40B)879-0334
FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE
--------------- --- --------- ------------ -----------
BREMHEAT P 6.11 0.00 6.11
MPERMITFEE P 35.52 0.00 35.52
--------- ------------ -----------
41.63 0.00 41.63
ID -------DESCRIPTION .--- VOICE ID ............................DESCRIPTIO
... . ........... ........
204 UNDERFLOOR FRAME 301 ROUGH PLUMBING
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL 514 FINAL PUBLIC WORKS
Ory. if Applicable Fee 10 Fee Description Fee Group
�BPERMFEEBLDG PERMIT FEES BUILDING
• ISCONSTAX ICONSTRUCTION TAX ISUILDING
ISENERGY ENERGY BUILDING
BENERGYADD JENERGY ADD MULTI BUILDING
BOVERTIME INSPECTION OVERTIME BUILDING
BTENIPPERM ITEMPORARY BLDG PERMIT BUILDING
BNIITIGAT IHOUSING MITIGATION FEE BUILDING
BPLANCHK PLAN CHECK FEE BUILDING
BPLANCKADD PLAN CHECK ADD MULTI BUILDING
BPLANCKREP PLAN CHECK REPEAT FEE BUILDING
BREINSPECT REINSPECTION FEE BUILDING
BSCBLVD SCS SPECIFIC PLAN BUILDING
SSEISMICOM SEISMIC COMMERCIAL BUILDING
BSEISMICRE SEISMIC FEE RES BUILDING
ESPECIAL SPECIAL INSPECTION BUILDING
BSWIM SWIMMING POOL BUILDING
ZADDCHG ADDRESS CHANGE BUILDING
EPERMITFEE JELECPERMITISSUANCE IELECTRICAL
BELEC1000 ELEC 600V <=1000A ELECTRICAL
BELEC1001 ELEC 600V>1000A ELECTRICAL
BELEC200 ELECT SVCS 600V <=200A ELECTRICAL
BNEWMULTI MULTIFAMILY RES ELECTRICAL
BREMBUSWAY REMODELBUSWAYS ELECTRICAL
• BREMFIXT LIGHTING FIXTURES ELECTRICAL
BREMMISC MISC APPARATUS ELECTRICAL
BREMNRAPP REM NON-RES APPLIANCE ELECTRICAL
BREMPOLE POLEIPLATFORM FIXTURE ELECTRICAL
BREMPOWER POWER DEVICE/APPARATUS ELECTRICAL
BREMRECEPT RCPTL, SWITCH &OUTLETS ELECTRICAL
BREMRESAPP REMODEL RES APPLIANCE ELECTRICAL
BREMSIGNAD RMDLSIGNS ADD BRANCH ELECTRICAL
BREMSIGNS REMODEL SIGNS, MARQUEE ELECTRICAL
BREMTHEATR THEATRICAL LGHTNG FIX ELECTRICAL
BSF&2FAM SINGLE&2 FAMILY ELECTRICAL
STEMP TEMPORARY POWER. ELECTRICAL
BTEMPSVCS TEMP DIST SVCS ELECTRICAL
MPERMITFEE IMECH PERMIT ISSUANCE MECHANICAL
BAPPLOTHER OTHER APPLIANCES MECHANICAL
BBOILERI BOILER <= 100,000 BTU MECHANICAL
BBOILER2 BOILER>100KTO500K BTU MECHANICAL
BB0ILER3 BOILER>500K TO 1M BTU MECHANICAL
BBOILER4 BOILER>1M TO 1.75M BTU MECHANICAL
BBOILERS BOILER> 1.75M BTU MECHANICAL
BREMAPPLI APPLIANCE INSTALL MECHANICAL
BREMHEAT HEATER INSTALLATION MECHANICAL
BREMVENFAN VENT FAN SINGLE DUCT MECHANICAL
• BMNEWMULTI NEW MULTI-FAMILY RES MECHANICAL
BMNEWSF&2F NEW SF&2F RES SLOGS MECHANICAL
I aft
Revised S/10/99
BREMACOVER QAC UNIT >I C000CFNI INIECHANICAL
JBREMAIRHAN JA/C UNITS <= 10.OGCCFd,t IMECHANICA.L
BRENIFURN RELOCATION OF FURNACE IMECHANIC AL
BRENIFURNOV IRELO FURNACE > ICK STU IiNIECH,ANICAL •
i
BREMINHOOD JINSTALLATION OF HOOD MECHANICAL
BRENIRELOCA IRELOCATION OF HOOD MECHANICAL
BREMREPALT REPAIR/ALTER HEATING MECHANICAL
BREMVENSYSVENTILATION SYSTEMS MECHANICAL
PPERMITFEE JPLUMBNG PERMIT ISSUE PLUMBING
BNUMULTI NEW MULIFAMILY RES PLUMBING
BNUSFD NEW SINGLEFAMILY RES PLUMBING
BPBACKFLOW ATMOSPHERIC VACUUM PLUMBING
BPCESSPOOL CESSPOOL PLUMBING
BPFIXTURE PBLG FIXTURE PLUMBING
BPGAS GAS PIPING SYSTEM FEE PLUMBING
SPINTERCEP IND WASTE INTERCEPTOR PLUMBING
BPREPIPE REPIPE OF FIXTURES PPLUMBING
ING
BPSEWAGE SEWAGE DISPOSAL BPSEWER SEWERS INGBPSPRINK LAWN SPRINKLER/BACKFLO BINGBPSTORM STORWRAIN WATER BINGBPTRAP KITCHEN TRAP BINGBPVENT AL'T OF DRAIN &VENT BING
BPWATER INSTALL/ALTER WATERPIP PLUMBING
BPWHEATER WATER HEATERIVENT PLUMBING
BPWSVCS MAIN WATER SERVICE PLUMBING •
ZDEVAGREE DEVELOPMENT AGREEMENT PLANNING
ZDIRTM DIR TENT MAP PLANNING
ZFULLHR FULL APPL BASE+ HR PLANNING
ZFULLTM FULL APPL TENT MAP PLANNING
ZFULLUP FULL APPL USE PERMIT PLANNING
ZFULLZONE FULLAPPLZONING PLANNING
ZGPAMEND GENERAL PLAN AMEND PLANNING
ZLIMAMEND LIMITED AMEND PLANNING
ZLIMTM LIMITED TENT MAP PLANNING
ZLIMUP LIMITED APPL USE PERMI PLANNING
ZMATEMPUP MIN AMEND TEMP USEPERM PLANNING
ZMINHILLEX MINOR APPL HILL EXC PLANNING
ZMINSIGNEX MISC SIGN EXCEPTION PLANNING
ZMINTM MINOR APP TENT MAP PLANNING
ZMINUP MINOR APPL USE PERMIT PLANNING
ZMISCASA MISC ARCH SITE PLANNING
ZMISCEXT MISC TM AND UP EXT PLANNING
ZMISCFENCE MISC FENCE EXCEPTION PLANNING
ZMISCGEN MISCELL APPL GENERAL PLANNING
ZMISCPCINT MISC PC INTERPRETATION PLANNING
ZSIGN SIGN PERM] PLANNING
ZTEMPSIGN TEMPORARY SIGN PLANNING
ZVARIANCE DIRECTOR VARIANCE PLANNING •
2 oft
Revised 8/10199