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00010100 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY 00 I V 0 CITY OF CUPERTINO &BUILD(NOR. CTRICAL M MIT NO. BUILDING DIVISION APPLICATION/PERMIT HANICAI.IIENTIFICATION SANITARY NO. APPLICATION SUBMITTAL DATE B ILDINC ADUHE55yjOOWNERS NA PHO CONTRA R'SLIC NO: NIC CONTROLM bixHITF.C1'/ENGINEER: LIC O: ADDRESS: /' O ❑ /^ CONTACT: PHONE: BUILDING PERMIT INFO ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT PLUM MECH El 1:1 21 ED LICENSED CONTRACTOR'S DECLARATION QTY ELECTRIC PERMIT FEE 1 hereby affirm that I um licensed under provisions or Chapter 9(commencing lOB DESCRIPTION D a'Z with Section Divlslon 3 ofthe Business and Professions sale.and my license is PERMIT ISSUANCE I- in full force and e L WL ❑KITCHEN REMODEL EU Incense Class Lich gppl.lANCES-RESIDENTIAL ❑ADDITION ❑PLUMBING RE-PIPE F Z W Dam Conduc r H7h CHITGLTS DE RATION _ PANELS ❑MULTI-UNIT ❑STRUCTURAL Z O m Z I understand my plans.hull Ee used as public records MODIFICATION OZN-,- UP TO 200 AMPS ❑INTERIOR L1 CHIMNEY REPAIR I„ah; Licensed Professional 201-1000AMPS IMPROVEMENT L]SWIMMING POOLS GNY ..I OWNER-BUILDER DECLARATION OVER I(XOAMPS ❑BATH REM 01�•UREPAIR ❑DF.MOI.ITION C IY w 6 I hereby aRmn that 1 am exempt from the Conmtetor's license Law for the �d O 09 U following reason,(Section]03 L5,Business and Professions Code:Any city or county SIGNS ELECTRICAL ❑OTHER I a 41 W LL h- which minims a permit la consuceuc6 alter,improve,demolish,or repair any structurestructure06 prior In its issuan ,also requires pp qs the alicant mi lit such pert to file asigneJxtem mcm SPECIA I.CIRCUIT/MISC. that he is licensed puts uanuo the pro ki.m.fthe Commcmr's License Law(Chapter 9 m 00 (commencing with Section 7")of Division 3ofthe Business and Professions Code)or TEMP.METER OR POLE INST COMMERCIAL: a p. IY that he is exempt thcrtftom and me basis for the alleged exemption.Any violation of ❑NEW BLDG/ADDITION ❑DEMOLITION i� lL Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty or POWER DEVICES ❑TENANT ❑FOOD SERVICE y of mom than five hundred dollars(55(0). ^ Q ❑1,as owner of the property.or my employee..wird wags.as dheirsole compensation. SWIMMING POOL ELECTRIC IMPROVEMENT [I OTHERwill do the work,and the structure is not intended or offered for sale(Sec.7033,Business 3 and Professions Cade:The Contmemr's License Law Jaa oat apply to an owner of OUTLETS-SWITCHES-FTXT _ property who builds or improves Neuron,and who does such work himself or through , his own employees,provided that such improvenseux arc not intended or offered far NEW RESIDENTIAL ELECFR Q FT. sale.If,however,the buildingimprovement is sold within one of completion,the SQ.`.FLOOR AREA SQ.FT. ownar ed of leaving yenta p builder will have the burden of proving Ihat he did not Wild or improve for par- ' Iasecof anted. 1.as owner of the property,am exclusively contracting with licensed contractors to .T L: JAN 2 12000 construct the pmjecl(Sec.7113x.Business and Professions Cade:)The Conductor's Li- cense Low does not apply to an owner of property who builds or improves thereon,and QTY. PLUMBING PERMIT 'FEE whe contracts for such projects with a co nntctogs)licensed pursuant to the Cont actor's License Law. PERMIT ISSUANCEI. gy 1 am exempt under Sec. .B&P C for this mason ---.�_ ALTER-DRAIN&VENT-WATER(EA) "�Vg1aATAAA['� Owner Date WORKER'S COMPENSATION DECLARATION BACK FLOW PRQI'ELT.DEVICE 1 hereby affirm under penalty of perjury one of the followingW Worker's Croatian- V ❑Ihave and will maintain Cernficiam of Consent to Code,fort for erformace of the DRAINS-FLOOR,ROOF,AREA,GOND. RIES TYPE CONSTRUCTION whoa,as provided for mi Section J9fX)of the Labor Code,for the performance of the work for which this Permit is issued. FIXTURES-PGR TRAP I have and will mainfam Worker's Compen.wtion Insurance,as required Ey Section 300of the Labor Code.for psrfomerxvaf the work for whicht 'spermitisissucc. GAS-EA.SYSTEM-I INC.30UTLE1'S OCCGROUp APN M W Com on Int -ca r$nd Polis nu r Carr(¢/�' Lq� �Elicy Na. GAS-BA.SYSTHM-OVENJ(EA7 `9 r yoz CERTIFICATE OF G M ION FROM WORKERS' GREASFANDUSTRL WASTE INTERCEPTOR ` [a r COMPENSATI NINSURANCE BUILDING DIVISION FEES ('Kris section need not be completed ifihe permit is(or one hundred dollars($1 on GREAS17TRAP or less.) PLANCHECK FEE Ieenify Nm ilmhe performance nfNe weak fee which this pe man is issued.l shall SEWER-SANITARY-STORM EA.200 FT. not employ any person in any manner so as to become subject to the Workers'Courtier- ENERGY FEE Z cation Laws of California.Data WATER HEATER WNENT/FLECfft Z O_ Applicant GRADING FEE El NOTICE TO APPLICANT.If,after making this Certificate of Exemption,you should WATER SYSTEMaREATING SOILS FEE E^ become eobject to the Worker's Compensation provisions of the Labor Calc,you moat Uj ti forthwith comply with such provisions or Nis permit shall be deemed revoked. WATER SERVICE Q S CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMB. SQ.PC PAID Date ReceiplM L) thereby affirm that them is acnnstmction larai..gagency for theperformanceof the work far which this permit is issued(Sec.3097.Civ.C.) OTOTAL: V Lender's Name W Lender's Address TOTAL: y 1 certify that 1 have read Ibis application and aside that the.have inform.....is BUILDING FEE [— h correct.l agree to comply with all city and county ordlnuncesa..d stem laws relating to QTY, MECHANICAL PERMIT FEE („J Z Euddingcmrswction.and herebyenuaimm,rawalativex ofthis city to enter upon the SEISMIC FEE above-mentioned property for inspection purposes. PERMIT ISSUANCE (We)apace to save,indemnify and kap harmless the City of Cupertino against ELECTRIC FEE liabilities,judgments.costs and expenses which may in any way acaveagainsl said City ALTER OR ADDTO MECH, PLUMBING FEE In consequence of she griming of tho permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT IT010,(X10 CFM) MECHANICAL FEE SOURCE REGULATIONS, AIR HANDLING ON['1'(OVER 10.000 CFM) CONSTRUCTION TAX Signature of ApplicanoCommmor Data EXHAUST HOOD(WMUCT) HOUSING MITIGATION ME HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material HEATING UNIT(TO 100,1100 BTU) as defined by the Cupertino Municipal Cade,Chapter 9.12,and the Health and Safety Cafe,Section 25532m)? HEATING UNIT(OVER 100,000 B'IT) ❑Yes 7N PAID VENTILATION FAN(SINGLE RESIO) Date Recaps X Will the applicant or in nts a building occupant use co Air Qu m devices which BOILER-COMP UUP OR 100,0X0 BTU) mit hazardous air contaminants as Jcfined by the Bay Area Air Quality Management TOTAL: District? ❑Ne BOILER-COMP(OVER 100,0011 BTU) I have maar d the hitdamaterials aterials requirement mode,Chapter 6.95 of the Cali- AIR CONDITIONER ISSUANCE DATE Roma Health&Safety Cook.Sections 25505.25533 and 255M.I understand that if the NEW RESIDENTIAL MF,CH. SQ.Pf. building rrently hmeamnntit,that it is my mspunsibilitym notify the occupant xt Prier m iwuancc of a'k-a-1— ervi I<.m mf occupancy. u ave .gem Data TOTAL: ISSUED BY: i OFFICE BRENIACOVER QAC UNIT>1 CCGGCF,`.I 1bt CmANICALi JBREMAIRHAN IA/C UNITS <e 10.000Crib1 IMECHANICAL JBREMFURN IRELOCATION OF FURNACE (MECHANICAL BREMFURNOV JP,ELO FURNACE > 10K BTU MECHANICAL BREMINHOOD 1INSTALLATION OF HOOD IMECHANICAL BRENIRELOCA IRELOCATION OF HOOD JIVIECHAKICAL BREMREPALT REPAIR/ALTER HEATING MECHANICAL BREMVENSYS IVENTILATION SYSTEMS IMECHANICAL PPERMITFEE PLUMBNG PERMIT ISSUE PLUMBING BNUMULTI NEW MULIFAMILY RES PLUMBING BNUSFD NEW SINGLEFAMILY RES PLUMBING BPBACKFLOW ATMOSPHERIC VACUUM PLUMBING BPCESSPOOL CESSPOOL PLUMBING 13PFIXTURE PBLG FIXTURE PLUMBING BPGAS GAS PIPING SYSTEM FEE PLUMBING BPINTERCEP IND WASTE INTERCEPTOR PLUMBING SPREPIPE REPIPE OF FIXTURES PLUMBING SPSEWAGE SEWAGE DISPOSAL PLUMBING SPSEWER SEWERS PLUMBING BPSPRINK LAWN SPRINKLER/BACKFLO PLUMBING SPSTORM STORWRAIN WATER PLUMBING BPTRAP i; TCMEN TRAP PLUMBING BPVENT ALT OF DRAIN &VENT PLUMBING BPWATER INSTALL/ALTER WATERPIP PLUMBING BPWHEATER WATER HEATER/VENT PLUMBING • BPWSVCS MAIN WATER SERVICE PLUMBING ZDEVAGREE DEVELOPMENT AGREEMENT PLANNING ZDIRTM DIR TENT MAP PLANNING ZFULLHR FULL APPL BASE+HR PLANNING ZFULLTM FULLAPPLTENTMAP PLANNING ZFULLUP FULL APPL USE PERMIT PLANNING ZFULLZONE FULLAPPLZONING PLANNING ZGPAMENO GENERAL PLAN AMEND PLANNING ZLIMAMENO LIMITED AMEND PLANNING ZLIMTM LIMITED TENT MAP PLANNING ZLIMUP LIMIT D 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 ISCASA MISC ARCH SITE PLANNING ZMISCEXT MISC TM AND UP PLANNING ISCFENCE MISC FENCE EXCEPTION PLANNING ZMISCG N MISCELLAPPLGEN PLANNING ZMISCPCINT MISC PC INTERPRETATION PLANNING ZSIGN SIGN PERMI PLANNING ZTSMPSIGN TEMPORARY SIGN PLANNING • ZVARLANCE IDIRECTORVARIANCE PLANNING 2cf2 itM N10199 le, Moo / yob Qty, if Applicable Fee 10 Fee Oescription Fee Group - IBPERMFEE IBLOG PERMIT F=—=S IBUILOING ISCONSTAX JCONSTRUCTION TAX 1BUILOING IBENERGY JENERGY IBUILDING BENERGYAOD JENERGY ADO MULTI IBUILOING ISOVERTIME INSPECTION OVERTIME ISUILOING STEMPPERM TEMPORARY SLOG PERMIT IBUILOING BMITIGAT IHOUSING MITIGATION FEE ISUILDING SPLANCHK PLAN CHECK FEE BUILDING BPLANCKADD PLAN CHECK ADD MULTI BUILDING BPLANCKREP PLAN CHECK REPEAT FEE BUILDING BREINSPECT REINSPECTION FEE BUILDING BSCBLVD TCB SPECIFIC PLAN BUILDING BSEISMICOM SEISMIC COMMERCIAL BUILDING BSEISMICRE SEISMIC FEE RES BUILDING BSPECIAL SPECIAL INSPECTION BUILDING BSWIM SWIMMING POOL BUILDING ZADOCHG ADDRESS CHANGE BUILDING EPERMITFEE ELEC PERMIT ISSUANCE ELECTRICAL BELEC1000 ELEC 600V �1000A ELECTRICAL B LEC1001 ELEC 600V>1000A ELECTRICAL BELEC200 ELECT SVCS 600V c=200A ELECTRICAL BNEWMULTI MULTIFAMILY RES ELECTRICAL BREMBUSWAY REMODELBUSWAYS ELECTRICAL BRENIFIXT LIGHTING FIXTURES ELECTRICAL BREMMISC MISC APPARATUS ELECTRICAL BREMNRAPP REM NON-RES APPLIANCE ELECTRICAL BREMPOL POLE/PLATFORM FIXTURE ELECTRICAL BREMPOWER POWER DEVICE/APPARATUS ELECTRICAL BREMRECEPT RCPTL, SWITCH &OUTLETS ELECTRICAL BREMRESAPP REMODEL RES APPLIANCE ELECTRICAL BREMSIGNAD RMOL SIGNS ADD BRANCH ELECTRICAL BREMSIGNS REMODEL SIGNS, MARQUEE ELECTRICAL BREMTHEATR THEATRICAL LGHTNG FIX ELECTRICAL SSF&2FAM SINGLE&2 FAMILY ELECTRICAL STEMP TEMPORARY POWER ELECTRICAL BTEMPSVCS TEMP DIST SVCS ELECTRICAL MPERMITFEE MECH PERMIT ISSUANCE MECHANICAL SAPPLOTHER OTHER APPLIANCES IMECHANICALl SBOILERI BOILER<= 100,000 BTU MECHANICAL BBOILER2 BOILER>100KT0500KBTU MECHANICAL BBOILER3 BOILER>500K TO 1M BTU MECHANICAL BBOILER4 BOILER>1M TO 1.75M BTU MECHANICAL BBOILIERS BOILER> 1.75M BTU MECHANICAL BREMAPPLI APPLIANCE INSTALL MECHANICAL BREMH HEATER INSTALLATION M CHANICAL BREMVENFAN VENT FAN SINGLE DUCT MECHANICAL BMNEWMULTI NEW MULTI-FAMILY RES MECHANICAL BMNEWSF&2F NEW SF&2F RES SLOGS MECHANICAL loft It .wa MOM INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO BUILDING PERMIT INVOICE OPERATOR: karenb Ser. Twp: ROB: Sub: Blk: LOL:36918024.00 INVOICE DATE......: 01/21/2000 REFERENCE ID # ...: 00010100 SITE ADDRESS .....: 831 CANDLEWOOD DR SUBDIVISION ... .... CITY ..... .... .. ..: CUPERTINO IMPACT AREA . . .. .. . OWNER ............ : ADDRESS .......... : CITY/STATE/ZIP ... : CUPERTINO CA, CA 95014-4651 CONTRACTOR ....... : GARZA, KEVIN N LIC # 14200 COMPANY ..........: SAN JOSE PLUMBING ADDRESS . . ........: 2667 ALDERWOOD DR CITY/STATE/ZIP .. .: SAN JOSE, CA 95132 TELEPHONE . . . . . . . . : (408)296-1820 FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE ---------------- --_ --------- ------------ ----------- BUSLIC P 90.00 0.00 90.00 r� PPERMITFEE P 35.52 0.00 35.52 --------- ------------ ----------- 125.52 0.00 125.52 ^ E ID DESCRIPTION VOICE ID ... .. DESCRIPT IONv- . O63C6 SEWER I WATER 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 302 TUB 6 OR SHOWER 502 FINAL PLUMBING ENERGY 506 GAS TEST 507 FINAL PLUMBING •