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00050063 (2) CITY OF CUPERTINO PERMITNO. BUILDING DIVISION PERMIT CONTRACTOR INFORMATION: 600.6-00 D j� BUILDINGADOgESS: & C S�s�r/��G C �� . to SANRARY NO. APPW(C/ATION TAL SUBMfIDATE V• J OWNER'SNA ` W CONTROL# 'PG/.l ' .' ' t HONE: (p 0 3'7"t - 0300 `T, gSJ17 ❑ BALDING PERMIT INFO q ARCHITF.Cf/F.NGINELR. r � /y G 2z ON thereby affirm Nhasi that Incensed under provisions ofnChvger 9(cmnmencing p lob Description e „ F_�w with Science 7000)oand my 3 ofthe Businwand Rofnsiov Cade.amY license is <z < in NllrarteaMeB«t. Clb it l O ggSS Woonse chis "•Lic.a _ te t•u O 6 ARCNI'I'P.LTS DECLARATION ��y-e Iwdmuad mY Plw shd'beu iapubiie mmdr �/y-�`�� j��f/(.� (/T/'// r gLicwedRofeuiavl - OWNER-BUILDER DECLARATION t < 1 hereby arRnn that 1 am exempt from the Contractors License Lrw for the • - F O following resume.(Sctimi 703 1.5,Bvrcce W N iMeaiov Cade:Any city or county , C which m,uirti a permit to construct.sive,borrow,demolish,or rapist any swcrure 3 m finesseits itsuanee,also".I.,du applicant for each permit to F.I.augnedmm tecm Sq. Ft. Floor Area Valuation that he is licensed pointer to the provisions of the Contractor's Liana lew(Chapta9 anmme.ang with satin.71K10>nrliimalrn3 nrthe Bariooaa.ne pmre..lm,e cade)ar ,yp Number Occupancy Type dual he is exempt therefrom and the bait for the alleged ewnphout.Any^^Inion d 10 �, Yp Sawn 70313 by any appliuvt fee•permit subjects the cep ilicanno a civil penalty of (�a J✓I not mom than Eve hundred dollen(SSW). ❑1,asownerofinepropeny,mmyemww�awimwvge.uwe oleenmpenwan, Required Inspections will do Nework.and me mature I. intended oroRered farad.(Set.7060.Buriva a and Profasiw Code:The Conuanor's License taw does nal apply w an owner a ' property,wed Wilds or improves overarm,and who door such work himself or through his own employees,provided Wt such imgwemanu art nal intended or olfned for - sale,If,however,the building or improvement is told within one you of completion,the owvr-Wilder will have the burden of proving that W did not Wild.,improve for pm. P.of We.)., 1,as owner often property,sure exclusively contracting wit licensed contractors to construct the projrct(See 7066,Box.and Prokuiov Code:)The Connector.U. ,are law doe,nor apply to an owner of pmpeny w W Wilde or imprrve.thartem.and who commits fonuch prejects with awnuacmr(q licensed puauant w me Contactors Wcense law. ❑I an exempt underSa. .BAPC far ria rcaan •. Owner Das - •- a:.J '- - WORKERS COMPENSATION DECLARATION - 1 hereby affirm under penalty of perjury ons of the following da Watiov: ❑o a,:ovl ill for by ecuon 337W of o nant ,Coda,awe the Workdr ce of the ration,as provided(pe by Section 3700 of the Labor Cade,Ire site Performance of me wvI has which ria petmit is i winders 1 have and will odemaln WoM1srs Compensnion work for whi h required by Section 7700o ri a laWr Code,frame perfer,wae ofthe verb for which this permit u issued. My Wmkcrs i i ran ca Paltry nu art: Cvnicc_ yN., CER loCATE OF •KEM ON FROM WO KERS' - - MMPENSATIONINSURANCE mit cece.needed Le comp W ed it du premia a tar one hundred de l lar(SIM) or lea) I caddy that in one performance ofthe work for which this peri,is iatued,I shag - not employ any Pana.in any manor w as to become subj.t,.On,Workrn'Compen- -.tion laws of California.Dile Applicw r , NOTICE TO APPWCANf:If,after meting this Certificate of Exemption.you shwld hecorrc mbject to me Worker.Compensation provisions of the labm Code,you mart _ forthwith comply wit such provisions or this PermitaWll be deemed revoked. t CONSTRUCTION LENDING AGENCY 0 I hereby aRem the mart is a construction lending agency for the perfero umec of _ 7�- the work fm which this permit is issued(Sec.3097,Civ.C.) . ^Fy Lender.Name a > Iandue,Address t - f� 1 certify that 1 have read thu application and avec ma,this,above infomuationis d once,.I upon,u simply with all city and c ty ardi.. surtW m laws ing.. - - D z building construction,sed hereby audwrise a i'rx oft s citywevmrupabdm U O nWve-mentioned property for inspection Pit ... , W stip (We)agree w save,ind mdfy inti P leu the ty of Cupertino against (� Iiabilitia,Judgcei apensea h 'irianyw accry yainsluilCity li ntequerNc of dug nn ofthis perm API (CANT UNDER. AN AND WII CO PI.YWIAI.LNON-' INT U � OU .F..ftF.OULA'fl S. Sig of ApplicanJC 'Dau FIA7d US MA A DISCLOSURE - illmeapplicant^f oral, i upememmorhandlehasirdounmaenal Re-roofs - a by,he Copertin .did e,Chapter 9.12,and the Hedm and Safety Type of Roof ' Code.satire21st=(a)^ ❑Yes E3 No Will the. Roue Wilde a pmkuac ipment or devices which All roofs-shall be inspected'prior'to any roofing material being end,hnndons sR..manhunts at deft b BB.y . it Quality Management installed. If a'roof is Installed withoutfiirst obtaining an inspection District? I agree to remove all new materials for inspection. Applicant ❑Y<s W[DN. ghaveead m ma rGapwd.95rfWGali. understands and.will comply with all non'point source regulations. ,y 333 and M.1 undersand that if theildi ffiundcuit myna 'bilialms rrcnuw Cenificcar Oc puny. _Signature of ApplicantDate rude - All roof coverings to be Class"B"or better OFFICE - — - - INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO BUILDING PERMIT INVOICE OPERATOR: nancyc Sec: Twp: Rng: Sub: Blk: Lot:34259005.00 INVOICE DATE. . . ...: 05/10/2000 REFERENCE ID # ...: 00050063 SITE ADDRESS . .. . .: 21160 CANYON OAK WAY SUBDIVISION .. . .. .. CITY ......... . ...: CUPERTINO IMPACT AREA . . . .... OWNER ............ : O'BRIEN GROUP ADDRESS ......... . : CITY/STATE/ZIP . ..: CUPERTINO, CA 95014 CONTRACTOR .......: LIC # 21563 COMPANY ..... . . ...: ACME & SONS SANITATION/ELECTRI ADDRESS ... . . .. ...: 1880 S. 7TH ST CITY/STATE/ZIP ...: SAN JOSE, CA 95112 TELEPHONE ... . ....: (408)275-2263 FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE _______________ ___ ------------ BTEMP P 57.50 0.00 57.50 EPERMITFEE P 35.52 0.00 35.52 --------- ------------ ----------- 93.02 0.00 93.02 VOICE ID DESCRIPTION VOICE ID DESCRIPTION UFER 304 ROUGH ELECTRICAL • Ory. if Applicable Fee ID Fee Description 'Fee Group 18PERNIF== JBLDG PERMIT FEES (BUILDING JBCONSTAX CONSTRUCTION TAX BUILDING • IBENERGY JENERGY BUILDING JBENERGYADO ENERGY ADD MULTI BUILDING JBOVERTUYIE INSPECTION OVERTIME BUILDING BTENIPPERM TEMPORARY BLDG PERMIT BUILDING BNIITIGAT HOUSING MITIGATION FEEBUILDING ISPLANCHK PLAN CHECK FEE BUILDING SPLANCKADD PLAN CHECK ADD MULTI BUILDING BPLANCKREP PLAN CHECK REPEAT FEE BUILDING BREINSPECT REINSPECTION FEE BUILDING BSCBLVD SCB SPECIFIC PLAN BUILDING SSEISMICOM SEISMIC COMMERCIAL BUILDING BSEISMICRE SEISMIC FEE RES BUILDING BSPECIAL SPECIAL INSPECTION BUILDING BSWIM ISVIAMMING POOL BUILDING ZADDCHG JADDRESS CHANGE BUILDING EPERMITFEE JELEC PERMIT ISSUANCE ELECTRICAL BELEC1000 ELEC 600V <=1000A JELECTRICAL BELEC1001 ELEC 600V >1000A ELECTRICAL BELEC200 ELECT SVCS 600V <=200A ELECTRICAL BNEWMULTI MULTIFAMILY RES ELECTRICAL BREMBUSWAY REMODEL BUSWAYS ELECTRICAL BREMFIXT LIGHTING FIXTURES ELECTRICAL • BREMMISC MISC APPARATUS ELECTRICAL BREMNRAPP REM NON-RES APPLIANCE ELECTRICAL BREMPOLE POLE/PLATFORM FIXTURE ELECTRICAL BREMPOWER POWER DEVICE/APPARATUS ELECTRICAL BREMRECEPT . RCPTL, SWITCH &OUTLETS ELECTRICAL BREMRESAPP REMODEL RES APPLIANCE ELECTRICAL BREMSIGNAD RMDL•SIGNS ADD BRANCH ELECTRICAL BREMSIGNS REMODEL SIGNS, MARQUEE ELECTRICAL BREMTHEATR THEATRICAL LGHTNG FIX ELECTRICAL SSF&2FAM SINGLE&2 FAMILY ELECTRICAL BTEMP TEMPORARY POWER ELECTRICAL 8TEMPSVCS . TEMP DIST SVCS ELECTRICAL MPERMITFEEMECHPERMITISSUANCE MECHANICAL BAPPLOTHER JOTHERAPPUANCES MECHANICAL N_ BBOILERI BOILER <� 100,000 BTU MECHANICAL BBOILER2 BOILER>100KT0500KBTU MECHANICAL BBOILER3 BOILER>500KT,01M BTU MECHANICAL BBOILER4 BOILER>1M TO 1.75M BTU MECHANICAL BBOILER6 BOILER> 1.75M BTU MECHANICAL BREMAPPO APPLIANCE INSTALL MECHANICAL BREMHEAT HEATER INSTALLATION. MECHANICAL BREMVENFAN VENT FAN SINGLE DUCT MECHANICAL BMNEWMULTI NEW MULTI-FAMILY RES MECHANICAL BMNEWSF82FNEW SF&2F RE5 BLDGS MECHANICAL • F oft Rs Lwd vlass I 9R°SIACOVER QAC UNIT I IGG0GCFA.I JNIECnANIC AL IBREMAIRHAN �A/C UNITS M 10.OGCCFIMcCFIAVICA 1. I �BREMFURN RELOCATION OF FURNACE IMECHANICAL IBRENIFURNOV RELO FURNACE > 10K BTU U Ji'mFC`i NIG L BREMINHOOD INSTALLATION OF HOOD MECHANICAL BREN RELOCA IRELOCATION OF HOOD I MECHANICAL BREMREPALT REPAIWALI ER HEATING IMECHANICAL BREMVENSYS VENTILATION SYSTciMS 1MECHANICAL IPPERMITFEE PLUMBNG PERMIT ISSUE PLUMBING BNUMULTI INEW MULIFAMILY RES PLUMBING SNUSFD INEW SINGLEFAMILY RES PLUMBING BPBACKFLOW IATMOSPHERIC VACUUM PLUMBING BPCESSPOOL CESSPOOL PLUMBING BPFIXTURE PBLG FIXTURE PLUMBING BPGAS GAS PIPING SYSTEM FEE PLUMBING BPINTERCEP IND WASTE INTERCEPTOR PLUMBING SPREPIPE REPIPE OF FIXTURES PLUMBING . BPSEWAGE SEWAGE DISPOSAL PLUMBING BPSEWER SEWERS PLUMBING BPSPRINK LAWN SPRINKLER/BACKFLO PLUMBING BPSTORM STORM/RAIN WATER PLUMBING BPTRAP KITCHEN TRAP PLUMBING BPVENT ALT OF DRAIN 6 VENT PLUMBING BPWATER INSTALL/ALTER WATERPIP PLUMBING BPWHEATER WATER HEATER/VENT PLUMBING BPWSVCS MAIN WATER SERVICE PLUMBING ZDEVAGREE OEVELOPMENTAGREEMENT PLANNING ZDIRTM DIR TENT MAP PLANNING ZFULLHR FULLAPPLBASE+HR PLANNING ZFULLTM FULL APPL TENT MAP PLANNING ZFULLUP FULLAPPL USE PERMIT PLANNING ZFULLZONE FULLAPPLZONING PLANNING ZGPAMEND GENERALPLAN AMEN 0 PLANNING ZLIMAMEND LIMITED AMEND PLANNING 71IMTM LIMITED TENT MAP PLANNING ZLIMUP LIMITED APP-USE PERMI PLANNING ZMATEMPUP MIN AMEND TEMP USEPERM PLANNING ZMINHILLEX MINOR APPL HILL EAC PLANNING ZMINSIGNEX MISC SIGN EXCEPTION PLANNING ZMINTM MINOR APP TENT MAP PLANNING ZMINUP MINOR APPL USE PERMIT PLANNING 7MISCASA MISC ARCH SITE PLANNING ZMISC MISC TM AND UP EXT PLANNING ZMISCFENCE MISC FENCE EXCEPTION PLANNING ZMISCGEN MISCELLAPPLGENERAL PLANNING ZMISCPCINT MISC PC INTERPRETATION PLANNING ZSIGN SIGN PERMI PLANNING ZTEMPSIGN TEMPORARY SIGN PLANNING ZVARIANCE DIRECTOR VARIANCE PLANNING 7 ort O K"i$Xd utoe"