00010111 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELEM RICAL PERMIT NO.
BUILDING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL i
Rt111.DIN(:PROJF, 'IDENTIFICATION
F CILDINGAII;1 E9S: SANITARY NO. APPLICATION SUBMITTAL DAT'
__2 MANI TI� GT , CGCpE�jiNv_ � -CJS U/ Ta,;, 2s-, 2D"
^WNER' NAME: PHUNF.: CONTRACTOR'S NAME: LIC NO:
N 2rz_a E D NIC CONTROLa
CHITECUF.NGINEER: 'I LIC N(l: KT ADDRF_5S: T_ ❑
CONTACC PHONE: BUILDING PERMIT INFO
❑ Consnl/ani Fees Paid by Applicant(Initial) BLDG' ELEl' PLUMB MECII
LICENSED CONTRACTOR'S DECLARATION QTY. ELECTRIC PERMIT IEE
I hereby arum Thal l am oansod rider pmvnidns of chatter 9(commencing
W O J08 DESCRIPTION
❑C,Z with Section 7000omf Dlviuion 3ofNa Business and Promoin.Code,and my license is RESIDENTIAL
PIi
l—,_- ce load toll farm elfca. RMIT ISSUANCii ❑SFDWL KI'1'CHIiN REMODEL
a Ur, License Class Lica APPLIANCES-RESIDES I'[Al. DDI'TION [I PLUMBING RE-PIPE
NZ(y Date Connacht
ARCHITECT'S DECLARATION MULTI-UNIT 0 STRUCTURAL,
PANELS; MODIFICATION
ZpyZ I understand my plans shall be used as public records UP'1021XIAMPS OZ-0 [I INTERIOR [3 CHIMNEY REPAIR
FyFW Licensed Professional 20I-1000AMPS IMPROVEMENT 0SWIMMING POOLS
C a'4 I hereby IErm that am PuamD1DECLARATION
1Bom the Contractors' License Law for the OVER)Bid AMPS 0 BATH REMODELREPAIR 0 DEMOLITION
a ya P
X3 i U following reason.(Section]031.5.Rusiness and Professions Cade:Any city or county SIGNS ELECT RICA]. El OTHER
m w h which reynio,.o IamN m conurna,alcor.impm.e,demolish,or repair any structurepmmm its issuance,alsoIpires rhell,licum fmaeh Permit to Rleasigned s...round SPECIAL CIRCUIT/MISC.
thomislicctwJpursuunuo the pmvi'moof the Commmlu's Llacnsd La,(Cbupe,9
lawG$O hnnnncncing with 5caion"I(NPO)of Division Sof the Business and l4ofessionsCNc)m TENP.ME`FERORPOLEINST. COMMERCIAL'
d ty a Nat he is a®mpl therefrom and the basis for the alleged excional Any violation of El NEW BLDG/ADDITION ❑DEMOLITION
4 Section 7031.5 by any applicant for a Permit mh]a.s the inflictor too civil penalty of POWER DEVICES 0 TENANT 0 FOOD SERVICE
on mnmr$l�an five hundred dollars(S500).
Fz6 lj 7eiF rimer"'Ne rima bees with vex esu 'heif sole cam lion, SWIMMING POOL ELECTRIC IMPROVEMENT
dTIT trope Y Y of amended
Y 6 Mrea
fW-Z; Nthework.and the see Contractor's
riots License offeredfor
nor
raale pply Al J4.Business ER
0.3 and Notes CWe:'ITemcmthereo License Law Jcecsolapply to owner of OU'I LETS-SWIICIIES-11%'i'URES
Prete.who builds IF .video th thrush and who Jots such work Motor[if through
hie own employees,Provide)that such impnrveold w arc sol intended nr pliertd for NEW RRSIUIENTIAL IELLiCfR SQ R.
ole.ILhn�evcr.the building orimpmvemem is sold within rine year of completion,the SQ.FF Iq.00R AREA QSQ.Ff.
owner-builder will h
v
ave the burden of proving that he did not build or improve for put
G .as owneI.r of the,mi am exclusively rush a,Bog with licensed comoraors to TOTAL:
rmvnen the Pmja'r(Sec.7044.Businms and Professions Code:)The Conaactor's la-
nxLaw does not apply it)
r an owner of podiatry who builds or improves thereon.and QTY. PLUMBING PERMIT FEE
la-
mine
farsucb pmjmts ,in a nrnuaaods)Iicensul pumaanvo the Comeacnn's
Licence Low. PERMIT ISSUANCE
01 am exemp4u��er Sce. ,i{&i'C fur this rassn
In, ALTER-DRAIN&VENT-WATER(EA) VALUATION
e Dae /—
ORKER'S COMPliN SA'TION li TARAI'[ON BACK FLOW PROTECT.DEVICE S l`O Q
t I here door under Penalty of perjury on the following declarations, J
0 l have and will maintain a Certificate of Consent self-insurc for Worker's Compri- DRAINS-FLOOR,ROOF.AREA,GOND. S'ORII,S TYPE CONSTRUCTION
,anon,as pre,ided for by Station 1900 of IT,Luhor Codefur the poforrecom of the
work for which this permit is issued. FIXTURES-PER TRAP
I have and will maintain Worker's Compensation Laurence,as required by Section
191X1 of the Luhor Code,for the performance of the work for which this permit is issued. GAS-IiA.SYSTEM-1 INC.4 OUTLET S OCC.GROUT' / AI y�
My Workers Compenanion lmutanee artier and Policy number arc: (e C
Carver. Policy No, GAS-EA.SYSTEM-OVER 4(EA)
CERTIFICATE OF EXEMPTION FROM WORKERS' GRLASI%INDUSTRL WASTE INTERCEPTOR
COMPENSA'I'[ON INSURANCE BUILDING DIVISION FEES
(Hr-vainanccdnnlbe,.mrplcmd if rhe permit is Toren hundred ddllars(SIM) GREASETRAE'
or Ices.) PLANCHECK FEE
I ocrifvthat in the ped'urmmnce of the work for which this penun is issued l shall SEWER-SANITARY-STORM BA.21X1 F1'.
not employ any person in any nurnner so as m become subject ser the Worked Compcn, ENERGY FETE
,Z anion Laws Of California Dale WATER HEATER WIVENTIIELEC'I'R
p—) NOTICE TOAPPLICANT ker' after making Nis visionsofof LikearCode,)ushould WATER SYSTEh1/fREAi'ING X50145 FEE L In
(•" > hal subjecttothe Worker'ssi,inme,his provisions oftheCode,you must ' 'I
� fnhwilh comply with sucb pnrvisinns nr this permit shall rte deemed revoked. WATER SERVICE
QIflLhq
CONS'I'RUCI[ON LENDING AGENCY NEW RESIDENTIAL PL MB. SQ.FT. 'PAID v lIslip
�Is p�J
V 0 I hcnby affirm thouherc is a coreouction lending agency for Ne perromemeenf I at a/ N
Ll. H she work for which Nis peril is issued(Sec.3097.Civ.C.)
U Isndars Name
Q TOTAL
Lender's AJdmss --
1 1 eenify that 1 have read Ibis application and Ylae that the above loformahnn is BUILDING.FE4
F^ h clanCrt.Ingreem comply with all city and county ordinances and state laws reining m QTY. MECHANICAL PERMIT FEE SEISMIC FEE
V Z building eanenuction,and herebyauthoam rep.wit ivesoi this cinyln tomo a,,. he
aM»xn eamiuned property for'mcpecuou Purposes. a
(We)agree to
.cave,indemnify and keep modules,the City of Cupcdino against PERMIT ISSUANCE ELECI'RPC FEEliibiliticc.jadgmeas,coolant expenses which may in any way accmc ugainq said City ALTER OR ADD'H)MECII, PLUMBING FEE
conscyuenee of rbc grunting of Nis permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH AL1.NON-POINT AIR HANDLING UNH(TO PU.OII(i MECHANICAL FEE
SOUR REGULATIONS, n
F /' AIR HANDLING UNIT(OVER IILIXM]CFM) CONSTRUCTION TAX'Igt rc of Atplicanl/Comructnr CCC l me EXHAUST'HOOD(WNUCry HOUSING MITIGAr10N FEE
HALAROOl15 MATER( S DISCLOSURFi
Will arciddlicam or luturc lwilding wcupant nnrc nr banJle haemJuus material HEATING UNIT TO IUkg10 BTU)
as defined by the Cufcrdnu Municipal Care,Chapter 212,and the Health and Safety
Code,Section 25512(x)'/ HEA'IINO UNIT(OVER IN)01ID BTU)
❑Yes 0NoVEN'1'ILAI'[ON FAN(SINGLE RESID) PAID
Date Receipt a
Will the appbcunt an future building cecuptnl use equipment nr devices wbkh BOILER-COA1P OHP OR 100,000 BTU)_ mit harurdous air cnmaminuna'nn domed by the Bay Arca Air Quality Managemcm TOTAL' f
t District' BOILER-COMP(OVERI oxo B'TU)
❑Yea ONO
I have mad the Inarticulate tamale requirements under Chapter 6.95 of the Cull AIR CONDITIONER ISSUANCE DATE
labor Health&Safety Code.Stains 25505,25533 and 25514,1 undcsamnd that if the NEW RESIDENTIAL MECII. SQ.FT. /� �� .�2 A./1
buildings nor culsemly h:rvcaawnt,that it is my msiwnsihility mnmify rhe sacupam T� l eko
..rl rt nam icn nryppe. Pnr enfa CenBle�e (ke _y
umhomcd ugem 4�- D J te!/D TOTAL: ISSUE)BY:
OFFICE
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
.� BUILDING PERMIT INVOICE OPERATOR: christya
Sec: Twp: Rng: Sub: Blk: Lot:36223047.00
INVOICE DATE. .....: 01/25/2000
REFERENCE ID # ...: 00010117
SITE ADDRESS .....: 21086 MANITA CT
SUBDIVISION .......
CITY .. . ... .......: CUPERTINO
IMPACT AREA .......
OWNER ... . ........: ANANTHARAHAN, ARUN
ADDRESS . .........:
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-5074
CONTRACTOR .......: LIC #
COMPANY . . ........:
ADDRESS . . ........:
CITY/STATE/ZIP .... -
TELEPHONE . .......:
FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE
--------------- -__ --------- ------------
BENERGY A 35.10 0.00 35.10
BPERMFEE P 117.00 0.00 117.00
BPFIXTURE P 8.33 0.00 8.33
BREMRECEPT P 2.22 0.00 2.22
BPF 'ENFAN P 41.63 0.00 41.63
ICRE P 0.60 0.00 0.60
.TFEE P 35.52 0.00 35.52
:RMI TFEE P 35.52 0.00 35.52
PPERMITFEE P 35.52 0.00 35.52
--------- ------------ -----------
311.44 0.00 311.44
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
101 FOUNDATION 102 PIERS
103 UFER 104 REBAR
105 ANCHOR BOLTS 106 SEWER & WATER
202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL
204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION
301 ROUGH PLUMBING 302 TUB S OR SHOWER
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
305 FRAME 306 HOLDOWNS
307 INSULATION 308 SHEETROCK
309 EXTERIOR LATH 310 INTERIOR LATH
311 SCRATCH COAT 313 ROOF NAIL
501 FINAL ELECTRICAL ENERGY 502 FINAL PLUMBING ENERGY
503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERGY
505 FINAL ELECTRICAL 506 GAS TEST
507 FINAL PLUMBING 508 FINAL MECHANICAL
509 FINAL GRADE 510 FINAL PLANNING
514 FINAL PUBLIC WORKS