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07030137 CITY OF CUPERTINO BUILDING DIVISION. PERMIT � ��R I) Ff�Rl1!� TIOI�t• BUILDADDRESS: PERMIT No. IN2300 STEVENS CREEK BLVD C H REYNCLDS ELECTRIC INC 07030137 PERMIT ISSUE DATE OWNER'S NAME: SYMANTEC CORPORATION 1281 WAYlE AVE 03/19/2007 SANITARY NO. CONTROL NO. .ONE: (408) 436-9280 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH a 0 0 a p o LICENSED CONTRACTOR'S DECLARATION Job Description Vi- I hereby affirm that I am licensed under provisions of Chapter 9(commencing zUW with Section 7000)of Division3ofthcBusinessandProfessionsCode,andmylicenseis UNDERGROLND BORE TO REPAIR ELECTRICAL LINE. =N in full force and effect. ? License Class Lie.# t-O Datc—r Contactor ARCHITECT'S DECLARATION a 1 understand my plans shall be used as public records yU w y Licensed Professional OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt Gum the Contractor's License Law far the pO following reason.(Section 7031.5,Business and Professions Code:Any city Of county m which requires a permit to construct,alter,improve,demolish,or repair any structure y prior to its issuance,also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's license Law(Chapter 9 Sq.Ft.Floor Area Valuation Z Fo (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $17000 3^ that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of Number Occupancy Type not more than five hundred dollars(5500). 36901019 .'V G ❑1,as owner of the property,or my employees with wages as their sole compensation, will do the work.and the structure is not intended oroffered forsale(Sec.7044,Business "Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of q p property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If. however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law docs not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. ❑I am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for workces Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the pert rmance of the work for which this permit is issued. Ca Wor tris ompe ion 1 a cr and Policy number are:_ 0 Cartier. � Policy No.: {J•'Lr nl..-!/�/ CERT KATE F EXE PTION FROM WORK RS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must O forthwith comply with such provisions or this permit shall be deemed revoked. — CONSTRUCTION LENDING AGENCY .r(A I hereby affirm that there is a construction lending agency for the performance of . CY > the work for which this permit is issued(Sec.3097,Civ.C.) S7 Q Lender's Name =Z Len Address J 0 I certify that I have read this application and state that the above information is r. correct.I agree to comply with all city and county ordinances and state laws relating to rJ building construction,and hereby authorise representatives of this city to enter upon the / W shove-memiuncd pro sty for inspection purposes. /\\ (We)agrc o sa e,in mnify d keep harmless the City of Cupertino against Q" liabilities,ud nts, sts ex n hich may in an way accrue against said Cit C/I J g S lx Y Y Y B Y U Z in consequenc, f th of this c it. �+ APPLICANT N DS ILL COMPLY WITH LL ON-POINT Issued by: Date SOURCE RE L 3 Re-roofs Signature of A li UCon r Dale HAZARDOUS MATERIALS DISCLOSURE Type Of Roo Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Munici 1 Code,Chapter 9.12,and the Health and Safety Cede,Section 25532(a)? All roofs shz ll be inspected prior to any roofing material being installed. ❑Yes o Will the applicant or future building occupant use equipment or devices which If a roof is it stalled without first obtaining an inspection,I agree to remove emit hazardous 41aam, tried by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes 1 have maialsre u remcnss under Chapter 6.95 ofthe Califor- niaHcalth&Safe5,25 25534.1 understand that if building does not currentlt h risibility to notify u t mf the requirements whissu o Certifrcalcol'0 Signature of Applicant Date � All roof coverings to be Class"B"or better Owner or authorDa CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: BLk: Lot: APN 35901019 . 02 DATE ISSUED. . . . . . . : 03/19/2007 RECEIPT #. . . . . . . . . B3000000723 REFERENCE ID # . . . : 07030137 SITE ADDRESS 20300 STEVENS CREEK BLVD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SYMANTEC CORPORATION ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR . . . . . . . : CHARLES H REYNOLDS LIC # 25945 COMPANY . . . . . . . . . . : C H REYNOLDS ELECTRIC INC ADDRESS . . . . . . . . . . : 1281 WAYNE AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95312 TELEPHONE . . . . . . . . : (408)436-9280 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- -------- BPERMFEE VALUATION 17, 000.00 245.16 0 .00 245 .16 0.00 BSEISMICOM VALUATION 17, 000 .00 3 .57 0.00 3 .57 0.00 EPERMITFEE FLAT RATE 1.00 38.37 0.00 38 .37 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 287.10 0.00 287.10 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 287.1( VISA --------------- TOTAL RECEIPT 287.1(' VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- --------------------------- - -------- ----------- 304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY 505 FINAL ELECTRICAL CITY OF CUPERTINO N FORM CITY OF PERMIT APPLICATIO C U PEk INO VPN# Building Address: ailing A dr ss (i differ nt from building address): Phone#: -7 / Owner's Name: KA License#: Contractor: „ -- �� — Cupertino Business License#: Contact: 'n� Phone: p -- I Fax: Building Permit Info: Q -pft ��2 �`�� '��' ff� '� otoj� Elect (V Plurib ❑ Mech ❑ Bldg ❑ •,rte c`:Y� �` `' C-'Y► Job Description: (iV1i��c� �'�12Uf.� �' Commercial Residential ❑ Sq.Ft.: Sq.Ft. Floor Area: Cost of Project Occupancy Group: Cons cti0n; ❑ Please check this box if the project is a Type of second-story addition: _ roject Size: - Staaid "` Large ElMayor E - --� Fee "Grou Fee ID Fe a Descri tion ---p-__ - - Quanti MECHANICAL BAPPLOTHER Other Appliances BBOILERI Boile-<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILERS Bol er> 1.75M Btu MECHANICAL Cc Tax BUILDING BCONSTAX BUILDING BCONSTAX Ind/Off/Comm/Quasi Con. Tax for BQ Zone BUILDING BCONSTAXBQ BCONSTAXH Hotel and Motel BUILDING Cons tax-Resi/Mobile BUILDING BCONSTAXR < BELEC 1000 Elec 600V = 1000A ELECTRICAL BELEC1001 Elee 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING Er.ergy Add Multi BUILDING BENERGYADD BUILDING BINVESTIGA Investigation fee 1 cf3 Community Development 10300 Torre Avenue ,- Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 ';UPEI�TINO Building Department JOB ADDRESS: r PERMIT 0 3 of 3 OWNER'S NAME: PHONE # - GENERAL CONTRACTOR: Ilk FAX# 122 - , I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet R Tile j i' v T Owg r/C trac r Signa e Date CITY OF CXPERTINO CUPEkTiNO PERMIT APPLICATION FORINT Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rm 31 Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Thoatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD S56 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 Ekc Permit Issuance ELECTRICAL MPERMFEE N echanical sq. foot MECHANICAL MPERMITFEE Meeh Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG-., Plianbing Fee sq foot PLUMBING _ PLLONGRNGC' Planning LR Comme/Multi-Fam PLANNING _ PLLONGRNGR kAnning Long Range Residential_ _PLANNING ZADDCHG - Address Change BUILDING 3 of 3