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06050165CITY OF CUPERTINO PERNIIT BUILDING DIVISION z,CON-�TRA aORI�NFORMATI01Y BUILDING ADDRESS: MAUREEN KHOO PERMrr No. 06050165 10341 N BLANEY AV OWNER'S NAME: FERMO ISSUE DATE MAUREEN KHOO 05/18/2006 NE: SANITARY NO. CONTROL NO. (650)969-7663 HITELT/FNGINFFA: BUILDING PERMIT INFO I�ith.rwl BLDG ELECT PLUMB MECH 0 0 LICENSE t CONIRACTOWS DFLT.3RAnON Job Description I hereby am,Ju I am liunrd .n e, Pro tma of Ci.plcr 9 (commeteinn 7070) of DiWeoo 3 of the Brim.a Prakavau Code. admy lkueu �SaIpn 200 AMP PANEL UPGRADE Dam; 'gorrnor ARCHI D O 1 onderuz J my pier pfic Li cr,ed P or.o.l OWNER-BUILDERD N I hereby "To. Not I am a orpt from the coon oes Boric Law mar Ih rdic g renae (Sudor 70313, Bu*Inetl a,b Plofasam Code: My thy or—Y $2050 whkb Mwints .permit to ImnNYLL .1w. impmme, dvnNW, or repair hay auucum pram b iter=rcc..lao tryubca the appll fah Permit to filea alpmai wternern law(Chapta9 Sq. Ft. Floor Area Valuation that h la liallxd putrtanl to the pmd.lau a theCoolraeoo" lJCevc (eo mm mdM viN Savor 7000) of Division S or lite, Bttm a otd Prafenimu Code) or lw he k xem" Ncmefrom uM the wk for the WeSrd eaempdor. My rkl.Jm of r Occupancy Type Salon 78313 byv it iic•ot for. Permitwbn. the applic.m b.Ciel peuYy N era more Iham Bw hvadmd m14. ($500). ❑ tuO of Ile Koperry, or my=PlOYeea a "Ilea at Ihir ark eompcaullai, e Required Inspections ,U mdc wo,t.nd da Nnallm B tool imen A otartW for. ak(See 7014, Burd . Nd PIore,6om, endG The cooma &s I k Law does hal apply b N M of '1 � propenywhobui1M Irlmpvw Nnmm,aodahod aoe,aortbimfdfaN thbit own corp Namepcmprommevuart moaimradedaaRertathe, IL beboipmdmd Waverer, de bwNmSaumpmavnanVhale as lea of Pfo, the, nve dW ko or Wilda wiB Dae th hsvda of pmWnn that h dW ret buk a Mptoae for purpoc d FIN D ule.} ❑ 1, u w a be Property, an exctbau cly corttu+inp mih Ilaued cmnbactom. W nneuve, the ploj n (Sec 7014, Brsinea and Plofeitimu Code) he COaO.CWs U clma Law ma as pply b an owns of Kcere,, who hvlcia or Impmms,Jereor. amd . JUL alto eem .aa for aaeb pmoe= nNa anuamor(i) T dprha mm the ComraaaYa vu U f% 1 I,eos luw. ❑ lam navPr under See .Bb.PG fa Vd. aaaoa Owtra Dere f{ayi�©A�� BUILDING WORKERS COMPENSATION DECLARATION 1 bembY.f . bMer perulry ar perp.] rete of the to lowio{ ^ ^•^ I^^� Ibaoe.td will m.inui.. CervOau of Cotuem b.elf.lnwrt fa Wo .Campeu even, at pro bled for by Savor 3]00 of the Labor Cade, for the perfatmam of de w'aat mor rbiN lhu permit U lam d ba, and wU maimubl wor . Compuuulem Imuana. u roctdrtd by Seedon . of the, Inbar Code. for Ne Perflrouna of Ne a it fa wbkb Ibis Permit Is I,"— My Warkces Compeautlao buuranm artia.nd Policy number are: Cama: Polley No: CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (hue ,eedhalbecaopktcJ Ifde permitkformatehmdrtddo0a.(5100) r 0u] I amvfY ba, M de pennon. a ds work for which Nim permit la bbo ed I "I era employhay petaon�p maacrha aynhmmc hab3M lath watua'Caopeam0an . Lm of Cali[aa� — NOr10E TOAAP7PU : If. .fin matins this CCNBraC of E Pliw Yoe ahmw baome wbjcn to the War s Co mpetv.tlor lmo io oau a the Lubar Cam. Y(m omu I foMwiN mmPly am inch PtoWaivu a Nu Permit awl h dented o mice. 5 CONSTRUCTION LENDING AGENCY I bereby.m. dw dere U. letdpin5.oey far Nc Perform. of eer pl Is Ivued (Sec. 3097. Co. C.) the ark for whkh damt L<nmfa Name Ludo'. Ammon 1 unify tb t,1 lute read llva aWkui. had snte ihu de .here infmmavon b con I anrte b Comply Nth dl City aM coamy matin..... and ore I.n reWinn b W ildinn calRrucdoe,.md hereby wNovre rtpt�nuliva of Nu citamy b caterupm ibe aWm.t mord M,,mty for insmmoo purpcs (We) .Ver IO u.e, lodunmfy aid keep bmmlua the City of Capcnnw.SaiNl nIlabilidn,jdnmemu,caLL.nd apwa wbiclmayinarl-al—all.tnsta.d CitY z, in C®cgaxc of Ne n of Nis A 'CANT U ANDS 1 COMP WM4_AU NNON. INT Issued by: Date SOURCER5� /�/�///Pp0 RC-roofs Type of Roof Sltnuum err App1lanllCorOa:ta �6 HAZARDOUS MATERIALS DISCLOSURE IhIYihuan.l IX9.12. CmWy fMwli Whal u definedWcAIepCpdvapammaibdlulldCinapdmeC. baPWe Health Safety Core, Section 25532(:)7 All roofs shall be inspected prior to any roofing material being installed. 0Ya `i� If a roof is installed without first obtaining an inspection, I agree to remove Vol ft appliant or furore WidlnS a aapaot too mrw cmem aac. w+,icb emit b.,...x.,..0 conumirunu, u m�firsd by the Bay A= Air IZuallly Management all new materials for inspection. Dwrci0y. 1 b.m orb to bav o romriabregrbevemsunkr Cyupa6.95oftheC"ra- odaHwih&weiyC 235(15.255) d255N.1 umdctvzd Nallda WlMien u Jaa ret eimewY he elYnl, pmvhlli o mtr Nc aavp��m//or dr tc Ititre situ ea , ilea T cc Signature Of Applicant Date IYIil All roof coverings to be Class "B" or better Owner a wllbrvW apw D, ,m 1 of 2 CITY OF CUPERTINO I»iC7uFi11f :L�1:M�lyY Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 31633006.00 DATE ISSUED.......: 05/18/2006 RECEIPT 4.........: 34455 REFERENCE ID # ...: 06050165 SITE ADDRESS .....: 10341 N BLANEY AV SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ...... OWNER ............: MAUREEN KHOO ADDRESS ..........: CITY/STATE/ZIP ...: , RECEIVED FROM ....: BONITA JENKINS CONTRACTOR .......: LIC # *OWNER* COMPANY ..........: MAUREEN KHOO ADDRESS ..........: CITY/STATE/ZIP ...: , TELEPHONE ........: •FEE ID UNIT BELEC200 METERS BENERGY PERMIT FEE BUSLIC FLAT RATE BSEISMICRE VALUATION TOTAL PERMIT : QUANTITY AMOUNT PD -TO -DT ---------- 1.00 29.43 0.00 1.00 34.86 0.00 1.00 105.00 0.00 2,050.00 0.50 0.00 VOICE ID DESCRIPTION -------- ---------------------------- 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL • 169.79 0.00 OPERATOR: amyw COPY # : 2 29.43 0.00 34.86 0.00 105.00 0.00 0.50 0.00 169.79 0.00 VOICE ID DESCRIPTION 501 FINAL ELECTRICAL ENERGY CITY OF CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM of5O R 5 APN # OW Date: 0 b Building Address: Mailing Address (if different from building address): ,16P31-11 i1. Owner's Name: Phone #: Contractor. ' License #: 7�--5 z3 z Contact: Phone: 942 Cupertino Business License#: iTne- Fax: / G 0 Building Permit Info: Bldg ❑ Elect Plumb ❑ Mech ❑ Job Description: Residential Arm F Pa,,,� ommercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: Occupancy Gro Cosa • ism MECHANICAL Type of Construction: Please check this box if the project is a BUILDING second -story addition: ❑ II[Pro'ect Size: Standar&'&Lar e ❑ Ma or ❑ BUILDING Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BB01LER3 Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA investigation fee BUILDING e 1 of 3 O CITY OF CUPERTINO acilyo PERMIT APPLICATION FORM CUPERTINO uanti Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Stomi/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAHUiAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Fumace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMLSC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREWOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Re air/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 . a CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM r1 Quantity Fee II) Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection 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 Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/ Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Chane BUILDING • 3 of 3 CITY OF �UPEkTINO Community Development 10300 Torte Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department I am not using any subcontractors��� Signature Please check applicable subcontractors and complete the following information Date �. SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # I am not using any subcontractors��� Signature Please check applicable subcontractors and complete the following information Date Owner/ Contractor Sigrwdwe Date 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 Rock Tile Owner/ Contractor Sigrwdwe Date