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00030168 CITY OF CUPERTINO PERMrr NO. BUILDING DIVISION PERMIT BUILDING ADDRESS: �\ /f /�'� `' t qS � /` vc'` II� ` • \ � �� / » 1. / SANITARYNO. APPLICATIONSUBMITTALDATH OWNER$NAMFIt/y�V"Y \t yvtr 'w C//\J//�4 C,g.� Iy�/�/•�J �,»)GAt�y»wuL N/C CONTROL» PHONCIV~.»YUV• V' f` OV I�O- -/ / G � Y�y.'Vlo414e D/" ❑ RCHITL'CGENGIINL'ERd' �A- � J- ^Y 'easy; H LD1 GIPERMIT'IN:Bp�T ' 1360 ,cub H6m d 0 7 i LICENSED CONTRACTORS DECLARATION z=o I herby affirm Nat 1 w licen+d undo provisions o(CMpa 9 Nommeneing Job Description with section 7000)adroition JoftM Buinessad fm'ou ad myliceueis s z in full face ad eRew 1 ? r• O co O I�mpoeCI u gC Lic.» .aM,...0b t n a F Due��onoecmr iy O`3 A0. S DECLARATION v�a� 1 undenund my Plroo shall M Sad u public rands 05 Limns'"Rofeui and ser�— OWNER exempt R DECIAMTION t < 1 herby e(Bmr on I un exempt from the Contractors s:Any Lew for the D following reason.permit t ]onstru Business end Pmf ioos Cade:Any city n county $ wnich hs iwm a permit m camwc4 dtec,improve.h p1 orit 1 m e A tir my awenent 3_ Sq. Ft. Floor Area Valua[io � primtojuscerci,alsongo the themoors of for suchmemo'mGlnUw(Chaptent Netbela licensed pursuant to the provisionsof the Conminess nLicense rtaw sCode)9 (cut he xepttSecdonloo0)of Imis for oftheeged exemption.My Code)or pp�i Num r Occ ane Type Net ur ix exempt Nacfrom ed for Maio for Ne alleged the exemption.Any vialWun of _(!1•+'A O 1 ' Y YP Sedm 7031.5by hundred doll for•,erode objects the applicant m•civil perWry of rwt Edo, five hudrd dollen IS3001. '�I,u owmrardre property,a mr an,lnyee.with w.ges u Heir ooln nompennaon. Required Inspections Ell dodo,work,W Neatmcture I.Win intended m offered for•de(See 1011.Business and ProfeuNm Cade:TM Conue la actor's Licensw dons,not apply to m owner a prolixity who buildm improves thereon,and who don such wort himself or through his we xroployeea,powided Nu such inmrooternots sm off Intended or offend for sinea-bolwer will the hhil ft hom impovemem isedd within oneywofmprove for see Pond-Wider will Mw do WtMn of pavin8 Net M did nes WRpe a improve for Pur- pose vWowrcrto ❑1, of the property,am exclusively pro nwith licensed communities m ' omwalthe,dproject(Sa.1011,wrier ropeprofessionsCodexTMCmuactohLt. whoIsco don nut chplr t...wner of property wce Milds m improver thesmn,end whenceUconstructs for such projects with acmtrutaAa)licensed puecunt m the Canoa'oes /� License Law. ❑Lem exemptunderSec. .Bk PG fa Nis rtasm Owner new— WORKERS ^ WORKER'S COMPENSATION DECLARATION v 1 hereby e1111cm under pevlry of mrjmy one oldie following decluatiom: El I M-rusd will romme t aCnnificea of Cauen m sclGinme,forWorker.Compete- - union,u provided for by Section 37M of the Isbor Cade,for the performance,of the work for which this permit is issued. ❑1 Mve end will mainuin Warknra Camps in Insucmce,u required by Sand. J100of the LeWrCab.fm Nape o sunk for which this permit u issued. My Warnes Compeuvi Ino er dPolicynumberaR: Cuncr: Po icy No: ' S' /^w•''-"r" CATE O BXEMMON FROM OR 5' COMPENSATION INSURANCE (This section need not Mcompletd if lie,emit in PormehurWdddlva1k100) or Ina..) 1 certify Net in the perf.c of une wools forwhich this pemdt Ie issued,'shW not employ any person in my me rcr so ayuyecorrc mbb..tot Wyrken'Compete- uni.I-ewaofCali ^M�' �O " Applicant NOTICE TO APPISWANT:If,after making this Certificate of Exemption,you should J become oubjec'to due Warnes Compensation provisions of Ne Lehr Code.you must faMwith comply with such provisions or this,molt shell M deemrd reword. CONSfRUCDON LENDING AGENCY O I hereby affirm NU Vert iso cam mcdan lerdin8 egenry for the peromunce of 7a M the work for which this Kinn t is issued is..3097.Civ,C.) e. Lenders Name r . (y" lenders Address fzl 1 curtly pew 1 Mve reed this application and ame then Ne above infomuthm is Lcorrect.I upon,to comply with all city sad county m coundmoces and mMoor d relating m V 0 building construction,and hemby authmice npsesmutivo of this city to enter upon the nbuva-mentioned mope.,for inspection purposes. LL E~ (We)egrte to saw,indemnify and keep Mmileu Ne City of Cupertino e8•inst O IiaMlitea,jdgmmn,costs and expenses which may in any wry accrue against mid City y 0. in cone tmon of she granting of this permit. EC•i' A- APPLICANT UNDERSTANDS AND WILL COMPLY WITH M.L NON-MINT L.) z SOURCE.REGUTATIONS , Signuuue of AMlicent Comnaor Date HAZARDOUS MATERIALS DISCLOSURE Wdl dte applicant or future WikinB arupmt nnnahmNe hawdms maredel Re-r 5 u dcrind by the Cupertino Mu . 1 Cde.Chopur 9.12,mtl she HcaW and Safety a of Roof Chile,Section 25532(n Type - , ❑Yes No Will the amplicrot or future Wilding occupant use equipmem or devices which All roofs shall be inspected prior to any roofing, material being emit Mwdous ah mnuminenua ned by the Bay Aru Au Quality Manegcmcm installed. If a roof is installed without first obtaining an inspection 'DistrictP .g J// I agree to remove all new materials for inspection. Applicant . ❑Yee No IMwn regainmanmuMUDhapter695oftheGli. understandnd will comply with all non point source regulations. forrM Hee S .esti 2550.5,255]3 end 75514.I udmurA Ne'if the ` r� Wilpein py w nro4 Nuitis my respomibilirymectify Ore acuprot l/✓� of Ne save 'ch Mmet ptiormueuame ofeCmvjr�ateo�p+my. , Signature of Applicant Date Uomermro n Dete 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: Loc:34222100.00 INVOICE DATE......: 03/27/2000 REFERENCE ID # ...: 00030168 SITE ADDRESS .....: 10645 CORDOVA RD SUBDIVISION ....... CITY .:...........: CUPERTINO IMPACT AREA ....... OWNER ............: HEVIN F. O'GRADY ADDRESS ..........: CITY/STATE/ZIP ...: PETALUMA CA, CA 94952 CONTRACTOR ........ LIC R COMPANY ..........: ADDRESS ..........: CITY/STATE/ZIP .... , TELEPHONE ........: FEE DESCRIPTION CHH TOTAL FEE PAID-TO-DATE BALANCE DUE --------------- --- --------- ------------ ----------- BPERMFEE P 77.00 0.00 77.00 BUSLIC P 90.00 0.00 90.00 --------- ------------ ----------- 167.00 0.00 167.00 • Ory. it Applicable Fee ID Fee Description Fee Group IBPERMFEE SLOG PERMIT FEE5 IBUILOING IBCONSTAX 1CONSTRUCTION TAX IBUILOING . �BENERGY JENERGY IBUILDING BENERGYADO IENERGY ADD MULTI ISUILOING 1BOVERTIME JINSPECTION OVERTIME IBUILDING BTEMPPERM ITEMPQRAKY BLDG PERMIT ISUILOING BMITIGAT jHOU5ING MITIGATION FEE BUILDING �BPLANCHK PLAN CHECK FEE IBUILOING 13PLANCKADO PLAN CHECK ADD MULTI IBtUILDING BPLANCKREP PLAN CHECK REPEAT FEE GBREINSPECT REINSPECTION FEE GBSCBLVO SCS SPECIFIC PLAN GBSEISMICOM SEISMIC COMMERCIAL GBSEISMICRE SEISMIC FEE RES GESPECIAL SPECIAL INSPECTION GBSWIM SWIMMING POOLGZAODCHG ADDRESS CHANGE G EPERMITFEE JELEC PERMIT ISSUANCE ELECTRICAL BELEC1000 ELEC 600V�1000A ELECTRICAL BELEC1001 ELEC 600V>1000A ELECTRICAL BRI EC200 ELECT-SVCS 500V <=200A ELECTRICAL BNEWMULTI MULTIFAMILY RES ELECTRICAL BREMBUSWAY REMODELBUSWAYS ELECTRICAL BREMFIXT LIGHTING FIXTURES ELECTRICAL • BREMMISC MISC APPARATUS ELECTRICAL BREMNRAPP REM NON-RES APPLIANCE ELECTRICAL BREMPO POLE/PLATFORM FIXTURE ELECTRICAL BREMPOWER POWER DEVICEIAPPARATUS ELECTRICAL BREMRECEPT RCP% SWITCH &OUTLETS ELECTRICAL BREMRESAPP REMODEL RES APPLIANCE ELECTRICAL BREMSIGNAO RMOL SIGNS ADD BRANCH ELECTRICAL BREMSIGNS REMODEL SIGNS, MARQUEE ELECTRICAL BREMTHEATR THEATRICAL LGHTNG FIX ELECTRICAL BSF&2FAM SINGLE&2 FAMILY ELECTRICAL STEMP TEMPORARY POWER ELECTRICAL BTEMPSVCS . TEMP DIST SVCS ELECTRICAL MPERMITFEE IMECH PERMIT ISSUANCE MECHANICAL BAPPLOTHER OTHER APPLIANCES MECHANICAL BBOILER1 BOILER C= 100,000 BTU MECHANICAL BBOILER2 BOILER>100KTO500KSTU MECHANICAL BBOILER3 BOILER>SOOKTOIMBTU MECHANICAL BBOILER4 BOILER>1M TO 1.75M BTU MECHANICAL BROILERS BOILER> 1.75M BTL MECHANICAL BREMAPPLI APPLIANC INSTALL MECHANICAL BREMH T H NSALLArION M CHANICAL BREMVENFAN VENT FAN SINGLE DUCT MECHANICAL BMNEWMULTI NEW MULTI-FAMIL RES MECHANICAL • BMNEWSF&2 NEW SF&2F RES SLOGS MECHANICAL F of 2 BRENIACOVER QAC UNIT >IGGOCCFA.1 IM EC:r.ANICALi 18REMAIRHAN JA/C UNITS <= 10.00CCF�b1 IMECHANICAL `- JBREtvIFURN IRELOCATION OF FURNACE IMECHANICAL JBREMFURNOV IP.ELO FURNACE > iCK BTU IMECHANIC.;L . BREMINHOOD 1INSTALLATION OF HOODMECHANICAL BREIVIRELOCA IRELOCATION OF HOOD JIVIECHANICAL BREMREPALT REPAIR/ALTER HEATING MECHANICAL BREMVENSYS IVENTILATION SYSTEMS MECHANICAL PPERMITFEE JPLUMBNG PERMIT ISSUE PLUMBING BNUMULTI NEW MUUFAMILY RES IPLUMBING BNUSFD NEW SINGLEFAMILY RES PLUMBING BPBACKFLOW ATMOSPHERIC VACUUM PLUMBING BPCESSPOOL CESSPOOL PLUMBING BPFIXTURE PBLG FIXTURE PLUMBING BPGAS GAS PIPING SYSTEM FEE PLUMBING SPINTERCEP IND WASTE INTERCEPTOR PLUMBING SPREPIPE REPIPE OF FIXTURES PLUMBING SPSEWAGE SEWAGE DISPOSAL PLUMBING BPSEWER SEWERS PLUMBING BPSPRINK LAWN SPRINKLER/BACKFLO PLUMBING SPSTORM STORWRA1N WATER PLUMBING BPTRAP KITCHEN TRAP PLUMBING BPVENT ALT OF DRAIN &VENT PLUMBING BPWATER INSTALUAI.TER 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 FULLAPPL USE PERMIT PLANNING ZFULLZONE FULLAPPLZONING PLANNING ZGPAMENO GENERAL PLAN AMEND PLANNING ZUMAMEND LIMITED AMEND PLANNING ZUMTM LIMITED TENT MAP PLANNING ZLIMUP LIMITED 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 ADPL USE PERMIT PLANNING ZMISCASA MISC ARCH SITE PLANNING ISC MISC AND UP PLANNING ZMISCFENCE MISC FENCE EXCEPTION PLANNING ZMISCGEN MISCELLAPPLGENERAL PLANNING ZMISCPCINT MISC PC INTERPRETA ON PLANNING IZSIGN SIGN PERMI PLANNING jZTF-MP5IQN ITEMPORARY SIGN PLANNING ZVARIANCE IDIRECTORVARIANCE PLANNING 2 oft • M1eMiud tltO/"