99110044TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING - ELECTRICAL cocoa r 111.
BUILDING DIVISION APPLICATION/PERMIT PLUMBING - MECHANICAL.
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NAME �r PHONE� CONTNAC'IOR'. NAME: LIC NO:
/I:fIN R/TR: LIC NO: ADDRESS:
PHONE:
❑ Consultant Fees Paid by Applicant (Initial)
Ciif.ICFNSI D COVRACfORS DECLARATION - - '1
QTY. f LECI'REt PERMIT
I hcrehy affrm that EI' sW d p IChap¢r9fummme g r
FW0Z wilM1sarnm]Otx1)utU sm .nrOvBmx'rvs,mJira�nJJ'�ri 5Cn uuullplldm)'cee - --.
1- in full finec end eRea, V / +� PERMII ISSUANCE
�UV License Clan LIC.H
N %yam Dwe CTSDIan APPLIANCES-HLSIUBN'fIAL
CHITECT'S UECLAR
PANELS
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11P'I O 200 AMPS
O Z - O
Licensed Fri nniil 201-I000AMPS
gy OWNER -BUILDER DECLARATION OVER I(qO AMPS
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0. U 1 Imreby u(Bmm den 11, exempt mi Ino Corti or's License Law Bribe 63 L F following flosfa (Serino ]O3L5, Business and i demons Core: Any city or cnumY SIGNS 1!LECI'RICAI.
LLLL1l a y whir, rWui su a permit re wnstmel, plots Improve, dnnout t nr repair ed statement tnemre
O� coupe laissuance,
ensed In altoe,1. be the pro,mlicant mol,he such Cmdracmil micensle ae aw(C SPECIAL CINCUITIMISC.
WI (cmuncucis ia with
pursuant 70m) Division
nl'Ihe Comwness nd Poae Law fClale)
(cat he
xempt therefrom
ion romadthe iaiisfr the
the
eged Business and Pro AaxinmColn or TEMP.METI!ROR POLE INST.
6 W Qo Vy That he it 31.5 b Ian, i non acts the oasis for IM1e allege) exemption. Any vipenai penalty
IT
�..m notfircionmo than by an,iifm apermil xubjems the applicmv macivil penalty of POWER DEVICES
tmomthan rivehundreddoloarsy Soon.
�6 �Lothe as won, one property, rtemyemployers wish wages
racirsol...... n...... SWIMMING 1`001, ELECfRI
{$�Fq ad Frohuwm, and the he Cmisnoli mended uraw,Eoffered f a, ale pply. 7044, Business
oil `m and Professions Cole: The C es theor's License Law, does not apply to an owner nl' W'ILGfs- SWITCHES -flXTl1RE5
progeny who hails, or improves therein, and who Jeal such work himself or through
his own nvev bate provided Inm such imus i, mi ms ore not intended m offered for NEW RESIDENTIAL EhECTR SQ fTa
rales IL nowevcn Inc pudding or en of proving
i, sold within ora year of..mpWfor pi
er -W Boder will have the burden of proving OaI he did not buil) or improve for pur-
,seal salt).
1, as owner of the progeny, am exclusively contracting with licensed contractors to TOTAL
..morn the prnjecl (Sec•. 7044, Business and Pmfeasinns Coi Tne Comraean's U. — I,s s.W! „ ,1 v �q
mo
nee Law does reapply a a wner,.
ofp, y who build, or iThenmve, Thea ad 'Qjy.'1• ;: PLUMB C PERMIT q'!'fi
t who commas for such projects with a coa
ntctorls) licencertt
d purano The Contractor's
license Low. PERMIT ISSUANCE
❑ lam exempt under5tt. ,B&PCfn,hotea,nn
,dllkkOwner Dole AI;PER- DRAIN &VINT- WA[ 'ER(EA)
WORKER'S CONIP12NSA'1'ION DECLARATION BACK PLOW PROTECT. DEVICE
I hereby affmn under penally of perjury one of The following decimations:
I have and will maintain a Certificate of Consent ovelf-insure for Workers Compen- DRAINS- FLOOR, ROOF, AREA. CON D.
as provided I'or by Section 37M of the Larie Code, fur IM1e pert ranee of the
its for Is Inch this permit B issued. FIXTURES- PER TRAP
1 have and will maintain Worker's Cnmppusation Insurance, as roqu lred by Section
73700 of the Labor Cade,for/hep nee of the work for w�hh ch Box permit is issued. GAS - EA. SYSTEM -I INC.4 OUTLETS
y W,�'I'fs C�n)I ensetia0lnsIpplWulumbl'rA¢e:_ irrier"r'1 /IMf/M AST�Q/`�xx GAS- EA. SYS TEM OVER 4(PAT
N AERN WORKERS' IT GREASFANDUSTRL WASTE INTERCEPTOR
�'�Rclifn net I pc J Tars($1 W) GREASETRAP
11fE�I I ga yie K /r't/fin
Ies�TR�Nfyl nlT sin Rte perfnrmuneenfrhe work forwhlch lb is lfessued.l ,poll SI!WER-SANITARY -STORM P,A.2IXI frf.
not anploy any person in any manner sir as m become svbJem Io the Workers' Co.rani
Z eatlon Laws of Cali Line, Dae
z 0 Applicant WAI'F,N IiF:ATEk WNF.Mf/F.LELTH
NOT ICE APPLIC_A Mf: 11; afar nutkirli this Certific.m of Exemption, ya, should WATER SYSTEM/TREATING
abecome subject to the Worker's Compensation provisions of The Jahn Cede, you must
W fonbwiO comply with such provisions finis permit shall he deemed reveled. WATER SERVICE
aQ
U0 CONS're is ac (nNLItNDlNndinga AGENCY NEW BESIDES FIAT, I'LMB. 51',
U O InerwhichlTh mmeatii,aennxIm.300, Cj, C.).py for me Performance of
fL U The work for which Ibis pcemil is issued (Sed. 31yJ], Civ. C.)
O �Lenses, Name
Lcr Address AL.
;es 1 rectify Bad l ha' d this application d stateInul lh ' h r I
0 correct 1 agme to comply with all city and county ordinances and state laws oflating
t, QTY.) MEC, ' NIC ; ti PERMIT, ! �'s.
U Z building....Import., and hembyiuNnde, offsponTnives nil or enterupon the t=•
0
shove -mentioned pmporty fire inspection purpose,, - .)
(We) agree m save, indemnify and keep hapi the City of Cupertino against PlikMl'I' ISSUANCE
fur Iitiex,jud menI c I and expenses which nay in any way u¢mc against snlA City ALITRORADD'IOMECIL
mmequ c of The gaming o(,his permit.
APPLIC UNDERSTANDS AND VILL COMPLY WITH AL NONE OINT AIR HANDLING UNI 'P(TO 10.0110 CFM)
SOU .E ULATIONS
1f�T �� a�I9u AIR HANDLING UNIT (OVER 1),01))CPM)
Sig mu ofeTlWfur UCon �V EXHAUST HOOD(W/DUCT) -
HAZARDOUS MATIHUALS DISCLOSURE
Will the uppliered., more buildingmcupamamenr handle InoWdeus maremil HEATING UNIT (TO 100,000) BTU)
as demand by the Cranium Mumf ipul Cci Chain, 9.12, and On Health and Safny
Cal,, Secon n 25532(a)] HEYFING UNIT (OVER jordoi0 R'U)
❑Ye. VENTILATION FAN (SINGLE RESID)
�. s
Will the
Il the applicant or future building occupant use equipment or devices which BOLL IBR -CONY (3HP OR IW,000 RTU)
mil If .... dous air contaminants as defined by Tire Tiny Arco Air Quit try ManugenanT
FKars, BUTLER - COMP (OVER 100,000 []TO)
I nave as the nand trial, tequireme..x under Chapter 695 of the Cali- AIR CONDITIONER
[ronin l Leal .ufery Code. Seefirms 25105,25533 and 25534. 1 undersumd,hat if The NEW RES I DENTIA I. MECH. SQ.FI'.
building o I prosody have a human. nhri my responsibility if took the witupant
TOTAL:
OFFICE
❑ `Y70
F, I,hi, J: i BUILDING PERMIT Hif
SLUG/ ELECT PLUMB -
JOB DESCRIPTION
FDWI,
❑ KITCHEN REMODEL
❑ADDITION
❑PLUMBING RE -PIPE
❑MULT'I-UNIT
El STRUCTURAL
MODIFICATION
El INTERIOR
❑ CHIMNEY REPAIR
IMPROVEMENT
EJSWIMMING POOLS
❑ HATH REMODELREPAIR ❑ DEMOLITION
❑ OTHER
COMMERCIAL.
El NEW BLDGIADDITION ❑DEMOLITION
❑TF,NANT ❑ FOOD SERVICE
IMPROVINENT
Cil OTHER
SQ. IT. FLOOR AREA SISQ. PT.
g114
797 q
VALUATION
/-/,0/lZ(o. `Jq
STORIES 11 'TYPECONSTRUCIION
„ s BUILDING DIVISION FEES
PLANCIIECK FEE
ENERGY FEE
_Z07 U
GRADING I'EE
Receipt X
TOTAL:
BUILDINGR
I' b SEIIMIC FEF.
PLUMBING FEE
MECHANICAL PCF,
CONS3'RUC'OONTAX / I17)
HOUSING MITIGATION FEE
PAID I _-
Date ReceipTN
/("I- I z.0.- Q g
•
•
JAN.1B.2000 12r06FTt HRIRN KANGRS FOULK j
Brian Kangas Faulk ,
Enolnears • SurVevors • Planners
January Ig, 2000
19990104-50
Gary Ables
O'Brien Group
23505 Oak Valley Road
Cupertino, CA 95014
Subjaatt Oak Valley— Foundation Verification
Dear Gary,
N0.378 P.3i3
On January 17,1000 we performed a field survey of the location of the foundation farm for the building being
constructed an Lot 1.10 of the Oak Valley project in Cupertino,
•tile results of that survey aleerly show that the location of the foundation form is consistent and in
eonformanco with the desi'g'n location of the building, as said location is shown on the plans prepared by our
funds.
This latter is intended to provide you with the verification of that wilt per our survey. If there are any other
questions concerning that location, please do not hesitate to call.
Sincerely,
BRIAN KANGAS FOULK
"�RAOLE;' A .il/02 81160 A
E70' S/ ► S�alh/ t6l�
��teyMag
Ber3, GP.L.S.P,L.S.6141 u'Dated
Survey Deparanent
540 Prise Avenue • Redwood City. CA 94063 , (650) 452.6300 • FAX (650) 4ei�6399
f
S zy�r, S (�v
JZZA
Csu/ting Engineers and Scientists
425 ROLAND WAY
OAKLAND, CA 94621
(510) 568-4001
Date (—ru f..rtr/
Hours Charged To Project
Field Task Number
THE FOLLOWING WAS NOTED:
GIVE 50METHING 6ACK • (600) 2662619
Nuclear Density Tests
Concrete Cylinders
0
DATE
/— /2 -
uvt)
JOB NO.
—,?Y 0 — 7-:6
PROJECT
LOCATION
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- 0
CONTRACTOR
OWNER
WEATHER
TEMP. oat AM
'at PM
PRESENT AT SITE
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