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03070041jrez 00 fz 1�H d�z LL J e r r.o �00 <ia _za yF0 00 Z.r h d A Uz UUw _O 0U U F� U CITY OF CUPERTINO"` BUILDING DIVISION PERMIT CONTRACTOR INFOBMATION.': ..a.x4, , ``." , h., a ..;- ,AAA BUILDINGADDRESS: C) 1 11 7QLTN MR ELECTRIC INC PERMIT NO 03070041 OWNER'S NAME: 3245 STEVENS CREEK BLV PERMIT ISSUE DATE NE: (408)557-8899 SANITARY N0. CONIAOL No. ARCHM-CTIENGINEER: - BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 DECLARATION LICENSED CONTRACTOR der Chapter 9 I Wrtby I limned Job Description ender fof (commencing orf rm Ilial am previsions wish Scctian ]Otg))u ivisi9 3ofthc ausin¢Y ufpssions C/nptl/yliccnu is in fun corm ods c.I//�� 6 /4-+ REPLACE MAIN PANEL cn V Llc LicCmfirms TO 200AMP ARCHITECTS A ATION tl nJ plansshall W mud S Puhlic rcwrd5 Licensed Pmfcssionel OWNER -BUILDER DECLARATION 1 hereby affirm I am susin from the Contractor's License Low fur the / \ Q reaso Co ng rcnspa. (SCCIIpI ]ID l.; Business and Professions Code: Any city or roomy on which which rots issuneS a eCmsl e, alar, improve for demolish. Or orelsoc COOmires pair any .atement re such Prior b) its issuance, also requires the applicant for Con rermil m Glc License signed namment t a mol lim es lean ed pursuant III a Provisions of the (Chapter Sq. Fl. Floor Area Valuation - (commencing with Section eBusinor'snProfessions of Division J of the Business Doti Professions Coda) or But, he s and Natio u exempt mem from and the basis for one alleged exemption.anto Any yiolntion of 36933036.00 Section ]031.5 by any applicant for a permit subjects the applicant m a civil Penally, of APN Number Occupancy Type not ¢ort than Gvc hundred dollen (5500). C1 1, as owner of Ne property, or my employees with wages as their sole compensation, will do Be, work. and the swcmrt is not intended or record for sale(Sec.]044, Business and Pmfessiom Cock; The Conhacon, License law docs not apply m an owns, or ns pmperty who Wilds .1 escomi.and whodrcsauch work himxlfor through his 501 - FINAL ELECTRI AL ENERGY own employes, provided thmsoeh improvements are not ntended or offered for sale, If. SOS - FINAL ELECTRICAL however. me building or improvement is sold within one year of completion, the owner. builder will have the burden of proving that he did not Wild or improve for purpose of sale.). ❑ 1, u owner of me property, am exclusively contracting with licensed emilracmrs to coswcl the project (Sec. 7W, Business and Professions Cade:) The Contrxcmrs Lb throw law does not apply to an owner of property who Wilda or improves themon, and. who contracts for such projects with a eo rractor(s) licensed pursuant to the Contractor's Liccnu law. I for exempt under See. , B & P C for this recon Owner Dale WORKER'S COMPENSATION DECLARATION I hereby affirm under Penalty of perjury one of the following decimations: 1 have and will maintain a Cenifcom of Consent to xl6insum for Worker's Compere cation, as provided for by Section 37M of the Labor Code, for me performance of the work for which this Permit is issued. ❑ 1 hoe and will maintain Worker's Compensation Insurance, as myuimd by Section J]W ofth her Calc, or thc pertormancc of the work for which this '7'1's isswJ. My Wo er' t wrsnes camicr and olicy r(y _ rt aerriePi y No.: 1 �� X/ CER FIC TE OF E%EM ONFROMW RKERS' COMPENSATION INSURANCE (Thu auction need not W completed irthe remail is faro¢ hundred dollars (SIM) loss.) I certify that in the performance of the work for which this Permit is issued, l shall nut employ any person in any manner so as In become subject in be Workers Compensation Laws of California. Dale Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject m the Worker's CompCsatlon provisions of the Labor Code, you most fuMwilh comply with such Provisions or this permit shall W dmmsd mvaked. CONSTRUCTION LENDING AGENCY 1 heehy aflon that there is a cornu ethin lending agency for Ibc Performance of the work fur which Nis permit is issued (Sec. 3097, Civ, C.) Lenders Name Lender's Address 1 certify that 1 have read this application and Slane that the above information is cancer.I agree to comply with all city and county ordinances and state laws relating to Wilding consweion. and hereby authoris representatives of this city to cnmr upon the ab for inspection (We) agree t a . indemnify and keep hsfmlcss the City of Cupertino against Renee ellodProperty liabilities,] 6mcn rc ats and cxpcnus which may in anyway seems gains) said City which may in mosey he f c among 0 1 is permil. N U ST D D WILL COMPLY ITH L NON -POINT Issued by: Date SOULI Re -roofs gat fA scant/contra Ior Date HAZARD S MATERIALS DIS LOSU E Type of Roof Will the applicant Of future building storm eial or to file ha alth ni e. Chapter 9.1 s defined try Ne Cupertino Municipal Code. Chapter 9.1 i. and the Health and Safety and Safe[, code, Beaten. zss3xa)? No ❑Yes No All roofs shall be inspected prior to any roofing material being installed. /0 Will thea licantorrol c building applicant g ¢coram esu equipment or Devices which If a roof is installed without first obtaining an inspection, I agree to remove g p it haramcus air cpntamdchncJ by the Bay Arta Air Quality Management viol? all new materials for inspection. ❑ Ycs I how re her r materia yuirtmcnts under Chapmr6.95of cCalifor. nia Health&Sof .25 . 533 and 255Jd. l undo BOOK Wilding dos nm curve Y Svc y respofar ibilit in n up., of the ¢yuirtmcn s of uamc of a Ceoifieafe u `(A Signature of Applicant Date All roof coverings to be Class "B" or better Owner r authonred agent Dam CITY OF CUPERTINO CUPEICTINO PERMIT APPLICATION FORM o3->7 l W Quantity Fee ID N# Date: BAPPLOTHER Building Address: p MECHANICAL Owner's Name: LPh Bldg Permits . foot ne#: jf 9191�� e(f q �-ttkT / BBOILERI Contractor: / License #: �/ r 7- b BBOILER2 f / . Contact: l A 1 l_1 �Jv f l_ Cupertino Business License#: BBOILER3 Building Permit Info: Bldg ❑ Elec Plumb ❑ Mech ❑ MECHANICAL Job Description: Residential ►J 7-6-vmercial ❑ Boiler> IM to 1.75 M Btu Sq.Ft. Floor Area: /Sq.Ft.: Boiler> 1.75M Btu Cost of Proje t: 2 Occupancy up: Construction Tax Type of Construction: BCONSTAX W Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> IM 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 <= IOOOA ELECTRICAL BELEC1001 Elec 600V > IOOOA ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATCComm. HousingMit. Fee BUILDING 1 of • • i lY( I��t,` CITY Of CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi -Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNiJCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g 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 rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Tra 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 am MECHANICAL BREMAIRHAN 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 Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc A aratus ELECTRICAL BREMNRAPP Rem Non -Res A liance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2 of 3 Sam CITY of CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL 13REMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT 'Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 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 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 Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3 1 J •