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02030032.. ,.� i. • ... _. ........ suss . ....... _ OFFICE p DIVISION OF O CI BUILDI G PERMIT CONTRACTOR INFORMATION: BUILDING ADDRESS: PERMIT NO, 10100 N TANTAU AVE 02030032 OWNER'S NAME: APPLICATION SUB DATE COMPAQ 03/08/2002 PHONE: SANITARY NO. CONTROL NO. 00 ARCHITECOENGINEER: BUILDING PERMIT INFO - u BLDG ELECT PLUMB MF.CH z u L J C_I L.._J IJ y i LICENSED CONTRACTOR'S DECLARATION Job Description 1 hereby affirm that i am licensed under provision, ifChopmr 9(comm.encing wih$ccu.n1000)ofDivision3ofth.Bo ssoitProb<'amCode.undmylicense T.I. (PDU) Cw z injul)forcc an lffc �(�/f^ < a0 Licen class LPv.x Dam CDntmaor_TIWPI F8NAL� ARCHI'fECfS DECLARA 0, ,� 1 understand my plans shall be used as public records APR 2 9 2002 Licensed Professional p z OWNER -BUILDER DECLARATION I hereby affirm The, 1 am emmpl from due C.moscmr's License Law for the ? a -' following reason. (Section 1031.5. Business and Professions Code: Any city or county BUILDING $ 6 000 M which requires a Pamir to consumes, alter, improve, demolish. or repair any someone ' 3 m Pnor sol alum q th ppli<antf M1permiu fl ugnW aammcm Q, (, pa�p1pp .T'�.a Valuation - n Chep s of Contractor isLr Low... Code) (cmum n dp Section CndU (cote with Seca lura TD''cionJ of he Business npPd. g Any vi or that h6 is exempt herefrvm and the basis for the all[gcd exemprbd. Any violation xi... of Semon 7031.5 by any, apaicam for a permit subjecm the applicant m e civil penahy reare, more than five hundred dollars ($500). A Iy�'�',P1 l0i-PN-ETJL-1N�DATION " "Occupancy Type ❑ I, as owner of the property, or my employees with wages as heir sole eompenmtion. PIERS willdowork, and he struetum is not intended or'offered 'for sale' pies. 70D, Bunness'and Professions Cade: The Contractor's License Law does not apply to an 103 - UFER Required Inspections -' owner of property Who builds or improves thereon, and who does such work himself orr though his own employces.provided that sucnimprovements ae not intendedur__ 104 - REBAR ... .._.._._..-. _ — .... ... __ __._.. ._._ offered? I'If"ho c h buildingimprovementis old h rte year of Completion >.' 105 - ANCHOR BOLTS :.1. ' e ow will have the burden of proving hos he did not Wild or herbo improve for purpose of sale.). 106 - SEWER & WATER cr none : contracting ol; rropny,ameuwsssa 'hl e d ontmaomtD 202 - UNDERFLOOR PLUMBING - E.use the protea (Sec ]OW owner o d Prof to tee, Code) The Contractors c'I-rowdoesa.,applytDanownerorproperty wM1nWila p vasher<nn, 203 - UNDERFLOOR MECHANICAL .. and. who omracI for. saeh. projects with a contractors) licensed pmauam.lo. he. -=-UNDERFLOOR FRAME --- r eonma<m xueenw w. .. ❑Iamexempt under Sec.' I.B&,PCfor his rtason 205 - UNDERFLOOR 'INSULATION = ownci "` `'" Date y 301 - ROUGH PLUMBING - WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER and, N ith,of perjue of ha fallowing declaration,: ' I hereby affirm ry di 303 - ROUGH MECHANICAL ❑ 1 have and will inaimt in a Certificate of Consent to'self-insure for Worker. 304 - ROUGH ELECTRICAL Compensaiinn, as provided for by Sectinn-3700 of he Labor Code, for he perfom,ana onhe work for'.'fame chi, pemtd is iswpd' , 305 - FRAME n. n�tl Illymywohm� W k Compensation - 306 - HOLDOWNS —tt. 10o fhe LW Cale f h f aeeof he wbrktr which this,!mar rssuedMno s tion 1 sb rte r a Pol c be a 307 INSULATION _._308",-,_SH,EETROCK'..,., Can " PolicyNo.� tS� ;.,,,, .'. CERTIFICATION OF E%EMKI'[ON FROM WORKEjISI r 309'- I EXTERIOR LATH" CE ... ,. COMPENSATION INSURANCE _ .__... _._...... 310;;%, (INTERIOR ZATH "' r (That 5[ction rte P pe is fm one hundred dollars cd eat be Com lescd if he vnd 311 SCRATCH COAT - 1 ) n(ydiedin the Defa .;hhc kIrh h afar pennili tssucJ,l ny mamerso as.to become ubjectIntheworkers ....:' 313' _...ROOF 'NAIli T. -. �' '. �'� ,• .. •_• •^..•, ._. ._, .. ,hart our[ ply anyPe Compensation Laws of Cal foram Date Applicant - 501 - FINAL ELECTRICAL ENERGY --- -- ---502 --FINAL- PLUMBING ENERGY - - - z iNOTICFTOAPPLICAN]'If ft kn, lM1 Crrf mnfE peon, you should becomewhjcmtotheWorkcrsC mp wt p ,on,,d theLuM Code, yWhusl 503 - FINAL MECHANICAL ENERGY mnndmneomplywirn,aenpro.mmm�rtm,p .it shrill dammadreoked. 504 ----F.INAL -BUILDING ENERGY.._.._ ` iCONSTRUCTIONLENDLNGAGENCY" y constructionleading g n y f thepert niece work 505 - FINAL ELECTRICAL,, '7 l. f I of the for ,hch has pent sii,a(See 30W C C,) � ,t�vy .` 506 - GAS TEST .. __.-- _-._ .-., . _ .._._ _ ......- (] Lender's Name _ ._.. �.0 _. .... .r .... Lcnper;Addresr ...._ _ .. .. 507 - FINAL PLUMBING z t�0 hat l hove read this application and store that the above information is , 508 - FINAL MECHANICAL l!cenify cericc1 agree m comply wish all, city.Ydcmofy mclieraces and slate laws relating 509 - FINAL GRADE CF W to Wilding construction. and hereby nodanae rep ntativesofrini oityto.enter upon m<above-m.endonedNoPetforinspectionpurposes. 510 - FINAL PLANNING , (Wc),rsmcote dem dy ioudkest, hamill. the Cty of C6pnnoa,mino s.y o U!) liabilities judgments. cla andep.enses nIM1my in any way accom againstsoie 514 - FINA PUBBIC WORKS z .. Ch in ePenistiftlia, magofthisa mail. ' r AP CA rU\DEA TIS 5 N ILLf NTTHALL'.Ob pppO��EVVV'//r/ `` S R I t ATI s Issued b Date Si'. ser ' TDxim %U of Apph Re -roofs HAZARDOUS MATERIALS DISCLO SURE ,, , . 'u he ppf< t r r reholding oceuy nt.ore handle hazvdous m.tmal _Type of Roof- s d,f d by to Cupertino Municipal Code Chapter 9 12 and he Health and Safety Code Sea 255321.1 ❑Ye t ,.1 rl r : i apPfca 5g All roofs shall_be Inspectedprior to any roofing material being. installed.._ All W"Il th t f r eb ld p t crap t d ccs wh¢A If a roof is installed' without first obtaining an inspection, I agreei,t0' remove it h d oat I n dcfne I h B, A en A Q I t, M agement District?all : '. new materials. for inspection. Applicant understands_ and will comply with .. oyes - r. _ .. all non -point source regulations.,,. , . ;t. have mad the Int doses m t ak req ms'und 'Chaps 693;of he Califinii Henry&Safety Code. Sections 25505 25533 and 25534-1 understand that if ding does not curmmlyhave amount. that is is my responsibility to notify the- cupv r Ne rt nm which moa h a poor to iswan<e of a can of Gfieam a Y Signature of Applicant Date D/Q AI] roof coverings to be Class "B" or better " wn � tWnagd ago f , I .; v Date .. .. ,.� i. • ... _. ........ suss . ....... _ OFFICE p CITY OF CUPERTINO BUILDING DIVISION PERMIT F" 2 LICENSED CONTRACTOR'S DECLARATION � M I hereby affirm that I am licensed under provisions of Chapter 9 (commencing co F with Section 7000) of Division 3 of the Bess and P in �yo cson, Cole, and , license or it. vt ARCHITECT'SDECLARATIWII < I understand my plans shall be used as public records qi Licensed Professional c. OWNER -BUILDER DECLARATION W-1 I hereby affirm that I am exempt from the Contractor's License Law for the L following reason. (Section 7031.5, Business and Professions Code: Any city or county O which requires a permit to construct, alter, improve. demolish, or repair any structure C4 W prior to its issuance, also requires the applicant for such permit to file a signed statement � that hells licensed unutarittothe rovisions of the Contractor's License Law Whot 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that be is exempt therefrom and the basis for the alhiged exemptimi, Any violation ofSection ,703 L5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 0 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 or off6red for sale -(Sec. 7044, Btsm-ss'and Professions Code: The Contractor's License Law does not apply to an owner of 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'f6r 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.). Q I, as owner of the property, am exclusively contracting with licensed contractors to constructthe project (See, 7044, Business and Professions Code:) The Contractor's License Law does not apply to an owner of property who builds or improves thereon, .and whocontracts for such -projects with a contractor(s) licensed pursuant to .the. Contractor's License Law, ©1 am exempt trader Sec.' B & P C for this reason OwnL4 Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 0 1 have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. W:"and will r,iraintalm Worker's Compen sullen Insurance, as r'equi'red by Section .Tthe Labor Code, for the performance of the work for which this permit i issued. M Wcirker', Com tAnsation �1 stnance ca ilei aro Poll Jer I �'o Can , ��r Policy KY 9 CERTIFICATION OF EXEMPTION FROM WOR Si COMPENSATION INSURANcE `(This section need not be completed if the permit is for one hundred dollars ($100) or less.) shall �n I certify, that in the performance of tfib'work for which this permit is issued, I or employ any person in any manner sous to become subject to the Workers' Compensation Laws of California. Date Applicant i 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 forthwith comply with such provisions or this permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY I hereby affirm that there , ere is a construction lending agency for the performance of the Work for which this permit is issued (Sec. 3097, Ci, C,) Lender's Name tendes Address I certify that I have readthis applkcalion and state that the above information is correct. I agree to comply with all city and county ordinances anj state laws relating to building construction, and hereby rl dnmizii representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless City of Cupertino against liabilities, judgments, costs and expenses which may many way accru against said PERMIT NO. 02030032 APPLICATION SUBDATE 03108/2002 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO BLDG ELECT PLUMB MECH L__J C-1 L -'*I L Job Description T. I. (PDU) 3 $6000 Valuation 103 - UFER Required Inspections 104 - REBAR 105 - ANCHOR BOLTS 106 - SEWER & WATER 202 203 - UNDERFLOOR MECHANICAL - UNDERFLOOR FRAME - 205 - UNDERFLOOR INSULATION 301 - ROUGH PLUMBING 302 - TUB & OR SHOWER 303 - ROUGH MECHANICAL 304 - ROUGH ELECTRICAL 305 - FRAME 306 - HOLDOWNS 307 - INSULATION 30$.--- _;_S1KEE'XROCK' �309 EXTERIOR LATH __.310 _'INTERIOR "LATH 311 SCRATCH COAT 313 ROOF 'NAIL, -,- 501 FINAL ELECTRICAL ENERGY -502 FINAL PLUMBING ENERGY 503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERG"f,.. SOS FINAL ELECTRICAL 506 GAS TEST 507 -FINAL PLUMBING 508 FINAL MECHANICAL 509 FINAL GRADE 510 FINAL PLANNING 514 FINAL. PUBTiIC WORKS S An't s- Date V/ U/ U ���qjIssuedby: V ign, fApplic4m/Comracior V Date-, Re -roofs HAZARDOUS MAtERTALS DISCLOSURE 71111 the applicant or future building occupant store, o I r handle hazardous material Type of Roof as defined by the Cupertino Municipal Chapter 9.12. and the Health and Safety Collie, , Section 25532(aV Qy,'s All, . roo - fs shall any roofing material being zztstalled Wjll the applicant or future building occupant use equipment or devices. which If a roof is installed without first obtaining an ed -by inspection, I agree to remove emit hazardous air contaminants as defurthe Bay Area Air Quality Managernent , S DiStriet7 all new materials for inspection. Applicant understands and will comply with by" W" all non -point source regulations, I have read the hazardous olaterilds requirements under Chapter, 6.95 of the California Health & Safety Code, Sections 25505,25533 and 25534,1 understand that if ding does not cuilrenry have a tenant, that it is thy responsibility to notify the cimpari f the ie item qats which radst,bemetprior -to issuance ofii,cerijficateof o apart Signature of Applicant Date it wauthorized agent All roof coverings to be Class "B" or better Dar�e OFFICE BUILDING ADDRESS: 10100 N T OWNER'S NAME: COMPAQ PHONE: 0- Z. ARCHITECTIENGINEER: 8zm F" 2 LICENSED CONTRACTOR'S DECLARATION � M I hereby affirm that I am licensed under provisions of Chapter 9 (commencing co F with Section 7000) of Division 3 of the Bess and P in �yo cson, Cole, and , license or it. vt ARCHITECT'SDECLARATIWII < I understand my plans shall be used as public records qi Licensed Professional c. OWNER -BUILDER DECLARATION W-1 I hereby affirm that I am exempt from the Contractor's License Law for the L following reason. (Section 7031.5, Business and Professions Code: Any city or county O which requires a permit to construct, alter, improve. demolish, or repair any structure C4 W prior to its issuance, also requires the applicant for such permit to file a signed statement � that hells licensed unutarittothe rovisions of the Contractor's License Law Whot 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that be is exempt therefrom and the basis for the alhiged exemptimi, Any violation ofSection ,703 L5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 0 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 or off6red for sale -(Sec. 7044, Btsm-ss'and Professions Code: The Contractor's License Law does not apply to an owner of 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'f6r 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.). Q I, as owner of the property, am exclusively contracting with licensed contractors to constructthe project (See, 7044, Business and Professions Code:) The Contractor's License Law does not apply to an owner of property who builds or improves thereon, .and whocontracts for such -projects with a contractor(s) licensed pursuant to .the. Contractor's License Law, ©1 am exempt trader Sec.' B & P C for this reason OwnL4 Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 0 1 have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. W:"and will r,iraintalm Worker's Compen sullen Insurance, as r'equi'red by Section .Tthe Labor Code, for the performance of the work for which this permit i issued. M Wcirker', Com tAnsation �1 stnance ca ilei aro Poll Jer I �'o Can , ��r Policy KY 9 CERTIFICATION OF EXEMPTION FROM WOR Si COMPENSATION INSURANcE `(This section need not be completed if the permit is for one hundred dollars ($100) or less.) shall �n I certify, that in the performance of tfib'work for which this permit is issued, I or employ any person in any manner sous to become subject to the Workers' Compensation Laws of California. Date Applicant i 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 forthwith comply with such provisions or this permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY I hereby affirm that there , ere is a construction lending agency for the performance of the Work for which this permit is issued (Sec. 3097, Ci, C,) Lender's Name tendes Address I certify that I have readthis applkcalion and state that the above information is correct. I agree to comply with all city and county ordinances anj state laws relating to building construction, and hereby rl dnmizii representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless City of Cupertino against liabilities, judgments, costs and expenses which may many way accru against said PERMIT NO. 02030032 APPLICATION SUBDATE 03108/2002 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO BLDG ELECT PLUMB MECH L__J C-1 L -'*I L Job Description T. I. (PDU) 3 $6000 Valuation 103 - UFER Required Inspections 104 - REBAR 105 - ANCHOR BOLTS 106 - SEWER & WATER 202 203 - UNDERFLOOR MECHANICAL - UNDERFLOOR FRAME - 205 - UNDERFLOOR INSULATION 301 - ROUGH PLUMBING 302 - TUB & OR SHOWER 303 - ROUGH MECHANICAL 304 - ROUGH ELECTRICAL 305 - FRAME 306 - HOLDOWNS 307 - INSULATION 30$.--- _;_S1KEE'XROCK' �309 EXTERIOR LATH __.310 _'INTERIOR "LATH 311 SCRATCH COAT 313 ROOF 'NAIL, -,- 501 FINAL ELECTRICAL ENERGY -502 FINAL PLUMBING ENERGY 503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERG"f,.. SOS FINAL ELECTRICAL 506 GAS TEST 507 -FINAL PLUMBING 508 FINAL MECHANICAL 509 FINAL GRADE 510 FINAL PLANNING 514 FINAL. PUBTiIC WORKS S An't s- Date V/ U/ U ���qjIssuedby: V ign, fApplic4m/Comracior V Date-, Re -roofs HAZARDOUS MAtERTALS DISCLOSURE 71111 the applicant or future building occupant store, o I r handle hazardous material Type of Roof as defined by the Cupertino Municipal Chapter 9.12. and the Health and Safety Collie, , Section 25532(aV Qy,'s All, . roo - fs shall any roofing material being zztstalled Wjll the applicant or future building occupant use equipment or devices. which If a roof is installed without first obtaining an ed -by inspection, I agree to remove emit hazardous air contaminants as defurthe Bay Area Air Quality Managernent , S DiStriet7 all new materials for inspection. Applicant understands and will comply with by" W" all non -point source regulations, I have read the hazardous olaterilds requirements under Chapter, 6.95 of the California Health & Safety Code, Sections 25505,25533 and 25534,1 understand that if ding does not cuilrenry have a tenant, that it is thy responsibility to notify the cimpari f the ie item qats which radst,bemetprior -to issuance ofii,cerijficateof o apart Signature of Applicant Date it wauthorized agent All roof coverings to be Class "B" or better Dar�e OFFICE ?2- Ct fY OF I3 'T 02,030 CITY OF PERMIT APPLICATION FORM CUPEkTINO APN# 7BuildiEngAEddrEss: Date: � fly �. Fee Group C 95p/ Owner's Name. Phone #: BUILDING W BBOILER1 Boiler <-- 100,000 Btu Contractor: 1A License #: Boiler > 1 OOK to 5 OOK Btu MECHANICAL CIO )`01 Contact: evik in Phone #: Dj 777o), Applicant/Contractor: Fax lum Building Building Perm:nif Info: f 0- =B_ : rr Ind/Off//Comm/Quasi _Pldg Elect Plumb Mech Job Description: Hotel and Motel Residential: Commercial: Constax Resi/Mobile Sq.Ft. Floor Area: $/Sq.Ft.: Elec 600V <= 1 OOOA Architect/Engineer: 'BELEC1001 Valuation: Elec 600V > I OOOA Type of Construction: Occupancy ip c cy Gr ly: BENERGY 77? - 3 333 I of3 Fee ID Fee Description Fee Group 'BAPPLOTHER Other Appliances MECHANICAL 2- :BBLDGFEE BUILDING BBOILER1 Boiler <-- 100,000 Btu Boiler > 1 OOK to 5 OOK Btu MECHANICAL Boiler > 500K to IM Btu MECHANICAL Boiler->- 1M to 1.75 M Btu lum rr Ind/Off//Comm/Quasi Con. Tax for BQ Zone Hotel and Motel BCONSTAXR Constax Resi/Mobile !I BELEC1000 Elec 600V <= 1 OOOA ELECTRICAL 'BELEC1001 Elec 600V > I OOOA ELECTRICAL BELEC200 Elec S-vcs 600V <= 200A BENERGY BENERGYADD_ Energy Add Multi• -1 Investigation fee EROSION !21111MAV��K[ Comm. Housing Mit. Fee 77? - 3 333 I of3 _.._... .... _._.. ._..__._._ __. awl ® U MUM aHAAN HHOR61moll,�i-W ti 0HE�tji71-7W I -40 -n rC --j 1,4 IF F n1111 VO 11M,111110 11111V_I 1111. M =N 'NIS 3 P�q MM[� �,C' - nM Y,� Kv, 0 IV I 9 LIg L 3vj pS