06040021 CITY Or CUPERTINOr
CONTRACTOR^INFOATI
BUILDING DIVISION PERMIT l2MON ",
BUILDING ADDRESS: PERMIT NO.UZ
20425 STEVENS CREEK BLV
OWNER'S NAME: PERMI7TL3UEDATE
WESTWOOD COMPANY INVESTMEN 04/05/2006
ONE: SANITARY NO. CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0
dap LICENSED CONTRACTOR'S DECLARATION Job Description
4 C 1 hereby affirm that 1 am licenses under provisions of Chapter 9(commencing p
n�d
with Section
on](If )afDivislon3ofNCBusinvadPmf Cattle. is
nth Sfeta 120V 20 AMP. CIRCUITS/EXISTING 225A PANEL
_
;q,�= Lia.scClaza - Lie.# 2 FROM ONE PANEL 6 FROM THE OTHER
° Dart0 W1 ARCHrt CT`S DEC
Lil IAR oN RE COLEMAN ELECT PD FOR BL 4/5/6
w1 understand my plans shall he used as public reenNs
6
s G t; Licensed Professional '
S OWNER-BUILDER DECLARATION
.� I 1 hereby alarm that 1 am exempt from to Contractors License Law for the
p O following moron.(Section Rn L5,Business and Pmfessinm Cede:Any city or county
2$� which esquires a Permit to cmmncL.ler,improve,demolish.or.,air any..tree
LIy prior to its issuance.also regWres the applhcautfor inch permit in file a Signed Statement
< that he is licensed pursuant o the provisions of the Computer's License Law(Chapter 9 Sq.Ft.Floor Area aCIQ
(commencing with Section 7000)of Division 3 of les Business and Professions Cole)or 4000
_ that he is exempt tmref ion and the basis for the alleged exemption.Any violation of NNW
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of
ml mee than five homebred dollars r$SXdL APN Number AI f cy Type
C]I.amneroflhepmpeny,ormycmploycuwilhwagaazteirmlecompenadnn, 31626094 00
ill do thcwert,end thes.ctom is not intended or offered for We(Sm.7W.Business
and Prty who
builds
or The Contractor'.License Law tines not apply to an owner is Re Butt
builder
ggp8��t
progeny whet huildo provided
bavesch impr and who are
himue edNmugh his
own employees,provided Nat such impmsemen0 are not intended mplunires for sale.If,
however.the building or improvement is mid within one year o(compledon.be owner-
builder .will have to burden of proving bit he did not build or improve for purpose of
a1eJ.
❑1,as owner of the progeny,am exclusively contracting win licensed rontrac.to
comncl the pmjccl(Sec.7 1 .Business and Professions Code:)The Contractor's Li. '
come law docs not apply to an owner of propeny who Wilds or improves themun,and
who contracts for such projects with a contractor(s)licensed pursuant to the Conueetors'
License Law.
❑I am exempt under Sec ,B&PC for this nxmn
Owner Dare
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of be fallowing doelandans:
p I hire and will maintain•Certfica t of Comem toself-insum for WmkcrsCmnpcn-
selon,w provided for by Section 37M of the Labor Code.for the performance of the
wesrls for which this permit is issued.
SKhave nave and will maintain Worker's Compensation Imuran.,as"uimd by Section
37M of be labor Code.for the performance of the wok for which this Permit is issued.
My Worker's nmplIpnsadon lnsuance,carrier and Policy, WralhS/.
Cartier. i 0 Policy No.: 2 ` 2_?
CERTIRCATEOFEK PTIONFROMWORKERS'
COMPENSATION INSURANCE
(This Was.need mer W co ni lc¢d irthe permit Is for..hundred dollars(SIM)
or Ices)
1 cirdfy that in be performance of be work for which this Permit is issued.I shall not
cmpley any person in any manner an a in become subject to the Workeri Compemadon
Laws Of Califo��ry}}}... al!
Applicant �a
NOTICE TO-APPLICANT.IC after making this provisions
of of Li
oplio Code.you should
.J Obecome subject y to Worker's Comp or this provisions of the ebur yok . ..it
forthwith comply with such provisions or thin permit shall W dcemrA evoked.
Z M CONSTRUCTION LENDING AGENCY
[-v I hereby efion that then is a construction lending agency for de performance of
CL the work for which this pc.i,6 issued(Sec.3097,Ci,C.)
W Q lender's Nam.
0+
z lender's Address
U
V Q I certify nn 1 have read this application and sum that the above information orating is
tryU corm.l.gra to comply with all city and countyordinariesof and sum lawselatingto
�U above-mentioned
construction,andheehyauthorimrcprtsenmivm of thiscity lnenter upon the
.hove-(We)are in saw.for imnifyanpurposes.
(We)agueto ase,indemnifyandhicp may
an the Cilyni Cogent said
h in
encs o nts,cmmeng of bit expenses which may in anyway scenic againslaid City
f,z A APPLICANT
NDERSTf dic skNDS A Permit. f/
^ APPLICANT UNDERST[sNDS AND WILL COMPLY WITH ALL NON-PO NT Issued by: Date
BDD GLIL�TIOM6.A 1�.6 �---_
sign. ppppucami/C/ormaactorr DT—n� Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building Occupant stow or handle heveirdous o bond
az defined by the Cupert
❑Ye ino Municipal Code.Chapter 9.12,and the Health and Safety
cese.Sccdnn us3z(a>7 OD14/ All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
coil 6--ok us air
co
anis as defined by the Bay Arca Air Quality Management all new materials for inspection.
Di.tricll
❑Yes Nu
I have mad the harardous maerialsrequimmems under Chapmr6.95 ofthe Califor-
niaHcalth&Safmy Code Sccdom 25505.25533 and 25534.[understated the ifthc Wilding
docs I cirmem have a t,in. 1 is my rtspom.1.1.Y m hwdfy rte occupant of the
rty inuc .q na n .tpriern,iazemanr.cen;feale ere ac#paney� Signature of Applicant Date
Owner or aulhoriyed agent � / D mob All roof coverings to be Class "B"or better
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub:' Blk: Lot:
APN . . . . . . . . : 31626094.00
DATE ISSUED. . . . . . . : 04/05/2006
RECEIPT #. . . . . . . . . : 33852
REFERENCE ID # . . . : 06040021
SITE ADDRESS . . . . . : 20425 STEVENS CREEK BLV
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : WESTWOOD COMPANY INVESTMENT
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : R.E. COLEMAN ELECT
CONTRACTOR . . . . . . . . LIC #
COMPANY . . . . . . . . . . :
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
TELEPHONE . . . . . . . . :
*EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
__________ __________ __________
BREMMISC FLAT RATE 8.00 27.58 0.00 27.58 0.00
BENERGY PERMIT FEE 1.00 34 .86 0.00 34 .86 0.00
BSEISMICOM VALUATION 5, 000.00 1.05 0.00 1.05 0.00
EPERMITFEE FLAT RATE 1.00 38.37 0.00 38 .37 0.00
BUSLIC FLAT RATE 1.00 105.00 0.00 105.00 0.00
----------
TOTAL PERMIT 206.86 0.00 206.86 0.00
METHOD OF PAYMENT AMOUNT NUMBER
__________________
CHECK 206.86 3002
TOTAL RECEIPT 206.86
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
•
J
af�1 Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building Department
JOB OADDRESS:SS , v e k• ( v e r K 81 v � PERMIT #��O oGa
OWNER'S NAME: SC v PHONE # rjO- 7317, O 2 cfY
GENERAL CONTRACTOR: C� e C (�� r FAX # 5 q p.,,
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
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 Signature Date
dV ACCORDANCE WITH THE CITY Oi
• CUPERTINO CODES AND ORDINANCES \
)ATE
'AGNED
j o k i f This �eboi 'lai n'd speciii�ations Mf�S.
� N
he kept 4 r113O at all times and it is= ?. t }�
lawful w rq 'ff' aAY changes -or alterati
m same v& luw;inch PeJJnissibn frbr�
i n ) I ie buifding.Dept City;of �I rl, .!I
''he stamp Mg ei this plan 2p
;HALL
:HALL NOTIbe he d to pe mit or tc be al nm C
)f an l City
Itj1retis�i"�ae o )' anyI pr�v lr v N?
r( an City Orinq(ice df�rare If.a,•�
n
.'q.- r6i.:•Wi r :�.; :1: _ mo
A II 117-1� omN '. ^I• (/O
IL
a I:i• I: : eP�l � I c
NJ
Ln
tj
��\ r_ . .I .--ter l�l ! .— 8-. a ■ = ! tf
� I
rte, '
C. {l `\� ` p JN•-moi I N ! 1 + b alN
h� _ ¢v��v� , _
1z'
f�l�-� � h I� ��. x� ��'� I' )� .�•.. .i 3� i {. n� o I � I� -.. �mr.. N,r:% � - nr �. `-",���I�
N I:
F Ij II t Z� 'A
7_ wrfjJ ]'w � ^ �r�
oi
Rip-
� i
[ n rrN .J.I
r
W �
�' Community Development
10300 Tone Avenue
Cupertino CA 95014
Telephone(408) 777-3228
* CITY OF
U P E DT I NO Fax(408) 777-3333
Building Department
All Cupertino building permits must meet certain conditions related to maintaining
environmental quality and public peace and safety. The two most corm-non
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District control stormwater pollution. Educating local
residents and businesses and enforcing stormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains flow directly to local creeks and San
Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
• Construction debris, including dirt, concrete and paint;
• Landscaping runoff containing pesticides or weed killers; and
• Any material dumped or spilled into streets or storm drains
The property owner and the contractor share ultimate responsibility for activities
occurring at a construction site and will be held responsible for any environmental
damage caused by subcontractors or employees. .
For more information on construction-related stormwater requirements, see the
Stormwater Quality Regulations section of the City of Cupertino web site at:
http://www.cut)ertino,org/citv--g-overnment/departments and offices/
environmental services
COMMUNITY NOISE CONTROL
The basic noise control requirements for construction sites are as follows:
• Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street construction is prohibited on holidays.
• Residential daytime noise levels from complaint site - 60 dBA
• Nonresidential daytime noise levels from complaint site - 65 dBA
For more information on noise control, please see Chapter 10.48 of the Cupertino
Municipal Code, which can be accessed at http://www amlegc ti com cupertino ca(
Greg Casteel
Building Official
N N N • gN I d _ r CD '\
11•• � - � � 1 ) N
� I _ Vi a ' a 'r 4 I�•�•�
+ ..- gi C..� 1 N -� JN �� '• � r�= N :. ._ N�❑� N .. ppl�� r(��� pNn IJ I�
r Q @O@ J I_—• 'T•�.Nj. 1 I '� N -
W a
^L'
1 .ice \' tom• �I :jl3 '^- r nYn,1 ,q- d_y I •
[` W W .� \moi-C` t..;`y 'f• '. t�I
,•i ry• -J .i. -`' �� �-ip / �.1:�. ti1�./i - - lil __._ I� � 1�J.1
:.}� .S� u _l�_I :f • � _�. � I:Ir _ ?elf L
po
NNN �q.tj
J
Q• I_ %0 N Iri N r \:- ������ -T 1' ^ -- I I I�r-+{_`_• --
rX QN �• ,I
Oi
J
C1c:i 1
rn
- F _i fi ,. cn
.� \ N ^� 1 W } '• N :h (. IJ J i ry Y !r Z ) n.. py `� ..I I• �I. N i v .} II ` ,
ro ,t, fh1"9N N �illa
y N
1� ��' N .`•J A I 1 g 11 I w 1 T w (yL` �I r.Ni N�I N '
v1 3 j _ +r�fl 1 { ? 1L N [� W (-1 II•�� X1`�'�j'1j(1 I A )L Fk w �1
• l^ V- I� Nom'. • - - N N � ::t N .\ N' 11, \.�.�� 1rN � W
c..-.
.�[ N �u�" �'J�i � '• �� ti � w % � N ) saP �� ,I �rv �h � 3-96 � ; 1
\� �. N SI �O -• .I .' IG N •. 0 ...-.- CV 3Ya-'v '� YN i-I
4 1 •
3` a a C N ! ` L A J a ,i � , A ..•Yf'_� � • - r6 �
C� CITY OF CUPERTINO b(�OU OOZI
a`ivor PERMIT APPLICATION FORM
CUPEkTINO
APN# 6 c2 49 h 2 Date:Oki/057/0,6
S 0,6
Building Address: C/ Mailingg Address (if different from building address):
ZD S eVetnS CrneK BI� � • Cv v� kv
Owner' Name: Phone#:
e15 V-1'dQ COMR4k,JnU4 P✓i slf"Os
Contractor: ILicense#:
9• F e im as C e JV i s q 7 6 44 0 ,5
Contact: Phone: M 4L Cupertino Business License#:
& C.o`evAAK Fax: 51 7311-0Z9
Building Permit Info: /
BldgEl Elect I Plumb ❑ Mech ❑
Job Description: I20v ZO ", %sF C.Zrcvt e. E'y��s 'nJe ZZSA pavie 14
Residential ❑ 2 �roON ane , •,., aA.Commercial [P�
Sq.Ft. Floor Area: Sq.Ft.:
Cot t of Project: Occupancy Gro
1
Type of Construction: Please check this box if the project is a
e GI.O i C rn fh 5 �t°� second-story addition: ❑
roject Size: Standard Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BBOILER3 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
1 of
Zoos , CITY OF CUPERTINO
cifyOF PERMIT APPLICATION FORM
CUPEkTINO
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME New Comm,Electric ELECTRICAL
BNUCOMMM New-Comm'Mcchanical ' MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIME Ins ection 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 I 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 Storm/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
BREWSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm 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 Apparatus ELECTRICAL
BREEMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
2of3
CITY OF CUPERTINO
CUPEfZaTINO PERMIT APPLICATION FORM
Quantity Fee ID 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 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 Mechanical sq. foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
AWL PLLONGRNGC Planning LR Comme/ Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Change BUILDING
•
3 of 3