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03060088CITY OF CUPERTINO MA'ION BUILDING DIVISION PERNIIT�,ONTI2AT�ORINA`N . Bu1LDINGADDRESS: CUPERTINO ELECTRIC INC PfJtMRNO03060088 OWNER'S NAME: 1132 NORTH 7TH ST "'W711/2003 E: (408)991-1000 SANITARY NO. CONTROL NO. ARCHITEC ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 1=3 0 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under Provisions of Chapter 9 (commencing lob Description= with Semi 7") IDivieion Sof NC Buundisuid Prolminns Codedndmylicensei, in full (nrce e 1. ✓y 171,7 INA�-E� License CI Lt. M ' °awCHI7,�stDcL�' ►'a UPS REPLACEMENT AUG 2 8 2003 I nderaund my plans shall be used as public monde BUILDING Licensed Professional OWNER—BUILDER DECLARATION i/V I thereby am. that I am exempt INm the i.'OnlraClOra License Law for the following resents. section 7031.5. Business and Pmfevtom Cole: Any city or county which mquirm a Permit in numerous, alar, improve. demol4h, or repair any ,velum prior to its issuance, 4110 requiem the applicant far such Permit w file ulgned si umenl that M is licensed pursuant In the provisions of the Conuuutor's1-cume Law (chapter 9 Sq. Ft. Floor Area $6816iip®tion (commencing with section 7(000) of Division 3 of the Business and Profesimns Coda) or that he is exempt therefrom and the bub for the alleged exemption. Any violation of 31W)9llAIi McrO 0 Occupancy Type Section 7031.5 by any applicant for a permit Subjects tha applicant to a civil penalty of hot more Nan nva hundred dollars ($500). 0 I, m awmr of the pmpeny. m my employs, with cores a Nab mla mmpemlion, —RUUUHg will do tite work. aha Ne,wnum berm lnunded ora@red fmsate(Sec.70a, Buri^•.. and Profession, Code: The Conuacmes License Law doe Intl apply m an owner of 5 0 1 — FINAL nCNERGY property who buiids mierproves theean,and whodoes such wmkhimtdf m through his own employee, provided that such improvements sm not intended oroReed forsake. If. SOS — FINAL ELECTRICAL however, the building or improvement is sold within one year of completion, the owner. ' builder will have We hordes of proving that he did not build or Improve for purpose of ale.). ❑ 1, as owner of the propeny, am exclusively contacting with licensed commission to construct the pmjecl (Sec. 70ed, Business and Profeatom Cade:) The Canuacmr's L4 come Law docs not apply an an owner of property who builds or Improves thereon, and. who contracts for such pmjccu whin a conmxetor00 licensed increased in the Contractors ' License Law. ❑ I sue exempt under See. ,B d PC for this reamer Owe Dau WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one or she following declaretiom: . have and will maintain • CertiOcsu of Contend la self -imam for WarkeM1Compen- orlon, u provldrA for by Seniors 3700 of the Inbar Code, for the performance of the wort for which this permit is iatned. 0 1 have and will maintain Worker's Compensation Lowrance, u required by Section 3700 of the labor Code. for the perfarmance of On work for which this Permit 1, issued. My Wo era Com enation Imuranee artier and Pot cy number tie: Gam 2,�Po o.: faG343{ u 0 E FlC TE OF EXEMPI7 FROM WORKERS' COMPENSATION INSURANCE (This section need net be compteteJ If the permit Is furore hundred dollar (5100) or less.) 1 certify that in to performance of the work for which this permit 4 issued, l ,hall not employ any person In my manner an as an become subjecuo the Workers' Compensation Laws of Cslimmia. Dau Applicant NOTICE TO APPLICANT. If, after making this Certificate of Exemption, you should become Subject In the Workout's Compensation provisions of the Labor Code. you most forthwith comply wish such provisiem or this permit shall be dammed a inked. CONSTRUCTION LENDING AGENCY 1 hereby arthro tha Nem is a consauction lending agency for the perfunne ved of the work for which this Permit is Issued (Sec. 3097, Civ. C.) Lendch Name Lender', Add.. I unify Net 1 have read this application and sate Nat the above Inform W un I. ' correct. 1 agme to comply with all city and county omimmes and state laws missing to building camhlrclion, and autiadm rcpregrnutiae of this city to enter upon the xlwve mentioned forhereby ertysave far Wpeeuan to keepha. (We) agnea m grass indemnify and Yep harmless the City of Cupertino against liabilities. judgments, emu and expenses which may in any'w'ay arm against said City mcameguence of Negmmtim ofNis permit. Q/ APPLICANT NOERST SAND WIL OMPLY WITH ALL NO POINT Issued by: Date SOUR E R O A710 Re -roofs Type of Roof 1 sur fAp icanVConlasior e HAZARDOUS MATERIALS DISCLOSURE applicant m futum building occupaol slom orhandle hazardousmaterial as dented by the Cupertino Municipal Code. Chapter 9,13. and the Health and Safety We, smten 25532(a)7 ❑sem pyaa��.... No All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove coal Nm.pprxant m/ favors building occupant use equipment or devices which Aaardous air contaminants as defined by on, Bay Arta Air Quality Management all new materials for inspection. i,mlet7 ❑YesNu ves I herow the mom eramaterials requimmenu under Chapwr6.95 ofthc Caiifor: ria Hcolth B:Saleycodc,Smu 25505,35533and8534.1undemtand N4lifdhe building Java not carte am a te m, at n b my roup pability m noul'y IM mcupan of Nc mquiromcmu hie me m prior wi an isCndfuatearaan r. Signature of Applicant Date All roof coverings to be Class "B" or better o,ne a Na aces, ,te V IceZ UOC UU z 3�z nFu i �LL� :Ca Y Y in L � C y�v -Z> £zC L C C -• v `r x> � Z UC � L �+ IS a U2 CITY OF CUPERTINO ' CO:I�Ti�AGT�O]2 �NCIRNA,� BUILDING DIVISION PERMIT .:;> BUILDING ADDRESS: CUPERTINO ELECTRIC INC PERMIT N00 3 0 6 0 0 8 8 OWNER'S NAME: HEWLETT PACKARD 1132 NORTH 7TH ST I�R"t`r L�i6D� 1/2003 PHONE: (408) 991-1000 SANITARY NO. CONTROL NO. ARCHITECT/F NGI NEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Chapter 9 Job Description I hereby affirm that 1 am licensed under provisions of (commencing with Sectio 70(10) of Division 3 of the BusincS(d Professions Code, and my license is in full .me de L „ •�j 7 ( J (J' UPS REPLACEMENT License CI Lie. N J DaleConl tet. 1 011',11 t t�A CHITECTS R N [ nderstand my plans shall be used as public records Licensed Prufessional OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 71031.5. Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 Sq. Ft, Floor Area $ 6 8N.�ibI®tion (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of 3 1k9)8i(CiMer O O Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, 3 U 4 — will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law docs not apply to an owner of prisDeu 501 - FINAL A nNFRGY 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 for sale. If. 505 — F I NAL ELECTRICAL 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.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a conuactor(s) licensed pursuant to the Contractors ' License Law. ❑ I am exempt under See. B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a Certificate of Consent to self -insure for Workers Compen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain Worker's Compensation Insurance, as required by Section 3700 of rhe Labor Code, for the performance of the work for which this permit is issued. My Workers C1omJpe�nsaation Ins(ura�nce caprricr and Policy number are,: Carticrj �,/tf 'tER'rIFIC TE OF EXEMPTIO FROM WORKERS' COMPENSATION INSURANCE (this section need not be completed if the permit is for one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall net employ any person in any manner so as to become subject to the Workeri Compensation Laws of Califomia. Date Applicant 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 is a construction lending agency for the performance of the wurk for which this permit is issued (Sec. 3097, Civ. C.) Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby aulhorim representatives of this city to enter upon the ahovc-men(ioncd property for inspection purposes. (We) agree to cast, indemnify and kith harmless the City Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City ru 2:�5 to consequence of the gran I' of this permit. APPLICANT�--��ii,,NDERST SAND WILL.,f:OMPLY WITH ALL NO -POINT Issued by: Date SOURCE R GULATIOY, r 1 & Re -roofs Type of Roof U aw turc�of ApplicanUContractor c f HAZARDOUS MATERIALS DISCLOSURE �(iR11te applicant or future building occupant store or handle haiardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Code, Section 25532(a)? ❑Yes No All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? 11 yesNu Zous Ihavemadthehuarmate: ials requirements under Chapter 6.95 of the Califor- niaHcalth&Sgc Cod 'Sec 25505.25533 and 25534.1 understand that ifthc building docs a leant, at it is my to not curentlylhave responsibility nosily the occupan of the f requircmcotswhic tm stbymet'prior toiss anccofaCenificatcofOcc'p y. Signature of Applicant Date All roof coverings to be Class "B" or better owns adtho iedagent— „e 0 '' CITY Of CUPERTINO Cii i Y OF CUPERTINO PERMIT APPLICATION FORM APN # °, TDate:. Fee Group BAPPLOTHER Building Address: 19-333 V L . C4f) Owner's Name: n Phone #: —J. Contract,Qr: License #: C& �i '�� A/o MECHANICAL Contact: Cupertino Business License#: ujkdn�rmrt Info: Bldg Elect Plumb ❑ Mech ❑ Job escription: (j y�-- 1000� V47Elk-J; esidential ❑ Commercial Sq.Ft. Floor Area: $/Sq.Ft.: 7 BBOILER5 Cost of Project: ",� �., � � � °� °�"'�`��"` Occupancy Group: BCONSTAX Construction Tax Type of Constructio Ind/Off/Comm/Quasi BUILDING 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 50CIK 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 BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of 3 S U TY OF CUPERTINO CM OF PERMIT APPLICATION FORM CUPEQ:lNO 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 BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTEVM Inspection 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 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 BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cf n MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > 1 OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2 of 3 �5111- carr of CUPEkTINO CITY OF CUPERTIN w PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BRENI ESAPP 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 BSPECLU Special Insection 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 MECHANIC A MPERMITFEE Mech Permit Issuance MECHANT L PPERMITFEE Plumbing Permit Issuance PLUMB G PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3