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99080114 CITY OF.CUPERTINO - """' BUILDING DIVISION PERMIT � � CONT"CT0i2 INFORMATION:a — - BUILD]NO ADDRESS: PERMIT NO. 11425 'CHARSAN DR " AQUATIC TECHNOLOGY OOL .ANDa SP99080114 OWNER'S NAME: I ' APPLICATION SUB DATE " DORAN DRUSINSKY n- — . `1546E, LOS -GATOS—BLV FMB=24008116/1999 'HONE: - - SANITARY NO. CONTROL NO. -.800440'161t1;a= - ' pCO ARCHITECUUNGINEER. ;-r- BUILDING PERMIT INFO BLDG E ty LECT PLUMB MECII ' Z HLICENSED CONTRACTOR'S DECLARATION Job Description OZ 1hereby afir (htI ma licensed ander,wWom.ol Clipt 9(conalloscroing w(hS f 7000) ❑D,k l t the Brilitelsold1 Jas.haml Code,andIf,license , u�kqI'm fall force and rflr,l. 3 Dole I CI s ARCHITECTS Ondular TION - I SW MING POOL (=LL S I uukmmardnyflat"hullheused aspublic roundly, INAL.ED `c Lie.naW rrorm,htnal f , OWNER-BUILDER ino exempt mDECe Contractor MAY 2.92001 1� 1 heresy main,that 1 t santr(tram mo Cnmmas Co a Any r Law for Iho 3< following mneoa.permit ]o Lract,alter,roo, mp ve,eh"ions Code:Any City lir caunre - F G which requilex a ry:rmit to cnnwrtn,alter,improve,Aemnlish,or rep:ur any structure 3m prio,1.its i...atire,ako requires the.pp&ant Parsuch pemtiuo Me a signed statement DING that he is licensed punurma the Proskil of Communal,License la.(Chapter 9 s Sq. Ft. Floor Valuation (commencing with Section 900X))of DoNlon 3 of the liminess and Prorca"ion,Cale) crime he is exempt themfoon:tad the basis for the alleged enemPtion.Any vimatian of Semian,](Lil,y by any nrplicam fora Dermic euhjens the nDDlicunnnneivil penalty v �� ofnm mredtu nn nvehondreJdulk—S500), APN Number _ Oceu ❑1,as owner of the property.or my employees with wages us their udc comDcnsation. , will Jo the work,and Ne hwcwrc k not imolai or offered for sale(Sec.7841. Business and Professions Code: Me Contractor's License law doe"not apply to an 7 3621.0060 J�i*ired Inspections owner of property Who builds lir improves thereon:and who does such work himself , or through his on employees.provided Nat such improvements sere not intended or offered Icor sale.If.however,the handing or inmrovenicat is sold within one your of completion,menwnar-hui dra will hive mehnmen of proving that Ile did not build or 103'- — UFER PuprovafmDarrocofsale.). 104 — REBRR . . ❑I,as owner nfthe P..way,seit,caclusively contracting with licensed contractors to t o..Ima he project(Sea.9044.Holmes,and rrorc„mm,cane:)*Me Cnnlmc m s 107 — POOL/BONDING License Law docs not apply to an owner of property who builds or improves thereon, and who enmraum wch project,with a contractufor s)bcen"ed.pumuam to the 301 - ROUGH PLUMBING. y . oltantoa, In auto,Sec. ,B&-PCBtrmkrun"an' .'304 ROUGH ELECTR3CRL Ewan, Date 502 — FINAL PLUMBING ENERGY` WORKER'S COMPEN SATION DECLARATION 503 — FINAL MECHANICAL ENERGY , Ihereby of rm.under penalty of PeiuD line arthe foBawing declarations: 506 — GAS TEST ❑ I huvc mid will maintain a Certificate of Cnmoat to"el insure rnr Worker'" 510;::—...FINAL PLANNING Cmr,rhmdon, as provided for by Section 3711(1 nf'tha Labor Cod,, fr othe' tied toteeofthe work far which this permit iswould. b 51. i. FINAL POOL of have cad will maintain Worker,Compensation instant as mgained by section 516 — FINAL BUILDING 37W of the Ichor Codu,far the performance of the work far which this permit is sued.My Worker”Compensation Itnumm a carrier and Policy number ora Currier " Policy No CI3R1'IFICAO OP T EXEMPION FROM WORKERS' - COMPENSATION INSURANCE (Thi,mesion need not be completed if the pumtit is for one humbed killer, _ (SI W)or less.)- . 1 certify that is the purl amtance or the work for which this pemti(is issued,1 shill not onadoy anyparson in any mum er so it,to reunnia",,blue(at the Workers' Cma,mttit Laws Of Calilhrnla,Ilam '- •. " Applicant s NOTICE,'TO APPLICANT:It,idler making mi,Certificate of Exemption,you should become subject e Worker's Com,scroa to,provisions of the Labor Code.)on must 2 Z O m m forthwith comply with such poomons or this permit shall be deemed m,oked. ' CONSTRUCTION LENDING AGENCY s aI h.mlayot which this(here l".ksued(Seidl l,lullllg v C,)y for the perliamoneo , i, Fs7 lir Iho work for which this penin I.imued(Sec,3097.Civ.C) - L Q Lender's Name ;:I z Lender',AJJreis ' - V I certify that 1 have read this application and Stam that I const ve information is correct.1.gree m comply with all city and county mdinunees and slam laws miming - Q 6j to buJdingcnmrac(inn,and herchy amhorim repre.mntmivas of his city m enter upon - 1 kj the ahove.mentioned prnpeny lin Inhlrenlon Prr,awe,! C1, (Wu)agrcc m save,indcn o,y mid keep hnnale"the City of Caperdnu ogdas( " t4 liabilities,jadgmcm..mats and cxpcmes which may in airy way.,me against said V Z City in cnnacquence of the griming of this permit, r •SAPPLICANT OURCERT:GUI UNDERSTANDS AND WILL COMPLY WITHALLNON-POINT Issued by: Date Signature or Applicdm/ConM1ncnc ,Date Re-roofs HAZARDOUS MATERIALS DISCLOSURE Will theapplicant orfawmbuilding occupom"tnraorhandle haaaNnmmit""9I Type of Roof as defined by the Cupertino Municipal Cade,ChapmroJ.l2,and the Health and Stifety Code.S.am 25532(x)? ❑Ye" C3 Nor All roofs shall be inspected prior to any roofing material being installed. . Wil l the applicant mmlure building oceupdal a,,equipment or lecke,which If a roof is installed without first obtaining an inspection;I agree to remove omefined it bazanlnuv air cnaturrinart,as dby the Bay Area Air Quality M ion,i men( , i Dinrbrf all new materials for inspection. Applicant understands and will comply with ❑Ye.v ON., all non-point source regulations. 1 base mad the hamNans madid,re moduli is under Chapter 6.95 lir the California Health&Safety Cade,Sections 25585.25533 and 25534.1 understand that " - if the building does not currently have a tenant.that it is t6 responsibility In notify Ne oocupam of the requiremems which must be met prior to issuance of a Certificate of liecup,°`y' Sij;nature of Applicant Date owner or aaotori,ed.,car uwa - ' 'All roof coverings to he Class "B"or beiter OFFICE APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITYOFCUPERTINO _ BUILDING-ELECTRICAL ERMI'P� BUILDING DIVIS/ON APPLICATION/PERMIT PLUMBING-MECHANICAL S001 BUILDING PROJECT IDENTIFICATION "- V J dUl LDING ADDRESS: - SANITARY NO. APPLICATION SUBMITTAL DkfI. HIS N, _ P(H NG C NTRACfQ}I S NAME: I�l LIC NO: ' f�-• -�1p,��n j>CtAs v\J ka 1_G a W /� N/C. CONTRDL4 ARCHITECTIENGINF,ER: }•� LIC NO:I All .V I�-� � /1` O -� ❑ CONTACT: p PHONE: 6 VK W o " BUILDING PERMIT INFO PAUL- 1'��^'r't", 640'71 LO ❑ ConsW[ant Pees Paid by Applicant(Initial) SLUG/ BrLrP,,CTPLUMB /MErnCII�/ r,Txry LICENSED CONTRACTOR S DECLARA(I ION / 'l• QTY. ELECTRIOPERMiT FEE rL'�7✓ t.7 r/��/ LT I hereby afford that I one licensed ,der previsions of Chapter 9(commencing JOB DESCRIPTION 1C1�cz In SI 9000) fOit ion 3 oflhe Badnessandl' essona Code,and my license is RESIDENTIAL: F+�O in full force and of f�'� ''I PERMIT ISSUANCE License Loans APPLIANCES _ ❑SFDWL ❑KITCHEN REMODEL y QU APPLIANCES-RESIDENTIAL. El ADDITION El PLUMBING R&PIPE 0. Dnle TS G,ua [[�rr Dy ARCHITECTS DIiCLA A' ON PANELS El MULTI-UNIT ❑STRUCTURAL Z8yz lcode rstand my, stroll be usW os PuMicrec dv �,��.o�� - 0 MODIFICATION OZ-, &I i '50A UP FO 200 AMPS ❑INTERIOR ❑CHIMNEVREPAIR F.N.FYI Licensed Professional OWNER-BUILDER DECLARATION 2(11-IOWAMPS MPROVEMENT .�WIMMING POOLS OVER IINI0AMP5 - I�TH RIiMOr3EL/REPAIR ❑DEMOLITION I hereby dfirm that I am exempt from the Contractor's License Low far the ipy.O a O following reason.(Section 91131.5,Bnepnvss and Professions ode Any oity m coumy SIGNS ELECTRICAL V WDA I+i a IL y which require.,u permit m amsuua,alter.improve,dmnol' I,or repair any structure � isi prinnnile isvuance,alvn requires 0v vpplicam for eucbp iImfileasninal tatement SPECIAL CIRCULOMISC. y that he iv licensed pursuant to the provisions ofthe Co acmes License Law(Chapter 9 1CD (commencingwiNSection 90801of Divisinn3oh anandmnd Pmfc,xiam Cede)dr TEMP.METER OR POLE INST. COMMERCIAL. d c eG Ihat M1a le exempt thercYrom end the bnsle fart alleged exemption.Any vinWlion of ❑NEW BLDG/ADDITI ❑DEMOLITION Swtlon 91Y.i15 Fy any app Ileal.forapennit Jwathe vpplicam mevivil penalty of POWER DEVICES [I TENANT ❑FOOD SERVICE FZ6not more than five hundred dollars($500 IMPROVEMENT Dl,as owneroFlhe propeny,or nye loycee with wages as their sole compensation, SWIMMING PHIL ELECTRIC ' 40 will do thewmk,and the strvdure is .intended or olfered for sale($ea A144,Bushtase - ❑OTHER W � and Pmfessiuns Coda The Co dors License Law does not apply to an owner or OUTLETS-SWITCHES-FIXTURES 4' pmlrny who milds or'in s thereon,and who does such work himself or through his awn employees,Provi d mat such improvements pre not intended or offered for NEW RESIDENTIAL Et SQPf. sale.If,however the bu' mgorimprovetnent is sold within one unrofcompiction,Ihe SQ.FT FLOOR AREA $/SQ.PT. owner-builder will h the burden of proving that he did not build or improve for pur- poseof,A. - ❑I,as n 'r the propeny,am exclusively contracting with licensed contractor,to TOT ns¢ t dig JCCI(See 9IW4 Bostnese vnd Pmfssiovs Code 7 The Contmemr s U - nseL .not apply to a a owner of ,.,,y who bolds or-mprovostherean and QTY. �PLUMBINQ PERMIT FEEL ho to utforeuch pretax with d emoomm(O licensed pursuant o the Contractors - Lt om Use, ` PERMITISSUANCE amexempluader Sec. ,B&PCfnnhis reason ALT['R-DRAIN&YEAH-WATER(BA) VALU�N er Ding /� air,.WORcoCOMPENSATION DECLARATION BACK FLOW PROTF.Cf.DF.VICF. 20 000 I hereby orude, penalty of per]ury one of the following dwlaio mnv: ' f:lhaveand will maintuinu C¢rti Tiwk of Censenl In self-in.vure for Wnrkc,,C..Nh DRAINS-FLOOR,ROOF AREA,COND. STORIES TYPE CONSTRUCTION station,as provided for by Section 37M of the Labor Cade,for the performance of the work for which this permit is issued. FIXTURES-PER TRAP I have and will maintain Waders Comperto0on Insurance,as required by Section - nflheLnMaCodafarNepednmmncanfm itsforwIt hthta eml t is issued. GAS-EA.SYSTBM-I INCA WTLETS �7 OCC.GROUP A My Work pyy carrierolic Policy- _ Carrier: - Policy No.: GAS-F.A.SVSTF.M-OVF.R4(EA7 © „ / D W //�� C¢R¢T�CAyF F. P O WORKER ' - IO I Kfa P117L i GR ASF INDUSTRL WASTE INIERCEP'I OR ( coon cod no'iYo"e'k/ p n if'hha'rl' nes l^o'ronehundmd do en($I(Nq ° r e j' - ,BUILDING DIV ISI'QN PyE3 GREASETRAP Q e nr Inss.) PhANCHF.CK FEE f oenify thvtinthe perfarmoneeofthe work for which thispennit ixisaued,lahall SEWER-SANITARY-STORM FA.200 FT. not employ any person in any man rs ubjmltothe workers'Cme'sch-_ ENERGY FEE ZZ cation Laws of Cid omia.Dole WATER HEATER WIVdM/ELEC R Applicant ( GRADING FEE rayj NOTICE TO APPLICANT:If,ate g Iris ciourwate of Exnnptinn,you should WATER SYS'1'EMA'RBA'1'INC aF•+ become subject to the Worker's Compensation previsions of the Labor Code,you must SOILS ITE G11 forthwith comply wilhsuch provision,or this Permit aholl be deemedersked, WATER SGRVICE Q L CONSTRUCTION LENDINQQAA6NCY NEW RESIDENTIAL PLMB. SQ.FT PAID I hereby affirm that Ihac is a conswdmyyJJtTdrtg agency[or Ihe performencoe[ Receipt N us the work for which this permit is issued(S (.T097,Civ.C) r Q ULender's Name TOTAL: Lender's Address TOI L: -� I certify shat I hoveis applico[ion and state Ihat he shove in rich is - „ BUILD P /� �i y conect.l agreemcomplll city and coumy ordinances and stem laws relating to QTY. MECHANICAL PERMIT FEE g U Z building co/,Z' herebyamhorizerepresenmtiveaoFlhiscitymcnle......he t , SEISM F vlwve-memlyforirepmtinpurposesPERMIT ISSUANCE(Weindemnify and keep harmless the Cily of Cupertino against J c ELECTRIC tP.Eliabilities,jastsanit expense,whichnayinanywayanchor against said City ALTER ORADD TO MECH, PLUMBIN FEE.inconvegoanting of this permit - APRSTA' WILL COMPLY WI:}I ryl/N�IOT AIR HANDLING UNIT(TO Ig000CPM) MOCHA CATTLE S EI 1 .A ONS. Yy' 1/44 ( /� AIR HANDLING UNI'I'(OVER 10,000 CFM) CONS TR ION TAX ig atureof pltcarriOnincmr �7 Dote EXHAUST HOOD(W/DUCT) H011SINO MI 'GATION FP.B HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle haramous material HEATING UNIT(TO I u.000 BTU) ZO , as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safely •,S ti,.25532m)/ "��//n�I HEATING UNIT(OVER 100,0(10 BTU) ❑Ys )On. PAID T1-' VENTILATION PAN(SINGES RESID) Will theapplicant or future lendingcecu and ave a tent or devices which - Dale Rec p �it retentions un ntaminants as defined by the Area BOILER-COMP(3HPOR 10Q00r BTU) y y Quality Management T Dlvtnc@ ❑Yes WVy.�nBOILER-COMP(OVER 1(1(1,000BTU) . ' I have read the hatadm s mulemils repurcntenti under Chapter ti 95 ofine Cali- AIR CONDITIONER ISSUANCE DATE pompHealth,&Safely Cade Sections 25505,25533 and 25534. nti J NEW RESIDENTIAL MECH. SQ,PI'. / bvit ere y e a tenant.lam it is my responsibili }';�l{�''tk outl _ cw Im ma prior,to issuance'of.Ce t mor p -iY14 Own o onzedagdt � Uat TOT L: P Z ISSUSD dY: OFFICE ~