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HomeMy WebLinkAbout22133 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES- USE BALL P,OINT'PEN ONLY Building Project Identification - - PERMITNO. , Bulldmg Address: - - � n- ������ 2.2133 wnera SSD ;,CITY OF CUPERTINO-BUILDING DIVISION / Contractors N.me: - - Lie.No:. APPLICATION / PERMIT '� 7 'J BUILDING ELECnUCAGPLUMBING MECHANICAL CATEGORY CONTROL N ! itect/Engineer• - c No yELEGI'RICrPERIv11T 51 lrti Ell i;"1'.;xr :�UtCI�ING PERMIT:INFO '•.W S�AGLc28.��• / � „PERMITIBSUANCE - - LICENSED CONTRACTOR'S DECLARATION' - T ^ ❑ I hereby affirmthat l am licensed under piovismaeof Chap4r9(oommsm. APPLIANCES-RESIDENTIAL, JOBDESCRIPTION ingwith Se on7000)of Divbion3ofthe BusinessandpmfessionaCode,andmy licenm le in full fo and effect. • '. PANELS { �]�`, 1 r License 1m Lie. ,�'3 `� (�h.-YNTe�.� r'1� V Date '� Contractor V 'ARCHITECTS DECIJZRAf ION - - 201-1000 AMPS OVER 9',z I understand my place shall be used as public records. - - OVER 1000 AMPS SQ.FT.FLOOR AREA $/SQ•FI'. dq° l t Licensed Pmfesslorsl - ,- • ' SIGNS ELECTRICAL le�3 ' ,OWNER-BOLDER DECLARATION SPECIALCItCU1 s, IherebyafflrenthatIamexempt fromthe Contractor.Liernse Law for the ZO y a following reason.(Section 7031.5,Business and Professions Code:Any city or gEh1P,METER OR i"' Countywhlch.gltr saps twmmtact,alter, pmve,demollsh,oirepalr Y� < aoystructure Intern,its Issuance,also requimathe applicant forsuch permit to POWER DEVICES 3 re O file a signed statement that Kele Licensed pursuant to the provisicv of the 3 ti Contractors License Law(Chapter 9(commencing with Section 7000)of Divi- SWIMMING POOL EL P9EVALUATE (J {{ O sion3ofthe BusnemmdProfeeslom Code)orthat helsexempttherefromand ''11 Y3 the basis for the alleged exemption.'Any violation of Section 7031.5 by anyot OUTLETS-SWITCHES-FIXTURES v/ d O 65. 'applicant for a permit subjects the applicamto a civil penalty of nmmethan five hundred dollars($500. IN FT. �n oO I,as owner of the property,or my employees with wages'as their sok' ' NEW RESIDENTIAL ELECSQ' STORIES' TYPE CONSTRUCTION c mpensation,wfildothework,and thestmcture is not intended or offered for qsale(Sec.7044,Business and Professions Code:The Contractor's License Law • $ does not apply to an owner of property who Wilda or Improves thereon,and OCC.GROUP RFS.UMTS -. . who does suchwork himself or through hisown employees,provided that such Improvements are not intended or offered for sale.H,however,the building or, TOTAL: " Imprevementissoidwithinoneyearofeo plelon,theowner-b gderwBl have ,r , tkgkuNen of vin that he did not build or unrove for purpose of sale.), t•i'.. 'S•'Y„t?::,'•,t� u proving P P m 'Q71'.',;i'::,,.:PCUfvIBING.ELR11•IT:::�„ E:•i:'' FcooD wNE ApN L as owner of the property,,am exclusively Contracting Wlth liceneed PERMIT ISSUANCE•, contractors to construct the project late.7044,Business and Prolamines Code: F_ The Contractor's License Law does not apply to an owner of property who ALTER-DRAIN&VENT-WATER Q?N Wilds or Improves thereon, and who contracts ntracte for each pCojewith a w tr ,; ogptT+ctor(s)licenmd pursuant to the Contractors License Law.: `rr •.,FEE:;$UhfMgRX' IJ I am exempt under Sec. B&P C for this reason BACK FLOW PROTECT.DEVICE DRAINS FLOOR ROOF,AREA,COND. SANITARY Y_'N_ Owner Data - - - RECEIPT N WORKMANCOMPENSATIONDECLARATION FIXTURES PER TRAP SCHOOLTAX Y_ N_ certificate hereby affirm that I have. of consem to self-Insure,or a RECEIPT N nificate ofworke Compemationlrsuranceor.cedifiedcopythemof(Sec. GAS P.A.SYSTEM-11NC.40UTLECS PARK FEE Y_ N 3800,Lab CJ /V/.I— — ..RECEB'TN cy Y""pe ' GAS EA:SYSTEM-OVER4(FA). y � 2 BUILDING DIVISION FEES �MZified copyle hereby ff nrlshed. . PLANCHECKFEE I�CeAllied copy b filed with the dty inspection division. GREASE/WDUSIRL WASTE INTERCEPTOR CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE TRAP PAID COMPENSATIONINSURANCE r SEWER-SANITARY-STORMEA.200FT., Date Recei t# ' (This section need not be completed if the permit isfor one hundred dollars ($100)rnless.I11 WATER HEATER W/VENC/ELECTR - ENERGY FEE Y_ N_ vo 01 I mmlylhat le the performance of thework forwhichthls permit is issued, I shall not employ any person In any manner so as to become subject to the WATQ4 SYSTEM/TREATING .PAID �] / Workers'Compensation Laws of California.Date C) Z Applicant NEW RESIDENTIAL PLMB. SQ.FT:- Date• Recei t# Z'.O NOTICE TO APPLICANT.II,after making this Certificate of Exemption,you should becomesubject to the Workers'Comp ..tion provbiorenf the Labor - TOTAL: N Code,you mu at forthwith comply withnich proviskmamthls permi[shall be BUILDING •SD {!.I j deemedrev,ked. IL CONSTRUCTION LENDING AGENCY SEISMIC FEE Z I hereby affirm that there leaconstruction lending agency for the perform- TOTAL: ELECTRIC FEE Z ance of the wmkffa�rwhich this p mallets ued(See.30970,C.) ' .(� O -Lenders Name V6Nria•.. .�2.•��� a =r t •,r, PLUMBING FEE LL F Lender.Addreaa QTY.•.,;: MfiCIdAN CAL YERMCf" :y,'•.F`EE`;", MECHANICAL FEE U Icertify that l have read thteappllcation and nate that the above Information 0 L iscormet.I agree to comply with all city and countyordinances and state laws PERMIT ISSUANCE' FEES PAID: , O• relating tobullding construction,and herebyauthorim representativesofthis (— W city to enter upon the above-mentioned property for impaction purposes. ALTER OR ADD TO MECH. ? (We)agree to save,Indm enity and keep haremess the City of Cupertino - Date •r Receipt# V - against liabilities,pidgments,contained expenses which may to anywayaccrue AIR HANDLING UNIT(TO10,DOOCFM) SUBTOTAL: 16 ag t said Ci consequence of the granting of this permit. � �L� �-, ?� AIa I{ANDUHc uNrr rovER 1B,mocFM) CONSTRUCTION TAX . Sigriatureof Applicant/Contractor _ Data EXHAUST HOOD(W/DUCT) CONSTRUCTION TAX PAID: HAZARDOUS MAtERIALS DISCLOSURE - Will the a applicant or future building occupant store or handle hazardous HEATING UNIT(TO 100,000 BTU) PP P material as defined by the Cupertino Municipal Code,Chapter 9.12;and the Date Recei t# }kalth and Sa(etyC a Ilion 25532(.)7 HEATING UNIT(OVER 100,000 BTU) TOTAL: 3 ❑Yes No Willthe hacarant rebrand O as defined ndby the Bay Arordevices VENTILATION FAN(SINGLE MID) ISSUANCE u DATE which annit rirt?. mob as de(Ined by the Bay Area Air - .W 4' `K' Quality Management Dis rict7� BOILER-COMPpHP OR 100,000 BTU) --y' Yea N ve 'JUN aread the ou terlals requirements under Chapter 6.95 of BOILER-COMP(OVQt l00,000BN) the California Health&Safety Code;Seetlore 25505,25533 and 75534. I understand that if the building does not currently have a tenant,that it is my NEW RESIDENTIAL MECH. -'SQ.F'I. N.� ,4. �IY�ID 7&poisibllity to notify the occupant of the requirements which must be met CjNsaN1j W CU p' to lssu c of a Certificate of Occupancy. I - ner or a�or zed agent Date -TOTAL: ISSUED BYJ I ��•'SCC OFFICE COPY September 9, 1991 CITY OF CUPERTINO 10300 Torre Avenue Cupertino, California 95014 Reference: Apple T.V. Remodel 10443 Bandley Drive Dear Building Inspector, © John Redinger, project superintendent, has asked me DEVCON CONSTRUCTION to address Inspection Notice dated 8-22-91 with the INCORPORATED following changes: General Building Contractors 1) Sheet AT-IA: Delete detail 7-AT-4, change to 6-AT-4 . Substituting 20 gauge 3 5/8" metal studs on 16" centers for ceiling joists and add one (1) larger 5/8" gyp. board to walls. ` 2) Sheet AT-lA: Delete detail 5-AT-4, change to 6-AT-4 . 555 Los Coches Street Milpitas,California 95035 Phone(408)942-8200 If there are any questions, please call. FAX(408)262-2342 Lic.;399163 Very truly yours, DEVCO CONS RUC ON, C EVC? Bar L. Ludwig, AIA ,SED ARS Q Vi Pr sident ��C �{ L• BLL:a c 1 t `K•��'- -�yn