24436 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
Building Project Identification PERMIT NQ, 4 4 3 6
BuIIianz IFA R/� nb
C.R SO/
M4 at� l IC4�VL S £ a S I CITY OF CUPERTINO-BUILDING DIVISION 1 A 3 pAZ
Cmumider's Name: APPLICATION / PERMIT 1 l
BNLDINC MF.CTRICALPLUMBING-MECHANICAL CATEGORY CONTROL M
Ar ted/Fs nae Lk.Na
'I' S r 1• BUILDING PERMIT INFO
y,, QTY ELECTRIC PERMIT FEE
Address 395170 S T 0 DE 5wli 209 ` PERMITISSUANCE �j D
K 5z
LICENSED CONTRACTOR'S DECLARATION �y '00—
Iherebyaf(Irm that l am licensed under prmisionsof Chapter 9(..cc- APPLIANCFSRESIDENTIAL JOB DC KIVTIO
Ingwlth Sedlon 70(0)of Dlvlslon3 afthe Bualnessand ProfesslonsCedgand my
Bcense is in fail force and xl# I PANELS 8 �C�v
0.1nseC a Lich l /
Date _ Contractor
ARCHITECT`S DECLARATION OVER
PS
a0�uOC (understand my plain shall be used as public records OVER 1000 AMPS SQ.Fr.
/FLOOR AREA f/SQ.FC.
0 Licensed Professional SIGNSELECTRICAL
OWNER-BUILDER DECLARATION SPECIALCIRCUIT/MISC
Iherebyafflrmthatlamexempt fromthe Contractor's License law forthe
pqq following reason.(Section 70315,Business and Profenlons Coda:Any dtyor TEM
Q/
k `bq county which requires a Fernald rommanact,alter,Improve,demolhh,ormpalr P.MlI'PROR POLE(NST. oD
g anystrochme pdorto Its Issuance,alsorequires theapplcant(orsucb permit to
file a signed statement that he limned pursuant to the pmm vlaoof the POWER DLV CTS
0 F
u, Contractor's Lkeux,Law(Chapter9(comelthSect1on7000)olDivl-
3 O�i (commencing with SWIMMING POOL ELECTRIC
s theat. 3 of bass for
Buelneu and Profption. AnyCadrorthat lation f exempt therefrom and VALUATION
the bash for the alleged exemption. Any violation of Section 7031.5 by anyQ
applicant fare permit sobjectsthe applicant to a civil penalty of not more than UTLETSSWITCHFSFIXTURES 6 g7 7, D
6 C"C
five F11,ashundred
wner ofthe pro NEW RPSIDFNTIAL ELECTR_SQ.F1'. STORIES TYP� 7R TION
F1 1,as owner of the property,ormyemployees with wages r 1Mtr sole AA
compeneaHon,wllldothc work andthestmdurc boot Intended or offered(orn
J O Bale(Sec.7044,Buelneu and Pro(emloru Code:The Connactols Licerua Law 'I 1, I A
6iS$ does not applytoenownero(propertywho nImparImprovestedthaLand R
0.0. whorl of apply
sucto an owner ortheough operty en builds rimprravidedecon such
improvements arc not Intended aroffemd far wale.If,however,the building ar T
Improvement b sold within one yearofcompletWM the owner-builderwilI have
t3�o uNeno(provingthe bedkl notWld orI.p waf.rpurpxxsof.I..). QTY, PLUMBING PERMIT FEE ,DDD zoNE A
M1,as owner of the property,am exclusively contracting with licensed PERMIT ISSUANCE E r IA.dB
CC
contractors to corotract the project(Sec.7044,Business and Profmoloru Code:
The Contractor's Lima Law does net apply to an owner of property who ALTER-DRAIN&VENT-WATER(EA)
bWilds or Improve,thereon,and who contracts for such plo)ects with a
�N[ador(q flamed pursuant to the Contractor's License Law. BACK FLOW PROTECT.DEVICE FEE SUMMARY
(_f I am exempt under See B k P C for this masonOUTSI DE FEE 5
Owner Date DRAINS FLOOR,ROOF,AREA,COND. SANITARY Y N
WO RK MAN COMPENRECEIT kSATION DECLARATION FDiTURESPERTRAP �+ SCFIOOLTAX Y N
❑I hereby,((Inn that 1 have a certl(late of consent to seimmure,or a RECEPT M
cartiflate of Warkars'Compematlan huuranre ora artifkd nopythcreuf(Sec. GAS FA.SYSTEM-1 INC.4011ITkT5 PARK FEE Y N
3800,fab C.)
Policy p RECEIPT 4
GAS IA.SYSTEM-OVER Com any BUILDING DI VISION Fr.IS
ertlled copy is hereby with the
city CREASE/INDUSTRL WASTE INTERCEPTOR PLANCHECK FEE
1�3a
Certified copy k filed with the city inspection division.
CERTIFICATE OF EI(EMPTION FROM WORKERS' GREASETRAP PAID 8
COMPENSATION INSURANCE SEWER-SANITARY-STORM EA 200Rf Date Recei t#
IThlseectlon need nor be completed lithe permit Bfarane hundred dollars
(8100 aoless.I WATERtfEATERW/VENT/ELECTR O ENERGYFEE Y_ N_ 6-S:
I rti(ythat In the performance of the work forwhkh this permit b Issued, 71
I shall not employ any person In any manner at ae tr become subject to the WATER SYSTEM/TREATING
W plica Compensation laws o(GII(omb. Date PAID
O Z nppuant Date R i t#
1Z O NOTICE TO APPLICANT-.]L after making l his Certificate of Exemption,you NEW RESIDENTIAL PLMB. SQ.FT.
should became subed to the Warkers'Comperueson provislomof the Labor T AL: 0
VT Code,you at forthwith complywlthsuch provisions arthls permit shall be BU a d0
deemed revoked.
W O CONSTRUCTION LENDING AGENCY .EE 6 s
a Z Ihembyafflrm Mat there is a construction lending agency for the pariorm, A -LE TRIC
D O anceoftheworkfor
which permit (Sec.3097,C1v.C.)
U c^dere Name PLUMBt GFEE
ly F LendersAdde, QTY. MECHANICAL PERMIT FEE MECH 1 CA'E
O W EE V
Iartlfy that l have read thisapplcationand statethatthe above Information
1 bcornat.l agree to comply with al dtyand ar.myordinanas and state laws PERMIT ISSUANCE FEES PA D:
_ W relating to Wilding construction,and hereby authorlas representatives of this
(— U) city to enter upon the above-mentioned property for Impedlon purposes. ` ALTERORADDTOMECH. Date t'1�6(We)agree to save,Indemnify an d keep harmless the City of Cupertino against llabiBties,judgment ste and expenses whkhmaylnanywayaoatue, AIR HANDLING UNIT GO 10,000 CFM) SUagainstacid ItyInnon of the grant g ofthispermit. AIR HANDLING UNIT(OVER 10,000CFM) CONSTRU TIONIgnatu pplican/Contractor Date EXHAUST HOOD(W/DUCT) CONSTRU IONHAZARDOUS MATERIALS DISCLOSURE
Wlllthe applicant or future building occupant stare or handle haaardom HEATING UNIT(T0100,000 B ) Date material as defined by tM Cupertino Municipal Cade,Chapter 9.12,and the
I lealth and Safety Code Section 25532(a)? HEATING UNIT(OVER 100,000 BTU)
❑ Yes Lj No
Will the applicant.,kind.building ocmpant use equipment or devlae VENTILATION FAN(SINGLE RESIIJ) ISSUANCE DATE
which coat haeardous air contaminants as defined by the Bay Area Air
Quality Management District? BOILER-COMP GHPOR 100,000 BTU)
Yes ( J No
I ave read the haram�ous materials requirements underChapter6.95of BOILER-COMP(OVER100,000 BTU)
the California Health&Safety Code,Sedlotn 25505,25533 and 25534.1
understand that lithe building doesnot mrmntly have a tarsal,that it 14 my NEW RESIDENTIAL MECH. SQFr B
nsponsibWty,to notify the occupant o(the requlrementswhich must be met FEB ��
prior to issuance of a Cartlf cam ofOccupanry. �l+
Owner or authorlred agent Data ISSIIE'D
TOT
OFFICE COPY
i
— DESIGNS
APPROVED
12 MMMOCE WITH THE CITY OB rbc STf}N1�1� MDQ 1 ftorJ
rNO CODES AND ORDINANCES
10382 MIRtE VISTf�'
071E C�lP> RTIe to / Cft 1504
=Eb
Tlhtes to of p'sas and specifications MUST
be W on the jab at all times and it is un �t 1�M1 T 244 3�
Il2tOM to =M any changes or alterations
Oa same without written permission from
tL*p414:n fie L. City of Cupertino.
6 flte a'.a np.ng ct t is plan and specifications
Y D•D PocV(iuty�8)aE RkDhA?I.YI f'� ea h 'd to pe mIt' r to be an
FLOOR- TNllb\WG +pproval a the vi :latfon �` E7,iSbf�G�isi s Zx4 S'fu05 @ Ib O.C•
,f Inv C" O dl:!n ice or . tate Law.
6K6� t10 kLkLMeStk
'N
6MiL t/hpop, nARRiEf P, 1 D•F MuDSILL
(B)Conk.SL it lb
O O O
• o /i x 10
' tIEO COAgETE FT6,
12..E fSElov.1 �i
U�OIST
0 So1L-
3'�CLR.
. IED ` — �4 roe � �ana1, ��T• II
REVS IZ( o HEWED
OFFIRLIWECIPY MAR 2 2 1993
BLDG. INSPECTION DEPARTMENT
CITY. OE CUPERTWO
rJ�w foo r)AU 6M5T-W (.s Plf-T-iO SLA-3
834 Main Street, Santa Clara, California 95050 (408)374-6580 r
Specifications
Zone control specifications
Pump: 115 VAC, 1.0 amp, 1/25 h.p.
Normal Output:90°F to 140°F.
Maximum Fluid Temperature: 180°F.
Control Circuit:24VAC.
Maximum Operating Pressure:30 psi.
Tubing specifications
Tubing:Thermosplastic made to
ASTM D 3309.
Design Rating: 100 psi at 180°F
Dimensions: Nominal 3/5-inch inside
diameter, 1/2-inch outside diameter.
Lengths:Up to 200 feet/circuit.
(See manufacturer's specifications for
larger diameter tubing.)
Therma-Floor specifications
Function: Interior underlayment,not a
wearing surface.
Compressive Strength:Up to 2,500 psi
(modified ASTM C472).
Point Loading: Up to 2,000 psi.
'k'Factor:4.96 BTU/sq.ft./hour/oF/inch
. thickness.
Thermal Resistance:0.208 BTU/hour/
sq. ft./°F.
Specific Heat: .224 BTU/Ib.—°F @ 85°F.
Weight:At 1Ya",less than 12 lbs./sq.ft.
Dry Density:Typical density is 1151bs./
cu.ft.
Minimum Depth: 1 1/4inches.
Maximum Temperature: 150°F.
Maximum Operating Temperature: 140°F.
Thermostat specifications
(for heating system applications)
Electrical Rating,24 to30VAC.
Heat Anticipator Setting, Factory set.
H 0 T W A T E R
I�I�1 ,AAA
� iiV�Ic
HEATING SYSTEMS
For more information, contact:
Gyp-Crete Corporation
Listed with Applied Research Laboratories,Miami,Florida. 920 Hamel Road
of authorized
Heating Systems are installed by a nationwide network
P.O. Box 253
of awnodxea aealera. Hamel, Minnesota 55340
Thermi lnnoor,and the associated logos are the (612)478-6072
trademarks o1 the Gyp-Crete Corporation,Hamel,Minnesota FAX: (612)478-2431
Q 1957 Gyp Crete Corporalion(Revised 11/91)
Printed in U.S.A.
6020