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26715 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY CITY OF CUPERTINO PLUMBING.- E PI:RMff Ivo. B41II,DING DIVISION APPLICATION/PERMIT PLUMBING PROJECTIDEN GFIAL 26715 BUILDING PR(3dEC'f IURNTIHICA'I'ION BUILDINGADDRESS: SANITARY NO. APPLICATION SUBMITTAL DATE ©l OCI ` 61- VU UNIT# LOT# PHOItb RACE R'S p//MJE'� �{/!� 1•J�/ 1 ARCIII Lam/' LIC NO: _� ADDRESS 999 ��/�i � ! ©-3 / N/C C OL CoNTACD PHONE: $` �,-I k, a a �q''=`=' O'tx'BUILTDING PERMIT INFO QTY',e:,,`n;'43d.-BLE TRIC'PLERMIT FEE '' BLDG ELECT PLUMB .0 PERMIT ISSUANCE ❑ ❑ 11 LICENSED CONTRACT'OR'S DECLARATION APPLIANCES-RESIDENTIAL O=Z I hereby affirm that l am licensed underprovisionsofChapter9(commencing with TOB DESCRIPTION FOOk-. Sec tim17K(dafDivismn3ofthefLeareatandoodessionC �d�(![�ylicmmisin PANELS IVU full force undeff Li<.# 0✓ UPT0200AMPS �Zpy Llrens loss n D e Commcmr /� 201-1000 AMPS Z O ee ARCI11 CE E SQ.FT.FLOOR A EA S/SQ,FT. Ie d pl s hall u. as oras. OVER 1000 AMPS FSIGNS ELECfR1CAl Q sed Profen. nu Lq� OWNER-BUILDE ECLARATION SPECIAL CIRCUIT/MISC. xxOa 1 hereby affmt Not 1 am exempt ons the Conracims License Law for the W 3 a y following reason.(Section 7031.5,Business and Professions Cade:Any city m county TEMP.METER OR POLE INST. CayOeeQ which requires a permit to comwct,after,improve,demolish,or repair any structure POWER DEVICES K y"1Q� prior.its issuance,also requires the applicam for such permitw file a signed statement ty�n O p that he is licensed pursuant to the proviaions of the Cmancemr's License law(Chapter d y�eff 9(commencing with Section 7")of Division 3 of the Business and Professions Cade) SWIMMING POOLELECIRIC VALUATION ly_y or that he is exempt herefrom and the basis for the alleged exemption.Any violation of OUTLETS Q Section 9031.5 by any applicant for a permit subjects the applicant TLS- o a civil penalty of FIXTURES , $ O not more than five hundred do1lms(5500). NEWRESIDENTIALELECTR5 .17. 4'�� ❑ I,.sawneroflhepropen,ormyemployeeswiNwagesmtheirsolec=Nnsauon, Q STORM'S TYPE CONSTRUCTION a3— will do the work,and thesuucures not imendedoraffered fars.le(Sm.7144,Business and Professions Cale:The Comracmr's License Law does not apply to an owner of property whobuilds nrimproves theme ,and whodoes such work himselforthrough his own employea,provided theuuchimprovementsme nminteadedoroffercdforsale.If, OCC.GROUP RES.UNITS however,the buildinger improvement is sold within one yerrofeempletion,the owner- TOTAL: builder will have the burden of proving that he did not build or improve for purpose of scale. ❑)1,its owncrof the property,am exclusively contracting with licensed contractors to QTY. ",;PLUMBING PI?RMIT a FEE I7LOOD ZONE' APN $'. newer w project(Sec.ouna Business and Professions Code:)The Convenor's License trawdforsucapply roj monith.manaroony whobuildsorimproveethemogand PERMIT ISSUANCE: who commas forsuch projects with a conwctorts)licensed pursuenuo the Contractor, Liccns Law. ALTER-DRAIN @ VENT-WATER(FA) FEE SUMMARY ❑ 1 ant exempt under Sec. ,B&P C for this ressonUTSIDE rEE. BACK MOW PROTECT.DEVICE SANITARY YN Owner Date RECEIPT# DRAINS-FLOOR,ROOF,ARFA,CONU. WORKMAN COMPENSATION DECLARATION OOL TA% Y ❑ Ihertby affirm thstlhavescenificme of conunno self-insure.ore urtifcam of FlXTURE.S-PER TRAP RECEIPT# Workers'Compensation Insurance or acenilied co pyrhereof(St 3800,Lab C.)which ARK PEE Y N rsallemplaye' rid / GAS-rA.SYSTEM-I INC.40UTLEfS RECEII Is Pol'my# C BUILDING DIVISION FEES ❑ Certified copy is toren fimrste . `�..�—"l��rr f - HECK FEE ❑ Certified copy is Ilea with Ne city inspection division. r'L;INTERCEPTOR GRADING FEE CERTIFICATE.OF EXEMPTION FROM WORKERS' GREASE TRAP '90BSFEE COMPENSATION INSURANCE (This section need not be completed ifthe permit is for one hundred dollars(SIX) SEWER-SANITARY-STORM EA.201 ENERGY FEE or Tess.) I certify that in the performance ofthe work for which this permit is issued,)shall WATER HEATER W/VENT/F.LECTR net employ any person in any manner so as to become subject to be WorkersPAID Compensation Lawsof Califamis. Dam WATER SYSTEMTREATING Dam Receipt# O Z Applicant 7-. 0 NOTICETO APPLICANT:If.after making this Certificate of Escntption,you should NEW RESIDENTIAL PLMIL SQ.FT. 'TOTAL: y become subject to the WorkersCompconation provisions of the labor Code,you most I"-' ; forthwith comply with such provisions or this Permit shall be deemed revoked. BUILDING FEE a r {2.1 CONSTRUCTION LENDING AGENCY SEISMIC FEE zhereby affirm that there is a construction lending agency for the performance of O she work for which this permit is issued(Sm.3037.Civ.C.) TOTAL: ELECTRIC PEE u, Lender's Name T"' b 's - �- ' � x t - � PLUMBING FF.F: F Lender's Address Q - MECHANICALPERMIT°. SEL U I cenifY that I have read this application and state ],at the above information is "q - ECIIANICAL IrIiE correct. (agree to comply with all city and county ordinances and stem laws mletingm PERMIT ISSUANCG buildiagconnruction,and hereby authorize representatives ofthis city to enter upon the U anocr-rum toned proxCONS'1 RUCTION TAXperty for inspection purpos. ALTER OR ADD TO MECH. Ud (We)agree m save,indemnify and kap harmless the City of Cupertino against Iiohilities,judgmenu,coas and expenses which may in any wayaceme against said City AIR HANDLING UNI'1'(TO 10.000 CFM) in consequence of the Bantu,of this Permit. AIR HANDLING UNIT(OVER 10,000 CFM) Signature of ApplaurrojContmcmr Date EXHAUSTI WOO(W/DUCT) PAID ' HAZARDOUS MATERIALS DISCLOSURE HEATING UNIT(TO 100,000 BTU) Data Receipt# Will theapplicart or future building occupautaore or handle hmardans material BEATING UNIT(OVER 100,000 BTU) 'TOT ,. as defined by the Capetian Municipal Cade,Chapter 9.12,and the Health and Safety Code,Section 25532(.)4 El Yas 13 No VENTILATION FAN(SINGLE RISID) Will the applicant or fuwrc building wcupunt use equipmem ordevices which emit BOILER-COMP(311P OR 100,0110 BTU) ISSUANCF.D E vendors air contaminants as defined by the Bay Arca Air Quality Management BOILER 100,000 BTU) p district? ► D ❑Yu ❑No NEW RESIDENTIAL MECH.—SQ.FT. I have read the ham it marrows requital ems and,Chapter 6.95 of the MAY41 ,U Cnlifnmia Head &Safey CW e,Sections 25505, 533 and 25534. 1 understand Nat /r �r the bniOccur cYi <urtentlY haves mnank@ it is my ms onsibiliry to nothe C//` f occupa I u'ements which mu t b prior ace n ani t e a Ownero nthorimd.,ard V Data TOTAL: ISSUED BY: CITY OF CUPERTINO PERMIT'No 26715, ^6715, IIU;A,DING DIN'ISION BUILDING PROA,,c f IDEN"H FICATION VIII LDING ADDRI[SS: SANITARY NO. APM.IG\TIONSDIIMITI AL DAT OWNERS NAME: PHONE : . C'ONORACIOR'S NAME: LIC NO:, NIC CONIROLp 1 RCIIIIECIn-NOISEER: LIC NO: ADDRESS ❑ BUILDING PERMIT INFO INSPECTIONS DATE INSPEC. INSPECTION RECORD BLDG eLLcr Pl.pam wpf FOUNDATION/PIERS/H.D.S. NOTE: ALL GRADING AND DRAINAGE El F-1 El '❑ ' . UFER GROUND SHALL BE INSTALLED TO COMPLY WITH JOB DESCRIPTION THE APPROVED PLANS AND CITY OF PAD/SET 13ACK-CI-RT CUPERTINO STANDARDS. GARAGE SLABS/I'Ii EG U NI T POUR NO CONCRETE UNTIL ABOVE IIAS BEEN SIGNED INSPECTION SPECIAL INSPECTION D\.I'I: INSP. IJ N D1312G 120 L1 N D/SLA B REQUIRED ❑ PLUMBING ELECTRICAL DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED PLUMBING MECHANICAL ELECTRICAL FRAMING VENTS INSULATION PLACE NO SUB M- OOR UNTIL ABOVE HAS BEEN SIGNED ROOF SHEATH/DIAPHRAM PLUMBING TUBS&, SHOWER PAN MECHANICAL ELECTRICALMOOL BOND 'RAMING/STAIRS/E.EGRESS INS[JI-ATION/VENTILATION COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED EXl'ERIOR SHEAR/HOLD DOWN INTERIOR SHEAR/HOLD DOWN SHEEIROCK/SIIEETROCK SHEAR EXTIiR[OR LATH/W-SCREEN SHOWER LATH NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED SCRATCH COAT SEWER/WATER TEMPORARY APPROVALS BUILDING ELEC'T'RICAL GAS FINALS GAS TEST GRADE.- FIRE RADEFIRE APPROVED FOR OCCUPANCY ❑ HANDICAP TO ARRANGE INSPECTION ISSUANCE DATE CALL AFTERNOONS(12:30 PM -4:00 PM) ELECTRICAL/ENERGY 252-4505 MONDAY TO FRIDAY 24 HOURS PLUMBING/ENERGY BEFORE REQUIRED INSPECTION. JOB AD- P A I D DRESS AND PERMIT H ARE NEEDED WHEN IECFIANICAL/ENERGY PHONING. RRryyi 1 .y UII-DING/ENERGY ATTENTION CONTRACTORS: f�!!f E S L �,q9� ELECTRICAL FINAL TEST NO PERSON(S)SHALL PERFORM WORK ON THIS JOB SITE WITHOUT WORKER'S OCCUPANCY OF BUILDING IS NOT PERMITTED COMPENSATION INSURANCE. UNTIL BUILDING FINAL IS SIGNED BY BUILDING , IMPORTANT! . INSPECTOR. PLEASE READ REVERSE SIDE BEFORE r CALLING FOR FINAL INSPECTION! ISSUED BY: APPLICANT'S POSTING COPY