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20330
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALL POINT PEN ONLY Building Proed Identification Building Address: PERMITNO. 20330. 10100 Torre Ave. Unit 130 (Kl'.1) corsName: one: PropertiesTo�jn Center CITY OF CUPERTINO-BUILDING DIVISION APPLICATION / PERMIT AFFLICA [ION SUBMIl IAL 5/09/90 ' Contractors Name: LIe. No: BUB.DINGELECTMCA4PLUMBING-MECHANICAL CATEGORY CONTROL# - Architect/Engineer. Lis N. QTY ELECTRICPERMIT FEE BUILDING PERMIT, INFO Address © FV •© PERMITISSUANCE 12 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that l am licensed under provisions of Chapter9(commere Ingwlth Se ion7W0)of DiWkw3oftheBwlneaeand ProfeslonsCodga dm APPLIANCES -RESIDENTIAL jo 0ESCAREM QN lice license Is in full force and effect. PANELS V� IIS License Clam Lk,1 B Data Contractor _ UP TO 2DO AMPS 201-1000 AMPS ARCHITECTS DECLARATION I understand my plans shall be used u public records. OVER1000AMPS SQ. FT. FLOOR AREA $/SQ. FT. SIGNS ELECTRICAL Licensed Professional - OWNER -BUILDER DECLARATION IherebyafBrmthatlamexemplfromtheCuntndoea Llcenselawfathe 713 74.92 SPECIAL CBtCUIT/MISC TEMP METER OR POLE INSI. following reason.f5ecron7031S, Business and Professions Code: My city or c ntywhlchmqulresapenmdttommtmd,alter,Improve,dem iLsh,orrepair - anystmd mpr toltsissuance,als mquimatheapp0antforwchper tto file a signed statement that he Is licensed pursuant to the provlslom of the Contradore License Low(Chapter 9(commencing with Section 7000) of Divl- Arm3 ofthe Business and Professlons Code) mthat he Is exempi therefromand ROWER DEVICES SWIMMING POOL ELECTRIC VALUATION the basis for the alleged exemption. Any violation of Section 7071.5 by any applicant fora permit subjects the applicant to civil penalty of not more than OUTLETSSWITCFIESH%7URES $53,418.00 NEW RESIDENTIAL ELECTR -SQFT. Ove hundred dollars LISW). F1 1, as owner of the property, or my employees with wages as their sole STORIES TYPECONSTRIICUON compensation, will do the work, and the structure isnot Intended or offered for sale 03..7044, Business ml Pr feslons Code: The CoMmet.e. License law V_N does not apply to an owner of property who Wilds or Improves thereon,and who does such work himself or through hisewn employees, provided that such OCC. GROUT' - ,RFS UNITS Improvements an not Intended moffered forsale. If, however, the Wilding or Improvement Issold within oneyearofcompletlon, the owneabullderwill have TOTAL: R-3 UILk+rden of proving that he did not build or improve for purpose of nbJ. L j L as owner of the property, am exclusively contracting with licensed contractors to construct the project(Sec. 70K Bushes and Professions Code: The Contractor's License law does not apply to an owner of property who Wilda or Improves- thereon, and who contracts for such pwisces with a cgnl7adw.)Bmnsed pursuant to to the Contractor's License Law. LII am exempt under Sec. B k P C for this reason QTY, !PLUMBING PERMIT FEE pT-ODD ZONE MN PERMIT ISSUANCE ALTER -DRAIN 4 VENT WATER (EA) 12 FEE SUMMARY BACK FLOW PROTECT. DEVICE OUTSIDE PQ DRAINS FLOOR ROOF, AREA, GOND. SANITARY Y_ N_ RECEIPT N Owner Date WORKMAN COMPENSATION DECLARATION C31 hereby affirm that I have • asrtUkate of consent to sel4lnarre, or certificate ofWorkeri Compensation Insurance or a certified copythereof(Sec. 3900,Iab C.) PolicyN FO(Il1I�S PER TRAP SCHOOLTAX Y N RECEIPT N GAS EA. SYS EM.1 INCAOUTLETS PARKFEE Y -N RECEBN C�any GA& F.A.SYSTEM-OVER 6 (EA) eU1LDING DIVISION FEES inspection division. (elified copy is hereby tumie city L'�C rlBied copy b filed with the cicity CREASE/INDUSML WASTE INTERCEPTOR PLANCHECK FEE CREASETRM CERTIFICATE OF OtEM PTION FROM WORK ERS' PAID COMPENSATION INSURANCE (rhat aedlon need net be completed Elba permit Is fearone hundred dollars SEIVFR-sAc-n.1•ARy-SroRM FA, maFr Date ReceiptM WATER HEATER W/VENT/ELECTR ENERGY FEE Y N - PAID (II0(fimlen.) I certify that In the pedummanceof the work forwhich this permit is Issued, I shall not employ any person In any manner so m to become subject to the Workent' Compensation Uwa of California. Date WATER SYSf{B.f/TREAl7NG Applicant NOTICE TO APPLICANT: If, after maW.g this CertBlcam of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Date Recei til NEWRESIDENDALPLMB. - SQ.FT, TOTAL: B UIL12ING FEE 432.50 Code, you =at forthwith comply with such prevIsbes or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY SEISMIC FEE 3.78 I hereby afflrmtlat there is a construction lendingagenryfortheperform- ance of the work for which that permit Is issued (Sec. 3097, Civ. C.) Landers Name Lenders Address I certlfythat I havereadthis eppliationand statethaltheabovelnfomatlon is mrr <. I agree to comply with all city and county ordinances And state laws TOTAL: ELECTRIC FEE 29.83 QTY. -'MECHANICAUPERMIT - PERMIT ISSUANCE FEE 19 PLUMBING FEE MECHANICAL FEE FEES PAID: , relating to building construction, and hereby aulhorla representatives of thio city to enter upon the above-mentioned property for Inspection purposes. (We) agree to save, Indemnify an d keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may In any way acme ALTER ORADDTO MECH. Date ReceiptiY AIR HANDLING UNIT DO 10,ODO CPM) SUBTOTAL: aga Wtsaid Inco en oting of this permit. r G AIRHANDUNG UNIT (OVER I0,MOCFM) CONSTRUCTION TAX Signature of Applicant/Contractor e D e F7(HAUST HOOD (W/DUCT) CONSTRUCTION TAX PAID: HAZARDOUSMA IALSDISCLOSURE HEATINGUMT(M 100,000BTU) Date Recei I# WOltheappliant or futumbulldleg oe<upantstore or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.11 and the I lealth and Safety CodeSSectlon25532W? ❑ Yes N No HEATING UNIT (OVER 100,000 BTU) TOTAL: 2, , VENTILATION PAN (SINGLE RESID) ISSTWAM(IR RATE . Will the applicant or future building occupant use equipment or devices which rout hazardous air contaminants as defined by the Bay Area Air Quality Management District? Yes No ihave readthe hazallom uaateriabrequirementsunderChapier6,95of A:i�'S�+� 5+'1 IST J J 1790 BOILFR.COMP OTO' OR IWM BTU) BOILER-COMP(OVER 1ro,00DBTU) the California Health & Safety Code, Sections 15505, 25533 and 25536. I understandthatlfthebuildingdoesnotmrrentlyhaveatenanLthatitIsmy responsibility to not lfy the occupant of the requirements which must be met .a City of CBQertlnn NEW RESIDENTIAL MECH, SQ.Ff. prior to Issuanceof a Certificate of Occupancy. ISSUED BY: V' Owner or authodeed agentDate TOTAL: OFFICE COPY