20338APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALL POINT PEN ONLY
Building Project Identification
Building Address:
PERMITNO.
f1 O
10100 Torre Ave. Unit 138 (B1)
G 3
nen ane: ane:
CITY OF CUPERTINO-BUILDING DIVISION
APPLICATION / PERMIT
5/10/90
Contnnor's Name: Lic. No:
BUILDING -ELF MCA PLUMBING-MECFIAMCAL
CATEGORY
CONTROL
Architect/Engineer. Lk. No:
QIY ELECTRIC PERMIT FEE -
BUILDING PERMIT INFO
Address
ly
PQthUTI55IlANCE12
LICENSED CONTRACTOR'S DECLARATION
Ihereby a ion that I am n7DW)o(DtAlcensed heorder Busiprovisions
wand sot Chains ails an en
IngwBh5ecilon to. and effecn3o(IhebudneumdPro(euionsCode, and rtry
license Is Ins forteandellen.
APPLIANCES -RESIDENTIAL
JOB �
••�F
S
PANELS
License CMss Lics
RCB
Date Conhactar
UP TO 2DOAhTS
301-1000 AMPS
ARCHITECTS DECLARATION
I understand my plans shall be used u public records.
OVERI000AMPS
SQ. FT. FLOOR AREA
$/SQ.Fr.
SIGNSELECTRICAL
Licensed professional
1, 398
74.92
5PFfIALCIRCIIT/MISC
OWNER -BUILDER DECLARATION
I hereby of irm m that I aexempt fromthe Commotorn License Law torthe
TZ4P.MMIRORPOLEINST.
following resson.(Section 70315, Business and Professions Code: Any city or
county which requires permit to comtroM alter, Improve, demolish, or repair
any structure prior to its Issuance, also requires the applicant for such Parrott to
file a signed statement that he Is licenced pursuant to the provisions of the
Contractor's License Law (Chapter 9(mmmeneing with Section 7000) of Divi-
sion 3 of the Business and Professlom Code) orthat he b exempt therefmmand
the basis for the alleged exemption. Any violation of Section 7031S by any
appfiant for a permit subjects the appacanHoa dvil perulty of nn come fluor
POWER DEVICES
POOL
OUILETSSWIICHFSFIXTURFS
$104,738.00
live hundred dollars (.SS00),
MI, as owner of the property, or my employees with wages as their sole
NEW RESIDENTIAL ELECTR SQFr.
STORIES
TYPE CONSTRUCTION
componestlon, wRldothe work and theswcture Is not Intended or offered for
vie (Sec 7014, Bt dins and Professions Code: The Contractors License Law
V—N
does not apply to an owner of property who Wilds or improves thereon, and
who doessuch work himself orthrough his own employees, provided that such
OCC.GROUP
RES UNITS
Improvements are not Intended oroftered for sale, If, however, the building or
Improvement b sold within one yearof completlon,the owner-bu0derwBl have
tFlLtlorden of proving that he did net bund or Improve for purpose ofule.).
Lf L as owner of the property, am exclusively contracting with licensed
contractors to construct the pmject (Sec. 7044, Business and Profession, Code:
TOTAL:
QTY; '.;'j; <; PLUM91NGPERMIT FEE
R-3
I
FLOOD ZONE
APN
PQtMIT ISSUANCE
19
The Contractor's License Law dm not apply to an owner f,property who
builds or Improvesn
thereon, and who contracts for such p(ojea with a
c%4.etm(e) licensed pursuant to the Contractors License Law.
LL -)I am exempt under See. B Is P C for this rcaon
ALTER -DRAIN kVENT-WATER VENT-WATER(EA)
FEE SUMMARY
BAIX FLAW PROTECT. DEVICE
DRAINS FLOOR ROOF, AREA, CONTI.
SANITARY RECEIPT
Owner Data
WORKMAN COMPENSATION DECLARATION
QI hereby af(Inn that I have a artlfkute of consent to eum
el(-Inre, s
certl(late ofWorkers'Compemdlonlmuranceoraartificd copy thereof ($ec.
3800,1ab C.)
Policy
PDITVRFS VER TRAP
SCHOOLTAX Y_ N_
REGEIPr I
GAS EA. SYSTEM -1 INC.4 OUTLETS
PARK FEE Y N
RECEIPT
C.
GAS EA. SYSTEM -OVER 4 (EA)
BUILDING DIVISION FEES
ified copy It herebytehed.
ertilied copy b filed with the city inspection division.
GREASE/INDUSTRL WASTE INTERCEPTOR
PLANCHECKFEE
GREASE TRAP
CERTIFICATE OF EXEMPTION FROM WORKERS'
PAID
COMPENSATION INSURANCE
(Thissectbn need no be completed If the pernot isforone hundred dollars
BEWER-SANITARY-STORM EA 2(XIFC
Date RCCCI t#
WATER HEATER W/VENT/ELFiCTR
ENERGY FEE Y_ N
($100)miess.)
]artlfythat In the performance ofthework forwdchthis penult b issued,
WATdt SYSTEM/TREATING
I shall not employ any person to any manner an as to become subject to the
Workcn'Compenutlonlawsof Callfomla. Dale
PAID
AppilciNOTICE
NOTICETO esubjeANthe after making this Certificateproisomoftof the
should become subject to the Comp Lab or
NEW RESIDENTIAL FLMS._SQFT.
Date Retlsl t#
'
TOTAL:
13UIL12ING FEE
6`37
rovisinprovbis permit shall
Code, you must forthwith amply witA such proWbm or this pertNt shill be
ply with
deemed revoked.
CONSTRUCTION LENDING AGENCY
SEISMIC PEE
-nn
I hereby cfflooork f Wtthem bammit It tion Wodedingag7,Civ. .) perform,
Lend in the work for which this permit b lowed (Sc. 3097, Civ. C.)
lender.NamePLUMBING
Lender. Aaarees
I artifythat I have read this appllationand statethattheabovelnformatlw
bmrren.I zgnoto comply with all city and county ordlnanms and state laws
TOTAL:
ELECTRIC FEE
46-95
FEE
MECHANICAL FEE
_Q5_
49
QiY. MECHANICAL' PERMIT' ' PEE
PERMIT ISSUANCE 1Z
FEES PAID:
relating to building comtrocilon, and hereby autho tee representatives of this
city to enter upon the aIxwennmtiored property for Inspection purposes.
Mr) agreeto save, indemnify an d keep harmless the City of Cupertino
against liabilities,judgments, mstaand expensss which may In anywayaccue
ALTER OR ADDTO MECH.
Date Retei t#
P
AIR HANDLING UNIT CIO 10,000 CFM)
SUBTOTAL:
.gains vid Cy co ones t gra ing of thla permit.
TDite
AIR HANDLING UNIT (OVER IO,lDO CFM)
CONSTRUCTION TAX
Signature of Applicant/Contactor
E(HAUSTHOODM/DUCT)
CONSTRUCTION TAX PAID:
FIAZARDOUSMATMALSDISCLGISURE
HEATING UNIT (TO 100,000 BTI)
-
Date Recei t#
Will the applicant orfuture building occupant store or handle hazardous
material as defined by the Cupertino Municipal Code, Chapter 9.1 3, and the
Health and Safety Code Stolon 75532(a)7
No
HEATING UNIT (OVER 100,00) BTI)
TOTAL:
Q ,ZD
VENTILATION FAN (SINGLE RESID)
ISSUANC-EE DATE
I�[('-'' J
RYes
ill theappBantm ture building occupant use equipment or devices
which rood,a
t hardous air contaMuntsas defined bythe Bay Area Air
QualdyMamgemxm Db❑❑trin7
No
1haveQ Yesreadthehaudo smaterials requirenwritsunderChapter6.95of
BOILER -COMP OHPOR 100,000 BT()
BOILER COMP(OVER 100,000BTU)
the 011f.M Health A Safety Cod, Sections 25505,25S33 and 25534. I
understand that if the building does not currently have a tenant, that It bmy
responsibility to notify the occupant of the requirements which most be met
City of rB09(Ijlq
NEW RESIDENTIAL MECH. SQ.Fr.
prior to Issuance of a Certificate of Occupancy.
ISSUED
Owner or authorized agent Data
TOTAL:
OFFICE COPY