20356APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALL POINT PEN ONLY
Building Proem Identification
Building Address:
PERMIT NO.
% O l C C
20356
10100 Torre Ave. Unit 156 (D1.2)
G J J ilii
wars Name; one:
Town Center Properties
CITY OF CUPERTINO-BUILDING DIVISION
APPLICATION/PERMIT
5/10/90
Contnctars Name: - - Lie. No:
738-4444
BUR.DINr—ELECTRICALPLUMBINGME LAICAL
CATEGORY
CONTROLM
Architect/Engioeer. Lic-No:
QTY ELECTRICPERMIT FEE
BUILDING PERMIT INFO
Address:
IE M
PERMITISSUANCE
LICENSED CONTRAROr DECLARATION
I herebydfhm that ]am Bcenaedurderprovrdonsaf Chapter 9(mmmm
pr
inenseISectfon 7WJ)ofd died. the Buusnessand ProlnslonaCade,andm
license ie In (sal force and died.
APPLIANCES -RESIDENTIAL
JOB DESCRIPTION
PANELS
Lice.. Cless Lk.M
Data Contractor
.•
UP TO 200ANIPS
RCB
201-1000 AMTS
ARCHITECTS DECLARATION
Iundersland my plansahall be used as public records.
-
OVRR1000AMPS
SQ. Fr. FLOOR AREA
S/SQ.FL.
SIGNSELECTRICAL
Licensed Professional -
OWNER -BUILDER DECLARATIONSI'ECIALCIRCUIT/MLSC
I hereby affirenthat I am exempt from the Contrectoes License Law for the
669
74.92
TEMP METER OR POLE INST.
following masce.(Section70115, BudnessaM Pmfessions Code:Mydtyor
cmntywhkh mquima a permitrommtmc, alter, bnpmve, demolish, ormpair
anystmc mpdortoibi ame,alsomquimstheappllcaniforsuchpermltto
file a signed statement that he h m licensed pursuant to the I visions of the
Contractor's License Law (Cha pter9(emmening with Section 7000) of Divi-
sion3 of the Business and ProfessionsCode) or that he is exampt therefromand
the bash for the alleged exemption. Any violation of Section 7MLS by any
applicant fora permit subjects the applicant to a civil penalty drat mere than
POWER DEVICES
SWIMMING POOL ELECTRIC
_
OUTLEISSWIICHESFIXTURES
VALUATION
$50,121.00
NEW RESIDENTIAL ELECTR SQJT.
five hundred dollars (5500).
❑ I, as owner of the property, or my employees with wages as then sok
STORIES
TYPE CONSTRUCTION
compensation, will do the work and the stmcture is not intended or offered for
.k (Sec. 7054 Business and Professions Code: The Contractees License Law
V—N
does not apply to an owner of property who builds or Improves thereon,and
who does such work himseLforthro igh his own employees, provided that such
OCC.GROIIP
TIES. UNITS
Improvements are wt intended or offered for sale. If, however, the building or
Improvement hanld wlthinomrarofcmnpldior,theowner-bu8derwlll have
TOTAL:
.
R-3
thc*rdenofpmvingthat hedid not build orimprove forpurposeofsate).
L as owner of the property, am exclusively contracting with licensed
contractors to mnsro
tct the project (Sec. 7064, Business and Professions Code:
The Contractors License Law does not apply to an owner of property who
Wilda or improve, thereon, and who contracts for such projects with a
r7a4ador(e) licensed pumuant to the Contractors Limn. Law.
LJI are eaempl under Sec B k P C far this reason
QTY. PLUMBING PERMIT FEE
FLOOD 7DNE
APN
PERMIT ISSUANCE 12
ALTER -DRAIN A, VENT- WATER (EA)
FEE SUMMARY
BACKFLOW PROTECT. DEVICE
DRAINS FLOOR ROOF, AREA, COND.
SANITARY Y_ N
RECEEPT a
Owner Date
WORKMAN COMPENSATION DECLARATION
❑I hereby affirm that I have a certificate of consent to eelf4mure, or a
mrtificate of Worken' Compensation Insurance ora cartlf nd ropy thereof (Sec.
3800, Lab C)
FIXTURES. PER TRAP
SCHOOL TAX Y_ N_
RECEIPT M
GAS EA. SYSTEM.1 INCA OUTLETS
PARK FEE Y_ N_
RECEIPT 11
Co�any
CD.PM
GAS. PA. SYSTEM -OVER 4 (EA)
BUILDING DI VISION FOES
IRedmpyhhereby furnished.
ertlled ropy h filed Mth the city inspection division.
CREASE/INDU573IL WASTE INTERCEPTOR
PLANCHECK FEE
GRFASETRAP
CERTIFICATE OF EXEMPTION FROM WORKERS'
PAID
SEWER-SANnARY-STORM EA. 200FC.
COMPENSATION INSURANCE
(Thissectien need not be completed if the permit bforone hundred dollars
Date RCtt'1 til
WATER HEATER W/VENT/ELECTS
ENERGYFEE Y_ N_
PAID
(SI00)orless.)
I cartify that In the performance of thework forwhich this permit is Issued,
I shall am employ any person in any manner so as to became subject to the
Workers Compen.danlawaof Califoenb. Data
WATER SYSTFAf/TREAnNC
ApplicaNOTICE
OTICE
NOnCETO APPLICANT: a after making persationlateof Evemptb Labor
Lab or
shouldbecame eubth to the Workers' Compensationprovhla
NEW RESIDENTIAL PLMB._SQ.FT.
Date Recei til
TOTAL:
BUILDING419.
0
peofthe
d,c,md re meet forthwith comply with such provisions orthb perMtshall be
deemed revoked.
CONSTRUCTION LENDING AGENCY
SEISMIC FEE
3.5
1 hembyafRmithat there is e construction lead ilagency forlhe perform
ance of the work for which this permit h (sec 3M, (s 3097, Civ. C.)
IaMer'e Name
Lender; Address
I certifythat I have read thhapplicatlonand usatethatthe above information
hcorrect.I agreeto comply with all cityand county ordinances and elate lawn
TOTAL
ELECTRIC FEE
PLUMBING FEE
QTY. , MECHANICAL PERMIT!'' FEE
MECHANICAL FEE'
PERMIT ISSUANCE 12
FEES PAID:
,
relating to Wilding construction, and hereby authorim representatives of this
city to enter upon the above,mentioned property far inspection purposes.
(We) agree to save, Indemnify an it keep harmless the City of Cupertino
agaWt llibilltkro,judgments, muse a ad expenses which may in anyway accrue
against .Id Inm�fg .permit
X5/..
9. /Mte
Date Reeeiptk
ALTER OR ADDTO MECH.
AIR HANDLING UNIT (7010,000 CFM)
SUBTOTAL:
Q I
AIR HANDLING UNIT (OVER I0,000CFM)
-
CONSTRUCTION TAX
EXHAUST HOOD (W/DUCT)
CONSTRUCTION TAX PAID:
Signature of AppllcAZAR nOUS to
HAZARDOUS MAT92 LSDISCLOSURE
torefuture building nicipantode, handle rdous
Will the defined
material as defined by the Cupertino Municipal Cade, Chapter 9.12, and the
HealthandSa(ety Cade Section 75932(aI7
❑ Yes , No
Will the applicant oe tore Wilding ocvpant use equipment or devices
HEATING UMT(TO 1fD,000 BTU)
-
Date Recei fN
BEATING UNIT (OVER 100,03(t) BTU)
TOTAL:
VENTILATION FAN(SINGLE REND)
IS3pp
which emit hazardous air mntandnants as defined by the Bay Area Air
Quality Management requirementsistrict?
4 Yea N No
have read the haze ous materials requirements under Chapter 6.95 of
�N(,F,IJATE
1l''lLYY1��
'
J a 1690
BOILER -COMP QHP OR 100,M BTU)
BOILER -COMP (OVER 100,000 BTU)
the California Health A Safety Code, Sections 25505,25S33 and 75534. I
'
NEW RESIDENTIAL MECH. SQFT.
understand that if the budding does not currently have a tenant, that It h my
responsibility to actify the occupant .(the requirements which at be met
prior to Issuance of a Certificate of Ocevpanry.
(�{.� /� 1
Cis) of Pune-'tillti
ISSUED BY: -I• 3A as .e—
Ownerorauthorized agent , Date
TOTAL:
OFFICE COPY