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20358APPLICANT TO FILL IN INFORMATION WITHIN RED LINES— USE BALL POINT PEN ONLY Building Project Identification Bulking Address: - PERMITNO. 10110000 Torre Ave. Unit .158 (D1.2) 20358 wnereName: ane: Town Center Properties CITY OF CUPERTINO-BUILDING DIVISION APPLICATION / PERMIT BUILDINGELECTRICAI PLUMBING -MECHANICAL 5/10/90 Contrattor'a Name: Ls. No: 7.38-4444 CATEGORY - CONTROLY Archltect/Engineer. Lk. No: QTY."�" ' ELECTRIC PERMIT "FEE " BUILDING PERMIT INFO Address: PLUMB M1,LH © © R] yl PERMITISSUANCE 19 LICENSED CONTRACTOR'S DECLARATION pr 'withS on7Olhatlamlkm3ofthe usiro slonsoffnemsr9(mmmm inenseIs in fon force affect. ftheBudnwandPro(esdmsCode,endm license is In full fora and affect. APPLIANCESREBIDENML JOBD N S� -PANES Llan. Clan Lic.Y RCB I Date Ca union, UP TO 2DO AhU 2114000AMPS ARCHITECPS DECLARATION I understand my plans shall be used as public record& OVERIODOAMPS SQ. ET. FLOOR AREA f/`Q.Fr. SIGNSELECTRICAL Lia sed Professional SPECIALCIRCUIT/MISC OWNER -BUILDER DECLARATION I herebyaffhm that I am exempt fro nthe Contnctora License Law for the 669 74.92 TEMP. METER OR POLE INST. "following reasoo.(Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demollh, or repair ' any structure prior In itshssece, also requires the applicant for such permit to file a signed statement that he at licensed pursuant to the provisions of the Contractor's License Law (Chapter.9(comnencing with Section 7000) of Dlvb sbn3ofthe Budnessmdlm mbm Code)orthatheisemmpttherefromand POWER DEVICES SWWM[ING POOL ELECTRIC VALUATION the bash for the alleged exemption.. Any violation of Section 70315 by any Applicant for a permit subjects the applicant to a civil penalty of see ot rn$50,121.00' OUD.ETESWITCHESHXTURES NEW RESIDENTIALELECTR SAFE five hundred dollars (5500). 71, asowner ofthe property,ormyemployees with wages astheir sole STORIES TYPE CONSTRUCTION compensation, will do the work and the structure h not Intended or offered for sale (Sec. 7064, Bustram and Professions Code: The Contractor's License law V—N does not apply W an owner of property who bunds or Improves thereon, and who does such work himself orthrough hismen employees, provided that such improvements are not intended oroffered formas. If, however, thebuildlog a Improvement haold withinomrarofcompldt mtheowner-buBderwlll have TOTAL: . OCCGROUT' R-3 RFS. UNITS / tlajZunlen of proving that he did not build or improve for purpose ofus.). U L as owner of the property, am exclwively contracting with licensed antrattas to corutruct the project (Sec. 7044, Business and Professions Code: QTY, ,. .r" 'PLUMBING PERMIT FEE FLOOD ZONE APN pp yp Lr{yUANCE 12 The Contractor's License Law does not apply to an owner of property who lou Ods or Improves thersan, and who contrasts for such p(ojem with a cgplr+slor(.) Ikensed pursuant b the Contractor's License Law. L,J f em exempt under Sec B As P C for this ..on ALTER -DRAIN & VENT- WATER MA) FEE SUMMARY - BACK FLOW PROTECT. DEVICE DRAINS FLOOR ROOF, AREA, GOND. SANITARY -Y_ N_ RECEIPT Y Owner Data WORKMAN COMPENSATION DECLARATION F11I hereby affirm that I have a certificate of consent to self-ineum, a a cenieofWorken'CompareaHonlrisurma or a certifsd copythereof(Sec. fica/ 3800, Lab C.) Paltry .N FIXRES-PER TRAP SCHOOL TAX Y N RECEIPT I GAS F.A.SYSTEM-1 IJCAOUTLETS PARK FEE Y N RFCEIPfX Y Con - GAS - EA. SYECFM-OVER 6 (EA) BUILDING DIVISION FEE S WBled copy is hereby furnished. Ned copy b filed Mth the city inspection division. CREASE/WDUSTRL WASTE INTERCEPTOR PLANCHECKFEE - GREASE TRAP CERTIFICATE OF EXEMPTION FROM WORKER S' PAID SEWER-SAM'IARY-61ORM E.A.XpFf COMPENSATION INSURANCE (rhiesection need not be completed lithe permit atfaane hundred dollen Date Retell I# WATER HFATERW/VENT/EL.D= ENERGY FEE Y N— (5100)afessJ that In work lNmsxtnbtis ao. anypehe I.annce I ...c,he so g, to I shall not employ any person f any manner at m to become abJM to the to the Workere'Compensstbn Lowe of California. Date WATER SYSTEM/TREATING PAID Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workeri Compewt Ion provhlons of the Labor Date Recei till NEW RESIDENTIAL PLMB. SQFr. TOTAL: Code, you moat forthwith comply with such provisions or that permit shall W deemed revoked. CONSTRUCTION LENDING AGENCY BUILDING SEISMIC FEE 1 3.57 T hereby affirm that there Is a construction lending agency forlhe performance of the work for which this permit is issued (Sec. 3097,Civ. C.) Lender's Name Ianderb Address I adifythat I haveread thbappllatfonand datelhat theabave infornmlion atcornct. l agree to comply with all cityand county ordinances and date lave PLUMBING FEE28.7 �;: QTY. ".,_ •`,MECHANICAL PERMIT' FEE MECHANICAL FEE 78 7 PERMIT ISSUANCE 12 FEES PAID: relating to building construction, and hereby authorize representatives of this city to enter upon the abov menuoned property for Inspection purposes. (We) agree to save, Indemnify an d keep harmless the City of Cupertino against liabilities, judgments, code and expenses which may In any way accrue ALTER OR ADDTO MECH. Date Recel ttl AIR HANDLING UNIT(TO 10,OD0 CFM) SUBTOTAL: -% agar Ily In uen f gr' Ing ofthb permi�0 - AIR HANDLING UNIT (OVER 18,000 CFM) CONSTRUCTION TAX - [-` Signature of Applicard/Contractor /X / Die EXHAUST HOOD (W/DUCT) CONSTRUCTION TAX PAID:" HAZARDOUSMA ALS DISCLOSURE Will the applicant or future building occupant store or hands hazardous material as defined by the Cupertino Municipal Code, Chapter 9.1$ and the Health and Safety Code Section 75537(a)I M Yea L_I No HEATING UNIT (TO l 00,OW BTU) Date Recei td HEATING UNIT (OVER 100,000 BTU) TOTAL: VENTILATION PAN (SINGLE MID)' ISSUANCE Will the applicant or future building occupant use equipment or devices which emit haurdous air coniaminaMsas defined by the Bay Area Air Quality Management District? Yes No have read the hour ours nuledale requirements under Chapter 6.95 of �DATE lY�Li' - BOILER -COMP OHP OR 100,000 BTU) BOILER-COMP(OVER100,000 BI U) the Glifomh Health & Safety Code,Sectbns 25505,75533 and 75534.1 understand that if the building done not currently have a tenant, that It is my NEW RESIDENTIAL MECH. SQ.FT. responsibility to notify the occupant of the requirements which mud be met prior to issuance of a Certificate ofOnupanry. ^�L-B`r t jy 1 rl/QPrtwi ISSUED BY. J. Awad G• Owner or authorized agent - Data - TOTAL: OFFICE COPY