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HomeMy WebLinkAbout24656 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OF CUPERTINO BUILDING-KILERI AI. PE`MITNO 2 4 6 5 6 APPLICATION/PERMIT PLUMBING MECHANICAL NUILUINr.DIVISION BUILDING PROJECTIDENHF'ICAIHON BUILDING ADDRESS: SANITARY NO. APPIJC4TIONSUBMrrfALDAIF. l00 O re)o-siclJ C1 UNIT# ©O LOT l OWNERS NAME: PIIONF_� CONTRACT'OR'S NAME: LIC NO: rJoN t-c_ AVL- wkkek L 4oSi 151 -73(o sem.L_YF IEC CCOONTROL# \RCI 11 L'UT/P.NGINFIR: LIC NO: ADDRESS: ❑ O. 4,o6Z!-1 .to03 v5n.00�f'L • vti<NJ �3i,c CONTACT: PHONE BUILDING PERMIT INFO QTY. ELECTRIC PERMIT PEE BLDG ELECT N. P PERMIT ISSUANCE LICENSED CONTRACTOR'S DECLARATION APPLIANCES-RFSIDEN1A QWz I hcfeb,.ffi.,ou l m lisrnaafiii r m,im.of Cl4ptcr9(.in,with JOB DESCRItnON I 4100 Sadism 7000).f Division Sof the Bum.—trid Profenims Code.a m]my l'censek in PANELS K W full lone and effect. 2j Lamose Class Lia# UP TO 200 AM F rFiaa Due Cowaclm 201-1000 AMPS ZFINALr Ovtni"L ARCHITECTS DECLARATIONOVER I000AMPS SQ. .Ell AREA VSQ.IT. 'O-L�O IunJerataM my aAeB handupublie reaad., Prn Fes; SIGNS EIRCTRICAL QY�Q faacnwN lhareuwrW OWNER-BUILDER DECLARATION SPECIAL CIRCUIT/MISC.TIATE CCa�O w f0f-.. 1 Amb,afTw m d 1 aesemp from ft Cort.ori Licenae law fu the +4-N Maw,reaum.(Simion703".Bmines and Pmfemorm Code:Anyeiry orcamly TFAIP.METER AzMLE INST. otg which rryuirn apmoW nit In cucl,dtm.impnve,dcmart oliaM1, pah anN y nclme mnn5 :; mor it) uHrtalimlu its letocc, amuims the ppwnl for much Pen file a.good rnNEWER DEVICES nummt - 1y�Op hal he is liceneW pumuamm the mlismtnof the Gmtrvcmt',Llcenue law(Cftepter Ida9cvmmnrin SWIMMING POOL ELECTRIC xo�' ( gwilh 9cmim)000)o[Dvi.ion3o(tlu Bmitca eM Pm[usior4 Code) VALUATION W=rn ashat he is exempt derchom and the hasis for do dkgM carnption.Any videtlon of OIHLEIS-SWTTCHFS-FIXTURES Fla Smlion]031.5 hyanylt hOsi lforaprtnitmOjecnsheappl'crnitoacivil penally of 7 gaWS,O 1hnn Bve hundeM rbllefa(g50o1. NEW RESIDENTIAL ELECTR SQ.FT. apon 6 � .avwreroftM1epy,ormyempluy�wihm wuBntheirsolecmtpensuionSTORIES tt' 'NPEC(l SPR ❑ N y� .theumk,mtd lheslnnumtsndimenJed oroffctW f«uklSec.]09a.tlminess 1 Prafoaos.Code:The Contra ,lie.law doe not apply b en owner of ptoPem wM1u buJd+m'uny¢nrnehaeon,udwMdoevrh went M1imuJfeclhrwt{hhu ownrnEloyaa.providN husuch improvcmcnls verwtim<MNmoRcrtdfmaalc.lf, C.—GROUP RFS.UNITS bailds w,itlhleNhtveihi cmimpmvCnneenl is u0Jreldlhdin ormelmIdmnficmmptpolveforpthepowrsrcuf- f T ❑ I.nowxroftM1c pmpny,mnn<Iwivclyrnntnning with lkensulmnoaclmto QomPLUMBING PERMIT FEE FLOOD ZONE APN ecmtfue the pojeu(Sec.70,14,Bnineas eM Poofevimu Code:)The Comnetar's Liecrex law Joe rd.pplymen owrcrofpnryrnywho WiM.mimprovn hncon.aN PERMIT ISSUANCE who cuttrama twsmh pnjcct.with a cmfiac,r(s)IicrnsW pursuant to dee Cotimm"'. ALTER-DRAIN&VENT-WATER FA Llanw law. ( ) FP.0 SUMMARY ❑ 1 am exempt utile Sec. ,B&P C fm this rtason BACK FLOW PROTECT.DEVICE OUISIDEFTAIS SANITARY Y N Owm Due REM.PT# DRAWS-FLOOR,ROOF.AREA,COND. WORKMAN COMPENSATION DEMRATION SCHOOLTAX T N ❑ IM1emhy affirm lhulhawoecnifknm of consrnno rel Gimuremacmi0ame of /1 RECEIPT# 1 WorkcriC anion I.,mmaoraamificJc FIXTURPS-PER TRAP lO mrtpan opylMcur(Ss.3P.(Ifl,lah C.)which PARK LTG YN m all employe'.uMcr hn permit. GAS-EA.SYSTEM-INB C.Y0UTL EI RLCPT# Pdiryx BUILDINGibIVISION FEES Com,mr, GAS PIANCHECK FEB❑ CcfEmL,,,,isbebyfumOsd. ❑ GREASE/INDUSTRLWASTY,INTFRCEPfOR GRADING FF,' CERTIFICATE OF EXEMPTION FROM WORKERS' GREASF,TRAP SOILS Phil 1i COMPENSATION INSURANCE (Ild..mBon need was is emnheud ifhe pcmdl is for one Modred all(5100) SEWER-SANITARY_WORM PA.2)0PT. aI—J Iccnify that in the ef.mofhe wotA farwhich this permit inisaucd,I shill WATER HATER W/VIl. /ELIICIR not employ any person in any m n to be<mne subject to the Wol PAI Cmnpewtlonlawsof CAfonia Due WATER SYSTEM/IRFATING e Rmipt0 0 z APplront z 0 NOTICE TO APPLICANT':If,afte making this Cmif to a(Esemption,you sleouM NEW RESIDENTIAL PIMB. SQ.ET. TOTALE-" ZZ ex hon.subject to O Worer k 's Cou mpe. eflon prcomons of the labor CWe,you mud > (mhwith amply wIM1 such prm,kmns w this Pemtil JwlI M dcemcd oc omtl. BUILDING iE aQ CONSTRUCTION LFNDNG AGENCY SEISMIC Z I crtby w dthem is a omtl tion lading agetcy far the peffammce of T ELECTRIC FI ' U O the work for whichihis permit is issum(Sm.3097,Civ.C.) w Lender's None lender's Addrea QTY. MECHANICAL PERMIT FEE PLUMBING El' O U L miify hat I Iwve mot his appllculon aril nate Out the above information is eoromi- Iaptt to eumply with dl cit,anJ rnunty emilm vet end Rafe law,rtluiog wPFJiMIT ISSUANCE MECHANICAL I-' N buirdin eamamcoorr,ofd hereby wehoriu n,,msmum,,..f Ws citymrnler upon he CONSTRUCTION X U Z above memlond pmpeny for inapeelim pur,ass. ALTER OR ADD TO MECB. (Wc)agree m sere,irakmm and p hafmkss the Gty of Cu,,Ooo agains IieMlilie,juJgrtcaeu deaprns. shit,howym-,wity aantc.,umisaid City AIRIIANDLINGUNIT(TO IB.Oh0CFM) In cwassNacn g lin ofhls on 1. O AIR HANDLING UNIT IOVFR I0,000 CFM) of AWficant,Cmnoctm VDvae GXHAU.STIIOOD(W/DUCN PAID NAZAR DOUS MA'ITMALS DISCLOSU RE I IEATING UNIT(TO I W.000 B'FU) Date Rceei Will the applicant or future build, u,Fm,some m barufle hamooko.malaial HEATING UNIT(OVER 100,000 BTI!) T n defined by the,Cupenino Municipal Cale,Ch.ptc 9.12,tail dei,Heli h ofd Safety Code.Section 255]2(x7+ El Ya ❑No VFI.TIIATION FAN(SINGLE:RESID) ISSUANCE DATE ` BOILER-COMP(3HP OR I(I(I,LGO BTU) Will zur mottim orfuture building by the ity A Ai,Q devic Mmuichcmit Qd Darinlamomou,vh tmtwinafas n defrcd by the BaY A.Ai,Quality Maeugemrnt BOILER-COW GVER 100.000 BTU) DiuricR ❑Yea ❑No NEW RESIDEN IAL MECII. SQ,FT. JAN .S 1993 I have fwd the M1v ikxis materials rcyuircmcnls untkr Chapur 5.95 of the {7 1x7 a7 Calirsxnu lkdth s not a ode,Seethe.,um.ffi u5v and 2s5b. I ity to atif ohe CI I y Ur isurcn l Hry ifhesant oft don rot cumrn0yhave•m be etui1umyrtsponnofa towdfy the occupant of he rtquhvnenu which mum be meet pilo-m ivrwce of•Cmif to of aMdacy. �V si V s\��/y.��(��/ OwnenKautM''zed.gem Dam 'Tt ISSUED BY: OFFICE