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23654
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY Building project Identification - PERMITNO. Building Address: ' YOB E 23654 caste time: one: A CITY OF CUPERTINO-BUILDING DIVISION aa���Z a^ c a r.Name: 39 No: APPLICATION /PERMIT 40 BUILDING¢ECTRICAGPLUMBINC-MECHAMCAL CATEGORY CONTROL N ArcIlett/Engineer. 1 Lk,No: 1.LJ QTY ELECTRIC PERMTT FEE BUILDING PERMIT INFO Addrel WE. 3d0 r PERMIT ISSUANCE r Z% � Lm that ED CONTRACTOR'SON DECLARATICB. [hereby affirm that lamlicensed under eBUMroe provinces fl h msr9(comment. APPLIANCESRES[DENTIAL JOB DESCRE'TION Ingwith Sento 100)of DlNelon3oflhegusineasandlarolesalone Code,and my license le In d effect. PANELS L= Llc N I ' T l 1 D Contractor ' c, UP TO 200 AMPS1/ ARCHITF.CI S DECLARATION 701-1000 AMPS K OVER I ODO AMPS FT.FLOOR AREA qq��vv C [understand my plow shall he used as public records `$ S/SQ.FT. Fi (/ Licensed Professional SIGNS ELECTRICAL �-t OWNER-BUILDER DECLARATION SPECIAL CEtCU1T/MISC Zs' � I hembyaffirmthat l...xemptfmmthe Contractor's Llrensalawforthe p qqqq following reason.(Section 7031S,Business and Profesions Code:Any city or r. courtywhich requlresa permit tomrutmit,alter,Improve,derrolth,orrepair TEMP.METER OR POLE[NST. 0 anystmmm prior to its issuance,atso mquimsthe applicant for such permit to file a signed statement that he t[located pursuant to the provtloru of the POWER DEVICES Contractor's License Law(Chapter 9(commencing with Semon 7009)of Divi- 3`�5 SWI.(MINC POOL¢ECTRIC 7 the bass for the Professions Any yvirlation f exempt 7015therefiby any VALUATION the bast for the alleged exemption. Anyt tolatkn of Section 70:1,5 by any /JETS-SWITCHES-FIXTURES dew O O O,w 65 five applicant aperrs($5Dectethe applicant too dull pe rally of not more than'1 ♦\.V nuc hundred manors(95001. NEW RESIDENTIAL ELFCIR �n ❑I,tie owner will the property,or my employee with wage as offered sok �'FT• STORIESTYPECONSTRUCTION rale(Sm. 0Kion,wildothe work and the Code:dare t not Intended or offered(or q saes not pply Busto a ness a owne d Professkre bTLs C improvh License Law $$ whodossuch ark imserofproperty isomempuilds orlmproovidedreoRand (TCC.GROUP RES.UNITS whodoemcnea ntintelfedorargh hleowne.If,ho eprovidedthatsuch improvement is3old ttendne3varfccerproffered rsak,the owerc1rulklarwdlng or have TO \ 1;11 Improvement taold within one ycarotcompldiary the owner-bulldor will have tljtg4rden of proving that he did not build or improve for purpose ofsale.). QTy, PLUMBING PERMIT FEE —14-COD ZONE ARNP Lf ae owner of the property,am exclusively contracting with licensed PERMIT ISSUANCE contractors to construct the project(Sec.7044,Business and Nde sums Cade: �e The Contractor.License Law does not apply to m owner of property who builds or Ira rove therto ALTER-DRAIN -WATE RIA) contractor(s)ficcosed pursuant to the C ttrramis Lienee Law with a FEE SUMMARY 0l am exempt under Sec, R&P C for this reason BACKFLOW PROTECT.DEVICE QIITSInF FI 'ES Owner DRAINS FLOOR ROOF,AREA,COND. SANITARY Y N_ Date RECENT N WORIONAN COMPENSATION DECLARATION pp(gUgp;S.PER TRAP /r\/s $CI100L TAX Y N ❑I hereby affirm that I have a artlficate of convent to self-insure,or a �+V RECENf N re00,lAeo(Worken'Camperuatien lrouranceora rertifkd ropytM1emof(Sec. GAS EA.SYSTEM-3INC.4DUTLTTS �• policy Lab C.I _ PARKER Y_ N_ Comm GAS G.SYSTEM-OOVER RFCENfN Y BUILDING DIVISION FEES Camthed copy k heed with the cityed. CREASEANDUSTRL WASTE INTERCEPTOR PLANCHECK FEE 78 CertHled copy t(Ikd with the city Ilvfxctlon division, l CERTIHG MPE NSATIONI NS RAN WORKERS' GREASE TRAP PAID COMPENSATION INSURANCE SEWER SANITARY STORM EA 700Ef R 2111w (This sedlon need fid be completed If the permit t forom hundred dollars (910a)mlasa.) wATERHEAIERw/vENr/¢ccrR EN E I certify that N the perform occof the work forwhich thio permit Is timed, I shall not employ any person In any manner so as to become subject to the[aWATER SYSTEM/TREATING I"t Workers Compensation we of California.Date PAID \.\ 0 Z Applicant NEW RESIDENTIAL['LMB._SQFf. Date Rerni ill Z 0 NOTICETO APPLICANT:If,after making this Certificateof Exemption,you Fshould become eubjectto the Workers'Compensation provisions of the Labor TO N Code,youmustforlhwithcomp]y Mth.uchprovtioosorthi permit shallbe ' j dcemcd revoked. _ aC CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the perfomf ` E IC FE Z afire of the work for which this permit t Issued(Sm.3097,Civ.C.) 17 PL BIN V 0 Enders Name LL I- I..dare Address QTY. MECHANICAL PERMIT FEE O W Icertlfythatl have read thin application and sttethatthe above information ME HAN E tcorred.Iagreeto comply with all city and county ordinan...nd state laws PERMIT ISSUANCE FEESP } a (jrelating to building construction,and hereby authorte representatives of this cit t entero the above-mentioned H Z y o upon props uryoses. ALT M, OR ADD TOMI:CH. _ e to save,?iMd.nnaily aW ess the City f Cupertino D e Ccei tq rut ablljtke,judgmionkhmaylna wayamue AIR}fANDWNC UMT(fO 10,000 CFM) �' S TOTAL: gal 1Id sty In mnn hle peAIR HANDLING UNIT(OVER 10,000CI•M) CONSTRUCITO TAX Wm.f Applicant/ ra imat EXHAUSTHOOD(W/DUCT) CONSTRUCTIO TAX PAID: HAZAUS MSURCWill the appBant or future buildmorhandl azardous HEATING UMT(TO 100,000 BN) oulertlaadefineciby the Cupertinoe,Chaplrr 9.17,and the Date CCC[ N I and Safety Code Section 25537(x)? HEATING UNIT(OVER 100,000 BTI) O [ Yc. M No Will thedpplicant or future building occupant use equipment ordevlcca VENTILATION FAN(SINCLE RESID) TCIZUAJCATE which emit haea d..air conlandoant a.de0oed by the Bay Arca Air Ib Quality Management District? BOILER-COMP OHP OR]OQO(D BTU) 4Y,, —I No Tuve read the Imxa auematedab requirements under Chapter&95 of BOILER-00MP(OVERIW,000BN) JUL a@l6 �^^^ the California Health&SafetyCode,Sectlmvs 75505,25533 and 75534. [ U 992 understand that if the building doe.not currently have a tenant,that it is my NEW RESIDENTIAL MECH. SQ.FT responsibility to notify the occupant of the requirement which moat be met CITY f Of' Ilurr. TV( prior to issuance of a Ccrtificato of Ocmpanry, I�J Owner or aulhmlecd agent Date &Ar T ISSIlEDO OFFICE COPY June 12 , 1992 David W. Scannell City of Cupertino Building Department 10300 Torre Avenue Cupertino, CA 95014 Re: Ikos at 19050 Pruneridge Avenue Dear David: © In preparation for commencement of demolition DEVCON CONSTRUCTION on the aforementioned project, Devcon INCORPORATED Construction, Inc. obtained samples of General Building Contractors materials scheduled to be removed as part of the selective demolition. Results of Asbestest, Inc. testing of these materials are attached for your review. These materials j constitute the entire scope of materials to be removed under Devcon's contract. Therefore, we respectively request issuance of 555 Los Coches Street a demolition permit which coincides with the Milpitas,California 95035 entire project currently within your department Phone(408)942-8200 for plan check review and permit issuance. FAX(408)262-2342 Lia 9399163 c e , Steven Cowles Project Manager SC/tc Attachment AS•BESTEST, INCORPORATED 1550 Dell Avenue, Suite F • Campbell, CA 95008 (408) 374-3362 • Fax (408) 374-7269 DEVCON CONSTRUCTION REC EIV E D Date JAN. 10, 1992 555 LOS COCHOS MILPITAS, CA 95035 JAN 14 1992 Job No. A-8885-92 ATTN: STEVE COWLES D EV C ON Project: IKOS ASBESTOS IDENTIFICATION BY POLARIZED LIGHT MICROSCOPY Fibrous Other Non-Fibrous Sample Asbestos Fibrous Materials or identification Minerals. Materials. Minerals, i 1 WHITE FLOORING NONE DETECTED NONE BINDER, SAND, 100% �2 SHAFT LINER AT NONE DETECTED FIBERGLAS, BINDER, 5% , PENTHOUSE ORGANIC FIBERS, 95% 3 HOT WATER PIPE NONE DETECTED FIBERGLAS, BINDER, 5% INSULATION ORGANIC FIBERS, 95% 4 DUCT WRAP NONE DETECTED FIBERGLAS, BINDER, 5% 95% A negative floor tile result is not conclusive by the polarized light microscopy (PLM) method. It is recommended that transmission electron microscopy (TEM) be used for confirmation. The materials were examined by polarized light microscopy according to Environmental Protection Agency methods. In California, positive test results indicate the sample contained 0. 1% or more asbestos, as per California Code of Regulations, "Title 8, Section 341. 6 et seg. " Reported asbestos percentages were estimated based on comparison to t reference samples provided by the EPA. Respectfully Submitted, ASBESTEST, INCINCORPORATEDO }A�TEED RATTMA. umaga !� Microscopist ffi a n c n s a s a s c a s a a v d vac ns - - - - - - - - a m ••A J V ]`J N:p G Z 'MV ! V V A "•I ]� Z .l V 39 �� ] tlJ I:p NCf] mu NV V JOU VV �N r l -P 1..,] h] 1".] 1 l f'y m I It. �N r m i V N ✓+ O. + N r.l � n r-• r t rl O .'• '• �y! � m ..p � .P ..J ! rn r',..1 '' I y V 4:. 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