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S 1685APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY CITY OF CUPERTINO BUILDING DIVISION BUILDING - ELECTRICAL APPLICATION/PERMIT PLUMBING - MECHANICAL BUILDING PROJECT IIIPYTIF[G'1'[ON NEW RESIDENTIAL El :C71t T. PL 1'f NO. 1685 .DING DOR SSS: , /1 1\\J\ ❑PLUMBING RE -PIPE SANITARY 7PLICAI ]ON SUBMIT ]TAT. DATE �� 19 :S NA li: I PHONE}� OL �I—leV1 ImpItOVEMENT '1'RACI(l'SNA E: LIC ly SC, N/C ❑ 2 IIEMOLITION CUNTROLX HHECTIENGINHER; LICNO, / 49 �U S 06 CUACP: PHONE: WATER SYS EMU'RIiATING ❑ Consultant Fees Paid by Applicant (Initial){7LyI [I DEMOLITION BUILDING PERMITINFO GG a_l. ELECT [Toll MEC I ❑ ❑ LICENSF.DCONTRACfORS DECLARATION QTY. I hereby affirm that I ran licensed under provisions of Chapter 9 (commencing with Section 71)010 cT ivision 3 of Ibe Business and Professions Cale, and my licence is mod rmee non erc Licenn Iso Lic.x Dlrc Crmm�a ARC111'fECTS DECLARATION /.r I undentnnd my plane nball he aced as public r.... I �i Licensed Professional OWNER -Il U1LDFR DECLARATION 1 herehy affirm that 1 um exempt front the Contractor's License Low rnr the following red . (Section 7031.5, Business and Professions Code Any city or counly which m,...ex n permit n, IXmYnrect alter, improve deme h, or rcpnir any slnmturt grionoiu issuance, also rc9uim.o the applicant for such germineit, aligned aatmncm pa'heincia,wiit punmin althe provisions nl'Inc emasin:,, tProfessions roessiw(Chnpmr9 (amines exempt with Section ](XX6 the Division t of the alleged g einexe and on, A y violation i Cutlet or Sec faces exempt Tany applicant anA the bears for Ibe Subjects th applis loon. Nry viper lty of norean9111ed e, anyydreddoll for apenult subjects the applicant ntacivil penalty of not mea wne five hundred Dollars ($51X0. Lothewr0 (liek,add theiaryor nryor intended or twred forme(Se. 044,8one,axmien, will dr fie work, and the hecturc is nor s Lice s oro w do for ole (Sec. to an Boniness and cdy what Cods: The C a, themes License Law docs urn Imply to :m ownerof gh properly who builds or imp mvec thsuch improvements end who does such work hied! or or Throered f r his own oxes ees, provided Ihot Hocho,,daiarc on inrtnor or offered for soli.ILhowever,ll hbuilding ores of int Isar hwithin nneynlrof provelfar phe per-builder will hoax the burden of peeing that he did not build or improve fm pur- e ,resole.). ❑ I, ase r of The progeny, am exclusively connecting with licensed commenrs m construct Iheprojmt (Sec. ]BLL Business and Professions CndeJ The Commends Li- veLawdoes nnlapply m an owner of properly who builAs nr inlprovice lherwn, nmd QTY. whit eontraatc for such projects with a eontesc nr(s) limned pua uunno the Contractor's L em, Lie. I am exempt under Sec. B & To Con this canon Owner Umc c: WORKERS COMPENSATION DECLARATION I bcrehy:d accomie peT111yrfpe jury aneofelf-imuse ewmg dacWorker C. Ihuve unJwie for by the cone xl6in� orefor ieWorker'sve'dh- lion, vat pn aided for by Ss issued 37 X of the Leber Code for lie perfonnunc of the esuI have an ch will pedal is icor d. 1 have and will maintain Workers Compensation he Inwmnen. It required by Sectiond, 191X1 nflbc Lubar Code, bar hc p,rfonn Ina of the w irk for which alt, Its pernli: ion ow d. My Wa ntcana n.cuman.ann.cumanand Policy Comer. a icy Nn�_ CIiILCIPICATIi (lP I3XL'M 'ION PRONT OkKiikS' COMPENSATION INSURANCE (This wenod aced not bcc ne,ln W it far parfait is for one hundred dollars 1S I Illb or less.) 1 cenify tem in the perfnnnanee of the work for which (his permit is issued, l xhall Hol employ any pcnvn in any manner so as m me Wer subject to the Workers' Compact ,z satire Laws of California. Data zApplicant NOTICE TO APPLICA ST. IL after making dtis Cenificam of Exemption, you should F` N become sober, to Ilie Workers Cr ,aurin on pmvisirns of the Labor Cale, yon rn el forthwith comply with such provisions or This permit shall be deemed marked. W n C(INSI RUCT1ON LENIIING AGENCY V 0 l hereby affirm that them is aconnurion lending agency for performance of fie work for which Ibis permit is issued (Sec. 309]. Civ. CJ VLenders Nurse W Lends/a Address 1 ecnee n c 1 comply read all is city and coup Imd Tomloss that It,and above interaction mfmirn is hdeem.iagreemanmplywithyautyand coumyntniiveceetndatem lawsrelvning to QTY. huilJingcunmmetinn.unAhuebyaulM1orivercprc nmliv nflbiseityloc� ruponthe mauve-mom'mned property for insp ©tion purposes. (We) agree In save, indemnify and keep harmless fie City of Cupenin, againq Iiobililice,judgmellp. n,xlsund expenses which Itiny In airy way acme againel sail Cily in nseque a m,he grirm, nfthin permit. APPLICANT UNDERSTANDS AND SFILL COMPLY WITH ALI. NON -POINT HAZARDOUS MATERIALS DISCLOS(IRE WIII the applicant nr farce building occupant sere nr handle hoz.Nnus encau.l as defined by the Cupertino Municipal Code, Chapter 9. 12, and the Health and Safety Cela Section 255321ay1 ❑Yes F1 No Will the applicant or toter, Wilding occupant use equipment or devices which emit n mrdoue air comm tinanls as defined by the Bay Area Air Qual Try Management ❑Yes El No I have read the hazardous materials raquircmems under Chapter 695 of the Cali- fnmia Health & Safety Code, Section 25505, 25,133 and 25534. 1 andersend Ihot If the building does not currently have a radars, that it k Iny respmsihi lit,,, notify the occupant of nhc requimmems which must M mel prior to issuance of a Certificate of Occupancy. Owner or authoriecd agent Data ELECTRIC PERMIT' FEE PERMITISSUANCE A PI'I,IANC[S - RISIDEN'TIAI. PANELS UPI( 1200 AMPS SIGNS ELECTRICAL SPECIAL CIRCUIT IMISC. T&W'. MET HR OR POLE INST. POWER DEVICES S WIMMI NO POOL IEL _I'Ij4C JOB DESCRIPTION RESIDENTIAL: NEW RESIDENTIAL El :C71t T. ❑SFDWL ❑ KITCl LEN REMODEL ❑AUDITION ❑PLUMBING RE -PIPE ❑MU171-UNIT El STRUCTURAL ALI'17R- DRAIN &VENT-WAI'HR(HA)J11P1,11y MODIFICATION ❑INTERIOR ❑CHIMNEY REPAIR ImpItOVEMENT QSWIMMING POOLS ❑ BATA RE h EI/ I' 2 IIEMOLITION ❑OTHITIt �� ENERCYI _' WAI HR HEATER WNENT, d;Ll:C'1'k COMMERCIAL: WATER SYS EMU'RIiATING ONEW BLDOIADDI'I'ION [I DEMOLITION ❑TENANT ❑ FOOD SERVICE IMPROVEMENT TO'T'AL: ❑OTHER BUILDIN( FEE �I OUTI.ETS-SWITCHE, E NEW RESIDENTIAL El :C71t T. My FI'. FLOOR AREA ti/SQ. 14. 'l n QeD VALIDATION %fall l - Uf '-OUT STORIES TYPE CONET$DCTIGL OCC. GR( AI'N TOTAL. PLUMBING PERMIT FEE, PERMIT ISSUANCE ALI'17R- DRAIN &VENT-WAI'HR(HA)J11P1,11y BACK FLOW PROTECIL DEVICE IaRA1NS-Fl DOR, ROOF. AREA, CONE), FIX I V RES - PER 'I'RAP CAS- 9A. SYSTEM.] INC. 4 Oil TALE S GAS -EA. SYSTEM OVER 4 (]its) GREASEBNDUSTRI. WASTE INTERCEPTOR 111 I)INW)[VisvO4 Tj r'5 PLANCHE PI:' GREASE TRAP SEWER -SANITARY- S' I' ORM EA. 200 IT. ENERCYI _' WAI HR HEATER WNENT, d;Ll:C'1'k GItAUIN'171. WATER SYS EMU'RIiATING SOILSFHB WATER SERVICE. PAID at, Receipt# NEW RESUDIIN I' [Al. PLMB. SQ, ETL TO'T'AL: TOTAL BUILDIN( FEE �I MECHANICAL PERMIT FEB SEISMIC ITE PERMIT ISSUANCE ELFICTRR TF ALTER OR AUD'I'O MECH. PLUMBING FEE AIR HANDLING UNI' f(IO 0,000CFM) MECHANICAL FEE AIR HANDLING UNIT OVER 10,000 CFM) CONSTRUCTION TAX E.XHAUSf HOOD OODUC) HOUSING MITIGATION FEE HEATING UNIT (TO 100.000 BTU) I ]CIA] INC. UNIT F (OVER 100,000If'I'U) PAID Date R,eciptN VENTILATION FAN (SINGLE RESID) BOILER -COMP (311P OR 100.066 BTU) TOTAL.. BOILER - COMP (OVER 1(X1000 BTU) AIR CONDI I [ONER ISSUANCE DA'I'S iY1 NEW R13SHAiMNAL MECH. SQ. FI', OFFICE I% DANCE WITH TH g MMID CODES AND. 01 This; sg 0 Elms and specifications MU; O be; k t�i the ?oe et all times and it is u to lawtvi c aR, '�t changes or alteratiolig On sawpermission fi tt bui!�, fid, . of Cupertino. T,he staW—jg r S,'. s �.. end specificati ng ZHALL i'�QTt � "�:a .c s. ,D or to be art pprovAJ el 41�,stiG� 0 z provis Ong Ifr any, Qt/' �i'`ebuiCE a State L POS+'A' - • llu la m 4kvv tut`. -t. Pjvttat ty% . voor ra J +tort of v Jj P) �CJowvt �Spout A 37%z It !o% x 24' 1" + 91J Iatt« NOTES I. The a lu lam climeNslor, 1S 37%Zu h -x 6 %g w x vtttv►. 24-' 1" leinstln. If sl•Iall 6c +lAe cowtvnc•iors rczpovl •S► 6t1 4u) -to vGviV dtmcA5LoL z wt 44c file -14, Zhc Co"4vacf0✓ 51., 11 oder A Iseavn j� or rtjgfcfe-4 lea"11 i fo allow Cov yield cu+s �� � fL h 1= ' �I to Y 1 }; F%- - � 2 A. Posf A iL4eva ►s a no -kb► of ur►kvrowvt deptl.►. \ MAY 19 1998 puvtvtg trcw►oua( of Ivc=vvt a0ev suPpovi oF-{IAE BLDG.INSPECTION DEPARIeX,}Sttn9 voo( -4I,tc Cor.ufvacive st-tall ctdur5e- -('1..e CITY OF CUPERTINO Enc weev of 50 p povF ctrrd lool ht j :tstcYn. '.�: Cov►-Iv�Lcfov' -fo Pvoutde SvF1=1C (eN+ IpyaG<✓t� awd 5010porf 40 /rc+AAL4 fL� �eXts4tvtos rooFauci beawt py,7'g' YaFfcvs IN Plat�NNe. CotA�vacFov to vesfvlc4 PLAN NIF-W- V't 5rr cleSfVlavr iYptttG ✓Ovvt tu-- Gtkea doiroL44 9ytl GOStI 0.---f co ... 4 � E.X:dowlAspov+ IAol 3_flnvv Totoc clenaed A. A -F Post ' �' �Ine Go�tiwlc�er slta.(l vtu✓lora +Lte Lpla+e fov extstrv19 beam a+vl refatH t!~e extsttHs I c.ormect-foul at,►cbtor lolafe. 14 is Jnkv`otvN flu ir, u. -.j R*t'W no+clncd hof no pia+e vrstclele.- Cot.fvcLc+ov to Levt(.� atfncllwcer,.+ SL�OaM upon. V-aV",0VZJ. PETA.1L POST 'At 3 t(wo bol+5 I o; 9Y4N tao+clneal \ SoP(wv+ post 1E7&IL. POSTi 'g' I W'= Oat, ex. 6olf ., lyZu= ,t_O.I EY•no�clAed 007CE COPY 11 % 17 PRINTED ON N0. 1000N CUARPRINT• Ear. Plate , t•,l ,a, _ 3 eY.1001•fg , , � ,,� . _ SE:�TIoN 6'is P06T IV o.dq(t+tovtat,l a+KGto✓• plate w�rde f+.�e I�t.tvt. lF�l<evc Ij tl.�le Catnttztcfov SGto-ll also vc�H +1.�•{ play -c. Corn+vrucErov fo Iool� beawt ►v► a 11ke vHctunev fo tl..e extsf•tvtq p1oiCLu„�j�o5¢. 5. TL►e CatfuAc-Eov sltaLll exctiwttvta ft..e exts+t...9 F�`-E Baur, sf�tis OFvofzxx ,Uutsto -flee lr:�r„cecv Cc•-i'1-te CoKtvcLc+ov slTa�ll VBvrFrJ. %Ltof �lte ciowr,�dvarvt ►oetitrtci loos} 'A' Is operr�ft� au.lc( �veE L7FnLuJ de�vte . 1. -Tlie (fvA tv-4ov is msptcsiWca -fou olo�c.tvttt rteces ;eA y.L-vwttHts and fusIOeciw"s. I Replacamani oF' GluLaw► at (v1d&,k42+ Place Ctv111 e1 Cvpe-44" CaltF. sr -ALE: aCj 6t. DLaiGl APPROVED BY: PRE RAWN BY fL DATE: 1I APY 9,$ Fr4Hit ?• i_ewts tZCG 324.01 VISED Ft, Ev=-sFUN6 GttaouP- laoIt N.Fb6jHit.-L. 8LvD:tL 107 CuFuC-rtNo 4A4115b14 - 4o6-343- 1088 FT aItneer tvt9- 23Ci+ Pave• GVc DRAWING NUMBER �i'aCavo.. 406 Z47 1477 H A