20335APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALLPOINT PEN ONLY
Building Project Identification
Building Addre,,:
PERMIT NO.
20335
10100 Torre Ave. .Unit
ners ossa: one:
APPLlCAIIUN SUBMI1 IAL
Town Center Properties
CITY OF CUPERTINO-BUILDING DIVISION
APPLICATION / PERMIT
BUTLDING-ELECTRICA PLI BINGMECHAMCAL
5/10/90
Contralm.N.me. 738-4444 LIC. NIX
CATEGORY
CONTROL#
Architect/Englmer. -Lt. No:
,QTY, '•.-ELECIRICPERMIT.- .FEE
BUILDING PERMIT INFO
Address: t
PERMITISSUANCE
LICENSEDCONTRACFOR•S DECLARATION
I hereby affbm that l see licensed under Pepe Were of Chapter 9(commune.
ing Mth Sedt n7OD)of Divlsion3ofthe BuslneesandPmfesslqu e,and my
license I. I. full force and died.
License Ckss Llo.N
APPLIANCES -RESIDENTIAL
JOB DESCRIPTION
RCB
PANELS
Date Contractor
UP TO 200 AMPS
5 �b W1,
71111000 AMPS
ARCHITECT'S DECLARATION
I understand my pkra s3aB be used as public records.
OVERIODOAMPS
SQ. FT. FLOOR AREA
$/SQ. FT.
SIGNSELECFRICAL
Licensed Professional
909
74.92.
SPFGIALCEiCUIT/MLSC 9
OWNER -BUILDER DECLARATION
I hereby affirmtlat I am exempt from the Contractor's Llcenee Law for the
TAMP METER OR POLE INST.
,
following mame.(Secdon 7031.5, Business and Professions Code: Any city or
county which requires permit to construct, alter, Improve, demolish, or repair
'
anystmmmpriortoits Wusnc"isorequimtheappUc tforsuchpermitto
file a signed statement that he le licensed Pursuant to the provisions of the
Contractor's License Law (Chapter 9(commencing with Section 7000) of Divi-
slon 3 of the Bu do ess and Professions Code) or that he Is exempt therefrom a nd
POWER DEVICES
.
SWIMMING POOL ELECTRIC
VALUATION
the bulls for the alleged ...minion. Any violation of Section 7m15 by any
applicant for a permitsubjects the applicant to a civil penalty of not morethan
OUTLETSSWITCF3ESFTXTURFS
-
$68,102.00
fit�undrad dollars ($W.
I, as owner of the property, or my employees with wages as their sole
NEW RESIDENTIAL ELECTR Fr.
STOW FS
TYPE CONSTRUCTION
compensation, will do the work and the structure b not Wended or offered for
sok (Sec. 7064, Business and Professions Code: The Contractor's License Law
V—jv
dues not apply to an owner of property who builds or improves themor, and
who does such work himself orthrough his own employees, provided that such
OCC. GROUP
RFS UNITS
Improvements are not intended oroffered for sale. If, however, the building or
Improvement Is sold within one yearafcamplention, the Owner-bullderwlll have
t11L,¢rrden of proving that he did net buBdor improve for purpose of sale.).
L j 4 as owner of the property, am exclusively contracting with licensed
centnctom to construct the project (Sm 7014, Business and Professbru Code:
TOTAL:
QTY. �'. •' PLDMBING PERMIT` FEE
R-3
j
FLOOD TONE
APN
PERMIT ISSUANCE 12
The Contractors License Law does not apply to an owner of property who
build. or improves thereon, and who contra for auris ptojela with s
cgllt actors)licensed pumant M tee Contractor's License Law.
1_31 am exempt under Sec B A P C for this reason
ALTER -DRAIN & VENT -WATER MA)
FEE SUMMARY
BACKFLOW PROTECT. DEVICE
DRAINS. FLOOR ROOF, AREA, CDND.
SANITARY Y_ N_
RECEIPT T #
OwnerDate
WORKMAN COMPENSATION DECLARATION
❑I hereby affirm that I have a certifbte of consent to eel( -Insure, or a
certificate of Worken'Compereatlon lruu men or a meddled copy thenrof(Sec.
3800, Tab C.)
Policy
FIXTURES PER TRAP
SCHOOLTAX Y_ N_
RECEIPT
GAS EA. SYSTEM -1 INC.4OTILETS
PARK FEE Y_ N_
RECEIFT X
N
Com any
GAS EA. SYSTEM -OVER 4 (EA)
BUILDING DIVISION FEES
[fled copy Is hereby furnished.
Candied copy Is filed withhlM city
thcity inspection division.
CREASE/INDUSTRL WASTE INTERCEPTOR
PLANCHECK FEE
, GREASETRAP
CERTIFICATE OF EXEMPTION FROM WORKERS
PAID
COMPENSATION INSURANCE
(Thlssection need not be completed lithe permit is for one hundred dollars
(Stm)m1cae.)
1 certify that in the performance of thework forwhich this permit le Issued,
SEWER -SANITARY -STORM FA 2DOFT
Date Receipt#
WATER HEATER W/VENT./E.ECTR
ENERGYFEE Y_ N_
WATER SYSTEM/TREATING
I ,hag not employ any person In any manner an as to become subject to the
Workers'Compensation Lawn of California. Date
PAID
NEW RESIDENTIAL PLMB. BD.FT.
Applicant
NOTICE TO APPLICANT: If, ager making this Certificate of Exemption, you
should become eubjeet to the Workers' Compensation provisions of the Labor
Date Recei I#
TOTAL:
BUILDING
Cade, you must forthwith comply with such provIsdnrs orthis permit shall be
deemed cooked.
CONSTRUCTION LENDING AGENCY
SEISMIC FEE
I hereby affirm that there is a construction lending agency forthe perform
are, of the work for which this permit Is Issued (Ser. 3097, Cle. Q
lcnder'. N.
Lend.ex Addrees
I certlfy Uatl fuse and thisapplloBonaM patethattheabovelnfomutlon
Isomoct. I agneeto comply with all city and county ordinance and elate laws
TOTAL:
ELECTRIC FEE
PLUMBING FEE
34.7
c -
QTx: -:.--M_ECHANICAL PERMIT FEE
MECHANICAL FEE
14-73
PERMIT ISSUANCE 12
FEES PAID:
relating to building construction, and hereby authorlre representatives of this
city to enter upon the above-mentioned property for Inspection Purposes.
(We) agree to save, indemnify an d keep harmless the City of Cupertino
ago Inst liabilities, judgnnnts,costs and expenses which may in any way amus
ALTPRORADDTDMECH.
Date Reaei t#
AIR HANDLING UNIT (TO 10,000 CFM)
SUBTOTAL:
O .O
agaimtsaid�j Yin segue he aMirg.1thi.pamit.
/ �JP �� � /'J /�
5
AIR HANDLING I1MT (OVER 10,000 CFM)
CONSTRUCTION TAX
Signature olf Ap/pRCont•/Co`n'tractor 4Mtt.
EXHAUSTHOOD(W/DUCT)
CONSTRUCTION TAX PAID:
HA7ARDOUS RIALS DISCLOSURE
Will the applicant or future building occupant store or handle hazardous
material as defined by the Cupertino Municipal Cade, Chapter 9.12 and the
Health and Safety Code Sedion75537(a)7
❑Y. No
WBllhedppllant or turebuildingoccupantuseequlpmentordevicce
HEATING UNIT (TO 100,000 BTO)
Date Recei t#
HEATING UNIT(OVFR 100,000 BTI)
TOTAL:
0 -0
VENTILATION FAN (SINGLE RFSID)
ISSUANCE DATE
which emit hazardous air contaminants.. defined by the Bay Area Air
Quality Management District?
71 Yee No
JRAIo /L OV
BOrUER-COMP OHP OR 100,000 BTU)
BOILER-COMP(OVER 100,000 BTU)
I have read the b. 2.3 materials requirements u nder Chapter 6.95 of
the California Health A Safety Code, Sedlors 25505,25533 and 75534. 1
understand that if the building does not currently have a tenant, that it 1, my
qp
„r'7 1 -�Ld
NEW RESIDENTIAL MECH. SQ.Fr
resporslbility, to notify the occupant of the requirements which must be rant
prior to Issas ore of a Certificate 01 OccuPancy.
City Of,\�C,t-ingrtinn
#'
ISSUED BY: Ar v o
Owner or autholred agent Date
TOTAL:
OFFICE COPY