20347APPLICANT TO FILL IN INFORMATION WITHIN RED LINES USE BALL POINT PEN ONLY
Building Project Identification
Building Address:
PERhBT NO.
10100 Torre Ave. Unit 147 (N1.1)
2.0 347
t1weerName: one:
A
Town Center Properties
CITY OF CUPERTINO-BUILDING DIVISION
APPLICATION I PERMIT
5/10/90
C.Mracto'. Name: Lm. No:
38-4444
BUILDING-ELECTMCAL-PLUMBINC-MECHAMCAL
CATEGORY
CONTROL
Arehltect/Englaer. Llc. N.
QTY ELECTRIC PERMIT FEE
.BUILDING PERMIT INFO '
Address:
PERMITISRUANCE
12
LICENSED CONTRACTOR'S DECLARATION
Ihereby
ection mthml under Busi .sand sof Chapter 9
tagwithis force of Diviic.sion (the Buelmmandl'rofnsloneCode, and
Lin full force and effect.
APPLIANCFSRESIDENfIAL
JOB DESCRIPTION
D , w/ �
Vs'
PANELS
LI..
Dale Contractor
Date Clam Cont
RCB -
'
101-1000 AMPS
ARCHITECT'S DECLARATION
Iundentand my piznsshallbeuaed as publictecorde
OVER1000AMPS
SQ. FT. FLOOR AREA
$/SQ.Fr.
SIGNS ELECTRICAL
Licensed Professional
OWNER -BUILDER DECLARATION
Iherebyaffinnthatlamexemptfromthe Contractor's Lkenxlawfmthe
following ... (Sedim,7031S, Busines.and Pmfessiana Cade:Avydtyor
cmntywhich requires a permit tomruttutl, alter, Improve, de.1i h,o,mpalr
909
74.92
SPECIALCIRCUT/M15C
TpAtp METER ORPOLE INST.
anystrvcture pelorto its Issuance, also requireslheappliant forsuch permit to
file a signed statement the he Is licensed pursuant to the provisions of the
Contractors License Law (Chapter 9(commencing with Section 7000) of Divi-
Yon3 of the Business and Profsad.. Code) arthat he b exempt therefrom and
POWER DEVICES
SWIMMING POOL ELECTRIC-
VALUATION
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applIam t nt for persubjects the applicant to civil penalty of not more than
five Jtunded dollars ($S00).
l, es owner of the property, or my employees with wages as their sale
compensatlon, will do the work and thertrvceare I. ant intended or offered for
vie T. 7044, Business and PMessbrn Code: The Conlnnora License Law
OUTLETSSWITCHFSFI%TURFS
$68,102.00
NEW RESIDENTIAL ELECTR SQ.Fr.
STORIES
TYPE CONSTRUCTION
V—N
does net apply to an owner of property who builds or Improves thereon,and
who dors such work hlmulf or th=gh his own employees, prov ided that anti
OCC. CROUP
RES. UNITS
Improvements are net Intended oroffered(mule. If, however, the Wildingor
improvement bmldwithlnomyurofcompldiorytheawner-bullderwRl have
TOTAL:
R-3
the burden of proving that he did not build or Improve for purpose ofule.).
LJ L as owner of the property, am exclusively commuting with licensedET.00D
rontntton to mnstrvct the project (Sec 7014, Busineu and professions Code:
`QTY; •^ PLUMBING PERMIT FEE
7ANE
APN
PERMIT ISSUANCE 12
The ContnCoYs Limed, Law deed not apply to an owner of property who
Wilds or Improves thereon, and who contracts for such pTopcts with a
egn4actorW Basesed pursuant to the Contractor'. License Law.
LI I am exempt under Sec B 6 P C for this mason
ALTER -DRAIN k VENT- WATER (EA)
�
FEE SUMMARY
BACK PLOW PROTECT. DEVICE
OUTS I DE FEES
DRAINS , RI
FLOOR, ROOF, AREA,
SANITARY Y_ N_
RECEIPT 11
Owner Date
WORIQ4AN COMPENSATION DECLARATION
01 hereby affirm that I have a crtlfiate of consent to self-Inan, or a
crtl(late of Worken'Compeaatlonlnauranceora artBkd aRpy Thereof (Sec.
3800, lab C.I
Policy
Polley M
FIX'NHF_S PER TRAP
SCHOOL TAX Y_ N_
RFImT p
GA S EA, SYSTEM -1 MICA OUTLETS
PARK FTE Y_ N—
p
GAS EA. SYSTEM -OVER 4 (EA)
C
BUILDING DIVISION FEES
I 1C d Ified copy hercbytumcity
ertNed ropy 6 V filed with the city Inspection division.
GREASE/WDUSML WASTE INTERCEPTOR
PLANCHECK FEE
GREASE TRAP
CERTIFICATE OF EXEMPTION FROM WORKERS'
PAID
COMPENSATION INSURANCE
(Thtesectlon need not W completed If the Nna t Is forum hundred dollars
($10))or lead
I mnifythat in the performance of the work forwhich this permit to Issued,
I shall net employ any person In any manner n as to became subject to the
Workers' Compensation Laws of C.Ifomla. Dale
SEWER SANITARY STORM EA 2007
Date ReCCI [N
WATER HEATER W/VEM/ELECTR
ENERGYFEE Y N
PAID
WATER SYS'TFA1/TREAnNG
NOTICE
OTICE
NOTICEco a objeAM:IL aftermakingthen Certnlpmo(Exempda Lyou
ehmld became aubjM to the Worken'Compeaatlon provenlans of the Labor
Date Recei to
NEW RESIDENTIAL PLMB. SQFT.
TOTAL:
BUILDING FEE
gon-on
Code, you at forthwith comply with such pme ldoru orthis pereelt shall be
deemed revoked.
CONSTRUCTION LENDING AGENCY
SEISMIC FEE
4.83
Iherebyafflnn that there is a construction lending agency for the perform
ance of the work for which this permit en Lamed (Sec, 3097, Civ. C.)
Lender's Name
Lendar'.Addreu
l mAdy Natl havereadthis appllationand slatethattheabove Information
I.mreact.Iagree to comply with all city and countyordinanres and Yate law,
TOTAL:
ELECTRIC FEE
3
PLUMBING FEE
34.73
-
QTY:' "''MECHANICALrPERMIT .- FEE
MECHANICAL FEE
34.73
PERMITISSUANCE
FEES PAID:
relating to building construction, and hereby authe ire representatives of this
city to enter upon the abovo-narntlorud propertyforimpMlonpurpa,es.
(We) agree to save, Indemrdly an d keep harmless the City of Cupertino
against liabilities,judgments, mscand expenses which may In anyway acme
ALTERORADD'NMECH.
Date Recei tM
AIRHANDLINGUNIT(TO10,000CF11)
SUBTOTAL:
(eJ -
agabul said CB m encW
o ant g of this permit.
-
AIR HANDLING UNIT(OVER IQODBCFM)
CONSTRUCTION TAX
Signature o(AppBantARDOUS pat
IXHAUST HOOD(W/DUCT)
CONSTRUCTION TAX PAID:
HAZARDOUS MATEKIWLSDISCLOSURE
HEATING UM7(TO l0(,fID06TU)
Date Recei to
Will the applica
materials. dlmdrat or future rtildingocmpantode, handle
by the Cupertino Municipal Code, Chapter 9.17, and the
Hennlvc UNIT (OVER 100,000 aT1)
TOTAL:
. O
Health and safety core Semon 25532(a)?
Safety
0 Yea No
VENTILATION RAN (SINGLE RESID)
ISS()P(MaTE
U�(J �Dp
Will the applicant or lure building occupant use equipment or devices
which emit hazardous air contaminants as defined by the Bay Area Air
Quality Management Dia rict7
1AYes Q No
, read the Fara mus materials requlrementsunderChapter6.95of
F
'
{� a
BOILER -COMP DFP OR 100,000 BTL!)
BOILFR-COMP(OVER 100,000 BTU)
the California Health A Safety Code, Sections 25505, 75533 and 75534. I
understand that lithe building does wt currently have a tenant, that it is my
NEW RESIDENTIAL MECH. SQFr
responsibility to notify the occupant of the requirements which moat be met
pdarloi,uanmofa Ce iflateofOmpancy.
Ia„ OL CBQQI lII10
City ttjys 1 l,.
ISSUED BY
Owner or authorised agent Date
TOTAL:
OFFICE COPY