S 2007 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE SALL POINT PEN ONLY
CPPV OF CUPERTINO BUILDING-ELKC]'RICAL IT n'NO
RUII.DING DIVISION APPLICATIONIPERMIT PLUMBING.-MECIIANIC'AI, 2007
BUILDING,PR(1JE177'IIIENTIFICA'IION
BUILDING ADDRESS: , SANITARY NO. APPLICATION SUBMITTAL DATE
,2 ( 9-71 Gark/Kvlew
OWNER'S AMI! �VllOty' CUM() NAME: IJCN '
C NIC CONTEDI.I
zlc
AHc1u'n;crnWcl !I!u: LIC NO: - ,;DDµEvs: O a Son 0. 1h
CONTAC"{' PuoNE: BUILDING PERMIT INTO
I hAa Roy TOg, Z 5.Z — Consultant poly Paid by Applicant(Initial) BLDG ELEU PLUMB MECH
ori- I-goo-771-898 ❑ ❑ ❑
LICENSED COMACO)RS DF,CI.ARATION rQTY ELECTRIC PERMIT FEEI I,emby.britt 0.1 em IicenN naly proomon,tri CLepw 9(.in, QTY DESCRIPTION
accZO with Scctinn9(X00)oI vi,i.nJuftna Ntuio,ax wd Prcrosssimn CMc,aadmyli,r.cia PEHMI'I'ISSUANCE RESIDENTIAL
in hull lincenodcImcl. ❑SFDWL ❑KFfCHEN RI?tODEL
QUU Lex"`O�'"` �'Y APPLIANCES-RESIDENTIAL ❑ADDITION ❑PLUMBING RIS PIPE
��W Dwe Contractor
,^7y ARCIII'IE(7TS DECLARATION PANELS ❑MULTI-0N1T ❑S7RUCRIRAL
Z O nZ I uMmuM my plaits mil be uscl n public rt,:ads MODIFICATION
OZ—� UPTO200AMPS ❑INl'ERIOR ❑CHIMNEY REPAIR
W Licensed Paic.vmn,il 201-IgpnMPS IMPROVEMENT C]SWIMMING POOLS
9 C Z Qby o n INFO,c clmM frumEm C v 's Liccnw w for c OVER 1000 AMPS [I RANI REMODF,IJREPA1R [].B£�IOLFIION
GUfollowing reumn.fkctioxi]
y ❑OT'i 11iR
Y . 7031 3.Itusicecv and 1'n,fcuiom Calle,Any city m n^tY SIGNS ELECTRICAL c �y�
O Na which rcuirtx v Permit to coruuun,alter,in,pmre,denNian,a mMir say wluclule /r tiO
prion.it,iauanac.elm rcquims lbcappictotfor-Oh l>cmit to hlcavigncd smma,cat SPECIAL CIRCUIT/MISC.
thetlmlelianwlrywununmcprvoioneonbcCor,o nieLanny:Law(Cllnmcry
WC�p (commcncingwhn Scniom]IXMpol Diviim tonne❑usimn;uvl Anfgsions C-Or,r JESKSIETERORPOLEINS. COMMERCIAL:
ay ey ghat he is eacn,M Ihcrtfrvm and the bnk far 0¢vllcgd eannPllon.Any vi.lmion of ❑NEW BLDG/ADDRION ❑DESI OLITION
XmN SOction 7031.5 by any aliamam for a ,a+urwbJ¢Id tlac uIvIdicwt to a civil(nnwlty of POWER DEVICES UTENANT 0FWD SERVICE
W
not from Nan five hunlmd dollars(S50d.
E Z'r IMYROVCMFN'f
Q wi I&, mtcrnflhe proapnr,c s emocadMor.iwage r,am(cc.ca„penanion. SWIMMING POOL ELF.CIItIC
ind In .ihm on,Codste cis,ComismsinmMMirzolfern : a,'le 11 to to Oueitrm ❑OTIIER
IY
1�'� vM l'rufe�sionn C'oxk:'I he Gtnnp:l,e Licence I.aw ot,cs ad apply In an owomr of OUTLETS-SWI'I Cf1ES-Il%TUHI!5
gag,,,.M h tihR or impmvea thcrtas,eM xho closes wch work hini oc hoot
his own empl.yccs,prnvidid that wch impmvcmcnu em not immndcd or offcrM for NEW RESIDENTIAL HLEL7R SG IT
sale.IL howc,eq the buiWing or improvcornt is add within on,yraf nfcomplmiat.the SQ.14.EI.OGR AREA $/SU.IT
ner-Fuihkr will.arc the bums.of Proving dor ne did not Wid or impmve for pur-
ow,of sok).
n I,ae nine,of the propcny a n cl1lrovely comI'll
wide lianvd contrast" T(YTAI p (''�
g,nP,cl ai pored(Ss 701 Husinns nM ms PirmssioCodehe:)TC.naactor's Li- of O D 0
eme law docs one epply to an owou of porpeny ,N)builds or improve.Samna,and QTY. PLUMBING RMIT FEE
whocnmmcis hrsack Pn9aa with a r f ritimq,O liecnml ponnnnt,,Oc Corn. lots
Liceme hw` NJIMIT ISSUANCE
I am emir,urda Sec. .H S P C for this rtvon
ACI1H-UHAINk VENT-W H(IiA) VALUATION
Owe
Dom
W'ORKP.PS COMPENSATION DIi olio ION BACK II.OW'PROTECT.IOIiVICIi
naeny err nMA,rlrnaRr.rpa,inry a,n none rmn,wmg rxewradan,
L] Inave mdwillomdnby na Ceni lane of dr,Lsbrr Cocr;memss,WnokefsCn of die DRAINS-FI.WR,ROOKAHEA.COND. STORIES T1'YF;CONSTRUCTION
.anon,r poridhi for by Section 1700 of the tabor Code,for she Icdovrmrwc of sM
wok for whish this prnnit Is;owed, II%Tl1RiiS-PI!R TRAY
❑ I lave and will mai main Work,,,C.mpcnsarinn Imw .,m mluirtd by Scalian
37M na diel dw,rCale.for the porformnre M tic xod,fox winch ods Punta u h2witd. CAS-I:A.SYSTEM- WC.3 OfTf1.I:IS OCC.GROUP APN
My And"Com va.ion Insar rce cart,.aM Policy vuml,er am:
Carrlor'. Policy No. GAS-HA.SVSI ISFOVI!H 4(EA)
CERTHICATF.OF EXEMPTION MOM WORKERS' GREASFIINDUSTRI.W'ASTEINT:RCEPIY)R
COMPENSATION INSURANCE! BUILDING DIVISION FTs Ps _
FThis scriomnarlwg occ..n..nMlfIn.innnit is foraw hm,dnd dollam(S hill) GREASY,TRAP ��-
a less.) PIANCHECK FEE
I ccray that in tic peHamamc of the work fm whicb this Pmnit iv issamiIdball SEWER-SANITARY-STORM E,%.200 FT
It.employ.11I PunnImyn ,,nese mnecox,w wbjau,the WnM1ctx'0—Iscn- I!NF,RGVIEE
It.,Z susion Wwa d CaNfami.llate1C11 WATER HEATER W/VFNTIEd.ECTR
Z2 Applicant GRADING FEE
G NODCE TO APPLICANT If,"Her meting his Cenifcem of E.cmpnon, on Mould WAFER SYST Wfl REATTNO
a ; Icmn,c wn at t.Ibc Wrkcr's Co ssi f th,IaMr Cl],,Ioo mast S '
j ,pea porrat Olmsu
0. fathwilh cm,ply with eacn provision.or permit al,aD MJccnsd rtrnkM. WATER SERVICE CA
uZ dCONSTRUCTIONiso mmw1.CNDINGnGIiNCY NEW RISIDFNfIALPLh1R. SQ.FT. PAID Dv Y
1 hereblR
y arm Ihaflads dere is a cliokregc
n ling sscy fa the pedarmrce.f.
V. do,wind,for which this petrit is iuuul(,Scc.100],Cie C.)
fxrdcr'a Hants, ',OTA L:
V Irnlds Addhons TUTAL'
d
I cenify that 1 lase mad this upplicalion and stem the ilbo eNoi,inion ion is Y BUILDING FEF,
.r m carat.l Cgrtc to comply with all city cad county uNitwnee.and etmc lows rowing m QTY, MECHANICAL PERMJO
IT
UZ building c.nstrvnimitast himby auduoix at,menaal of this city to ether upon tic SEISMIC TIE
aMvc mcnx,ncl pmpcny for im'Icclion tar , s, PI:RMID SSUANOH
(Wc)agree m viva,irdnnnif,and keep hanolou the City ofCupcoino Cgaino LLE
Iiabilidn.judgsrcnts.mdaaM npen.va wnich may in any way eccweag�ins�evil City ALTER ORADDTO MECII.
in corm tai of the gnsuing ofthis prank. PLUMBING M.
APPLICANTUNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIF11010AX)CRr1)
SOURCE REGULATIONS. MFTfIANICAIJF.
AIR HANDLING UNIT(OVER 10.00O CFM) CONSIEUCDO X
Signature of ApplicantPCoatrador Dem EXHAUST HOOD(W/DUC) HOUSING G NIKE
HA%ARDOUS MATERIALS DISCLOSURE
Will d,capplicem or forum huildingoccotant wire or handle Ism ackne mwmal HHATING UNIT(10 100,000 BTU)
ae defnnd by Jia Co,noo Municipal C 3c.Ctupteo 9.12.and tHL I Iealth aM Safely
Cod,.Stttion 25532(p] PLEATING UNIT HOVER I W.(M BTU)
Vo 0No
VI!NTII,A'1'ION ITNfSINOLi:RESOD) PAID Yum RcccilrY
Will n,epplicanl a haute building alamci use esuipnev or OR,ias which
emi,hvafdvs air contamim n,m okhneJ by she slay Area Air Quality Managrn,enl HOFER-COMP Off OR I W,010)BTU) TOI
Dill rill^ BOILER-COMP(OVER 100,000131U)
(]Ya C3 No
AIR CONDITIONER
I lw6 -.1 the hvmdow mari,uartyn lmnnmt.ualca Ck pm,n95 or hasdhad Cali- r1 t IS$U`NCEI T13�
fano IIeulth ra Safnt Code,Sarin rte 25ti is my and 255L.I to"try
out sf,M NEW RISIIIFNOAL MECH. SQ. '((ffJ�(( L.
omit;aNancnmcunnvly hnvc auoct drain `w1areONCillldratc Fydrttancy. XU
of the rtyulrtncnlx which mu4Mncl inion.irsmwcufa Cmif tc nf(Ltu(kircy. '
Owncr.remlrni,Magcnl Dam TOTAL ISSUFD IIY'.
OFFICE