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S 1666 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY 2.N)4Q-� vUvIOC. 0/v CITY OF CUPERTINO Buu.DING-ELCM RICAL rIs rrn0. BUILDING DIVISION APPLICA'PION/PI:RMIT PING PROJECT IDEM MECHANICAL - 1666 - .- nmf.mrvc rxOJr:c'r mnrv'rlHlcn'nory BUILDING ADDRESS. SANI'T'ARY NO. APPLICATION SUBMITIAL DAI'H 'NER'S NAME; Q U I PI CON'1'HACfO 'S N ME LIC y5 xr� UY L ♦ q N/C CONTROL Eft ,III'1'IiC'/E,NGI HERE LIC NO'. Ill_lK1:SS'. I^- Le T � ❑ �� /� 4 (✓✓\\{tJ I ItIlAillit- CONFA • PHONE: �f 5� BUILDING P1iRMFEINFO C-aodg29 ❑ Consultant Fecs Paid by Applicant(Initial) BLUED ELECT' PLUMB MECH ❑ ❑ ❑ ❑ .ICHNSED CONTRACTOR S DECLARATION QTY. ELECTRIC PERMFI' FEE QW Z 1 be arrrn that I aa,rcenxee a,mer pmvismas or chapao 9 temnmenamg - JOB UESCI211'TION CO [^Ill Seth n )of llivisionJnf the Business anJ Profez.inm Coale.avd my license is pliRhlIT ISSUANCE RESIDENTIAL: Fq'BF full lo, and effect. gAl�lL ❑SPDN'L ❑KITCIIIiN REM0IlE1. 6ZU Licen.c CF v Lic.p L-I Cr I�1VJ I' -NS API'hIANCIiS-ItIi51UENTTN. ❑ADDITION [I PLUMBING RE-PIPE Vo<a, Ilaalc GoS DIE - r,Dh AHCIII'rECT'S DECLARATION PANELS. ❑MULT'FUNI'I' ❑S'IRl1C'I'1111Ah Zoiatz lumeramal my Plan..hall bcusedir,mblic records MODIFICATION ' IllTO 2W AMTS OZ=� ❑INTIiRIUk [I CHIMNEY REPAIR F^4LW Licensed]'adnsiaand 201-1000AMPS IMPROVEMENT E]SWIMMING POOLS :FE-I OWNER-BUILDER DF.CLARxITON lElBATH RHMOUP.UREPAIR ElDEMOLI'I'ION ry0.� wW� I Ian,hyHuffim,'lle"A unli � , d, on,the Ga: m mha'.L icns cc Law on,la, OVERBtMlAMI'S X 3 W U follow'ntg ....a.(S,,iad 711.315.Blooms,and Ymfic,ions C,me:Any city m'county SIGN$ELGCfI11CA1. ❑OTHER W U.I` which requires a permit a,consumer,alter,improve,demolish,or repair any structure O Prio t c : h requires m ppl t f h fie , fl .-g Ion Inca SPECIAL CTRCIJI T'/MISC. thin lie islicensed p . tt thepollismea ElftM1 C l t laterea,Law'(Clapter9 �'' Q'F' (wmn rte nbw WSect nt)IHp)nf Divnin,3 nDhe Bts rex,nullmfe' :Ludc)or rEMPMFI'FRORPOLETNST. COMMERCIAL, 4aoC iC Iouin.ol.um^ ,111.I1i'atn and the hurt,fnr he aIleol cleanlii.An Iwlo^o1 p g IiY v^' El NEW NLDOIADDITION [IDBMOLI'I'Il1N Seatinn 9!13145 by any efficient far o permit uht,cls the applicant toe civil pcnallyol POWER DEVICES L1 TENANT ❑FOOD SERVICE y nal mire than five hundred dollars l55(NB. F-Z>• IMPROVEMENT QUI,as owner of the pmryny.or mYemploymswith wage.av hcinnle cnanpens:ninn, SWIMMING 1'001.ELECTRIC will(ill the k and thestructuretintendedofferedf El 9044 Bu. ss ❑09'HER o dao End f I'.' . Code,Th Characters 1 L Joe, t apply I of Ol1TLP.TS SWTrCH FI%TUNIS y1 pr,p p h 'IJ' 1 ' . thereh . : workh 61or 11 FM1 hkown enn,lo,ol,pI 'I d l . 1 1 t:am Iintended fl sed for NEW RLSIIII:N'I IAL It I SO ETL VIe.If,however,he billd',gnr'mpeovetn,.nt —.1d Milan omyearofmmpluim,Ihe — SQ.TT.ILOORAREA 5/SQ.ET. owner-builder will have the burden of proving that be did not build or improve lair pur- pose of sale.). ❑ Lax owner of the property,um cscmivdy contracting with licensed connuemrs to TO'PAL: onxuud the pmjeol(Sec.71144,Braine.nnA Profession.Cn le:)'Um CanuaroPs IJ- . - - .e Law doo,nd apply maaownerolproperty whit build.m!mph,,human,atm Q'I'Y. 'IPLUMBINOi JIM[' FEE.. who convicts mroch,unpov with o ,,ntricmd.)licensed pmauannn the Conwcmrs License law. I'IiRh11T ISSUANCE ❑Inm eacmpt u^der Sea .B&P C far this renxnn Owner Duro AMER-DRAIN&VENT-WA''R IIIA VALUNI ION COM WOIunderSnalty tNSAHON UECc billowing Eng RACK[=LOW 1'ItrtI BCT.DEVICI? I handy of&^,under Penalty [ of enc o self-i dlowinr Worker's Cardillo- �© Q �ne.no andwill forbi Section 37atcof Consoslad, oade,fartie WodeJsseeft DHNNS-FLOOR,RWP.AREA.CONIC. STORIES TYPE CONSTRUCTION satioaf r an,h onl for ..Section issued 4]00 of the IaMr Cale,far Inc perfom,vncc e(the - ,I h h h 1!i.p I d. Il%TURES 1'IiN TRAP Ih will anaholion Workers Cluou'lialloonal 11111.1juale.Ell rel'aledIySicilian ' 1�1WiuducLabo,Cod,lot lhuparfo'nwme of the work hololehlli-rptrnni ax'xsted.' GAS EASYSfIiM-I INQdOil'I'I,hTS UCC.GROUP AI'N My W.: is n e c ion lmuinee c finer and Picy olicy iyaylb�y 144 Y GAS-EA.SYS'I EM-OVER4 BtA) - CERTITECN GGFEREMVI'ION FROM WORKERS' GREASEANDUS'T'RL WAS I'E IN I'ERCF.PTOR COMPENSATION INSURANCE. BUILDING DIVISI(lNF1iC4 (Pit....io^cordial he cord'Ual i l he format is far on all moldullm,6100) or les..) GltfiASE'1'ItA1' YLANCIIECK PIER I cert ify but name peconnote,of the work for which l a,lormil is I.snal,kholl SEWER-SAN]TARY-STORM HA.200 FT. nm employ any Mandin uny n amer se av m Ied,me subject In the Worker:Clarified- ]ENERGY PCG O z smion Laws of California.Mute WATER HEATI7R W/VEVDE-LFCfR GRADING FIE y Q Applicant - Gf/1 NO]'ICH'1'0 APPLICANr:It,ulicrmukiny llde Cenircanaf Pxemp,ioa yen should W,IFIR SYS'IHNIVI RHATING SOILS THE F 5 became subject to the Worker'.Complaisant... provision.of he Labor Cade;yea,,sent Wforthwith comply with wah pro,i-.ions or this prr^it bill he deemed rcoined. WATER SERVICE - a � CONSTRUCTION LENDING AGENCY NEN'RESIIl1iNT1ALl'Lhtn. SQ.F[ PAID '7 z 1touchy afemnn:tt mere is a mnrtmohan landing agency for me permriawe of Ga Remiptro U O he work for which ad..per.n i,issued(See.309].Cie.C -- Ha H Lender'.Name 'TOTAL: V Isnder's ABdrexs TOTAL: r 0. I[ci ify mot 1 have read his appli.hrri intrinsic mot the above iaf namilion is - BUILDTN( ' F" rA carred.l agree to comply with ill city and county otdimenro:md sure laws relating to QTY. MECHANICAL PERMIT FEE U Z building construction,unit hereby authorize representatives of this city to enter upon the SEISMIC/.? above-mentioned property lair inspection po,no,s' PIiRMI'I'ISSUANCEI We)agree h,pave,i nde^mlfy E (keep harmle"'In.Ci,y err Cupartinu alienist ITEC' IC 1;1717liabilities.lndgmemv,costs and expenses which may In any waynerrueagaitm said City ALI'UK OR ABU 1,MECII. in conseyucnceof he granting open f this ial. 1 MBING FFF 3 3 2e.pp APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-MINT AIR HANDLING IINIT(TO 10,000 CFM) SOU CE RT ULATIONS b11 HANICAI.PEE /_ / A114 HANDLING UNI"['(OVER 101N0CFM) CO S'rRUGITON TAX Signature Ell ApplicanVCnntmct 7 L v e li%HAUS'f 11001) W/DUCT[ TIC SING MI'I'ICA'fION FEEHA-LARII( IAITUALq DISCLOSURE Will the applicant or Boom building occupant store orhandle hmurdms material HUNTING UNIT(11)loops)B'RD as defined by the Cnpenino Municipal Cade,Chapter 9.12,and the Health and Safety Cale,Scdion 25532(^)'! I IEATING UNIT(OVER 100,000 It'1'U) El Ycx PAID n vH31. N'IA1'ION PAN(SINGLE IiIts]D) Date Reveiptk Wi 11 the appliemlser future building occupant use equipment or devices which BOILER-COM['13liP OR I W,0N)BTU) - ,it hazardous air contuntintmm as defined by the Bay Area Air Quality Management 'i'OT 00 isvim", Yes BOILER-COMP(OVER 100,000 BTU) ❑ o AIR CONUD IONHN bavc rcuJ the hwmlou..mmerivl.myvimmcnis under Chapter 6.95 of he Culi- ISSUANCE DATE. remain Ile:dm&Safi,,G.Ic,Sections 25505,25533 add 25534.I understand That if the NEW RESIDENT"IAL MECH. SQ.FF. building does not currently have a tenant.that it is my resl.,rrvibiliry to notify the -upon ocNra ) J cp,ire -.whicfynmat be mm prior fin isnummc ofa Cenifi - O authanmd ugan uta TOTAL: ISSUED IM � OFFICE 00 d± ) C1, O v as as n. azz z z z z .L LL. y'. P6daaaaaaa o. Ma. 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