26978 C.11 Y OF C,U13ERTINO DUMB Nli-MECH N I A1. I I'I:RMII NO.
BUILDING.DIVISION APPLICATION/PERMIT PINGPR PROJECT MECHANICAL 2 C n�7
I .• .. a BUILDING PRUIN.CT IDENTIRICA'1'ION ' I L U J 1
BU I.DINNG�ADORTESS: [� -k'• SANITARY NO AllI,IIC CA('II(JIBINSS/I]I]Nil[IAIAbI.DAII;
oa� SI' A A) �;0�40 (�`,\ �—y� ��NI]�{0 (�\ ( T LOT 11�y -�1
OWNI:R$.ItIA� �\'.' ` 8 T� 1 C N}}f_I \S `a � r 'Y .]V�4- I I
CCr//\\ NC CGNIHOLg
RCIIIl1iCl AiIMINIiIiR: LIC No D S
f 3 Qa�scos *o
•� nry Goer rnoNla: QTY. 11c,'tpsi')'he'.�(,lCf1tIC Pg U. ��'^�I'` + Y�L+E�• �'- ' BUILDING PERMIT INFO
a%r - •..y" °I 1 I Y BLDG ELECT PLUMB MECII
t PER MIT ISSUANCE �^ I lIL177— 0 El
1.ICENSEDCONIRAL OR'SDECLARAIIGN APPLIANCES-RESIDENTIAL I JOB DESCRIPTION
�yz Iherebyaffimubat lamliansedunderprovisiom oi..Prcr9(.at:nencingwih
tslono�Swann]aryuf Division Aid tire Business and Profession.Corle.runinq harm ism PANELS
keac.to Lmrnac Class Lic.g ` UI'T02(X1AMPS
to<Z�Dare ARCIII�anracor I 201-I0a)AMPS
g-'Dso FECES DECLARATION SO Pf.ROOR AREA S/SQ Pf.
ii i:—I I 1 tl my Pl.mas ImA as public rcnmir, OVER 1000AMPS I
O]� � �hn'=rat nt'TY r_` I SIGNS ELECTRICAL
y'CK<� � IianmAlhnfcssi^tad OWNER BUILDER DECLARATION I SPECIALCIRCUITMISC.
OyU I hereby affirm that I am«enter front the Contractors t cove,law for he
1+1 u3. H following e.nn ISectinn]OtL5,❑nsinav mN Prnfe+slnio Curie Anycitymermnty 1EMP.1,1IITERORPOLE.INST,
t yg wMch requires.Permit to nmumcL alter,improve,rketraloh,o,repair may stmctum
}� priorbi i"llare',also require+the applicant for such pernm to rile a signed statement POWER DEVICIS
�p hatheiv licensedpursuammrne provisions of he Contncmr's License Law(Chl
�d02'19rumnmenomg with Section Tarts of Division 3 of he Basincwand Professions Code) I SWIMMING POOL ELECTRIC VALIIAI ION
ul—m or Ghat be itatilipa therefrom and[lie bran forthe.Ilcg.Jeaemptmn Any virlolum of OUftEfs-SWI1CIIfS-
tza Section 7011.5 by say.p,lrrnm fm.permilsnby,,t.he.ppre.nnn.civil Penalty of I FIXTURES
$$p nor mnchan five hllodmddollars(SSn0)' NEW RESIUPN D R ALELECT S I
❑ 1,am,wnvnOFCprrgvrty.army employ<mwithw.gaaatheinnleminPCnsabnn, Q T. I STORIES I YPE CONS FRUCDON
3.. will do the wok. nd the obscure is notimendcdoraffned battle See 7044,11 ties,
and Professions Coale r Ill,Contractor's License Law doe+not apply to en owner of
moi'crty w ho Nild+or inipnrwahemon,aml whodcewuch wmk himal f or rhrongh bi+
own nnployres.provided unit such improvements am not intendedoraffercl include IL Or C.GROItP RES TWITS
however,the brldingor inrpmvrrcrr L sold within aria year ofcunplerion,the owner-
builder
x III have the burden of proving that he did not build or improve fm pnmose n!
safe.) Q'T'Y.' r '�f�I,IJIk�bINO�QR {Tf:•.`% '' .e;`pg8::: 11.001)ZONE APN
❑ I.as owner of the Property,am exclusively contracting with licensed contractors to
i. » r,{,�ipF+•},1 r. ::)'{.
novae,Him project(Sec 1I44,nation"and Professions CadeI The Contractor's ppRb11T ISSUANCE
License law her not apply to an owner of properly who builds or improves thereon,and I I I
who contracts for such project with a contract oq)reenter pno.nntmthe Cenbarors
License law I ALTER-DRAINAVENr-WAIT.R(EA) I r FEESUMMARY
❑ lame-or"node,See. B A P C far his rcasml I PACK FLOW PRO fRCT.DEVICE I ODUoDL lkloi
SANITARY YN
Own., Doc I RECTUM 4
DRAIN ELWR.ROOP,ARCA,COND.
WORKMAN COMI'CNSA'iION UECLArcATION - ���. S fOL'TAX Y_N
❑r l iter<FY effinn this l have a ceniGcam of consenno s elf-insone.or a cenifca¢of r ���q
RECEIPT g
FlXTU E. ERT A' s II '�
nr1"oCmnpenaati,`so1 an,,erecetifiedo.pythereAScc.39WjahC)which ..��11"""" PARKflili Y N
all eniplayee's under this permit I (GAS-J.sysiih1Td INC.40Uh1i 151 1 BUILDING DIVISION PCIS
Policy p it
Cmupan-
Carr GAS- ASYS'ITiM OVER 4IEA) PLANCIIECK FIiIi
❑ CmifieA COPY is hereby fumivhrl. I
❑ Ceninied copy is Bled with the city inspection division. GREA INDUS'IaYA' ErF INTRRCFPTOR at il T G+DING ILr:EXEMPI TON[TOM CPRTIPICCO PFNSAI ION INSURA CEORKERS' I IGRIiASE'1'NAP I 150115 FF.E
('ITnwOionnerd nor he amtplreJ iDhepermit is hr an<hnndrM Anllnrs lSlOp I ISHWER-SANITARY-STORM EA.201111'. I (ENERGY PER
as less 1
I certify that in the performance of the work for which this Permit is issued.I shall I I WA I ER BEAT IT W/VEN 1'AiLECTR
ntPloy person in any equl so at to become subject to the Worker: PAID
Cm pcnvri wso Cl lifulpYs ITiit.� µ� I I WAI r:R SYSTEM/1'RIiATiNG I I Dam Rccriptx
O O fciml r1 A w cn
7�+ NOIf(F Tf1APPI.ICANi'.If,after risking this Certificate of Exrnptinn,you should ) I NEW RESIDEN'UAL PLMB. SQ FT I 'TOIAL.
becanesnM1junolhe WnrACr'nf-onipenantian provisions of he L.Mn Cwie,you nma
FFFa""; forthwith comply with...h provisions or his Pennitdmll hedeenmdrcvoked I I I BUILDING lliE
U7(] CONSI RUED ION LENDING AOENCY I I I SI71SMIC ITT!
' az I hereby drint that there it a construction leobng agency for the performance of
U the work for,wbmh Ibrt,leciol n killed(Sec.3097.Cis.C) I I TOT AT,: ELECTRIC FT
LL I<oil,,a Nnnr r If ,;,, !I• PLIIb1BINO Rif:
Leaders Ade,-• QTY. ,,, ',r MECIIANIC�L'Pblibll'F'.. hEQ";;;,I
Y W
correct,I certify that I have rcud This application nntl Nam that the ahrv<iws misting M MECIIANICAL Ili.
`+ 0-r Iegme ut comply with old city and contrary edm.ncn mW state lawsrelatingmI I PURMI'I ISSUANCE Ir I I
F �y Luildntgconwaret a.end hereby.ninnim representatives of this city or enter upon the DNS IT IKON TAX
U .tame mentioned property for,inspection Pugxoer, I I ALTER OR ADD TO MECII
(We)ngra m save,indemnify and keep harmless the City of Cnpnti m ngrinst
Itabilaics.ponuarents.costs Nrd expenses which may in tiny way eccrueageinsOeiJCiryl (AIR HANDLING UNIT(TOIO,oW CP6ry I I
incnnmquence oOh�e-grn1i i+permit n^ q^9� I I AIR IIANDLING UNIT(OVER 10,ap CPM7
I{. e nf�n'p4plicnm/Cnmmnor 1 Date I I EXIInUSrII000I WA)l1CT) I I PAID
1 J I IAZARDOUS MAI ENIALS DISCLOSURE (IRA"IINGUNIT(iorin,fa II'fU) U:ne Receipt
Will the applicant or future budding accup.nl store or handle h.mrdnin material
as JeEned by the Cuperino Municipal Cale.Chapter 9.12.and he 412,h 1M,'"a I I MATING UNIT'(OV ER 100,100 BTU) I TOTAL: I
Code,Section 25532101? Q)� all r ❑Yet ❑No I VENT'ILA'1ION PAN(SINGLE RPSID) —J
ISSIIANCC DATE
Wllhhenpplianmrluuuchuildingoccupam u¢equiprtRnmrJevicn whichcmit I IBOILIiR-COMP(JIIPOR II0,000 OTU) I
I�hmmdous air comnntirants its defined by the Bay Arcs Air Quality Managnnect I ❑OILIiR-GGMP(OVER I01.W11 Bl U) I %�.1 I, i a
Cisuiet, - 1u'
❑Yes ❑No I NEW RESIDENIIAL MECl SQ FL SEp
I have read lie h.... our martinis requitement+under Chapter 695 of he I C r 8 �g9
Calif..do Ilmlth A Safety Cale.Section,255(15,25511 end 25534. 1 understand Thar
ji(thebo'doifho m mcurrently r,st, ich mot be arm, o 1.....nnet of at Certificate oil •/d2 k1f' C'(4-•.-
cuPUn dnimm n+w pro
Uwnrr nr mnMrcvrA agrnt Da1< I Ti)l'AL: IISSUED B)`
OFFICE ! '"