04020089 CITY OF CUPERTINO 77'maF! "' �yj°' ''
BUILDING DIVISION Pj+' cioR�1.GTQl��0 "
BUILDING ADDRESS: DOYLE CUMMINGS PLUMBING PER""N 4020089
R S A PERMIT ISSUE DATE
qE SANITARY N0. CONTROL NO.
ARCHIIEC IENGiNEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
Dp
LICENSED CONIRACDR'SDECLARATION
P, Job Description
C I humby of rna Nat 1 am licensed under provision of Chapter 9(commencing
Zw wMSadon7")ofDivision3ofaie Bus'�Lestand Prf ion ode.an ylieenseis
<o. in full fol¢ c r v4
ga
D. Or Us cog TI-STORAGE SHELVING
FF
K plan shad be DEC
rocnrds
0� LiccnsedP tfn' al
5 OWNER-BUILDER DECLARATION
f I amity affirm,Nal 1 am aacmpt from Ne eonuenor's License Law for de
00 following masons.(Section 90313,Bushmen,and Profession Code:Any city or county
$E! which rcquims a Permit in camsutmr,alter,hormone,dcmnlish.or¢pair any saucturo
Zw, prior b1 its issuance,also mquima die applicant for such Permit us rile a Signed suourmenl
i<p than he is licensed pu..atmthe pmvisionsfMoContractor'sU.. aw(Chapter9 Sq.Ft.Floor Area Valuation
�$ (commencing with Section 7000)of Division 3 of the Business and Profession CMe)W
_ that he u exempt drcreflom and Ne basis fm the slteged nemption.Any violation of
Section 7031.5 by M applinnt fora permh subjects the applicanno a civil penlry of
nm mem Nan RK hundred dollars($500). 3 2V1Y*Ip4er0 0 Occupancy Type
❑1.as owner of the p.Perry,or my employees with wages as Nen a.).compcnnrlon,
will do the work,and rte structure,is not intended or offered far sale(Sec.ION,Business
and Profassisn Code The Contractors License Law dors ant apply to an owner of Required Inspections
property who builds or iminom theroon,and whodonsuch welt himselfor through his
own cmployen,provided that such imprsKments are not intended wslfased forsale.IL
however.the building Or improvement is said within one year of onmplomm,Ne owonr-
h older and haw the burden of proving Nat he did not Wild Or improv for puryom of
cal'.).
O 1.as owner of the Properly,neo exeluvvely convening win lianud conml[mas to
cenrwet the projco(Ste,7044.Business and Professions Code:)The ContsaemYs Li.
anti Law does am apply m an owner of property who builds or improws Neese,and.
who cuntracm for such proposes with a contrecmr(s)licensed pursuant to the Convectors
License Law.
El I un exempt under Sem ,B d:P C for Nu mason
Owner Data
WORKERS COMPENSATION DECLARATION
1 hemby art=under pctWty of perjury one of the following dalaratien: -
haw N
and will maintain a Ceficate of Consent m se
nt lr-insure for WorknersCompen-
ssion,as provided for by Section 3100 of the Labor Code,fa Ne Performance of she
work for which this permit is issued.
❑1 hew and will maintain%,kea Compcwdon lotion¢,as mounted by Stenion
37W ofthe Labor Code.forQtcpcfformmec oefnMePwoort for which this pcmtit is owned.
MY Waite rope sec 1 u �Irry
trier. I/ Po}kyjy No.:
C TIFlCATE OF EX Pf10 FRO ORKERS'
COMPENSATION INSURANCE ,
(This auction need not be completed if the Iemtitisfwoon bundmd dollars(SIM)
or lass.)
1 cenify Nat in Ne pmfummnee of the work for which Nis permit is issued,l shall nut
employ any Noun in any manor an as in become subject in Ne Woken'Comper.sa0on
Laws of California Date
Applicant
NOTICE TO APPLICANT:If,after making this Cenirleam of Exemption,you should
biome subject to Ne Workers Compm.ntion pmvisions of Ne Labor Code.you most
z f'Mwin..Ply with such pmvisinna w this permit Nell be domed newkcd.
y' CONSTRUCTION LENDING AGENCY
I hemby affirm Nat them is a comwctinn landing agenry for the Pertmmwa or
e de work for which this permit is issued(Sec.3091,Civ.C.)
lenders Name
z Lender's Add.
O 1 certify Nat 1 ltave rod this application and sum ttir the show immomdmt is
Fcoroner.1 agree to comply with all city and county ordinances and state laws misting to
V buildingeonsm tion.and hereby aunmina mpreaenetiea ter Nu o
city to cerupon the
U shove-mentioncd pmpeny for inpenion purposes
(We)ogre to saw,indemnify and keep harmless the City or Cupcnine egaint
y liabid es,lvdgm te and axpenea which may in any way accrte sgainlsuO Ciry
Z in corvequenc ing of Nis Permit.
^ APPLIC U ANDS AN OMPLY WITH ALL NON-POINT Issued by:
SOURG O
�.
-+si natureXY15532(a)?
Re-roofs
g p can manoDe¢HAZARDOUS MATERIALS DISCLOSURE Type of Roof
appliam orfuwm building oaupantsrom orhandic harsrdous malarial
u dcBnedeCupertinoMunicipplCalc.Chapmr9.1I,anddeHaINuW sarnycede.sc Yu / All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant ser future building acuWm use equipment or devices which g
t harsrdnus air conmminanta n .ned by rte Bay Asea Air Quality Management all new materials for inspection.
Disvictl
❑Ycs No
I have theba,rdnu,mamrimsmqui¢mens under Chapter 6.95 ofne Caliror.
nice HcalN ons 25M5,25533 and!2553x.Imacmand dm ifde Wilding
docs tm a moan.Nmw
at it y aponibility notify the pceuparn of the
mquim ct n tau be m issuance of a Crstibcae Occupancy.of Occupes
y. ,D Signature of Applicant Date
c own¢ ser t ;assent Date All roof coverings to be Class"B"or better
7"LARA 0" FIRE PPARTMEW _ _ . S
+� CONTROL NUMBER
IR,E .e SANTA CLARA COUNTY
• 14700 Winchester Blvd., Los Gatos, CA 95030-1818 d �o Z 0 O 8 1q
r+ (408)378-4010(phone) • (408) 378-9342 (fax) PERMIT NUMBER
PLAN CHECK No.
PLAN REVIEW COMMENTS
CODE/SEC. SHEET NO. �) „ O..-.-, ���„ .[� 4et_- 4� 7/� IL y
The following CHECKED items apply to this project:
Existing fire sprinkler system shall be modified as necessary. A licensed C-16 fire protection
contractor shall submit to the fire department, three sets of shop drawings, a completed permit
application and applicable fees for review and approval, prior to performing work. UFC 1001
Existing fire alarm system shall be modified as necessary to accommodate new construction. A
licensed fire alarm contractor shall submit to the fire department, 3 sets of shop drawings, a
completed permit application, and applicable fees, prior to performing their work. UFC 1001
Tenant shall have access to a minimum of. 2AlOBC minimum rated fire extinguisher(s).
Travel distance to nearest extinguisher shall not exceed 75 feet. UFC 1002
Tenant shall have access to one Class "K" type fire extinguisher, within 30 feet of commercial
cooking equipment. Post sign near"K"extinguisher noting commercial fire protection system
should be activated prior to using the portable fire extinguisher. UFC 1005
• Exit doors shall be openable from the inside without the use of any special knowledge or effort.
Thumb-tum dead bolts that require more than 1/4 tum to operate are not acceptable. UFC 1207
Exit Illumination: Provide illuminated exit signs. UFC 1212
Contractor shall field verify the integrity of existing rated construction/assemblies and restore or
repair as necessary as part of this work. Penetrations in rated walls/ceilings shall be protected
by listed fire rated assemblies (dampers, doors, caulking, fire stopping material etc.). UFC 1111
At time of final inspection, the tenant shall provide to the fire department a labeled emergency
access key for placement in the building fire department key box. UFC 902.4
4? This plan check does not permit the use, storage or dispensing of hazardous materials, operations
or waste. The tenant shall provide a completed HMIS to the fire department's hazardous
materials specialist for review and comment. Furthermore,a CLOSURE PERMIT is required prior
to terminating the storage of hazardous materials at a permitted storage facility. Demolition of
any facility/storage area that previously stored hazardous materials shall not be approved
prior to obtaining a CLOSURE PERMIT.
® APPROVED FOR BUILDING PERMIT ISSUANCE subject to compliance
with the above checked comments prior to final inspection.
JURIS PLANS SPECS NEW REMODEL AS DATE PAGE
❑ ❑ Y ❑ CONST. . UL �S BY
a4iJiT
/)-D `' 1 O 1
SEC./FLOOR OCC OCC.LOAD AREA ARCH G/CONTRACTOR/OWNER
NAME OF FACILITY LOCATION y
A California Fire Protection District serving Santa Clara County and the communities of
Campbell, Cupertino, Los Altos,Los Altos Hills, Los Gatos,Monte Sereno, Morgan Hill,and Saratoga
- -
o
EO
�
D '
p.
n •
cn
® �D
I R)
V C
a
7 _
0 M
a
V
r
u �
D .
A O:
A
r W
tJ� m •
C') -
m
n
0
m �
N
b14-
� z.
o �.� �� .
jb
a O .O 7 O m O
T ti
C
i
UY.'1 D IS ION
INTERIQR / : MSTALL*4LLS, DOADJUST LIGFITS.QND
SUPPLY ',AND RElUF�`1$..Rt&TAIL ELEGFFtIGA1 OU7LfT8 .
j
ACRES
SCfE AfZFA:•I FT• a
BOOM AREA: t 1,52
SO. FT.
FT.
2.
TOTAL sa: FT.
AREA, of Tms:imp, OVENIf=MT: 12.7 $Q. FT.
BUILDING COVERAGE: CARS
PARKING REQUIRED:
PAAKlNG PROYIDED _ STANQARp STALLS
tDICAP STALLS;
'^
COMPACTSTALLS
TOTAL STALLS .
,PAOKING RATIO: �.
PAVED- AREa
SO FT.
PA�7ING.'COYERAGE @k�z S
tlN4+i(2SCAPE AREA: Sa: FT.
LAND$CAPt1G COVERAGE}„ %
T�?E, 6P, _CakSTRUCMN: Yl9 ccQwxt_;S$
a OCCUPANCY �----
ZONE
FIRE SPRK Eft:'.$XSfEM 10--;^--UTt�MATIC ..
' U$.0
UFC.
U P:�
T
i� gF 24 FdAkF)ICAP CODE
O71E.:
t ,
r.
1 •TTT
Cs�
"
`
� �� W l
N
O
A
i
FILE No.750 02/11 '04 12:53 ID:SYSTEM CONCEPTS, INC. FAX# 873 8024 PAGE 2/
1 Sliding Divider
s :2':. Full Divider'
3. ,Angle:Divider
a t ' 4'jc':Side�Sway.Braces
• y 5Back Sway.Biaces
is,
'Closed Base Strip
7 LalielHolder
8 Endpanel
9 Back Panel.
.•.i. s ltl'Sltel Clip
FEB lh�?'.Ttpllace ;
Angle Post Delta Post Beaded Post
• • Our most popular style Double-sided design—ideal Double-sided design—ideal
• Stiffening offset rib as common posts between as common posts beiwcan
applications multiple ts with ndepen- multiple units with indepen-
• !deal for seismic a
a PP dent shelf positioningdent shelf positioning
• Always used as rear posts in Roll-formed of 14-gauge steel • 13-gauge tubular steel design
combination with other posts �t
• Shelf access is reduced b 2" Smooth front face for office Maximum weight-bearing
Y applications capacity for heavy-duty and
Post Heiglrts available Not suitable for seismic or mezzanine applications
applications
from S ft.to.,2 ft. heavy-duty.for most Y- ry Pp ations
applications Unobstructed shelf access
Shelving System Growth
t 1
11
♦Yoe ,,^�.'. =. r".b4+x.`. a :.?Pl' S* r':Fi.r.- �•MSYi• its . ..,,
1^ Angle Post Pelta Post Beaded Post
Add'to Shs11 Wldth ;,'. 3/e��per unit3/a' penuntt 3/x11 per unit
+t/z'lper row +3/4"per row
Oatetttlne�ShetFEfa�o OpemnQ. '
' p a ,' Su r�t fratufihelFyWf th 1 7AII4g' 6/a
f �
�y
p4,'j r 'S,. 7�4' T"-r---•'�
\f• n� �N�uly'j�c�.�S,rv�ae • � de51y. �f,t� �Cy'f,$J`HSH M�'r���`afr�,s#r���yyt ytv n..,S,•,..tty5�Gi�y''`Pt`.Sy��. IS
�31 .?•��yZ J4l
The perfect storage system for all your needs!
FILE No 750 02/11 04 12:54 ID SYSTEM CONCEPTS, INC FAX 50 873 8024 PAGE i
R
Shelf Construction
•Shelves are 18 gauge, ' • '
except class 0,which are +,�a
20 gauge
•All shelves double flanged` ��u £ Class 2B
on sides and triple flanged ` ...'. 1 1 CIa65�' Class.�B
front and rear ,20 gauge metal18 gauge meta# + +!;` ••18 gsugemeW >
•Tops are punched on 2" for lrghtloads' for normal to medium loads •'for medium.to heavydoads
centers for adjustment of -;nb retnfoiceibents Vx IN"barju!ftnnt flange 7 x /e'tiarin frotii and rear
dividers ,¢angel
•Front and rear faces are
punched for label holders, ?ti�'•.F%`
angle sway braces and *'
reinforcing bare and angles j�a. : - •�
•standard widths: 30",36"
42 48'
•Standard depths: 12", 15"
la" 24", 3011, 36" Class r ' Class 1`A O as1 2A
•Note: reinforcing bars and 18 gauge metal r 18:gauge metal al
1 me
angles are sold separately for normaLlogds for medtumllo " for heavy,loads
and tnstalled'at customerU
location s do remforCerttepts': 1 x l x++/r:'an nT 1 x•1" x'/ef angle m front
v .aad/'ear flanges
Shelf Load Capacities
• Shelf Size Weight Capacity (lbs./shelf)
Width/Depth Evenly Distributed Load
Class 0 Class 1 Class 1B Class IA Class 2B Class 2A
30 x 12 N/A 865 976 1050 1389 1615
15 N/A 855 966 1040 1382 1610
18 N/A 845 956 1030 1372 1600
24 N/A 825 945 1025 1325 1525
30 N/A 805 931 1015 1270 1440
36 N/A 740 896 1000 1150 1250
36 x 12 400 775 853 905 1205 1405
15 390 765 843 895 1198 1400
18 380 760 835 885 1182 1380
24 360 750 825 875 1130 1300
30 N/A 745 817 865 1072 1210
36 N/A 730 802 850 1000 1100
42 x 12 240 475 550 600 792 920
+�. 15 250 470 542 _• 590 779 905
x
is 260 465 531 575 764 890
24 290 455 521 565 730 840
30 275 445 514 560 701 795
32 270 425 503 555 642 700
-� 36 250 425 503 555 642 700
48 x 12 210 360 400 440 500 610
15 220 375 400 445 510 620
- 18 230 390 415 450 525 630
24 250 425 450 475 550 650
30 210 345 365 395 430 540
35 200 335 350 375 410 450
FIL- No.750 02/11 '04 12:54 ID:S1'STEN CONCEPTS, INC. FAX: FO 873 8024 PAGE 4/
15.1 .2@6= 12:58 H1111 ----
..--- . -
•
Anchoring Systems
0 Kwik Bolt 11 Expansion Anchor 4.3.3
Carbon Steel Kwik Bolt If Allowable Loads in Concrete
edment 2000 psi(13.8 MPa) 3000 psi(20,7 MPe) 4000 psi(27.6 MPa) 8000 pal I41.4 WanAnchor -�;
inameler Dept Tension Shear Tension Shear Tension Shear Tension Shear
in. Unm) in. (MO I6 (RN) no (i<N) Ib M) Ib (M) IS (KN) No (W) Ib (m) Ib (RN)
1'/a 270 430 330 430 380 430 470 436
(29) 0 2) 11.8) (1.5) (1.9) (1.7) (1,8) (2.1) (1.9)
2" 560 590 630
(6.4) (51) (2.5) 530 (2.6) 530 (2.8) 530 670 530
34/.` 670 (2.4) 670 (2.4) 670 (2.4) 13.0) (2.4)
(95) (3.0) (3.0) (3.0)
1% $30 990 650 1040 750 1100 850 1100
1,1) (2.4) (4.4) (2.9) (4.6) l3.2) (4.9) (3.6) 14.91
1/5 21/2' 1200 1290 1370
(9.5) (64) (5.3) 1470 (5-7) 1470 ISM 1470 1550 1470
4114" 1330 (8.5) 1390 (6.5) 1440 (5.5) (6.9) (8.5)
(108) (5.0) (6.2) (6.4)
2`G 1170 1940 1310 1870 1450 1870 1730 1970
(57) (5.2) (8.8) (5,8) (8.8) (8.4) (8.8) 11.7) (8.8)
31/2` 1870 2130 2400 �p (\�\�
(12.7) (89) (8.3) 2450 (9.5) 2450 (10.71 2150 A N 4 f r
6- 208(1 f10.9) 2310 (10.9) 2530 � (1� �M I
(152) (9.31 (10.3) (11.3)
• 24/. 1600 3070 1870 3070 2130 '2070 3070
(70) (7.1) (13.7) (8.3) (13.7) (9.5) ( ) (11.8) (13.7)
6/e 4"" 2400 2850 3290
(15.9) (1021 (10.7) 51140 (12,7) 3840 (14.6) 3840 4190 3840
7"- 3200 (17.1) 3470 (17.1) 3730 (17.1) (18.8) (17.11
(178) (14.2) (15.4)
3'/4 1970 4140 2320 4140 2670 4140 3200 4140
(83) (8.8) (18.4) (10.3) (18.4) (11.9) (18.4) (14.2) (18.4)
2/4 43/,"' 2930 4130 4800 5870
f19.t) (121) (13.0) 6120 (18-4) 5120 (21.4) 5120 (26.1) 6120
8-- 4000 (22.8) 4930 (22.8) 5870 (22.8) 6320 (22.8)
(203) (17.8) (21.9) (26.1) (28.1)
4112 3330 7070 4050 7600 4670 8140 6070
(114) (14.8) (31.4) (18.01 (33.8) (20.8) (36.2) (22.6)
1 6 4030 8000 7070 8400 9200
(25.4) (152) (21,01 9200 (26.7) 9201) (31.4) 9200 (37.4) (40.9)
9 6670 (40.9) 7670 (420 01 8670 (40.9) 10670
(220) (29.7) (34.1) (38.6) (4Z5)
values shown are for shear Through The Threads Values shown are for Shear Through The Bolt Body
a shear plane acting a shear plane acting
0irough the anchor through the anchor
bolt body.When the �P bolt body.When the
Shear plane Is acting shear plane is acting �P
through the anchor ° through the anchorbolt threads,raduce ?i, bolt threads,reduce
the shear values by the shear value by
All other values shown are for Shear plane acting through either body or threads,
120 Hini Product Technical Guldo20o14 Hilo U.S.:1.800.870-80DD/www.us.Md,com 4 Hell Cenaoa:1-800-363-4458/www.ca.hilo,com
LOCATION:Hilti RX TINE 01/15 '04 11 :45
FI•L[ No.750 02/11 '04 12:54 ID:SYSTEM CONCEPTS, INC. FAX* 873 8024 PAGE 5i 5
95:90; VTITO 3W11 X23 80EO TSV 606:N0!1d00-1
_ L' M
s
Wit
^ C
O
o v O
N W ° I
� I
vi
U _ i
W
—aj
F
Q cu
r l
WCo
W I
W
N
3
? �• w I
4 �
U J �
Z
H� • � 1
H\Q I
N U J M
Lj
EO/E0 3'Jt/d SSdM 80E0-LSD-606 ZS:80 ti00L/6TiT0
OCITY OF CUPERTINO*
CITY OF PERMIT APPLICATION FORM b ° Z- 6
CUPEkTINO
• LIZ
APN# 2_6/ 3 3 Date: IT/4
Building Address: /038
Owner's Name: Phone #:
ContractorkNI License #:
Contact: Cupertino Business License#:
uilding ermit Info:
Bld Ele Plumb ❑ Mech
o scription:
Residential ❑ Commercial
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Project:dff 600
O Occupancy Group:
Type of Construction:
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler> IM to 1.75 M Btu MECHANICAL
BBOILER5. Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax —Resi/Mobile BUILDING
BELEC1000 Elec 600V <= IOOOA ELECTRICAL
BELEC1001 Elec 600V > IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V <=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGATC Comm. Housing Mit. Fee (/ BUILDING
1 of3
C - WITY OF CUPERTINO*
CITY OF PERMIT APPLICATION FORM
CUPEKTINO
Quantity Fee ID Fee Description Fee Group
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL
BNEWMULTI Multifamily Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BNUMULTI New Multifamily Res PLUMBING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
_ BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinkler/Backflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Fumace> I OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Devi ce/A aratus ELECTRICAL
2of3
*CITY OF CUPERTINO*
10 S
CITY OF PERMIT APPLICATION FORM
CUPERTINO
Quantity Fee ID Fee Description Fee Group
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSC13LVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Insection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
\ MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issuance PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
BMISCELL Building Misc Fees BUILDING
3of3
CITY OF CUPERTINO
BUILDING DIVISION PERMIT C0NTRACTQR�INk RMATION 4
���,.. ..A _. l. :� .
BUILDINC�ADDReF.ELE% DOYLE CUMMINGS PLUMBING PERMIT N`64020089
PERMrf ISSUE DATE
ONE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MEIf
LOO LICENSED CONTRACOWS DECLARATION O O
U 1 hereby id' not I am licensed under provisions of Chapter 9(commencing Job Description �0,
U with section 7000)mf Division 3mfthe BuQBD0em arbP f ions ode,m ylicamais A �m
^': or
ualmrC TI-STORAGE SHELVING JUN
Da� Gam 24 200
S DEC 4
-+ phos ahail be usedu public runms
3 a Licensed faal
OatNEm exempt
DECLARATION
I crehy affirm on 11. exempt Bum the Cosine Co License law for the
00 following mama.(section 7(5 1.5.Guiness and are.datiuna h.or Any city or county
+�$ which its Issuance.
s learn ac construe,.aiaa improve,demolish,fi repair any tatement .
that he ,l ensedpalso acquires the priAst lima.tofsuch Cat mo Permit to file a signedLaw
(Chapter
<
that chigwidpurm700eprovisiomnfuteCamracmrilucnrclaw(Chaptcr9 Sq.Ft. Floor Area Valuation
¢�$ (cat ha is ing with Sector.four and
this
basis for o(Ne Briegad exemption.
Profusion Cwk)of
Net io u campy therefrom and da bests for be alleged esemant to Any violation of
hot
doLS by my applicant for a Permit subjects the applicant ro•civil penalty of
not mare Nen five hundred dollars(SSIYII 3 YJ- I3y3eIp 0 Occupancy Type
❑1,es owner of Ne pmpeny,w my employee,with wages u dein sole compensarlon,
will do the work and rte sw,mm is not intended aro@red formic(Sec.7(44,Business
and Profession Code:The Committers License Law docs ter appy b in owner of Required Inspections
property who builds or i m provesthereon,and who does s uch wart himsel f orNmugh his
own employees,provided nm such improsements meant intended oroRered farsals.IL
hawewn the building or improwmenr ismld within Doe year of completion,the owner.
builder will have the burden of proving that he did not build or improve for Purpose of
salt.).
❑1.as owner of the property am closings contracting with liceued contractors in
construct the project(Sec.70,14,Butfir m and Profusions Cade:)The Conrrmlor's Li
[cage Law does not apply to an owner of property who Wilds or ba,mo s thereon,and
who contracts for such projects with a contractor(a)liccued pursuant m the Conrrse,ols
License Law.
amuemplinder See. ,BAPCfofthumamn
er Dam
WORKER'S COMPENSATION DECLARATION
1 hereby aMmr under penalty of perjury one of the following declaruiona:
137]00
have and will maintain a Certificate of Consent self-insure for Workc/s Comper-
n,u provided for by Section 3700 of the labor code.for Ne performance of rte
for which this pcnnit is issued.
hew and will maintain Workers Conflagration Insurance,as mpuired by Section
of Ne Labor Codc,for c performmce of the work for which Nis permit is issued.
Worke rope sa' 1 u t� Is No.;
nstw r oar
artier. !/ Po No.:
C FICATE OF EX Pr10 FROM WORKERS'
COMPENSATION INSURANCE
(Thlsaccunm need not bccampleted lithe permit u faronc hundneddollars(g10(1)
or less)
I Certify that in Ne performance of the work for which this Permit is issued,I shall not
employ any person in any anannerm u to become subject to the Workers'Compensduon
laws of Califomie.Dam
Applicant
NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should
become subject ro the Workers Compensation previsions of the pater Code,you mug
.JZ forNwidt comply win such provision muni,permit shall M deemed revoked.
z OCONSTRUCTION LENDING AGENCY
F+� I hereby trim that Nem is a construction lending agency for the performance of '
C'
the work for which Nu permit is issued(Sec.309'1,Ci,C.)
ALendefs Name
Z) Z Lender's Address
U C) 1 certify that 1 haw read this application and sum Nat Ne above information Is
U, F cancer.I agree to comply with all city and county ordinances and state laws relating to
�U building construction.and hereby authorier representatives of this city to inter upon the
I, ahove-mcnuomcd property for inspection puHeses
F D. (We)agree m mw,indemnify and keep harmless the City of Cupertino against
I, inconamptudgm a s and of thisumit. may in anyway acme against said Ciry
V z SAPPLIC OUR Born GU 0 ANDS AtNp`�tr OMPLY WITH ALL NON-POINT Issued by:
KY Re-roofs
Sigm toc can no etor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Wi applicantwfuwre building occupant gone or handl,barsNom maerul
r,-d' y sax Cupertino Monte I Cade.LTaper 9.12,and Ne Health and safety
e, ee
s-i on 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes u
Will the applicant or future building occupant use equipment or device,which If a roof is installed without first obtaining an inspection,I agree to remove
it W,,m ous air comaminants u recd by the Bay Arra Air Quality Managcmcm all new materials for inspection.
District?
❑Yes Nu
[have NehmaNrws materials requirements under ChaverG95ofNeCalifor-
nisHwlth om,Secoma 25505,35533 got 25534.1 undersand Nat if um Wilding
don no n are a mnenl Nat it u Y mapomihility m nntil'y the¢eupant of We
requi a ts uft less issuance of a Comfort,of Occupmcy Signature of Applicant Date
1 'o
owne he r dagent m All roof coverings to be Class"B"or better