24418 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
Building Protect identification PERMIT NQ, 4418
Building Addreee:
Ny0
A • parse: one:
AR r �e(E� CITY OF CUPERTTNO-BUILDING DIVISION
ntrad.re Name: Lie.No: APPLICATION if PERMIT"3 CiTs:%N
• prchltect/Englnse I L �_Llc. G
BUILDINELFOTRICALPLUMBINC-MECHANICAL CATEGORY C
W �
�
V X10"� l_ QTY ELECTRICPERMIT FEE BUILDING PERMIT INFO
Addres> � �_OS Imo\ PERM1UTISSUANCE ❑ ❑
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that l am licensed under provision..! ia.pler9(commen. APPLIANCES-RESIDENTIAL J BDFSCR(IrT10N
Ingwlih SeMon7ODO)ofDlvlsim3ofthe BudnemandPmfeulonsCode,andmy y�
license is In fuB Uuc,and Affect. PANES y�
License lass Lk.a 3G�i I b 3 _
Date Contrador e—A UP TO 200 AMPS
IOW AMPS
ARCHITECTS DECLARATION
OZO l understand my plam.hall be used as public records OVERIOWAMPS SQ.Fr.FLOOR AREA $/SQ.FT.
Licensed Professional SIGNS ELECTRICAL -
OWNER-BUILDER DECLARATION
g
SPECIALCIRCUTT/MISC
7(., I hereby af0rmthat l am exempt from the Contractor's Licence Law for the
following reason.(Section 7011.5,Business and Profe.ebns Code:Any city or
Fmuntywhk mquW sapert ttomrutmc;alter,knpmve,dem lWh,orrepair TMP.MIETEROR
an ystmmmprlartoiu Wuante,alnrequircatheappB.nifosuchperndtto POWER
file a signed statement that he la Ikensed pursuant to the provisions of the
u,y Contractor's License Law(Clupter 9(commencing with Section 7000).(Out- SWIMMING LELECTRIC VALUATION
d.n3 ofthe Business and ProfesslonsCcde)mIhat hula exemptthercfromand
app ^
6 the basis for the alleged exemption. Any violation of Stolon 70715 by any UTLETS SNITCHES IX 1 (.
e
applicant permit the applicant to civil
pevltyof nit ITt4
l
00 five hundred dollars($SDN. ` NFWRFSIDENTIAL ELECTR I' 1 SQFI. STORIES TYPE CONSTRUCTION�n ❑1,ae comer of IM property,or my employers with wages as t it sok
<
- pe ]on,wllldothe work and thestrocture le not Intended or offered for
❑ .ale(Sec.7044,BusNe..and Professions Code:The Contracture LI �'se Law
$ does not apply to an owner of property who build,or Improve.therc.lV and OCC.GROUP RES UNITS
EEE whodoeaeuchworkhmmlforthrough hismvnemployess,prwWed thatnch
impmvemenbamnwt tendedoroffeyedfmule.lf,h.wevegthebuildin(yj j(: TV6 knu
improvement lasold within omyearofcmnple ion,the owneebul derwlll have
t110JHrden of proving that he did not build or improve for purpose of sale.). QTY. PLUMBIN RM IT FEE FLOOD ZONE AIN
u I,as owner of the property,am exclusively=trading with licensed PERMIT ISSUANCE
cont.ctars to rorelruct the project(Sec.70K Business and Professions Code:
The Contractors Lice.Law does net apply to an owner of property who ALTER-DRAINk VEM-WATER(FA)
Wilds or Improv.therem
on,and who mrects for such ptoktla with a FEE SUMMARY
cg6t�+ctade)licensed pursuant to the Contractors Licence Law. BACK FLOW PROTECT.DEVICE
LJI am exempt under Sec. B k P C for this reason
OUTSIDE FEES
DRAINS FLOOR ROOF,AREA,CONI. SANITARY Y N_
Owner Date RFCE[PT p
WORKMAN COMPENSATION DECLARATION FDOTURFS PER TRAP SCHOOL TAX Y_ N_
�I hemlry affirm that I have•cert10.rc of conceal to ceB-Inure,ora RECEIPT p
certi late ofWorkers'Compewtl.nlnsuranceon certified ropy there.((Sec. CAS FA,SYSTQ.6I INCA OUTLETS PARK FEE Y N
�
Pakyp L� 014t32'3
GAS.EA.srsreM-oven a(EA)
Com anv -1 to BUILDING DI GDIV VISI EES
entified ropy Li hereby fumbhed. GREASE/WDUSIRL WASTE INTERCEPTOR PLANCHECKFEE
CertBled ropy laliled with the city Inspection dlWelan. � a—
CERTIFICATE OF FXEM PTION FROM WORK ERS' GREASETRAP PAID
COMPENSATION INSURANCE SEWER-SANITARY-STORM EA 2WFT Date CCCI t#
(Thla•ectl.n need vat be completed tithe pemnit b furore hundred dollars
(SIW)Orless.) WATER HEATER W/VENT/E.ECTR ENERGY FEE Y N
I mrtifythat In the performance of the work forwhlch this penla la
ia •u.d,
I shall not employ any person In any manner An as to become subject to the WATER SYSTEM/TREATING
Workers Compensation Laws of California. Date PAID
ZZ Appllcent NEW RESIDENTIAL PLMB. SQYr. Ovate RLYCI [#
O NOTICE TO APPLICANT:]Leiter making this Certificate.(Exemption,you
should become nb)ed to the Workers Compamattre provisions ofthe Labor TOTAL:
N Code,you at forthwith comply with such petwiabmu orthla parent shall be �e
LU ] deemed revoked.
CONSTRUCTION LENDING AGENCY SEISMIC F
d Z Ihercby afOrmthat them laecomtructmnlo(Sec. agency for the perform- ELECTRIC E
O Larder'.Namekf(��whkhlhla permit bLuued(See 3097,Civ.C.)
TOTAL:
Lenders Name MnAI�"' PLUMBINr FEE
LL E- Lender.Addre.. QTY. MECHANICAL PERMIT FEE MECHA CAL FEE
OW IcedllythatlhavereadthisappR.tlonand us ethattheaWxelnformatcut
a lamrrcct.lagmtocomplywithaUdtyaMd ntyardlnanc.andatatelawe PERMITISSUANCE FEES PAIP:
>. relating to building construction,and lumdyauthotlzerepresentativesafthla
F Z city to enter upon the above-mentlonnd property for inspection purposes. ALTER OR ADDTO MECH. Date RCCeI t#
V — (We)agree to save,Indemnify an d keep harmines the City of Cupertino
.gains Babilitk,Judgments,m sandexpens.whlchmaylnanywayac a AIR HANDLING UNIT 00 IO,ODO CFM) I SUBTOTAL:
agal .Id Clay lncons� gtiencsofthegnnting.fthiepem t. AIR HANDLING UNIT(OVER I0,000CFM) CONSTR CTION TAX
CONSTR ION TAX PAID:
Sig.mreof AppOml C.at.tl.f Date EXHAUST HOOD(W/DIX:T)
HA RDOUS MATERIALS DISCLOSURE
Will the applicant or future building occupant store or handle haaardous HEATING UNIT(TO I00,000 BTU) Date cel t#
material as defined by ten Cupertino Murddpal Code Chapter 9.17,and the
Health and Safety C Section 25531(a)? HEATING UNIT(OVFR 100,000 BTU)
❑Yes No
Will the appllrant ar tore building oempant..equlpmeat or devices VENTILATION FAN(SINGLE RESID) 1 DANCE DATE
whkheent harardousalr conUec.et..A de0ned by the Bay Area ASI �� Q
Quality Management District? BOILER-COMP DHP OR 100,000 BTU)
4haveYea `�No NOVI (�
readtheha>aTil�usmaleda6requImmentsunderChapter6.95of BOILER-COMP(OVEt100,000BTD) Iy + �7��
I he Callfomla Health A Safety Code,Sections 755#5,15533 and 25534.1
understand that if the building does era currently have a tenant,that it is my NEW RESIDENTIAL MECH. SQ-FT
Ali resporin lytonoli(y the cctipantof the requirements which must be men
prior ssuance 4a roofoccvp..q. CITY ut CUYo-.
C J1
mer or aulhoriu`d a{g/e'-rat Date ISSUED BY:
TOTAL:
OFFICE COPY
TR'
�+ SANTA CLARA COUNTY CONTROL NUMBER 7130
CENTRAL FIRE PROTECTION DISTRICT
14700 WINCHESTER BLVD. PERMIT NUMBER 24418
Q$' LOS GATOS,CA 95030-1818 )408)378-4010
SERVICE 'roµ SINCE 1947 FAX(408)378-9342
PLAN REVIEW COMMENTS 92-1363
CODEISEC. SHEET NO.
Review for the tenant improvement to provide shipping access and drop off
point.
CBC 1 Both new openings shall be protected by listed and labeled self-closing,
3305(h) twenty (20) minute assemblies, to include smoke and draft gasketing and
positive latches.
2 Corridor shall not at any time be used for storage or receiving of
merchandise. All materials received shall immediately be taken into the
warehouse.
Okay to issue the building permit subject to compliance with the above prior
• to final inspection.
JURIS. PIANS SPECS NEW REMODEL AS CONST.DESCRIP. BY DATE PAGE
CUP ® ❑ 11 ® ❑ V - N G. BARNES 11/10/92 1 OF 1
• SEC.IFLOOR FZOCC OCC.LOAD ARIA ARCI4ENOICONTRACTOWOWNER TP
BUBB 7 B 2 DEVCON
NAME OF FAGLRY LOCATION
APPLE COMPUTERS 10440 BUBB RD
Serving West Valley Cities of:
Cupertino, Monte Sereno, Saratoga, Town of Los Gatos, and Adjacent County Areas