04050067 t
ITY OF CUPER'I'INO
BUILDING DIVISION
PERM* C®NIRACTOR INFORMA�N
fi�. . '2^
SAMUEL CONSTRUCTION "'""'0405006744"; rITT)7PT1NQ RD
NER'S NAME: PERMITISSUEDATE)NE: SANITARY NO. CONTROL NO.
1121/9004
408 249-28
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
It" LICENSED CONTRACTOR'S DECLARATION
w❑ 1 hereby affirm shlicensed
at 1 am under provisions of Chapter 9(commencing Job Description
iW with Suction 7001)of Division 3 ofthc Business Pmfessiom Code,ana my license is
it aerra. 5 7— REVISION--VENT LOCATION
n Z Liccnm Lic.A
Zi,
i m Date c Comreete Sit :1
ou ARCHITECTS DECLA ION
tey ea dcrsiand my plans shall he used as public records
3 u G Licensed Prvfessiunal
O OWNER-BUILDER DECLARATION
<E I hereby affirm Jim 1 am exempt from the Conuacmr's License Law for the
oo following reason(Secuun 7131.5,Business and Pmfension Code:Any city Or county
m which equirm a permit to comment,alser,improve,demolish,of repair any suuctum
r•¢a prior in its issuance.also requires the applicant!orsuch Permit o file a signed statement
< that he islicensed paravanrtolhepmvisinn,tfinecommelmr•sLicence Law(Chapter 9 Sq. FC Floor Area Valuation
XFa (commencing with Section 7000)IdDivision 3 bfthe Business and Professions Code)of
i
that he is escmpt therefrom and the basis for she alleged oxemp icuo Any violation of $40
Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more Nan Eve hundred aallars(5500k P Y YP
❑1,as owner or the property,a my employs"with wages Of Nair able compensation,
will do the work and theawcium is not intended or offered for sale(Sec.7044,Business
and Profiled...Code:Tire Cenntrectors License Law doss Wt.,1,m an.weer of Required Inspections
property who his
tun employees,provided mat xueh improvements are nut immnded oronerea formic.B.
however,me building or improvement is sold within one year of completion,don owner-
builder will have un:burden of proving mu In did not build or improve for purpose of
sale.).
❑I.es awver of er property,am exclusively convecting with licensed cantnaoa i
conswn she pmjen(See.7W.Business and Professions Code:)The Curr entor's Li-
ene Law don not apply to an owner of pwpeny who builds m improves menton,and
.ao canvacka for such projects wire a eomncror[s)]lanmd pursuanuo the Contractor's
remail Law.
❑I am exempt under Sea. .B h P C for this reubn
Owner Dale
WORKER'S COMPENSATION DECLARATION
1 hereby of ton under penalty of perjury one of me following declarations:
I haw and will maintain a Certificates of consent to soft-insum for WorkersCompen-
same.as provided for by Section 3700 of on Labor Cone,for the performance of the
wank for which this pcnnft is refund.
❑1 have and will maintain Worker's Compensation Insurance,as mquired by Section
37W of the Labor Code,for the performance of the work for which this pcmtit is issued
M�y�}Yv or'sCompenationlnsunnacarrier anc1P rynumher
CnM r.
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(fhissection Med sent he completed if the permit Is for ons hundred dollara(2100)
nr lcsx.7
I Camay that in the performance of be work for which Nis permit is issued.1 shall not
employ any person in any manner m as at become subject to she Workeri Compenairm
Laws of California.Date
Applicant
Nj)TICE TO APPLICANT:If,after making this Cenifiate of Exemption,you should
become subject ro she Wbhcr's Compensation previsions of the Labor Code.you must
.J z
forthwith comply wish such provision or this Permit shall be deemed rewled.
z'O CONSTRUCTION LENDING AGENCY
p.= Iherehy affirm that mere is a construction lending agency for me performance or
Cthe work fur which which mis permit is issued(Sec.3097,Ci,C.)
14 Larder's Name
alenders Address '—
U 0 I sanity mat 1 haw read this application and state mel the above information is
IL f-' comma 1 agree to comply with all city and county oNinam'es and ser¢laws relining m _
0U Wilding convection,and hereby amhmim mprucnutixes of mis city in enter upon the
W above mentioned property for inspection purposes.
O. (We)agree m save,indemnify and keep harmless tho City of Cupertino against
p3 liddliuu.judgments,casts and expcnus which may in any way accrue against mid City
his
U z Perot
APPLIICCANTcUNDERSTANDStAND WILL COMPLY WE i ALL NON-POINT Issued by: Date /
SOURCE REGULATIONS.
0Re-roofs
41Fignmun of Applin nmctor Date
LEA
DOU$MATERIALS DISCLOSURE Type of Roof
Will me appl
can
m uwre building occupant store or handle hamormus material
az defined by the Cupertino Municipal Code.Chapter 9.12,and me Health and Safety
Code,Section 25532(a)/ All roofs shall be inspected
— ins ected prior to any roofing material being installed.❑Yea *b
If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or future building occupant use equipment or devices which
nit hazardous air contaminants as dermed by U,Bay Area Air Quality Management all new materials for inspection.
Imrlal7
❑Yes �No
1 have mad she hanrJousmm:rials requirements under Chapter 6.95 bf the Callror,
ria Helm A SafetyCook.Section 25505.25533 md25534.I undersand mat flour building
Jos off urenJy haw a tenant.that it u my respmuihilbt V notify me oaupant of she
regmirtrryCmx wnreh ream be oft paprmiefpana an eem0\2fIrV\enraap,ney. Signature of Applicant Date
/J7re^ '17Date
owe aumomcJagcm � D,¢ All roof coverings to be Class "B" or better
J
design west partnership
Food Service Design&Project Assistance
--
J
PLUMBING NOTES rlurb con"'�' pi"""°"`
;-
atleEAse Tit AID MAY 10 INSCIU11100 s:
P1. ALL ROUGH-INS RELATE TO FOOD SERVICE EQUIPMENT ONLY. If a grease trap to required by local ,
SEE ARCHITECTURAL/ENGINEERING PLANS FOR ADDITIONAL PLUMBING hsalth and/or plumbing codes, -
Mechanical Engineer and/or plumbing ;, l
REQUIREMENTS. ~'
contractor to provide all details, exact ✓` '
P2 FINAL CONNECTION TO ALL EQUIPMENT TO BE BY PLUMBING location and specification& for trapping >i•, % —
devlee. Also, verified with local
/
CONTRACTOR, INCLUDING REQUIRED MATERIALS, SUCH AS STOPS,
VALVES, FILTERS, TRAPS, CHECK VALVES, PRESSURE REDUCING agencies exact installation method:
Receesed and flushed with floor, or fi
VALVES, PIPING, ESCUTCHEON PLATES, TUBING ETC.
` -
- f-� 33 Embarcadero Cove
p3 VERIFY ALL PLUMBING ROUGH-INS AND LOCATION WITH OWNER
VENDOR OR G.C. LU EXISTING EQUIPMENT OR OTHER EQUIPMENT NOT Plumbing contractor Plpse note i I J Oakland - CA 94606
SPECIFIED BY DESIGN WEST. INSTALLA710N OF INDIf�CT WASTE UNES) ` :` ff r c y
PLUMBING CONTRACTOR TO FURNISH AND INSTALL THE Please notice that drain lines (Denoted as . Phdne 510.261 .4664
P4 PLUMB "i/ / / `� _
FOLLOWING AS PER CODE. A.G.D.) from equipment to Floor Sink ,i Fax: 510.261 .4393
indicate general direction only m d not ' ,`, " tf
A ALL WATER, WASTE GAS AND STEAM SERVICE TO POINT OF installation method. There are two ways to r t.. � �mail:designwp@aol.com
ROUGH-IN AS SHOWN ON PLAN ROUGH-IN OUTLETS TO STUB 4 run Indirect Waste Lines: i '' ` ;` J
OUT OF WALLS AT HEIGHT INDICATED FROM FINISHED FLOOR TO
1. Inside the walls. fi \ A
CENTER LINE OF OUTLET. ALL CURBS AND FLOOR OPENINGS 2 Surface mounted on walls.
If method # 2 is used, lines must be either
ARE TO BE SEALED WATERTIGHT. / \ \
sealed to the wall(s) or installed at least J
B. PRESSURE REDUCING AND/OR REGULATING VALVES FOR one inch(1') away from wall surface.
DISHWASHERS, BOOSTER SEDIMENT BUCKETS SET FLUSH WITH Plumbing Contractor to chased method l ',
FINISHED FLOOR, UNLESS NOTED OR AS PER LOCAL CODE. i NI
Plumbing aantraCtor Pleads POtC h' i 1Y i
C. ALL FLOOR SINKS, COMPLETE WITH TOP GRATES INDICATED AND WAS HEATER REQUIREMENTS: r�i/i
REMOVABLE SEDIMENT BUCKETS SET FLUSH WITH FINISHED FLOOR, _ Y _
(By others than Design West Partnership) r
UNLESS NOTED OR AS PER LOCAL CODE. ` ', f/
1 Cold Water supply
D. ALL WASTE LINES,
DIRECTOR INDIRECT, EXCEPT AS NOTED, ) v `.-max yi
SHALL BE PITCHED DOWNWARD, ALL WASTE LINES SHALL HAVE 2) Drain for pressure relief valve \, /
ADEQUATE CLEAN-OUT PROVISIONS. 3) Gas or Electrical supply `- -
E. INDIRECT WASTE LINES FOR WALK-IN REFRIGERATOR/FREEZERS, 4) Vent to roof as required / r/
5) Seismic straps as required > 7O•
PITCHED 1/4 TO 1"-0 (MINIMUM) AND WITH A "P" TRAP AT
MINIMUM Y ABOVE FLOOR SINK. 6) Mount on 5' legs or platform
y
F. HEATER TAPE WITH 35 WATTS PER LINEAL FOOT OF DRAIN LINE
AND INSULATION OF ALL DRAIN LINES INSIDE FREEZER COMPARTMENTS. —
A
pMass
G. INSTALL FIRE CONTROL GAS SHUT-OFF VALVES AS PER rkaabfn8 cowda Or \
SUPPLIED BY FIRE PROTECTION SYSTEM .CONTRACTOR. p L O O R D R A t N 8 ``k ` '
(IF GAS COOKING EQUIPMENT IS USED) Floor drains) shown in these drawings are for J/� AGD
general placement only, to facilitate` cleaning r' 6 IFS
J ` :
H. VACUUM BREAKERS AS REQUIRED. in Food Service Areae. This information is not
intended to be complete and/or Inclusive of
I. CLEAN-OUT VALVES FOR STEAM CONDENSATE AND AIR LINES. full requirememe by local codes. Verify with \ CW P P HCW
Mechanical Engineer' exact number, etze and 166 1 7 6-
Engineer
ALL PIPING TO AND FROM EQUIPMENT SHALL BE KEPT AT location of such fixtures, as wall as, Installation
A MINIMUM OF SIX INCHES (6") CLEAR ABOVE FINISHED FLOOR method and compliance with code regulations. 1 TO ALLOW CLEANING, OR PREVAILING LOCAL CODES. \
AGD.
K. IN LINE WATER FILTERS ARE RECOMMENDED FOR THE Plumbing controotor Please note i' TFS ---,
FOLLOWING EQUIPMENT: (WATER FILTER BY P.C. UNLESS QUICK DISCONNECT for Rem$ '
OTHERWISE NOTED) COFFEE EQUIPMENT, STEAM EQUIPMENT, SODA
B others than Design West Partnership) ;
SYSTEMS. SINK HEATERS, GLASS WASHERS, ICE MAKING MACHINES. ( Y
NOTE: Plumber or Kitchen Equipment
Supplier to provide " QUICK GAS
PS PLUMBING DIVISION TO INTERCONNECT DISH MACHINE WITH BOOSTER
HEATER AND WATER-TYPE VENTILATORS WITH CONTROL PANELS AS PER DISCONNECT " and restraining chains '
MANUFACTURERS INSTRUCTIONS, WHEN APPLICABLE AND NOTED. r ` µ �' �'�� l / SUNNY
for all cooking equipment. VIEW
P6. ALL VENT PIPES ARE TO BE CONCEALED IN WALLS OR COLUMN / ,' k DAT
CHASES. hexa- LUTHERAN
DW HCW S1G10 ,;, F t
P7. GREASE TRAP TO BE SPECIFIED AND LOCATED BY MECHANICAL _ F 4 +12 +16"
ENGINEER AND PROVIDED AND INSTALLED BY MECHANICAL OR _ — r P P \_ ThISset 0�t1. e8 sii� £ HOME
PLUMBING CONTRACTOR. 21 21 0 i3 CW \ be kept ke a y -rYrr t
6• {awful to rt°
P8 A GAS PRESSURE REGULATOR FOR EACH PIECE OF GAS FIRE �J. „ Gq same wrWh-nt Cy Gl s e —
EQUIPMENT SHALL BE PROVIDED AND INSTALLED E P.C. UNL3 HCCW`\ the boddinB pspt o be 21445 Cupertino R�
Thestampio4�thisp'•aneR;tio�+m CUPERTINO, CA
OTHERWISE NOTED. IN ADDITION A HIGH PRESSURE GAS REGULATOR \` be
(VENTED) SHALL BE PROVIDED AND INSTALLED BY P.C. WHEN NECESSARY. held to p
NOT be ravisr
3HAll the violeflon ai $011 D I
Pg FLEXIBLE GAS CONNECTIONS WITH OR WITHOUT QUICK DISCONNECT appf�at pidiryenCe at piste Law.
FEATURE SHALL BE PROVIDED WITH SHUT-OFF VALVE BY P.0/ THIS ROUGH—IN PLUMBING SCHEDULE ; ,i *nVCdV Date 11�19�DI
VALVE HAVE PERMANENT HANDLE, AND NOT BE LESS THEN THE NOMINAL TFS P OP
AGO
SIZE OF THE CONNECTOR AND BE INSTALLED AT THE GAS P �$ S E R V I C E T 0 S \ Designed
IMMEDIATELY AHEAD OF THE FLEXIBLE GAS CONNECTION. MARK QlY 12D o GW Sanitary DESCRIPTION REMARKS
Wadta Size ITEM ��
H.W i; i \ Drawn AS
P10. PLUMBER SHALL PROVIDE ALL DRAINS FROM FIXTURES INCLUDING P_ 1 1 EA - 1/7 AGD TFS K- 1 ICE MAKER
WALK-IN BOX EVAPORATORS. -- j
P- 6 AGD TFS - K- 6 PREPARATION SINK % Scale 1/4"�1�-0'
P11. IF REQUIRED BY THE BUILDING DEPARTMENT, THE PLUMBER, UNDER K- 7 FAUCET /
HIS PERMIT APPLICATION, SHALL PROVIDE DRAWINGS OR DIAGRAMS OF o_ - i EA 1/1 t/Z -- ' ' Dwg File DWG
PIPING LAYOUT, SEWER PIPE SIZES, VENTING CONNECTIONS, ETC. - K 11 3-COMP. SINK * `
P-11 1 EA - - AGD TFS
P12 PLUMBER SHALL DETERMINE AND BE RESPONSIBLE FOR THE TOTAL p- 13 1 EA 1/T 1/2" -- K 13 FAUCETS Xref File By Architect
PROJECT REQUIREMENTS AND VERIFY SIZE OF SERVICE REQUIRED FOR K-14 SOILED DISHTABLE
GAS OR WATER. P-14 1 EA - - 1-11T DW
K- 16 PRE-RINSE FAUCET w �W
P- 16 1 EA 11T 1/`L"
P- 17 1 EA 1/Y - AGD TFS - K-17 WAREWASHER `w
PLUMBING SYMBOLS _ --
p_ � 1 EA 1/1' 1/1' 1-1/1" DW K- 21 HAND SINK �' HCW P •`
• Drain to GREASE TRAP if it is required, a6" 16 ` 7 TFS
HOT WATER(HW) OR COLD WATER (CW) FLOOR SINK. / . f
Plumber/Mechanical Contractor to verify .r �� � k , � �� � � ` � ,_ ASSESSOR COPY
GAS SUPPLY. t+12 P : CAS BOOSTER
r -size and exact location of GREASE CRAP. ,,2" 14 \ '\
Q HOT AND COLD WATER WITH DIREC, BASTE — `J �/ J \
U 17 Vf;
O WASTE, DIRECT CONNECTED UNLESS NOTED OPEN HUB
HW
00
FLOOR DRAIN
JI, J
' FLOOR SINK WITH HALF GRATE UNLESS NOTED W l
Drawing History
FIELD CONNECTIONS \ 1 I
•; _ '
DAtfEn LINES FROM EQUIPMENT TO ROUGHANS INDICATED 2
� - - - -_ l Prelim#1 111/19/02
GENERAL DIRECTION OF PIPING AND NOT ACTUAL j- - 4' O.D. VENT PIPE CONNECTION i I 1 Prelim#2 11/25!0
PLUMBING UNES PATH. /� '
- ✓ 1, FLUE TO BE INSTALLED TO MEL
i , ` i Prelim#3
i FOR AREAS FOR FLOOR SINK r_ i i I Sub.Set 1/10/03
FSK-1 I F R AREAS
=' LOCAL CODES BY INSTALLING
ABBREVIATIONS --�'f ,, ` CONTRACTOR 26 �' aF.F.
HCW — HOT AND COLD WATER
HW HOT WATER TYPICAL FLOOR SINK SEE PLAN FOR CRATE
CW = COLD WATER w/OOmf STRANER ARRANGEMENT i
Da DiRtCT WAST ~�
Revisions
FD = FLOOR DRAIN
FS - FLOOR SINK
AGD TFS + AIR GAP DRAIN TO FLOOR SINK PLAN VIEW J i I
B - STUB-UP FROM FLOOR i 10/21/03
+STU I I
2/9/04
' FINISH DRAINS AT LEAST - (, -
INDIRECT WASTE �i" OVER FLOOR SINK TOP
G.C. TO GROUT IN
GAP BETWEEN i 'K l f+
a t700R ' � i (
( I ! t t
FLUSHED WITH FLOOR ' ( ' ' ' I / � 'I if � � _
11
t 1, f I !
SECTION
FLOOR SINK DETAIL FSK-1
- K.T.S. (FOR REFERENCE Ot Ly) .
fm, this drawinq.