31030 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE SALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO. 31030
BUILDING DIVISION APPI.ICATION/PERMIT PLUMBING-MECHANICAL
BUILDING PROJECT IDENTIFICATION
BUILDING ADDRESS: SANITARY NO. APPLICATION SUBMITTAL DATE
Io10 z� P�P• �,J =Talo 7j \SCAIAL
OWN RS NAME: PHONE":110 . CONTRACTOR'S15"A. � II�n� N/C CONTROL Is
RCHITECT GINEF.R: LICNO: ADDRE'SSS � A. 9 ❑ y1)�
GZv� art 4�/� � if
aNTACT PHONE: - BUILDING PERMIT INFO
J 2� 71;?-7 .2'u!_ ❑ Consultant Fees Paid by Applicant(Initial) B E PLUMB, MECH
F--_t s LICENSED CONTRACTOR'S DECLA/RA`T10N �/-�V QTY. ELECTRIC PERM IT FEE ld�l[`'�`�{
a Z 1 hereby affirm shin 1 am licensed under provisions of Chapter 9(commencing JOB DESCRIPTION
with Section 701%0 of Division 3 of the Business and Profession Code,and my licensee is RESIDENTIAL:
O O PERMIT ISSUANCE.
Ful" Licenfalse
fame anJ effect. ❑SFDWL KITCHEN RIiMODEI.
k.VZ UU License :Ins Lic,At
N6y 'well C Conon,cmr APPLIANCES-RESNENTIAL [2 ADDITION OPLUMBING RE-PIPE
�Oy ARCHI"fECTS DECLARATION PANELS ❑MULTI-UNIT []STRUCTURAL
Z de m blicrecord, /'� MODIFICATION
OZ—m u y 7 yl( t UPT0200AMPS G.
N O Li cased Pr �� / �� ❑INTERIOR [I CHIMNEY REPAIR
�- 201-IOt10 AMPS IMPROVEMENT
pd 1 c O NER-BUILDER DECLARATION OVER I"AMPS ❑BATH REMODFUREPAIR 0 DEMOLITION
K 6 nae ammo that I am exempt from the Cnnlmcmts License Law for she
O y V which
reason.(Section 7onstr Business and Professions Calc:Any city or cmuurY SIGNS ELECTRICAL []OTHER _
LL 3 LLaF which requires n permit re cores the alai improve,demolish. file
repair any tanwrc
prior to its ixsuwce,also requires she applicant for such permitm fileasigned statement SPECIAL CIRCUI'TIMISC.
j;Qthat he is licensed pursuant m w
the provisions of the Canmnrs License law(Chapter 9
D (commencing with Section 7")of Division 3 oldie Business And Professions Code)m TEMP.METER OR POLE INST. COMMERCIAL:
yy
that he is exempt therefrom And the basis for the alleged exemption.Any violation of ❑NEW BL /ADDITION ❑DEMOLITION
^�4 Section 7031.5 by any applicant far a permit subjects the applicant to.civil penany of POWER DEVICES - a A
^�y �TENANTE X I D El FOOD SERVICE
} not mare than fivehundred
rrsy SUIT' IMPROVEM
Q ❑Las the wcrofthe property,earm,myemplonded.,hwages as their idle 044.Business SWIMMING POOL ELECTRIC
O will dothewons Co theThe Cmdismntl License offered awdrw ..,ply to 71704.Business
end Professions C«le:The Cummctnfs License Lew does nm apply m en owner of IITLFI'S-SWITCHES-FIXTURES
L�.. properly who builds or improves them..,and whin does such work himself w anough
his own employees,provided that such improvements are not intended or offered for NEW RESIDENTIAL CLECTR SQ FT.
aide.If.however.the building or improvement is sold within one year of completion,the B.FT FLOORAREA S/SQ.FT.
owner-builder will have the burden ofproving this he did not build m improve for pur- kyr0rih ,A{I'
paseofwle.). I'J40 a
❑1,as ower of the properly,Am exclusively enmnacting with licensed cnmmctors h, A I Q
commat the project(Sec.7M4,Business and Prafessimma Code:)The Cwthateme.Li. C/
cense Law does not apply to an owner of property who builds or improves thereon,and QTY. PLUMBING PERMIT FEE
who contracts for such projects with a contractors)licensed pursuant n the Conlmcmr's
License Law. PERMIT ISSUANCE
I am exempt under Sec. .B&P C for Nl6 rcasoa
OwnerUate ALTER-DRAIN&VENT-WATER(PAT VALUATION
WORKER'S COMPENSATION DECLARATION BACK FLOWPROTECT.DEVICE A n
I h y affirm under penalty of perjury ono of Ne following declarations: L
I have n will mainmin a Cenifcale of Consent to self-insure for Worker's Cumber- DRAINS-FLOOR.ROOK AREA,CORD. g TYPE CONSTRUCTION
it.., to id for by Section 3700 of the Labor Code,for she performance of the
irerc amut is issued. FIXTURES-PER TRAP
1 v d In 'nt in mrkoea pensation Insurance.As required by Section
37 f r r o cif she work for which this� Permit is eJ. GAS-PA.SYSTEM.I INC.40 DEC.GROUP
I n o 'er and Policy r� f GAS-V.A.SYSTEMOVER 4(EA �•h.�il�)
artie r Poli Nn: rf
+EJp Pfll FR0�1.WJs1RKER /
e(�J `��p GREASI%INDUSTRL WASTE INTERCEPTOR""
(Thiesectionncwl an becm, the ifthepernius By onahnndreddn ae($IW) BUILT NGD 1510th FEES
or less.) GREASE TRAP PLANCHECK FEE
I certify Nat in the performance ofthe work for which this permit is issued,I shall SEWER-SANITARY-STORM EA.200 FT.
nm employ any parson in any manna,so ax m b acome subm the e Wwkwrv'Cmnpen- ENERGY hE
,Z cation laws of California.Dam WATER HEATER WNENTMLECfR
z Q Applicant I GRADING
B
.N. NOTICE TO APPUCANT,If,After making this Certificate of Exemption,you should WATER S Y S T E M n REATING
a ' become subject In the Worker's Compensation provisions of Ne Ishtar Code,you most SOILS
FLU
{$1 fonhwid,comply with such provision nr this Permit shall he deemed revoked. WATER SERVICE.
d 0
��.
CONSTRUCTION LENDINGAGENCY NEW RESIDENTIAL PCMB. SQ.f.. PAID Date Receip
L)Q k for
rwhich thi that thele issued(Suclioalending gency l'or the performance of
f~' the work for which this parotid is issued(Sec.3W7.Co,v.C.)
O U landcr's Name 'OTAL:
Lender's Address TOTAL:
[,,a I certify Nes I have read this Application end dame that the above informeuna is BUILDING FEE
L.i
CA correct.l agree to comply with all city and county ordinances and ante laws relating to QTY, MECHANICAL PERMIT FEE
U building nswnion.and hereby amhorica representatives of this city to enter upon the. SEISMIC FEE
above- property for inspection purposes PIiRMITISSUANCE
( e t save.indemnify and keep harmless the City of Cupertino against ELECTRIC F
iia 'lit cont. oats and eapcnseswhich may in anywayaccrue.agamatsuld City ALTERORADD TO MECH.
inc e e m ting of Nis petrol PLUMBING
APPL N 'U I S \ND.'AND WI LC MPLY WITH ALL NON-P^OINT AIR HANDLING UNIT(TO 10,000 CFM) MECHANICAL 13,
(/� / AIR HANDLING UNIT(OVER 10,"CFA) CONSTRULTI TAX
".am It a n Co., Dam EXHAUST HOOD(WOUCT) HOUSING MITIGA ON FEE
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building occupant store or handle Tomatoes material 11EIUNG UNIT(TO 100,000 BTU)
as defined by the CoNom,Municipal Code,Chapter 9.12.and Ne Health and Safety
Cade,Section 25332(a)^ HEATING UNIT(OVER 101,000 BTU)
❑Yea ❑No VENTILATION FAN(SINGLE RESID) PAID Dam eceipsg
W ll the Applicator or future building occupant use equipment or devices which
a(I herardous air contaminants n defined by the Bay Area Air Quality Management BOILER-COMP OHP OR I WAl10 BTU)
TOTAL:
met? BOILER-COMP(OVER 100,010 BTU)
a ❑No
AIR CONDITIONER
1 vat Ina do materiulsre uircmenI rater Clupmr6.95ofshe Cali- ISSUANCE DATE
fo
that f G e.Stwd'ns 25505 5533 and 25534.1 understand that if Ne NEW RESIDENTIAL MECH. SQ.FT.
buil dr s d n nL that xray sponsihilisym nmify she occupnm
nes s port i c of a Cclificate of Occupancy.
Owner r acro u ISSUED BY:
—� OFFICE
10300 Torre Avenue
Cupertino;CA 95014
Citc of
11perthio Building Division
(408)777-3228
(408)777-3333 (fax)
January 30, 1998
Maxim Properties
10101 N. De Anza Blvd.
Cupertino, CA 95014 `
SUBJECT: Permit# 31030, tenant improvement
Dear Owner:
We have been going through our files in the Building Department, and contacting those
people with permits remaining"open".
According to our inspection records, this permit has not been finaled by the Building
Department. We show that Central Fire signed off in May, 1997, but we do not have the
final on record. Man times an inspector will sign the permit in the field, but
• building y P g
o the clerical staff for in computer.input into the
overlook reporting all of the information t p
If this is the situation and your permit card shows the final sign-off, would you please
contact us so we may complete our computer records?If the permit is not signed off,
please call to schedule an inspection for final closure of the permit.
Because of the large volume of paperwork within the building department, we cannot
separately monitor the progress of each permit. We ask that you give this notification
your immediate attention. If we do not hear from you within ten (10) working days, we
will dispose of the file and remove the records from our computer.
Thank you for your assistance.
Sincerely,
CITY OF CUPERTINNO�O
z;tG fig
Christy Akatiff, Administrative Clerk
C ry ,
•
Pnoted on Recvr..lea Paper