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S 4341 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE SALL POINT PEN ONLY C(TV OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO. -.BUILDING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL S 4341 `t 'Lr -BOIIDC INPROJECTIDENTIFICATIONt;'� {S BUILDING ADDRESS: SANITARY NO. APPLICATION SUBMITTAL DATE � u7HS S )6 aNaa cid. _ _22� 9 NER'S NAME: 1k'np PIIONG: CONTRACf(IR'S sNYAMIi: LIC NO: 1 A'f� 017 M L�(..C( / ;4 a-" s 93 NIC IW CONTROL N ARCHITECT/ENGINEER: LIC NO. IID RE 1 ❑ CONTACT PHONE: BUILDING PERMIT INFO ❑ Consultant Ftxs Paid by Applicant(Initial) BLDG ELECT PLUMB MECH a17.Soo o ❑ ❑ ❑ LICENSED CONTRACTORS DECLARATION t I hereby affirmthat l licensed d previsions f Chapter 9(comme g QfY. ' ELECTRIC PCRMI'ft' 'tl �_Ip'FEE't TOB DESCRIPTION WOO with Section 7")of Divides.3 of the Bus .and Profe,,,md,Code.ands Ice sets FF-w. in full force and eRecyv y PERMIT ISSUANCE rS0 RESIDENTIAL aVU LicenseC ae 1. �I7 Liak 1� ❑SFEWL [I KITCHEN REMODEL yQL Dam�Contracmr APPLIANCES-RESIDENTIAL ❑ADDITION C3 PLUMBING RE-PIPE I„prn R HITF.CTS DECLARATION PANELS O Z El MULTI-UNIT El STRUCTURAL Z O vi UY'f0 2u1 AMP$Z I understand my plans shall be used as public records MODIFICATION FSE- awl Licensed Professional ❑INTERIOR El CHIMNEY REPAIR 201.1WI)AMPS IMPROVEMENTSWIMMING POOLS Y�,4 OWNER-BUILDER DECLARATION F x C 6 I hereby affirm that 1 am exempt form the Comracmrs License Law far the OVER 101VAMPS El BATH REMODEUREPAIR ❑DEMOLITION x 0 aa following react.(Section 9031.5.Btatmessm l Professions Role:Any city or CountySIGNS ELECTRICAL 20 ❑OTHER y wM1ich rrquires a permit to cnnmmn,abet,impmve,Demolish,or repair any structure FNO< prior to its lsmance.also requites the applicant for such permit u file a signed statement SPECIAL CIRCUIT/MISC. } that he is licensed pursuant to the provisions of the Contractors License Law(Chapter 9 W25 00 (commencing with Section 7")of Division 3 of the Business and Professions Code)or TEMP.METER OR POLE INST. COMMERCIAL a a p C that he is exempt thcmfrom and the basis for the alleged exemption.Any violation of ❑NEW BLDG/ADDITION ❑DEMOLRION WM^ Scion'1031.5 by any applicant for a permit subjats the applicant to a civil penalty of POWER DEVICES F Z" nm more than Five hundred dollars(5500). [ITENpNT ❑FOOD SERVICE E=CEl 1.as owner of the property,or my employees with wages as their sole compensation, SWIMMING POOL ELECIRIC IMPROVEMENT will do the work,and the stmcture is not intended orolfered formic(Sec. Business ❑OTHER W3 m and Professions Code:The Contractor's License law does not apply to an owner of OUTLET S-SWITCHES-FIXTURES property who builds or improves thereon,mW who does such work himself or through his own employees,provided that such improvements um not intended or offered for NEW RESIDENTIAL ELECTS SQ ten sale.If,howevot,the building or improvement is sold within one year of completion,the SQ FT FLOOR AREA $ISQ.P-n marea-buDder will have the burden of proving arm he did not build or improve for pur- poseir salve). ❑1,as owner of the property,am exclusively contracting with licensed contractors to TOT L: Crammer the project(Sec.70,14.Business and Professions Code:)'fhe Camra ode,Li- cerise Law does not apply toanowner ofpropmy who builds or improves ihemon.and QTY PLUMBING PERMIT . FEE' who contracts forsuchpmjects with acontmcmos)licensed pur,alto the Convenors - t License law. PERMIT ISSUANCE I am exempt under Sec. ,B&P C for this reason ALTEiR-DRAIN&VENT-WAT ) mer pate VALUATION 4 WORKER'S COMPENSATION DECLARATION BACK FLOW PROTE E I hereby affirm under penalty of perjury one of the following declami inns: ❑I have and will maintain a CenlBeele of Conscm)o self-insure for Workers Cnmpen- ❑RAINS-1%.00R, OO• tE NO, YPE CONSTRUCTION .,ran,as provided for by Section 3'100 rf ilira STORIES T a labCnJe,far the performenw of the work for which this permit is issued Po%TURISS-1'IiR TRAP ❑ 1 have and will mailmen Worker's Compensaime Insurance,as raryircd by SGatirn R - 3710ofthe Labor Code,fonhe performenceof the work for whhiichp{tThis paicart is issued. GAS-EA.SYS'Ilihf-1 INC.4 OUT] a My War ' Crit pap{c}Ins q pramria,mv1 Pot Cy �-{r"+oI-�� GAS-PA.SYSTEM-OVER 4(EA) !DOCC C2R)L A Carrier: Cil) 3AVA J CERTIFICATE.OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE GREASIDINDUS'I RL WASTE INTERCEPTOR (Thio section need not be completed ifthe soul is borons hundreA dollars($Its)) m hese.) GREASE'fRAP PI CHECK FEE I certify shot in the wrfromaneofthd work for which this permit is issued,l�hull Sf3lVElt-SANI'IARV-S'TOHM EA,200 Tr1'.' d7. z latior onLwys of Call 16,y Domn in inner ayn-t(Lbecmnlr ed to the Wurkerh Co )ad- GRADINGFEE O O Applicant O LL.•(t�'+I °I WA'I'lilt 111?A'fliH W/VEN9'IBLIiC'I'R NOTICE TO APPLICANT':If,vOc in FEE y g This viWom of of E Labor ori yon u o w WATER SYS'IU 01PREATING F ? become subject m the Worker's Gto s or this pmvieshall of the Labor coke.Ynu nntsl SOILS FEE Qforthwith comply with such provisions or this permit shell be deenteA revoked. WATER SHRVICE 24 zCONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PI.MB SQ.FT. PAID V O l hereby affirm that there is a umsraction lending agency for the performance or Data Receipt# r D. the work for which this permit is isoom(Sec.3097.Civ.C.) O Lender's Name TOTAL: H yV Leaders Address TOTAL: 1 certify that I have read this application and state that the above infomwtion is BUILDING F' Iti fn armed.I agree to comply with all city and county ordinances and state laws relating to QTY', MECIIANIC'AL'PERMIT 1 FEB, U building construction,and hereby anthracite Mp¢.mntatives rf Nis City tuemerupon the SEISMICF• shove-mentioned property for inspection proposes, PERMIT ISSUANCE, D (We)agree to save,indemnify and keep harmless the City of Cupertino against ELECTRIC FEE Iiabilitie.e,judgments,costs andet,drues which may in any wiry accrue against aid City ALL ER OR ADD TO MECH. in consequence of the granting of this pemtit. PLUMBING FEE APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO IR"CFM) SOURCE REGULATIONS MECHANICAL FEE N Yom( [ ,2•G-i9 AIR HANDLING UNIT(OVER IQ(KKI CFM) CONSTRUCTION TAX r' Sig nature o_f`Ap',llk!n Rmm, v �( Dam EXHAUST HOOD(W/DUCI') HOUSING MITIGATION FEE AZABOGUS MATERIALS DISCLOSURE Will the applicant or future building hampantmmre or handle hmnrdet,mmerial HEATING UND(TO I00.0fl0 BTU) as definal by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety CodIT e,Section 25532(a)P HEATING UN (OVER I W,IKKI BTU) LJ Yes ❑No VENTILATION FAN(SINGLE RESID) PAID _ Will thea applicant or future building occupant use a Date Receipt p PP g p .Air Quality .h.,e which BOILER-COMP QHP OR 10(1,100 BTU) mit haurdous air ronmminsnts as defined by the Bay Arca Air Quality Menegemem District? L: ❑Yes ❑No BOILER-COMP(OVER I(A,B(VI BTU) I have read the haaardous mmerial,requirements male,Chapter 695 of the Cali- AIR CONDI'T'IONER ISSUANCE DATE forma Health&Safny Cak,a atiote,and i 25533 and ns5J4.1 understand that if the NEW RESIDENTIAL MECH. SQ.PT. r �l building dcesnot<urremly hareamnant,that it is my responsibility to notify the rocupant C 7 of the Concerts wNch must be mer inono issuanc fa Cmificem of Occupancy. �1. - fin 6 —Lu-94 Owner or author d em fate TOTAL: ISSUEDBY: OFFICE Propose One (1) Illuminated Building Attached Sign 24 ft. Store front above store front(facing to Oe Anza _ Aluminum Individaul Pan Channel Lette LETTERS: 12ft.3" King 5alad= Faces GKEEN LOGO: ( — Teriyaki Chinese = Faces ORANGE w/W ITE copy fig" T. l Y' Vi vl "Ir1 I t% '!LAI z 'v t ll `tel t/ LETTER5 KETOKN 5"RACK w/3/4"BLACK TRIM PLOT" PLANS ��fir.. SERI AKI Cu3C-_.--,27T) BY, € " G I If E1V DATE.-Al2 L 4 k1ZEowL I 'a' DATE6�2— c bIDG. DFP i. Novi9 Metal Pan Channel Letter PROJECT APPRE55: 3exigfa o Capt _ king Salad 10745 So. De Anza Blvd Cupertino CA, 95014 Plexiglassuair Project: PAN CHANNEL LETTERS 51GN ON BUILDING UL Aprove PK Insulator Housing� �- Neon Tube — #1ox2"Hex 3 Each Min, Diawing NT5 Business Approved: � _ Metal Transformer Box Supplied W/On/Off Service Switch \ u• x DATE: 6-20-99 Landlord Approved: l \ s .,.,M 1/4"Drain Hole 20 per ULlfH /,AITC sjg ns Monte 2ring W. CommoroW sye •San Jose,CA 95112 Mounting Detail PLAN-NTS TW:(408)lav-s000•s.:(aaa)aav- 551 12ftoY v lb " To , Propose One(1) Illuminated Building Attached 5ign above stare front(facing to Pe Anza Blvd.) PROJECT ADDRE55: Aluminum Individaul Pan Channel Letters Neon Illuminated king Salad 10745 So. Oe Anza 51Vd Cupertino CA. 95014 Project: PAN CHANNEL LETTERS SIGN ON BUILDING LETTEK5: King Salad= Faces GREEN Drawing NT5 Business Approved: LOGO: Teriyaki Chinese= Faces ORANGE w/WHITE copy DATE: 6-20-99 Landlord Approved: a uo.Haim CC'' ULTrHMATE LETTER5 RETURN 5"BLACK Wig" Maw(«turirg Ca. W1314"BLACK TRIM °"wm^��w$^n•s�^,°..°"%"'