S 2855 - -APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-IlLE,C'TRICAL PERMIT NO.
BUILDING DIVISION APPLICATION/PFRNIT PLUMBING-MECHANICAL
BUILDING PROJECT IDENTIFICATION
BUILDINGADDRGSS: SANITARYNI AI'IB.ICATIONSIBMIITALDATI!
7 9 l 7 FE&TI VAL ))L,IICT�/ / 7-
OWNERm/ti'NAME:1l.5NNY Hf,1BaiL.//� �J!•O - �ONfrRACTOR:SNA LIC NO: NtC COYINIII.N
1 ...c LC�'/FN /L/P/�I u
LIC I^ 2� ADDRESS: W ❑ Z V
6 V oVn
CONTACT': PHONE: p� Q BUILDING PERMIT INFO
L I_g,�p,U� CSI^) 56 -4 j ❑ Cm.ltam Fees Paid by Applicant(Inlllal) BLDG E LEM PLUMP, MECH
\7(//V v lzi— (�-- o— 0'
LICENSED CONI'RACIUR'S DIiCI,AHA'1l0N QTY ELECTRIC PERMIT FEE
I hcrehy affirm Thal T ani ransd radar M,l lxions ofrnaptor 9 anmmencins JOB DF,SCRIPT'ION
�a'Z with Seauct-70(M.rDi ,mar Jof dre Besinssard Prefe.uime G,de.aM my liecei is RESIDENTIAL'
O O %JtA11T ISSUANCE
F-� in full farce eM dLYt. ❑SFDWL ❑KITCHIN RI1.f01]EL
Q V U License Cl., lie N
r Zuj Data Comrsnor APPLIANCES-RESIDEN)'IAI. )Uff10N PLUMBING RE-PIPE
,pro, ARCHITECTS DECLARATION Pl IJS El MULTI-UNIT ❑mucTURAL
Z O y 3 1 uMedaM my plans Amit bo used ae public mnmis MODIFICATION
UP TO 2fO AMUS
O Z.�r, ❑IMPROVE ❑CHIMNEYREPOL
LiccnscA i'nalcrosmn:J 2111-HMp AM45 IMPROVEMENT DSWMMINO I'OOIS
C I hereby dfim,
OWNER-BUILDER... IuDlitd C mm,lb,❑anus law for the OVER I(XICANIPS ❑BXIH REMODEIJREPAIR ❑DHMOLI'PION
60follrawing...lS Iron 703 I.S.Best.aM Praft ares CNC:Any airy or cuanry SIGNS EL[CIIt CAh ❑OILIER
LL13 4 F which rryldr,r a{colut to omlewcl,mar,InynnM.denIDhWl,or repair any mm wm
FLLt�O rymare,ill ixm..alm r:,in,me Npilicane for such pmnamfle.,i,ndomit m SPECL\LCIRCUIT/MISC.
that he is hetescd lamawl to the provisions ofhr.Cmlhmcnn'S l,kenw law(Chaptar9
W C, (cmonsi,ng.im See.7E001.Division JoOhe llaeircre mist Pmfi,,ems Gde)or 'I EMI'.MISH3R OR%)LH IN5T
E a e IY that 1,t,,em IF,therefrom wd dr.hues W0e alleged aeWoco.Any violainn d ❑NEN'BLDGIADDITION (3 DIl f01.TDON
vi Sation 7031.5 by my,,sheme,fK a pammit mb*h the opplic-ant m a civil fewlry er %)WriR DEVICES �TENANT' C]FOOD SERVICE
,ve mare man five hmail,0 dodo,IS51gb.
F z r IMPROVEMENT
=Q p l.a Iownerofilb,thewmk.aM prolcny.,rm remPlnyco with xagn as their Scm.7 p. n.l':Ilion. SWIMMING%R)h IH.ECIBIC
will dothework,aMtheu,Clrrcitroti Li cense La. for sale mo.,I,i re Busirszr ❑OTIIF.R
S aN Pmfe bobs Cels:Tho LlmlmellMe License law sac nm upply to nn mvnr of (IITII,ITS-SWTfC{II:S-FIXTURES
his own who M1uildr m imp d that
thcmn,aN who rksa.onwork Ilimclf or mmuglr
his rasa o i N,beildild IM1m moM1 rromm Vemanls are my i,eaMd m olfcnd fur NEW RF_SIDENTIAh ELECIR 5014.
ala.ILM1,wcvcr,the huek4n6 nr improvement la aoW wimin oK year of cmnPktiun.meSQ.IT.FLOOR AREA 51.50.F1'.
huihier will hove me harrkn ofpmviog thw hcdld not Wild or is,mve for par- `07
qny. e
Lii,L
P� ak�- 2
.t r of the See,70y,.B oadueivdy ennmctsng with li The C mm be,I, .- O
cwamet,d e,. ('Ay 70JJ.......r ro .1imrrts CuJe:l The CMlraelor'.1;- •-r
m law Jcesrrn apply Ulmowncr ofprrpcny wM buihL or impruaa'IM con,awl QTy, PLUMBING PERMIT NEE • ` �� �•��
wM crmtmcn hr such projms with•mntmemr(el leansd punusnt to ae ComrrrMs
License I". PERMIT ISSUANCE
❑ lam no derSa. .B♦Ir P C far this rtewn
= [)meALTER-DRAIN K V ENT-WATER(EA) VALUATION
WORKER'I OMI'l? S'ATION DIiCL\HAI'ION BACK FLOW PROTECT.DEVICE
�~ Ihereby affirm ablerp telly(w Rrlur)'mcofmcfMl inedcclmetims: 1 O
❑ I in,end.,It nwin"n a CeniflamcofGn. 11,wif-illrure fm Wndcer's Camper DRAINS-FLOOR,ROLE,AREA,COND.
,fish, r pms'iJcd Rr by tiatim J7(p of the Iahm Code,fir Ih'perftmwruc of me S---IEti Tl'%:CONSII(U('1lON
[] I beerwhich mis maintain
WorkLY FIXTURES-PEH'THAP -Z_ V
❑ I have aM will maintain lie t-m Comlensvion Lformc,as raryird by S"mel, VVV
l]I10 nfmc tabu Code,fnnM nuncn[IM wKlfm which the• lis ioud. GAS-IA.SYS'IlJ.1-I INC. OUfLI'IS
perfnn flrnnl OCC.GROUP PN
P
Car ier, .Cmnpcmurion Inuuvrcc carr'rcraMNiry numM ec:
fenirn
I'ulicY Nn.: GAS-IA.$YSII?h1�OVBR 3(TAI 7�
CERTI%CATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE GRFASFJINDUSI'RL WASTE INTERCEPTOR
BUILDING DIVISION FEfiS
Qbisu,boo rcd N4 he crmd mit pinif Peris bm(me huMel dollars 1$100) ORtASEIRAP T - -
w It.,) PTANCII IRE
yo
T terrify mat in the parformameoflhc work forwhich lhispermil is easmYl,l shall SEWUR-SANITARY-SI'ORMIA.2g11T.
nm employ my pcnom in eny manrcrw ur to be,,me,ab*,m the Woram,Con i EN YAG 2 LO
2 Z smien law.of C.liforma,Date WATER H HA IER WNIorFn1EC1'R
O Ap,4.t GRAD I
ti NOI ICE 10 AP%JCAINHE If.after mating this Cmli Teale of Fiempmm,yoo should WATER SYS'TEM/I REATING
F , brcune sesSect it,Ills Worker's Corn a t'm pmvisilw d tK tailor Code,you mu SOIL
Ganbwoh Complywill saoh pmv kionror Ibis Pomdl shall h,Jccnrd rcvnkal. WATER SERVICE
CONST,i,.e ON coon leadi., ,NCI, NIiW R151DIiNfL\L I'Lh1N, SO.IrI'.
PAID
uIM1erebhich lex FI is sueontrve.ionkrdiagercy futhe lerRrrrern<d Lane RaciptN
tM work for which air permit is issued(See.J0')].Co,..C.1 '
ULencLencs Name O T�,:-2:2--,
LcMcr's AJJrccr
F_ 1 1 ccnify Thu I have read ria a,Ikmmri mad tree that the.1men irimmutien is BUILDING Flit; L
rAtorrem.lagnc lllovm..lyx'IIII all city and<omi,crb lm,res aN..In low,nel.b.,la QTY MECHANICAL PERMIT FEE
U z building cs'Iru n,.Iw(I.aM hcrtby.monre«PrtreNalisii of lhistily to cmttupnn tie smsylic)-fiA !
ah,vc.men6nmd Imlpcny
No,inspection Fgn¢s.
1Wq.gamm.r,iMcrpaify and keep harmlem the City of Cu,nesaim againt %JO.fll'ISSUANCE ELF.Ac - ZZ
IiuM1Blliew'.Jadgnruntecr,a.ars]cepenw..hida mu yin any way.,me u➢limed Cil, ALTER OR ADD TO NIECE.
in n.,equcnrr
e of the granting of Bon Paait. Y. In' NEI!
APPLICANT UN D ERSI A NDS AND WII.1,COM VI.Y WI'1'11 ALI.SON.POI NT ATR HANDL]NO UNIT ITO I0.000 MB
//� O MF„ A ICAh ILII
SOU �'GUR 1z �C.{!
AIR HANDLING UNIT M000 CED CONS' UCIIONTAX
Signature nfApplirmlAlm ,crux Duro EiHAUSTHOODIWNUCO H( TNGNTTIGAIIONFEE
I{AD RDOUS AIATERIAIS OISCLOSIIRIi
W by
CuWrfirf fuanici,ll Came.Cu ritsr 912,hamtk hHeardwrrmalALly HEATING UNIT(TO IDU.OBU BTU)
m seefiKd by(Be Cupenim Municipal CWC.Chapter 9.12,nM the Health red Sulny
CuJc,Satin,25512(u)" HEATING UNIT(OVER 100.000 UTU1
E]Y., ANO PAID
VENTILATION FAN RF_SID) Hoe Rtaim
Will he apP omberinme,ae fieloo,MefinaIg by Ithe BIrarymryr Usably
Nfirma,whkT
rest tivarrk,m air cuntvni.end m htircd by Ib[Bay Area Air Olrmity hlm,garKnt BOILER-COMP IIHP OR 100.000 BTU)
-I Uwrid7 1
1 ❑Yn ❑Nn BOILER-COMP(OVER lghfJDl BTU)
AIR CONDfIONER
T Erma III to hzeedausmalarial.rcgnirnrcnts unr Chasvo 4,95 of the Co.- ISSUANCE DATE
Gini.I IcaIIII&Safety CNE.Sa'lium 25511.1,21.5)9 and 25111.I wdcrslaM mm II'Ik NI'W RI-91Di-NfIAL M1tl!CH. 50 Err.
11-ia IedK.&Sale CWe,S riont lha it is mYrnry IIS lXL I mre"aartrcmpam f /
nfl )tI115whh1r,nall t e l o, IN In lar.' Cnle Cl'ltifKall'.of(kYulklrey.
ner or umhurired agentISSUIDBY'
OFFICE