S 2151 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO REMIXING-ELECTRICAL Pp..Rp1IT NO. 2151
BUILDING DIVISION APPLICATIONIPERMIT PLUM BENC-MECHL IAN `v
BUILDINII PROJECT TDF.NTIFICA'rioN
BII I LDA NO ADXRF_SS: SANr1'ARY NO. APIggIC'ANONSUBMITI'ALDA'FE
-o
OWNER'S NAME!: I'I LONE: CO I'RAC )R' N IE. 1 GNQ:
r.. NIC COSHbiN
ARCHITECIANGINUER. LIC NO AI ❑
4L Mhtjlg!q
v-uONi . BUILDING PfRMIT IUCGL"CgCll
CwBVUltepf F¢Cv Paid by Applieanl(Utilinl) pI.DC FLIiCf PLUMB MliCll
❑ ❑ ❑
IJCHNSEIICONTRACITIH'S I11!CAARA'I ION QTY ELECTRIC PERMfr FEE
I hereby of Na I am licensed under pmvisiones of chaser 9(comnrncir, JOB I)FSCRIPTION
CZ, Sector Divi&m3uf the Banner,mallrd
Profeavor,Cat.anry livens is
BIOwith I'IiNMI'I'ISSIIANCp RESIDENTIAL
F+W-F- nfullrhe". m I O ❑SFDN9, El KITCHEN RIiMODLL
L.icrnsc Clercs Lic.N / AppL1ANCLS-RINDENIIN. [:1Y 'ION [I PLUMBING RETIPE
N Q 6 Dale "."amens
ARCHITECTS DECIA ATION ❑NIULTI-UNIT OSTRUC9'URAI,
Z~OnZ I understand my plwu a h,ll M teed as public rmxJa PANF15 MODIIICAT10N
OZ-M UPIO2 AMPS ❑INTERIOR CCHIMNEYRITAIR
F�FW lime"Pmfe.uimd 201-1000AMIN IMPROVEvIEN'f E]SWIMMING PDOUS
ow<
OWNEN-BUILDGH DECIAHATUN OVER I(IBII AMPS CBATH REMODFLRITA1R CDF_MOLITION
a Q 1 omwer.(Sc Thal 11. a-inecri s an Nc CClarw'IC x,Any
city
o for Ilse
Xy 4 U which moven.(Scetion]11)15,Runnels and pa,demolish.
Code:Any city ter aan7 SIGNS I!LIiC'N G1L ❑IH]dER
IL y prior t its irtx n Trail lis anslmat aeon,improve.h permit t m e a lig any�Iruvtancesart
F-1_OQ pialhiitn i.e—cl,.,rall ,,Is,don
sro,iu nsol hesuchm it to Hlc L,w(swcmrnt SPECIAL CIRCUITIAIISC.
tMtwislic'un-cJlwrsunnimilefrcrrvi.virmnofiM1CCnnirvcrnr'xLia:naLiw[Chvpmr9
COMMERCIAL
�ap0 (commencing with Scan.7")of Di vision J of Be,Hmairru and Pnsfesaiom Code)ar TE\1P.NIEfER OR POLE INST.
Q. y that ti,is cancer Naefnen and the,huffs for the vlkgd escmptxm.Any violation of C NEW IILDGIADD HON C UEvEo.Tr10N
Semon 71131.5 by any applicant for a permit sameets the applicant to a civil penally N POWER DEVICES
to mmc than five wmBd Meters($31101.
m-m ' ❑TENANT v("KID
~Z^ SWIMMING POLL 1!LECfRIC IMPROVEMIiNT
xd p 1.otowreronhe pnsprny-or mem intended wim heaped ere are,
(See
(W.B ri iers
W G wdldo NcNml,Cdlllc Otte Clommena'sI.IMIcd RnRrrCJ fnrsak'1y ,,an arwre,or
3 am erty w1nom Crde:'Dr rm,i ere. I.krnac law Ma rxg apply m an owner of 011fl.l!I'S-SWITCIIF_S-19XTURES
pmpeny herds wilds nr'ualxover Ilnenn,and hew Joes aah work hmself sx IhnwgM1
his own empbym,povi ld that sock impmwcmrna are not imendled or offered for NEW RESIDENTIAL.EIJ:C7!7F[ SQ IT.
sa1c.1[M,werer.Else wading in impromnent ie sold within mi nRompletirm,the SQ.IT.IIJ"R AREALSO IT.
rr,-wader vi nota&lamcn or pri Nat w did on,Wild or improve ow pur-
e 1, osonar
of(e progeny.a aelur vale contracting with Bi contractors to 'HAAL:
a,rutN[I the gaojrct(Sec.11tH.Bu.sines and Probesxinna Cade:)The CcmtnM
cts Li-
aLa.dx_x nm apply to an nwnerofvropeny who hillJxor infrov,therms.and QTy, PLUMBING PERMIT FEE
wMs contracts for wen M"j'xa with a centrad.,)Iicerned punuem Ito the Co marRa's
Licca¢Law' PERMIT ISSUANCE!
El l am exempt maiSm. ,B&IV C For lbisrtuwn
Ow rcr I)fttc ALTER-DRAIN&VENT-WATER(EA) VALUATION
WORKERS COMPENSATION DBCLARA'DON RACK ROW PROTECT.DEVICE
I hdeR o
by arder u
penally of nr ,con, mving e otihc folldevisraimns
pIG.mnJwilllnuintuinaCcniGcdmnfCrmwnunsdFlmmrFor Worker',Cmnpcn- DRAINS-R.00k,ROOF.AREACOND. STORIES TYPF.CONSTRUCIION
swum,as wu vidd for by Secden 3]00of the Eabar Code.for the performarrce of the
wn(A fir which this pends a r,s ri PI3'ATIRM-PHR TRAY
c wd will maintain Wacker,Comprnanion Insurance.v"Ithred by Secrina
](10 ofrtw laver Code,In he scrfommnac of rhe wont rex which this prrtnil e,iasued. GAS-I:S.SYSTEM-I INC.d OUTLETS OCC.CROUP APN
My W( r ln.rurn $�micr wJl'nll< Y91M1a sayer
Catric r PMtn'Nn�Tl11 <�iII CSC GAS-ISA.SY.SIFJC ONTR4 HIA)
GIiR IFlCA; Oh PXIJNI'I](1N EItOM WORKERS'
CONIVI NSATION INSURANCE GREASIYINUUSTRL WASTE INTIiRCFJ'1'OR
BUILDING DIVISION IFF_S
(thin xdrc
cm edmm
he coMwdiDwpenpil is Income rd
ehured dollar.($100) ORCASIi THAT -
nr InsF PLANCHECK Il?E r
I rectify Unit in the perRrnonce oflhe work for which this permit is issaimi.IVall SEAMEN-SANITARY-SMARM FA.21X1 FT
nm rntpl,ear,si in any noun m as to h,cmn, cbjcelmttr Vi Conn- PNIRGY 113E
� Z srtionLaos,MCaliRxnia.Din, WATER Hi VVrvFMn:u_crR
Z O App]it. GRADING IIF
h NOTICE'I I)API'LICA 'L IL decr noking this Candice¢of Eccntprion,you ehwlJWATER SYSIEM?RFATINC
P ? become wbject m dee m
Wadi Crtrt oamem provisions or the Labor Coou
Code,y .suis SOILS FEL:
W r-. Rnhw'iN amply with such pnrvsinna nr this pctmit xM1ull w Mcmed rOmk<J. WATER S ICE
aIn
o z CONSTRUCTION LENDING AGENCY NEW REST AI,P If. Q F . PAID
U O I hereby affirm tlmt t here k a conamdinn larding agency for perlorearr of TIF Done Ri#
i-+ the work bx which Nis pemdt is nerd(.Sae_: 7,Civ.C.)
O f•" Lemli Name - 'ICIAL:
r L<rdsYS Addle Is TO L
n, 1 ccnify that I have rem Nis awlicamen and sone Nat IM above Inbxnudon is BUILDING FIE
IF. Z) ax(sn.lagreemd.mpiy wim all cil'ted county sxdisvvorsaml arae la-mladoC to QTY A ?CHANICAL.PERMIT HE
V z building conirracrion,and hereby euthxim rclvescotntivexafthis city memaripon Be SEISMIC ITE
absom-nrntiomJ property Irx imrpection pmryacs. I'I!HMI'I'ISS
(We)ugrae,,save,in lmnnify awl keep harmless the City of Cupcnim.'aloe ELECTRIC I'(lam'
liawlitiajud8menta Cwsard ealxnsca which may in any way aerie aBeimtsvd Ciry ALTER OR ADD TO MECH.
in omuryrner orthe granting It Wr.lxmtit 1'LUMBINOIBP,
APPLICANT UNDE STANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING ONI'TITO 111.001 CFA I)
SU' ! ItLAT NS. MECHANICALEEH
�/ a [/ AIR HANDLING UNIT(OVER 10.000 CFM) CONSTRUCfIONTAX
SigrOomeorAp karibCrxnracax we FXHAUSTHOOD(WiTi HOUSING MITIGATION FEE
HAZARDOUS MATERIALS DISCLOSUH
Wrildre.,brenlnrfutum wildingrecupum am.c or hardlc hvrooll mmenal H9ATING UNIT TO 1000 BTU)
an MErxJ by Ne C'uWmms Municipal Cure.C'huNcr 9.12,atd the,HemN am Si
Crdc,Smirm 35]20)2 HEATING UNIT(OVER 100.000 BIM)
E-1 Y- ❑No VENTILATION CAN(SINGLE RESID) PAID
Will the a1Tl'traw or ,(utter,wilding mvuli mac a m,penemt or devices which Date Rmipt N
,mil toucans It ronamommdr an,JeGnd by the Hay Area A.Quality Man,.r IB ILER-COMP CHP OR OBOOD 9TU1
TOTAL:
District.'
Pres C]No BOILER-CUM P(oVIR I(IOp(p I, O)
I have rhe haratdoterialr,renHunch Clemprrr 611 of the Cal i- AIR CONDITONER ISSUANCE DATE
rtyuirtmcn
hi
IAread!calm h Safety C de.Sciences 255115,25533 and 255}1 I uddamxl the if the NEW RP_SIDPNfIAL MECIL SQ.Cr.
htdml,dna statcmot have....Brad it is an,repsomihilitym nvif,the oavpvnl
I enh,ralmimnw,ttx wh.n�naxt wntu l,dona iasnmta t,lacrnibt�tn ar(1c,mpwcy.
Osvmroramm,tri cf,i l Dan, 'IOTAI.: ISSUI',D BV:
OFFICE