99110028APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
CI TV OF CUPERTINO BUILDING - ELECTRICAL
P N.
BUILDING DIVISION APPLICATION/PERNUT PLUMBING - MECHANICAL
BUILDING PROJECT IDENTIFICATION
^T
BUILDING
SANITARY NO.
APPLICATION S DATIi
JC
' S
f NER;S S :: 1
CONTRACTORIS NAME: LIC NO
NIC
CONT'RULR
'dITECDENGLNEER: LICNO:
ADDRESS:
❑
CONTACT: PHONE
BUILDING PERMIT INFO
❑ CoMLllenl Fes Paid by Applicanl (Ildlild)
BLDG ELECT PLUMB MECH
❑ ❑ ® ❑
LICENSED CONTRACTOR'S DECLARATION
I berehy nlerro mal turn Ecenwnl aa1e, prov,aors of Cbnpe, 9 (eommm
emg
wuhSection ]gyO al Division3ofthe Bisinesmgl Pm! dorm Cuk.wW my liceveir
full font vM
IJceuc Lic.
Uutc _ " Ca
QTY ELECTRIC PERMIT FEE
CZ) �a
F OPERMIT
<FVzU
JOB DESCRIPTION
RESIDENTIAL:
❑SFDWL KITCHEN REMODEL
RH-DEL
❑ADDITION ❑PLUMNING RE�PIFE
ISSUANCE
APPLIANCES -RESIDENTIAL
X61
ZO'z�0
ARCHITEFvz Itugk,unrdm leas 00 be uP.W w,puhliccoTION remdr
YP
AL
❑MULTI -DNR ODISTRUFlC ON
PANELS
[E-�F'LLI
O L U
W j LL
FI_ -O
UPTOBDAMPS
❑INTERIOR ❑CHIMN17Y REPAIR
IMPROVEMENT ❑SW'Ih1h11NG POOLS
❑ BATH REMODEUREPAIR ❑ DEMOLITION
Cl O- TM�
Licclverl l'rufusimal
OWNER -BUILDER DECLARATION
I M1e¢hy af0mt mal 1 em evetnp from Inc Contnnor's license Lew for the
fallowing rw.son. (Section ]0313. Busines and Professions Code: Any city or coumy
e, which requira Permit a.conunsn, filter, improve, dttit noloh, or n anY santer.
prior to in i.sua«e. also requires meapplicaot for such pumil to rile a signal uatcmrnl
toss -is licensed purxuant lu Be pnrvnmm n[ ma C9nR«lair Licc,. La.(Clmper9
to.oking with Section]tgXB of Divi.si,n 3 of tbo 9uvrtes and Profesons Costs) or
NI-1000AMPS
OVER 1000AMRS
SIGNS ELECTRICAL
SPEMAL CIRCUIT/MISC.
/�
TCM P. METER OR POLE INST.
COMMERCIAL
a d
mask u esemp metcfmm mrd Ile huis for fie alkgM evcmpion. Any violmion of
[I NEW BLDGIADDITION ❑ DEMOLITION
X ^q
Way
?�
Section ]1131.5 by fin, applicant fm a prams uahlecu Be,appheant va a civil Pesky of
not mart Ilton Evc huMind &,this ($"I)
01,uowrcrof the papas.«mY cmpbycs wdm wagnulh[E sale c«nlensmim
willdomcw«k.w theury umisn ini edmoReredforsk(Sm.] .Busine.s
a«I Professions Code: Thn Caranall-'s Licenm Law arcs Ism apply to an iter of
popery who builds «improvn dereu,, nW who mrxi such work hirrcelf or mrough
POWER DEVICES
❑TENANT' ❑FOODSERVICE
IMPROVEh1FM
❑OTHER
SWIMMING POOL ELIiCfRLC
OU'ILLTS-S W ITCIII'S-PI%T P�
his sun emplmen, pmvidN mal mach impmc<mena K not intended or.Rend f«
NEW RESIDENTIAL ELECTR SQ PT I
w1e. If, hawser. the M1uilding urimErovcmcrt is sold wiminarm yew of emryleion, can
SQ. PT. FLOOR AREA
5/SQ. FP.
fir -W filler will ha -the burden of proving (het rte did no, W ild m impove folio,
psec of sele.).
0 I, a owsar of the properly, am exclusively convening with licemed contracts to
TOTAL:
Xuwa the projud (541 ]OLI, Buo,M, and Profession, GNc:) TW Contractor's Li-
crnseLaw daesnot applyto an awner of ProPerry who builds«impmcs dererm, W
QTY PLUMPING PERMIT FEE
who ccmtrans for such gojccu maim a canlPClor(a) licroscsl ptasvw a Its Convecmis
P17RMII ISSUANCE
Litc,se law.
0 l am comp uMer scr, , B h P C far mix rector
ALTER - DRAINh VENT'-W'ATF]t (CAI
r Dale
VA I.UATION
QO a 0 p
WORKERS COMRiNSATION DECIARATION
Peri L hereby vlErm uMer Per prow
jury «n of Use falling drelarelio,n:
BACK FLOW PROTECT. DEVICE
DRAINS -FlAOR. ROOF. AREA, COND,
I has arW will mainteina Cenificemo(Cmscm w¢IGioone f«N'McfsCmmpcn-
sari«, u pmvidM far by Action 370)of Ile Iabor CUM, Hs me peHammrca of IW
STORIES
TYPE, CONSTRUCf10N
FIXTURES - PFR TRAP
rk for which that Pnmit is i.arucd.
jet have iski will maintain Worker's Comprnwion Insururce, m rcruirM by Section
3700 of Be Labor Cock, fm lbe performance M the work fayrQwhich thhir perm(itlissiis�.s�u]M.
MyW«A��o {ryy Vw.srxrPohdcy No. [l[.x<Qamito
arks: 1�m Al
GAS - EA. SYSTEM -I INC. 4 OUTLETS
OCC. GROUP
� AP.I�
GAS-EA.SYSMM OVER4(EA)
CFRFIFICATE OP EXEMP ION (BOM WORKERS'
COMPENSATION INSURANCE
lrnmpletM i(mermi
(This mW the is f«onehuMeN dollar (SI00)
« It,,)(This am«ce
GREASEt NDU.SIRI. WASTE INfERCHPH)R
BUILDING DIVISION FEES
U
GRSE TRAP
PLANCHECK FEE
SIiWER -SANITARY-STORM F.A. 21X114.
Z
O
z O
I certify that in the perfm,lance of I W work liar which this parrot is issued, I shell
an employ any pcwn in any twnram w u, m becnrre-mhlen m the Wtrkcri C9mpn-
uasn Laws of California. Due
Applitutl
ENERGY FEE
WATER HEATER WNENT2LECIR
GRADING Ftili
NITIICE Til APPLICANT'. IL ufnr necking Chia CeniOcatc of F cmpion, you a sokl
orre ma
hecbjnn 10 IIs Workermpen
a Coswion Dowisions c f Ee labor Cadm
Cools. you must
comply with with Provision, or this permit shall be decred revoLel.
CONSTRUCTION LENDING AGENCY
Ithereby which thi mat Uert is a lending figerey f«me perf«menceaf
IW work for which this p:rmit is isudl (Sec. 3097, Cis CJ
WATER SYSIIiM/I'RI!AGfNG
WATER SERVICE
h
Wfonnwim
�=
LLQ
O U
ZI
U
SOILS FEE
PAID �•
��/fLL Aa 1Rctrip C.\sl
\ \ 1
e� TO A
�S%
UILDING FEB
NEW RESIUINTIAL PLEB. gQ. FT.
Lectl�Nana
Isrder'I Aatif,
I cenifY mu L rent oristy
acro mar IW above iwsminling to
TOTAL:
h
ei z
and coup y o
nxtcel. l agree m neupy maim all dry end taunts «dimmccs mrd Sone macs miming e
ply
byauUwvercp mwivuof0 scirymen up n h
WIIJingconstruction.ent
QTY MECHANICAL PERMIT FEE
S
a
r
above-mce)sgoe to stoc. simpectian laceP hs.
(We)verato seas, ikcsfayyand keepharinlero IW CityroCupcnia oagainst
PERMff ISSUANCE
LECfRIC FEC
inhiliti,,saccg nS.11 urdcvpensX which may in env way atcme agwnw swJ City
neVnaeeA 1 gaf Otis pemtiv
ALT ER OR ADD TO MEM
��-
SIRING FEE'
_
AIR HANDLING UNIT CTO IUdN1fIC1 M1
CHA -[CAL TLE
A ' T" U DS ND WI C MPLY WTITI ALL NON -POINT
gD' P .f U
AIR HANDLING UNIT(OVER 10.000 CFM)
CONSTRUCTION TAX
gnmwe of Applicen Isogon Dale
I IALARlX)US MATERIALS DISCLOSURE
P.%IIAUST I{(K)D (WNUCI)
HOUSING MITIGATION TLE
HEATING UNIT ORD 100.000 BTU)
Wdl the epplicemm(uture Wilding occuPartl use«hmWchvvdwu melutal
nc me Cupertino hlunsipJ Cade. Crapes 9.12, erd the 1lefilm erd Safely
4
Iby
C, ,1
CnJc,k SCCIinn 25532004IIEA'fINC
DYa V ni No
Will Es, applicwt m fume Wilding occupant ase egaipmenl or device. which
d nusrrlau air cnnWntirents as &final by lin Buy Area An Quality Managenent
D'aWn0 Ye, KNo
UNIT (OVER IIXI,(f(M) PTU)
PAID
Dete Receipt x
VENDLATLON FAN (SINGLE RESID)
BOILER -COMP (31111 OR wgft) BTU)
TOTAL; �
BOILER- COME (OVER 10),N)0 BTU)
AIRCGNDITIDNFRuunder
l have real fila C'lupv 6.95 of Ue Ceti-
ISSUANCE DATE,1I
NI:W RFSIDI;NTLSL MECH. SQ. FfW'ddin
sty and 25531, 1 uMcaard cont if 0e
co sheapotuihilllylun«ifslbClccupmt
e MaCeNBcaeof OV u
W
O oreabcaozW"in IA¢/
ISSUF,U By
TOTAL:
OFFICE
County of Santa Clara
"Dcparoncnl of Hnvir<nnlcnral I Icallh
Cow; if Olficc -2220 WK)rhork Avcnuc. East Wing. I'tfAnI1 100
11
P.O. 13115 26070
San lost, Calilnmia 05159-(3070
1.u3n12fN7{�p1�
FAX 298-62(31
November 4. 1999
Aquatic Technology Pool Service
Attention: Paul Benedetti
15466 Los Gatos BI, STE 109-240
Los Gatos CA 95032-2542
PROJECT NUMBERS: SRI 16232 8r SRI 16233
PROJECT NAME: FOOTHILL VILLAGE APARTMENTS
PROJECT LOCATION: 10210/10300 FOOTHILL BL, CUPERTINO
The renovation plans for the above project have been reviewed by this department and
have been approved.
At least two (2) inspections are necessary in order to complete the swimming pool/spa
construction approval process. Inspections for pre -plaster and final construction will
be required. Contact the Plan Review and Construction Unit forty-eight (48) hours in
advance of the required inspections.
The pool contractor must notify this department upon completion of the pool(s)/spa(s).
Pool(s)/spa(s) must not be placed in use until the owner or agent has received an
inspection report, in writing, from this department signifying the pool/spa and it's
appurtenances have been constructed and equipped in accordance with the approved
plans.
We also request that a key to both the enclosure and equipment room be provided so
that our staff can conduct unannounced inspections throughout the swim season.
If there are any questions regarding this letter please call this office at (408)299-6060,
between the hours of 8:00 a.m. and 9:30 a.m., Monday through Friday.
V, - (" _)
ERNEST WONG, REHS
SENIOR ENVIRONMENTAL HEALTH SPECIALIST
PLAN REVIEW AND CONSTRUCTION UNIT
DEPARTMENT OF ENVIRONMENTAL HEALTH
co!
City of Cupertino Building Department
lioard nl Sulwrvisurs: Dcmold 1'. Gogo. Bl.mca Ah'arado. I'cn: Alcliugh. Iamcc T. I.WN1 JI., S. Icscph Sim'uian
Cuunlq E.ACC111N0: Itichortl W111CJJ1 :rg ,�,