S 1261 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPF.RTINO BUILDING.-ELECTRICAL ... NO 1261
BUILIJING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL
BUILDING PROJECT IDENI'IF'ICATION
IfU1LIlING ADBRF$$'.
SANITARY NO. APPLICATION SUBMTTfAI.DATI!
21 Uti i fa Dr; e C 2r , o2 Qj a
(IW 'S NAME: ` %IONI?'• L�Z� CONTRAC OR'S NAME: I.ICNO,
y ` NIC CONTRol,0
r ITECDENGENEER: �l LIC No ADDRCSS: ❑
CONI' CI': PHONE. BUILDING PERh11l'INFO
❑ Consulmnt Pees Paid by Applivanl(Initlal) ❑1.1>c IiLECI' �q
PLUMB Nil CH
I.ICI!NSED CON'I'RACIOR:S DECIARA'I'ION QTY ELECTRIC PERMIT FEE A
T
I l,erehr elrrrm tltll 1 an hem,ea ander pnr.:i.irrha M cnafnery lrnmcrrming JOB DESCRIPTION
m
ZO wIIM1 Sltllon]IXFII of lJi
sou 3ofmu na.inra eatd l'mu, n
fcciuCode d sty hcNwit RESIDENTIAL:
vi�
O PI?HMII'LSSUANCF,
Infull faavlalcRm. ❑SFDWL ❑KITCHIiN HIiMOUII.
hiccnw Gla,. IJcx APPLIANCES-RESIDENTIAL []ADDITION ❑PLUMBING RE-PIPE
Q 1 Ihm Cararectrx
ARCHITECTS DECLARATION ❑MUI.TI-UNIT ❑SI'RUCI'ORA],
F h PANELS
ZOr�Z IurdcraanJ myplans shall he lscd m pubic rtcmds MODIFICATION
cZ- UPTO?MAMPS El INTERIOR ❑CHIMNEY NIii'AIN
QN~.] Limnued Pndn,iortW 201-I"AMIS I IPROVFAIEYT EjSWIMMING POOPS
OWN'I!R-BUILDI!N DECLARATION OVER EXCAMPS A'I'II RF.MODEUREPAIR ❑DEMOLITION
Q I hmrawr affirm Incl I usm exunpt Brom Qtr Code:
Any Lar co IM
a06U Billowing rteaart.renorm.APS.Buaineu and I4ofeulonal,cc Any Cry or county SIGNS ELECTRICAL ❑O IiR
3 y vetch rays,.t ,itho ......,,utter,h,fer e.h Paderrrdik a rr rt ,ir any iiicl cafe.
prior toi1.i. ,ertaootuln,Ir'INIM ......enlfar rvchpernlil L"cil,Law(Charrru S%:CIALCIHCUITIMI.SC.
yEy'' Y thus Mis iii,wd purtuunt In Il )pnDoiiao of thecBri'l orklcl Probe' (Cloplar
Ia1YOO (cTMn'"`"Ging wim Sttliun]0001 of DiviFifrlldlhC Bu,irau and Profnairvs Codelar TIP.MI:IYR OR IroLE INST. COMMERCIAL:
I., Oar hu 1,ecwp nIhcmfnnn and tM baW
sis r Ilw.11,A umn.emplAny violalion of [:]NEW BLDG/ADDITION ❑DEMOLITION
M le- ticaim]UJI.56v aoyeppli.,for.Permit wba.the applicw laacivil pc.It,of POWER DEVICES ❑TENANT ❑FOOD SERVICE
cot rame thou five hawral dollar,1551X0.
F Z>' IAIPROVEAIENT
�FC' 0I.o Ilio wort,rid,heoni,,dr myompluyenw'ilhwage,ax tiriIS,.cnmpenWat SWIMMING IYKIL ELECTRIC
.� will do For—ohk enda. he Conlitunti Ijecomonofh:rcdfi nota Src.o111yB caror ❑OTHER
6 5 anJ 1'rofra,hro Coda.the Co fico.,Liccnro Law don nm apply m lf rwhrr of OUTLEIF-SW'ITCIIES-FIXTURES
hisProorn,own who build:or imlrmve.thcrcon,and rosdm o rot
aJ or o tharugh
be Own cmplo,thus pmvXYd ilia arch iminncomnd thin trot inter ic' on nifemd fur NEW RESIDENTIAL CLECTR SQ FL
saY.It.hnwe,'er.It ua,,ldinBaimgncrovic i.sot within ar b ymrofc,rr Mfor the SQ.Fr.FLOOR AREA 5/SQ.FT.
ow er.nailter will base me Iwmen orPrasilrg mat rw did�.tree nr il�,nrse for par- P A I D
of owner
W iwner
nllhcpnrpunyu xcluuvnd cccfi,, g Co&:)cThaCrnmrucernm O]AL.
uwrvcr Ih[pmjmt(Soni 901x•emlma tw Prufnrimc Conb:)Ila Comanoton'n Li
enw Law diu,not apply to an racer(if propcny who hoild.oriniproi, ncreon.nod QTY, PLUMBING PERM' FEE FEB 17 Am
who contract:fon such Project,with a conaaetw(xl Iicrn,eJ pursuant m the Cmimetals
Liana Law. I ERMI'I ISSUANCE
❑ Iora eacmpt urdha Sm. .It A P C fur lbs crown CIIY vr
AEIER-DRAIN&VENT'-W'A117R(EA) VALUATION
)RKFAS GDNII'EN$A lrr ARATION BACK FLOW PROTECT DEVICE O N.
I hcrahy.1r,.umkr penally of perjury Una M b.G Ellrrxing deelarutimc,. ✓
.J l halrarN will rrsinlsin.Cmif mofCrwacm mwlGimurt rarwonkGrx Canpcn- DRAINS-FLOUR.ROOF.AREA. SIURIES TYPE CONSTRUCTION
wtiun,nX provided for by Scclinn 37011 of IM Labor CaY,for Inc reHnmmocc of Inc
work bar which his factor t,iswcd. FIXTURES-PER TRAP
I nava aid will ttoinraiu W..kcr.Conipenation Insurance.u..ra9uircnl ny Section
3100ofdc Lhor Cosy.forthc Mrfnrtrl+^ceufthin it furwttich lhiapissued. GAS i,issuGAS-EA.SYN EM-I INC.i OVRETS PICC,GROUP APN
My wanes,eanrpens tion mwrame mrri,Ord Poli y nrnnner art.
Carnes. Policy No, GAS-EA.SYSTEA1 OVER d(FA)
cEFTI%cATE OP uumi hoN PRom WORKERS'
COMPENSATION INSURANCE GREASNINDUSTNL WASTE INERCEPb'(IN
a �Orr
fni, nirm nhe nrnpineE if lle pcmm is for orc hurdred dollars($100) BUILDING DIVISION FEES
GNIiASI!'I'RAI'
on In,.l PLANCHECK IPE
Iccnlfy Bw,. nthn perfmmun<e Nubia,.rrklon shah this lea Wcv cs C...anall SF,WFR-SANI'G\RY-SB1RM 1!A.21X1F1'.
nuI cnlpluy any puru�n uny ltunncrwwln lenmw.wNJm nr the Wonen'Cnngrn- ENERGY FEB
CZ nation law,W Celiforria.Bare WADER IIIATF.R W'NIN'VELECIR GNADWG ITE
O Apphewl
.. y NOTCE TO APPLICANT:If.after meting Ini,Cenif m of Exemplian,you should WATER SYSDJNTREATING
F hecane xa1dcO m tow Wonlcr.Crrnp m.slion pmvisionn of Inc LMa Calc,yN Inca SOUS IIiI!
WEinhwilh comply with such provisions or this permit,hall ba dtthml raveled. NATER SERVICE
0. Q CONSTRUCTION LENDING AGII:CY NEW RHSIDEYIIAL PLMB, SQ.Er. PAID
U 0 Ihshy affirrii bar,i4 econamclion lending ii,ny f«Ihe rerfirmana of Dmc r x
the vers[fur which Ibis penin is issued(Sec.3197.Co.C.)
Il" U Dencler,Nana OTAL
U knees,Aadre.t TOTAL:
} y ¢ eed
I nify that 1 have r 'Ibo.,hearvew
i.eee Ihl the
vabove inforrotiou i, BUILDING FEE
F+ h correct.l agra:to comply with all city and manly orduancn and.mm lawg relating to QTY. MECHANICAL PERMIT FEE
U Z baiminemn.rrraa
ttion. . lmrthy aallwiae relrevntrivGn ar lhiedmra
ly larer arthe SEISNECEE _
" vMrvcnnntlnrwd prupcnY for imprstinn pugnnec PFKMIT ISSUANCE
(Wc)egra m wvc,irdcmoify sod kGcir nahmina Inc City of Cupcn'utn agairra ELECTRIC EFF,
Iicludi da.judgorecl,cc.,oN.,.w,which coy i u any wtyarerae egainal raid City ALTER OR ADD TO MECII.
in con.xryocrrce of ftgranting of this b'conit. PLUMBING FEE
APPLICANT UNDERSTANDS AND WILL COMPLY WfrH ALL NON-POINT AIR HANDLING UNI 1'(1010AX)CFM)
E SiS
Siglmwre ofA I/Conv���s r �` I��Ia� '
MECHANICALURC:HEGU ION AIR HANDLING UNIT I1,1X1(:991 CONSTRUCTION TA
%
Dem E%IIAUSTHOOD(W)DUC7O
HOUSING MI]'IGATION CFE
IIA%ARDOUS MATERIALS DISCLOSURE
55iHdm.tribeaolon furanWiting n<upant stone nr hnrxlle harudnu.malenel HEADING UNIT(TO 100, 00 BTU)
to defood by Ibe Cupenioo Monlclpd Critic.Chapter 9.12,urd the Health mal Saciv
G.Y.S"etion 25532(a)° HEATING UNIT(OVER 105.010 BTU)
ElYo E]No VENTIL\TIONIAN(SINGLE RESIDE PAID
Will the tpplicsul or fulum baiting iuupont csa eyuipmd
nul rr ic�w which U G Recv1X x
Iharerdoua air cmumirunu m defiow by ftrc Bay Arm Air Quality M1tarugerrerR BOILER-COM P(31 IPOR 100dN)0 BTU)
TOTAL
DiYhcl'! HOLLER-COMP(OVI?R IXI,Bg)N'I111
❑Yo ❑No
AIR CGNIBTIONER
I Haut read the 11:varmrn m.,rsials reyuirtmcns ower Clupmr M1 95 nl I}c can- ISSUANCE D "
Tots Hicslth k Safny C'onY,Sccrimx 255()5,25533 rune n!i.x.I uwc+,mhd trust it fns NEW RESID NI'I Al.MF.CI I. SQ.EL
huitingrX notcurrentlyloventm'm6Rut II ismyrngrtdbilltytonMily ItooccuPmt
M dr rcquincmcnm whYn muu fie rin mon la icauarrc of a CmitintG of OCNpary.
pwn[nnemhanzM.gent Date TOTAL: ISSUED BY:
OFFICE
RANDA££ BRAUN DBAH.O.M.£. LIC # 396119 (415) 265-663
Sap Remodelfor: Eva & Lou Daaaw205Freedom Dr. Cupertino, Ca. 9014
/& 4 (40) 2»m8
� . .
f 60 JOBS:
. .. . .REPL CE 3 X O
. ... . .. .
® $ SHOWER WITH
\ \ NEW30X60 TUB.
% NEW "ANTI FAN/LIGHT p
( s a 2 v E
§ } wNS ALLNEW
§ ( PRESSURE BAL
\ SHOWER
{ I CONTROL VA/VE
\
RELOCATE DRAIN
{ .
/ RELOCATE DRAIN
\ 3 TO TUB LOCATION'
\ NEW TUB IN \ -NEW LOW FOW
9
EXIST. LOC. \ TOILET IN
/ teGPF \ EXISTING LOC.
TOILET (N) %
{ 'REPL CE VANITY/
N'.
WITH PEDESTAL
\ SINKINEXISTING
\ NEW TILE ON & LOC.
90 \ FLOOR & \
SHOWER WALL / .NEW TILE ON
§ $
FLOOR, h TUB
r « SHOWER ARE%
§ FLUOR. im \ \ BEHIND SINK &
\ TOILET.
\
It
\ �D
INSTALL NEW
\ �GFD OUTLET w
SINK{ (m 7y \ �+STINGLOC.
���r¢ �
. } c 0¥ % .REPL CE MED.
CAB. IN EXISTING
( »
LOCATION.
�\ c(N)` LIGHT, ` ►
.
MED.
FAN,
K (
� LIGHT E) a Scale: t ='