19634 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
Build) Pro'eat Identification PERMIT NO.
a��g 19634
Iante. o .
— (anis OF CUPERTINO-BUILDING DIVISION i _
an «sN.me: .APPLICATION I PERMIT z 7- CT D'
1
Archdect/Rngleeer: yyE Na BUH.DIN ELDZ RICALI'LUMBINGMECHAMCAL CATEGORY CON RO1.I
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I1 S_X -3767 QTY ELECTRIC PERMIT FEE BUILDING PERMIT INFO
-
Add. PERh4TISS'UANCE
LICENSEDCONTRAMerp DECLARATION ✓�`h
IFth Sy Wb000).fam llcevedhe Be rovWonsaf Chaper9(mmmm APPLlANCESRESH)ENITAL BDESCRL�HON
ingweis I.ion 7000)of Dcfeet. (the Buafwaand ProlmlovCade,and - � �
Liens is I.fuO force and dfect. PANELS
Llceraa C6w Lk.I
Date Contractor UP TO 2DO AMPSP
ARCHITECTS DECLARATION 201-1000 AMPS ` t
q�u ot 7 ]urdersta rad my p6v shah he uaeti u Fublic recvrda. OVER 1000 AMPS SQ.FT.FLOOR AREA S/5Q.FT.
I k o Licensed professional SIGNS El v-TRICAL 0 Q 4,1-f- Vi a
<6� OWNER-BUILDER DECLARATION SPECIALCH2CUTf/MLSC ` IT"Z ttZ.(V
I.., Ihembyaffin thatI.m xempfromlhe Contractoet Lkenw Lawforthe �st•s /
i'�� following osa .(Section 7(315,gushaa aM Profmlom Code:My city or TEMP METER OR POLE INST. GO�� ZT
I�� contywhichmqubeapemdrtomvlxuG,alter,Impmve,demo h.armpair , I (/ r'-k7
anystructere prbrto Its 6aunce,aleo requite the appOcent forsuch Femur b �I/
c O 5 Ne a signed statement that he 6 BcemN pursuant to the pm,si e,of the IUVFlt DEVICES 112—
QaJ�
:bil ,� _ Contractor's License Law(Chapter 9(mrvrcnWg with Section 7000)of Dhd- / T
I t-3 aum3ofthe Buetomand Pvfmbv Cade)orthat heb exemptherefmmard SWMfh POOL ELECTRIC VALUATION
app4 the ban sub)"the
applicant
tolatbn of Seabn net mom
Lyany OUH,EISSWITCHESFl%7l1RFS �j Gd
I,J 6i loc hundforaparmlr eubj tetheappl{canttoa civil penakydnat nnrethan I / vQ '
a. fivF-11, deed d,of r 1
k,< I,as ower of the Property,or eery employee with wage as,their sob NEW RESIDENTIAL EI-ECTR SQ.FI'.I STORIES TYPE CONSTRUCTION'
mmpevatlon,wllldothewmkand lhemucturt6wt Intended or affenH for _
5 O sale(Sec.70K BwLius and Pmfm[ma Cade:The Comeacto's License Law
$ don rotapply to an owner dproperty who buildsor Improvethereon,and IL
I _ R UI'
who donsuch work himselfur through hie own employee,presided that such
Impmvemcnts are wt letended tendered forsale.f(however,thebullding a IOTA
lmprovem,ot GaddwithinarcyearofcompleO tMownerbuaderwlll Tuve
Rol proving that he dm rest build or lv,prtvn for purpose of sale.). QTy. PLUMBING PERMIT
a owner of the property,am exchafa<ly contracting with 11¢naed
PERMIT ISSUANCE
tractors to mtct the PmjeR14,(Sec.70Buainu and Protmv loCode:
mm1
i ComractoYa Greve Law does race apply to an owner of property,who
build• or Imprwn thereon,and who contracts for such ptvjem with• ALTER-DRAIN&VENT-WATFA
L-jI m exemsedpunwn,to the Contnct«a L4erue Law. RACK FLOW PROTECT DEVICE - OUT
UE ES
I_J I am exempt aurin Sec B&P C for this renin
Owner Date DRAINS FLOOR ROOFFA,
.ARCOND. SANITARY/' Y N_C}__s�f y
WORKMAN COMPWSATION DECLARATION EII'1'I -----t —1
E31 hcesby affirm that I have•certlRete of ronxnt to self-Insum,m a N RFS'PER TRAP SCfi00L TAX Y_ N_
cedBiate of Workera'comperoaOon Inerrancem•certified copy tbereef(.Sec. RECEIPT
3800,LbC.) GAS EA.SYSTEM-1 WG4 OU'11=i PARKFEE Y_ N_
1bIIcy I RECECAS EA.SYSTEM-0VER 4(EA) DING DI I
Cam ray BDILUINC DI VISION FEES
I Certified copy b hertby&the city
�
Certified mpy6(lld with the dry lvpaabn division. GREASE/INWSIRL WASTE QJTEI.CEPtt1R PLANCHECK FEET 30/. 7�
CERTIFICATE OF EXEMMON FROM WORKERS GREASE TRAP PAID L
COMPENBATIONINSURANCE SEWER -STORM EA.211�T. Date Recei tit
(TMssectbn need eat PENS
COMPENSATION
RLA 6lmorchundred dollas
(S1m)erl.) l-IFATFn w/vExriFlecrR ENERGYFEE Y N
]cedlfy that in the perfomunm of the work forwhlch this permit is issued, wnrFn r 6 6 .O
I shall not employ any person In any manner n as to become subject to the
Workers'Compsmation Lawsof C.UfomWATER SYSTEM/TREATING la. Date PAID—
Z 0 Z AppBnnt NEW RESIDENTIAL PLMR SQ.FT Date Recei tM
I Z O [:ONCE TO AP1a1.ICANT:d,after making this Cxmfl to of Exemption,you
should become subfet to the Worken'Compevatbn pronsams of the[JWr 'TOTA 93-7.
~ N Code,you mr•tforthwith comply with such provislomorthis pemutshall Is, N G.
] deemed.ked.
CONSTRUCTION LENDING AGENCY SEISMIC FEE
CL Z lherebyafflrm that there 6 a construction lending agency forthe perform, - IOTA[ �y ELECTRIC FEE tW
once of the work(or which this permit b beued(See 3097,Civ.G) \—1
V O lenders Name P 'LUMBING - cL{IC
• LL Menden Addrn, e QTY. MECHANICAL PERMIT FEE MECHA .1
U ladifythxlla me th applkatbnardmatethmtheabove informatlm� FE —F�`
O W limier,I agreeto comply withal[CRY and county ordinance andetate LIZ PERMIT ISSUANCE !CON
!Date
} 1 relating to buildi g construction,and hereby wise rtpratuoutives afthis
N dtytoenter nthe above-mentbnrd for the ion parpoen. ALTEAORADDTOMECH. ,
(We u to cave,Inde p eCity of Cupedbn tR
V ago tin ' dgfrcnb, a >ti wh yin Y. a AH<HANTIuNGUMT(TOIO,O cFm) S
a Wt conscpre ming of
AIR HANDLING UNR(OVER l0,000CFM) RUCTIONrtrat/contnmm to EaTiAusT Hoop pv/DIIrn RUCTION
RDOUSMATE ALSDI SUR WWtheapplkamorfttereWading pant raorhsndlehavrdoue. HEATING UNIT(IO IM,0n0 BTU) '�materialasdefinNbyrwCupertino mdplCadpChaper9.12,andtheHn❑lthaMSafetycwo 2W? HEATING UNIT(OVER IOB,l100 RTU)
Rill appl[oMarr Wm WOdinga pantuaeequipmemmdevim VFNHLATION FAN QHJGLE REQ) ISSUANCE DATE
which enot h,i.rdous dr mntamlvMa as deflmd by the Bay Arca Nr
Quality Management District? BOILER-COMP OHP OR 100,000 BTU)
❑ Yn ❑No
t Ihave mad the havrdoue materials requirements underChapter 6.95 of BOH.FR-NMP(OVIR I00,000 BTU) 1- 4
the California I Nath&Safety Code,SMIum 25505,25M and 25534.1
understand that if the building dm vt currently have a tenant that It 6 my NEW RESIDENTIAL MECH.—SQ-FT. �! fj
rePvrb
oWty to notify the occupant of the requhemeres which roust be and 'T1 6
Prue,to Issuance of a Certificate of Occupancy.
Pvnerm suthorisd agent Dale ISSUEDB
OTA
OFFICE COPY
. J. . 1.uJ �� vlVlir.�lVlvl VI . VlLU11VV 6
�J cgITY OF UPE�TING � �
llVSPECTiON DI V ISIOIJOB INSPECTION RECORD . `
JOB ADDRESS 21, -E.19 /UNITM y. CATEGORY CONTROLN. -.,,,", .
y—�G1 1 @ �- LOT 4— /.
WNER ;,.�}(�2'�i - I i At" - BUILDING PERINIT INFO j"
CONTRAQ`I'OR �' •.nv«ar�M-1....i.:,.�r+ten .qY7
JSPECTIONAM MATEM INSPECTOINSPECTION RECORD
FOUNDATION PIC•RS (c ` NOTE ALL GRADING AND DRAINAGE
LIFER GROUND SHALL eE INSTALLED TO COMPLY MT11 lou UESCRII'f10tJ
PAD/SETBACK-CERT o- _r I
THE"PROVED PLANS AND CITY OF
. CUPERITNO SGNDAIiDS. S{+y/ y t • C' , G.
GARAGE SLABS PREGUNITE o-Lf_f
IPOURWOiCONCRET AUNT/LugDOVE+HAS;BEEN' 1GNED7%
UNDERGROUND/SLAB INSPECTION DATE INSPECTOR
PLUMBING /
ELECTRICAL T P
MECHANICAL
aDOWOPPOUWFLOORWNTTL'ABOVE'HAS BEEMSIGNED
WOOD FLOOR O
PLUMBING
MECHANICAL ti O o
ELECTRICAL Liz ' d
FRAMING VENTS CLEAR -/y-T•
INSULATION
WLACE•NO'5I/BFLOOR'IU L!'ADOV'E'HAS'BEENfSIGN.EDI. 5L
ROUGH
PLUMBING 1,
TUIIS&SHOWERPANtl
MECFIANICAL - G
ELECTRICAL ACUZZI BOND_
FRAMING STAIRSQl; -
INSULATION/VENTILATION' .
E•MERG.EGRESS i .
SGWER WATER
ICO VERINO'.WORKtIIM' `IADOVEsHAVBEEWSIGNEDkUY.
GXTEMOR SHEAR BOLD DOWN
'TERIOR SI TEAR/BOLD DOWN - ,
IEETROCK/SHECTROCK SHEAR
' T•RIOR A 1-1/ -SCREEN -
S RA CR ATH
SCRATCI-I COAT ,
I P B t I fHAS:B E i5 C D, .
NOTE.'WO,FINAL-,INSP,,ECnONI,SHALLt BE�MADE-BEFORE• +.
'THfirCOIJSTRUCTIONITAX1151PA1D?�� �1l+Yup%f�7t"1. Y C ;,.,,.rj;;.- ';'.t
!GASTrsT
DATE INSPECTOR
ENERC 2
ING ENERGY
ENGRY NG ENGRGY PZ2 FINAL TESTNG _ Ll
Fc�rL .,.i d
MECHANICAL
1.
1 IEATINC - -
GLECTIiICAL RL•LEASE _ ! _
LIRE DEPT. -1 J
GRADE O
c / R
t
OCCUPANCY
TEMPORARYAPPROVALS
ELECTRIC '
GAS
BUILDING -1 f .
NLOCCUPANCY,OF,BUILDINCIIS;NOTPERMITTED,., ' g ISSUANCE DATE
'BUILDING FINALNIBC RJ
Wo
ARRANGE FOR INSPECTION BY PHONING 252-4505 BETWEEN
12:30 PM AND 4:30 PM MONDAY THROUGH FRIDAY,24 HOURS JIJN G 1991 .,
BEFORE REQUIRED INSPECTION. JOB ADDRESS.AND y
PERMIT# ARE NEEDED WHEN PHONING. fat Of QgDerta¢ P 1
`,�'Lf.'E'�r• `Ie IF ;a1;?;'^'1 jr I.:,� I' IMPORTANTId�f e3jEk` Ph �a ,^'AYtfi ISSUED By'.
PLEASF.RF,ALt REVERSE SiDE'BEFORH'CAL 'TN' R'FINAL INSPECTION'.-
APPLICANT'S POSTING COPY
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Ok 4yr
M®11141nI�Rl�r�wl�wa�1� - . . - • �.
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SANTA CLARA COUNTY EXPIRES:
CENTRAL FIRE PROTECTION DISTRICT
14700 WINCHESTER BOULEVARD D
LOS GATOS, CA 95030-1818
SERVICE. SINCE 1947 (408) 378-4015 JAN 0 4 1993
Granted to: V ( cr kc3pcwsc F„? r S' rzrNKck hohas
PERMIT applied u
�/J 3 the provisions of the Fire Prevention Code of V r12 T r _
J -
/ 3 — 1 O / to (NSr—ACC Drvt714 r( FF sPr;' r.vKcra
......:..............................
Location: Z ct'� Fi R AnJ iq 1/C NOTICE
1.�t �j This permit does not fake the
�� Z j C t \ l C- : place of any license required
Premises known as: by lew and is not transferable.
Any change in me use or occu-
__
Legal owner of premises: ? pancyofpremiaes shellrequire
a new permit.
/� - 30 93 :...................................�
Issued this date . Subject to the following conditions:
WL permit is issued on condition that there shall be compliance with all provi5lons of the Fire
vention Code, Sections through . Any viol of Mese ovisions ir�ay
grounds for revocation of permit. u
POST ON ~
PREMISES
Appllcenl Fire Prevention Division
H]3s]Peter"..(1NB0) Form"0
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