25875 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO °IL>alr-(:-ET.>.1`I PERMIT"°. 25875
APPLICATION/PERMIT PLUMBING-MECHANICAL
Bj111.I11NC,.+IVISION BUILDING PROJECT'IDEN'TIFICA'TION _
BUILDING ADDRESS: SANITARY NO, APPLICATION SUBBMMI PIAL DATE.
10'2
J� UNIT# LOT# 2^ I^.-M I�
OW. .R. AM' A N CONPRACTOR'SN LIC NO: 1 1
,1 NIC CONTROL#
FRCIII'Ibut AeNUINEERL - UC NO: ADDRESS:
CONTACT: PHONE: ❑
^� BUILDING PERMIT INFO
QTY. + zFLI?C5'RIC PERMIT FEB
' tBLDG ELECT PLUMB MLCH
PERMIT ISSUANCE � ED
LICENSED CONTRACTOR'SDECLARATTON APPLIANCES-RESIDENTIAL
Ce'Z Iherebyoff Division
umliansWiress and
Professions
Ch ode. nd mmecense with JOB DESCRIPTION
Lr100 Section 7m00)(if Uivisian3ofthe Business end Prnfenione Cade,end my]liana is in ppryCLS a
FbE<Z, to[] las-fleet.
License Class Lie. UP T03W AMPS
y<y Data Contractor 301-IOW AMPS
ZOvK ARCHITECTS DECLARATION - OVFR lap AMPS SQ.FP.FLOOR AREA S/SQ.M
OZ,® 1 undenwnd my plans shall be uud as public records.
SIGNS ELECTRICAL ,
Q Licensed Proleaconul
C< OWNER-BUIIDERDECLARATION SPECIAL CIRCUIT/MISC.
aU 1 hereby affimt that 1 am exempt from the Comment's Licause Law for the
f�j�O
p.Y.Oy following remon.(Marian 7031.5,Business and Professions Code:Any citym-aunty TEMP.METER OR PoI2 MST.
which requires a permit to convect,alter,improve,demolish,or repair any structural
prior to its issuance,also requires the applicant for such permit to file a signed statement POWER DEVICES
<C) that that he is licensed pursuant to thcpmvisions ofib.Contractors License Law(Chapter
9bermmencing with Section 70M)of Division 3ofrhe Business and Professions Code) SWIMMING POOL ELECTRIC VALUATION
❑y orrhat he is exempt berefrom and the boars for the alleged exemption.Any violation of
tZa Section 7031.5 by any applicant for a permit subjects the epPlicwtmecivil pcndtyof OUTLETS-SWITCHES-FIXTURE'S
SAI] nm than five hundred dollen($500). NEWRBSNENTIAL ELECBt S .PT.
a�3Q wLasa eroOheproperty.armycmployaswithwegexmtheimolecompemefon, Q STORIES TYPECONS'IRUCTION
ill work.and the macrame isnot imendodoroffbred(aisle(Sea.7044,Business
and Rofessions Code:The Contractor's License Law does not apply to an owner of
property who haddsorintproves]hereon,andwhodoes such work himsefforibrough his
ownemployess, improvemennare not intendedoroffered forsNe.If, OCC.GROUP RIM UNITS
however,the building or improvement is sold within one year ofcompletion,the owner.
builder will have the burden of proving that he did not build or improve for purpose of
saleJ.
❑ I,mownerofthepmceny.amexclusivelycontructingwithlicwn cont/ comto QTY. PLUMBING PERMIT' FEB ROOD ZONE APN
construe the project(Sec.7044,Banner.and Professions Code:)The Contractor's
License latwdoes not apply to an ownerofproperty who builds or improves thereon,and PERMIT ISSUANCE
whocomiact for suchprojects wi@ac.mactmo)licensed pursuant or the Cottontails ALTER (EA)License law. FEE SUMMARY
❑ )oro exempt under Sec. ,B&P C for this reason BACK ROW PROTECT.DEVICE SANITARY - O Y D FEES N
Owner Date RECEIPTp
DRAINS-FLOOR,ROOF,AREA,COND.
WORKMAN COMPENSATION ofem DECLARATION SCHOOL TAX Y N
❑ Ihereby al rimanicsothat lhave
ourica ni carteof copydieradf(sent to Snsum,or.adi.)which
of RF.CEIfTp
Workeis'Comp:.nutionlnsurenee oreccrtifed copy tbercof(Sec.38W,Lab C.)which I*IXTURES-PER TRAP PARK FEB Y N
Oven d)employees under this permit. - A.GAS-ESYSTEM-1 INC. "S RECEIPT#
Policy# BUILDING DIVISION FEES
Company GAS-EA.SYSTEM-OVER (EAS O ��` P N H.-K HE I
❑ Cenifed copy is hereby famished.
❑ Cenilled copy is fled with the city inepafion division. ORPASE/INDUSTRL WAS 1 'RC I>A FEE.
CERTIFICATE OF EXEMPTION MOM WORKERS' GREASETRAP5011 1•
COMPENSATION INSURANCE
(Thisuctionneednmt completMift epumiti3foronehundreddollan(51W) SBWER-SANITAR -STOR FEE
or less.)
I certify that in the performance ofthe work for which Its permit is issued,l shall WATER HEATER W/VFNT/ELECIR '
not employ any person in soy mount so as to become subject to the Worken' PAID
Compere.boal.vismCilifmmia. Data WATER SYSTEM/IREATING Dte Receipt#
Z Applicant
Z 0 NOTICE TO APPLICANT;If,after making this Certificale of Exemption,you should NEW RESIDENTIAL PLMB. SQ,Fr. TOTAL:
HDO become subject o the Workers Compensation provisions ofthe Labor Code,you must
a 7 forthwith comply withsuch provisions or this pcmtiuhail be lamed mvokcd, BUILDING FEE
CONSTRUCTION LENDING AGENCY - SEISMIC PEE
Z I hereby affirm that them is a contraction lending agency for the performance of
the work for which this pemtitis issued(Sec.3097,Civ.C,) TOTAL: ELECTRIC FEB.
W Lenders Name _ PLUMBING FEE
Landers Address QTY. MECHANICALPERMIT PER
0 U I cenify tbn I have read Nis application and nate that the above information is
W carted. I agree to comply with all city and county ordinance and nate laws relating to PERMIT ISSUANCE MECHANICAL FEE
Cn building construction,and hereby amhodze representatives ofthis city to enter upon the
U Z above-mentioned property for inspection purposes. ALTER OR ADDI0 MECH. CONSTRUCf1GNTAX
•7 (We)agree m save,indemnify and keep herinleas the City of Copan on against
liabilities,judgments,costs and expenus which mayirony way accrue aim said City AIR HANDLING ON IT(TO 10,000 CFM)
in co oaf n !this pe.it.
11" AIR HANDLING UNIT(OVER IO,WO CEM)
Slgnommof Applicant/Cowneco Date EXHAUST HOOD OVIDUCT)
PAID
I IAZARDOUSMA I IMDISCLOSURE HEATING UNIT(TD 100,000 BTU) Dam Receipt#
Will the xpplicam or furore building pee sem or handle hezwdaua mnlcrial °EATING UNIT(OVEIiIW,WO BTU) TOTAL:
as defined by the Cupertino Municipal Code,Chapter 9.12,and Ne Hal and Safety
Code.Sation 25532(a)? VENTILATION FAN(SINGLE RISID)
❑Yes ❑No
BOILER-COMP(3HPOR 100,00(1 BTU) ISSUANCE DATE
Wit I eapplicant orfuwre building occupant use eyulpmemordeviceswhichemit pp B1s
hazardous air cam.minanls as defined by the Bay Are.Air Quality Management BOILER-COMPDVER IOD.ODO BTU)
District?
❑Yes ❑No NEW RESIDENTIAL Mr:CH. SQ.FP, oQ(e�
1 have revel rhe haurdous materials requirements under Chapter 6.95 of the ��R 199
California I Icuhh&Safety Code,Senium 25505,25533 and 25534. 1 undemwd Nat V
if rhe building docs not currently It...it tenant,that it is my m,paralbilay m notify,the 1 1
occupant
Occupancy.m of the rcqulrcnmms which must he met prior to Issuance of a Cotillion,of City
Owner or omhoilt agent Data TOTAL: ISSUED BY:
OFFICE
a
Ll
• PROJECT: Bill L Doris Nye, Residence
l 1133 Kentwood Ave
Cupertino, CA 95014
\,
G$ SS &F
ow CONSTRUCTION NOTES:
`� \\
I. Remove existing kitchen cabinets.
• 2. Remove existing appliances and sink.
q, ! \ 3. Remove existing linoleum and underlayment.
11Nfj 4. Remove existing drywall as required
5. Install new modular cabinets
6. Remove and replace existing kitchen electrical to
_ conform to currant local building code.
7. Install new counter top.
B. Install new underlayment and linoleum flooring
6. Install new recessed fluorescent light fixture
9. Install new range, exhaust hood/ microwave combo
unit above range, new sink and faucet,
APpROVEE) N)/E KIYGHEnr REMODEL dishwasher
IM ACCORDANCE PITH THE
'ERTMO CODE$
� Apfp CITY OF 4
I �ii ORDINANCE ELECTRICAL NOTES:
DAM �- �� 1. All new electrical to conform to current local
SIGNED -� FL O o R P L-A- N
building codes
This set o�— - - 2. New outlets at sink counter to be GFI
be ke plans and specflcations F` (� 3. New 4 tube florescent fixture to have double
lawful to on the any chaat r Mmes and it is un. pT�
Make switch
on same without
written
or alter-.6
the building Dept., City of Cup Issf on from NU S ►?W c j UR A t_ C NG-ES j
The stamping of this EXISTING SERVICE: 100 Amp, (no upgrade anticipated)
SHALL NOT be t a plan and specification, (��(� (A 126�.
approval of Id to permit or to be an
the violation of
any City Orany provisions NEW APPLIANCES:
°f dinance or State Law,
1. Range /oven; GE Model JBP45GR
240V, 24 amps
2. Hood/Micro. combo; GE model JVM152K
120 V, 12.6 amps
3. Dishwasher; GE model GSDI25OR
120V, 8.6 amps
4. G. Disposal; GE model GFC800R
120V, 4.5 amps
dtfB Respectively Submitted
�Aq.,PoSP
Bill Nye, owner
Ilk OFFICE copy