S 2292 APPL(9ANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO.
BUILDING DIVISION APPLICATION/1'ERMIT PLUMBING-MECHANICAL (N /]
BUILDING PROJECT IDENTIFICATION J G
92
BUILDINGAODKESS: SANITARY NO. APPLICATION SUBMITTAL DATE
3 P G ,i/3 C C o K eT /o-s=se'
OYLN ql p/,. cz �aevy I'NONL:_ �/� CONTRACTOR'S NAME: LIC NO:
01AC ,` r{ / N/C CONTROL#
ENGINEER: LIC NO: ADDRESS ❑iw.., i.s ,a PHONE: BUILDING PERMIT INFO
❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT I LU❑MB MECCH
0— El EJ
El
LICENSED CONTRACTOR'S DECLARA'I ION QTY ELECTRIC PERMIT FEE
1 hereby tderm that I am licensed under provi.slnnx of chapter 9(commencing JOB DESCRIPTION
WOO wire Section 700(oof Di u..3.1 tic B.,mrsand Prtfc,,inn Code,undmy license is S ,� RESIDENTIAL:
F�� in lull fi...nd effect. PERMIT ISSUANCE ❑SF 1. ❑KITCH17N REMODEL
W_V License Class - Lic.#
BZW Datc Camracmr APPLIANCES-RESIDENTIAL DDITION [I PLUMBING RE-PIPE
ARCHITF,CTS DECLARATION ❑MULTI-UNIT ❑STRUCTURAL
Z O y Z 1 understand my plans shall be used as public records YANF.IS MODIFICATION
OZ�Q UPT02(#IAMPS 0INTERIOR ❑CHIMNEY REPAIR
F�FW Licensed Ponfcssional 201-IXIIIAMPS IMPROVEMENT 0SWIMMING POOLS
C C Q 1 hereby affirm
OWNER-BUILDER
mN am Bump Efrom the Contractor's License Law for the OVER 100BAMPS ❑BATH REMODELTEPAIR Cj DEMOLITION
xGx.p 6 U following reason.(Section]B31.S,Business and Professions Code Any city or county SIGNS ELECTRICAL E)OTHER
.134 v.' which rx,m .a permit to ci ndood.when imponve,demolish,or repair mo stmeture 6n'o17/L'l/-v/
< prior to its:suance-also requiresare applicant fsuch permit t file asigned a teond SPI'C IA I,C I RCUIT/MISC.
vWvW11y
he(tic d pusumat thepoovikinim,of,hoC t Liwo,00 Law IChapmr9
CQD
COMMERCIAL,!CMI'MFI'RR OR 1101j;i s O
0.q o oL mut be is exi t m herefircurn and the basis for the alleged excionion.Any vitiation of ❑NEW BLDG/ADDITION ❑DEMOLH'ION
W moi Section 7031.5 by any applicant for a permit subjects the applicant in u civil peoulty of POWER DEVICES [I TENANT El FOOD SHRVICH
t more than Eva hundred dollars(5500).
F Z N IMPROVEMENT
FD< Q Los dotbov nk.mltho,me,mmy employees wimwages as.IeXnk tent Business SWIMMING POOL. .1' 'RIC
will Jn Ne work.anJ theswcturc is notimenJed oroRercJ Inr sole(Scc.]fN4,Rosiness []OTHER
and Profession,Code:The Conaacmis License Law docs not apply to an owner of G. OUTLETS-SWI! 1_- FI O
6 3^ propeny who builds or improves thereon,and who does such work himself or through
his own employees,ImAided Nat such improvements arc not intended or offered for NEW RP_SIDENTIAL ELE R SQ
sale.If.however.the building or improvement is sold within one yearofcompletion,the SQ.PT.FLOOR AREA VSQ.PT.
iter-builder will hove the burden of graving that he did not head or improve for pur- 7 "
El 1 a(solo.).
woP Z/
❑1,if owner al the propenY,am exclusively contracting with licensed rnnlrennm m TOTAL: 6• 6o
,..nota the prnject(Sec.)B W.Baaincas dad Ihnfes.4m,Codeq The Cantrucou's U- G
eLawdoesnotapplytoanownerofpropenywhebuildsormtProves thereon.and QTY, PLUMBING PERMIT FEE /ytbl7
who contracts for such projects with a eomommons)licensed pursuant m the Convaemfs /
License Law. PHRMITISSUANC �3 Z-Zp
❑ I a. s,ri pt under Sec. ,B&1'C for this.,on _
N.TI:k-UkAIN li
Owner Date POTS VALUATION O 0
WORKER'S COMPENSATION DECLARATION BACK FLOW PROTECT.DEVr
I hcrchynflirm under penalty of perjury one(if the following declarations: 3(3 ^—
❑ Ihmve mnJ will maintain mCcniOcam tfCunsenuu sdf-insure Iia Worker's Co.,.- DRAINS-FLOOR,ROOF,AREAMP, STORIES TYPH CONSTRUCTION
station,as provided for by Section 37M of the Labor Code,far the performance of the
work for whicb this permit is issued. FIXTURES-PER'I'RAP
❑I have and will maintain Worker's Compensation Insurance,as required by Section is n
37I0ufthe LbooCade.funs,perfmmture.fam work furwhich thispeord,is issued. GAS-FA.SYSTEM-I INCA GUTLETS C.OR APN
My Worker's Compensation Insurance carrier and Policy number am:
Carver. Policy N., GAS-EA..VQ-Al-OVER 4(EA)
CERTIFICATE OF EXEMITION FROM WORKERS' 111
GRI:ASI%1 INTERCEPTOR COMPENSATION INSURANCE B L GOIVISION FFIS
(ILis.section need not becompleted lithe permit is foronehunJred dollars(8100) GRLASETNAI'
or less.) PLANCHF.CKI 5" y+
Iccnify ohm in the performance of the work for whicb this permit in issued,lxhall SF.W ER-SANITARY-S'IOHME D
not employ any person in any mamc,. as a ltecaomesabjnet n the Workers'Compers ENERGY FEE $jl
zZ ration laws of Culifnrniit Date WATER I IEA'1'IiR W/VI3NT/ELECTR
0 Applicant GRADING
tiO NOTICE 10 APPLICANT:IL after making this Croficuo of list, dier,Yno should WA'T Idx Sys'IEmn BEATING
a 2 hec.mm subject m the Wnrka'a Ctmpenamlon provisions of me Labor Code,you must 'NOILS FEE
rodiwith comply with such provisions or permit shall be demned revoked WATER SERVICE
Q
a' CONSTRUCTION LENDING AGENCY NEW RIiSII]ENTIN.PLMB. SQ.FT. PATO w�'V—'�`=—'••�—
U Z Date Receipt#
V Q I here which his
isaco Svsc i3n leading agency for the prfommnce of
the work Gn which this pcotit is issued(Scc.309].Civ.C.1 I(] / If I ' —� O
V. F" Lenders Nume 1 b II ,' TOTAL:
G Lerdves AJdtcss TOTAL: VJa I'HUILDING FEF.— t" t
1 cenify mat 1 have read this applicant.and state that the above information is <7�•U G
«F-tN coact.l agree to comply with all city and county ordinances and state laws miming to QTY. MECHANICAL PERMIT FE- ^'
V Z building convection,and hereby authorize representatives ofthis city menterupon me FIC-1998 1•
`t alawe-mentioned ptnpeny for inspection purposes. [•�
(Wel agree to save,indemnify and keep harmless the City of CupPERMIT ISSUANCEenin,against J LY73 ELECTRIC FFE 36• Go
hmuliies,judguont.,costs and expenses which may in any way accrue against said Cay ALTER OR ADDI0 MFCI. BL G. INSPEC YIQUISIERARIIvILviI
in sequase of 0e granting ofthis permit. T1
APPLICANT UNDERSTANDS AND WILL COMPLY WI'HT ALL NON-POINT AIR HANDLING UNI'F(I'01(1,000 CPM) CITY AU LfI
SOURCE RE
V
AIR II ANGLING UNIT(OVER 10,000 CFM) CONSTRUCTION TAX
Signature of Appllcant/Conanctm Dam EXHAUST IIMD(W/DUCF) HOUSING MITIGATION FEE
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant m Boort building cec.p.rdm.o,handle haonahm,matenal HEATING UNIT Cf0100.000 BTU)
res defined by the Cup,mrs,Municipal Code,Chapter 9.12,and the Health and Safety
Code,Section 25532(.)! HEATING UNIT(OVER I)(3.000 BTU) e•
Yes ❑No PAID � '71 et
❑ 751
'$J
'L VENTILATION BAN(SINGLE RESID) a / Date OReceipt a
Will the applicant or Name building occupant use equipment or devices which BOILER-COMP(3HY OR IB0,000 BTU)
emit contents air contaminants as defined by the Bay Area Air Quality Management TOTAL:
/ District' BOILER-COMP(OVER Morkl BTI)
E]Yes ❑No
I have mud the hazardous materials requirements under Chapter 6.95 of the Cali- AIR CONDITIONfk ISSUANCE DATE
food.llcuhh&Safety Codc,Sections 25505,25533 and 25534.1 undo wod that if the NEW RESIDENTIAL MFCH. SQ.PT.
hudi ing does not currently have.tenant,that it k my no,voihlliry In notify the occupant
allhcramiremm"ts whichoust he metpriorm Issuance,"a Coo icnm rel'0ttupunay.
Owner or..thonttd agDat
ate e TOTAL: yl. 60 ISSUED BY:Joe
OFFICE
MR'i-18-2000 019:58 P-02
CITY OF CUPERTINO P tTNO
-
BUILDINC DIVLSION BUILMNO reoncrZtENITLIFICAlnoN
Ust
! RUILV!IlC APDAUS- -"— I T-- ANY Na. um,N;+TON SUBMITTAL
L C 2F T y V �'r AD =Y,�
'P/ / /(�' CONTRACTOR'S NAM@ N'my nl. CVJNTRUI p
NGINEHR: Lrt:NU: AImMpYj [] w/
BUILDING'PBRM?INFO
INSPECTIONS DATE INSPEC. ❑ CoNWtant Fra:Paid by APPl14M(IPiH+ID —.._. ,., BLDG SLECT PLUMB MBCN
n ❑ ❑ ❑
FOUNDATIUN/PIERS/H.0.S. .ysd INSPECTIUN RECORD JOB DESCRIPTION
UFER GROUND fly-5 NOTE: ALL GRADING AND DRAINAGE Ay�F:SIUF.NTIAI_
PAI>ISLT bAI'K-CB1Y1' SHALL BE INSTALLED TO COMPLY WITH V CUICH"MMUD
.. 'I'HE APPROVED PLANS AND CITY OF +ODITION ❑PLUMBING RB•NI
GARAGE SLABS/PREGIJNI'I'H Cl1PERTINO STANDARDS. CMCLri•UNBT riSTRUCTIIRAI.
MouU1CA
POURNO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
TO ARRANGEINSPEGTIUN CJINI'Fxwx [':CHIMNEYRFJRnm
'AIR
UNDERGROUND ISLARIMPROVrMFNT SWIMMING POOI.
CALL AFTERNOONS 11:00 PM - 400 PMI LJ BATH NE'MOLIbOW'AIR HUEMOLITION
PLUMBIN(i 777.3228 MON UAY'ro FRIDAY 24 HOURS BE- 17.1 tr
ELE('fRi('AI.
FORE. REQUIRED INSPECTION. JOB ADDRESS '�`�
DO NOT POUR FLOOR UNTIL ABOVE HAS DEEN
AND PF.RMI'I'A ARE NEEDED WHEN PHONING.
SIGNED .. ,.
__ COMMFRfL+I
PLUMBINGL;/�_y ATTENTION CONTRACTORS: (1 NEW BLDG/ADDTON UDFMCILITION
— _
MECHANICAL NO PERSON(S)SHALL PERFORM WORK ON r.I TENANT LJttrtm S6kv ICE
1' _ THIS JOB SITE WITHOUT BEING IN COM. IMrxuNeMn+r
ELECPRILALnU a
PLIANCE WITH WORKERS'COMPENSATION
FRAMING VENTS z y„-7p INSURANCE REQUIREMENTS.
INSULATION 2yJ-y INSPECf70N SPECIAL INSPECTION UQUIRED ❑ DATE INN
PUCE NO SUBFLOOR UNTIL-ABOVE HAS BEEN SIGNED --
! ROOF SHEATH/DIAPHRAM
PLUMBING
TUBS&SHOWER PAN
MECHANICAL --•� _.,...._
/ RICAL/POUL BOND
FRAMINO/STAIRS/E.EGRESS y
i INSl11.ATIONNF.MI1-AT70N
COVER NO WORK UNTII.ABOVE HAS BL-FN SI¢ -. .... . .._
EXTERIAL SHEARIHOLD DOWN iZ '
INTERIOR SHEAR/HOLD DOWN -
SHEETWROCKISI¢ETROCKSH_LAlt —.-.... .....—
! F,XTERIORLATIf/WSCILELJ)
SHOWER LATH c
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED -
SCRATCH COAT � ... ..__.._
SEWER/W.ATER _
. TEMPORARY APPROVALS
OCCUPANCY •"'
'I F.I.RC.7RICAI. .... ..- .
(IAS - _T
Cil r.._.�
CASTES'C •- " �
98
GRADE.. ..—
FIRE
HANDICAP
ELECTRICAL.
PLUMBING r- fq
MECHANICAL. 99 _ _.._.._.
ENERGY CERTIFICATE OF OCCUPANCY f_I
VISUAL FINAL ONLY
BUILDING -/v--79 SSP IMPORTANT: ISSUANCE DATE 3
IIit I�WIrSN67;IPf.,R'bl'IT PLEASE. READ RFVFRSF. SIDE BEFORE
! CALLING FOR FINAL INSPECTION!!
IreuNU BY:
TOTAL P.02