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24123 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY Bwidin Fmjcd Id—I fkatton PERMITNO Building Address: 24123 /0371 1;?I AI' P4 weer ne: 6f—Tx( }' C -'— ZCI.?7 1/73 9C90 CITY OF CUPERTINO-BUILDING DIVISION ` �_ Cl cnmraryy shame: �- Llc a APPLICATION /PERMIT (CT /S`GL r� ` 207S� ; BUILDINGELECTRICALPLUMBING-M HAMCAL CATEGORY CONTROL. MWArchitect/Engineer. Lk.No: QTY ELECTRIC PERMIT FEE BUILDING PERMIT INFO Address: PERMITIS5UANCE S.J2 ZU ❑ LICENSED CONTRACTOR'S DECLARATION K I Mreby affirm that l am BcenxM under provisions of Chapter9(movment, APPLIANCE-RESIDENTIAL JOBDESC ION Ingwlth Sectlon7000)of DWblon3ofthe Businemand Pmfessions Code,and my 11...Is in full and effect. PANELS Llcenrc class Lz. Lic.p ZD ZBf Date - ontradmr CLUP TO 2D0 AMPS ARCHITECTS DECLARATION 201-1000A.M1'S re0 V I understand my plara.hall be used as public record.. OVER 1000 AMPS SQ.FT.FLOOR AREA $/SQ.Fr. CCO (/� 1 a Z U Licensed Profemlonal SIGNS ELECTRICAL 'DD � � � � © IN QCce OWNER-BUILDER DECLARATION G SPEC ALC RCU T/M 5C E, owing nester. 'hat lam exempt from the Contractor's Lkenm Law for the ® la n r� Z$j 9 following reason(Section 7W15,Business and Professions Code:Any city or TEMP.METER OR POLE INST. III MCR CYC/ P"I"'� countywhich requires a parent tocom ud,alter,Improve,demolish,orrepair UTER <m4m5 anystmu mpr rtolbissuancgaLorequireatheapplimntfor.uchper tto �y�R DEVICES of K j file a signed statement that he Is licensed pursuant to the provisions of the DATE S G. O Conlndor's License Law(Chapter 9(commencing with Section 7000)of Divi- SWIMMING POOL ELECTRIC 3VAL A 0 sion3ofthe Buslnessand Pro(esslom Code)orthathebexempttherefmmand 6 5 the busts for the alleged exemption. Any violation of Section 7031.5 by any OUTLETSSWITCHES-H%TURES O O O applicant fora permit subjecbthe applicant to a civil penalty of not morethen c. o five hundred dollars($SM. NEW RESIDEMIAL ELECTR SQ.FT. I,as owner of the roe STORIESIYPECONSTRIICTION' 7 property,cine,or my employees with wage.as thele sok C or ompensallon,Business and kandthes Code:Thure is e ContraIntenctors w $ O sak 6ec.apply to Business and f property Code:The Contractors Mcense Law F3$ does not apply to an owner or property who builds or improve thereon,and OCC.CROUP RFS.UNITS who improvements a orkhimself ed orough hisownemployces,hove provided that such improvement Wold thindneyearferedfoleio thea evegflder,the ilI g orhave TOTAL 6.o improvement pmvIwithin he did otbuil plr Improve for prposerwlllhave thSj I,.. weer fthephedtdnot build or Imp contrapng with(cense QTY. PLUMBING PERMIT FEE FLOOD ZDNE nPN u I,m owner tr the property,am.70K usl rs,.rding with licensed PERMIT ISSUANCE ...Ir contractors to construct the project(Sec.7044,Business and Professions Code: V(/ The Contractor.License law does not apply to an at of property who ALTER DRAW k VENT WATER(EA) builds or improves thereon,and who contracts for such pRo).d.with a FEE SUMMARY cotLt�ador(s)lkenxdpursuanttothe Contrador.Lkcn.e Law. BACK FLOW PROTECT.DEVICE L,J I am exempt under Sec. B h P C for this reasonOUTSIDE FEES DRAINf,FLOOR ROOF,AREA,COND. SANITARY Y_ N_ Owner Date RECOPT I WORKMAN COMPENSATION DECLARATION r FIXNRF.SPER TRAP SQ;lX1L TAX Y_ N_ hereby affirm that I have•certificate of cansant m.elf-Inure,or RECEIPT a certificate ofWorkeri Compensation Insurance or a certifimi ropy thereof(Sec. GAS EA.SYSTEM-1 WC.40UTLEfS PARK PER Y N Policy If //i 19 -��.�Z RECEIPT If Policy M _ GAS EA.SYSTEM-OVER 4 BIA) � v BUILDING DI VISION FE ES rtlfied copy is hereby furnished. GREASE/INDUSTRL WASTE INTERCEPTOR FEE Certified copy Is filed with the city Inspection division. CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE TRAP PAID COMPENSATION INSURANCE SEWER-SANITARY-STORM EA lsXBT Date Remi tit (Thissedlon need not W completed if the permit la for one hundred dollars (IRMorlass) WATER HEATER W/VENT/ELECTR ENERCYFEE Y_ N_ I certifythat in the performance of thework forwhich this permit Is bared, I stwll not employ any person in any manner su as to become subject to the WATER SYSTEM/TREATING Workers'Compensation Laws of California. Date PAID 0Z Applicant NEW RESIDENTIAL PLMB. SQFT. Date Remi tN Z O NOTICE TO APPLICANT.If,after mu king t his Certificate of Exemption,you should become subject to the WorkerCompensation provisions of the Labor TOTAL: CC N Code,you must forthwith comply with such provislom orthis permit shall be BUILDING FEE $NK.0 LU y deemed cooked CONSTRUCTION LENDING AGENCY SEISMIC FEE I CL O I hereby affirm that there isa construction lending agency for the performTOTAL: tvELECTRIC FEE Z ante of the work for which this permit is beand(Sec.3097,Civ.C.) PLUMBING FEE • 00 C'.) O lender's Name LL F Lenders Addres, QTY. MECHANICAL PERMIT FEE MECHANICAL FEE W co1ordifythatl havereacithis applicationand atatethatthe above Information 0 1 rma.I agreetocomplywth all etyand county ordinances and state laws PERMIT ISSUANCE FEES PAID: �. relating to Wilding construction,and hereby authorlu representative ufthis F N cityto enterupon the abovcmentloned property for inspection purpose. ALTERORADDIOMECH. Z (We)agree to save,indemnify an If keep harmless the City of Cupertino Date ReceipHl V against liabilities,Pcignorms,cua.and expenses which mayor anywayaccrue AIR HANDLING UNIT(TO 10,000CFM) SUBTOTAL: against said City in consequence of the granting W this permit. AIR HANDLING UNIT(OVER tO,OW CFMI CONSTRUCTION TAX Signature of Applicant/Contractor Dace D(HAus r HOOD(W/DUCT) CONSTRUCTION TAX PAID: HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous HEATING UNTT(TO 1W,"BM Date Recei tN material as defned by the Cupertino Municipal Code,Chapter 912,and the Healthand Safety Code Se 25532(a)? HEATING UNIT(OVER 100,000 BTU) TOTAL: F1 yes I Will the applicant or future building occupant use equipment or devices VENTILATION FAN(SINGLE RESID) ISSUANCE DATE which emit hazardous air contaminants as defined by the Bay Area Air q'� Quality Management Dstri BOILFR-COMP OHP OR 100,000 BTU) � .� D 4Ycs have redlhe haaa ousmaterials requirements under Chapter 6.95 of BOILER-COMP(OVER 100,000 BTU) the California I lealth k Safety Code,Sections 25505,75533 and 25534.1 1 understand that if the building does not currently have a tenant,that it is II my NEW RFSTDFNAL MECH. SQ.R AUG 8 1992 responsibility to notify the occupant of the requirements which must be met prior to Lssu of a Certlfcateo Occupancy. cur (t�-�.,E,�,.r aI,IH4V Owner or authotlred agent Date ISSUED BY:�,-��1_'.� TOTAL: ff OFFICE COPY APPLICATION FOR PERMIT Kathleen Elliott 10371 Mann Drive C,pe��;�c, CAg5DI4 APPROVED CONTRACTOR: Bill Fry IN ACCORDANCE WITH THE CITY 01 CUPERTINO CODES AND ORDINANCES QATE_� �— Bedroom Bedroom SIGNED This set or pans and specifications SI be kept on the job at all tim9fiM4 9&Wer lawful to make any changes or alterations on same without mitten permission from he bui:dmg Dept., City of Cupertino. sh, Cl. "� The stamping of this plan and specifications Tubb ;r SHALL NOT be held to permit or to be an 0 =1 cl cl. approval of the violation of any provisions. cl. :ny City Ordinance or State Lew, -\ FIG.1 FIG.2 Pump Access I propose to demolish a shoNrer 29" x 32'' and the non- supporting galls sho\Nn in figure -I as dashed lines. In the 31" x 74" space created by this demolition I plan to place a 48" N 7/ 2" � hirlpcX-A tub with t\\o shoN\ er heads. All plumbing gill remain on the same: side of the wall that the demolished shower occupied. Some electrical work for pump hookup, air switch and above tub lighting \ •ill be required and a neN\• shot\-er door will be installed. Access to the pump for ser,\'ice \rill be through a trap door in the remaining closet space shown in figure =2. 20 0/'�- w.w DOul� AUG 18 1992 • BLDG. INSPECTION DEPARTMEKT o��� r� COPY CITY OF CUPERTINO Bedroom 13'-9" 61-01, Tub Faucet 0 0 • 4'-5" Toilet Vanity 0 Tub Shower Heads �FZ Closet Lighting Fixture Over Tub Pump Access PUMP wig i&- Geos nt YJ DETAIL PLAN (5'kG rC. Zp Qit/"EL OF FINISHED JOB •