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S 2659 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-U BALL POINT PEN ONLY CITY OF CUPH:R"f INO INIIJXNG-I[I,IiITfMICAI. YIiH111'I'NO. ItUI1.nING DIVISIUN APPI.ICA'I'ION/I'F,RMIT �'i.��nmwc.nt�?cunnir.,u. S 2 6 5 9 INII,DINf.PNU.II?CI'IDEN'PIFICN'IDN ❑UII.UINGADURGtiti: SANITARYNO. AI'PLICATIONtiU11M1'PI'ALUAI'li o v . y- z-G ,' 9' OWNIIN'SNAMP: I'110NG �' CONTRACfON'tiNAMii: I.ICNO: L NIC CUNI'NOI.M • AHCIIII'IiCI'/6YGINIiIiN: I.IC NO: ADDRGtiti: ❑ I'fW NPrlloNftl �Av £. �pM��: PnoNE: 6UII.DWG PBRMIT INPO ❑ ConsW[ant Ftts Paid Ay Applicant Qni�ial) pLUG GL[Cf PLOM MfCll p �a � i ❑ o ❑ LICIiN51iDCONTNnCIOH1U[CI.AMTTIaN QTY HLECTRICPLftMI'I' FIiE �n�rcny�rr����m,i i,m im��..���w«p���.�.�o�.or cn.pm�9��omm��d�g JOB DESCRIPTION GSZ �nscahm'IaXpnfol�;von]�,nheil�dnnsandrmtc.zlomG.laanemyncen.e�. 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PERNIT ISSUANCE ❑1 ani exemp�unJer Sec. .N k V C fnr iM1is mawn ACfEH-DRAIN K VLP"f-WAT13N UiA) VAWATION • Ox'ncr Uac WONKIiH:S CUNI'IiNtiATION Ili[CLAHATION 9ACK PLOW YHOfF.Cf.IILVICIi O/�d� L71 IhcmbynffmiunJcrpenaliyofperjuryonenlihclollowingJcclvaions - � � JV �IhmcanAwillmainminaCcnifcmeofCanacmmsNGinsurtlnrWurker'sCompcm DRNNS-FlI)OH,NUUI[ANIiA.CUNII. STORIES 9'1"P�iCU�51NUC190N :'unn,us pmviAcJ fnr by\cainn J]Ip nl'ihc I,uMrz CWc.Por�hc pcefuminncc o(IFe wark Inr which ihie�nnii ir i�nncd. PIXTURFS-VI?N TNAY ' ❑ I M1ave nnJ will ma'�nwin WorAef.Conip.newion Insurunce ac rcyuia�d by Scnion 3�1Mlnlih<LVMrtC�Ne.InriLe�rtunnan<enliM1eworkfnrwhicM1thi�penni�icisrued. GAS-Eh5Y5TIiM-IINC.JOVfI.IfI:S OCCfROUP AYN MyWorkei�C� �'tln Inxu carticranJl'olicynu bcrn¢: n na c,,,,��,:�.,ll`�q-AJ�O�t�S r��ilcr��,.:03-.I[KDn0�01lC cns-en.Svsr[M.ovi?kar[n� GLk�'IPICATCOI�Ii%IiMI'1'IUNIItOMWORKCNS' GRP.ASPIINDUS'IRI.WAtif1i1N'f1iNCIiITUR COMPIiNtiA9lON INtiUkANCIt BOILDING UIVISION f131i$ i (fhi.nm�iunnculnrnR�umPlaedifNepcnniilxfornneFundmtlJnllvnl5lW) GNLASI318AP �� — ����i„� YLANCH[CK PL8 I n'lyihi il p f ' alll � kl 'hl<h0 I i':-ewcdlshall SCwLN lANffANV tiIUHMLA.21NIP1'. nn� P� Y YP . y � .�n�i b .� fm� iM1 W k m�'Cninpci IiNhNCYFCt. ih O z xai I'we�I C:I'h r ' .I}ai WA'IT.R HLKI'LH WIVI N fll LI!CI'K GNAUING�[F, z � API I u � NO'fIU IOAIIIICANI II' 'I k b0 ( il i !I p� y nAu�ld qr�qpgyy}fl?M/I�ItLAI'ING �-""' bµ . hj '�i il K A . 0 � : I �� ' fh I�M1 C 1 ynmua SOILSM1LL i W � fatlLwiheonl�lYw'Ihuvl�pr i n �rll P�nuinLullhvdtt JrcvoAcJ. WAI'Y.kSM1NVICL 0 I � z CONti'IRUQItONI.IiNDINfAGiiNCY ULWRGtiIUIiNTIA1.19.M11. tiV.l'I'. PND U;nc Hcacip�a I hcreAy ulfnn ihm ihcrc In n connwciinn IcnJiny ugcnry f rihc performamm�l w � ihc wark for which thl.pernii�I,.iFmeJ IScu.?[H)],Civ.C.) O U IxnJchNun¢ TOIAI.: W I.�.�nJcr.cAdArt.� TUI' } d 1 canify ihm I Lm�c rcaJ tbi.�applicminn anA nnvc�Am ihc abrvc infnmimion is b11I1_UING FI': . F tA e mcn.laFm'���comnlY�'�ihLllciryuMa�unryoNinancc.�nas�acl+w.rcla�in&��� QTY MECtIANICAI.P1iliMl'1' FEI' V z �uiWin6�^���^���ion.anAhvrcM1yuwhori�crcprt.wnmiivc.�af�hisciiylacnmruponihc � tiF,ISNIC � � uMwcnmminncJ propcn>'Im inepcc�ion pmry�sc<. I'F.RMIT ISIUANCIi (N'c)ugrte m mvc,inAnnnily und Acap humticxs�he Ci�y of Cupcnino apainn� EI.FCfRIC P�2 IiaAili�ic.,ju�gincnn.�anJ �pcmcswFichmayinmywayaccmeagvns�saidCiry pLTGRORADDTOMIiCII. PLONHINGFE inennuyuenttnli n n ipi�,p i. APPI.ICM l�• .lil' �'1 ANU Ll. r �PLYW11'HALLNON-YOINT AIRHANUI.INGUNI'f(TOIII,IXpCfAll MLCHANIC. FLE SOIINf rt1 �W' ti. 6 AIRHANDLINGUNIT(OVIiHIO.qpCPM) CONSTNUCf10 TAX 1��9q� 1 SiydmreafApp Cnmrv or " ' ' ��« E%HAUSTHOOD(W/DUCI') HOUSINGM1IITIGATIOUFE[ IIA%ANWUti MA'I'IiHIA1S DISCLOSURE WIl�hvuppliaun�arlwumbuilding�Kcupame�arturhandleM1vmedoucma�enal HEA'fINGUNIT�I'OIIXLIMNINI'U) ae JctineJ by�he Cupenino Municlpal C�Nc.Chapmr 9.13,md�hc Hcah�anJ S+Iciy COJe.Seainn 25532(nit HF.ATING UNI'f(OVF.R IIMI.IXNI I{'�'U) �Y� � VCNTII.ATIONMN[$INGLIiRCSIDI ���� Dmc Nc�vtip�K . e H'ill ihe applicnm or fmu2 buildin6^n'�Pun�nxe cyulpmem or devleev wM1ich BOILGN-CUMY[JHP OH IIXI,IXMI II'R]) inil ha�nrJnuc uir cnnlmninun�x u.v dclinW by�hc Nay Arcu Alr Quuliry Mvwgemcm 'fl AI.. Dlninn" IfOILF.R-Q)hIPfOVLN IINI.OIXIN'I'Ul . ❑Y�" � II' "lil I I : �i �d y i: I 6h'pi O5 fiM1 C'I'- '��HCONDI'11UNI:H ISSUANCF.DATf3 In '� II'll ffil fiy( I \ �i ' S505 ZSSIi� 1255tJ I I .� Ilh'i'IIM1c NI:WNLSIDI�NIIAI.MLI:I�, tiU��'I'. �� � % � � � b� ll' 6� � ilyl �� ' , I � i y' � . Fltyi ifylc� ipnn �o , nI A � � Tc,wl' h .i hu u� i I C h l 'vv d0p �_�1 i 91 q 9. rarn�,: `fi?] o ���m� s���� �� isswsnur: � OFFICE