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S 2386 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OF CUPER'1'INO BUILDING-ELECTRICAL PERMIT No. nun.DINC OIVINION APPLICATION/1 rl.uanunc-..+v[cw+n'ICM, C+ 2386 3 O C NUII,DIN'O 1`HI1IECT IDENTIFICATION O O V BUILDINGADDRESS: SANITARY NO. APPLICATIONSUBMIITALDADd 0 77 OWNER'S NAM:: ONE COW]NA' 'S. M111i: 31.1E NU: JNIC C'ONTROLp ARC II IfC1YliNGINHER: LIC NO: U R _2 F Sa {f ❑ CONTACC VHONB.I J IJU HANG PERMIT INPC) ❑ COnSNRard Fees Paid by Applicant(Initial) ITT Do ELECT' PLUMB MECII i4L_ L - z -© Z� ❑ B' ❑ 0% LICENSED CONTRACTORS DECLARATION QTY ELECTRIC PERMIT I°lili JON DESCRIPTION 1 hereby affair aInterred!u N 1 um nder prooinns of Chapter 9(contraction,,0C, with Section 7000)of Division 3 oftheflminess and ProfesmonsCde.and myliecnm is PERMIT ISSUANCE S f"�� RESIDENTIAL: �r1n6FaIIIfoenJT� D` . � B � V ❑SFT WLb [I KITCHEN REM ODEL QUU YQ110. APPLIANCES-RESIDENTIAL El ADDITION El PLUMBING RE-PIPE PzW ❑MUCIUNIT El STRUCTURAL AHCHITECI'S DECLARATION , Dm PANELS MODIFICATION z0zyZ ndrsla ncnJ my plana shall he uscA W'PnhllcrwnMs UP'r0200AMPS ❑INTERIOR El CHIMNEY REPAIR h+�F"yW LicemcA Pede"ional 2111-I00()AMI'S IMPROVEMANTSWIMMING POOLS �set'e- OWNER"BUILDER DECLARATIONOVER I(XIB AMPS ❑BATH REMODELIREPAIR (]DEMOLITION C C 6 1 hcrchy affna that 1 on aacmnl form the Cmdowtm's License Lits,]or the 3 L F following reason.(Section 7031.5.Buoreu:md Prsl Wers Coda Any city or county SIGNS ELECTRICAL ❑OTHER y4 which requires a peunn to constrvd alter,anion ,demolish,or repair any stmctore E-�oy prior nn its issuance,also requires the applicant for such permit to file a signed Statement SPECIAL CIHCUI'1'/MISC. E.y That he i.liccnwd persona,the provninfrof)he Commuters.License law(Chaptery COMMERCIAL, �w R,nnmeneing with Sectio7000)ofDouro,J of the B.dmI and Profeainm Cadet or 'TEMP.MT'ER OR POLE INST. a X e W thin he Is exempt therermm unit the ha.i..for The alleged exemption.Any violminn of ❑NEW PhDG/ADUII'ION ❑UEMOhII'ION LLI^m Seed...17131.5 by any applicant for a person oalact5 the.,heunfit enalty a civil pof POWER DEVICES ❑ ❑ TENANT I'OODSEi RVICI not Inure than live hundred dollars(S5(I0). IMPROVF,MEN'I .F.=6 IJ fthe p ,o Y IIy t 4:'.leci,,I,lc e...ulpenon SWIMMING I'l1U1.411'CIRIC wit I life work.and thstructure I haeadedo,oltolf . I IS 7(94,Bu' ss ❑O'rHP W and lnfxse...I,Code.The Cnncwnrs Lu rte Law does not apply uo at,osall of OL11LE:IS-SWI'WIRES-41%TURKS prolway who build.or improves Iherson,and who dohi es such work mself or through his two cnnpinyco,provided thin such improvements am not intended or mftered for NEW RESIDEN'I'JAI,EL So SQ 1"' %ale.If,however,the building or inipmvemem is sold within oneycorrecompletion.the SQ PI'.Il(H)HARBA $/SV.PI'. weeremilder will have the burden of proving that he did not Wild or improve for pur- 'we of wleJ. 'TOTAL E]1.as owner of the propenY,am exewsively contracting with Ecea.J contractor.to O m,tmcl the project(Sec.7194.Business and Prufesions Codcj The Contractors hi- mLow does not apply to an owner of property whn builds or imposes thereon.and QTY. PLUMBING PERMIT FEE who aistran.for such projems with a enntmmnr(,l licensed pursuant un the Contmeon's _ l.lcense Law. PERMIT ISSUANCE Iain exempt under See ,B&P C To,this nraon ACINI2-DRAIN&VICN'I'-WAI'EI2(EAJ VALUATION O U • Ilwncr WBACK Iq.OW 1'I2(YI'I[CI'.UIiVICIi ORKS :S COMI'IiNSNIIU DECLARATION .7J wand alaanundcr Penalty of of Consent et)dlefolurwmg Wrkera Citation- i]Ihavc and willtwimnma Certificate ofConwm un wlf-insure for Worker's Gnmpan- DRAINS-IIAOH,HUOR AREA.GOND. SJURBli., T'YPECON'$'1'HUCHON tylion,as pmvldad for by Section 170(1 of the Labor Code,for the peAonmance of the work for whidt,its permit is Rood. FIXTURES-PER TRAP El I have and will maintain Worker's Connpensmeon Insurance.as required by Section J 1701 ofthe Lido,Code.far the perfrmmorof,he work for which this pencil is i...siL GAS-EA.SYSTEM.T INC.4 OUTLETS OCC GROUP AYN My Works'-QnnPj�,�1Jm lnsR{r3}t_ rant Policy YUYl7 �/ Cunficr: •r^'rV lYliel a�'c Policy No.:uu LJ-Z�L GAS-PA.5YST1iM"OVIik4(PAT C17RTIFICST 17 OF EXEMPT ON FROM WORKERS' GREASEIINDUS'I'RL WASTE INTERCEPTOR COMPENS/O ION INSURANCE BUILDING DIVISION FEES (Illiascono.newt nal be vonlpletcJ it his proof lS frnone hundred rs Jolla (SI oto GREASE'I'RAI'ur lcns.l I'LANCIIECK I'lili I ccnlfytbul in The pcfonnnncant the work fnrwhictlthisper is issued,l shall SEWER-SANI'T'ARY-S'IORM BA.200FE. mgslay any Panora in any amour.,,us to b�eonne.wbject a the Workecv'Co.men- ENERGY ITEOz Iwhon laws of Caldron.,Dina WATER HEATER WNESTUFLECTR GRADING PER. Q Applicant z N NOTICE*111 APPLICANT.IL after making this Certificate r(Emmptimn,you should WATER SYSTEM/fR1iA1'ING SOILS FEE a ? hecome stibrocl n the WnAcr's Comiamorion lei......of the Labor Code.You must a Q forthwith comply with such provisions or this Permit%hall M deemed revoked. WATER SERVICE CONSTRUCTION LANDING AGENCY NEW RP_SIDEN'I'I AL PLMB, SQ,IT. PAID I hereby attinm that there ix x unmlruction landing agency for the perfmmunce of Data �- the work liar which this permit l%icwul(Sce.9(197,Cie C.) LenderSanta, ', AL: TU"fAl. C..) Leader'a Addres. : cenily That 1 buvc rcuA Ihiv application mW ,are than the ahovc infonnatinn Is B .>ING Ilel3 Nconfect.l agree to comply with all city unit county ordinances and stale laws relating or QTY. MECHANICAL PERMIT FE S. P (� V z building contraction,and hereby a lion ra"cwnwtive,of this city I"can,.,),I the .7 aMwe-mentioned property for inspection purTowl. PERMIT ISSUANCE E ECTRIC FIIi (We)agree to save.indemnify and keep haimless the City of Cupenino against liabil'nie>judgmenu.costs and expenses which may in any way accrue against said City ALTER OR ADD TO MECII. PLUMBING ITT. in consequence of the Scanting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT CT)I B.IXXI CPM) SOt' CE REGULA9'IONS. /pr Q AIR HANDLING UNI"1'(OVfiR I0,000CFM) RUCTION TAX S cifApplfcmVComnnnor VV areC EXHAUST HOODIW/DUUH I IOUSINGMHIGAI'1ONl7pE HAZARDOUS MAI EI ALS DISCLOSUR: y ] Will lif,c,liunmer fuaac bandingoa'salpummuren,handl,lvrranlouslnmcrhd HEAT ING UNI'1'(I'01 01,((X)13'1'U) vet delincJ by I n Calwoino Mraregwl Code.Chapter 9.12,ani The Ileuhh and Safety Gde.Section 255320P HEA'T'ING UNIT(OVER I50.001 BTU) ❑1'cs ( VENTILATION RAN(SINGLE RESIDE PAID �b�� 077 5 Date HeceiplM Will the applicant or future Wilding eseepam use equipment or device,which f BOILER-COMP1OTW BTU) . Z,J emit hateardous air man nwmintx as def nod by the Bay Arta Air Quality Managcmcm I TOTAL.CjCf,(SD Dotrid? BOILER-COMP(OVP.R I0B(XX)BTU) El Ye. I bwc readnhe III...snnannalemquiremcros under Chepter(triol the Call- AIR CONENI ONER ISSUANCE DATE O humin I Icalm&Safely Cldc,seen 25505,255)9 and 25531.1 undcrsmnd Ibw if the NEW RESIDEN HAL MECII. SQ.Fr hnik'n•Arnms'col evmnlly buvc u wr:mt,tem h in my tcxrymsfhility to,wily the xuynnlnl of the nems whicfi nmol cel rnr to Lsuune ofu Cone (Oce p.ynnY v S} TOTAL: p /b TO Own orizcd agent bate / \ ISSUED BY.f„ OFFICE