Loading...
22221 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY Building Pro'eat Identification PERMIT NO. Building Address: ^^/"I f"I a� 7556 Dra, e 6(o55ai, D'> sYt oro' C4 `15 1 2222 I e am _ e . .AA A 25 weer. s:�I.. `/ CITY OF CUPERTINO-BUILDING DIVISION Contrador' arae: LIc.No: APPLICATION / PERMIT 36 BUILDINGELECTRICALPLUMBINC-MECHAMCAL CATEGORY CONTROL N/ ^� Architect/Engineer. Lic.No: Cwt QTY ELECTRIC PERMIT FEE BUILDING PERMIT INFO Addrcu: PLUMB PERMITISSUANCE LICENSED CONTRACTOR'S DECLARATION - V� Ihnrcby affirm that l am licensed under provisions of Chapter9(commme APPLIANCES-RESIDENTIAL JOB DESCRIPTION ingwith Seddon 7000)of Dlvlelon3ofthe Bushes sed PmfmionsCode,and my , license IS In full form and effect. PANELS + LicenseClass 'Lk.N / Date Contractor ARCHITECTS DECLARATION 201-11100AMPS o2CC I understand my pla.,h.0 be used as public records OVER 1000 AMPS ! SQ.FT.FLOOR AREA S/SQ.FT.T. red(/ L�J� 4 tl 7 C uu�� 9CN5 ELECTRICAL 4 V Licensed Professional l V�a l �<� OWNER-BUILDER DECLARATION SPECIAL CIRCUIT/MI y I.,�]'� IhembyafBrin that lam exempt from the Contractors License Law for the 'r-`OQ �h rgZ ' following reaser.(5ttUon 70313,Business and Perfmions Code:Any city or TEMP METER OR POLE INST. cmntywhichrequliesapermittommtmd,Oter,lmpmv demolbh,orrepair �aCC�.6a anystmu mpHorto Bstssrawgalsorequrc theapphuntforsuchpertNtto POWER DEVICES ce U file a signed statement that he b licensed pursuant to the prowloru of the Ou,CContractor's LicemeLaw(Chapter9(commencingwBhSedbn7000)ofDivi- i SWIMMING 7OOL ELECTRIC 30 sion3oftheBwinm and ProfmlonaCodc)orthrt hebexem themfromand VALUATION Q'� the basis for the alleged exemption. Any violation of Sections 7th LS by any OUTLETSSWITCFIGSFIXTUBES I /'] MO appdontfora permiteubjeRsthcapplicanttoa dull pemltydnd morelhan sw 9)© Y[6 five hundred delta.%M. ��. V s - NEW RESIDENTIAL ELECTR ti STORIES TYPECONSTRUCTION ] F1 1, owner oftheproperty,ork,and he employees r their �� 6 compensation,Business andldothe rofesso"Cde;Thee is Contractors orofferedLw �� LOZ (Zf/ O sale(Sec. tapply y to Businessand jumpery, Code;The Contractors ves heroes Law [jr$ 'wh.do'ssuch Roan ownerdproughhis on implylds or mproovided that e-5^' whodonauch work hlmsdfwthroughhlsown employers,provided that vela OCC.GROUP RES.UNITS Improvements are not Intended or offeredforsale.df,however,the building or - TOTAL: - Improvement lssold within oneyearofcompletiontheowner-buaderwill have Ft men of proving that he didnot build or improve for purpose ofsale.). QTY. PLUMBING PERMIT FEE FLOOD ZONE APN ,as owner of the property,am exclusively=trading with licensed PERMIT ISSUANCE tractors to construct the project(Sec.70K Businm am Profmlow Code: Contrador'.License Law does not apply to an owner of property who ALTER-DRAIN k VENT-WATER MM Wilds or Improves thereon,and who contracts for such pipleds with a FEE SUM MARY RYttador(a)licensed pursuant to the Contractor's License Law. BACK HOW PROTECT.DEVICE L-.f 1 am exempt under Sec. B k P C for this mesonOUTSIDE FEES Owner Date DRAINS FLOOR ROOF,AREA,GOND. SANITARY Y_ N_ RECEIPTN WORKMAN COMPENSATION DECLARATION pp(.j(JRES PER TRAP SCHOOL TAX ,Y N ❑I hereby affirm that I have o Insurance o consent to copy self-insure,(Sa RECEIPT'N cnrtifi380Q,LabC.Worken'Comperuatlon Insurance oracertlfied copy thereof(Sec. GAS EA.SYSTEM-1 INCA OUTLETS PARK PEE Y N Policy If C.) RECER'TI Policy p GAS F.A.SYSTEM-OVER 4(EA) Com any ' . - BUILDIRG DIVISION FEE �CertlfiN copy b hereby furnished. GREASE/INDUSTRL WASTE INTERCEPTOR PLANCHECKFEE OCcrtified copy b film with the city inspection divmion. _ E- cc CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE TRAPPAID COMPENSATION INSURANCESEWER-SANITARY-STORM PA.200FT. Date RCCCI IR(Thisaedlon nem not be completed If the permit b forom hundred dollarsOl�Jar1ces') WATER HEATERW/VENT/E.ECTRENERGY PEE Y NI certifythat In the performanceofthe work for which this permit le Issued,I shall not employ any person in any nunner so as to become subject to the WATERSYSTEM/TREATINGDatePAIDO ZApplicant NEW RESIDENTAL PIMB. SQ.1T. Date ReceT # Z O NOEGETO APPLICANT.If,after making thisCertificate of ExempBan,youF • should become subject to the Worker?Comperuatlon provlsloruofthe Labor TOT h Code,you=at forthwith comply with such prowwro or this permit shall be BUILDING _ L LU dmmed revoked. - CONSTRUCTION LENDING AGENCY SEISMIC FEE / 6 a O Ihereby affirm that them Is.mnstrumon lending agency for the perform ELECTRIC FE' Z anceof the work for which this permit is evued'(Sec.3097,Civ.C.) TOTAL: _ 02 lamer.Name PLUMBINGLK IL H . Lender's Add ress QTY. MECHANICAL PERMIT FEE MECQ O W I certly tlthu that l have read thix.pplicaonand maze ttheaboveinf..tion 1 bmrrect.lagreetocomplywithalldtyandmuntyoMd anceaandmatelaws PERMITISSUANCE FEESP� >. N relating to building rovtrudion,and herebyauthorlaercpresenhNvesofthis 1.- Z city to enter upon the abwcemxrntioned property for trupedlon purpoees.. , ALTERORADDTOMECH. Date RCC to m _ (We)agree to save,todenly rm and keep haleas the City of Cupertino P against liabilities,jrdgmenb,min,and expense,which may lnanyway.,.e AIR HANDLING UNIT(TO 10,W0 CFM) SUBT AL: against dity mnxyuenceofthegnuaingofthbpermlt. - / AIR HANDLING UNIT(OVER IQODOCIM) CONSTRUCTIONTA) 'igw reef AppBcon con rsctor Date EXHAUST HOOD(W/DUCD CONSTRUCTION T/il PAID: HAZARDOUS MATER ALS DISCLOSURE _ .Will theappilcent or future building occupant storeorhandle hazardous HEATING UNIT(TO 100,000 BTU) Date Ruttiptlit material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Ileslth.nd Safety Code Section 25532(.)? HEATING UNIT(OVER 100,000 BTU) TO AL. ❑ Yea ,Ta�-,l Will the a pplicant or futRoN.building occupant use equipment or devices VFN77 LATION FAN(SINGLE RFSID) ISSIJ which emR harardous air contaminants as defined by the Bay Area Air . Qua lity,Ma rugemnnt Dist rkt? BOILER-COMP DEE'OR 100,000 BTU) Yea M No '+ havered Hth.Ith a ousmazedabrequi25505, under Chapter 6.95 of BOILER-COMP(OVER iW,000 BTU) .A0 T s the understand t Health bSafetyCoda of cure currently have. ands,that 1 �7 #' E understand that if the building docs rad mrrcntly haveatenant,that itbmy NEW RESIDENTIAL MECIi. SQ.FT. responsibility to notify the occupant of the requimments which most W met HM NL CO prior to issuance of a Certificate of Occupancy. YIV.K ) Owncrorauthoriu agent Date ISSUED BY TOTAL: OFFICE COPY SERIAL P N ; 15175 SEWER CONNECTION PERMIT NO. •CUPERTINO SANITARY DISTRICT R.O.S./P.M./Tract No..2o. �{.. Lot No...'7Z ..... 20065 Stevens Creek Blvd. A.P.N. Bk A.(461........ pg..P....... Par.p 6 ... Building C Cupertino, California 95014 [�v ........1................1 19...... Phone (408) 253-7071 Date....!.!.......... /.. 9 The undersigned,being the owner(or owner's agent)of the property located at ........................................................ 556..... 6' '.! .e? P- e1.f.... , le,5So."'....r% ... ' r �... .Per f nv , ................................. consisting of the following TYPE OF BUILDING: Residential: Single family...x...... Multiple............ No. Units.....I....... Commercial............ Industrial............ Other............ No. Units............ does hereby request a permit to connect to the sewer system of the Cupertino Sanitary District. In consideration of the granting of this permit,the undersigned agrees: 1) To comply with all existing regulations and Ordinances of Cupertino Sanitary District and all future regulations and Ordinances which may be adopted. 2) To maintain the house sewer(that portion of the sewer within private property)and to provide access to the lateral sewer through a cleanout raised to grade at the property line or at the limits of any existing District easement. (Note—Detail J) 3) To acquire a permit from the ...C'. .. �' 9.....(S! '� ` h t> ... Building Depart- ment and obtain inspection and approval by said Building Department prior to covering of the work or use of the sewer. 4) To first expose and inspect for serviceability the lateral sewer prior to starting construction of the house sewer. Property Owner's Namem, d�i5 G� Jr7��✓1G)...yQ r? Telephone...2.5.��.'9�?S 9..................... Mailing address if �OJ�3. ....P. /. 0....r r•P � n (vIr2n.. �nD different from above............ .... ... ...`. ........... .............. ..:................... ❑ A standard backBow protective device shall be installed, to the satisfaction of the Building Department, for the above property.(Note—See Detail/) FEES: ov Connection Permit Fee Sewer Service charges to June 30, 19 /mo. x..�7.mo. ...... ......... Inspection Fee for backflow protection device 00 TOTAL $ nn 4Weceipt of$.9.L ...... acknowledged and permit granted. MARK THOMAS&CO. INC., District Manager-Engineer By, ........... NOTE:See Details on other side of this permit CUPERT/NO SANITARY DISTRICT NOTES: All valves to be accessible and maintained by Property Owner. Overflow point at least twelve inchos(12") below lowest finished floor containing plumbing. Kelly Valve installed at Property Line to be readily removable for Lateral Sewer maintenance. J a Finish Flo r Leval d ` Kelly Valva Finish Floor Leval nt E Finish Grade 'o rae Nelly Valve Valve Access B x —/ IS with Vented C s, t E Valve Access Bon Backwater Valve Fes W w, Figure I Figure 2 Figure 3 Kelly Valve- Below Surface Backwater Valva—Normally Kelly Valve-Above Ground Inslallallon-Shown at required installed at shallowest point Installation-Shown installed Property Line Cleanoul. along House Sewer between close to building. Properly Line and building. DETAIL STANDARD BACKFLOW PROTECTIVE DEVICE INSTALLATION I Distance from R m be as close as practicable. J LRlsbrPipe eonout Plug Wye for Riser ✓n nout Box with Lid to be accessible ed by property owner. Short length AdoDtorcoupling FLOW m Laterol Sewer I House Sewer OTE inimum slope determined by Building Oepartmenl. Lolaral Sewer Cleanout to be same size as Lateral Sawa,. • DETAIL STANDARD CLEANOUT FOR LATERAL SEWER J