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S 0412m 11"Al rtO FILL w INFORMATION WITHIN RFD LINES. IIStF BALL POINT PEN ONLY e.e1..rs.+...,. .��... .... .......�..._.. ......... ..__ _...__ ___ __ _- CITY OF CUP''RTINO Of111.DING - 4:Lf:C1'HIG\I. BUILDING DIVISION API' LICATION/PF,RAIIT 1'LUpIHING-bIEC11ANIC.\I. BUILDING PROJRCI'll)ENI'IFICATIO\' PERM] I' NO. S 0412 lJ APPLICATION SUBMITTAL DAT IILDIM1'G ADDR1ISSE a&os� �2-taPHONE NAME: Ko.4l� 330'40 C IO S NA : ICNOWNL'R'S I ���`I'HOLECT ±SANIFARYO. CON'IROh4 BUILDING PERMIT INFO NOUNk',I:R:LI 1 7 VQ �f.�l �l�i �' � �} CONTACT: PHONE: Ins Seo q 2 L�^ ^ W� Y/ • "^'Si'rrY � M�04{ l..e ❑ ConsullnnY Fees Paid by Applicant (lniYiaq BL E PLUMB muck] QTY ELECTRIC PERMIT TEE LICENSED CONTRACTOR'S DECLARATION 1 hereby vffinm tum 1 um licensed under pmvisinnx of Chapter 9 (cnmmcncing in full fortt and diaDivisinn3ofthe Huxinen and Pmfexsinm CoJc. and my license is t. License Class Lic.of JOB DESCRIP'T'ION RESIDENTIAL ❑SFDWI. ❑KI"I CHP.N REMODHI, ❑ DDITION C] PLUMBING RE -PIPE pEHMIT ISSUANCE APPLIANCES -RESIDENTIAL. Date-Commmor ARCHITECTS DECLARATION PANELS t .TbUNI'T ❑ SS TRUCTURAL MODIFICATION I Incursion my plans shall be uI'd a, Palouse rccoN.0 Oil 10 300 AMPS [_1 INTERIOR ❑CHIMNEY REPAIR IMPROVEMHN'1' ❑SWIMM ING POOLS ❑ HATH RFMODF,FJREPAFR ❑DEMOLIIDON ❑ OIHIiR Licenced P+oficoukal OWNER -BUILDER OF LARATIONOVER I F hereby affirm that 1 am exempt from the Contractor's License Law for the following teawm. (Seoul,. 703 L5. Business and Profntion, Cade: Any city or county which require, a fermi+ m construct, alter, improve, demolish, m repair any saunurc prior in its issuance. also requires the applicant for such Permit o file a signed statement that he is licensed Fumuont o, me provi,imm of me Cmutramor, License Low (Chapter n (commencing with Serino 7000) of Division 3 of the Businesses and Profession, C+Nel nr that Ise is cnempk thcrcfmn+ rad the basis for the alleged exemption. Any violadm+ of Section 9031.5 by any vpplirnn for a pernitsnbjemx the rppli,annoa rill pcimlty of not more than live hundred dollar''($500), pensn, ❑I, as owner of the property, or my employee, with wages., their sole comatio will Jo the work, and in someoneisnotimenticlm.ffemdforale(Sec. 7W. Business and Professions Code: Th< Contractors License Law Joe, not apply ,o an owner of property who builds or inspmvn.thereon. and who does such work himulf or through his own employee,, pr+vided that such improvements art not intended or oDoed for sale. If, however, the budding tit improvement i, sold ,vnbW one year ofcmnplcdoo, he tier -builder will have (lie burden of proving that he did not hold I,, improve III' III' 201-1000AMPS IdN)AMPS SIGNS ELECTRICAL SPECIALC 5 . AA !!�1 TIiMI'. MEiT1iR ORKES S"R L" COMMERCIAL C ❑ NIiW BhDGIADDITION El DIiMOI.II'ION AN'I ❑FOOD SERVFCF. IMPROVE�M�E`�-,I".a ❑OTHFR G POWHRDEVICTp,�1� A❑H; SWIMMING POOL ELECTRIC OVIl.LTS -5 W PI NEW RISIUF.NTIAL ELECT'H u ESQ Ff. SQ, FT. FLOOR AREA VSQ. FI'. TOTAL: fuse nf,nleJ. ❑F, as own,,.mm w610(the property, am exclusively contracting with bcensed cnmctn to ncna's Li- mmct,he project (Sea. 7. Hashers and CIA':) C) lbe Cutn retire law does not apply man owner of property who builds or improves tucrcon.and who contracts for such projcats with a cuntmmnr(sl licensed pursuant the Contmctorx Y" �' /1 PAID 6f FEB 23 QTY, PLUMBING PERMIT FEE Li,enxe Law. ❑ l am cxcmp+ under Sec. .B& P C for + his Itasca PERMIT ISSUANCE ' csci, WW ALI ER- DRAIN & VENT -WA'I HR (EA) HACK FLOW PROTECT. DE ICE I: uu1-t: VN.UA,I1ION h I IIVV Date r .ouWORKIiRkS Co MP1iNSXIION DECLARATION I herehy anion ander Iwrally of perjury one of the following declannionm ❑ I have and will mainmin a Certifcme of Consenn, elf -insure for Worker's Compen- ,.tion, as provided for by Section 3700 cf am Labor Cole, for the peffommncr of,hc work for which this permit is issued. ❑Ihave and will maintain Worker', Compensation lmumnce. ax reaki lby Section ich this is issued 3701 of the Lam.Codefor the performanceor which permit of the wk for wj'6 DHA INS- FLOOR, ROOF. AREA, COND, STORIES I IFCONS'TRUCI'10 FI%TURILS-PER TRAP GAS - EA. SYSTEM LI INC. JOVILRS OCC. GROUP APN GAS -L•A. SYSTEM -OVER ensation Insnce canter and Policy RmK My Workers Cmnpum �-y"."I 0 (J3 Carrier: Policy No: CERTIFICATE, OF EXEM PTION FROM WOR KE RS' COM PENSA'r10N INSURANCE GWEASIJI N DOS TRI, WAS TI! VoGHRCEPTOR BUILDING DIVISION FC0.S GREASE TRAP PIANCHHCK Cup (Thissectionnced not RcmmpleteJ ifthc permit isfornnehundred Jaller,(SH10) less.) Toy any that in the performance of the word for subject to the all Wi,crs'Comper-ssued. I shall nm employ any petmm in any manner m as m become subject to the Wndcri Cnmpcn- ,.,amLawsofCalifornia.Date SIiWER-SANITARY - STORM EA, 200 Ff. [NERDY 1tiC WAttiH Hf:ATF.H wNENTRi1.UC1'R GRADING FEE Applicant NOTICE TO APPLICANT': If, after making this Cc, ificute of Ex,mp+ion, you should pnrvisinns n become abr,, in the WorkerLs Compensation of the Lvbnr Gxle, you mux iv f nhwlth comply with such prtulkinm or this pcnnit shall be dw'med evoked. wATER SYSTEM/TREATING SOILS PHU WSTI!1l SERVICE, PAID NEW RESIDENTIAL PLMB SQ. PC CONSTRUCTION LENDING, AGENCY 5 I hereby affirm that them is a construction lending agenery for performance of he work for which,hie permit is issued (Sec. 3097, Civ. C.) Dam Remip, b T(yl'AL: Isndel, Name I<nJd, Address L 1 certify that I have read this application and state that the above information is 1) , med,I., .,me to comply with all city and county oNinuncc, and settee law, rcmking n+ R building m,n,tru'Jon, and bcrcby nufhnrirc nTruwnunivcs of tris city (ocnmr upon the abovo-mentioned po,cry lisrusprO npamoxcs (Wm agree n. save, indemnity and keep harmless the City of Cupertino against liabil'nies,judgmenn. cuts and expense, which may in any way accrue against said City TOTAL: BUILDING ITIi QTY. MECHANICAL PERMIT' FEE SEISMIC l+lilt PERMIT' ISSUANCE FLECIRIC IPE PLUMBING FFE ALTER OR ADD TO M ECII. in mnrequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT AIR HANDLING UNIT(TO 110.00 CPM) oi MECIIANICAI. r:E SOURCE. REGAL TIONS, OURCE. AIN HANDLING UNIT OVER I(I,(Xp CFM) CONS 'IHIICI'ION TAX 9fR oJ, EXHAUSTHOOD(WIDUCD Signatu� nolmctnr Orm I IA-ZAKDOUS MAI'FRIALS DISCLOSURE WAhbeapfllevntnr fitemebuildialcalluPant marevehandle h.eardou, nmteri.l as defined by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety IIEA'IING UNIT(To iEfirob aI ID HINTING UNIT (OVER [00.000 B"IU) code. Section 25532(al'! E] yes ❑No =PA VENDIATION FAN (SINGLE RESID) Will the applinmt nr future building overpack use equipment or Jcvices which horardou, sir cnnmmin.nu as dclbard by the tiny Arca Air Quality Management BOILER- COMP CHP OR l D000 BTU)mit POILIER-COMP (OVER 100.00OBTU) 'Dillow, I ❑Yes ❑No AIR CONDITIONER ISSUANCE DATE 1 have read the h al f. Section, s materials 5, 25513 ora under Chvpler b 95 of the Cali- formsWiLdi g ies & Safny Cork, earShat i 2553) am12553J. 1 understand than if 0e building docs mu currency have a krnam, that n is ua ce'If- bility esta o fy citefloo, mvvfant of the r•;uirtments which mu,+ he mm prim w, issuance of a Cenificme of (kcupancy. NIiW HISIUEM1TIAI. M[CII, SQ. E4. TOTAL: ISSUED BV: Owner or nmhnrizcJ .gem Date UFFIIa 0 a m N W O co O O O O o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o m 1 (0 (0 O) (O 0 (O (O (O O) (D O (D m (O 0) (0 (D O) (0 01 (O W (0 0) (O W 8 O) 8 (0 O) (O m (0 01 (O 01 8 0 (O 0) 8 01 co 0) (O 8 m (O (O W (O (0 T (0 O) (O (O (0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ou au m m au ao au ao m ao a m au o 00 0o m m m m m ao a m au au m au w ou o0 o au w 1 W T m W a 0 'D a W W 70 W x x x ;u x x x x x x ;u x i C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C Z Z z Z Z Z Z z z Z Z Z Z Z z z Z Z Z z Z Z Z z z z z Z z Z z Z z Z Z y mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmy G)c)c)c>c)c)G�0G7G7G7G7L70 )G)c)G)G)G)c)c)G)c>c)c)G) m m m m m m m rn m m m m m m m mm mm mm mm m m m m m m m m m m m m m m m mm mm mm r D (n T O D- fn T O D (n O D T> O D 0 0 0 0 0� 0 0 0�; 5- 0 0 0 0 0 0 0 0 C 0 C r O r O r O r co O r O z Z z C W Z z Z W W W W C C C C C C C Z Z Z 2 r W r� —{ r W r r n n n Z n n n Z Z Z Z Z Z U) 0 Z cn 0 Z(n 0 Z c 0 Z Q Z M A W 0 x A x O O O O O O O O O W 0>0Q c -P G) D�0(�D0()011M� 1mm > O r— >c�O>—, mmm 000000000 n KmDKm>Km>3mDg�pp�z 01Ov�mmm0 zzzzzzzzzX 5�p ai G)cn D� D? �?Dlla) W W Z 1 0 m 0 m 0 m D m D m O 0 O D D D X 1 v D m C.n_ Cn_ W W W N N N N N N N N N N NN) j N N N A A A A m m (n (o(o(o(o((D0(c0(oc0to(nmmo 0000 o Oo O o0 o Oo O O O o nm o m 0o m au o0 0o ao m au au m au oo au au oo au au a oo m m ou m oo m m ao au a ao 0o ao ao au ao 0 lu C` (J W W W W 0 0 0 0 0 0 M m W �I v A W N A W N 01 O) A (O m N A O (O (O m\ (O 0) O 7 W O 00 OD W Ou CD ,M CO CO W CO OD CO W OD aD CO CO CO aD OD CO m aD co m OD do w D7 m m W w W m au Oo m (p DDDDDDDDDDDDDD--IDDDD--IDDDD0DD0DD0>'>>> 5 O, C 2. A A A Ul A -AIL U1 m W W W N W W N W W N W A N co (r W -v -uW-0-0 u-0 -u-V'O-0_0 -n -0 -0'oT mv N 0 T d 0 -00-0-uZ'0-0-um m n O CL N W O co 0 V) cn (n u) u) V)V)U) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o m N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N 3 N Q) Q) 01 T m Ql Q) W O) Q) 0) 0) 01 0) 01 0) W 01 m m 0) 01 0) W O O) W O) 0 0 0 0 0 0 0 0 0 C. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0n 0 0 0 0 0 0 0 0 0 0c O O CO W W OD O QD OD CD OD 0o OD 00 O O OD OD 0o OD OD DO DD OD OD W OD W Do OD O a0 QD OD 00 cn C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z (p mmmmmmmmmmmmmmmrnmmmmmmmmmmmmmmmmmmm �]y,� O c�c�c�c>cimmmmvc>cicimmmmmcimmMMc>MMMMc�c>c�MMMM m mmrnmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmM m co co c n p p n n p p n p p n n m m O 000 D D D D D m D m D D 00000 OOOO D 00000 Z Z Z Z Z Z Z Z r r r r r Z r Z r Z Z r Z Z Z Z Z Z Z Z Z Z r Z Z Z Z Z mmc� C�C�C�C)CCCCCmrmrmrnnnnn c�c>c�nrc>c�c�c>c� 2 z oox wxwxwcOcntn000000nxx�xw m O O O m m m m m m m m m m m m m m v On m m m m -i��� ���- 1 m p OOOOw0000aoa�nrnrpr�-i11� c- c- c m m m m m m m m m m m rn m m to n ZZ ccccxxA x7 aZKZKZKx O O O �u Ax To TT mm -n mm-l'n p G) G) X Z z z Z m m m m m Z z z m m m m m 0000 O O O O O v o v v z z z z z x z z z z z c c c c c c c c c v --I --I m T m m T D m m m m -n -n Z Z Z Z Z Z Z Z Z 1 D D D D D DDD D � Z A Ni v rn m 0 rn rn m rn rn rn M W c� c\ c� I — Ut (� (\ (\I N (P m Vi 0) r cn co — N C O (D (J� A W O au W �l V 41 N O O W En A N A Ou V m N (D .A (o (o (o (o (o (o m (o (o (o (D (o (o (o (o (o ((D (o (D (o (o ((D (o (D m (o (o (D (o (o (o (o m m au au mr000w oo oo aom oo oo oommao oo au au ao oow ao w oo oumwwao au au m mm rnrnrn �+ cn(\cnc�,cnc\c`c�n (�(�(\�, ^` �O D) 01 m W(D N N N N N(D r (P C\ N (` (� (\ W CT W N O O A W C) O v V O) N O (D Do CT1 A OD \ m A O (o (o (o (o (o (o (o (o (o (D (o (o (o (D (o (o 0 (D (D (o (o (o w (o (D (o (D (D (D to 3 00 w co co Oo Oo W O Oo oo 00 m w W w w w w Qu O d7 m m 0o w w w w W w m D D D (� D D D n D D D D D D D DDD (� D D D D D D D D D n D D D D g 000 n v 0 0 0 0 v v O 0 0 v v 0 0 0 v O O v O c v v O n v O c �) m t) O C D1 O) W N 01 A (.n N Ut W O m W A A W W Q) MA D1 W W 0) Ot -0 N N T N -0-u-0 0-0'D mm T m m m n O a co N W co O E 0 CD w a (n Cn V7 (n Cn NCn Cn0 N NN (n (n (/1 (/7 U7 C/) C/) (/1 (n (n (n C() l) (n U) (n (n (n co C/) C/) In Cn 'O O o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 AN 0 0 0 0 0 0 D6 0 S 0 A 0 A 0 0 4� 0 It6 0 Z. 0 A 0 D6 0 � 0 0 o m T1 N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N 3 J J m 0 m 0 0 0 0 C. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N m m m m m m m m m m m m m m W m m m m m m m m m N m m m m m m m m m m Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z cn m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m y O D p p p p p p 0 0 0 0 0 0 p p p O O p p p p O O p p p O O p p 0 0 0 M O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O m m m m rn m m m m m m m m m m m m m m m m rn m m m m m m m m m m m m m mm m c O m m mmm > m m m m m m— m m m m m m rn mmmmm m m m —mmmmm mmmmm T T Z ZZZEZZzzzzzz�zzzzzzzzzzzzzzmrnmmmzzz Z 000000 T T T T T T Nn T T T T 00m00000 T T T T T T T T cnr T T T cn T T OOO T T r x r x r x r x r x T OOO Cl) p x 0 .Z7 0 n_- .Zl 0 ;I7 0 z 0 Z n 00 n O Z O Z .Zl c�c>000 .� .'q .Z7 .Zl m m� (n m --I m m--- Z1 000-----C�c�c� .'il .-(7 m m m m m x A x m N zzzzz p c)nC-)00 z z zzzzzmrmmrmzzz m m m rOG)G)OO' Z nTT,iTzzz z Z Z Z-- 000 0 A 00000 xxXXX 00000r rr 0' "u vmmvv 'A���� M. m 1M cn(ncnxm mmm— x cnv)cn mmm DDnDD mm — — m m m rm-�mG�O 0 1 a D m m 0 \\ N W N N N \\` N N -4 N N \\\ J Z, rn W m N rn N rn N rn N m N m N rn rn rn m 0 O mcocococom�ocommmmmm—mmmmcommmcommmmmmmmmcom O CD m -I Vt A W N O w W -1 m m A O 0 m V W N� O (D m m A W N tD OD \ A m w m m m m m m m m m m m m w m m m m m m m m m co co m m m m m m m m m m \ W W N N N— \- N N N N -4\ N `\\\ m w m N m N m N m N m N m N 0) rn C)N 0� c0 t0 0 tD O (O m� (O (O N tD A IO W tD N t0 (O O (O W (D W f0 V t0 m t0 m (O A (O 0 (O [O (O m (D -I (O m (O `V tD (D O (O 0 <D m f0 Dl O A t0 W t0 N fD O (O m c0 J (O O 7 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m >0>>>>O> O pl p p p O Cn 0 D p D p D 0 p (n p fn p Cn D p D O p In � p (n p (n O In p Cn p (n p (n p In p Cn �n p (n D p D p D p p V1 D p D p g N CD a O C - A m m m A w W W m W w W m m m -+ W W m N N N w A W m m W m m m -a T T 'D m 'D 'O ou N N T d z 'D 'O m Z '9 m T m V 'O m T m O CL O A • T 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o m N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N 1 mmmmmmmmmmmmmmmmmCC)(D m�m(Ommmmw(D 1 m O m O m O m O m O m O m O m O 0) O m O m O m O m O m O rn O 0) O m O m O m O m O m O m O m O m O m O m O m o m O m O m O m O m O m O m O m O N m m m m m m CO m m m m m m m CO m m m m m CO m m m m CO CO m W W W m m m m N C c c c c c c c C C c c c c C c C c c C C c C C c C c c C c C C C C c C z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z z Z z y rn m m m m m m m m m m m m m m m m m m m m m m m rn m m m m m m m m m m U) O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O A m mmmmmmmmmmmGAG)mmmmmmmmG�G�G)L�mG>G�L m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m mmm m m mM — ao ao m m Co m m co co 03 On cncncn cncncncncncncncncncnmxcncncocncncncncncorncncncnto mpvc 2 2 2 2 2 2 x 2 2 2 2 2 2 2 X Q 2 S 2 2 2 2 2 S 2 2 2 2 S 2 2 2 D D -7 TD D m (n D D mm D m D m m m m m m m m m m r m(n D m D m(n D mm D m(n D m(n D m D m(n D m D mm D m D m(n D m(n D D m D m(n D A D Om A Z D D R O n >>>>>>> D D D D D z D D D D D>>> D>> m (n. m D rrrrrrrrrrrrrr D D D D D D D D 2 z Orr r- r rrrrr r r D D D D rr D r D rr D D r D r- � 0 r r r r r r r r r r r r r r r r r r r r m o M N� o m w o W 0 0 1 m m o _ 0 N 1 m m v (D (D m co m m m m OD m m m m m m m mco ao W Oo m OD � �� N N m (n O c0 m A W N m-4 0) (`II A� W W O O CO v .P W N -+ O m (\ .A W CN:)) 0 0 A 'O'D (D D D o 0 o COD D D R (D D D D (o D D o D (D D D D D (D Dco (o D (D o 0 m mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm (D _ co O fD (D (o (0 (D m W m N OD N m N m OD OD OD m N OD OD _ W _ m _ OD _ W _ W � W W m m m\ N � N v N o 0 O (D Oo A W N m J N A v W W O(D v A W N O V (T A W 0 0 0 0 c0 OD (D m (D m (O m (O m a) m (O m (D m (D m (\o m (D m CD m (D m c0 m (O m (D m (D co (D m (D m (D m (O m (D m (O m (D m (D m (0 m (D m (O m (D m (D m (O m (D m 7 (o 0 0 0 0 D D D D D 0 D D D D D D DD D D D O D D D D D D D D D D D D ()cnco(n 00000(n 00000000000u)(n000000000000 (A m K O C 7 N N W 0) O) m (0 m (D OJ(JO) W m W m m N m N m m A W W W N N -a-o-o-a m -0m -o?1-amm'O-0-0-0-nmm -u'0"O-o T-oT m'o mm N N N T d m mAm Zm m 'D -0A z A 0 O O. 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