S 3040 APPLICANTTO FILL IN INFORMATION WITHIN REO LINES-USE BALL POINT PEN ONLY
CITY OF CUPEWFINO BUILDING-RLI?CI'RICAL PEgIT NO, 3040
But HNG DIVISION APPIACATION/PERMIT PLUMBING-]u9cuANICAL
.Jd BUILDING PBOJE<:1'u)EhrI'iF'ICATION
BUILDINGADDRESS: SANITARY NO. APPLICATION SUBMITTAL DA'IT.
zo Kl?G c e IO 2619do
OWNER'S NAME PHONE: CONT A(JI'OR'S NAME: LIC NO'.
NIC CON'1'NOLM
CHITECr/6N INB13R: LIC NO: ADDRIiSS: ❑
coNTAcr: PHONE // BUILDING PEIiM1T'.INPO
❑ Consultant Fees Paid by Applicant(Initial) BLDGte I.[ECT PLUMB MECCH
LICHNSEDCONTRACIOR'S DE11.111ATION E QTY ELECTRIC PERMIT IIiE
1 hereby air...i firm 1 rant itemead under tar,ki.n,or chapter 9 monan iting JOB DFSCRIPTION
OCO with Section]BIXIInfDivkion 3ofthe Ebrood red Prntessinns Code,andnry limn,is r �0 RESIDIiN'1'IAI:
W O P13RA11'1'ISSUANCE
WO in full force and effect. ❑SFDWL C3 KITCHEN REMODEL
<UU License Class I.R. APPLIANCES-RLSIDIJPIIAL ❑ADDHPON ❑PLUMBING RE-PIPE.
y Z ul Dare Counselor
ARCHITECTS DECLARATION ❑MULTI-UNIT ❑STRUCTURAL
Z O v7i'NZ, 1 understand mY plans as shall he used public records PANIiLS MODII'ICATION
N UP'102MAMPS
OZ^� ❑IMpi yvE OCHIMMINGIPAIR
F�.F"u] Licenswl Pro(eti<iunul 211E IIlI1l1AMP5 / IMPItUVI:MI?NT SWIMMING POOLS
OWNER BUILDER DIiCLAItAT10N OVER RIBA AMPS [IBATH REMODEIJREPAIR ❑DI3MOLITIGN
s
6' 1 hereby affirm that 1 am exempt from the CotucmLicense Law LicenLaw lin the
EX:O L U following reason.(Section]1131 5,Business and Professions Cade:Any city or county SIGN$1!LECIRICAL ❑OTHER
W 3 LL which require.a permit to concoct,alter,impn,.e.demolish,or repair any idexu rc
F u'Og
poor itsissuance,also requires the applicant for such proud to file a signed statement SPECIAL CIRCUITIMISC.
� 'Q
that he is licensed purslmnun(be provisionsofthe Contractor's License Law...... r9
W QO (commencing with Seelind700gofD,To.d3ufBm Budinesa and Pmf..lons Code)or TEMP.METER OR POLH INSI'. COMMERCIAL'
0.i o C Ilan be is exempt Be,el}om and the nasi.rnr the alleged exempting Any violion, of ❑NEW BLDWADDIT10N _ 111iM01.1'fION
m
Scenic,70315 byany upitfrarl fora perniln subjcdx theapplicant In a civilpcnaityof POWFR1)13V ICESEl I
s more than live hundred dollars($5W). PROV ❑POOU SERVICE
7s IMI'ItOVI!MI?N'I
E � ❑ Lo the worolthepmpartgor myas maidceawith eredI , aldSe.contpen.mien, SWIMMING POOL ELECTRIC
will dmthewnr,aide: sre Condo tosLice se".does. apply.]IW.Im.inex O ❑OTHER
u�l'• and Profession G,JOr imp Conductors License Law dues not apply s an owner of OUTIJil:S-SWI'1'CHF_S-FIXTURES
a 3� prnpetty who builds or improves thereon,anJ who A:ws such work himself(ir through
his own employees,provided that such improvements am not intended.r offered For NEW RESIDENTIAL ELECTR SQ FT.
wile.If,howcvee the Funding.,improvement is sold within one year or c.mpletinn,the SQ.17.FLOOR AREA $ISQ.Pf.
cr-builder will hove the hurt,.of proving thin he AIA urn hwld.r improve lin pur-
d,,wvn)c /jam
rt^e� V
sG A m ow r of ace pr.Isony,am exclusively cnnea,mrs with I)Hat Conn ado, I.
and dueprotectnot t$ec.nan Businessand
rty who builds
or
pro Cs themen, nd
scoLaw dcesnsuchapply man with
of property whored pursuant
improves Contra and QTY. PLUMBING PERMIT PCE
who contracts for such projects wish a contractions)licensed pursuant m the Contractors
Licenx Law. PERMIT ISSUANCE
E3 Into exempt an 'e. B&PC for obis reason
)suerhate AL'I HR-DRAIN&VENT-WRI'ER(EA) VALUATION
WOItKNlt;S GMPENSATION UI!ChARATION HACK FLAW PROTECT.DEVICE /OP OQO` —
Ihereh fflrin under It [ t'the following declarations: Oo
hereby pcna Yn pe�lury once g
(have anJ will inainnnin aCentficam of Cnncnt in.df-insure for Worker's Gtmpen- DRAINS-FLOOR,RO STORIES 'I'YPH CONSTRUCTION
smmid,as provided for by Sectio 37W of the Ichor Code,fur Ne performance of the
work for which this permit is issued. FINAURE TRAP
❑1 have and will maintain Worker's Compensation Insumnee,to required by Section
3700 ofnhe Labor GMB,for the Performance of the work for which this permit is issued GAS-HA. ' S .M-IINC.a OVFL Is0 OCC GROUP APN
My Worker's Compmanner Insurance currier and Policmannerare
r :
Carrier: Policy NOT GAS-13A.. S ,M- :�A ITJO
CEIt'IICATE Op EXEM IT ION FROM WOR KERS' OI111ASIilIN STRL WASI'Ii IN'I'13RC131'TOR
COMPENSATION INSURANCE z BUII DINO DIVISION FEES
(This section need not bocompleed it In remaink foronehundreddollars151 Wl
.r
less) GNHA513'TR P PLANCIII!CK Mir,
cenify that in the per(onnanceufthe work forwhich this permit is issued[,hall SEWER-SA I -
n n Wil d.y.ny person in any m.........to bce.me mlijeel m the Worker,'Compen- ENERGY PITH
s� sminn Laws of C.lifomin.Dane W'A'I'ER 1117ATER WNENT]ELEC it
7�7 O Applicant GRADING
G N(yHCE TO APPLICANT:It,after makin6 Ibis Cenificme of Exemption,you should WA]'I!Id SYSTEYVTREA'I'INC, SOILS I T.bemntesobmet to the Worker's Contpegal,od pmvi,inm of the Labor Cn le,you nmnt
famwitli comply with nuhFo,l,tm,Orin,pmmin n'bull he deemedrovoked. WRI'PH SI!RVICE
a' CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMIi, SQ.ITT, PAI
U z Iherebyohdii, al them issued
(See 3 G.Cing agency for We perfmnancc of lore RemiptM
U O me work Torr shorn tui,permh i,i„ued(s«.syn.Civ.c.)
V. F• Lenders Name TRIAL:
O U Lenders Addmas T AI.:
G1 cenify that 1 have read his application amd state that 0c above inlnrananion i, - HUIL1 G FEE
IN correct.l agree to comply with all city and county ordinances and stave laws relining to QTY. MECHANICAL PI?RMIT FEE
V7 laildingmrim
norat,and hereby sort i.mp-cobras.m dui,city orae—mnh
m c SEISMI IT
ahnvn-mentioned propuny fur tnspection purposes, PIES11 I'ISSUANCE toted.,me mxavc,Indemnify.ad keep Wrtndesa the City of Cupertino against EL13C1'ItIC 313
umililles,judgmWO,ce.usiod expenses whicbntay nary wayaccse against said City ALTER OR ADD TO MECH. PLUMIIING PIiE
^t
in sequence of Rte gsmingofthi,permin. J
APPLICANT'UNDERS'T'ANDS AND WILL COMPLY WITH ALL NON-POINT AIR IIANIl1.ING UNIT TTO Ill,lkq CFAH
SOURCEREGU A]'IONS. MECHANICAL FEE
AIR HANDLING UNIT(OVER OJKX)CFM) CONS'1'RUCHONTAX
S nature of AppllcanVC.ITactor Dad 17XIIAUS'Ii IOODOMMUCF) HOUSINGMIHGATIONFEE
HAZARDOUS MATERIALS DISCLOSURE,
Will the applicant or I'utum Wilding occupant suite rehandle huzallous diamond IIHA'I1N(l UNIT(TO 100,000HFID
as defined by the Cupertino Municipal Code,Chapter 9.12,and the Healm:rod Safety
We,Section 25532(a)'! HEATING UNIT(OVER Iflojisto HTU)
❑Yes ❑No VENI'[LA[[ON FAN(SINGLE RUSIDI PAID Mare Recciptp I
rO
Will the applicant or furore building(se
ore equipment or devices which
nit hueirdou,.b ennmmiunds as defined by the Bay Area Air Quality Manugeownt ROILER-COMP(3HPOR 100,IX0BTU)
District?
[:1 or, EINo BOILER-COMI'fOV ER IIH1,fNH1 li'I'GI
I have readthc haaandons material,ONEiren cut%under Chapr,6.95 of he Cali- AIR CON DI I'ION ER ISSUANCE DA'I'F
hands Heal,&Safety GMs.Secni.ns 255(15.25537 and 2553E 1 undedrand that if the NEW RESIDENTIAL MECH. SQ.En
h adding does not currently have a recant,that it is my resptmsibility to notify the computer
of the requirements which must Ne met prior to issuance of a Certificate of Occupancy. ` L
Owner or authorized agent Dune TOTAL: ISSUED BY: I O L V I
OFFICE
2o6P� Rodr dues 9V� GuPu+A'jjo
wall 1
W1 I�
W2. o� o������U�i��
w,n z OCI
g 199a
—I--- \NSQEG�\ON EAS NOMro
�`uU. G\Z� OF GOF
• ul3
wq. wS
1, C�I�ti�e W1 144 "x73 - �0 144"x yo " S�i'J,Ad J'r
z. ��Ia2� wti,dows
to z Tz% X 2q • to 7z„ x 4,p "
OFFICT COPY '111w , 16 x Z* 40 96 x v
4 W` x -?.44 ' Eo 96` x 4,0
w5 961x=4'' 96" x36
3. Rte.)-ove Wall 9 a-4 Ye.l,,,,+t ps $ e/c
..1., 1Zzmove Mall 2 � ins�,QQ .�6 "p;
S 12zplace Lbe y 1 w 14h Y10 r,s+a,` wn e(
TRIM FILLER
36 :Z3 : 30 TO FR
11
11
830 �/" Go 2
rn y rd
N y
LOWER--_ __ WALL CABINETS
STO ALLOW CLEARANCE
27 FOR CROWNMOULDING
C CG 2O
V
96 y Q r
ATTACH DECO PANELS
B33 ON JOB SITE
33 / 9
30R
X
UBEPL USE OUTSIDE CORNER TRIM +,
66 3 ; _ TO CONCEAL PANEL EDGES
3Ea 29 9 p
;BD --__p•16 �
:630 ADD PANEL TO
30L ; 2 ;.2 CABINET BACKS
FWT ON JOB SITE
:824-__-
120
B2dL BUTT
'T USE BATTEN MOULDING
�- -------- TO CONCEAL PANEL JOINT
S 830
96
BD
DISH 6
.24'
Bi6L
-- TRIM FILLER AS NEEDED
2 UBEP R ON JOB SITE
46
42L 9'
6R
WBC4824R W4224
10A 16 62
90
Dwg no.
•L 92609CC4 Scale : maximum Design : 09/26/98
All dipiensions& size designations This is an original design and must Date 09/26/98
given are subject to verification on "E not be released or copied unless
HOME DEPOT LIN, LON-PHON
job site and ad' -nt to fit job applicable fee has been - ' orjob 20686 RODRIGUES AVE
conditions. order placed. Designer
CUPERTINO, CA ANTONIA S