31452APPLICANTTO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY -
CITY OF CUPERTINO BUILDING - ELECTRICAL
BUILDING DIVISION APPLICATION/PERMIT PLUMBING - MECHANICAL
BUILDING PROJECT IDENTIFICATION
PERMIT NO 31452
BUILDINGADDRESS:
j`012,40 Creek
SANITARYNO.
APPLICATIONSUBMITTALDATE
OWNER'S NAME PHONE:
CONfRALTOR'S NAME: LIC NO:
L `Y Q
N/C
❑
CONTROL#
ARCHITECT/ENGINEER: LIC NO:
N
ADDRESS:
�
cnN7'ACI'. PHONE:
❑ Consultant Fees Paid by Applicant (Initial)
BUILDING PERMIT INFO
RLD ELECT PLUMB MECII
LICENSED CONTRACTOR'S DF.CLARAUON
1 hereby afrrrn that 1 am licensed under provisions of chapter 9 (commencing
with Setion 70Mp of Division 3 ofthe Business and Professions Code, and my license is
I infant force and effaL 1�� ('
Liccnsef�asl Lic.p — / -lf ? _
Dent —Ll� Contrecmr
QTY
ELECTRIC PERMIT
FEE
JOB DESCRIPTION
RESIDENTIAL:
❑SFDWL ❑ KITCHEN REMODEL
❑ADDITION ❑ PLUMBING REPIPF.
❑MULTLUNIT ❑STRUCTURAL
MODIFICATION
El INTERIOR ❑CHIMNEY REPAIR
IMPROVEMENT
El BATH REMODEIJREPAIR ❑DEMOLIT]ON
❑ OTHER
PERMIT 159UANCE
APPLIANCES- RESIDENTIAL
ARColl be ma DECLARATION Alp IAh
1 understood my plans shall be used av public records �
Licensed PmEtdomd
OWNER - BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the
following reason. (Section 7031.5, Business and Professions Code: Any city or county
which requires a permit to construct, alter, improve, demolish, or repair any structure
prior to its issuance also amaires the applicant for such pormitto file a signed statement
that he is licensed persons to the provisions of the Contractor's License Law (Chapter 9
(commencing with Section 7000) of Division 3 of the Batista and Profircyons Cale) or
that be is eaempl therefrom trod the basis for the alleged exemption. Any violation of
Section 703 IS by any applicant for a permit subjects the applicant to a civil penalty of
not morn man five hundred dollars (S500).'
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the wodr, and no structure is not intended oroffered for sale (Sm. 71/44. Business
and Pmfosslons Code: The Contractor's License Law dots not apply to an owner of
properly who builds or improves thereon, and who does such work himself or through
his own cntployms, provided that such improvements are not intended or offered for
sale. IL however, the building.,improvement is s.Id winnoneyear.fc.mPlmi.n. the
builder will have the burden of proving Thal he did not build or improve for put-
pse.f sale.). 1, m owner of the properly, am exclusively contracting with licensed contractors to cansuun the prajecn (Sec. 7044, Business and Professions Came:)no Caroni Li-
[ease Law does not apply loan owner ofpmpeoy who builds or improves theater, and
who contracts for such projects with a commctons) licensed pursuant to the Communes
License how.
O l am exempt under Sec. ,B& P C for this reason
PANELS -
UPT02WAMPS
201- 1000AMPS
OVER 1000AMPS
SIGNS ELECTRICAL
SPECIAL CIHCUII'/MISC.
TEMP. METER OR POLE INST.
COMMERCIAL: -
❑ NE BLDG /ADDITION ❑ DEMOLITION
IMN NT ❑FOOD SERVICE
I OVEMkiNT -
OTHER
POWER DEVICES
SWIMMING POOL ELECTRIC
OUTLETS - SWITCHES - FIXTURES
NCW
NEW RESIDENTIAL. ELECTR
SQ.FTFLLQORfARgA®
V'' II`s��
NOV 1 5
/x T-s/
C�1, Ur UUrth I'INI
S /SQ. ITter-
QTY, PLUM •PERMIT
PERMITISSUAN
ALTER - DRAIN &VENT ATER 7
BACK FLOW PROTECT DEVICE
Owner - Date
_ -� �<VVAALU/A-TI�ON
^J
- 'TORIFS TYPE CONSTRUCTION
WORKER'S COMPENSATION DECLARATION
I hereby afore order pcm ny of perjury no ofne following dealarutions:
L have and will maintain a Cambria, of Cnnsent to self -insure for Workers Comport
station, as provided for by Section 37M of the Labor Code, for the peAormmnce of me
station,
w.rk for which this permit is issued.
i� I have and will maintain Workers Compensation Insurance, as required by Section
37W of the Lahr Code, for #commerce ofthe work for which this permit is is .cued,
My We - Cgmpen Lion lns it Policy nyy� j� Cl i
Carrier: �_ 11710 Policy No.: ^ an'lV �1n .ice
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
.(This section need not be completed if the Permit Is for one hundred dol Iota IS 100)
or kssJ
Tomby that in thepmandan[e.fthe weak f.rwhichthis peemitiswood, Ixhall
not employ any person in any manner m as to hearers, suhject to the Worker,' Cooper.
ration Laws of Califamia. Dale
Applicant
DRAINS ROO REA, GDNU.
-
FIXTURES _'ER'
RAP
GAS - EA. SYSTEM-1 INC. 40
OCQ GROUP
APN
GAS - EA. SYSTEM OVER 41G)
GREASE NDUSTRLWASTP.INTERCI'TO
BUILDING DIVISION PEES
GREASE TRAP
PLANCHECK FEE
SEWER- SANITARY - STORM RA. 20X1 FT.
ENERGY FEE
WATER HEATER WNENT/ELECDt
GRADING FEE
NOTICE TO APPLICANT: IL after making this Certificate of Exemption, you should
become subject to the Workers Compensation provisions ofthe Labor Code, you must
forthwith comply with such provision. or this permit shml he damned revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for me preparative of
the work for which this permit is issued X. 3097, Ci v. C.)
lender's Name
WATER SYSTEMMEATING
SOILS FEE
WATER SERVICE
PAIL)
NEW RESIDENTIAL PLMB, SQ. FT.
Date Receipt
TOTAL:
Lenders Address
TOTAL:
BUILDING FEE
1 certify that I have read this application and store that the above information is
act l agree to comply with all city and county ominances and some laws relating to
building construction, and hereby announce representatives of this city to enter upon the
Masse- mentioimproperty for ins,minunpurlmses. -
(We) agree to save, indemnify and keep Laundry; the City of Cupertino against
Iiabilides,jodgmemn, coramel expenses which may many way socon, gainstsaid City
in Consequence of the granting of this permit
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
SOURCE REGULATIONS.
QTY, MECHANICAL PERMIT
FEE
SEISMIC HE
.�
PERMITISSUANCE
EL17CTRIC FEE
ALTF.RORADDTOMECIL
PLUMBING FEE
AIR HANDLING UNIT (10 10,(X10 CFM)
MECHANICAL FF.Ii '
AIR HANDLING UNIT low CFM)
CONSTRUCTION TAX
g�'/�yg�,
Stgmmre ofAppfv:aHAZ RDO lam
HAZARDOUS MATERIALS UISCLOSUndl
Wilby the Cupertino Muniipaliode. Chaptsrmenr handle Health and Safety
m defined by the Cupcnino Municipal Coda Cheerer 9.12, and me Health enJ Safety
Code, Section 25332(x)'1
[I Yes ❑N.
Will dme 61 cicmtoffmure building by occupant u Area Air ton my Management
min District? s yr cannaminems as Defined by the Bay Area Air Quality Menagemeos
Di ricIT
El Yes FIN.
I havemad lhehnrurdmeamnmrlms requiremranoodcr Chapterfi.95 oflhe Cdi-
forma Health & Safety Cade, Sections 25305, 25533 and 25334.1 understand not if the
building does not conically have a morn. Out it is my resporeibility to notify Use occupant
of a rcyu' meats which man be met #nano issuunce of s Certificate of Occupancy.
EXHAUSI'HOOD fed /DUCT)
-
HOUSING MITIGATION FEE
HEATING UNIT (TO IOU,(Xp BTU)
HEATING UNIT (OVER 100,000 BTU)
, /�//
PAID /6/f
Date Receipt#
VENTILATION PAN (SINGLE BUSED)
BOILER - COMP CHIP OR 100,000 BTU)
,TOTAL
O
BOILER - COMPIOVBR 100,W0 tlTU)
AIR CONDITIONER
I$$ ANCE DATE
ISSUED Ely: gg ;e(
NEW RESIDENTIAL MECH. SQ. FT.
'
Ownenraumonzed age �— Dam
TOTAL:
OFFICE
THIS .SIGN PACKAGE COVERS THE PERMITTING AND INSTALLATION OF SIGNAGE AT
WATERHOUSE INVE.STOR.SECURITIE.S
19140 .STEVENS CREEK III, VD.
CUPERTINO, CA. 95014
THE PROPOSED .SIGN CONSISTS OF 10" X 8" LETTERS OF M2" PLEX IN TIMES NEW ROMAN
FONT, WITH PANTONE 872U GOLD PAINTED FACES AND PANTONE 5C2X BLACK PAINTED
.SIDES
.SIGN DIMENSIONS ARE: 10"X24'
F* TOTAL SQUARE FOOTAGE = 19.99
V
.0
CREATED BY UNITED .STRUCTURE AND SIGN
711 EUBANKS DRIVE
VACAVILLE, CA. 95688
OFFICE COPY
721 Eubanks Drive • Vacaville • CA 95688 • Tel 707.447.7976 • Fax 707.447.1823 Q
SIGN M BE IT I If LETTERS OF 1/2' THICK PLEI IN TaM DISH ROMAN FONT
WM PANTONE MU GOLD PAINTED FACES AND PANTONE 5C2I MACK PAMM SIDES
SIGN DEMENSIONS ARE 10' % 24'. TOTAL SQUARE FOOTAGE = 19.99
SIGN LETTERS ARE TO BE STUB MOUNTED
AND CENTERED ON THE SIGN AREA FACIA
0' -0"
43 -0"
3"
SIL
I
1
s
VAPTA
mE
E
E
m
PLOT PLANS i
CHECKED B%
r
1 I° ECENE
NOV 15 1996
{ n BLDG. INSPECTION DEPA T�
CITY OF CUPERTIN
• � y O
b I �6j
OFFICE UP,
FRONT ELEVATION
a
r
•
11 I I 11
O
cm
SITE I OLOOR OLN"
tm -f
W"MOM Mm"a am== 5.
im" BTKVM CREW BLVD.
----------
UNITED STRUCTURE & SIGN
r_n
cm
SITE I OLOOR OLN"
tm -f
W"MOM Mm"a am== 5.
im" BTKVM CREW BLVD.
----------
UNITED STRUCTURE & SIGN