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25558 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OF CUPF.RTINO ..It, r..ELEcrxlcnl. PERMITNO. APPLICATION/PERMIT PLUM RODE I IDENVICAL FICA 2[' C C Q BUI OF C DIVISION ERTI BUILDING IBN ICI'IDHANIF'ICA'1'IfIN L J J J o BUILDING ADIlluUM: SANITARY NO. APPLICATION SUBMITTAL DATE UNIT# LOT # OWNERS�r^NA.M�E..:A PHONE: CONTRACTOR'S NAME: LIC NO: �R-hAsly/ CONTROLM RCIIITECr/FIJGINIiIiR: LIC NO: ADDRESSEl : ❑ CONTACT: PHONE: QTY. ELECTRIC PERMIT FEE BUILDING PERMIT INFO ELECT PLUMB MECB PHRMITISSUANCE ❑ ❑ ❑ LICENSED CONTRACTOR'S DECLARATION APPLIANCES-RESIDENTIAL JOB DESCRIPTION OKZ I herebyaffim that lam licensed underpmvisionsofC Vlor9(commencingwilh WOO Section 9000)of Division 3 riffle Business and Professions Cale.end my license is in PANELS p;V full Tosca and effect Qzz License Class Lic.# UPT02fA AMPS F 6 oe Dam Contmerar 201-1000 AMPS F y- CT ARCHITES DECLARATION SQ.FT.FLUOR AREA 5/SQ.PT. OC Z-Q I understandmy plans shall be used as publicreOoNs. OVER IOOO AMPS Z^G F'n W SIGNS ELECTRICA $yt� Licensed Professional _ OWNER-BUILDER DECLARATION ier SPECIALCIRCUIT ESC WXX ; I hereby affirm that I am exempt from the Chummier.License law for the vl3 LL y following rtason.(Semon 7031.5,Business and Professional Cade:Any city arcounty TEMP.MEI'CR O LE INST. �0� which requires a peril to consumer,alter,improve,demolish,or repair any structure }� prior to its issuance.also requires theapplicunt for such peril to file a signed statement POWER DEVICES W I CC) Ihm he is licensed parsmmt to the provisions of the Contmetoh License Law(Chapter a 9(commercial IL Sortie.7Db f Division 3 of lbe Busiressond ProfessionsCode SWI MMING POOL Ii IC WMw gwi )o ) VALUATION ,Z- Section 703ISby thercfmm mfar.d me basis fmthe alkgedexemption.Myviolationof F.Z>• no,. ban by hu dpddolllrsr S51RE. subjecu the epplicum toacivil penalty of OUTLETS-SWITCIIFS-F =G not..,ban five hundred dollars(SSBB). NEW RESIDENTIAL ELECIR .FT. ❑term .,,.ahepmpeny,e tamemmealeeswithwedfirrihei(Sore compensation. STORIES TYPIiCONSTRUCTION yg� will dolhewonsCde:the no Contractor's Lienee Law not o(Siteapply to an Business and Professions Code:The Conbacmr's License Lew dcee not apply to an owner of property whobullJsorimpmvesthercon,and umbo Joessuchwork himsclfnr through his OCC.GROUP RES.UNITS awnemployem provided matsuch improvcmentsarenot imendedoroffered fmsale.If, however,the mildinger improvement Is sold within one year ofcnmpletion,tteowner- TOTAL: builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑ T.as ownerofthe property.unexclusively convecting with licensed conasctorsm QTY' PLUMBING PERMIT FEE FLOOD ZONE APN commuct the project(Sec.01104.Business and Professions Cal The Contractor's 1 License Lawdres nmapplym anownerofproperly who builds or improves thereon,and PERMIT IBSU ^'- ,r\who ('( Lice oracle for such projects wiNacomrannr(n)licenced punuummthe Contractors A1TLR-DRA1 &VP,NT-WATBR(P1`.�-�_ f •�.a ) FEESUMMARY LICGIse Law. ❑ 1 ser exempt tinder Sec B&P C for this reason • E r j' • .. FEES p BACK FLOWP TP.CT.DEViiv f,-:; ''A::1' SANITARY 9 Y DE N Owner Date "� e 1 RECEIPTp WORKMAN COMPENSATION DECLARATION DRAINS- OOR, F, —tgCHOVL TAX YN ❑ Thereby effm lhelihave ecenifcate ofconsemmself-insure,nracenifceteof FUCH]REAo ZLRJRAP Workeri Compensaionlnsumnceoramnifedcupythereof(Sce.38W,Lnb C.)which —�`-Y""� � PARK FEE Y N_ covers all employee's under this petit. GAS-EA.SYSTEM-I INC. OUTLETS RECEIPT# Policy# BUILDING DIVISION FEES Company GAS-EA.SYSTI?M-OVER4(EA) I'hANCHECK FIiI? enifed copy is hereby famished. ' Cenifed copy is Bled with the city inspection division. GREASEANDUSTRI.WASTE INTERCEPTOR GRADING FEE CERTIFICATE OFEXF.MPTION FROM WORKERS' OR BASE TRAP SOILS FEE COMPENSATION INSURANCE (This section need not be completed Bile,petit is forms hundred dollars I$IRB SEWER-SANITARY-STORM EA.200FE ENERGYM-E Ines.) I certify thm in the perfarnme.orth,work for which this permit is issued.E shall WATER HEATER W/VFNT/ELECTR not employ any Person in any manner so as m become subject to the Workers' PAID Compensation Lawse(Celifomia. Dae WATER SYSTEk1/TRBATING pate Receipt# O z Applicant Z 0 NOTICE TO APPLICANT:If,afmf makingrhis Crei6wm of Exemption.you should NEW RESIDENTIAL PLMIL SQ.PT. TOTAL: CC become subject no the Workers Compensation provisions of the labor Cade,you must > failcomply with such provisions 0s this peril shall he dremed revoked. BUILDING FEE aQ CONSTRUCTION LENDING AGENCY SEISMIC PEC 7 z J hereby affirm that there is a construction lending agency for lire perforence of U C) the work far which this permit is issued(Sec.3097,Civ.C.) TOTAL: ELECTRIC FEE Leader's Name PLUMBING FEE W. U Lender%Address QTY. - MECHANICALPERMIT FEF, U 1 certify that I have mad this application and shite that IM1e stove infommion is correct.E agree to comply with ml city and county ordinances and sure laws relating to PERMIT ISSUANCE. MEC)IANICAL FEE building construction,and hereby stil int representatives of this city to enter upon rhe(, above-mentioned CONSTRUCDON'rAX 7 ve-mentioned property for inspmtion proposes. ALTER OR ADD TO ME CI I. .7 (We)agree to u,Indemnify and keep harmless the Cay of Cupertino against l iahildies,judgme ,costs unJ ex nsex which may in any way aarueageinst said City AIR HANDLING UNITQ'O IO,000CrM) nugren n hegramirg is pcmit. AIR HANDLING UNIT(OVER 10,000 CFM) Sifh)0FoofAppfivmrQTykmEIor EXHAUST HOOD OVIDUCT, PAID I IAZARDOUS MATERIALS DISCLOSURE HEATING UNIT(T0100,000 BTU) Date Receipt it Will the p]cum or future building occurrent store or handle hamrdous material BEATING UNIT(OVER 100,000 BTU) TOTAL: as defned by the Cupertino Municipal Cale,Chapter 9.12,and the Ilmd th and Safety Cade,Section 25532(«)'! IJ Yes ❑No VENTILATION PAN(SINGLE RESID) Will rhe applicanmr fmure huilding wcupant use cquipmem andwiae which emit 000 BU) BOILER-COMP(311P OR 100, TISSUANCE DATE dihasammus air cantaminsnu as define)by the Bay Area Air Quality Management BOILER.COMP(OVER 100,000 BTU) Q District( q ®,D ED Yes ❑No NEW RESIDGM'IAI.MECII. SQ.I'I'. (��� 1 have read he hamrdous materials otrimaninus order Chapter 6.95 of the v ,S California Health&Safety Cade,Sections 25505,25533 and 25530.1 understand chat Coy 6 if IM1e building does not currently have atenant,that it is my responsibility to notify the Co ''II occupant of the requirements which most be met prior to issuance of a Certificate of V/-�` Occupancy. ��V Owner or aahobed agent Date TOTAh: ISSUED BY: OFFICE SANTA CLARA COUNTY CENTRAL FIRE PROTECTION DISTRICT CONTROL NUMBER ;� C~ 14700 WINCHESTER BLVD. LOS GATOS.CA 95030-1818 (408):379-4010 PERMIT NUMBER SERVICE TOP SINCE 1947 . FAX(408)378 9342 1 PLAN REVIEW COMMENTS CODEISEC. SHEET NO. L f- 5PR1NK_L(-7Q WOR-r, IS Px CrV IfL� p -IavF SPR " 1���2 2s -ro -t �r<i rrn,S �o � 5 G. su�r� I �' �P , Ft n.- Cckv�rRA -axL out or� f�� P2id2- 7ZD w02r, 6G-Iti1c-1 DoaE P-A-+-� -1)ootL Sf 1� LA-. &e 1' " ASS EN�Q LY • off- TO 1 ssu�' 6U i LO t n/krj PL-91--in 17 JURIS. PLANS SPECS NEW REMODEL AS CONST.DESCRIP. BY DATE J PACE BE JFLOOR F2 OCC OCC.LOAD AREA A N0000NTRACTORMWNE TP LJ-A C o a o -r Lsr SkA f rL3 �� Q0 5F&Q(r r5 Serving West Valley Cities of: Cupertino, Monte Sereno, Saratoga, Town of Los Gatos, and Adjacent County Areas Palenons H3002 .li i:=:_�•-_'l9' . . : i11+,b+fiFP:EI�i ._- PO.: r_ � l': _ ccrc - o© y • PpF�® IN ACCORDANCE TH®THE ITY OF gopl'RTINO CODES AND ORDINANCES SIGN=L6��3_____ 0 d This set of Ii'� be kept t ns and all j kation MST SEP 16 D P on the job at all times and it is vo TS93 lawful to make any changes or alterativas on same without BLDG. INSPECTION DEPARTf_v1EtfT, the buildin written Permission from City CE The Stam in Dept.. City of CUPS.lino, r (NU SHALL P B of this plan and specifications NOT be held to Permit or approval of the Violation of to be ua of any City 010,nance or Y Provisions State Law. •�N OFFICE COPY 1 i 1 ■ I�vJ CuS, 1-T, �'1�SIaJC-r Y A , 1�-cxlit Lbo��g '�t.aTC DZr-10 0o9T. `h11ty� �y '� 15 �93 2 1 /2" \ MET STUD BRACE TO STRUCTURE \ 8'-0" O.C. ® 45' MAX. \ SUSP. ACC. \ TILE CLG. TAPABLE ALUM. TOP TRACK • 5/8" GYP. BD. ON 2 1 /2 MET. STUDS POWER FAST. ® 24" O.C. LINE OF FLR. (:)_AWALL SECTION FLR. TO CEILING 3" = 1 '-0" 100 TITLE 24 MANDATORY LIGHTING MEASURES • N/A Buiilding Lighting Shut-Off. N/A Override for Building Lighting Shut-Off. N/A Automatic Control Devices Certified. X Fluorescent Ballast and Luminaires Certified. All fluorescent fixtures specified for the project are certified and listed in the Directory. All installed fixtures shall be certified. X Tandem wiring for Two-Lamp Ballast ' s. All one and three lamp fluorescent fixtures are tandem wired with two (2) lamp ballast where required by Standards Section 132 . X Individual Room/Area Controls . Each room and area to be altered in this building is equipped with a separate switch or occupancy sensor device for each area with floor-to-ceiling walls. X Uniform Reduction for individual Rooms . All rooms and areas greater that 100 squre feet and more than 1 .2 • watts per square foot of lighting load shall be controlled with Bi-Level Switching for uniform reduction of lighting within the room. N/A Daylit Area Control. N/A Control of Exterior Lights. TITLE 24 MANDATORY MECHANICAL MEASURES X Air Balancing: All space conditioning and ventilation systems shall be balanced to the quantities specified in these plans, in accordance with the National Environmental Balancing Bureau (NESS) Procedural Standards (1983 ) , or Associated Air Balance Council (AABC) National Standards (1986) . •