The URL can be used to link to this page

S 43629PPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY _ / CITY OF CUPERTINO BUILDING - ELECTRICAL BUILDING DIVISION Is APPLICATIONIPERMIT PLUMBING .MECRANICA / , I ' BUILDING PROJECT 1DENTTA'7 F ICATION PERMIT NO. S 4362_ BUILDING ADDRESS: .20 320 C—I evw.,� Chew k Co 9 SANITARY IN APPLICATION SUBMITTAL DATE y It ( O'WNH"PHONE: N_B CON CIC�ORNAM�NO 4en Adak� N/Cgu ❑ , CONTROLp IIEOJGINyLIC NO: I i CN'1ALl E �ITIC AyjSS � dQ 6PHONE ' BEHLDINOPhAMITINFO 00IZ t- ka Z W R Vz U rndl 0rUnZ Oz N."p E•. � `L.' W O. U W W y V4 O Q4'1WV 6sd_ [ZL0" ❑ Consultant Fees Paid by Applicant (Initial) BLDG ELECT . PLUMB MUCH El El LICENSED CONTRACTOR S DECLARATION I hereby affirm tit t i I' J d p ': f Chapter 9 (commen 'ng wins Scmien7(mvd fD'vis' on 3r17the Business and Profemmp, Code AAt��dmy license is / ^ in full force and effut. V 9 I -I License CWa Lic. M Date f• Clean. .�: _�i ARCHITECTS DECLARATION I understand my plans shall he used as public records QTY : I ELECTRIC PERMIT'= t ' • FEE' 4 " . -� � h JOB DESCRIPTION RESIDENTIAL' ❑ SPDWL ❑ KITCHEN REMODEL ❑ADDITION [_1 PLUMBING RE -PIPE ElMUUD-UNIT El STRUCTURAL MODWICATION [I INTERIOR El CHIMNEY REPAIR IMPROVEMENT SWIMMING POOLS ❑ BATH REMODEUREPAIR ❑ DEMOLITION ❑ OTHER PERMIT ISSUANCE. APPLIANCES -RESIDENTIAL PANELS UP TO 200 AMPS Llceremt Pref e..min l OWNER -BUILDER DECfARAI'ION I hereby affirm that I am exempt from the Convector's License Law for the following reason. (Section 7131,5, Business and Professions Code: Any city or county which b mm, a permit m varum cl, sites improve, d,mnlhh, or repair any mirma ro prior to its issuance, also requires the applicant for each pcmoil to File a signed statement the, he is licensed purtuanlmlheprovisionsorthe Connector's License Law (Chapter 9 (commencing with Section 90100) of Division 3 of the Business and Professions Code)or 201-1000AMPS OVER 1000 AMPS SIGNS ELECTRICAL SPECIAL CIRCUIT/MISC. TEMP METER OR POLE INST. COMMERCIAL: 0.r y o rY W"m Z6not 22 iM that he is exempt therefram and the basis for the alleged exemption. Any violation of Section 71131.5 by anyapplieant fora permit subjects the applicad R, a civil penalty of more than five hundred dnllare($510). Dl, as owner ofthe progeny, or my employees with wages as their sole compensation, willdblh,work, onithe swewre is nm intended oreffered muscle (Sec. 71,Business ,,❑,�,, N�EWWB�BLDG/ADDITION ❑ DEMOLITION HYIENANTOD SERVICE IMPR - ENT ❑OT J POWER DEVICES SWIMMING POOL ELECTRIC OUTLETS-, SWITCHES-FIX'NRES .R j {x¢13 Gam, and Professions Cade: The Continuous License Law does not 1 to an owner of apply Property who builds or Improves thereon, and who area such work himself or through Pei I • his own provided that such improvements not intended or offered far for NEW RESIDENTIAL ELECTR SQ FT. 77*1 in mle.ifhowev the gor is sold ware however, improvement _snide within non SQ. PT. PLO ftAREA FT. will haverden or uildorwmpletiogtha ar-builder will M1nvo the burden of proving that he did not build or improve for pur- poae castle.). El1, as owner of the property, am exclusively narrowing with licensed contractors to T AL: construct the project (Sec. 9044, Business and Professions Code:) The Contractor s Li- - - -- - - - I. se Law does not apply to an owner of progeny who builds or Improves thercnn, and QTY. PLU BI IT i " PEE'' who contracts for such p Jests with a commc urno licensed pureu nt m the Cortmetor s License Law.PCRMI'C E]I am exempt under, Sec. ,B& P C for this reams ISSUANCE ALTER -DRAIN - A Owner Data VALUATION WORKER'S COMPENSATION DE,CLARAI']ON I pemiry oe perjaDeneo following declurmions. ' BACK PLOW PR T DEVIL DRAINS -PLO O, E CO D. d anda (have and will mainwina Certificate ofGonscnl In self Compan- self on, as provided for by Section 37M of the Labor Cade, for the perfar....I— n1 tM1 work for which this perm , is issued. E]i have and will maintain Workers Compensation Insurance, as required by Section STORIES 4 / TYPE CONSTRUCTION Cb FIXTURES- PER RAP - 3700 of the Labor Code, for performance of the work for which flux permit is issued. My Worker'�Qampepyatlommnce come,Policy No and rfr8 r�'Zpjfa Grtler: M WW!! GAS - FA. S 1-1 C.40UT GAS-EA.SYS M- OCC GROUP APN CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE. Goiaacetion need coolbemmpleed ifthe permit is furore hundred dollers($I00) nr le".) GREASL/INDUSTR ASTE INTER EPTOR a p a ty s $BUIhDIN , QI 1510 GREASE TRAP •,FbS, PLANCHECK FEE SEWER-. -S' 1*1: Z ZO Uj F Zoo) z V 0 `k lz. H I certify that in the performance of the work for which this permit is issued, i shall ploy any pern in any mrvnersr as to be m nm emw oe subject m pen- the Workers' Com varies Laws o(Calllornia. Date Applicant ENERGY ME WATt WIVENT/ELECTR GRADING FEE NOTICE. TO APPLICANT: If, after making this Certificate of Exemption, you should become subpart m the Worker's Compensation protmena of the Labor Code, you must forthwith comply with such prov,ious or this permit shall be deemed marked. CONSTRUCTION LENDING AGENCY Thffi ere isa inn tdinK agency For the performance of lhvhconswmlundir, ereby arm u the work for which this permit is issued (See 3097, Civ. C.) WATER SYSTEMn'REAI ING WATER SERVICE SOILS FEB PAID Dam ReceiptN NEW RESIUEN'IIAL PLMD. SQ, FT. TOTAL: O U LIJ Iy m C.)% Lender's Nem, Lenders Address Icedfy that l havemadithspia tan and ,are that the l,... amberrusban is correct. 1 agree te comply with all city and ready ordinances and state l l i ,g mQTY. building constrcua,and hereby authamixampresenlalvesof thscty to enermponthe TOTAL: BUILDING FEE ,s �, _- MECHANICAL P-ERM)T =FEE',' SEISMIC FEE abovementioned property for inspection purpose,. (We) agree to save, indemnify and keep hamdess the City of Cupertino against PERMIT ISSUANCE ELECTRIC Iiabillties,judgmenlr, costs and expenses which may in anyway acemoagainst said City ine vsegaonm of the granting ethic permit. ALTER OR ADD TO MECH. PLUMBING FEE AIR HANDLING UNIT (TO 10,000 CFM) MECHANICALP E APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT SOURCERE .. AIR HANDLING UNIT (OVER 10,000 CFM) CONSTRUC'FIO TAX /�� Sigvomreo ntmemr Dale HAZARDOUS MATERIALS DISCLOSURE EXHAUST 'GOOD (W/DUC'D HOUSING MITIGAION FEE HEATING UNIT (TO 100,000 BTU) Willthe applicant or future bnilding occupanlsmncnr handle haundnustatenal as defined by the Cupertino Municipal Cod, Chapter 9.12, and the Health and Safety Code, Section 25532(a)? HEATING UNIT (OVER 100,000 BI U) ❑Yes Fl No Willthe applinta., futureminnts as bnilding by the B nscea Air Qualityrurau or Manages ement it hazortloue air contaminants as defined by the Bay Area Air Quality Management est s? ❑Yee ❑Na PAID ..- Date Receipt If VENTILATION FAN (SINGLE RESID) BOILER- COMP (311P OR 100,000 BTU) BOILER - COMP (OVER 1(IF000 BTU) AIR CONDITIONER I have mad the hazardous materialsreuirentema under Chapter 6.95 offthe Cali- 9 p ISSUANCE DATE NEW RESIDENTIAL MECH. SQ. Pm ibmia Health & SvfHy Code, Sections 25505, 25533 and 255]4.1 midersmnd Thal Tithe Llhrt itismyrc.f`alhilily moot fy iheacnpam oftherequinnotcurm cane reyairemen hlr ,istiaamee ofa cemE��. �r Ownercrauthorize TOTAL: SSUI BY: OFFICE • Inspection Quer a Specfic Permit 0199 f!ERM"f$lTV 54362 120330 gIT-l"AISTREET STEVENS CRE ELECT 7/1/99 11,100-1-11.1- 7/2/99 JB .units 2 P S4362 20330 STEVENS CRE PLBG— 7/1/99 JB 1 N 54362 20330 STEVENS CRE MECH ---7/l/99 7/1199 7/1/99 JB 2 N S4362 20330 STEVENS CRE FRAME 7/1/99 7/1/99 JB 3 P S�4 - 362 20330 STEVENS CRE SHTRK 7/1/99 —7/1/99 JB-- —1 N §4362 20330 STEVENS CRE ELECT JERRY -T/7/99 7/7/99 A 4 P P §4362 20330 ST—EVENS CRE ELECT DISTRIBU. 7/8/99 7/8/99 JS 3 P 4362 20330 STEVENS CRE GENERATOR — 7/8/99 7/8/99 JS 3P S4362 20330 - STEVENS CRE --CEILING REBAR -- W1 2/99 -— M 2/99 CC —2 15 S4362M30 - STEVENS CRE — 7/12/99 7/ 2/99 CC 2P P SS4362Y0330 STEVENS CRE FRAME -R 7/12/99 -W1 —12/99 &C 2— 0-- S4362 20330 STEVENS CRE ELECT -R 7/12/997/12/99 CC 2P S4362 20330 STEVENS CRE ABV GRID CEILING 7/14/99 --7/-j —4/99 CC-. —1 P -- S4362 20330 - STEVENS ABV GRID ELECT 7/14199 7/14/99 CC 20--- S4362 20330 STEVENS CRE ABV GRID MECH 7114/99 7/14/99 CC 113 54362 20330 - STEVENS CRE S4362 20330 STEVENS CRE REBAR 7/20/997/20—/99 CC-- — — S4362 20330 STEVENS CRE(ROLLOVER) 7/21/99 7/21/99 JB —2 S4362 2633-0 STEVENS CRE PLBG 7/22/99 -7/22/99 A 1 S4362 20330 STEVENS CRE REBAR 7/22/99 7/22/99 JB —1 —H 3 �62 �033O STEVENS CRE REBAR R—EBAR— —PLBG-- 7/26/99 7/26/991CC--30-- S-4-362 20-3-30 ST—EVENS CRE 7/26/99 7/26/99 CC 2P 2 P S4362 20330 STEVENS CRE 2ND FL OCCUPANCY--- 8/19/99 8/19/99 JB 4P 4 P S4362 20330STEVENS CRE PLBG-R —8/24/99 8/-24199 CC- 2 2P P P S4362 20330 STEVENS CRE FRAMING -R —CEILING-- —8/24/99 --6/2-4/99 CC- 2P WPP P S4362 20330 - STEVENS CRE 8/24199 — — 8/24/99 CC 12 P S4362 20330 STEVENS CRE UNDRFLRPLBG ---- 9/9/99 . 9/9/99M— 3P S4362 120330 ST—EVENS CRE JUNDRGRND ELECT 9/9/99 9/9/99 JB 113 S4362 20330 STEVENS CRE ICEILING 9/9/99 —9/9/99 JB 4P S4362 20330 STEVENS CRE PLBG-R �FRAME-R 9/16/99 9/16/99 C C 2P S4362 20330 STEVENS CRE 9/16/99 9/16/99 C 2P S4362 20330 STEVENS CRE 1 --- ELECT -R 9/16/99 -4/— C C 16/99 2P Page 1