29553 ° APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY -
CITYOFCUPERTINO - BUILDING-ELL+CTRICALPERMIT NO.
BUILDING DIVISION APPLICATIONIPERMIT PLUMBING-MECBANICA /,Y A C] C C
BUILDING PROJECT IDENTIFICATION 29553
J 5 J
BUILDINGADDRESSSANITARY NO. APPLICATION SUBMU7ALDATE
O N' :S A E: / NE:_, CONTRACTOR'S NAME: - N
N pAD ENRILCg� �/ (� /( NIC CONTROL#
A(t [ITiCf/[iNfiJNEER: _ I I/ C ^O) / C Y— E ' /- {�-C.4 - ❑
CONTACT: (� PHONE: ❑ Consultant Fees Paid by Applicant(Initial) ADO BUILDING PF�LUMIT IIL, MECH
LYLE Silt I+h yog'1 y/-u2aR
o ❑ ❑
- LICENSED CONnsed under P DECLARATION QTy ELECTRIC PERMIT FEE
1 hereby affirm that 1 ant licensed Ba under provisions of Chaptu 9(commencing JOB ESCRIPTION
Q0'Z with Section 9001p of Division3 of the Businean end Professions C.db,.ndLL licLnscis
0O y PERMITISSUANCE RESIDENTIAL•
<UUin full tone and after,
License Lic.# ❑SFDWL ❑KITCHEN REMODEL
S WM Dam Carmsem .APPLIANCES-RESIDENTIAL ❑ADDITION El PLUMBING RE-PIPE
ARCHITECT'SDECLARATION I ❑MULTI-UNIT ❑STRUCTURAL
FSr�
Z p y�7 1 underhand my plans shall be used as public rumrdPANELS s MODIFICATION
�L�.�'
Oz- UPT02W AMPS ❑INTERIOR ❑CHIMNEY REPAIR.
w menses Prefivaitent 2ol-It10oAMP5 - - IMPROVEMENT
a'••I ♦' r OWNER-BUILDERmDECLARATION OVER IWO AMPS ❑BATH REMODEUREPAIR I]DEm6LIT10N
a ng per o affirm that Pum vacantfroma the Coaitsp,C s License Law for the
RIO per, following rasom(Section N3LS,Business and'Pmfeselons Code;Any shy termarry SIGNSELECCRICAL ❑OTHER
4 FrwMch revuir4 a parol[m oonswet,neer,improve.demolish,or repair any structure
�O3 prior to its issuance.almorditire,the uppliam formch pemtit to lila a signed haremcnt SPECI AL C I RCUIT/MISC.
pr that ha,licensed fammanoshe provisions aide,Contractor's License Law(Chipter
�� u 9(commencing with Section 7")of Division 3 ofthe Business and Professions Coitoor TEMP.METER OR POLE INST. - COMMERCIAL: '
d e fB that he Is exempt therefrom and the basis for the alleged exemption.Any vlolntion of El- ❑NEW BLDG/ADDITION DEMOLITION
kxy I+• Section 7031.5 by any applicant for a permit subjects the applicant a a cLOI penalty of POWER DEV ICES
❑TENANT ❑FOOD SERVICE
not more owner
five hundred seldom y employees
IMPROVEME
��� ❑ 1,as owner ,and penarro mmyemntende with wages oed .their Sec.compensation, SWIMMING P001.ELECTRIC r
will dothework,and Uteee oreisnots intendedoffdoss,,,apply oar Puniness ❑OTHER
and sly who
Crib The Contractors Laid w Lawdoesnotapplytolf owner of OUTLETS-SWITCHES-FIXTURES
propeny who build,or improve,thereon,vend who doer such work himself or through
' his own employees,provided that such improvements are not intended or oRuul for NEW RF.SIDP,NTIAL ELBCfR SQ PI'.
sale.If,however,the building or improvement is sold within one year ofcomppoon,the SQ.Ff,FLOOR AREA $/SQ.PC
her-huilder will have the burden of proving that he did not build or improve for par-
D 1,as owner of the propeny,am exclusively contracting with licensed contractors to T
construct the project(Sea 9044,Business and Professions Coda:)The Contractor's Li- '
-cense Law does not applymen awnewfpropaay wen builds nrimproves thereon,end QTY. PLUMBING PERMIT FEE
who contracts for such products with u amonoha(s)licensed pursuant to No Comencmrs
License Loss - PERMIT ISSUANCE
❑Ism exemrSec.iatess ,B&P C for this reason
Owner Date ALTER-DR IN YxT
-WATER(EA) VALUATION
WORKER'S COMPENSATION DECLARATION BACK FLOWPt6KQTDEVICE '
1 hereby affirm Linder penalty of perjury one of the following declarations:
. � ❑I lacrimal will maintainaCenii.roof Conseanoself-insure for Wmkc/s Compen- DRAINS-FLOOR,ROOF EA,COND, ,STORIES TYPE CONSTRUCTION
sution,as provided for by Section 3900 of the Labor Code,for the performance of the
work for which this pemna is kmed, FIXTURES-PER TRAP
1 have and will maintain Worker's Compencition Insurance,as miltu nl by Section "
3700ofthb Labor Code,forthe performanccolthe work for which this permit is issued GAS-EA.SYSTE C.4 fL OCC.GROUP APN
My Workers Compensation Insurance artier and Policy number am:
Canner: Policy No.: GAS-EA,SYSTEM-OV. 4
CERTIFICATE OF EXEMPOON FROM WORKERS' GREASFJINDUSTRL WASTF.1 P K
t COMPENSATION INSURANCE _ UILDINGDN(SIpN.FEP.S'
'(fhie sution reedit bo completed On to,permit is fortune hundred dollen,($100) GREASETRAP or less.) - PLANCHECK FEE 7—
• Ioertify lM1m in lM1epufarlF
mance ofthe work for which this permit is issued,l shall SEWER-SANITARY-STORMEA.200
moa employ any person in any manner ro as m hecnme subject m the Workers'Compen- ENERGY FEE
,7., satins Laws of Califomia.Date
a) Applicant WATER HEATER WNENT/ELECTR GRADING FEE-
NOTICE TO APPLICANT.If,after making this Cenifcate of Exemption,you.should WATER SYSTENU REATING
a hecome subject to the Worker's Compensation provisions of the Labor Code,you must SOILS FEE '
forthwith dumply with such provisions or this permit shall be deemedrevoked. WATERSERVICE '
CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PUSH. SQ.FT PAID
V Q Thereby affirm that there isaconstmetion lending agency for theperformancerd Dam - Receipt it
V. (~ the work for which this Permit is issued(Sec.3097,Civ.Cd I -
0 'Leader's Name TOTAL:
WLender's Address - TOTAL:
CL 1 certify that i have read this application and state that the ahnee information is BUILDING FEE
f7A correct I agree to comply with all city and county in inances and stare lows relating to QTY, MECHANICAL PERMIT FEE
V r� building consumption,and hereby authorize rcprexenmtives of dd,ily incineration the SEISMIC FEE'
above-mentioned property fni inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against PERMIT ISSUANCE - ELECTRIC FEE
liabilities,judgments,repassed expenses which may in any way accrue against said City ALTER OR ADD TO MECH. "
-In umeeeneepof me granting of this permit. PLUMBING FEE ,
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT TO 10.000 CFM) _
SOURCE REGULATIONS. iMECHANICAL FEE n
AIR HANDLING UNIT(OVER 10,000 CFM)
CONS RI ON TAX '
Signature of ApplicanUContmrnmr Date EXHAUST HOOD(W/DUCT) SI 'LIGATION PEE
HAZARDOUS MATERIALS DISCLOSURE -p
Willtheapplicnator future buildatista emistore or handle hosannas material HEATING UNIT(TO❑AI,000 BTU) JBV�
as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety ,Wu o.,6
Calc,Section 25532(a)2 HEATING UNIT(OVER 100,000 BI U)
❑Yes I]No VENTILATION FANS INGLB RESID) - 'PAID
-
Will applicant m future building occupant ore equipment fl devices which -
Date Reoeipi#
nithazuNoul unairconmmimmsasdefiedbytheBzyArcaAirQualityManagement ROILF.R'-COMP(1HP OR'1 W,OW BTU) -
tatna9 TOTAL:
BOILER 100,001ORTU)
E]Yea []No . -
I have read the homrdoes mmerialsremeaterts under Chapter 695 of the Cali- AIR CONDITIONER
9. ISSUANCE DATE
fomia bHealthuilding
no Safety GWe,Sections 25505,25533 and 25534.1 understand that it NEW RBSIDHNTIAI.SUCH. SQ.PC. ' p
of thong prurient
notcurrentlyis hich must bemettenant,thafor o is my responsibility fficateto notifyoOcc pccupam G
' of the requirements which must be mea prionolssumcenfu Cenificateof Occupancy. G
Owneroraathorizedagena - ,Dote f TOTAL: ISSU BY:
OFFICE
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$ 1996 SA v I NCS 5 B/k\N K
c 1INSPEC DEPARTMENT
I Flui
TION � �E: NpTt p APPROVED BY: DRAWN BY
LOG. CITY OF CUPERTINO
REVQED-
�� OFFICE COPY SIGN +ENf�E�2a19
°$ A
C• -` - DRAWING NUMBER
- n:a rRvno w Ra were pEAII.RIwr. - _ - _ • - - _ - --- �tt, - - _ - - - _ - - . _ .. - - - _ - _ - _- _
00c
10300 Torre Avenue
Cupertino,CA 95014
oil,
Cupertill0 Building Division
(408)777-3228
(408)777-3333 (fax)
January 22, 1996
United Savings Bank
20510 Stevens Creek Blvd
Cupertino, California 95014
SUBJECT Permit: #29553, Electric for sign
Dear Homeowner:
We have been cleaning out our files in the Building Department, and contacting those
people with permits which have remained "open".
• According to our inspection records, the subject permit has never been finaled. Many
times an inspector will sign the permit.in the field, but neglect to report all of the
information to the clerical staff for input into the computer. If your records show the
subject permit as finaled, would you please contact us so we may complete our records?
If the permit is not signed off your permit can be reactivated and an inspection could be
scheduled for final closure of the permit
If we do not hear from you within ten (10) working days, we will dispose of the file and
remove the records from our computer.
Thank you for your assistance.
Sincerely,
CITY OF CUPERTINO
Christy Akatiff, Administrative Clerk
•
RTHWEST SIGN &LIGHTING 4084391596 P. 02.
TI %,nIP".KU NMAM I-HUNT OF BUILD tNz
[C.rrY bR—UPERTINO PERMITNO.
SANITARY.N0. APPI,I ,A IT)tj,i�IBMI DAT
N
THONE: CONTRACTOR'S NAME:
COWEN,0
IT, 71AINCIINMIR! LICNO: .....
ADDRESS:
............ .. .......
A
--dW ECTIONS: -D COn$1-114"f Fc"P;,(-1 bt,A;-,�ii ti-.J;:j PI -Wwmw;gaw
0 C3
�10 PBq ......
I POUNI)ATION/PlERS/H.D.S. INSPECTION RE(:OF.I)
i -- JOH ON
1 t;".R UTIOUND NOTE: ALL GRADING AND DRAINAGE
PAQM81'86WK,CERT SHALL BE INSTALLED 10 COMPLY WITH D svuwf- rl KITCHEN REMODEL
THE APPROVED PLANS A'qf) CITY 1,)F rIADDITION 2 I'LLIMSING MPIPE
I GARAGI!iSLAIWPREGUNITE CUPERTINO STANDARDS. UMO.TI-LINIT r$7RUCTURAL
RETE 04M
0 , 1. 'ICHIMNEY REPAIR
-—----- MODIPICAIIDN
TO ARRANGE INSPEC.1 ION
uNbegrjROUNDISLAB CALL AFTERNOONS 11;11 . 4:411) VMI IMPROVEMENT
I . P�IIAfII REM006DREPAIR L*j i)pmni,mnN
777-3228 MONDAYTO FIZ I DAY 2411(':U RS 13 F- LIJ f)-rljF.k
ILII?LI'�1j;iC 91 FORE REQUIRED INSPECTION. 1014 ADDRESS
QgR.VNTtAp AND PERMIT#ARE NEeDED WI IRN PI ION ING.
MN
TT7rFPII I(IRS)
'RFOXWORK ON F.J IHNANT r..l Foon SERVICE
-------- NO PERSON(S)SHALL PH IM
THIS JOB SITE WITHOUT 131 ENG IN COM- Omiin
ELECTRICAL PLIANCEWITH WORKr,.R*.N'(:.()MPENSjV'ri'ON I
FRAM6NC VENTS INSURANCE REQUIREMENTS.
INSPECTION SPFCIAI j7VECTION RE(A)TRED I.J DATE INSP.
BIC.00RUIJI'D„ IAS ,$B' �SJONER.;
kOOF,
.................-
PIXIMIM;
TUBS&,,SHOWER PAN
Ti-T"c5.ZR("Z130OL BOND
IRAM NO IS TA I RS/E.EGRESS
FSt11A1R)N/VENTILATIONWRUNTIL40sgoXTERIAL 5HFAP.IHOLD DOWN
INTERIOR SHEAR/HOLD DOWN
SHEh7WROCKISHEETROICKSHFAR ..........
I.Lix FFRI�)R iAl CREED
SHOWER JATH
KSTEP IN%
A BOW ....... .............
. .
SCRATIll COAT
SEWERAVAl ER
OCCURANCY
ELLC
0AST'IMT
.(;RAI)F.
FIRE
H1NUIt A(
rLECT,'TrAl, J V-1
PLQ.NIIIJ.1NO
MECHANY'Al.
XIT OF OC
TIC COVANCY I I
VI§U&PINAI.ONLY
' BUILUV4>j
IMPORY'V4I ISSUANCE DA
PLEASE READ REVERSE SIDE, BEFORE
NnRTHWFST CTGN RITGHTTNG 4RR4XR1MgA P- R1
NORTHWEST SIGN & LIGHTING
TO: k(,LLS .e
FROM. fZcc,fL- S
Northwest Sign �Lighting
g 8 9
DATE:
SUBJECT: T t.
✓f C..
Ir
FAX NUMBER: -7-)'1-3333
NUMBER OF PAGES (including cover sheet)
•".;. COMMENTS:
C� AtsT74P-
pg.1
C.wr,/f�ce.iVOY ►+ ii
�,.�. i.ti„ 9 ,5 4,� ti � [3,•>7��.
1 7 K cJ40 t,,)171,) /4" ,/ �);;.�f�•:S / l�U�.
L
L w ✓f-i �. i (tee
IF YOU SHOULD HAVE ANY PROBLEMS wrrH THIS TRANS OM,
PLEASE CALL 408 4484691.