Loading...
S 1941 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY ITY OF CUPERTINO RUG,)ING-ELECTRICAL. 1'Eiy`d,�ITND BUILDING DIVISION APPLICATION/PERMIT PLUNnnnG-MECHANICAL V 1941 C BUILDINC`PND,IRC'l'IDEN'CIF'il•A'1'ION BUILDING ADDRESS: SANITARY NO. APPLICATION SUBMTITALDATE .6 s cNs�ic _ Bl - 5 6- O IIRSN yl ��� ���IIG C I CI'Olt'SNAMIr AQ`W �ICNO: �� NIC COMTNOLM CHIrECT/ENGINFER: LIC NO: ADf Olio O� ❑ CONTACT: PHONE: IHUILllINL'PERMIT INFO ❑ Consultant Fees Paid by Applicant(Initial) BLDG EI IV PLUMB MECII © 66 E:] ❑ I.CENseD CON PEACE ORS DIICLARA'I'ION QTY ELIiCTRIC PERMIT I+EE 1 hereby affirm that 1 am licensed matter provisions of Chapmr 9(rommeming JOB DESCRIPTION OW2, wino Section7000hof Division3afne Hasmesa and Professions code, it my license is RESIDENTIAL' WOO PHRMI'f ISSUANCE FUF Aetna, and. r j�',l ❑SFDWI. ❑KD'CIIEN REMODEL �UU Licenxc Lich Al NUANCES-RFSIDENI At, ❑ADDITION El PLUMBING RF-PIPE n 6 U Data Canoe is ARCHITECT'S DECLARATION CMULTI-UNIT III RUCIURAL zo-Z I understand my plans shall be meatus public records PANELS MODIFICATION 07,4-a UPTO 21RAMPS [I INTERIOR ❑CHIMNEY REPAIR F+�_tW Licensed Professional 201-1000AMPS IMPROVI!MFNT SWIMMING POOLS z ;. OWNER-BUILDER UECLARAHON OVER 10o)AMPS [-113AT14 RUMODEUREPAIR QDEMOLITION eC 6/ I M1ereby rflinn that I am,tempt from the Contractor's License Law for the xa O MI U fal4,x'ing reawn.(Section 7031.5,Business and Professions Cade:Any city or conmy SIGNS ELECTRICAL2 Q C1OTHER 1+1 O p which acquires a permit m combruct,alta,improve,demolish,or repair any cartoon price t I I' fth ppl t tl hln (lCI g Ltamcut SI'11CIAL CIRCUIT'/MISC. yotitb I' JI at d : f( Contractor LawIClvpmr9 ¢S COMMERCIAL W 00 that c 6 with Section)land fD' J Ith Business ex don,Profession,Ction If TLNI'.METER GH POLE INST. Q.q o y' that he as exempt zany cep li and the basis for the subjects the p pt Any violation of ❑NEW BLDG/ADDITION ❑DEMOLITION IWC..y Section 70315 by any apphaunforapermit subjects thenpplicam t0 acivil pcnvhy of POWI!R DEVICES [D TENANT ❑FOOD SERVICE vy ant tnamthan da EvohnndreddMlnm[Seto). IMPROVE?MI?NT ^ hua ownernl the property, Inu+s with wages their urn ensatinn, SWIMMING IYNIh ELECTRIC Z ❑ drape c YemP rs E P f- an,itd profdo essions sions Code:auddihe Con:is tot inmaed or Law doesm of apply[I)an owner of ❑O'THI?R 3 ss m and I•mfmsi.ns Cadc:The Contractors License Law lows not apply m an owner of OVI'LfSS-SWITCHES-PI%'TURFS his ,,,y who baian a improves thereon,and who Jens o uM1 work himxelf or through 11 his awn ctnpinyecs,pmviJW tM1m such Imry'nvcnwnta mount role Id! ser ldramn five NI!W IIESIDIiN1'IAh IiLEC!'ll SQ IT. sats.IL M1nwever,the building or itnpmvemem is sold within nuc year cel'cmnvetforlive m- SQ.Irl'.Ph0012 A14IiA S/SQ.I•T. poncr lmrlder will have the burden of proving that he did not build or improve for duo ne saleJ. 7D ❑ Las owner nl she prnpeny,ices exclusively contracting with IsW summer,m cnmmcmL: mxlmet the p lecl(Sc,.7044,Baainexa and p...F,,inan Cm ca Tnu Civ....--s I.i. ecru,Law ancient apply to anowaerofpmpmy who builds of impmvea mcrea.,and QTY. PLUMBING PERMIT FEE sshn contracts for such projects wish a eonaaeuu(s)licensed pursuanuo the Contractor License Law. PERMIT ISSUANCE Inmosiane, der Scc. ,B&P C bbrmix reason OwnerWin At:[FIR-DRAIN&VHNT-WKI'HR(EA) VALUATION WORKER'S COMPENSATION DECLARATION RACK PLOW IROTIC1.DEVICE 1 hereby affirm under penalty of Perjury one of the following are Wr,kcr,declarations: _ Ihave and provide,] in,b i neCenificme ofCn1-abo, oG.I...(fm Wmker'aonmpem DRAINS-FLOOR.R(R)EAHIIA,COND. smian,ns pmviJul fur by Sactiun 371p of the Latnor CnJe,for the perlimtnuncn of the 5'1'0111 FS 'I'YI'H CONSTRUCTION work In,which his p.it is issued. FIXTURES-PER'I'RAP ❑1 have and rill mammin Workers Compensation Inenmnce,as required by Section P(Nl nfthe LvN,r Cade for the performance of the wairk fur which this permit is issued. GAS-EA.SYS'ITM-IINCAOU'I'LFCS OCC.GROUP APN Carrier °'npa"mu COMPENSATION anw ourricr Poky nyal DFi/ My Worker' C 6`� p Policy NO.: 2 r/�Y�l GA5-EA.SYS'I'BN1-OVRR 411!A) CERTIFICATE O EXEM PITON FROM WORKERS' GHI!ASFJINDUtiI'RI.WASTE INTERCEPTOR'ENSATION INSURANCE RUILDINDDIVISIO_NITES (This sermon need not M1ecompleed flhe permit is fnrommufirodollaciShXB GREASETRAP X nr lcvx.) I'hANCHLCK PEE Icenify that in the poo nnnance ofihe work forwhich fln,emod is issued,lehnll SEWER ANI'I'AltY-STOHNI EA.21N)IT. not employ any person in any manner sn as u,become subjcn m the Waders'Cole.- IiNI:RGY FI?E O Z satin.Lars of C.Iifumia.Date WA'IT:R HEATER W/VENT/EU!CIR FEE O Applicant GRADING F q NOTICE TO APPLICANT':If,after making this Ceniliuntte of Esemptlon,yr.shun Id WAI'lilt SYSTIF MIT REAl INO hecnme abject I, air Workers Compenvicam pm,kimna of he Labor Code,you must SOILS PEE W fimboomcomply with such Emissionsonhis prrail,hrill nc decmalousoked. WAFER SERVICE Q CONS]HOC[it ac ON LENDING AGENCY NEW RF,SIDEN'IIAI.PCMB. SQ.FT. PAID O D41c ItawciptX 1 hereby allirm that thrn:is a cannruetiun landing agency for the 1NHnnwncc nl the work for which this pem+il is isxaed(Sec.3WO,Civ.CJ LL y Conder,,Name TOTAL: O V Lentos AdJrcss TRIAL: 1 ceniry that I have read this application and sate that the vk,,c iofoonuumn iv BUILDING Pli gl�F. A cnfinet.I agree to comply with all city and manly ordia:mecs and some laws relating m QTY. MECHANICAL.PERMIT FIiE Z building comuntation. ad M1ereby aumoriu reprcsemativenofihth is city toenmr.fam e SEISMIC FEEC `+ aMrvrmemimed property,fur inspection puary+ses' PERMIT ISSUANCE (we)agree ,,save,indemnify and keep baml resx the City of Caper inn against IiLECfRIC FEE liabllhics,jud'event..acts and expenses which may in any way neem,against said City ALI'fit OR ADD10 MECII. 'on....race of the grunting ni'ou,pmmiL PLUMPING FEE: APPLICANT'Ubli ERSTANDS NO WE I.COMPLY WITH ALL NON-POINT AIR HANDLING UNI'f(TG 10.000 CFM) MECHANICAL FEE SOURCE RF S AIH HANDLING UNI'1'(OVI?k IQ[NN]CPM) CONSTRUCTION TAX Igna are o AppllmmUCnnt fur Dam GXHAUS'C IIOOOIW/DUC91 HOUSING MIJ'ICATIONI§?E HAZA DOHS AT.1ALS LdSURB Will theappliesuat furore lwildingaKi,foutsmmor handle h...Mean material HEATING UNIT 0`0 100,1100 I3'HE av defined Fy ma Cupertino Municipal Cade,Chapter 9,12,and he Heallh and Safety Codr,Section 25512(a)? 11171%1 INC.ONE I( EVER 1fid.no 1 RTU) ❑Yes [-1 No VIiNTILATION PAN(SINGLE HI!SID) PAID Dam RneipaX Will the applicant or loaf,building aceupant use equipment or testees gewhich .mmJam it hntair conmminann as defined by the Bay Arca Air Quality MamamentBOILER-COMP IJHP OR IfN)dNN)BTU) 101 Dlntrict] r ❑Yes No 8011.1!R-COMI'((1VER 100.000 BTU) I have read the humorous materials requirements under ChapterAIR CONDITIONER6.95 of the Cal �) ISSUANCE DA9'li /////� forma Health&Safety Code,Sections 25505,25533 and 25514.1 anderxetnd that if the N13W RHSIDEN'I'[A],MECII SQ.[IT / p building does not e yy eptly have a mn.nf,thm It is my reg+nnxihility to nmify the awutpunt S of the mqui rtbwhich a h c ii fa.isxuaun:ofuCcnilice Olc/3/tpyunpcy: �y q U "aa,i u'. agent Data k TOTAL: ISSUED BY: ✓� OFFICE e L e ATl.OKFOR'-'BUlLDlHG:PERolT' F I UNDERF le No OO 1 96, U ? I I Plot miI ii .......6 T, ELECI' SERVICE f lm It II VOU&,of Improv Pro�jG6 Me,en Jig; U� E 6 �RGR06N6-. FLEES p R 00 6 IV I kjNG" -,'Address o!f I NISI 'WIRING p I x t ....... U.'RI ehope ff wi 6 T-6 AL L pp,eV. J ........ .. 7 APO-(CATION F ELECTRICAL PERMIT J D,o F _Z6 UNDERGROUND _ '1 �C m Adil I:e s s PARTIAL ROUGH— - :NtVI C:H' WILLIAM D. r3E.. "ROUGH COMPLETE. A' roved (I VA ,':APPLICATION FOR PLUMBING & GAS PERMIT Data .966 GAS FEES _V GAS p I PIRG '.PLUMBING FEE S IC 7, S-S r.INAf-. Z:2 Ajd misc 3 t. 'L I c. 2-. misc AP prove APPJICATION-FOR APPLIANCEPERM# 'y E -7 77777r.77777 J'i6 E$ Y _V X, NiA MIA w" �'Z,0 UILDIN WK ZAPPC TOIn` 0!4'A X') FRAMES AfFj�W A T�4&'PLA TER FINALNs CTOR ATE Z, 4pp1knIi.n is 7— f�7%77 OL, ELECTRICAL DATE , NOPE bm :: UNDERGROUND 0 A T E t 0 T OR �e iij Vol . -k m �:Ntspcc TOR FEES m FINISH WIFtIHG' b "S C TO!" OWitlf tu R,E m A T I ;,Cobtt r .69 ATE"A T 9 -PE;ion. uut- � y�t� C�aA�st w,. r�� S "'PLO 6�I G APPLY -UNDERGROUND A T n INSP¢c I.R Ti PART IAL ROUGH C. ir. L O'ATfiIN 5 RRC OR k dU GH COMMPLETE Phone OATIM I F a c I OR A A 11 I?A T MINST C�" GASP1PING API GATE INS P,CT04 A L . I :6.I. .- 196 DATE. 11`14 P EC T 0. MitC DATE INSPECTOR :c on IN 17M."F DATIZ TOM APPLIANCE c on1r.. ht I S DATE,m MIsSC tk I.1,I- APPLICATION FOR-BUILDING,PERMIT CITYOF:CUPEATIHOi 7". Z' sdnIt.'y IN 01 41 z dq _UNDERFLOORS_ Application I. M1erebt mode-forli Perm to :FRAME -JFCA$T 6p Al .......ln:nccor ance,1,1A�Pibi'pid' (Plane-ohd's e, M(icollo led hprdlait . .0mlad Volvo aV ihprovia Z' pIqA check 7 j .nfr tat, L FINISHED,Wlkl Approved pP, Y.d 0 _T_ :Z OR '� ( erg q ' r APPLICATION PLiCATION FOwi!uCTkIGALPERMIT FEE$ Cie- A BAcK.'rLow f ANITAR'( H, U NDERGROU Approvild PARTIALRO APPLICATION FOR PLUMBING GAS PERMIT -Dom 19G GAS FEE MAiN DRAIN. PLUMBING FEE $ 4 FINA L P L OG fir` CoNr Addr..s FINAL'GAS_ swo FINAL A.RPL 777 11 A ppr ovu d APPLICATION FOR A PFLIA NCEr PERMIT 6 .Z L 'M 15 14 1 S 0 1 M I t it 'z ',.'1: $Y:'S'.'�n�",,.�. h"y"xy' pi..Hµf`y-.d "•,l '�tyy4<'a• (''' k' `tip i'1S x1.Hv >�'41�A3 �5N. - All +`+'"'; „ , Y aR�CORDOF INb�'pC�10y APPI{OVT�LS � k , +a ' ti wNr .3 r, w y �r } �\ t +• € N l i 5: v w n _y1r 5,� � �"3 .+. i 1�.`y'+ },?`c\h ',.Y y •4._' '2. K .Ort l 4 � ..,� '.A. •l t ,� :. 3h,. 4 ` f 4�DATS,F h ;FOUOwl ION V v UNOERFLOOR 'S .;tii, .FRAME _ Y ` LATH d PLASTER �GRAbINb FINAL 'kjNAi euoG � • v ` i DAA E'� INSf^ �TSR _ n115C _! : ,UtfDERGROUNDAOUur,_ ROUGI WIRING ;� FINISHER WIRING � �- _J �� FI%TURES`. • MOTORS " F,-'--.IVAL b Q 3: al PLUMBING, GA5 & APPLIAMC E -i DAT c'� IN SP EC TOH " MISC BACK PLOW REO SANITARY N0. ' UNDERGRbUND'R OU GH { y PI R TI A L,ROUGH ROUGH COMPLETE _ _-..-- MAIN DRAIN FINAL PLBO r 4 JI + F INA L'A'P PL IA NCE x v i LTA 1 F'. INBV E 7MISC \ Y T� L%�'.•$�iYnlr..l.. 'Al.�� fY '.V4' `k ul x' A ..w.,P«u i.H 3.A '1c`Y �" AIt R". +;i l h