19600APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALL POINT PEN ONLY
Building Pr.'ect Identification
Building Address
PERMIT NO.
19600
10100 Torre Ve. Parkin Gara e
nese a Ye Phone:
Ta r roperties
_
CITY OF CUPERTINO-BUILDINGDIVISION
APPLICATION I PERMIT
BUILDING-E.ECTRICAGPLUMBING-MECHAMCAL
5/10/90
Comtratlm
or'.Nme: Lk. No:
738-4444
CATEGORY
NTROL
CO.
Architect/Engineer: Lk. Na
QTY ELECTRIC PERMIT FEE
BUILDING PERMIT INFO
MELH
Add.
Ill ELI� PLUMB
IQI ❑
I�J LN
PERMITISSUANCE
LICENSED CONTRACTOR'S DECLARATION
-
I hereby affirm that l am licensed under provisions of Chapter 9(commeno-
fngwlth Se m7000)of DivIwd3 ofthe Busiuvand ProfessionsCode,andm
APPHANCFSRESIDENI7AL
)OB DESCRIPTION
license is in full form and effect.
PANELS
LicenseClass It. 8-S(j
Data Gonlranor
UP TO 200AMPS
PARKING GARAGE
201"1000 AMPS
ARCHITECTS DECLARATION
I understand my plans shall be used u public records.
OVERIOOOAMPS
SQ. FT. FLOOR AREA
S/SQ. FT.
SIGNSELECTRICAL "
Licensed Profcssionsl
OWNER -BUILDER DECLARATION
I hereby affirm Mut I amezempt from the Contractor's License Law forthe
117,000
38.87
SPECWLCIRCUIT/MISC
TEMP. METER OR POLE INST.
following rean.(Section 70315, Buslnero and Professions Code: Any city or
m
county which mqulma permit to tomtruct, alter, Improve, dem.ibh,orrepair
any stmdom prior to Its Issuance, also requires the applicant for such permit to
file a signed statement that W Is licensed pursuant to the provisions of the
Contractor's License Law (Chapter 9 (commencing with Section 7000) of Divi-
Aon 3.ftha Buslnemm and Pr f.i.. Code).,that he is exempt thmef a mond
POWER DEVICES
SWIMMING POOL ELECTRICall
VALUATION
the basis for Me alleged exemption. Any violation of Section 7031.5 by any
no
applicant fora perenit subjects the applicant to a civil penalty of t crew than
1XIV OUTLETSSWITCHFSFIXMtES 00
$4,547,790.00
NEW RESIDENTIAL ELECTR
five hundred dollars (SM.
n I, as owner of the property, or my employees with wages a. their sole
STORIES
TYPE CONSTRUCTION
mmpensat(on, wBl do the work and the structure Is net intended or offered for
eek (Sec 7044, Butlneas and Professions Code: The Contractor's License Law
^/--
1
docs not apply to an owner of property who Wilds or improves thereon, and
who dace such work himself orlhrwgh hisown employees, provided that such
Improvements are not intended oroffered for sale. If, however, the building or
Improvement b sold within oneyearofcompletion, the owner-builderwill have
TAL: (�
OCC.GROUP
RES. UNITS
tliii.iiurden of proving that he did not build or Improve for purpose of sale.).
u L as owner of the property, am exclusively contraeing with licensed
contractors to construct the project (Sm 7044, Business a rad Profeadom Code;
QTY. PLUMBING FERMI FEE
FLOOD ZONE
APN
PERMIT ISSUANCE oC
The Contractor's License Law don not apply to an owner of property who
Wilds or imprevn thereon, and who contracts for much pSojects with a
onaItttorp)Banxd pursuant to the Contractor's Linn. I.
I am exempt under Sec B k P C for this reason
ALTER -DRAIN &VENT -WATER (EA)
FEE SUMMARY
BACK FIAWPROTECT.DEVICE
' O DRAINS FLOOR ROOF, AREA, COND. 0 e8
SANITARY RFGERTB
Owner Date
WORKMAN COMPENSATION DECLARATION
Ell hereby affirm that I have a adficate of consent to .161nmre, or a
certificate of Worken'Comperaatim Insurance ma mdffeil copy themof (Sec.
3800,Lab C.)
Pol'ry a
p0( TURES, PER TRAP
SCHOOLTAX Y_ N_
RECEIPT #
GAS EA. SYSTEM -1 ING4 OUTLETS
PARK FEE Y_ N_
RECEIPT a
GAS EA. SYSTEM -OVER 4 (EA)
Co�any
BUILDING DIVISION FEES
](led copy la herebyfurnished.GREASE/INDUSTRL
crtlRd mpyb(Ikd with the tlty inspection division. '
WASTE INTERCEPTOR
PLANCHECK FEE
GREASE TRAP
CERTIFICATE OF EXEMPTION FROM WOR KERS'
PAID
/ gEVBg.gAMTAAY-STORM EA. 200FT. 2-00
jJ (�
COMPENSATION INSURANCE
(This section need not W completed lithe permit bfor one hundred dollars
Date Remi t#
WATER HEATER W/VENT/ELECTR
ENERGY FEE Y N
($1070orless.)
I certify that In the performance of thework forwhlch this permit is issued,
WATER SY57Ed/iRFAnNC
I shall not employ any person in any manner m n to become subject to the
Workers'Comptmati n Laws.( California. Date
PAID
Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you
should become subject to the Workers' Compensation providers; of the Labor
NEW RESIDENTIAL PLMB. SQ.T.
Date Remi t#
TOTAL
BUILDING ,635.5
FEE
Code, you must forthwith comply with such provisions or th is permit shall be_
deemed revoked.
CONSTRUCTION LENDING AGENCY
SEISMIC FEE 682.1
I hereby affirm that them Is aceramudim lendingagency for the perform-
ance of the work for whicblec
h this permit Is issued (S. 3097, Civ. C.)
Lender's Name
Lendre.Addreas
I certifythatl have mad thbappllcationand statethat theaboveinformation
hmm:ct. I agree to complywlth all city and county ordinances and state laws
TOTAL:Qp
ELECTRIC FEE
PLUMBING FEE
MECHANICAL PERMIT FEE
MECHANICAL PEE
IT ISSUANCE
FEES PAID:
relating to buildiag construction, and hereby authorize representatives of this
city to enterupon the above-mentlomd property for inspection purposes.
(We) agree to move, indemnify and keep harmless the City of Cupertino
against Babmunm expe. which may In anywayaccoue
, Judgment, csand nse
Date RCCelpt#
AL ORADDTOMECH.
AIR HAN NG I1M7 ('X010,000 CPM)
SUBTOTAL: /I ADJ
.galnsl uld ity I. an o the rating of this permit.
S��
AIR HANDL UNIT(OVER I0,000c)
CONSTRUCTIONTAX
Slgnatureof Applicant/Contractor k
IXHAUSFHO0D DUCp
CONSTRUCTION TAX PAID:
HAZARDOUS MA ALS DISCLOSURE
HEATING UNIT (TO 1(p, OB
Will the applicant or future building ompantm.. or handle hazardous
material as defined by the Cupertino Municipal Code, Chapter 933 and the
Health and Safety Code Section 25532(a)7
❑ Yes r] No
Date RCcei [#
HEATING UNIT (OVER 1 Alinii
TOTAL: a
VENTILATION PAN qKGLE )
ISSUAN5 DATE
Will the applicant or forum building occupant use equipment or devices
which emit hazardous air contaminants as defined by the Bay Area Air
Quality Management District7
4Yea ❑❑ No
have read the bazard..,material, requTrerrenb ander Qhapler 6.95 of
the Ca Vernla Health& Safety Code, Sections 25505, 25533 and 25534. I
understand that if the Wilding does net currently have a tenant, that it6my
flfl`''aM1l�.P
y q
i ,. t fl „) 19 J0
t"
BOILER -COMPO OR100,0MB
BORERCO. (OVLR 100,000 OTU)
NEW ENTIAL MECA.
responsibility to notify the occupant of the requirements which must Wmet
city O} CIIDRItiBp
prior to laws nee of a Certificate of Ompa ney.
ISSUED BY:_- a6
Owner or authodred agent Date
TOTAL:
_1k"
OFFICE COPY