20326APPLICANT TO FILL IN. INFORMATION WITHIN'RED LINES —USE BALL POINT PEN ONLY
Building project Identification -
Building Add.;
PERMIT NO.
6
10100 Torre Ave. Unit 126 (D1:1)
2 0 3.2
eraName: phane.APPLICATION
TownCenter Properties
—
CITY OF CUPERTINO-BUILDING DIVISION
APPLICATION I PERMIT
SURMI1 I AL DA IL
5/09/90
Contractor's Name: Lie. No:
—
BULDINGELECTRICA PLUMBING -MECHANICAL
CATEGORY
CONTROLX
Architect/Englmer. Lic. Na
6TY' ` ELECTRIC PERMIT PEE
BUILDING PERMIT INFO
Address:
�d E a
1—�
PERMITISSUANCE 1'2
LICENSED CONTRACTOR'SunderDECLARATION
Ihereby hScdIo 70aBof Ivcre RcensMundeameaeaonsofChapter 9 sudonsCodeanene
Ingwtihs1. ME force and eWon3 ofthe ButlnedwdProfmstaneCude,and my
license le !oil (oras and disci.
AI'1'LIANCFSRESIDENf1AL
JOB DESCRIPTION
1►
PANELS
ie
Llrense Clan Lk.M
Date Contndor
701-1030 AMPS
ARCHITECTS DECLARATION
(understand my place shalibe used as publlcrecmds.
OVER 1000 AMPS
SQ. FT. FLOOR AREA
$/SQ. FT.
SIGNS ELECTRICAL
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby af0rmthst I am e.empf from the Contractor's License Law f¢ the
followegreason.Godlan7891.5, Buslnesand Professions Cade: Anydtyor
cam my which requ fres a permit tc oostmct, alter, Improve, demolish, or eepal r
anystmd mpdortoltshmance,aborequimstheoppli¢ntfwsuchper tto
file a signed statement that he is ltmnwd pursuant to the providers of the
Contracues License Law (Chapter 9(commencing with Section 700() of Divi-
slon3 ofthe Businessand Profeslons Code)orthat he hesempt therefromantl
669
74.92
SPFLIALCIXCUT/MIST
TEMP METIRORPOLEINST.
POWER DEVICES
SWIMMING POOL ELECTRIC
VALUATION
thebash for the alleged exemption. Any violation of Se tion 78315 by any
applicant fora permit subjects the applicantm a civil penalty of no morethan
five hundred dollars ($500).
❑I, as owner of the property, or my employees with wages as their sola
OUTLETSSWITCHESFfXNRES
50 121 . ��
NEW RESIDENTIAL ELECTR SQJ1r.
STORIES
TYPE CONSTRUCTION
compensation, will do the work and the stmeture is not Intended or offered for
sh (Sec 7654, Business and Prefedlow Code: The Contractor's License law
V—N
does net apply to an owner of property who Wilde or Improves thereon,and
docs such work himself or through his own employee., provided that such
OCC.CROIII'
RF3 UNITS
Improvements are net Intended aroffered fordle. If,however,thebuildingor
Improvementhwldwlthlnowyearofcompldion,theowner-b Werwilllove
TOTAL:
',! �tPLUMBING PERMIT FEE
R_3
'
ttlgl�urden of proving that he, did notbullelorlmpeme for purpose ofdk.).
u I, as owner of the property, am exclusively contracting with licensed
contractors to wutrut the project (Sec. 7014, Bushes ios and ProfedCode:
O}y,
p�M1.I. rat r,U.ICE
FIADDTDNE
APN
The Contractor's License Law does not apply to an owner of property who
Wilds or Improves thereon, and who contracts for such pW*u with a
cgB(pdor(e) Bcensed pursuant to the Contractor's License Law.
LI I am exempt under Sea B & P C for this reason
ALTER -DRAIN & VENT -WATER (EN
FEE SUMMARY
BACK FLOW PROTECT. DEVICE
OUTSI OF FEES
DRAINS FLOOR ROOF, AREA, COND,
SANITARY Y_ N_
RECEIT T X
Owner Date
WORKMAN COMPENSATION DECLARATION
❑I hereby affirm that 1 have a certificate of consent msit-Inwm, or aNItFs'
3800flateolWorkes'Compewtlonlsunnce on cedilbd copythenro((Sw.
3800llab C.)
Polity X
FDrPER TRAP
SCHOOL TAX Y N _
RECEIPT X
S ILA, SYSTEM -1 INCA OUTLEIS
PARK FEE Y N
RFLEIIeI' M
Cum any
GAS F.A. SYSTEM -OVER 4(EA)
BUILDING DIVISION FE IS
�GrtNed copy is heed with the cid.
I1`zLJy�I�`` rlifled copy b filed :Wth the city inspection division.
CREASE/INDUSTRL WASTE INTERCEPTOR
PLANCHECK FEE
CREASE TRAP -
CERTIFICATE OF EXEMPTION FROM WORKERS•
PAID
SEWER-SANITARY-SIl7RM F.A. 700F1'.
COMPENSATION INSURANCE
(Thlssetion need not he complied tithe pereNt b foros hundred dollars
($]0(fiuries.)
I reer lestat Inthe petorman¢ of the work for which We permit is issued,
I shall not employ any person In any manner so as m become subject to the
Wmlum'CompenaoI..Lawsof CabforNa. Date
Date Recti [#
WATER HEATER W/VENT/ELECTR
ENERGY FEE Y N
PAID -
WATER SYSTE)d/TREAnNG
Applicant
N'OnCETO APPLICANT:B,ager maWnm a cation ire is EsempteLyou
should omeme subtest to the Workers' pro the Labor
Date Req J [#
NEWRESIDENTIALPLMB. SQ.FT.
TOTAL:
you ihb peof
Code, you meet (asthwah comply with such proWlos orlhh pedNt shall W
such Provide
decreed revoked.
B
419.00
SEISMIC PEE
1 17
CONSTRUCTION LENDING AGENCY
't hereby affirmthat there h a construction lending agency for the perform
an¢ of the work for which this permit is laved (Sec. 3097, Civ. C.)
Looder'c NamePLUMBING
Le.d.e.Addred
I certify that! have mad this application and statethat the above information
iscorrect.I egret to comply with all city and county ordinances and state lawn
TOTAL
ELECTRIC PEE
28
FEE
Qrv:'1 ME61ANICAL`PERMIT FEE
MECHANICAL FEE
PERMIT ISSUANCE 12
FEES PAID:
relating to building construction, end hereby authorize representatives of this
city to enter upon the above-mentioned property for inspection purposes.
(We) agree to eve, Indemnify an d keep harmless the City of Cupertino
agalstllabilltlea, jrdgmemeence and expense which may In any wayaccrue
ALTER OR ADD TO MECH.
Date Receipt#
AIR HANDLING UNIT (f010,000 CFM)
SUBTOTAL:
.get did Ci conte t gra ng of flits permit.
AIR HANDLING UNITvER loaoa CFM)
ro
CONSTRUCTION TAX
�_
sigutmre of AppBant ater Date
E%IgAUS'C HOOD (W/DIKn
CONSTRUCTION TAX PAID:
NALA R DOES MAT LS DISCLOSURE
HEATING UNIT (TO ]00,000 BTU)
Date Recel t#
Willtheapplicant the ruin building occupant atare hhandle hazardous
He.Ithmaterial as de0wd by odthe Cupertino Municipal Code, Chapter 9.1 3, and the
Health and SafetyCade Section 7%32b)7
nYes No
HEATING UNIT (OVER 100,00087!))
- TOTAL:
VENTILATION (SINGLE RESID)
ISSUANCE DATE
�Yill the a ppllcant or core building oavpart use equipment or devices
which emit havrdous air wntaMnand as deo red by the gay Area Air
Quality Management District?
Yes No
have ad the haze mus materials requirements under Chapter 6.95 of
p
7
BOILER -COMP 0HP OR 100,000 BTU)f"9�3':t!
BOILER.COMP(OVER 100,000 BTU)
the Califomh Health & SafetyCode, Sedics 75505, 75533 and 75534. I
understand that if the building does not currently have a tenant, that It b my
responsibility to notify the occupant of the requirements which must be met
<,pp r 1
4„ill J (9qu
NEW RESIDENTIAL MEAT. SQ.F7.
prior to issuance of a Certificate of Occupancy.
Vi P Cunettinn
y
ISSUED BY:
Owner or aufhorired agent Dof,
TOTAL:
OFFICE COPY,