20334APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALL POINT PEN ONLY
Building Project Identification
Building Address:
PERMIT NO.
10100 Torre Ave. Unit 134 (N1.1)
20334
wars ame, one:
A
Tn� Center Properties;
CITY OF CUPERTINO-BUILDING DIVISION.
APPLICATION / PERMIT
'
5/10/90
Crounteef.N.rne: Ge. No:
—
BUILDINGELECTRICAIPLUMBING MECHANICAL
CATEGORY
CONTROL B
ArcM1ited/Engineer. Llc No:
QTY ELECTRIC PERMIT - FEE
BUILDING PERMIT INFO
Add..
� EN
PERFETISSUANCE 12'
LICENSED CONTRACTOR'S DECLARATION
ON
thereby dflrmthat laivisim3ofthe under ofCh
Ingwe is in fon force and effect. fthegudweand ProlessloaCode,and my
usiroand ProCedoes9(roandm
license b In toll force and effect.
APPLIANCES -RESIDENTIAL
JOB DISC ON '
�F1) 1,
YY VVIVf
-
PANELS
Lksnw Claw Lie.#
Date Contractor
UP TO 2DO ANTS
RCB
201-100IAMPS
ARCHITECTS DECLARATION
I understand my plane shall be used as public records.
OVERI0100AMPS
SQ. FT.FLOOR AREA
S/SQ. FT.
SIGNS ELECTRICAL
Licensed PMesioal
OWNER -BUILDER DECLARATION
I herebyalflrenthat I am exempt from the Contractor's License Law for the
909
74.92
SPECIAL C]RCUIT/M15C
TRAP. METER OR TOLE INST.
following We (Sectlan7031S, Business and Professions Cade: Any city or
muntywhich mquima permit tommtmd, alter, Impmve, demallah,ormpalr
any structure peter to its Issuance, also requires the applicant for such permit to
file a signed statement that ha Is licensed pursuant to the provisions of the
Contractor's License Law (Chapter9(commencing with Section 7000) of Dlvl-
don3 of the Buslnessand Pedesslmo Cede) mthat he b exempt thersfromand
the basis for the alleged exemption. Any violation of Section 703" by any
othan
appllcant fees permit subjects Me applicantto a civil penalty of nut mrc
five hundred dollars (SM.
F1 1, as owner of the property, or my employees with wages as their sok
POWER DEVICES
SWIMMING POOL ELECTRIC
OUTLEISSW[TCHESRXTURFS
VALUATION
$68a 102 . OC
NEW RESIDENTIAL ELECTR SQ -7.
STORIES
TYPE CONSTRUCTION
compensation, will do the work and the structure Is not intended or offered for
sale (Sec. 7044, Buelness and Professions Code: The Contractors License law
V—N
don not apply to an owner of property, who builds or improves thereon.and
whodesssuchworkhimwlf orthrough hisownemployess,provided that such
OCC. CROUP
R6. UNITS
Imprevementsm not Intended oroffered forests. If, however, thebufWing or
Improvement 9eold within oneyearofcompletion,the owner-bulleterwlll have
TOTAL:/
,
_
tf�urden of proving that he did not build or improve for purpose ofuk.).
Lj L as owner of the property, am exclusively contracting with licensed
coetndone to matrues the project (Sec. 7044. Busines and Professions Code:
QIy, PLUMBING PERMIT FEE
ZONE
APN
PERMIT ISSUANCE
19
The Contractors License Law don not apply to an owner of property who
builds or Improves thereon, and who contracts for such p4ojeda with a
A( ,ctor(s) licenced pungent to the Contndae. License Law.
L I am exempt under Sec B & P C for thin resson
ALTER -DRAIN &VENT- WATER (EA)
FEE SUMMARY
BACK FLOW PROTECT. DEVICE
DRAINS FLOOR ROOF, AREA, COND.
SANITARY Y_ N_ -
/
Owner Date
WORKMAN COMPENSATION DECLARATION
QI hereby affirm that I have a ¢rtificate of consent to self -Insure, or a
ceDO,Lab C.) o(Workere'Comperuatlanlwuran¢era certRkd copythereof (Sec.
P
Pop, Policy B Lab
FD(TUFXS PER TRP
SCITOOL TAX Y N
RECErrs
GAS EA. S'YSrEM-1 INCA OUTLETS
PARK FEE V N
RECEIPT R
PA. SYSTEM -OVER 4 (EA)
Company
BUILDING DIVISION FEES
VCAS
I 7 Grtlnea mpybnanby furnished.
ertlled copy b filed with the city inspection division.
cRFASE/[NDusrliL WASTE INTERCEPTOR
PLANCHECKFEE
GREASETRAP
CERTIFICATEOE EXEMPTION FROM WORKERS'
PAID
COMPENSATION INSURANCE
(Thl.aedionneednotbecompided BIM permit i foroahundred dollars
DRIC RCCCI tai
SEWER -SANITARY SIURM FA 2007
WATER HEATER W/VFNf/ELECIR
ENERGY FEE Y N
(S100)mIcan) -
I certilythat ie the performance of thework forwhlch this permit is issued,
WATER SYSTEM/TREAnNG
I shall not employ any person In any manner n as to become subject to the
Worken'CompenuHenUmof Callfomk. Date
PAID
NEW RESIDENTIAL PLMB. SOFr.
Applicant
NOTICE TO APPLICANT: a sore making this CertBk ee of Exemption, you
should mme eublid to the Workers' Compmurtbn pmvhbw of the Labbe
Date Re i tf1
TOTAL:
BUILDING
ode,you
dermad urwet forthwith comply with auchprovlelow or this pertNt shill be
deemed revoked.
SEISMIC FEE
CONSTRUCTION LENDING AGENCY
pedorrry
Ihereby eork forthat tMrcbacoatmctlond(Sec. lending agency 097, Civ. C.)
once of the work for which this permit V Lamed (Sec. 3097, Clv. C.)
Lenders Name
Lenders Adders
1 ¢rtlfythatl have read this applicationand statethetheabovelnformatlon
iscorrecl. l agree to complywlth all cityand counlyadlnarmand date laws
TOTAL:
ELECTRIC FEE
PLUMBING FEE
1• �, •
QTY. r0 '•MECHANICAL PERMIT FGEt',
MECHANICAL FEE
34.73
PERMIT ISSUANCE 12
FEES PAID:
relating tobullding rorotruction, and hereby authorities representatives of this
citytoenterupon the abovcmenBaned property for Inspection purposes.
(We) agree to save, Indemnify an d keep harmless, the City of Cupertino
against liabilities, jedgments,cad.and expenwswhich mayfnanywayaceme
ALTER OR ADD TO MECH.
Date Receiplp
AIR HANDLING UNIT (TO 10,000 CFM)
SUBTOTAL:
O •,P
agalrut sddC In rone endo an11 gd this permit.
AIR HANDLING UNIT (OVER 10,000 CFM)
CONSTRUCTION TAX
---J%'e
Signature a/Appllnnt/Contractor Dee
-
IXFIA115T HOOD (W/DICT)
CONSTRUCTION TAX PAID:
NA2ARDOUS MATE SDISCLOSURE
Will a thea .d bythuC.pbuildln occupantICt, hrptnd9.12,.rdous
PP 8Date
materialneede0ned odthe Cupertino Munitlpal Code, Chapler9.12, and the
Health and Safety Code &lion 25532(a)7
Yea No
HEATING UNIT (TO 100,000 BTU)
Recci Its
HEATING UNIT (OVER 100,000 BT1A
TOTAL:
, Q
VENTILATION FAN (SINGLE RESID)
ISSUANCE DATE
devices
thesent applicant turernmandg
whichl as defied! by theequipmentBay Area
which emit navrdow air mntamianto a deRad by the Bay Arca Air
Quality Management Dlslrict7
Yr. ❑ No
FA➢Ps -
SS..Xt'
BOILER -COMP DhI'DR 100,000 BTU)
BOILERCOMP(OVER 100,000 BTU)
i have read the banrdous materials requlrementsunder Chapter6,95 of
the California Health & SafetyCode, Sections 25505, 25533 and 25534. 1
NEW RESIDENTIAL MECH. SQ.FT.
understand that if the building don not currently have a tenant, that it is my
wl I•�JQ
responsibility to notify the occupant of the requlremente which must be met
,
prior to Issuance of a Certificate of Occupancy.'
City of Cunettirin
g
Owner or authurieed agent Date(SSUEp
TOTAL:
OFFICE COPY