20337APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
Building Project Identification
Building Aaare
PERMIT NO.
100100 Torre Ave. Unit 137 (N1.2)
T
20337
cora Name: one:
wTn� Center Properties
CITY OF CUPERTINO-BUILDING DIVISION
APPLICATION / PERMIT
5/10/90
Coetracto sN.mr: Lk. Na:
8-4444
BUILDING-¢EcnuCAI.MUMBINO-MECHAMCAL
CATEGORY
CONTROL#
Archurct/Engineer. Lic. Nc% -
QTY ELECTRICPERMIT - FEE
BUILDING PERMIT INFO
Add..
f—I f-1
L�{-J
PERh9TIS5IJANCE 12
LICENSED CONTRSDECLARATION
IhthSyiaffirm that lamlicensed .i.3.fheB.grovWmsol..I... 9(mmma
under
fthegucineesandl'm(meloneCode,and my
ingweh In fon force
license la In tors rntl effect.
APMlANCESRESIDENTUL
JOB
JOB DFSCRR'170M{
PANELSi—
s
Ch® ic.Ccm
LIP TO 200AMPS
RCB
Dgc_Lt
Date Contnctor _
201.1000A.M -
ARCHITECPS DECLARATION
I understand my plans slut be used as pubic remed..
OVER 1000AMPS
SQ. FT. FLOOR AREA
S/SQ. Fr.
SIGNS ELECTRICAL
Ltormad Professional
. OWNER -BUILDER DECLARATION
I herebyaNrenthat l am exempt from the Contractor's Ltcenw lawforthe
909
74.92
STTCIALCIRCUIT/MISC
following reaeon.(SMion 7031.5, Business and Professions Code: Any city or
county which requires a permit to construct, alter, Improve, demolish, or repair
TIME. METER OR POLE INST.
any structure prior to its tseuaoce,.b. requires the spplant fasuch permit to
file a signed statement that he U licensed pursuant to the provisions of the
Contrictori License Law (Chapter 9(commencing with Section 7000)of Divi-
Yon 3oftha lh areas and Profe.10. Code)orthN m
he exempt therefroand
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant fora pernot subjectsthe applicant to a civil penalty of not more than
five M.
F11, asredner of ars
epra
sa owns of the property, or my employees with wages. there role
POWER DEVICES
g(ypd,�.RNG POOL ELECTRIC
QUTT,EISSWITCIiFSFTXIURES
VALUATION
$68,102.00
NEW RESIDENTIAL ELECTR SQFr.
STORIES
TYPECONSTRUCTION
e
compensation, will doth. wok and the structure V not intended or offered for
sale (Sec. 7064, Business and Professions Code: The Cotdnctols Llanse law
'
V—N
4
does not apply to an owner of property who builds or improve, thereon, and
who does such work Wr selfmthrough Ms own employees, provided that such
-
OCC. GROUP
RFS. [NITS
Improvements are na Intended oroffered tarsale. If, however, thebuilding or
improvement issold Mthinoneyearofcompletb theowner-buaderMll have
TOTAL:
R-3,
the burden of proving that he did not build or improve for purpose of sale.).
LJ Las owner tr the Properly, am exclusively contracting with licensed
to conswcitheproject(Sec.appy ons Code:
QTY. • PLUMBINGPERMIT ;.FEE
FLOOD ZONE
AI'N
-
PERMIT ISSUANCE 12
TheCcontraeasct
The Coor larpr'a License Taw dos nal apply e t f owner of properly who
to an of pro
builds or Improv. thereon, and who contracts for such p(okm with aFEE
antSec to theCrntractors License Law.
�qR�1 hain) Bam under
LJ [ am exempt uMer Sec B k P C for this reason
ALTER -DRAIN h VENT- WATER BEA)
SUMMARY
BACK FLOW PROTECT. DEVICE
OUTSIDE FEES
DRAINS FLOOR ROOF, AREA, COND.
SANITARY Y_ N_
RECEIPT x
Owner Date
WORKMAN COMPENSATION DECLARATION
QI hereby affirm that I have • cedllah of consent to "If-Insum, or a
certllateofWorkera'Comperualion lrouance ora certified copythercof(Sec.
3#00, lab C.)
Poltry#
HIRES. PER TRAP
SCHOOL TAX Y_ N_
RECEIPT X
GAS EA.SYSTEAI-1 INCA OUTLETS
PARK F� Y N
RECEIPT#
Com an
GAS EA. SYSEM.OVER4(EA) '
BUILDING DIVISION FEES
ified copy b hereby to mished.
Certified copy V Ned with the city inspection divlslon.
CRl:sep/INDUSTRL WASTE INTERCEPTOR
GREASE TRAP
CERTIFICATE OF EXEMPTION FROM WORKERS'
PAID
200FT
COMPENSATION INSURANCESEWER-SANITARY-STORMEA
(This section need not be completed If the permit is farom hundred dollars
(SI0(Borless.)
I cmLfy that In the performance of the work forwhich this permit to issued,
I shall not employ any person in any manner an, as to become subject to the
Compensatlon Lawaof C.Uf rnla. Date
Date Reoei t#
WATER HEATER w/VENT/¢FCTR
ENERGY FEE Y N
PAID—
WATER SYSTEM/TREATINGWorkera
Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you
should become subject to the Workers' Compensation proutd.. of the Labor
Date Re22!11t#
NEW RESIDENTIAL ELMS. SQ.FT.
TOTAL:
Code, you mu at forthwith comply withsuch proistons or this permit shall be
decmod revoked.
BUILDING FEE
500 .00
SEISMICTRIC
CONSTRUCTION LENDING AGENCY
)ending agency forme pedome
I hereby aoNm that There i a mmt b Issued
Looe of the work for which thio permit V Wued (Sec 3097, Clv. CJ
lenders Na
Landee.Addmm
1 cedifyth tl have read Ihisapplialionand Yalelhattheabove Information
Tscorenct. l agrceto complywith all cityand countyordinances and Yate laws
TOTAL:
FEE
ELECTRIC FEE
34 . 7
PLUMBING FEE
QW., ; MECHANICAL PERMIT FEE
MECHANICAL FEE
IL 7
PERMITISSUANCE 12
FEES PAID:
relating tobulldleg rorutmctlon, and hereby authonee representatives of thio
city to enter upon the above-mentioned property for Inspection purposes.
(We)agree to save, indemnify an d keep harmless the City of Cu ped Ino
against liabilities, pdgmenb, coYsand expenses which may In any way a..
ALTERORADDTOMECH.
Date Receipt#
AIR HANDLING UNIT (TO 10,000 CFM)
_
SUBTOTAL:
D
against aaig •lin �oneard the SrMingofthlspimnit/
�^— S//�il
Auto
AIR xANDUNc uMT(OVER Io,aopcFni)
CONSTRUCTION TAX
���"��//
Slgnaatum of Appuant/ContractdrL'e3
IXFfAUBTHOOD(W/DL1C'D
CONSTRUCTION TAX PAID:
HAZARDOUS MA ALS DISCLOSURE
HEATING UNIT (TO 100,000 BTU)
Will the applicant or future building occupant store or handle hazardous
material as defined by the Cupertino Municipal Code, Chapter 9.1Z and the
Health and Safety Code Section
ection 25532(a)7
❑ Yes _I No
L
Will the apphant orfuture building occupant use equipment or devices
Date Recei tA'
FiFATING UMT(DYER 100,000 BTU)
TOTAL:
-
0 '97
V EJMLATTON FAN( SINGLE REBID)
ISSUANCE DATE
which emit haaandou. air contaminants as defined by the Bay Ara Air
Quality Management District?
4Yee ❑ No
havcreadtheM1azallousmaterials requlrementsunderChapler6.95of
BOILER -COMP DEI' OR 100,000 BTU)'��®
BOILER -COMP (OVER 1W,000 BTU)
the Califomia Health& Safety Code, Sections 25505,25533 and 25534. 1
understand that lithe building does not currently have a tenant, that it ie my
NEW RESIDENTIAL MECH. SQ.FT
responsibility to notify the occupant of the requirements which most be met
prior to issuance of a CertNate of Occupanry.
- City of Cunarfino
ISSUED BY: hver—
Owner or authorizedTOTAL: agent Dale
-
OFFICE COPY