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20342APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALL POINT PEN ONLY Bulldin Pmj.d Identification Building Add;g: PERMITNO. ] O A 20342 10100 Torre Ave. Unit -142 (N1.4) G 4 weer. amc: ane: Elntpr Properties CITY OF CUPERTINO-BUILDING DIVISION APPLICATION I PERMIT 5/10/90 c°ntrattarsName: tic. No: 718-4444 BUILDINGELECTRICAL MUMBINGMECIIANICAL CATEGORY CONTROL Y Amhltect/Engfaen Lie No: QTY ELECTRIC P,ERIv1ITFEB BUILDING PERMIT INFO Adding: KI © © M PERMIT ISSUANCE 12 LICENSED CONTRACTOR'S DECLARATION I lumbyaHtrm that l am licensed under provWonsof Chapter 9(commenc ingwlthSedion7000).[MM ion3ofthe Busineseand P.feWon.Cade,.dmy license In In full tone and dfed. APPUANCESRESIDENIAL ]OBDFSCKB'll N I PANELS License Clam LILY Date Contsctor -201-1000 AMP"' ARCHITECT'S DECLARATION I understand my plana shall be used as public remNs. OVER 1000 AMPS- SQ. FT. FLOOR AREA $/SQ. FT. SIGNS ELECTRICAL Licensed Profemlmal 909 74.92 OWNER-RUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Prolamines Code: Any city or county which require a permit to matmd, alter, Improve, demolish, or repair anystmc mpdortoitsismance,ahorequirntheappEuntfwmchpert tto file a signed statement that he is licensed pursuant to the provbiors of the Contractors Lkcme Law (Chapter 9(mmmendog with Section 7000) of Divi. don 3 ofthe Business and Profegloa Cede)orthat helaexempt therefromand the basis for the alleged exemption. Any vlulalkn of Section 70315 by any for permit subjects the applicant to a civil penalty of nore than applicantno m five hundred dollars (.9500). ❑ I, as owner of the property, or my employees with wages as their and. - SI'ECIALCRtCNT/M1SC TEMP METER ORPOLE !NST. POWER DEVICES SW04WNG POOL ELECTRIC OUTLETSSWIPC}ffSEXTURES VALUATION $68,102.00 NEW RESIDENTIAL ELECTR SQ.FI. STORIES TYPE CONSTRUCTION compensation, wfld.th. work and thestrum. is not lntendedor offered for sale (Sec. 7614, Business and Professions Code: The Contractors Llmme law v_N - does not apply to an owner of property who builds or Improves thereon, and whodoessuchworkhiarthrough hisownemplayees, provldedthat such OCC.GROUP RFS UNITS Improvements are not Intended oroHered("sale. If, however,lhebullding or TOTAL: R-3 i Impmvement b add within aneyearof completion, theowner-buBderwRl have tlickurdenofpmvingthat hedid notbulld orlmpmveforpurposeofsale.). U L as owner of the property, am exclusively contracting with licensed mntracturs to comtruct the projed (Sec 7044, Business and Professions Code: _ QTY.,. PLUMBINGPERMIT, . FT -ODD ZONE APN ,,,FEE PERMIT ISSUANCE 12 The Contractors Limm a law does not apply to an owner of property who builds or Improv. thereon, and who contracts for such p(ojects with a a�kador(s)Bmneed pursuant to the Contractor's License Law. LJ f am exempt under Sec B k P C for this mason - ALM -DRAIN kVENTWATER ffA) .FEE SUMMARY BACK FLOW PROTECT. DEVICE OUTSIDEFEES DRAINS FLOOR ROOF, AREA, COND. SANITARY Y_ N_ REGEM 0 Owner - Date WORKMAN COMPENSATION DECLARATION 01 hereby affirm that I have a certificate of consent to u161num, are rertlflcate of Workers'Compewatlonlmurance or a certified copythermf(Sec 3800, Lob C.) - Y F.�.U� PER r SCHOOL TAX Y N RECFR'I' Y GAS EA. SYSTEM -1 INCAOUTLIDS PARK FFE Y N RECEIPT# Co.llry Cray GAS EA. SYSTEM -OVER 4 (EA) BUILDING DI VISION FEES dNed copy is hereby te chilled copy is filed withh the cityInspection division. ty GREASE/INDUSTRL WASTE INTERCEPTOR PLANCHECICFEE GREASE TRAP CERTIFICATE OF E)(EMPFION FROM WORKERS' PAID SEWER,SANIT.ARY-STORM FA pOFT COMPENSATION INSURANCE (This section need not be completed lithe permit is forom hundred dollar Date Rewi t# WATER BEATER W/VENT/ELECTR ENERGYFEE Y N ($100)orlem3 I certify that in the performance ofthe work for which this permit Is Issued, WATER SYSTEM/TREATING I shall not employ any peson in any manner an as to become wbjed to the Worker Compensation[awsof Callfomla. Date PAID Applicant NOTICEco APPLICANesubjettothe after kmaking thinCtion provisionsoftheyou to the Workers' Compewtbnprovisionofthe Labor shouldbecomeat NEW RESIDENTIAL PLMB.SQFr. Dale Recei T# TOTAL: NG FEE 500.00 Code, you raked. with comply with each provisions or this permit shill be deemed revoked. SEISMIC FEE 4.83 CONSTRUCTION LENDING AGENCY Iherebyaffirm construction there is aconstruction Lending agency forthe perform an. of the work for which this permit is blued (Sre 3097, Civ. Q Iendera Name' Lenders Address I certify that I love read thisapplication and pate that the above information Iscomect. I agreeto complywith all city and countyordinances and mate laws TOTAL: ELECTRIC FEE 34.73 - QPYia•;,MECHANICAL.PERMIT'' I; FEE .PLUMBING FEE MECHANICAL FEE PERMITISSUANCE FEES PAID: relating to building construdlon, and hereby autfumbe representatives of /his city to enter upon the abovcmentloned property for impaction purpoms. (We) agree to save, Indemnify an d keep harming the City of Cu ped Bio against liabilities, j dgmenis,canard expenses which may In any way adman agates[ said Cncon ft tin this permit. / ALTERORADDTOMECH. Date Recei t#, AIR HANDLING UNIT (TO 10,000 CFM)SUBTOTAL: O .V V/ (OVER lo,000cFM) CONSTRUCTION TAX Signatures of Applicant/Contractor Z D/' al I DA. EKHAUS HOODCVLING IXFIAUST HOOD(W/DUCT) CONSTRUCTION TAX PAID: HAZARDOUS MATER! DISCLOSURE PLEATING UNIT (TO 100,000 BTU Will the applicant or future building occupant store or ba fid to haaardous material as dell red by the Cupertino Municipal Cade, Chapter 9.1 2, and the Health and Safety Cade Section 25532(a)? ❑ Yes No Date Recei t# HEATING UNIT (OVER IW,000 BTU) TOTAL: 6Q , VENTILATION FAN (SINGLE RESID) ISSUAN^nATE Will the applicant or Lure building occupant use equipment or device, which emit haasrdous air contaminants as defined by the Bay Area Air aiity Management District? 51:d'11IlJ�f' BOILER -COMP OHPOR 100,000 BTU Y. 1�2j No have read the haaar�ous materials requirements under Chapter 6.95 of JO BUTLER-COMP(OVER 100,0c0 BTU) the California Health k Safety Code, Sodium 25505, 25533 and 25534. I understand that if the bu llding does not currently have a tenant, that It is my NEW RESI DENTAL MECH. SQFr. responsibility to notify the ocetpant of the requirements which moat be met Cllr of CB[)PItI III1 City priortoL uanmofa CedifioteofOmapanry. ISSUED OY: Owner or authorimd agent Data TOTAL: OFFICE COPY