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20357APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY Building Project identification Building Address: PERMIT NO. 7 O ^ C 10100 Torre Ave. Unit 157 (D1.1) 20357 G 3 J i-nvner.Name: one: CITYOF CUPERTINO- BUILDING DIVISION APPLICATION / PERMIT APPLICATION SUBMII IAL 5/10/90 cnntrad.r. N,me: Lic. No: BUR,DINGELECTRICAI PLUMBING -MECHANICAL CATECQRY CONTROL M AmchltM/Englnar. Lic No: ELECTRIC PERMIT FEE ` BUILDING PERMIT INFO Address; © ® ® ' PERMITISSUANCE 12 LICENSED CONTRACTOR'S DECLARATION Ihereby i.affirm that lamlicm3oftheuMp adPmfhonsC(commmc he Busrressand Pro(esslonsCade,andm inense 1. 1. fon to. Lienee 1, In full (ora and effect. APPLIANCESREADENTUL ]OB DESCRB'TI �j— Vv - V Sr�RO$ - PANELS LlcenseClam Lk.a B Date - Contractor UP TO 2DO ANTS — 201-IODO AMPS ARCHITECTS DECLARATION I understand my plans shall be used w public records. OVERIODOAMPS " SQ. FT. FLOOR AREA $/SQ.FT. SIGNSELEGTRICAL Licensed Pro(eadmud 669 74.92 9xECL1LCEtCU1T/MISC - OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. Sec11m 7031S, Business and Professions Code: Any city or muntywhich requfresa permittommtmd, Oteq improve, demolish,orrepair anystmu mpMrtoltslswa=c abomqulrestheappUmntfwsuchper tto file a signed statement that he la licensed pursuant to the provisions of the Contnxtorb License Law (Chapter 9(commencing with Section 700)) of Divi- ston 3 o(the Business and Pmdcssloru Code)ortFat he laexempt thercfromand . . TEMP. METER OR POLE INST.. POWER DEVICES gWEv1hBNC POOL ELECTRIC VALUATION the basis for the alleged exemption. Any violation of Section 70715 by any appIlant fora permit subjectsthe applkantto a civil penalty of not more than _ OUTLEISSWITCHFSnXTURFS $50,121.00 NEW RESIDENTIAL ELECTR SQrr. B oris nems hepr. I, as owner of the property, of uk, and he employees In wags as then sole Code; Thructure b, e mI-(Be.0Kthldothew Professions eLawdi for (Be. Contactor or License Code:The Contractors Llcemn Law STORIES TYPE CONSTRUCTTON' V_N , TOTAL: QTY. t; : PLUMBING PERMIT - FEE PERMIT ISSUANCE 12 don applyot to an owner property docs ocasuch torn owner ofp rough who Wimploylds or mprrovide that such whodaeawch son not himself art ed oroughhiaowneIf,ho everthe dedtbatwch improvementsmtswtd lntendneyear fcmpered riosale. t however, ve Improvemem lasoldwlthlnoneyearofcompletion,theawner-buBderwBlluve thq-kurdan of preving that he did not Wild or Improve for purpose of sale.). U L as owner of the property, am exclusively contracting with licensed contractan to construct the projad (See 7014, Busmen and Professions Code: OCC. GROUP R-3 RES. UNITS ' FLOOD ZONE APN The Contractor's License law does not apply to an owner of property who builds or Improves thereon, and who contracts for such ptojem with a licensed pursuant to the Contractns c9atpdaGU rsu Contractive. License Law. U I am exempt under Sm B A, P C for this reason ALTQS-DRAIN A VENT - WATIA FEE SUMMARY . BACK FLOW PROTECT. DEVICE OUTSIDE FEES DRAINS OR FLOROOF, AREA, CONI. SANITARY Y_ N_ RECEIPT p Owner Drte WORKMAN COMPENSATION DECLARATION ❑I hereby affirm that I have •certificate of consent to opy town, ora 3800,1.bo(Worken'Compewtlonlruurana oracertifkd mpythereo((Bec. 3800, lab CJ Policy N FDnURE -PER TRAP SCHOOLTAX Y N RECEIPT M CAS EA. SYSTEM.1 WCAOUILETS PARK FEE Y N RECEIPT M Co GAS IA, 9YSTEM-OVER4 (EA) BUILDINGDINGDIVISION FEES �anyIE �ed copy is hereby forchhed. cdified copy Is filed with the city Inspection division. CREASE/WDUSIRL WASTE INTERCEPTOR PLANCHECK FEE GREASE TRAP CERTIFICATE OF EXEMPTION FROM WORKERS' PAID SEWER-SANITARY.STORM F.A.200Ff COMPENSATION INSURANCE Crhis sectloa need not be completed If the permit b (mone hundred dollars Dale Remi IN WATER HEATER w/VENT/Ef.ECTR ENERGY FEE Y N — PAID (SI00)orless.) I Alfy that N the pwfomunaaf the work for which this permit is bored, I shall not employ any person In any manner w as to become wbjed to the Workers' Compensation Laws of California. Date WATER SYSTEM/TREATING Applicant tion, you NOTICE co MI'bpd to t: a after making this Certificate of Exemrt, should bums t to the Workers' provbis the Labor Date Recel ti( NEW RESIDENTIAL PLMB.SQFT. TOTAL: forth such prwtlun Code, you most forthwith comply with such provisions or this pemNt shall be permit deemed revoked. U 1 9.00 SEISMIC FEE 3-97 CONSTRUCTION LENDING AGENCY Ihereby affirm that there in a mostwction lending agency for the perform- ance of the work for which this permit la blued (Sec. 3097, Civ. C.) [..dors Name Lenders Addres I artllythat I have read this application and sate that the above Informad. Is correct. 7 agree tocomply with all city and county ordinances and rule laws TOTAL: ELECTRICFEE 28.73 PLUMBING FEE 28.73 QTY. ,MECHANICAL PERMIT FEE MECHANICAL FEE PERMIT ISSUANCE 12 FEES PAID: relating to building mrulwdlon, and hereby authorim representatives of this city to enter upon the above-mentioned property for Inspection purposes, (We) agree to save, Indemnify an d kap harmless the City of Gopertim, against liabilities,judgments, core and expenses which may In anyway accrue . ALTER OR ADDTO M5CH. Date Recei til AIR HANDLING UNIT CFO 10,ODO CFM) SUBTOTAL: agaWbald In aFyprquen ( gr ting of this pelrmitl A J//d��0 Sigrwtureof Applicant/Contractor 7ante AIR HANDLING UNIT (OVER 10,000 CIM) CONSTRUCTION TAX EXHAUST HOOD (W/DUCT) CONSTRUCTION TAX PAID: HAZARDOUS MA ALS DISCLOSURE HEATING UNIT (TO 100,ODO BTU) Date Rmei tic' Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.IZ and the IleahUNITh and Safety Code Section 25532(.)7 Yes No HEATING UT (OVER 100,000 BTU) TOTAL: Off 71 VENTILATION FAN (SINGLE READ) IS$I,IPI`I DATE IIl the epplicarat tor tum building occupant use equipment or devices which emit hamrd.us air contaminants as defined by the Bay Area Air Quality Management District? PYe.❑❑ No hav0 ad the hnaMous mitedab requiremcntsunder Chapter6.95 of iH 1, ` BOILER -COMP OFR' OR 100,00K) BTU) BOILER-COMP(OVER I00,IXD BTU) the Callfomia Health A Safety Crile, Sedims,25505, 25533 and 75534. I underslandthat Ifthe building does not currently have a tenant that is my NEW RESIDENTIAL MECH. SQ.FT responsibility to notify the occupant of the requirements which most be root prior to Issuance of a Certificate of Occupancy. T� /t ylty of rIIOP.fllfl0 ISSUED BY: 4M7tiD )A I Owner or authorized agent Date TOTAL: j OFFICE COPY