20359APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALL POINT PEN ONLY
Building Project identification
Beading Address:
10100 Torre Ave. Unit 159 (D1.4
PERMIT NO.
20359
wnern m.one: -
Town Center Pro ertieS
CITY OF CUPERTINO-BUILDING DIVISION
APPLICATION I PERMIT
BUILDING-ELECTRICALPLUMBING-MECHANICAL
q
5/10/90
Contracto/a Nacos: - Lie. No:
738-4444
CATEGORY
CONTROLp
Architect/Engiruer. Lt.. No:
'QIY r" ELECTRICPERMIT '.,';FEE
''BUJLDING"PERMIT .INFO - "
Address:
PERMITISSUANCE -. 12
LICENSED CONTRACTOR'S DECLARATION
[hereby aHirmthatlam Meneed underpmvWone of Chapters(comment-
ingwllhSedfon 70W)of Division3ofthe Businesaand PmfessimsCode, and my
license le In full force and effect
Llmnae Clara Lic.R�'
Date Contractor
ARCHITECTS DECLARATION
I understand my pbru shall be used as public records.
Licensed Professional
OWNER -BUILDER DECLARATION
I herebyafertnthat I am exempt fromthe Contractor's License Law for the
following reason.(Rection 7011.5, Business and Prefealons Code: Any city or
county which requires a permit to construct, alter, Improve, demolish, or repair
any structure prior to its Issuance, also requires the applicant for such permit to
file a signed statement that he b licensed pursuant to the provisions of the
Contractor's Leduc Law(Chapter9(mmmencing with Section 7000) of Dist-
slon 3 of the Business and Profemlone Code)orthat he Is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 70115 by any
applicant for a permit subjeatsthe applicant to a civil penalty ofnot more than
five Fj1. asred owner of hepr.
u as owner of the property, or my employees with wages as their sole'
compensation, will do the weal; and themmeture Is not Intended hes offered for
sale (Sec 7046, Business and Professions Cade: The Contractors License Law
does not apply to an owner of property who builds or improves thenen, and
whodoeasuchworkhtmeelfherthroughkis wnemployees,providedthatwch
improvements are not Intended oroffered for sale. If, however, the building or
improvement issold within oneyearofcompletion, the owner-bu0derwlll have
tltrden of proving that he did not build or Improve for purpose of sale)
L j L as owner of the property, am exclusively contracting with licensed
contractors, to construct the project (Sec 7044, Business and Profeasioru Code:
TM Commences License Law does not apply to an owner of property who
builds or improves thresher, and who comment for such ptojects with a
C tt{aam it) licenaed pursuant to the Contractor's License Law.
LJ I am exempt under Sec. B A P C !or thisreaeen
APPLIANCESRESIDENTIAL
JOB DEECRB'DON�
R
PANELS
UP TO 2DO ANTS
—
201 -IOW AMPS
OVER 1000 AMPS
SQ. FT. FLOOR AREA
669
S/SQ. FT.'
74.92
ISIGNSELECTRICAL
specuLcigclnT/MISC
TQ,.1p METIRORPOL87NST.
- POWER DEVICES
'
SWIMMING POOL ELECTRIC
_
OUTLETSSWITCHFSHXI'URES
VALUATION
$50,121;00
NEW RESIDENTIAL ELECTR SQ.FT.
STORIES
-
TYPE CONSTRUCTION
V—N
TOTAL:
i .,t;
Q7'y; ;-- ]tI;IJIViBji!iOPERMI`i
OCC.GROIIP
R.-3
RFS. UNITS
,:,FEE,:=1
pPgtiIT ISSUANCE
12 .
ALTER -DRAIN & VENT-WATER,(EA)
FLOODZONE
'
APN
_
FEE "•'
SUMMARY.
"f'"t' "�
BACK FLOW PROTECT. DEVICE
DRAINS FLOOR ROOF, AREA, COND..
FIXTURES PER TRAP
SANITARY Y_ N_
RECEIrr R
Owner Dare
WORKMAN COMPENSATION DECLARATION
❑I hereby affirm that I have a certificatere
of consent to arlf-Insu , or
mrtiflcate ofWorkent Comperuatinalru momma certilled copythereof(Sec.
38001 Lab C.)
Policy If
SCHOOL TAX Y_ N_
RECER f M
GAS EA. SYSTEM -1 WC.6OUTLETS
••
PARK FFP Y N `
RECENT M
GAS -PA. SYSTEM -OVER 4(EA)
Com any
BUILDING DIVISION FEES
filed copy is herebytume cityed. Inspection division.
CertHled copy Is (fled with the city
CERTIFICATE OF EXEMPTION FROM WORKERS',
COMPENSATION INSURANCE
(this section need not M completed Bibs permit Is (Drone hundred dollars
(S100)mless.) -
I certifyth s le the perforronce of the work forwhlch this permit Is Issued,
I shall not employ any person in any manner w an to become subject to the
Workers'Compensation Lawaof California. Date
AppliN077CE
NOTICETOAPPLICAtothe ager rs'Co perhin Certelateis Exemption, you
should ode,yo mostong lobject to the Workers' somperuatlon provhions, of s permit s Labbe
Code, you must forthwith comply with each provisions orchis permit shall be
deemed revoked.BUILDING
CONSTRUCTION LENDING AGENCY
Thereby afHrmthat there Is a construction lending agency for the perform-
ante of the work for which this permit Is Issued (Sec. 3097, Cie. C.)
Lender's Name
landefa Address
I certtly that] have readthis applicaHonand Rate thattheaboveleformatlon
iscomet.I agree to complywlth all city and county ordlnancesand .to laws
relating to building mmtruction, and hereby nobodies representatives of this
city to enter upon the abovo-mentioned property for Inspection purposes.
(We) agree to save, indemnify an d keep harmless the City of Cu pertbo
against liabilities,judgments,cost. and expenses which may In any way accrue
Ince ansae lie mipR, thispermlt /
againstsaidV/M
Signature of Applicant/Contractor' / Data
HAZARDOUS MATE LS DISCLOSURE
Will the applicant or future building ..part atore or hand le hazardous
material as defined by the Cupertino Municipal Code, Chapter 9.1$ and the
Health and Safety Codee, Section 25532(a)7
a No
Will the applicant or future building occupant use equipment or devices
which emit hazardous air contaminants as defined by the Bay Area Air
Qua lltyManagement District?
Ye. qNo
have read the h.9 us materials requirements under Chapter 6.95 of
the irnla Health & Safety Code, Sections 255a5,25533 and 25534.' I
understand that if the building does not currently have a tenant, that It Is my
responsibilit)to notify the occupant of the requirements which most be met
prior to Issuance of a Certificate of Occupancy.
GREASE/INDUSTRL WASTE INTERCEPTOR
PLANCHECK FEE
PAID '
Date - Recei t#
f
GREASE TRAP
SEWER -SANITARY -STORM FA 200FT
WATER HEATER W/VENT/ELECTR
ENERGY FEE Y N
PAID
Date -Recei t#
WATER SYSTEM/TREATING
NEW RESIDENTIAL PLMB. SOFT.
TOTAL:
419.00
SEISMIC FEE
3.57
TOTAL:
ELECTRIC FEE
a. - k, 1
QTY ?,n , MECFYANICAL':PERMIT ".'FEE''
PERMIT ISSUANCE
PLUMBING FEE9R
7
MECHANICAL FEE
28.73
FEES PAID:
ALTER OR ADD TO MECH.
Date ReCEi t#
AIR HANDLING UNTr(TO 10,000 CFM)
SUBTOTAL:
Q
AIRHANDLING UNIT (OVER 10,000CFM)
CONSTRUCTION TAX
EXHAUSTHOOD(W/DUCT)
CONSTRUCTION TAX PAID:
HEATING UNIT (TO 100,OW BTU)
Date Rixei t#
HEATING UNIT (OVER 100,000 BTU)
TOTAL:,
Ob`•7
VENTILATION FAN (SINGLE REBID)
1.50 IxI(�.DATE .
F'Ja'�ab9
-
City /of Qonertinn
ISSUED BV%_1 KJd I/ Cl— I 1eCp—
A
BOILE&COMP OFR' OR 100,000 BTU)
[R
BOILER-COMP(OVER 100,000 BTU)
NEW RESIDENTIAL MECH. SQ.FT.
th
Ownerorauorized agent Date
.. -
TOTAL:
OFFICE COPY