20362APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — U BALL POINT PEN ONLY
"
Building Project Identifkatlon
Building Address:
PERMIT NO.
10100 Torre Ave. Unit 162 (D2.3)'20362
nets lq= I Fluxes:
Town Center Pro erties
CITY OF CUPERTINO-BUILDING DIVISION
APPLICATION I PERMIT
5/10/90
Contractor's Name: Lic. No:
•
BUR.DING-ELECTRICAL-PLUMBING-MECHANICAL
CATEGORY
CONTROL M
Architect/Engineer. . Lk. No:
Qtr'.,; ,•-" ELBCTRIC•PERMff •: FEE.
BUILDINGPERMIT•INFQ;
t= ELhLI PLUMB
Address .
�. X
PERMIT135UANCE 1
LICENSEDCONTRd DECLARATION
_
I herewith ection mthatlam Bcen3 ofthe erinessa dProfehapter9(commenc
under w%,uwm
Butlnssand ProtesionaCade, and my
APPLIANCES -RESIDENTIAL
JOBaD�FSCRRi'[Oj�1�
rp /,
Ilrens I. I. fuuBf�)andlvislon d(ect,3o(the
PANELS -"
.LG ��/ r
Llanao Claes Lk.#
-
Ci
IC ,.
Dale -ContractorUP
TO 200 ANTS
201-100DAMPS .
a ARCHITECTS DECLARATION
I understand my plans shag be used aspublic ubhcrecorda
s:
OVER 1000 AMPR
SQ. FT. FLOOR AREA
S/SQ. FT.
SIGNS ELECTRICAL
Llamed Pref.ional
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt fromlhe Contrador's License Law for the
.730
74.92
SPECLILCIRCUIT/MISC'
following reason. (Section 7031.5, Business and Professions Code: Any city or
ceu my which requ Tres a permit to construct, alter, Improve, d emolish, or repair
TEMP. METER OR POLE INST.
anysmomrs prior to its Issuance, also requiresthe applicant for such permit to
file a signed statement that he b Barred pursuant to the provisions of the
Contractors License lzw(Chapters (mmmencing with Section 7000) of Divi.
slon3ofthe Buslnesand Profeslom Code)orihathebexempttherefmmand
POWER DEVICES
SWIMMING I'CIOL ELECTRIC
VALUATION
the basis for the alleged exemption. Any violation of Section 70315 by any
applicant fora permit subjectathe applicant to a civil penalty of nere than
OUTLEISSWITC:FIFSFIXTUfiES
54 s 6 92 • 00
,
NEW RESIDENTIAL ELECTR SQFT.
d dollars (,;50E0). .
fi�,hundreperty
Las owner of the pro, or my employees with wages as their sole
compematbn, will do the work and the structure V not intended or offered for
STORIES.
TYPECONSTRUCTION
V—N
sole (Sea 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of property who Wilda or Improves thereon, and
who does such work himself orthrough hisown employees, provided that such
Improvements are not Intended oroffered for sale. If, however, thebuilding or
TOTAL:
OCC.GROUP-
R-3
RES UNITS
improvement issold within mayearo(completion, the owner-bullderwillhve
OW-Il.uden of proving that he did not build or improve for purpose of oak)
LJ L as owner of the property, am exclusively contracting with Licensed
em. to coratmd the project (Sec. 7044, Business and Professions Code:
...
QTy ,.'y •'•PI;Ui1.7BING'PER]bilT "•FEET;'
/
FLOOD TONE
APN
pgRMyF ISSUANCEam 12
The Contndor's License Lw does nor apply to an owner of property who
Wilde or improves thereon, and who contends for such pkajects with a
dorWIkenaed Immuanttothe Contrador's License Law.
LJ I am exempt under Sec. B 4 P C for this reason
ALTER -DRAIN& VENT -WATER (EA)
";;FEE,$UMMARY
BACK FLOW PROTECT. DEVICE
DRAINS FLOOR ROOF, AREA, COND.
SANITARY Y_ N_
BBC=#
Owner - Data
WORKMANCOMPENSATIONDECLARATION
QI hereby affirm that I have a certificate of consent to self -insure, m a
ce00,lAeofWorkers Compensetionlnsuranawaartlfled copythereo((Sec.
Polis Lab CJ
Policy
FI%TIRE_&PER TRAP �
SCHOOL TAX Y_ N_
RECEIPT #
GAS EA. SYSTEM -1 INCA OUTLETS
PARK FEE ;Y N
RECEIPT #
#
Co�mpany
CAS EA. SYSTEM -OVER 4 (EA)
- BUILDING DIVISION FEES
I ICLrRaea copy is hereby fu nished:
r�aG ` rtNed copy Is filed with the city inspection division.
CREASE/INDUSTRL WASTE INTERCEPTOR
PLANCHECK FEE
GREASE7RAP
CERTIFICATE OF EXEMPTION FROM WORKERS'
PAID
COMPENSATION INSURANCE
(Thisaedlon need net W completed If the permit Isfor om hundred dollars
Date Receipt#
SbWF.R SANnAAY 51ORM EA 200FT
WATER HEATER W/VENT/ELECTR
ENERGY FEE Y_ N_
($100)orless3 .,
I unify that In the pedomunu of thewmk forwNch this permit le Issued,
WATER SYSTEM/TREATING
I shall not employ any person In any manner so as to become subject to the
Workers'CompensaBon Laws of California. Date
PAID
NEWRESIDENTIALPLMB. SOFT.
Applicant
NOTICETO APPLICANT: If, after making this Certificate of Exemption, you
should become subject to the Worker' Compematlon provisions of the Labor
Date Recei t#
TOTAL:
B N43
01
Code, you must forthwith comply with such provisions orthls permit shall be
domed revoked.
CONSTRUCTION LENDING AGENCY
SEISMIC FEE
.0
3.851
IhembyafBrm that there is a construction lend Ing agency for the perform
ance of the work for which this permit is burned (Sec. 3097, Civ. C.)
Lenders Name
Lenders Addmse ' - -
I unity that have read this application and state that the above information
bcorred.Idgrecto comply with all cityand county ordinances and state laws
TOTAL:
ELECTRIC FEE
PLUMBING FEE
30.25
s -+n is
QTX? MEGHANICALiP.EHMIT„ •iiFE,E:',',
MECHANICAL FEE
30.25
PERMIT ISSUANCE 12
FEES PAID:
relating to building comtmdlon, and hereby authorize representatives of this
city to enter upon the above-mentioned property for impmlon purposes.
(We) agree to save, indemnify an d keep harmless the City of Cu pertlno
against liabilities, Judgments, cats and expense which may in any way acme
against aid Ciy�n con�ygnna o(yf gysntlgpo(th1. pe It
i%�/ L eL/
ALTERORADDTOMECH.
Date Recei t#
AIR HANDLING UNIT CFO 10,000 CFM)
SUBTOTAL:
a
-
AIR HANDWNG UNIT (OVER 10,000 CFM)
CONSTRUCTION TAX
Signature, of Applicant/Contractor AC / Lice
EXHAUST HOOD(W/DUCT i
CONSTRUCTION, TAX PAID:
HAZARDOUS MATERTnSDISCLOSURE
HEATING UNIT (TO 100,0)OBTU)
Date Recei t#
Will the applicant orfuture building occupant store or handle hazardous
material as defined by the Cupertino Municipal Code, Chapter 9.12, and the
He❑alt,annd Safety Code Section 25532(a)7
No
HEATING UNIT (OVER 100,000 BTU)
TOTAL:
3 0
VENTILATION FAN (SINGLE RFSID)
ISSHhN@6:DATE
Will the applicant or❑❑future building occupant use equipment or devices
which emit hazardous air contaminants as defined by the Bay Area Air
lity Management Disfrid7
ah
X'.l'►�bX.e�#
'
BOILER -COMP OHPOR 100,000BTU)
Yea - nn No
ave read the haaer�ious materials requirements under Chapter 6.95 of
the California Health k Safety Code, Sections 25505, 25533 and 25534. I
u ndersta end that if the building does not currently have a tenant that it is my
1 k 1990
J
BOILER -COMP (OVER 100,000 BTU)
NEW RESIDENTIAL MECH. - . SQ.ET.
responsibility to notify the occupant of the requirements which must be met
#s
of �II>,)P.It111
prior to issuance of a Certificate of Occupancy.
yl}rr
ss'
ISSUED BY:
Osrerorauthonsed agent .. - Date
TOTAL:
OFFICE COPY -