20375APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALL POINT PEN ONLY
Building Project Identification
Building Address:.
10100 Torre Ave. Unit 175 (H1.1)
PERMIT NO.
20375
nera one:
Town Center Properties
CITY OF CUPERTINO-BUILDING DIVISION
APPLICATION/PERMIT
BUE.DINGELEC77ICALPL[JMBINGMFCHAMCAL
A
5/10/90
Contractor's Name: Lic. Nex
738-4444
CATEGORY
CONTROL.
Architect/Englmer. - Lk. N.
QTY ELECTRICPERMIT FEE
BUILDING PERMIT INFO
Acidness:
PERMITISSUANCE 12
LICENSED CONTRACTOR'S DECLARATION
I hereby ioflmnthat lamlkm3oftheunder provlaldPmf sions9(commcnc
Ingwe Is in fan force and died. ofthe BueimssandProleedoneCode,and my
license is In full force and died.
License Clam LIOM -
Date Contractor -
ARCHITECTS DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
OWNER -BUILDER DECLARATION
I herebyaf .that I am exempt fromthe Contmetors License law for the
following ... & cion7031.5, Business and Professions Code: Any city or
countywhich mquimsa penNttocoramud, alter, Improve, demolish,oreepalr
anystrotturt prior toits Issuance, also requ4eatheappBcent fersuch permit to
file a signed statement that he Is licensed pursuant to the provIslom of the
Contrsctori License Law (Chapter 9(commencing with Section 7000)of Divi.
slon 3 of the Business and Professlons Code) orthat he Is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 70315 by any
applicant fora permit aubjecta the applicant to civil penalty of not more than
Ove hundred dollars ($500).
I, as owner of the property, or my employees with wages m their sole
compensation, wIEdothe work, and the structure Is not Intended or offered for
sale (Sec14, 70Hushed, and Pmfemlom Code: The Contractors License Law
does not apply to an owner of property who Wilde or Improves theme, and
who dace such work himxlfor through hlsown employees, provided that such
Improvement are not intended oroffered formle. If, however, thebullding or
improvement Is sold within oneyearofcomplelon, the owner -W Ilderwlll have
th�Srden of proving that he did not build or improve for purpose ofeale.).
u L as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7074, Business and Professions Code:
The Contractors License Law does not apply to an owner of property who
Wilde or Improves thereon, and who contracts far such plojecis with a
cgp(ractw(s)Ikensed pursuant to the Contracture License Law.
Lj I am exempt under Seo B & P C for this reason
APPLIANCFSRFSIDENTIAL
JOB DESCRII'ITON
RCB
F P W (�
PANELS
201-1000 AMPS
OVER 1000 AMPS
SQ. Fr. FLOOR AREA -
8OS
S/SQ.Fr,
74.92
SIGNS ELECTRICAL
SPECL1LCEiCUIT/MLSC
Tph{p METER OR POLE INST.
POWER DEVICES
SWIMMING POOL ELECTRIC
OUTLEISSWNCHESFIXTURFS
VALUATION
$60,311.00
NEWRESIDENDALELECTR SQ.PT.
STORIES
TYPE CONSTRUCTION
V—N
TOTAL:
QTY, PLUMBING PERMIT FEE
OCC.GROIRa
R-3
RES, UNITS
I
FLOOD MNE
APN
PERMITISSUANCE
12
ALTER -DRAIN &VENT- WATER (EA)
FEE SUMMARY
BACK FLOW PROTECT. DEVICE
DRAINS FLOOR ROOF, AREA, COND,
SANITARY Y N_
REC13M R
Owner Date
WOR KMAN COMPENSATION mflDECLARATION
01 hereby affirm that I have a cecate of consent to self-inure,FIXIIURES
or
certificate ofWorkers'Compematlan lnaumnce ora certified cepythoeo((See.
3800, Lab C.)
Polity
PER s
SCIdOOL TAX Y_ N_
REC ]PT N
GAS EA. SYSIRM-1 WCAOUTLETS
PARKFEE Y N
RECER'T M
Y
Com an
GAS. FA. SYSTMA-OVER 4 (FA)
BUILDING DI V ISI ON FE EB
bified copy Is hercbyth the city
ertified copy Is filed with the city inspection division.
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(1'hisseation need nes W completed If the permit Is forom hundred dollars
($1013) or less.)
I certlfythat in the performance of the work (orwhich this permit Is Issued,
I shall not employ any perm In any manner so as to become subject to the
Workcra Compenastlon Laws al CaWornb. Data
Applicant
CREASE/WDUSTRL WASTE INTERCEPTOR
PLANCHECK FEE
PAID
Date Remi Ni
GREASE TRAP
SEWER.SAMTARY-STORM EA 200Ff
WATER HEATIR W/VENT/ELECTR
ENERGYFEE Y_ N
PAID
Date Recet tq
,
WATER SYSTEM/1REAnNG
NEW RESIDENTIAL PLMB. SQFr.
NOTICETO APPLICANT: If, after making this Certificate of Exemption, you
should become subject to the Worte a' Compenaation provisions of the Labor
Code, you =at forthwith comply with such provision orlhIs permit shall be
deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction lending agency for the perform-
ance of the work for which this permit Is Issued (Sec. 3097, Civ. C.)
Lender's Name
Leeders Address
I mdlfythat I havemadthIs application and stafethat theabove Information
Is correct. I agree to comply with all city and county ordinances and nate laws
relating to building construction, and hereby authmdu representatives of this
city to enter upon the above-rientlorvd property for impectlmn purposes.
(We) agree to save, Indemnity an d keep harmless the City of Cu pertlno
against liabNtles, jtdgermu,co&s and expenses which may In any way accrue
agalmbald CJJ{pytln ens Sh nyynng dthls pemnit.
/
TOTAL:
BUILDING
464.00
SEISMIC FEE
TOTAL:
ELECTRIC FEE
32.13
PLUMBING FEE
12.11
QTY. MECHANICAL PERMIT IEE
MECHANICAL FEE
PERMITISSUANCE 1'2
FEES PAID:
32 13
ALTERORADDTOMECH.
Date Reeei HI
P
AIR HANDLING UNIT (to 10,000 CFM)
SUBTOTAL:
AIR HANDLING UNIT (OVER IO,DOOCFM)
CONSTRUCTION TAX
Signature of Applicant/Contractor 11 Mte
HAZARDOUS MAT. ALS DISCLOSURE
Wilt the applicant or future building omspantnoreorhandle harardoua
material as defined by the Cupertino Municipal Code, Chapter 9.1 2, and the
IMYesd Safety Code Section 25532(e)?
Wlllthexpplicant or❑future building occupant use equipment ordevices
which emit hazardous air contaminants as defined by the Bay Area Air
Quality Management District?
Yes M Na
havcrnia the
ealth& Tet materials requirements undernd 25534 6.95 of
the California Pt earth&Safety Code, Sections25505,25633have a tenant, that I
understand that 11 the building does not currently have atenanL that ltIsmy
responsibility to notify the occupant of the requirement. which at be met
prior to Issuance of a Certificate of Oxcupancy.
EXHAUST HOOD(W/DUCT)
CONSTRUCTION TAX PAID:
HEATING UNIT CIO 18,000 BTU)
Date Recel t#
HEATING UNIT(OVER 100,(1(D BID)
TOTAL:
VENTILATION FAN(SINCLE RESID)
ISjj�$jJ��E,DATE
L�
t�J 1r 7
d J�Q
i 1
p
City of Cunp. 8111)
ISSUED BY:.,TQ
BOILER{OMP DHPOR 100,000 BTU)
BOILER-COMP(OVIR 100,000 BITn
NEW RESIDENTIAL MECH. SQ.I7
Owner or authorlzed agent Date
TOTAL:
OFFICE COPY