The URL can be used to link to this page

30772APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY TY OF CUPERTINO BUILDING - ELECTRICAL PERMITNO. 30772 BUILDING DIVISION APPI.hATIONIPERMIT PLUMBING -MECHANICAL. LNLLDINL' PROJECT ID1iNTIF'ICA•TION ILDINGADDRESS: I', SANITARY NO. APPLICATIONSUB ITTALDATI ad - ER'SNAMR: PHONE: ON RA NAM.: LIC O: • e iy7 NIC - CONTnnnNOLp �� / G7 i ECDENGINEER: LIC NO: A Jul❑ CONTACtt PHONE I ILDING PERMIT INFO - a ❑ Consultant Fees Paid by Applicant (Initial) BLDG ELECT PLUMB MECH ❑ ❑ ❑ ❑ LICENSED CONTRACTOR'S DEC RATION I hereby affirm Ihm 1 am)icensed under provision. f Chapter 9 (commencing QTY ELECTRIC PERMIT FEE JOB DESCRIPTION with Satian]000)of Division3of 0u Business erW Professio Code,andmylicameis in. full harried effect. censeC s Cm If i Co Date mntractor PERMIT ISSUANCE RESIDENTIAL: ❑SFDWI. ❑KITCHEN REMODEL ❑ADDITION ❑PLUMBING RE -PIPE ❑MULTI -UNIT [:1 STRUCTURAL MODIFICATION 'El INTERIOR CCHIMNEY REPAIR IMPROVEMENT APPLIANCES—RESIDENTIAL A :HITEL IDECL R I understand my plan shall be used is public records _ PANELS UP]0200AMPS Licensed Professional 201-I000AMPS OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Commences License Law Ne ❑ RATHREMODEIJREPAIR ❑DEMOLITION OVER 111110AMP5 SIGNS ELECTRICAL fallowing reason. (Section 7031.5, Business unit Pmfeasioro Code: Any city Or con y which requires a permit m conxlma, viae improve, demolish, or repair any souctu OTHER mimmitaiasuanc., also requires lheappliciou firri,mb,amon In filaasignedsetement SPECIAL CIRCUIT/MISC. that he is licensed Frau... a the praviumor of Ne Communes License Low (Chapter 9 TEMP. METERO Pf1L N COMMERCIAL' (commencing with Section ID0lp of Division 3 oflhe Business and ihnfessinns Cnde)or But he is exempt lhnefrom and the basis for the alleged exemption. Any violation of ❑ NF.W BLDG/ADDITION ❑ DEMOLITION VWER DEVICES Section 7031.5 by any applicant for a Permit subjects Elie dpplicanr to a civil penalty of not marc Nan frve hundred dollars (S5 W). Cl, as owner ofthe PmPerty, Or my employees with wages as their sole compensation, ❑TENANT 0FWD SERVICE IMPROVEMENT �f� AkNIMING POOLELECfRIC-F__��A/O will do the work, and the structure is not intended oroffercd for sale (Sec. 7044, Business OUTL S—SWiTCHE XTURES '0+8�� and Proficia urs Code: The Convenor's License Law does not apply to an owner of pmprry who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements ate not intended or offered for sale. If, however the building or impmvcmeon is sold within one year ofcompletian.the caner -builder will have Ne burden of proving that he did not build or improve for pur- NEW RES ENTIAL E SQ FT. SQ. FT. FLOOR AREA D P F SOT. prat of sola.).' ❑ 1, as came, of the property, am exclusively trouncing with licensed contractors to construct the pmject (Sec. 7044, Business and Professions Cnde:) The Commences Li. ease Law does not apply to an owner afpropeny who builds or improves thereon, and QTY L^ PLUMBI PER JAN 2 4 RECD who contracts f .such projects with a contmemr(s) licensed threaten to the Contractors PERMIT ISSUANCIi License Lew. lam exempt un der Sec. ,B&PCfonhisrevwn CIIY Vf WrcHiIN Dam ALTER —DRAIN&VENT —WA -R(H VALUATION /v oo� 00 WORKER'S COMPENSATION DECLARATION BACK FLOW P)6(9& DEVICE. hereby affirm under penalty of perjury One of the fallowing declamrinns: DRAINS — FL A, CON e and will maintain a Certificate of Consenuo self -insure for Worker's Compcn- .are, as Provided for by Section 3700of the Labor Code, for the performance of rhe STORIES TYPECONSTRUCOON work for which this permit is issued FD0fURn9'VR FIXTURE'TVP. ❑ 1 have and will maintain Wmker's Comismaid on Insurance, as required by Section 370Oof Ne LelanCodf far he perf.mor nceofthe work for which this permit is issued. GAS—EA.YS 40 ETg OCC. GROUP DPN• My Workers Compensation Insurance carrier and Policy number arc: Carrie,. Policy Nn.: GAS—IiA. SYSTEM -O iR 1i?A C13RTIFICATE OF EXEMITION FROM WORKERS' COMPENSATION INSURANCE ('Dais aatlon need cut lxcrnrPlwed if Permit is [Drone hundred dollars(5100) or less.) GREASFJINDUSTRL WASTE INTfRC )R BUILDING DIVISION FEES GNEASRTRAP PLANCHECK FEE I certify that in the performance afthe work for which this permit is issued, l shall employ Low Person in any manner sobecylBe sOdmAlo the Worker%Coni Applicant( �/Y�(vr I �/ /1errrll NW! SEWER—SANITARY—STORM EA. 200 FT. ENERGY FEE WATER HEATER WIVENTIELF.CfR GRADING FEE NOTICE TO APPLICANT.If, after making this Catania of Exemption. youshould become subject to the Workers Compcnmtlnn provisions of Ibe tathnr Coda, you must WATER SYSTEM?BEATING S IS FEE fanhwith comply withsuch Poveriarsor this permit shall be deemed revoked. WATER SERVICE CONSTRUCTION LENDING AGENCY I hereby affiant list nc ffi rthem is a commiction lending agey far the Parfarm:mcaof NEW RESIDENTIAL PLMB. SQ.FT. PAID Data Receipt am work for which Nis permit is issued (Sec. 31197. Civ. CJ Lenders Name TOTAL: Lenders Address TOTAL: BUILDING FEE 01 1 amity that 1 have read this appiiTgthon and state mut the above information is QTY. MECHANICAL PERMIT FEE SEISMIC FEE never. I agree to comply with all city and county oulacrces and side laws relonge building construction, and hereby amhorim representatives of this city to enter upon the PCRMIT ISSUANCE Or,FEE above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep familiars the City of Criterion again. livhilides,judgmenrs. costs and expenses which may in any way accrue against said City in conscquence of the gmming of his permit. ALTER OR ADD TO MECH. PLUMBING FEC AIR HANDLING UNIT(TO 10.0010 CFM) MECHANICAL FEC -NT DERS NDS D WILL COMPLY WITH ALL NON -POINT SOURC I LAT( S. AIR HANDLING UNIT (OVER I0,01s) CFM) CONSTRUCTIONTAX HOUSING MITIGATION FEE Signa e A i nVCommmor Uma HAZARDOUS MATERIALS DISCLOSURE EXHAUST HOOD IW/DUCT) HEATING UNIT (TO 100,000 BTU) Will the applicant or future building occupant store or handle baeurdo ew material as defined by the Criterion Municipal Code, Chapter 9.12, and the Health and Safety Cole, Section 25532(.)'1/ - HEATING UNIT (OVER 100,000 BTU) ❑Yes try' PAID VENTILATION FAN (SINGLE RFSID) Uare Receipt u BOILER —COMP GHP OR 100,000 BTU) Will thea heart nr future building t use e t or devims which pp g by the B a Air Qo pit hazallous air cnntaminanrs eo red by the Bay Arca Air Quality Management Dlxvia^ TOTAL: BOILER— COMP (OVER I pit BT U) / 4v— � AIR CONDITIONER AIR I have read Ne hauNoxa mvrerials requirements under Chaper695 of rhe Cali- ISSUAFN12DATE NEW RESIDENTIAL MECH. SQ. FT. hernia Health & Safety Cole, Sections 25505, 25533 and 25534. 1 understand and if the building does nm currently have a talent. that it is my responsibility, to notify me occuFam of the requirements which must he oat prior to issuance of a Certificate of Occupancy. ISSUED BY: TOTAL Owner.atrmhnriod agent Data OFFICE of 10300 Torre Avenue Cupertino, CA 95014 Cupertino Building Division (408)777-3333 (fax) March 5, 1999 SYMANTEC, INC. Property Manager/Owner 10201 Torre Avenue Cupertino, CA 95014 SUBJECT: Permit # 30772 — Sound wall Dear Property Owner: We have been going through our files in the Building Department, and contacting those people with permits remaining "open". According to our inspection records, this permit has not been signed off by the Building Department. Many times an inspector will sign the permit in the field, but overlook reporting all of the information to the clerical staff for input into the computer. If this is the situation and your permit card shows the final sign -off, would you please contact us so we may complete our computer records? If the permit is not signed off, please call to schedule an inspection for final closure of the permit. Because of the large volume of paperwork within the building department, we cannot separately monitor the progress of each permit. We ask that you give this notification your immediate attention. If we do not hear from you within ten (10) working days we will remove the records from our computer. Thank you for your assistance. Sincerely, CITY OF CUPERTINO 6c� Christy Akatiff, Administrative Clerk Printed on Recycled Paper