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29748--->^'•nrrcraww r•vv rscc saw u.rvnmwnvne _ - ' [� r CITY:DF CUPERTINO an nm ncv..uvc rr BUILDING'P.LEC'RICAL PERMITNO. �v./ 1 �'Iv BUILDING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL L JV #.1-.'y.n.�Y.`?e iL IN6 PROJECT BMD'ICATION.':Q-;l..F':J.'Me. BUILDING ADDRESS: SANITARY NO. APPLICATION SUBMITTAL DATE 0 4 OL C OWN ^;v-Ji y ?HON& NTRACR3R'S NAME: LIC NO: N� CONfROLg ACH3F GIN ER: +11' Px k r'.g k1JC NO:. r,{� ADDRESS:. rJ' r.I ❑ d=l4}�41f1iF'C' , F. Io CONTACT: 11{4'r:r1J:U{wW"``hj [ 'Congutant FePaid IbAy Applial(initial) �go_ BUILDllVO PPlJIPLUMB jMiEC:H 3341301. LICENSEDCONTRACIDRSDCLARATONV�,, 1 .25.• ft"UR C�'ERA•�IT, !� pgtl [I. alRnn Nst 1 am Ikenw1 undo provision.of Cluprer 9 konunencing L..1. t"'c1. Awve.ns.saw ,v... x4rn' JOB DESCRIPTION Z with Smine 7000)of=zkyo3of the Busimaa and Prbfe..imu Code.next my license is CE RFC_ IF�IJ_F:NTIAAf= PERMIT ISSUAN ❑� in full forte and offal. []SFTWL []KITCHEN REMODEL 1. {� License Chis 1.1c.0 APPLIANCES-RESIDENTIAL ❑ADDITION O PLUMBING REPIPE Date�s ARCHnE(TSDECLARATIONI • PANEIS ^' ❑MULTI-UNIT } ❑STRUCTURAL 5 1 tinderitenit my plans Abell En used u piddle records MODIFICATION pO '• UPT0203AMPS ❑INTERIOR ""OCHIMNF,V REPAIR •r3 Ucamed Profauimul 201-I000AMPS IMPROVEMENT ((5 OWNER-BUILDER DECLARATION OVER 1000 AMPS ❑BATH REMODEL/IiEPA1R []DEMOLITION O i hereby anion,that 1 Am exempt from the Camnctoc,Licerue Lew for the _ following aesan.(Sectlan 7031.5.Rottman and Pro,0.16n.Code:Any city of comay ''tl' SIGNS ELECTRICAL []OTHER a W 1y. rwhich require,a Femd1 to moonset,aher,improve.demolish,or repair Any structure too .?to inn.rocs.alsorequire dm applicenlfm each pemllt to file aAigned Nlemenl SPECIALCIRCUIT/MISC. g. that hntslkensnd punuans to Ne provhlmu afthe Cantmmrs Lken.law(Chepla9 COMMFRCIAI: CD (commneing with S.Oon 1000)of Dlvlelon3of NeBmine.s end Pmfeulon.Code)or / TEMP.MEIER OR POLE INST. Q IY that he is exempl thetefmen and the beat,r.the alleged exemption.Any violation of f O NEW BLDG/ADDITION D DEMOLITION •T•J Y'.taction 7031.5 by Any applicant Ni i pe hit Ab)"the eppliunt toe civil gamily a t POWER DEVICES - ANT'. r •� []FOOD SERVICE net mom then eve hundredn(f5 dolle00). PROVEMENT < Ol.uowner of the progeny.br myemployos with wege.n their solecomFcnsetlon, SWIMMING POOL ELECTRIC (:)OTHER dude wart,sad de couscous,head Intended moRnrtA fm We(5.,7044,BuAlne,s and profession,Code:The Cootiaci se.haemic liw'dcei Imt'apply to ed owner ofg OUTLUTS-SWITCHES;FIXTURES a� .. pmpeo,who Wilds or improve,Nes,an,end who does stich work himself m through his own employ..,provided Nat such Improvements K not Intended or offered for NEW RESIDENTIAL RLECfR SO FL SQ.FT.FLOOR AREA LSV.FT. sale.If,however.the bullding m Improvement to sold within mte yen of completion,the owner-builder will here the huNen of proving WI he did nm build in Improve for Poe ^ �© P000fstte). 1,An owner of the progeny,em e.chnively cantrsoiinl WIN Ikon ed conh.doss to comouct On Poj.t(See 70AL Bminea.And profession.Code:)Toe Contractors Li- a yy}v: i:�x�.4u_-dl.yry.:yF came law don n,1 apply 1.en owner of property who build,m improve,the..end �j('y.)6,x,.�.rtyTpvF'I;UMI�INCi P0R�M1Tsca AF _ P` I J(/N g� who conRMefm eskM1 paJeetiwlth ecmirecrnrle)licensed patetlsotlo Ne Conhaclaro "LL FI U.law. /" �*•'�t%�"✓�. '• PERMIT ISSUANCE - CII J'v 41996 O l an e,eapr underSee. .B&P C NA Ni.wan Ill Owner, - One ALTER-GRAINAV NT ATER(PA) P'ChVA/UATIO`' �tWORKER'S COMPENSATION DECLARATION BACK PL P UEVI ` 1 hereby aRrm under penalty dperJury one of Ne followin8 dcclentims: ]iluve and will maintain.Caificahe ofComem to self-imma for Workers Compen. DRAINS- R00. .0 D. STORKS TYPE CONSTRUCTION n lon.An provided fm by Section 37M of Ne labor Cade,fin the Fedmm.... of she 'r' �' soak fm whkh Nis pemtil I.ootid. FIXTU -PER TR 0 1 Lave end will malnuln Wmkcr c Cmnpemelion Luuranee,is required by S«tion /{ J100 of the labor Code.fm the peHmmerce of the work fm which this permit ie Issued. OAS-EA. smad-I ily.VIA OCC.GRO APN 1 ' My Worend Po11�11ymh.xgr�`I wf'1�+1 GAS-EA.SYS OVER i( 4 Carder ,saq.r�l' Policy Na: b CSR lwe'l�7 CERTIFICATE OF ID EMPOON FROM WORKERS' /. GREASPAN S L TE INTER R .rt?xlo`n,s• irk.iBU NI$IGtI FEESy: a'v„«a`,'�yt.;wu COMPENSATION INSURANCE ITh6xectim nod net beiampltlndlf NepemdlHfm one hundred dtilen(SIM) GREASETR ale,.) PLANCHL+CK FEE � Icenify that in the Fcrfmrmrce ofNewark fm which thio permit iso sued.Lhall SEWER-SANITA ->TOR .200 FT. O r rot employ n.y pawn In any manner so n a h.oro suhjtts to the Waken'Cmnpcn- ENERGY FEE L Coto Z .'N.Leweaf Celifamie.Dete WATER HEATER E GRADING FEP, I(dQ Applicant q•' NOTICE TO APPLICANT:If,After making this Cenincam of Exemprton,you ah.ld WATER SYSIE ITREAT I{aU•� became subject m the Workers Compensation provisions of the Lehm Codate,you moSOUS ME fuNwiN comply wlthmch,.vI.l.n,ar Or Fermi shll he domed rtvoknd. WATER SERVICE dQ ' PAID Z CONSfRUCf10N LENDING AGENCY N EW RESIDENTIAL PI. P SQ.FT. Data 0 IhemM1y affirm thin hem lu cmntoetion koll.gegency,for Ne performance of ' •�t•+ the wart fm which this permit I.Issued(Sac3097.Cl,C.) sO IC••T I<Mre.Ns. TOTAL: W Landon Address TOTAL I reap Net 1 have=it this Application and state that the Above mformnha i BUILDING fa/f cms,m 1 ego.m comply aiN dl airy end nounty ordinen.s end nate law,relit ng mP.CfIANICAI.�PP.RMITI r+, urdv V buildingmnsnsetion,Whereby euthmi.rtprtsenwimof Nisciry to enter upon titc - a.•n ee•rr• d s .� SEISMIC PER 5 .hove-men0ated property fm inspection pugxwe.. UANCE ELECTRIC (WC)egma m save,indemnify end keep hemmlen the City of CUFenino Against Iiabilitie,.Judgrrenu.cane Weapon..soh in any way, ay acme Agaimn old CityADD TO MECH. PLUM B( 4 In aonsequentt of de granting of This omit APPLICAN NDERSIANDS CO LY WITH .NON-POINT AIR HANDLING UNIT M 10.000 CFM) MECHANICAL FF SOURC LATIONS. j%MAV A1, AIR DANDLING UNIT(OVER IOJXH CFM) CONSTRUCfIO TAX Sign roof Applic. onhutm Data 1 EXHAU.ST000D(W/DUCT) HOUSING Mfii ATION FEE IAZARDOU MA ISCLOSURE Will the lkenl mturn. gt ulommhWlels.dmsmetnnAl , HEATING UNIT(TO 1(0.000 BTU) u dnfimd by the Cupenino Municipal C .Ch.,Ia 9.12.end the Hulth end SAfety Ca I'lok 25532(A)7 1 /`y HEATING UNIT(OVER IMBIBE BTU) / j$Ye, - ONo �rZ"D NL V hG ILATH)N PAN(SINGLE RPSIDI PAID o\ Data mind A • Will the sMlicent or future buildinj occepent use equipatem a devicex which BOILER-COMP(JHP OR 100,000 BTU) mil huard...ir...tealmu ne1 deemed by the Bay Area Air Quality M.nagemenl AL: sans? v BOILER-COMP(OVER IM.000 BTU) O Ye. p(no I have road the henmku.met .rtqu1rtoana . da CTwpmr Q95 of the Coli AIR CONDITIONER ISSUANCE DATE Not.Health A SAfe'y Cade.Sethi 2 O5,7,5513:yin nd 25534.1 undemmW that If the NEW RESIDENTIAL MF,CH. SQ.Ff. boiler n,1 e s t, oil is my rnpmstMliq to notify lha twcvpem �s irtnenu t min issue Caoflciaof(Mup.ne. 13 wmame 'and mUste AL ISSUEDBY: OFFICE Y GAN Tg9t SANTA CLARA COUNTY CENTRAL FIRE PROTECTION DISTRICT pan 14718)WINCHESTER BLVD, LOS GATOS, CA 95(13(11818 (408)378-4010 SERVICE FcnoN O SINCE 1947 FAX (409)378-9342 To: Christy, City of Cupertino Building Department ►�� RR From: Fire Prevention Bureau v� The building located at�/D /D Has been FINALED. The building permit number is: 2 / 7z18 Date: 7 Signed: Radio,Number Z k Z3