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22819 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT.P_EN ONLY Building Pm'amt Identification 7W ggjo PENMITNO. Building Address: // VV !OI -z -a Na fZD CWsMT)NO IG14 qS-0/4- 22819 CITY OF CUPERTINO-BUILDING DIVISION Contn+eto:+Narne: as Lic.No: APPLICATION /PERMIT BNLDING-ELECTRICAL-PLUMBING-MECIIAMCAL CATEGORY CO O Arcluted/Engineer. Lk.Na QTY ELECTRIC PERMIT FEE BUILDING PERMIT INFO Addreateg, PERMEEISSUANCE LICENSED CONTRACTOR'S DECLARATION Ihereby affirm that l am licensed under provWons of Chapter 9(commenc APP LIANCES­RE WE JOB DPSC ON ingwlth Section 7000).f Division 3ofthe Business and ProfessionsCode,and my licensele In fuB ce forane d(ect. PANELS i meChss Lk.N `l Cl.i Date Contractor ARCHITECPS DECLARATION 201.1 I19 It m7 I understand my plans shall be used as public records. O MAMPS SQ.FT.FLOOR AREA $/SQ.FT. 06 ti Licensed Profcmioml GNS ELECTRIC S Z V <Fh OWNER-BUILDER DECLARATION SPECIALCIRCUI LSC / t., 7 I herebyaffimmthn lamaxempt fromthe Contractor'sLicense la tO O t-O following recon(Section 7031.5,Business and Professions Code:Any city o gyp,M OR POLE INSI'. F4 W county which requires a permit to construct,alter,Improve,demolish,orrepair G '� anystructurc prlorm its issuance,ales requlreatheappBrant for such permit to PO DEVICES a file a signed statement that he 6licensed pursuant to the provisions of the O u,� Contractor's License Law(Chapter 9(commencing with Section 7000)of Divi- SWIMMING POOL ELECTRIC tJ30 eon3oflhe Buslnemand Pmfemlom Code)orthathe6exem therefmmaad VALUATION eF P� S the basis for the alleged exemption. Any violation of Section 70315 by any UTLETSSWITCHES.FIXI ONES � ,7 65 applicant fora permit subjects the applicant to a civil penalty of not more than Z� U LJ ©©©o. O 43 five hundred dollars($500, NEW RESIDENTIAL ELECTR Rip SQ.FI'. STORE TYPECONSTRUCTION ❑I,as owner of the a week a or my employees with wages r thele sole C7a compensation,will clothe week and thenwcturc6rotIntended or offered for D sxIr(Sec.7(M4,Business and Prefemions Code:The ConmactoJs License Law -FAN LE I P3§ docs not apply to an owner of propertywho W ilds or improvcs thereon and C. R S who docssuchwurkhimseif ortMough hisownemployecs,provided that such Improvements amour intended oroffered for sale.If,however,the building or TOT Improvement 6sold withinoneyearofcomplelloMtheowner-bu0derw111 have PUTER the�urden of proving that he did not Wild or improve for purpose of sale.). QTY. PLUMBING PERMIT FE Hppp 7pNE L I,as owner of the property,am exclusively contracting with licensed contrewast.canswct the project(Sec.7044,Business and Professions Code: PERMIT ISSUANCE The Contractors License Taw does not apply to an owner of property who ALTER-DRAIN&VENT-WATER(TNN Wilds or Improves thereon,and who contracts for such ptojects with a FEE SUMMARY coyyII ct (a)licensed pursuant to the Contractors License Law. BACK FLOW PROTECT.DEVICE tJ I am exempt under Sec. B&P C for this reawn ­e QVISIDLEEES DRAINS FLOOR ROOF,AREA,CONES ANITARY Y_ N_ • Owner Dee RECEIPT N WORIDAAN COMPENSATION DECLARATION FLCILRES PER TRAP ►r SCHOOLTAX Y_ N_ ❑1 hereby affirm that I have a certificate of consent to cel(-Inmre,ora RECEIVE N certifiate ofWorkeri Compensation Insurance ora certified copy therem(Sec. GAS EA.SYSTEM-1 INCA OUTLETS PARK FLE Y N 3800,Lab C.) RECEIPT N Pollayp GAS EA.SYSTEM-OVER 4(EA) �� BUILDING DIVISION FEES C. any ffCertlfied copy 6 hereby furnished. GREASE/INDUSTRL WASTE INTERCEPTOR " PLANCHECK FEE w ❑Certmrd copy 6 filed with the city Impectmn division. /6gi y CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE TRAP PAID r COMPENSATION INSURANCE SEWER-SANTFARY-STORM EA.200FT. Date RLYCi t# Rh6 section need nal M completed 1(the permit 6 furors hundred dollars ($100)mles.) WATER THEATER W/VENT/ELECTR ENERGY FEE Y_ N_ I certify that In the perfornenceof the work forwhich this permit Is'saved, - I shall not employ any person In any neuter so as to become subject to the WATIX SYSfF3.1/TREATING Workers'Compensation Laws of California.Data PAID O Z Applicant NEWRFSIDENTIALPLMB. SQ.FT. Dale RCC21 [# Z O NOTICETO APPLICANT:If,after making that Certificate of Exemption,you H CC N should become subject to the Workers'Compensation provisions of the Labor TOTAL: Cade,you=at forthwith comply with such provisions or this permit shall be B I LDIMLOFSE deemed revoked. IL CONSTRUCTION LENDING AGENCY SETS -E a Ihereby affirmthat there 6 a comuuctlon lendingagency forthe perform- EL$ E ^e ance of the work for which this permit 6 issued eirc.3097,Civ.C.) TO ILPLUM NGF Lender's Name { LL f Lender'sAddnss QTY. MECHANICAL PERMIT FEE MECHA �� U Iartilythat l have read thisappliationaM statethetheabova information �^ FEE P 0 1 6corn¢t.l agreeto comply with all cityand county,ordinances and state laws PERMIT ISSUANCE >_ N relating to Wilding constmNon,and hereby authorise representatives ofth6 F_ Z city to enter upon the above mentioned property for Inspection purposes. I ALTERORADDTOMECH. C we R el t# (We)agree to save,Indemnify an d keep harmless the City of Cupertino AIR HANDLING UNIT(TO 10,000 CFM) P U against 0abilltles,0dgments,mets and expenses which may In any way amus SUBT TAL: against said City in consequence of the granting of this permit. AIR HANDLING[RVTT(OVER 10,000CIM) CONSTRUCTION TA Signature of Applicant/Contractor Date E%HAtAT I IOOD(W/DUCT) ..-• CONSTRUCTION TA AID: HAZARDOUS MATERIALS DISCLOSURE WI1llheappBant or future building occupant store or handle harardous HEATING UNIT(TO 100,000 BTU) Date Re el [# material as defined by the Cupertino Municipal Code,Chapter 9.12 and the - HeethandSeotyCodeSect1on7553](.)I HEATING UNIT(OVER 1W,0008TU) T T ❑Yn No Will the applicant or tura building occupant use equipment or devices VENIILATION FAN;SINGLE RESiD) ]$SUANCE ATE which emit harardous air contaminants as defined by the Bay Area Air • Quality Ma mgement Dist ricti BOILFR-COMP OTB'OR 100,000 BTU) 4Vet ❑❑No pp havcmad the haardouamleria6requlrementsunder Chapter 6.95of BOILER-COMP(OVER 100,000 BTU) R B the California Health&Safety Code,Sections 25505,25S33 and 75534.I u ndersta nd that if the lou llding does not currently have a tenant,that it is my NEW RESIDENTIAL MECH. SQ'FT Rlp� 14 responsibility to notify the occupant of the requirements which must be met 1991 �^1 prior to Issuance of a Certificate ofOccupancy. Owner or authonmd agent Date TOTA . r iSSUEUIIY:_ OFFICE COPY POST THIS CAR FRONT OF BUILLf�G wwTN f� Q CITYUPERTINO (i 19 INSPECTION DIVISION- JOB INSPECTION RECORD 1 JOB ADDRESS_ 4 �jlf�,d� UIul9qo LOT # CATFMRY CONIKOLT HAWS` x-i OWNER �Qu 17�1� CONTRACTOR �"� �y`,{:,BUr1LDINC=P.ERM17'INFO'.,kyte'{?�xi INSPECTION=� }s s1t Sv4r'{`" «. 'DATE vl INSPECTOR INSPECTION RECORD FOUNDATION PIERS NOTE ALL GRADING AND DRAINAGE UFERGROUND SFIALL BE INSTALLED TO COMPLY WITH JOU UF5CW1'f10N PAD/SETBACK-CERT CUPAPPROVEDRTISTANPLANSRDS. cln OF - CUE NO STANDARDS. GARAGE SLABS PREGUNITG � 'POUR'NO,CONCRETE?UNTIVABO VE'HAS.BEF.N'.SIGNED iP UNDERGROUND/SLAB INSPECTION DATE INSPE TOR PLUM13ING -e. ELECTRICAL MECHANICAL p.E/ �� DO NOT'POUR FLOORFUNTIL'ABOVE HAS,BEEN SIGNEDII WOOD FLOOR �? PLUMBING f / 'MECFANICA'L GC jh ? ELECTRICAL " . _ - FIZAMING VENTS CLEAR INSULATION' PLACE NO.SUBFLOOR'UNTILlABOVE HAS.BEEMSIGNED� - ROUGH PLUMBING- To ew ery � ,$' TUBS k SI-IOWER PAN -T C MECHANICAL sl_ ELECTRICAL/JACUZZI 13OND FRAMING STAIRS ` INSULATION/VENTILATION EM ERG,EGRESS SEWER WATER COVER=NO'WORKvUWFWABOVE,HAS BEF,N)SIGNED TisA EXTERIOR SHEAR/HOLD DOWN INTERIOR SHEAR/HOLD DOWN SHEETROCK/SHEETROCK SHEAR EXTERIOR LATI-I/W-SCREEN SHOWER LATH - SCRATCH COAT `NOxTAP -'OR,PLAS R4UNTILrAIIVE•HAS+BEEMSIGN D� NOTE:,NOiFINAL.INSPECTION SHALL BE MADE BEFORE 7wE'CbNSTRUCTION TAX IS PAID ''- FINALS DATE INSPECTOR SAN.# ELECT.ENERGY - _ PLUMBING ENERGY _ rL°LLT ok 9,�c,2 7 MECI-LENERGY. - BUILDING ENEIZCY ,meq 76' iL^-c 11'�i- S ELECT.FINAL TEST - PLUMBING - o- GAS TEST MECHANICAL 7- HEATING ELECTRICAL RELEASE FIRE DEPT. b GRADE OCCUPANCY US TEMPORARY APPROVALS ELECTRIC �'- GAS 2 BUILDING - ISSUANCE DATE OCCUPANCY OF BUILDING,IS NO PE hl E IL BUILDING FINAL,IS SIGNED BY BUILDING INSPECTO ARRANGE FOR INSPECTION BY PH NING 252-4505 BETVYEEN PAID 12:30 PM AND 4:30 PM MONDAY THR FRIDAY,2 OURS plo� BEFORE REQUIRED INSPECTION. JOB D X11 4 1991 PERMIT# ARE NEEDED WHEN PHONING., G�I.Y UI ANTIG .- .. UF. - r.:y t IMPORT .., kh'IW�j . PL AS READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION`''-r ISSULD BY. APPLICANT'S POSTING COPY No. 879 cgrrtif tratt of (� rr�t�Nittxtr Tity of Tuprrtino 13pliartmPut of 'Nitithing 3tiopprflo" .This certificate issued pursuant to the requirements of Section 307 of the Uniform Building Cade certifying that at the time of issuance this structure nm in compliance with the various ordinances of the city regulating building construction or use. For the following: Use Classification Interior Improvements Bldg. Permit No. 22219 Group. B-2 Type Construction V-NUse Zone__21anned Development Ownerol'Building Taqueria las Floresut — Address -LD-L23 �_ WQUQ Road, Space 990 8 Building Address 10123 N. Wolfe Road, Sp. 990 Locality Cupert-ino . California _ a By: •Tnp Anf-onijcci Date: EehriiarI7 10 , 1992- Building Official POST IN A CONSPICUOUS rLAcr MT