5486041LICANT TO FILL, IN INFORMATION WITHIN REDLINES - USE BALL POINT PEN ONLY
rte'
' ,BUILDING PROJECT I DENT( F.ICATION
''^�• -
r
r 'APPLICATION &PERMIT
BUILDING=ELECTRICAL-PLUMBING-MECHANICAL
PERMIT NUMBER
5456
au'LOING -
ADDRESS "i:�'
"" E ..
�.i",
••
OTY. ELECTRIC PERMIT FEE
PLAN CHECK VALI TION,
f.- Q�(�/FT/'n/
�f-T/'
../WJ GI Sloe,HONE
/_7J"S
NAMpRADTGR's
•uc.
OUTLETS-SWITCHES-RECEP" 5.00/1,00
rvo, 5 L
-.
DATE OF APPLICATION
LIGHTING FIXTURES •' 5.00/1.00
"CONTRACTORS „
AORESS, '/ i';./OO/T
4 0 ,^ad vHONE
'�
'APPLIANCES - RESIDENTIAL 4.00
PANELS 5.00
ARCHrtECT _ -
OR
'ENGINEER// d •�., uc: No. '
SIGNS , 6.00
PLAN CHECK FEE P.C. NO.
SIGNS TRANS. ;• - 3.00
ARCH.ORENG. a ' -
DDRESS
.iL33 1toN N P
" SPECIAL CIRCUIT ' '5.00
PERMIT VALIDATION
fr�
J
TEMP. METER OR POLE INS. 15.00
APPLICANT'S •-
ADDRESS .,.
630
MOTORS 'SEE :FEE ICH.
SERVICE CHANGE 10.00
; LICENSED CONTRA CTORS &DECLARATION
I hereby affirm that l am lie,enwTunder provisions of ChaPler'9
(commencing with Section 7000) of Division 3 of the Business mrd'
Professions Code, 1 my license is in full fore • a d effec .
L'censej7jass- LIc. Number
ISSUANCE DATE
BLDG. ELECT.
PLG. MECH. ,
❑
Date .JAV-3.-J-L(J_ Contractor-
-
_ O`WNFR-BUILDER DECLARATION
from the Contractor's License
I by affirm that 1 am. (Sec. 7031.5, Professions
Law for tllor following Secuires Business to construct,
Anyrequires permit o its issuance,
Codd'Any c mlish county whiny structure, also
improve; demolish, or repair any sticture, prior to its atom nt also
requires the applicant for such permit m file a signed statement that
he is licensed pursuant m the provision's of the Contractor's License'
Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and, Professions Code) or that he is exempt therefrom and
INFORMATION
FORMATION
JAUI
�Q S/FT:
So 100 0O
TO
rr '
xr,MO DEL
• '?EMO It -
' MISG - REFER TO.ORD
-PERM( T ISSUANCE' 6.00
ELEC. CONTR. LIC. NO.
�
ELEC, p
TOTAL - V
CITY. PLUMBING PERMIT FEE
STORIES
TYPE CONSTR.
the basis for the alleged exemption. Any violation of Section 7031.5
by any applicant for. permit subjects the applicant to a civil penalty
of not more than five hundred dollars ($500).):
ALTER -DRAIN -WATER (EA:)4.00
❑ 1, as owner of the property, or my employees with wages as
their sole compensation; will do the work: and the structure is not
BACK FLOW PROTECT: DEVICE. 2.00
OCCGROUP'
.
RES. UNITS.
„
DRAINS -FLOOR, ROOF, AREA,COND. 4.00
intended or offered for sale (Sec: 7044, Business and Professions
Code: 'file Contractor's 'License Law does not apply to an owner of
property who builds or improves thereon, and who does such work
himself or through his own employees, provided that such improve=
oots are not intended or offered for sale. If, however, the building
Hoods
FIXTURES',- PER TRAP 4.00
50. FT. FLOOR AREA
TOTAL A REAGE
'
-
GAS -EA. SYSTEM INC.INC.4 OUTLETS 4.00
or improvement is sold within one-year of completion, the owner-
builder will have the burden of proving that he did not build or on-
prove for purpose of sale.).
❑ I, as owner of the property, am exclusively contracting with'
GAS - EA:•SYSTEM -OVER 4 (EA.) 1.00
-
BUILDING USE
RES IND CON PB Omer
❑ ❑ ❑ ❑ ❑
I N DUSTR I A L WASTE, I NTER. 20.00 '
.licensed contractors to colistowt the project (Sec. 7044, Business
and Professions Code: The Contractor's License Law does not apply.'
to an owner of property who builds or improves thereon, and who
LAWN' SPRINKLERS.- VINC.5 V.B. 5.00
-
LAWN SPRINKLERS -OVER 51EA.) 1.00
ASSESSORS PARCEL NO.
-
contracts for such projects with a contracloHs) licensed pursuant to
the Contractor's License Law.'
SEWER-SANITARYSTORM EA. 200ft/8.00
TRACT NO. -
-PARCEL NO.
0 l ani exempt under, Sec. " _ BAP.C. for this'
WATER" HEATER W/VENT 4,00
Reason
)
OwnerUate
.WATER SYSTEM .. .4.00
ACC. DATE,,;
ACC. FILE NO. -
WATER TREATING EQUIP. 4.00
WORKERS'COMPF.NSATION DECLARATION
1 hereby affirm that I have''" certificate of consent to self -insure.
or a certificate of Workers' Compensation Insurance, or a certified
-
ZONING
ENG. SITE NU.
-
copy thereof{ Lab.C.).•��_.-�_
_iii. 38000,
-Policy No jjQa ompany-HLAUSA" 7:41.�•
Or-Cerlilied Copy is hereyfurnished.
❑ Certified is filed 'til a cit pection division.
Applicant"y
'
-FIRE SPRINK
Y ❑ N❑
.' ENERGY T-24
Y ❑ No
MISC.- REFER TO ORD.
C'RTI A IF -F, O fRS'
COMPENSATION INSURANCE} ''
seelki 'Need not 6 complete&& the permit is m,,one
PERMIT' ISSUANCE .- 6.00
FLOOD ZONE
Y❑• N❑
A.L.U.C.
Y❑ N[]•,(This
PLG. CONTH. LIC. NO,
'
PLG,
TDTA4
'hundred dollars ($ 100) or lexi.) - "
. I certify that in the performance of the work for which this per-
mit is issued, I shall not employ any person in any manner So as to
-
OTY. MECHANICAL PERMIT FEE
FEE SUMMARY'
BUILDING
/p
become subjectto the Workers' Compensation Laws of California.
Date •' Applicant'
ALTER OR ADD TO MECH. .4.00
NOTICE TO APPLICANT': If, after making (his Certificate of Ex-
_
APPLIANCE 4.00
.''PLAN CHECK
emptier, you should become subject to the Workers' Compensation
provisions of the Labor Code, you mus( forthwithcomply with
such provisions or this permit shall be deemed revoked.,
• CONSTRUCTION LENDING AGENCY'
-
AIR HANDLING UNIT (TO 10,000C.F.M.)6- 3.00
FEE
AIR HANDLING UNIT (OVER 10PWC.RM.) 5.00.
_
SEISMIC FEE
„•.a "Cl
I hereby, affirm rfiat,4herc is a'construction lending agency for
tire' performance of We work for which this permit is issued (See.
3097, Cw.CJ. ,'
Lender's Name
EXHAUST HOOD (WITH DUCT) 2.00
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 4.00
HEATING UNIT (OVER 100,000 B.T.U.)7.50
ELECTRIC
'Lender's Address
I'certify,thrfthave- readttiisapplicationand state that the above
VENTILATION FAN (SINGLE) 3.00
inrmation is correct'[ agree.to comply with all`city and county
fo
ordinances andstatelaws relating to building construction, and
PLUMBING
BOILER-COMP(3 H.P.Da100,0008.T.U.)'4.00
BOILER -COMP (Over 100,000 BTU) SEE FEE SCH.
MECHANICAL
'hereby" authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.'r
MISG.'- REFER TO ORD.
-, (WcJ agreeto sak, indemnify, and keep harmless the City of
Cupertino against liabilities, judgments, costs and expenses which
may in any way accrue against said City in consequence of the
CONST. TAX
PERMIT ISSUANCE 3.00
grantullibuiEthis permit. ♦
MECH. CONT. LIC. NO. MECH.
TOTAL
TOTAL
of pplican roc r -,, Date
OFFICECOPY-
..r
i
CITY OF CUPERTINO INSPECTION RECORD
FINAL INSPECTIONS DATE I INSP.
1+
m
r,
m!z4
PLLMING DATE I INSP.
PE
IN
CENTRAL FIRE MOUCTION DMIUCi'
3072 DRIFTWOOD DRIVE,
, vow
SEHV14E. .: �..
`
SAN JOSE. CA. 9512f3
_.�..�.�....�.,.�..�,
SINCE 11447 408,37$-4010
PLN REVIEW COMMENTS #251
C 40Ej1E:C TTQN �.i F, ET NOe
1
Submit fire sprinkler modification plans to this office for approval.
4 2
The new store front does not appear to be of one-, (l hour construction.
All structural members shall be protected by one- (1� hour construction,
All
penetrations in the one- (1) hoer construction shall be protected;
i.e., at roll down grill penetration.
5 3
The ends of metal tie rods supporting soffit areas shown at Details l
and 2 shall be protected with one- (1) hour material.
"} 4
All duct penetrations in the one- (1) hour ceilings shall be protected
by approved fire damper assemblies. Submit installation details and
make/model specifications to this office for approval prior to instalia-
tion.
5
All recessed light fixture penetrations in the one- (1) hour ceiling
shall be protected by approved bonnet assemblies--show details.
5 6
The exposed framing at the T.V. opening shown at Details 3 and 4 shall
be protected with one- (1) hour inaterials.
7
Provide a 2A108C fire extinguisher centrally located.
i JN: jy
—iiN, f.LRNS SPECS NEW REMC0XL CONST. DESCRIP.EX. sy DATk_•••••• PR UE.
Cupertino X x IV 1-HR Dirk 45A4
Mattern 05 l f
SEC;-Ds,'lFt.0100Fz.: F.2
PCE 2122-2
OCC OCC.LD. AN C. fi&NO/C AN TR#CiCSi1 X1W!!E9! TP .
'
30 - .retail 1900 Kinney Shoe Corp.
NAME � :� R C :y
.tea.-..n..
LOCA TiON
Foot Locker
WOLFE ROOD - Vallco ; ishion Park