S0047 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECTRICAI, rERMH NO. n
BUILDING DIVISION APPLICATION/PERMIT rING PRUR N'C.-6p IDENTIFICATION
�.r�
BUILDING I'R(IJE(T IDFNTIFICATIUN 4�1(S,�f/
BU11.DINGADDRESS: SANITARY NO. APPAI'IIlNSU1lMl'ITALDAIT
O 0 D "�
(IWNEH:S NAM.: 10*
PHONE: CONTRACTOR'S NAME: LIC NU:
I APICC q N/C CUMI'Rllhp
ARCHITECUENGINEER: LIC NO ADDRIiSS: / ❑
CON'T'ACT: PHONE BUILDING PIiRMI'I'INFO
❑ Consultant Fees Paid by Applicant(Initial) IILUG P.LEC1PLUMB MECH
❑ ❑
LICENSED CONTRACTORS DECLARATIONQTy ELECTRIC PERM,r FEE
1 hereby afrlrn mat I am licensed under pmviliaal of Cnal is 9(commencing JOB DESCRIPTION
tyil=�z with Satin,9(NXD of Division3 ofthc Hasinexs and PmfessionsCale.ane my license is RESIDENTIAL:
�W0 in full fractions]effect PERMIT ISSUANCE.
QUV License Class Lica ❑SFDWL ❑KITCHIiN REMODEL
yQY pate Comrnctor APPLIANCES-RESIDENTIAL OADDITION ❑PLlID1BING RE-PIPIT
ARCHITECT'S DECLARATION PANELS ❑MULTI-0NIT ❑STRUCTURAL
F,oz I underaand my plan,shall be used as public raTo oth MODIFICATION
r�^-+ UP T0211f1AMPS ❑IN9"IERIOR ❑CIIIMNIiY REPAIR
Fa La ma; Licenced Profcsinmd 201-I WO AMPS'. IMPROVEMENT T 0 SWIMMING O POOLS
�yt=.J OWNER-BUILDER
an'he RATION OVER 1000 AMT'S E]PATH REMODEIlR1iPAIR CD13MG1.1'1'[ON
IY C 1 hereby.(Hees on 1 am cxcmpt train Thu Cmdracou'vCoeLicense; yLaw cu Thr ❑OTHER
X3 d U Which ing reason.(Section 9oodu Business and Professions Cade:Any city or amnry SIGNS ELECTRICAL
I'•H which requires a permit re.,orad,aper,improve.Jeermit t m repair any atlumurc
' u'�Q' prior niu issuance,also requires me applicant for such Permit file asigned,lalemmt SPECIAL CIRCUIT/MISC.
f' y
that he is licensed pursuant o the provisions of the Comractah License lrw(Chapter 9 COMMERCIAL:
t�al�a0$O mmimmang with Section TIDO)of Division Sof the Business and Professions Code)or TEMP.METER OR POLE INSI'.
1 a o C mat he is exempt therefrom and the basis for the alleged exemption.Any violation of ❑NF:W BLDG/ADD11'ION Q OIiMO1.IT10N
WwwSection 1011,1 by any applicant for a pemtit subjects me applicant to a civil penalty of POWER DEVICES ❑TFNANT ❑FOOD SERVICE
not.,,.,ban five hundred doll.,($500) 1MPROVEMEM'�g
FZQ (]Lxs owner of the pmpeny.or myennployceswi0n wage,as mcir solecnmpensaion, SWIMMING POOL ELECTRIC G
$E toRental
will Jo the work,and the,arvcwrcis nal inlenJcA..... forsale(Sec.7044,Business []OTHER
W w and 1'nolcxaione Code:The Coauaclues U'roo,Law doer not apply to an owner of OUTLP.TS-SWITCHES Ill JRES
pr+perty who huddi or improves thereon,and who mea such work hhnclf or mnmgh
Iii,own amployce..provided that tach improvement,are a(,,intended err ol'lemd far NEW RESIDENTIAL EI :'f SQ t•7:
vale lL however.the building or improvement I%sold witnause,ye.nf,empletio..the SQ.PI'.FLOOR AREA SISQ.F'f.
tovan,lamiche will have the home.of proving that he did not build m improve for par- Wry ,
ptxc orsale.). AL:
T.re owner of the pmpen,am exdmively cartoon,with licensed camra mean to AI�
construct the portent(Sec.9 .Business and Professions Cale:)The Contractor's Li. /��
verve Law does nw apply to an owner of property who builds or improves thereon.and QTY. PLUMBING P FEE C/
who contracts for such protects with o<wnmctor(s)licensed pursuant to the Contractors
License Law. PERMIT ISSUANCE
Q I am exempt under Sec. .B&P C for mil reason Lr CUr'.
ALTER-DRAIN AT VEM'-WWI'17R(I, VALUAI L 0
Owner Date
WORKER'S COMPENSA'I ION DECLARATION BACK FLAW PROTECT.DEVICE
1 herebyaffirmmn under penalty of of Con one t)the I'rllnwmgW mix ata,
� Iheve andWill maintain Section Bcao of the Labor�clbarsaurc cromuecof the
DRAINS-II,OOR.ROOP,AIiIIA.CDND. STORIES 'i'YI'ECONS"rRUC'1lOD
,wink,as provided forrt Section 3700 of lite Lubar Code,f the perfnnnancx of me
work for whish This perm,is issued. FIXTURES-PER'I'RAI'
El I have and will maintain Workers Compensation Insurance,as required by Section
391X1 of the Labor Cale.for the performance of the work for which this permit is issued
GAS-EA.SYST[M-I INCA OUTLETS OCC GROUP APN
My Work ,S,RmIpLy t Iny{pu"T Gamer and Policy nu her
Cartier. and
C �� 2 GAS-EA.SYSTEM-OVER J(EA)
CI TIFICAT6 OF F.%EMYf10N PkOM WORKERS' GREASE/INDUSTRI.WASTE INTERCEPTOR
COMPEtXATION INSURANCE. BUILDING DIVISION FEES
DTi,o,Onanecd not IN,completed film permit is framm hundred dollar,($100) GREASETRAP
I'LANCHECK FEE
ley any morin me any Tuar,r, ofthcwork
cetate objectch 1.Permibe
rker'C,I,b it- SEWER-SAN11'ARY-STORM EA.21X1 FT
not mnpinY any person in any manner.ao as m Mcome wM1jccuo the Workers'Cnm1am IiN1iRCY PF.F,
Z nation Lawsof C.alilornia.Date WATER HHATER W/VHN'IIELP.C'1'R GRADING FEE
N N(U-CH'1'0 APPLICANT:If,cher making Ibis Cenillcnte of Exemption,you should WATER SYSTEMn REAPING
H benlest
benne xuhjecto the Workers Compen,ation provisions of the Labor Cade,you nSo1191VB
tort ith comply with such pmvisiont or this permit shall be deemed revoked. WATER SERVICE.
0. Q
� CONSTRUCTION LVDINGAGENCY NEW RESIDENTIAL PLMB. SQ.FT. PAID
E
I hereby affirm mat there is a contraction lending agency further, of Dae RecciptM
z
U 0 the work far which mi,permit is jostled(Sec.30X99.Co.C.) TYPAL:
O I.enders Name TOTAL:
r IULI Lcndcrs AdJm,, BUILDING FEE
0. I certify that I have read this application and state that the above information i,
Ft VJcncct.l"ace
o+cmnply rales all city and coamyordinenccsand state laws relating to QTY. MECHANICAL PERMIT FEE 11 I1MICFEE
U 'Z. brikims I'amanr,and herehyamhonmreptexidwivexnfmi,city to enter upon the
a,oc.o mlawd property lior in,pewion Pugn c PERMIT ISSUANCE 1:1.17 TRIC PITS
(We)agree e;save,indcnmily m¢I kee1 elf"Am City of Capeniw+ngaina
Ilxbilitio,,juJgn+entt.costs and expecte.,which ay in aky w'aY acerae aguin.0 suiA City ALIF:R OR ADD'10 MIiCIL PLUMBING PEE
in torgneneaofthegramingof Ltpern+il.
APPLICAN"I'ONDF.RSTANOS AND VIhL DMP.1 WITH ALI.NON-POINT AIRIIANDLINGUNI'1'(1011B00CFM) 1CHANICAL I+Eli
SOURCE REGULATIONS.
_ AIR HANDLING UNH'(OVER ID(XIOCPM) C(INti'PRUCf10N TAX
Signature of APPlican no n Dote EXHAUST HOOD OMMUC) HOUSING MITIGATION FEE
NATAR .'ATA ER1ALS 'CLOSURE
Will the applicant nr imam building wcupam.more or handle haeaNnus mamrial HEATING UNIT(TO'(ill f B'1'U1
as Defined by the Cupenion Municipal Cotler Cbaper y.12,and the Health and Safety HEATING UNIT(OVER of
SIB ETU)
Calc,gonion 25532fa)^
❑Yen ❑No VENTILATION (To
a,
ING HRESIID PAID Dam Necuiptp
Will the applicant ur fumes builJ'mg uccup'am ton nluipmcnt nr dcviw,which I,OILBR-COMP(311,'OR I"(I,(sk,BTU)
mil hwardnu,air contaminants ax]Mined by me Bay Ap,a Air Qnalily Monagement 'fU'TAI:
DHrict( BOILER-COMP(OVER 100,04 I BTU)
❑Yes F7 No
I have and the havvdtwsmammd,an,iremcnu music,Chapter 6.95 of the Cali AIR CONDITIONER ISSUANC17 DATE
fomia Ileal.&Safely Code.Sections 25505,8513 and 25533.1 muchrommil that Brim NEW RESIDENTIAL MITCH. SQ.FT.
huilding Jucsnw currently have amount.Beat itisu resofaChrybce0fy thes,rcupan
of the requirements which must be met prior m ismance of a Certificate of Ocarymy.
Owner or tournament agent Date TOTAL: ISSUED BY:
�t OFFICE
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"All above sign designs&art works are belong to SIGNS EXPRESS NIFG.CO., Any duplication is prohibited. ALL RIGHT RESERVED.'•
10887 N. WOLFE FT. GLIPEKTINO
. ��a Date : 5 1-97 Drawing Scale :
mcni EXnEll MFGNoted Drawn g
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2446 MERCED AVE., SOUTH EL MONTE, CA 91733
-2
no1iIRR818-443.3333 ' 818-443-1615(FAX) APPROVED BY :
STATE LIC.#552097 ' U.L.APPROVED#E-119586
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"All above sign dwSta A at woks m belong to SIGNS EXPRESS MFG.CO., Any d,plicavion is padbSW. ALL RIGRF RESERVED.��
mGl1, e'XREM ram. coScale : Noted Drawn by:
.
2446 111111111t41319 AVL,1OM 9L at UM,CA 91771 Date : 5-21-97 Drawing i-
IMMW" a1"43-7777 • e1e-03-1a190AM APPROVED BY :
STAT, NC.#11132 7 • u.L APft V1D#&11ADa6
CUPERTINO VILLAGE SHOPPING CENTER
SIGNAGE APPROVAL •
TENANT TRADENAME:
UNIT NO.: C
ADDRESS NO.: /N•
SIGN CONTRACTOR: 1��j �'^(1 � /// L y
NAME: J i6/fS yNY•"•.' o� / , =6 • C- o
ADDRESS: k=
TELEPHONE: /1"iil �•� 5 •
APPROVED V DENIED
COMMENTS: ZD //fid 7/",
APPROVED BY: / C%2% '� DATE:
ICFs HAN FOR
CUYP@RTINO VILLAGE ASSOCIATES