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B 0478 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY P1NG-ELECTRICAL PERMIT NO CITY OF CUPERTINO YLUMPrvG-MEcHANICA. RUILDING DIVISION APPLICATION/PERMIT B0478 O BUILDING PROJECT IDENTIF'IC'ATION jSANITARYN0. APPLICATIONSUBMITIALDA) RUILDING AIIDRP55:D 69 13 . N Wel /�o . UNr 't6 -3p5_1NER:SNAh1E: I / PH�Yf:: CONTRA �� LICNO: CONTROL# \ AR H riCf/EN NlSM i C N / L PHONE BUILDING PERMIT INTO • 01 )m(� I To 4 ,\ ❑ Consullanl Fecs Paid by Applicant(Initial) HLDG HIA!Co _ PLUMB Mfi❑l V-/V ek(YQ`LII.CENSED CONNTTRAC JUST'S DFC1.ARATR (2TY ELLCT'RIC PERMIT Fell IJ! JORLDTF✓S'CRIPTION 1 hemby affirm 0m 1..n licensed under pewisiom of Charter 9(commencing COH with Sedinn]Ilfppd Division)of the Business anJl�esions Code,and my license is RF-ID ENTIAL �//l PERMITISSUANCE H full tivac and efyy ❑SFDWL ❑KITCHEN REMODEL QUU Llceree Clacs LiaN APYLIANC[S-RILSIDLN'1'IAI, ❑ADDITION ❑1'LIIMBING RE-PIPE Sol¢ Dae Comrderor ARCIIITECPS DECLA O. I'ANEIS MULTI-UNIT ❑STRUCfURAI. F-D Z I undcnland nh plat-Mil be ned as hllc rcaurdv MODIFICATION OZ�Z y Pu UPTO200AMPS ❑IN'ITRIOR ❑CII MNEY REPAIR F.�nLad Licensed lknfcssinnal 201-1011)AMPS IMPROVEMENT E]SWIMMING POOLS Sal OWNER-BUILDER DECLARATION OVER IIXX)AMI'S ❑BATH RF,MODFLIREPAIR El DEMOLITION C C¢ 1 herchY aflirm incl 1 am exempl Soon,Ne Coul nemr's Lue I Law for Ibe X�X a U balancing reason.(Section 7031.5.Business and Pmfe.sions Gds:Any city or county SIGNS ELECTRICAL ❑Ol'P{IiR W a ll h olish,which requires a permit to construct,once,improve,demor repair any.wcmrc c� priorchits lssrmnce,alsoe'aires,nc applicant forsuch permit o rile aligned slalement SPECIAL CIRCUS"UMISC. ,out he is licensed purs.ammrbe pnwoions of Oa Cnrace oLs License Low(Chapter 9 COMMERCIAL: �I=00 (commencing with Section 7000)ofDivision]oflhe Business end Professions Csde)or TEMP.MINER OR POLE INST. a a y then he is exempt durefmm and the basis for the alleged covert U.Any violation of NFA'BLDG/ADDITION ❑DEMOLITION IXmNSc....n703I.5 by any applinmt lora permil,mhjc., he appliunn ma civil penllryof POWER DEVICES ENANT FOODSERVICE n marc than five hundred dollars fS50). IMPROV EMEN'I' �E= ❑ 1,a owner of the Property,or my employees with wages as their sole nhmpcmarion, SWIMMI' LECfRIC F will J.Oe work,and Neswcture is norimenJeJ or olTemJfor sole(See Il144.Business ❑UTIIIiR a 3 and Pnd inns Code:'rhe Cnnvucu x hiconw lane dill not apply m mi owner Q OCTLIiT, CITES-19%'IURES -^�- pmWny who builds or improves theaom,and who Joss such work himself or through -, L1 his own employees,P widd that sown improvements am not intended or offered for NEW RI: EN ECI'R SQ FT. sale,If.hnwcven,hc holding or im,oweemen is sold withiamr,year of completion She I I S[)fFf.FL( ARE I ASU.FT. awn cr-holder will have the burden of proving Ihm IT,did nor build.r improve for 1UT- ,nue 11ar litene T MAY 0 1999 1,u owneroject Mc.70,4 am.Jeadusively contracting with licensed cul rbc, m "/ hmvncl the pmjcer ftiw.91W4.Business inW Prnfe,sl.m'Gxlei The ve,nlmmor'a nd comsc law docs not apply mon owner ofPTUPmty who build'minmrovea Jhorcon,ahhd QTY. PLUMBI sP IT who contracts for such prejens with a cammemds)licensed punoam m the Convacon, License law. PERMIT ISSUANCE T ❑ I ran unempt under See. ,If X P C For his rennin -` ALTER-DRAIN&VENT-WATER(IiA) VALUATION Owner Dam WORKERS COMPENSATION DECLARATION HACK MOW PROTECT.DEVICE /CIO O • Ihcrehy ullirm under lsnhhy of pcjuryar.II 0cjurame ng akeTins Cm V (] on vc and will mainmin aCenifwte nfC.nunl In mlf-insure rot Wnrkcr'e Cmnpem ' DRAINS-PLOON,ROOK.AREA,GOND. � © STORI iS "1'YI'E C.ONS'IRUCTI(1 lotion,as provided for by Section 3]W of the Lata Cade,for the performance of the 0 work for whi.a This Scor:,is is.med. FIXTURES-PER TRAP l� 1 hove amJ will maintain Worker's Cnmpensminn Insurance,no required by Section / PN 3100oldne tart.Ctdc.6nhe peramemove man,work for which his pnmiris issued. GAS-13A.5YSTIiM-1INC.4UITf1.l!rS OCGRIIDP AO� My Worker's Compemmion Insurance carrier and Policy number are: GAS-EA.SYSTEM.OVER 4(EA) Leede,: Policy No. '5 / C17RTIFICNI 17 OF EXEMPTION FROM WORKERS' GREASIYINDUSTRI,WASTE INTERCEPTOR COMPENSATION INSURANCE. BUILDING DIVISION FEES (This section need nal be completed ifthe pirmir is forme hundred dollars.($100) OREASIi'TRAP � O nr Icssd I'LANCIIECK 17IiE Icarythat in the performance of the work l in which this permit is issued.I shall SEWER-SANITARY-S'IY)RM EA.20X1191hl employ any snn in any manner m be as to come subject to the Worker:Compcn- IiNERGY IRIS Z, J lanpm ce.Lawn of Color nix,Dom WATER HEATER WNENTRELECfR GRADING FEE z O Appheeol 1 NO)'ICIi TO APPLICANT.H.after making St.%Certificate of Exemption,you should WATER SYSTEM/TREATING SOILS FHE F become xubject to IM Worke(s Compensation provisions of the Ubor Gale,you must Ret tonhwith comply with such provisions lir this permit shall be deemed revoked. WA)'ER SERVICE L Q R' CONSRUCTION LENDING AGENCY NEW RE.CIDENTIAL PLMB. SQ.For. PAID T z ac Receipt p U OZ) IMrtby af(inn incl lnerc iaarnmwcri.n lending agency foe the Pedonnancc of (•" Sha work f r whieb this permit is issue](See.]119],Cie.CJ TOPAL 0U Under.0 Name TOO W Under',Address RU A G Er. fy 1 ccnify,h t,1 have read this upplicatimm and state Shat the above inform......is h loorcIt.I came ,,c.... with all cirY nnA county arJinancos and moos lows miming hr QTY MECHANICAL PERMIT FEE SEISMIC U Z building con.swclion,and hereby amhoriec mprescnlallves of this city ah enter upon Inc above-mentioned property for inspection purposes. PERMIT ISSUANCE e ELECT C 'E (We)agree msec,'mdcmnify and keep hurmlcss the City of CUpcnino again liabilities.judgm•It.masundcxpenscs which:nay in any way.cents uguinstsuid City ALTERORADD'IOMECII. PLUMEI 'Flit: in comsequ j�}�the gmming of TT unit. APPIAC rI NDEIZT COMPLY WI'T'H ALL NON-POINT AIR HANDLING UNIT(TO Io.(IOO CPh11 NIECHANICA. `EE SOUR 'R-R .ATIONi I AIR HANDLING UNIT IOVIiR n1.000CFM) CONST RUCTION TAX Snamrc of Appli-a To ter Done C%HAUST HOOD OVIDUCT) O HOUSING MITIGATION FEE I PAZ DQUSMAI'CRI .. .Cy.(Y'URE WJltheappl¢amr-lama huilJ'mgrecuPam state ni handlchvallot,uncedil HEATING UNIT('10IIIII,IMNI BTU) as defined by the Cupeninn Municipal Cook.Chapter 9.12 and the Health and Safely HEATING UNI'I'(OVER 100.000 ISI Of Code.Suction 25532(.)! - OYe, 'LSO ) VF,N'I B,N'f1ON FAN(SINGLE RES IDI PAID Umc Rccciptp hx=Will rhe uppllcar,or future building occupant use occipment or devices which BOILER-COMP'OHP OR 100.10X1 BTU) Us air con aminanu as]dined by,he,Hay Area Air Quality Managemcm TOTAI DscYes BOILER-COMP(OVER 100.000 It AIR CONDITIONER ISSUANCE DATE I have renA the hamrsinus mar 'lits arpiiranenls under ChuparA95nfthcGrli- fnA.,Ul',A.memIyh fty Gds T5 s3J and 255)4.1 unJemm�J thm If the NEW RESIUPN'1'IAL MIiCH. SU,I9'. bur.r 'ooh than it ism onsihilitYm notify She owcupom hfto which must h priarmissm enfa Ccnificmc of Occupmcy. - d gent Doc TDI ISSUED BY: OFFICE