23069 (2) , APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
'Building PraiectIdentfnrationO.
- - PERNUT N
Bufiding Address: `.;. 23,059 . 1
I'o fro i Cuv mein 'l�oacQ CU�LsT2T n/o
w arse: e. A
Ie. N CITY OFCUPERTINO-BUILDING DIVISION
co Ira mraName:. /�1 /�• Lk. off: APPLICATION / PERMIT
�lOn -el/' LpY1Ci W ,�-17CATEGORY CONTROL«
Architect/Engineer. BUILDING-FI.ECTRICAI:PLUMBING-MECHAMCAL
BUILDING PERMIT INFO '
CITY'-' ELECTRIC PERMIT FEE
Address _ PERMITISSUANCE �` - ' ❑ ❑ '❑.'l
LICENSED CONTRACTOR'S DECLARATION'• L�` -
Iherebyaffirm that l son licensed under provialoneof Chapter 9(ourracerc, APPLIANCESRESIDENTIAL JOB DESCKIPFION
ingwith Section 7000)O(Dlvlslon3 ofthe Buslnessand ProfessionsCode,andmy
license is in full force and affect. PANELS
LlmmcClam S'.�_Lla# 3el7707
Date Contractor
'ARCHITECTSDECLARATION 201-1000AMPS '
1pp1uu Orzz LundentandmyplaushaabeuwdupubUcmewds OVER1000AMPS SQ.FT.FLOOR AREA $/SQFF
Licensed Prafessi,mal SIGNSELECTRICAL
Q OWNER-BUILDER DECLARATION S[rECIAL CIl2CUIT/MLX: I A L E D
z" a hereby affimthatI am exempt from the Contrador's License Law for the
op"" following reuon.(Section 7031.5,Business and ProfessAny city or TEMP.Code:A
OZTEMP.METER OR['OLE!NST.
P countywhlch requbuapermktororatruct,alter,improve,dennlbF,Orrepalr '
an yetmtlurepriorWitsismance,aleorequimtheappBuntfweuchpermltto POWERDEVICES
O file a signed statement that he is Bcensed pursuant to the provisions of the ^^aAs
{� Contractor's License Law(Chapter 9(commencing with Section lon 7000)of Divi- -' '
sun 3 of the Business and Professions Code)orthat he is exempt therefromand SWIMMING]VIOL ELECTRIC
6.•77 the basis for the alleged exemption. Any Nolatlon of Section 7031.5 by any OUTLETSSWITCHESFS
FIXTUR
❑ appUmntforapermitwbjedstheappllanttoatlWlpemltyofnatmore than "� D
tir]1.asVe
ewnerof the
NEW RESIDENTIAL ELEGTR SQ.FT. STORIESTYPE CONSTRUCTION
❑I,as owner o(lhe pwork,a or fiery employes with wages as their sole
com(Sec.700A Bu.1cethewwk endthestmde: isnot Ntendndoioffered(or _
O sale(Sec.7644,Busloeuend Professions;Code:The COntracto/eUceue law
does not apply to an owner of property who Wilda or Impre s thercory and - OCC.GROUP RES UNITS.
whodoesmchworkhlmaelfwthrough hlsownemployees pmvided thatwch
improvements are not intended oroffered forule.If,hawwr,lhebuilding or TOTALi
improvementbsoldwlthlo oneyearofcompletlorythe owner-bullderwlll have ,
ttlg,Vurden of proving that he did not Wild or Improve for purpose of sale.), PLUMBINGTERMIT - FEE FLOOD ZONE
APN
u m
I,as Owner of the property,am exclusively ntnding with licensed
contractors to routmuct the pmjed(Sec.7040 Business and Professlou Code: PERMIT ISSUANCE
The Cmucadoes License Law does not apply to en Owner of property who ALTER-DRAIN&VENT, WATER(EA)
WIk1s or lmprovu thereon, and who contracts for such pipjeds with. FEE SUMMARY
�actorIs)licensed pursuant to the Contractors License Law. BACK FLOW PROTECT.DEVICE
I am exempt under Sea B&P C for this reuon
DRAINS.FLOOR ROOF,AREA.COND. - SANITARY r Y_ N_ -1
Owner Data _ - RECEIPT X
WORKMAN COMPENSATION DECLARATION FIXTURES PER TRAP SCHOOL TAX + Y_ N_
,. hereby affirm w that I have a'certificate of consent to self-Insure, a RECEIPT M
'r' —mificate ofWorkeri Compensation Insurance or a ceMifled copy thereof(Sec. GAS EA.S1•b•I•Q.S-1 WC.40UTLEFS PARK FEE Y N -
381' Lab C.)' ,p
CO # .2 S kA)e OS 7�• GAS EA.SYSTEM-OVER a(EA) RECEIPT#
Com any BUILDING DIVISION FEES
ffCemllfied ropybhereby rnl,hed. oYYLah'ask GREASE/INDUSfRL WASTEINTERCEPTOR PLANCHECKFEE
❑CertRledropybfiled wlththeeltybupection div Won. - -
CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE TRAP PAID .
COMPENSATION INSURANCE SEWER-SANHARY-SIDRM EA.200RI. Date Recef t#
(Thbsedionneednat becompleted Vitus permit isfwonehundred dollars `
($100)Oh NT/ELECTH ENERGY FEE Y N
I cetifytr lesat In]he par(ormance o(the work(orwhkh this permit is Issued, WATER HEATER W/VE
I shall not employ any person In any mannerso u to become subject to the
WATER SYSTEM/TREATING
Wwker%Compenxtion Lawa o(Cali(omla.Date 'PAID -
Z Applicant - NEW RESIDENTIAL FILMS. SQ.Fr. Date Recei t# .
Z O NOTICE TO API'LICANT:If,after making this Certificate of Exemption;you
should becemn abject to the Workeri Compesation provisions ofthe Labor - i NOTA ' - t
Code,you=at forthwith comply with suchprwisiou orthls permit shall bel) ING FEE
W 7 deenadrevoked.' ,
CONSTRUCTION LENDING AGENCY _ SEISMIC FEE
(1 Ihere afflvnthat there ba romtmdlon lending agency for the perform,
-
M' . B cY P : ELECTRIC FEE
0 Z anOder'. Work for which this per=t is issued(:sec.3097,Civ.C.) TOTAL:
L O L'ender's Name • ' ' PLUMBING FEE
F Lender's Aaare„ + - QTY. MECHANICAL PERMIT FEE
.LL - MECHANICAL FEE
O W ormet. thatl agreet comply
us with all
and county
o me Natthe on,.nnformation -
S bctingt Wilding complywith all cityandrountyoedinanceaaati eesofthis PERMIT ISSUANCE FEES PAID:
rela} city to enter
upon t rostrudbryand dpropauthorize representatives of this - I
H Z city(We)
ree tdsaeabovemnifyaned property fm inspectionCity.fposes. ALTER ORADD TO MECH. Date Receipt#
— (0. agree%save,indemnify and keep harmless the City o(Cupe cmc . - .
agalna Illtka,judgments,cost nd expenseswhkh may In any wayawme AIR HANDLING[IMT Q010,000 CFM) � SUBTOTAL:
.gal d CityInce sequence the granting of this permit
AIRHANDLING UNIT(OVER I0,000CFM) CONSTRUCTION TAX
Signature of Appacant/Contracto - to EXHAUST HOOD(W/DUCT) ;CONSTRUCTION TAX PAID:
HAZARDOUS TER ALSDISCLOSURE -
Willtheapplicantorfuture building occupantstore or handle hazardous HEATING UNIT(TO 100,000 BTU) Date Re ei t#
material as defined bythe Cupertino Municipal Code,Chapter9.12,and the
Health and Safety Code�+.-SS�ection 2553200)7 HEATING UNIT(OVER 100,000 BTU) TOTAL:
❑Yes Ll No `
Will the applicant or future building Occupant use equipment or deviate VENTILATION PAN(SINGLE RESID) ISSUANCE DATE `
which emit hazardous air contaminants.,defined by the Bay Area Air B� '
�uality Management District? • BOILER-COMP(3HP OR 100,000 RTU) P A 0 D
L�Yes ❑❑No
l� !have read the busVous materials requirements under Chapter 6,95 of BOILER-COMP(OVER 100,000 BTU)
the '
California Health Code,Sections 25505,25533 and 25534.! DEC: O ��aax,a�
understand that lithe building does not currently have a tenant,that it is my NEW RESIDE-MAL MECH. SQXT DEX{00 17 99
responobility to notify the occupant of the requirements which moat be met s�T 1,
priorto issuance ofa CcrificateofOaupancy. ` My-v- VVrt ItIVV '
Owner or authwimd agent - Date ,ISSUED BY: '
TOTAL:
OFFICE COPY
Face of Bldg. Face of Bldg.
IE
Cap If Desired 61Min.
edge of 6 Min—+
� footing
Grade '/o Gra
I oi3�w.nat//!o'•V�oC!a �, '
1 r!I 2't4Bors X Bars
ertical "4 Bars at 16"o.c. �� 2 04 Bar
�•. Concrete Masonry wall- ,i Concrete asonry Wall-
4 I. All Cells Filled Solid E All Cells 'fled Solid With Grout.
---With Grout.
_E eL_ Omit Head pint In First Course
"O I• 2" 2 �4sBars
, '^ �, At 32" O.C. or Weep Hole.
in
G' Omit Head Joint At First
O `. • 'Course At 3f' O.C. For ( I �<pral Ro k
Weep Hole. 12 min. :y �
Y Bars Grode ► °p" ;;nlI+
C �nai,;. rr6,�
x
E -*I-Ora* Rock as req d.
17. L 14s
Bars
tont..
M' ' 's-4ea.
•i Gro ! ,'I � ' B
t f N E:
J P Footing o 9EG U�
�" I :N undisturbed Natural Soil.
n1� PEC710Id DEpARiB�
Pour Footing Against
Undisturbed Natural Soil. R• '•
f;; Drain PUBLIC R/W I 3 1.5
TYPICAL SECTION OVER 5'- n: ; �Koclv ADJACENT
11.5 0.5
PROPERTY
— t' n
li i yic .,
Pipe
NOTE:
B Drains ore req d.on ALL Walls
oa�PRDVED
NO CODE 'T" THE C/TY 01
T of Reinforcin Dq ORDINANC
a :0411 Q QY ® SIGNED SPECIFICATIg
NS:
3 6 - r4 at 24 o.c. �$at 4B o . This set E'V MASONRY UNITS.
d 8"12=b'1*ot32"o.e. '$at 48 o.r- a kept of plon thans In and YPE'�'�1i bf'S"GROUT
40
6 12 3- pectis
of l6 o e. of l2 oe r4 of 3 r �jwfumt0 makeeany cile all
l 30 'Yft.EL
a buildi ql Debut w4tien eS LA ,f Ions DING=.35
NOTES n Pe'lnissi °ns
I. Contact Building Dept. for Permit Requireg* "PiingMphgA fl°f CuAeitinon trnm
2. Plans
indicating Top of Wall (T.W.) ElevatiapIrmptlpg, hod t;, n't 'Pacif;catio
and Finished Grodes are CONCRETE Required on all (8 BLACK �'�fR95dIIIv�� nit °tfrs6 n
CITY OF CUPERTINIO APPROVED g
BY E -2
: T
STANDARD DETAILS c1Tr E EER