30651 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO. O
BUILDING DIVISION APPUICATION/PERMIT PLUMBING-MECHANICAL -`jl LVk
BUILDING PROJECT IDENTIFICATION
BUILDING ADDRESS: SANITARY NO. APPLICATION SUBMITTAL DATI'.
375 D -Anna, 914 9—
OWNERS NAME PHONE: C 'SN
A ORAM : `j0ELIC NO: NIC CO OLa
W rM N4
RCHITECT/ENGINFP LIC NO: ADDRESS1 467 Z ❑
CONTACT: 1� - PHONE: BU ILDING PERMIT INFO
Alar C�t6 gg�I O Consultant Fees Paid by Applicant(Initial) B❑DG ELF:C PLUMB MECH
., /- tl3V
LICENSED CONTRACTOR'S DECLARATION QTY. ELECTRIC PERMIT FEE
1 hereby affirm that I am licamed under provisions of Clutter 9(commencing JOB DESCRIPTION
O�Z with Section 1000)of Division 3 ofthe Business and Professions Code,and my license ie RESIDENTIAL,
00 in full forecast efPoc PERMIT ISSUANCE.
a ul. ,C- 4.5 4. p$ ❑SFDWL. C KITCHEN REMODEL
p
ate
Class Lic.q '
Dote OD Contmcmr APPLIANCLS-RESIDENTIAL CADDITION C PLUMBING RGPIPE
F.Oy ARCHITELTSDECLARATION PANELS ElMULTI.UNIT []STRUCTURAL
Z O Irl Z I understand my plums shall be used as paddle mmrds MODIFICATION
02,::l10 UP TO 200 AMPS ❑IMERIOR C3 CHIMNEY REPAIR
�'„H„�W Licensed Professional 201-1000AMPS IMPROVEMENT
OWNER-BUILDER DECLARATION OVER IBRB AMPS [I BATH REMODEUREPAIR ❑DEMOLITION
Q I hereby M.that I aexempt from the Cranst 's License Law for the
O m or
3 y U following reason.(Section 7071.5,Business and Professions Code:Any city or countySIGNS ELECTRICAL ❑OTHER
LL�a2 wM1ich requires a permit ro conswct,altee improve.demolish,or repair any swcmm
prior to its I...once,also requires the applicomfor such proton m file a signed statement SPECIAL CIRCUIT/M ISC.
S;!(y that he is licensed pursuant the provisions of Ne Communes License Law(Chapter 9
''pp^�ZQ0 (commencing who Section]0110)of Division 3 of Ne Inoinessinl Profession,,Gxle)or TEMP.METER OR POLE INST. COMMERCIAL,
4that he is exempt therefrom and the basis for the alleged exemption.Any violation of C NEW BLDG/ADDITION []DEMOLITION
al
m Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of POWER DEVICES ❑TENANT ❑FOODSERVICE
,
2,y not more than rive hundred dollars in,em). IMPROVEMENT
O Cl,as ownerof the
=1,orwish wagesmthei(Sec.c0tttpan iness SWIMMING POOL ELECTRIC
and dorhework,ands:no
is not intendedoroffered Tarsalepply to an Business ❑OTHER
and Professions Cade:The oyes ibcone License Law dcea not apply m lf owner of OUTLETS-SWITCHES-FIX'1'IJR[S
property who builds pr improves thereon,and who docs such work himself or through
his Own imwe.,,the provided that such mens is
within arc not iyou ofd or oifcmd for NEW RESIDENTIAL ELECfR SQ FT.
ownsoftl-however @e builthe bur en of prment is at hed one you(it improve
the - SQ. 9SQ.FT.
,examruilder will have the harden of Proving that he did not build nr improve for par- A P D
Lase ofaowne
❑1,u owner of the property,an exclusively contracting with licensed
hcontractors i-
construct the (See and i CMrT Te Comreccuies Li-
cause
eLow does
..Iappl,,.ad ownerof property
who
buirrimpnrvesherea,and QTY. BING PERMIT FEE
who contracts forsuch pmjemx with
annttmmnrts)littnsedpursuant n the Cammwnh OEC
.. -9
1996
License Law. PERMITISS C C17Y OF Cur +
lam exempt under Sec. ,B&PCfor Nisratim, Cfl l lly
ALTER-DRAIN -WATER(EA) VALUATION
10saner Dote
WORKER'S COMPENSATION DECLARATION RACK FLOW PROTECT. E
1 hereby affirm under penalty of perjury one of the following declarations:
]I have and will maintain a Certificate of Consenuo self-insure for Workers Compcn- DRAINS-FLOOR,ROO All STORIES TYPECONSTRUCTION
ation,m provided for by Section 37M of the Inbar Cade,for the performance of the, k for which this permit is issued FIXTURES-PER TRAPS,/E((ra1 have and will maintain Wmkers Compensation Insmnce,osmqumd by Stationkofthe LabraCalc,fortheperfommnecofthe wnrk for which thispennit is ixmed. GAS-I SA.SYS'FEM.I INC O OCC.GROUP APN
My, dPolicynrrUOMGson, slaeSs.18 F -Policy Na: aA�.z-_..9 GAS-EA.SYSTEM OVER 4(EA)
CERTIFICCCCATE OF EXEMPTION FROM WO KERS'
COMPENSATION INSURANCE GREASOINIIUSTRL WASTE INTBRCP, BUILDING DIVISION FEES
(Tbisxectiammed not hacnmpleted arse Nonot is fmonc hundred dollars(8100) GREASE TRAP
or less.) - PLANCHECK FEE
I certify that in the performance of Ne work for which Nis permit is issued,)shall SEWER-SANITARY-STORM EA.200 FL
not employ any person in any manner m as t b l m the Workers'Cmalpai ENERGY FEE
,C) salon Lawsof Califo�a�sDm ��-rfB�B�- WATER HEATER W/VENT/EI.ECfR
Z 0 Applicant If.Yp.6,—�{Y� GRADING FEE
NOTICE TO APPLICANT.If.afar making this Cenlficale of Exemption,you should WATER SYSTE- REATING
a ,become subject to the Worker's Compensation provision,of the Labor Cale,you amt SOIUS FEE
'fanhwilhconiply withsuch provisimumthispermitshall bedeemWrevoked. WATERSERVICE ,
an
CONSTRUCTION LENDINO AGENCY NEW RESIDENTIAL PLMB. SQ.FT. PAID
s Data Receiptg
Ihereby elRrm'hat isaca (Sri.30[ending agency for the Performance of
FBe,work for which Nis Permit is issue)(Sec.3091,Civ.C.)
Lender.Name TOTAL:
L) 'Icnder'1 Address TOTAL:
� BUILDING PEP.
sr 1 certify that 1 have mad thisapplicationandciunand state Boothe above information is
y correct.lmragree mcomply hwith cnb,ldtyandcounexammmncesais state laws .the QTY. MECHANICAL PERMIT FCC
V building connru<tion,and hereby authoriro representatives of this citymenmr upon the SEISMIC PEE
above-mentioned property for inspection purposes. PERMITISSUANCE
(We)agree to save,indemnify and keep hmmlew the City of Cupertino against ELECTRIC FEE
liabilities.judgments,casts and expenses which may in any way same against said City ALTER OR ADUTO MECH. '
in cam e,rance of the,growing of no,pemtit PLUMBING FEE
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10,1110)CFM) MECHANICAL FEE
SOURCE REGULATIONS.
AIR HANDLING UNIT(OVER IgO(X)CFM) CONSTRUCIONTAX
Signature of Applicam/Commicmr Date EXHAUST HOOD(WMUCT) HOUSING MITIGATION FEE
HAZARDOUS MATERIALS DISCLOSURE
Will tocii,liamam future building occupantsmre or handle hrard0ux material HEATING UNIT(TO 100,000 BTU)
as defined by the Caveman Municipal Code,Chapter 9.12.soothe Health and Safety
Cade.Section 255321x)? �s�g' HEATING UNIT(OVER 100,1100 BTU)
CYes Tenn VENTILATION FAN RESID) PAID
v Dam Receipt M "
Will the applicant or future building by the B use s.Air Qu or devices which
' mit humNous air cnnmminams as defined by the Bay Area Air Quality ManaBemem BOILER-COMP fJHP OR I00.1MO BTU) TOTAL:
Duarim?
El Yes �x'o BOILER-COMP(OVER 100.000 BTU) •1'
rethe hanud0us materials AIR CONDITIONER
I have ad
mquiretnents under Chapter R.95 of the C01i-
ISSUANCE DATE
foods Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the NEW RESIDENTIAL MECH. SQ.FT.
W ildingdoes net currently have a Roam.that it is my responsibility to notify the occupant
of the requitement,wlI as, tp'n a issuance nf.ccoifictle of poky.
Il ll 142(
Ownerm aulho� D t�e TOTAL ISSUED BY:
OFFICE
EXHIBIT A — ELEVATION & SITE PLANS
a P < m DE ANZA BLVD. we
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LAM
3/8'0 MOUNTING BOLT ..
(TYP.)
i
._� 2 1/4 20 GA. SHT. MTL CONT.
MIN. � 7RANSF. BOX k RACEWAY
- -TC200 NEON
HOUSING (TYP.) J—BOX
1 Y MIN."
1 3/4 'MIN.
48" MAX. i _ _ .. .. . .. .. I.
e .. 12-15 MM NEON CONDUIT
TUBING " i
MOUNTING SCREW (TYP.) _,. 30 MA — NPF�
1 3/4 TUBE TRANSFORMER
SUPPORT (7YP.)
3 _ _ EXIST. WALL
l ELEVATION SECTION `� s
N.T.S.
PLEX FACE 2 SECTION DETAIL
STANDARD R&H N.T.S.
COLORS
.050' ALUM.
BACK
I
WELDED OPRNST OR NOTES:
1/4"o WEEP
HOLES 1— MIN. OF (2) 1/4"0 WEEP HOLES PER.LF, ER
2— ALL SEAMS TO BE PLACED FOR MIN. VISIBILITY
3— LETTERS FABRICATED TO UL STANDARDS
4— LETTERS TO BE SHIPPED PREASSEMBLED
#17 SST. P IILLPS 1/2' 5— INSTALLATION TO CONFORM WITH SECTION 600 OF NEC.
PAN HEAD SCREWS 6— NEON LAYOUT 15 SHOWN FOR ILLUSTRATION ONLY
LOCATE FOR ACCESS I ACTUAL DESIGN DEPENDS ON SIZE do STROKE
0- LETTERS MAX.
3/4' TRIMCAP W/ 040' ALUM. J 7— 11T THICK PLEX• j�, ' THICK PLEC FACEFOR
FFOOR 3a� LEi iERS MAX.STANDARD COLORS RETURNS. PAINTED
8— STANDARD PAINT FINISH '!
3 DETAILN.T.S.
® {
� 10300 Torre Avenue
_ Cupertino,CA 95014
Cit N. of,
upertino Building Division
(408)777-3228
(408)777-3333 (fax)
September 30, 1997
Wolf Camera
1375 De Anza Blvd
Cupertino, CA 95014
SUBJECT Permit #30651 (sign)
Dear Homeowner:
We have been going through our files in the Building Department, and contacting those
people with permits remaining "open.
According to our inspection records, the subject permit has not had a final inspection.
Many times an inspector will sign the permit in the field, but overlook reporting all of the
information to the clerical staff for input into the computer. If this is the situation and
your permit card shows the final sign-off, would you please contact us so we may
complete our computer records? If the permit is not signed off, please call to schedule an
inspection for final closure of the permit.
Because of the large volume of paperwork within the building department, we cannot
separately monitor the progress of each permit. We ask that you give this notification
your immediate attention. If we do not hear from you within ten(10) working days, we
will dispose of the file and remove the records from our computer.
Thank you for your assistance.
Sincerely,
CITY OF CCUPPERTINO
Christy Akatiff, Administrative Clerk
prinleJ on Rnrprlgrl!'apw