S 3087 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
ITT-Y CF CUPER'fINO BUILDrur.-ELECTRICAL Pe UTNO.
CAL
BUILDING DIVISION APPLICATION/PERMIT PING PROJECIIDEINI IFIL 3087
BUILDING 1'NOJEC'I'1DEN1'IF'ICA'1'IUN
BUILDING ADDRESS p SAN'I'TARY NO. APPLICAT ION SUBMI'ITAI,ON]F
zl�'i °q Da GOYeo /eve . I X11 Q
OWN 5NAM1?' �� fY1�N �^L III�D� CON'IRAC'IY)R'S NAME. LIC NO:
N^ NIC CONTNULM
.HI
4w
LIC NO'. ADDRESS: ❑
CON'1'AC11 PHONE: BUILDING PERMIT INTO
❑ Consultant Fees Paid by Applicant(Initial) BLDG '/EITC'IPLUMB MECI
LICENSED CON IRACI OR S DECLARATION Q'ly ELECTRIC PERMIT FEE
❑z Z 1 hereby mrmt that 1 sen Eeensm ands"Prvisian, if chimer 9(commencing JOB DESCRIPTION
W O p
wnhSmmn9000ofDM,in113ofrbc Buenas and Pmy fc,di s Code,and. licenseis RESIDENTIAL:
PITRM1111'ISSUANCE
in full force and arca. ❑SFDWL ❑KITCHENREMODEL
QUV License Clue, Le.N AI'1'LIANCIiS-NT:SIUITNf1A1. ❑ADDITION [I PLUMBING RE-1'll'L
yZa Dnic Conoactor
<< ARCHITECFS DECLARATION ❑MUITbUNIT ❑STRUCTURAL
Z O V'z 1 ondentund my plans,hall be axed us public record, PANELS MODIFICATION
UP 1'021X)AMPS
❑[NTERIOR ❑CHIMNEY REPAIR
W Licensed l'ndcsxlnnal 201-100AMPS IMPROVEMENT E]SWIMMING POOLS
OWNER-Bl11LDER DECI,ARA'L'ION OVER IgXL\ML'S [I BATA REMODEIJREPAIR [I DEMOLITION
C Q I hereby after,that 1 um exanpt front We Commcmr:,liccaa law 1,11'be
❑axl3 LL F following rcemn.(Scan...0031.5,But,inae and Professions Citic:Any city ar county SIGNS ELECTRICAL ❑OTHER
m which requires a permit m consdracl,alcor,improve,deoa,li,h,or repair any,tmaure
F-LLOQ prior to its issuance.also requires the upplinm forsuchpermit are a signal mmamem SPECIALCIRCUIT/MISC.
he,her,licenud fornani ,, I....... _aI We C'nn¢ecur'x Liecn.tt Lnw(Ch;gner9
W CpO (commencing with Section]00)of Division of the Businma and Proresdon,Code)or TENIP.MIN I:R OR POLE INST COMMERCIAL:
a a e x mm he i,exempt therefrom and he Ina,fon the it al caemption.Any violation of ❑NEW BLDG/ADOPTION ❑DEMOLITION
.gym Section 91015 by any applicant ser u penhit subjects lheapplicanua a clvll penalty of POWER DEVICES ❑'TENANT ❑FOODSERVICE
t more than foe hundred dollars(S500),
F z YIMPROV I:MI;N'I'
6 dothe work.the pmpetty,..nnyuninPI tende orWeagc,[is rwW mm1.Business
nen, SWIMMING I'OUI.ELECTRIC
f=O dd..thework,and thestructure,Cominnorintendednraw dofrrvk(Sec.l Did.Bane, if OTHER
IIIxFo
3m and erry,honsild-, mi Cummarea License Lawdocsnalapply s nnnw;¢+of OIfILGTS-SWI'I CHF-S-FIX'RUSES
his o nY who builds pr sided t s thinch and who docs such work Mfnsor or through
his awn employees.provided that sect i ret v oenn arc not imen of,nr..BercJ for NEW RESIDENTIAL ELIiCTH SV Ff.
cele.IL how r.WcbnilJing o(Inpmv,. weis,olA within nncycur nfannplcfion,the SQ.FF FLOOR ANI!A 5ISQ.Pf.
ser-builder will have the Funder of proving that he did not build or improve for Pur-
pu,c
0 1,as owner of life pe ffany,sen ndn,ivcly connading with licumed conwaors 1. Tlyl'
omwct the project(Sec 90,il,Businens and Profession,Code:)The Contractor's Li-
'OF"'[-it.does 11111 apply of anowaa m property who builds or np,rvet lhercm,,and QTY. PLUMBING PERMIT FEE
who contracts for such project with a conmuony)licensed pursuant to the C..mracmh
Liccese Law. pF.RMI'F
ISSUANCE
❑ I am cecmpt under Sec. ,B&1'C Onion,rmrnn
I Own Uum - ALTER-BRAIN A,VF.N1'-WATER OW VA LUADON
ORK'R'S C( IPE A'I'ION DECL RATION BACK FLOW PR(TfECI'.DEVICE. ex 0 O
Ito aRw ua pent yet, janyone ofnc� ..flowingdadamuuns: (-1
have an will maintain a Cetificale of Comentm.elf-inwrc for worker's Coapcn- DRAINS-FLOOR,ROOT'.AREA.COND. ST IES TYPE CONSTRUCIION
nation,as pmvidcd for by Section 3](X)of the"Now Code,for the performance of the
work for which d.......tiff,road. FIXTURES_PER'I'RAI'
❑1 have and will maintain workers Compensation Insurance,a required by Section
3900 of the Labor Coda,fort he lxarfonnanccof the w...k far w hien Ilii,perm,is iw.ed. GAS-EA.SYS'1'1?M-I INC .d OIITLE'ILS UCC,6ROIJ1' APN
My Worked Cmnper sntion 1mur:mce carrier and Policy nmMer are:
Carticc Policy No.:
GAS-EA.SYSTEM OVER J UPO
CCRTIIICATITOFEXEMPIIUN WORKFIIs'
COMI'LNSAT ION INSURANCE GHIiASFJINDUSTRL WASTE INTERCEPTOR
BUILDING DIVISION FTill1
(U,ix r4lion nevA not henmpined if rbc pennil ix far ane M1nndrW AUllan(511X)) --
or lava-) GREASE TRAP I•LANCIIECK FEF.
I ccnify that in the pencrmance of the work for which this permit is issued.l shall SEWER-SANITARY-S'I ORM ITA.21X1 FI'.
Inpluy..y pen any an ea"',uw hcco se'naje'ImWu Wo ker,'Con(x, ENERGY FEE
nmc un in' rIn •. .
ZZ zfoom L awe of California Date WATER HEATER WNIiNICIELELTR
Applicant GRADINGFEE
.N. NOI'ICF,'1'0 APPLICAN'1:If,altar anddr,this Cerlilicam of Eaampmn,you should WATER SYSTE1sl/I'REA'1'ING SOILS FEE> become subjectin the Workers Compensation pr ,ions of the Labor Code,you must
kl forthwith comply with such I,of 11v.r this purmil Shull be d enudi revoked. WA'RiR SBRVICIi
a
C(INSI'RUCI'ION'LIiNUING AGENCY NEW A'ME LWT. SV IVFF
PAID
U O Ih RecdprX
I hereby illi,,Wit Wcre Ix u a;nxtrniun lending egancy for the perlowancc rl
he..it far which di,permit is i...W(Sec.3097.Co.C
U 1<rder,Ni to ny
TOTAL:
O U f<ndcf's AJdreu TITAA
r 0. 1 cattily Ikn 1 have read this upplicmio t n11d one fles the rNoe nal an11n e BUILDIN IlC
F rp
comer 1 agree to comply with all city and county ordinances and state law,relating to Q1 Y. ECHANICAL PERMIT
U Z building consaueinn.and herchyanthonm representatives of thiscity m cnmruponhhc SEIS 'FFF, V
above-o a.tionW propcuy lot Ingnction purpe,c,
(We)agree 11)a.e,indemnify and keep han nicsx We City of Cupenino again.t PERMIT �NCE � ELECTRIC FEE
Iiabilidla.judgntcmx,cooeand ccpcnw,which any ,arty way uArne riciaosuid Cry ALTERO 'IT1D II.
T)MGC
in vo
nscqucncc ofncc gmitirgof thi,permit. PI.UMBIN FEE
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT CTO 1(1.0(X1 CFM)
.SOURCE REGULATION$, / � 1MITCHANICAI.I FEE
' T� y AIR HANDLING UNIT(OVER 111,(0(1 CIMS F
) CONRUC'I ION TAX
ivrau ref. Iia r/Comm t r 1 1-)ua, 4 EXHAUST HOOD
AZARI US ATERIAIS I SCLOSURE HOUSING MITIGATION Hili
Il the applicanlor faun huildingocerpantwon,or handle hored0ax material HEATING ON[I('1'01gUNXt B'I'lJ)
as defined by the Capron.Mramicipal Code.Chapter 9.12,and the Health wd Safety
Coda.Section 25532019 �`// HEATING UNIT(OVER 110,000 111 U)
E]YO, fJu VENO LATION FAN(S]NGLE RUSIDI PAIIJ
W'11 the applicant or building nuu I,ac eui rnr devices which 0. f. Receipt ll
IP b Pur pntcn BOILER-COMP OfIP OR I01.000 BTU)
>
III hamNous air contaminants as dctmd by We Buy Arca Air Quality Management ( A U
,vial Yes 0 X0 BOILER-COMP(OVER 1(0.0BTU)
❑ N
AIR CONDI'1'IONBH
I b;nc read @c hv: one nakrids reyui,umnns ante CM1upmr fi.YS of We Cull- ISSUANCE UAfE
fomia Heath A Safety Codc.Senors 25505,25533 and 255A.1 understand that if the NEN'RESIDENTIAL MECH SQ.FL
building does nm contrarily hnvca tcn:en.that It is lay ecspomibililylo reify the wa;p1111
of the myuir nsenn icIt us'be ma priano in,uana..fu Ccnilinm of[kcupanc ry-7 q1�� 1
Owner or gem ' Dam TOTAL: ISSUED BY: / l�
OFFICE
Overhead Front View
12 inches J Bolt
114" 2 X 6 Rafters 16"O.0
4 X 6 Steel Post
Redwood 0
Plate
0
0 0
4 X 6 Steel Beam
Concrete Post
N
O
M
°' 6 inches Diameter Concrte
v
• c
Post with rebars
U
m
m
m
B
4 inches concrete Patio
0
'nor
�G�� 4��0'� � M� m
soa
m o�Jp\G\ypFGv
Orr P�' Wr
P��UIRELL
Concrete Post Side View
•
Concrete Patio Patio concrete
6 X 6 Mash Wire
Soil Soil
m
s
m
• Rebar(1/2")
Rebar 1/2"
x x x x x 8 inches
20 inches
00000000000000000000000000000000000000000
Gravel(6")
•
Overhead Top View
Joist
Hanger
16" OC Lag Screw 16'OC
2 X 3S, 4"OC
•
8 " Concrete Post 2 X 6 S, 16" OC Joist
N90°0'0"E 26'
Fence
A
N
W
12 feet
I
Top Viev
Patio Door
House