27102 (2) "^'TAPPLIUAN"O FILL IN INPUMNIA I IUN[1111 MIN'MCU LING`.3-U5r HALL I'UIN 1 PCN UNLT I
CBUILDING-ELECTRICAL PERMIT No.
ITY OF CUPERTINO APPLICATION/PERMIT PLUMING.MECIiANICAL 27102
i
BUILDING DIVISION
Pstaiscr
07$:
WILDING ADDRESS: SANRARY NO. APPLMATNIN 4U/ByM�OTAI.DATE
�� G UNR0 COTe
NAME �� MIONE CO ]NAME _ UC NO:
NC COMAOL
ICILITCC"r/MNNERR: UC NO: ❑
NTACf: ONE: "R Z BUkbiNO POUAtr D1Ye0'*1i111m
e.7 1f� .t
BIRO ELECT PLUMB MECII
PERMIT ISSUANCE ❑
LICENSED COMRACTOR'S DEMILATON APPLIANCES-RESIDENTIAL
KZ Ilerty.ffrm dwlonlicero*d mMerpoHdorouf Ch.p.a9(.ocimwlth TOB DESCRIPTION
00 Satbn 7000)4 DivDlort 3 a the 13"..Id Pmfn Coek,and my Ec< c in PANELS
y full
fa nl cffq t+Q
uce Uc.I4r 2 UPT00AMPCananac -
201-1000AMPS FT.FLOOR AREA $/SQ.FT.
OF�.T� AR011=SDECI.kRAThON OVER"XIOAMn
OO pqq I mdentud rM I>tue dull be upd u Vuli{c ravel..
F v� W SIRNS OECIAIGL. PAID
Uay �� OwNfER-9UBDal MCIARA1HON SPECIAL CIRCUR/MISC.
O I hucby.Rhm tho 1 an cscop rrd en the Caoan Co Lkrnlaw for Ne
30. MownMownrwsm.ISsrIbn TOlI.3,Bi.bea Pwfmlore Calc Any
city orcoumy TEMP.MLTER OR POLE INST.
f5� whIW pctnolt to concootci,W.,b0000,t1cono1W,.rith my.d m AN 2 REC-D
p+� prior m In lauvwq alwrequhv Oe Npl[I formuch perMl In I'll'.dped morocco POWER DeVICES
0 p duI Ine Y Becow,d pvlaiva to the n vl.lau of Oe C000-.cta'i Lk.L.w(Claw /C111
r
OKK 9(conittertcin[wlth Sectlnn 7000)o(Dividm 3 anthe Bubtru.M Prokoloru Code) SWTMMINO POOL.ELECITITC CI UAThON
thii he D catrnm thercil.grid the Intuit,for the dkped nrtrtptlon.Myriddlm a OIIII.LTS-SWfI'CIIES-FIXTURES LUr�H fI1YV/
j Sa+kn T031.3 by any� m
pliu fa.perhiu lM l iabjecaWkM b.civil po.hY of
not Lowe Dun Ra hmtdr*d ddlm($3001:
NEWRPSIDFTO I
Il $ ❑ I.aanerNthcl*We*tY.amjerylymwlNv.$nntbch.olarmqumwnn, NITALFT2C17 SQ.Ff.
3 MEdo Jr:ak.Cc&: rtrurmal.not Wvdcda w fa q0y to mctuhra
W Prafeadoro Code:The Cavrsmf.Liceoa lar doe noI WWY b to owner of
pwprty rho Wikba Irtgrorn Oamn,.rd.hodoamuN.ork hlmsdfativo.[h b.
re manrucm livendedaaffered ferule
If.
OCC.GROUP
hoc,.the WhRogm bc;pooronrn s wW within
ane lm o/conple0on.tle owrtu-
bWde r(II Wre 0e burden d prwle[tltY he del toI Meld a hopor<fa ptvpae of 'BRAC:
ales). r'UMtlINU
❑ I,nawmaftll*papert,sm exclusivelya {
exclusively ntocii with lionwcanuraa.dto FLOOD AM
roewa Ot*pej*cI(Ser.IOU.Budn*e ad Pronation.CMe:)The Contracmi.
Llnmelawdor.not.pplytomowomvon' enywho Wllbalmpovn thrrcan,and PERAIR ISSUANCE
vhocmjfwachpolecr.wlN.mbuta(
o .)Ikue
ad pmwntwtheCmlacta
Lov. '. ALTER-DRAIN&VENT.WATER(EA) PB85UMMART,�p ,
whoc amus
❑ I con e.emp uNa Sec. B&P C for tN.rtawn BACK FLOW PROTF.f.T.DEVICE ' 4 -
SANITARY Y N
WORKMAN COMPENSATION DECLARATION DRAINS-F OOR.ROOF,AREA,COND. S010OLTAX YECPJPfA N
•` ( ❑ I hereby afOlmthmllure.wdBuda ofcauerd m adf.iaure,a.cad0atrof MX.NR�-PER TRAP RF, ;I [
Weaken Cate Wloo laurarae ore vnlfled copy Oved(See J[00,lab C.)whkh PARKFEE Y N
coves IN enployc't order bispmdl. OAS-EA.SYSfEM-IINC.40(RILTS RF IIT.
i Pam.! _ _ d/3`91� t90Uo 2'7"1 BUDDING DIVISION FTEs
! Cartpny OAS-EA.SYS1n1EM-0VFRI(G) RAN01ECi(FYE
F; J& Crnlfbd mry h hacby fadsh*d.
❑ CeNOed coals Bkd rllh lbedry NupeNm dlriJorr OREASFJINDUSTRL WASTE INERCFTTOR ORADINO FEE
CERTIFICATE OF EXFJAPIION FROM WORKERS OREASETRAP SOILS FEE
COMMINSAITON INSURANCe
(Thi.anion nmE not b*tnnplctrd l ft,,Dol In laws hundred"I.($100) SE%tER-SANRARY-STORM EA.2IXIFf. ENEftOY FEE
a Im.)
I cmlfy that In die prfae®tce U the wok fa whkh thk pmnh h Imed.I dud WATER HEATER WrypNf/EIE(=
no, rmpby my pawn In my moue to u b bcawlc subject b the Worltm PAID
z CmSen.IM Nan MCdifwni.. Doe IP-
WATER SYSMPfRPATMt*O pRe ip♦
�zHsy0 NOICE TO APPLICANT:If,aOer makin this Cmlfkoe M fhary.Ion,you dtnuld NEW RESIDIRIMAL I'LMB. SQ,Ff. TOTAL:
[" V) beanie abject to the Worker'.Canprn m wo,lsiorni Mt he labor Cade,you truce
Inwhwith mrylywith much povWms"is prndt.M1aB b*deaad ovokrd. RUIIDMO FEE
E z COIRMUCNON LENDINO AGENCY SEISMICFEE
U I hnrhy zI did Jc,In a coto*roctbn kodln[•tcncY fa the performuta of
HEC RIC EFE
O the work for which Ibis permit Is mord(Ser.W.Cr.C.) TOTAL
f-� me.Nuts .pk[s r>,�I��w
O [^
Levier'.1. AddInnut .W* A1E�CNWAIM�A�pERMI"1' ai$/MPBB PLUMBING FEE
tJ I cc ofy Nu 1 N.r rtd N'u a .W"6on ad mu
nte Iw Ac.lave Infatb
nun In WIY'
W - MP.Cl1ANICAL FEE
carer.l.[rabconply rlNWdry.rd aamty ordWnce ud melaw.Mnin[m PERMRISSIIANCE
yWildhq canmctbn..rd brby wdvls rrpaenrativa of Nhdry beruerupmtlte
(', abawraabad paprny fa lrepeeebo puPa*a. ALTER OR ADD TO ME-CH. CONSTRUCTION TA%
(We)cepa to ua,IMewJfy ed keep humlm de City of Ctperllm aping
41,11 ie.jod .mum odnperaa whk marry w.y acora.pinu od CllY AIR HANDLING ITNfT('IO 10.0(4)CFM)
n m M p
_ AIR IIANDLINO UNR(OVER 10,0410 CPM)
s of Appllr tlCorur D,uc P.XIIAUSi IIIX1D IW/DDCT) PAID
II A2 'MA is Dlsaosuae
IIEATINO UNIT CIO 100,0110 RTU) Dion Rcccipt.
Will the appkmto (unve bddln[occquntsweorlmdleluurdoo.tvtiuid ILFATINO UNIT(OVER 100,000 BTU) TOTAL
n dcOm1 by Ile Cuprnl.a Mbddw Code,Chtprcr 9.1;utd the Nalth ud Way
Code,Senkn 233321x)2
El Ye El No VMVDONFAN(SINOLERFSID)
ISSUANCE DAIS
Will Oe.ppl{anlafauchalkRtt[uapntueequlptentaderkeswhich emit ROILf'.R-COMP I111P OR 100.00)BN)
'•hxrndo..dr cmtaNimiu n dcfhred by Je 9xy Ara AO QaWIy Micom, m BOILER-COMP(OVER 100.0g(l BTU)
R.uicR
-\"'�✓ ❑Y. ❑No NEW RISIDPNTIAL MECH. SQ.FT.
I hev*read the ha ardnu etwM.1,m,,ml.m ander O per 6.93 of Otc
y Cdifanda ilahh&S.fety Code,Smlorn 23305,25313 mud 23331. I adnnud that
S Iflhebdldltr[&esratcarert1ly h.aa ilhmy rty ibilny in notify the
errvpua of Ih* irmvilr w I poor b W twee of•CrnlOcnc M '
'� wdbdred rpm Dur ISSUED OY.
OFFICE