Loading...
S 2081 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OF CUPF.RTINO RUILD:NG- ?LECTRIC,AI. Pia II NO. BUILDING DIVISION AJ'PLICATIONIPERMIT I'IGPROG-MECHANICAL 2081 IBUILDINGNI:PROJItCT IDFNI'IF'IL'Ay'ION If1/1LD1 GADDRISS: SANITARY NO. APPLICATION SUBhIITTAL DATE 53 1�in95bur lace Cuperl-ino Ca - 950/q_ 1,R OWNER'S NAME: I 1'HON 1: x- �S)MICr�'RAIOne �IIr 1.1 O: NIC CONTROL# fflBr RCIII'I'FMIENGINEER; LIC NO', AI)I NE,S: C (lino clue Cowl ej CON'I`ACC BUILDING PERMITINFO / PHONE: m�ehelle 3 /l��(Q Ill Consultant Fees Paid by Applicant(Initial) BLDG CLFCI PI.UMR MRCH ID ❑ ❑ ©- LICENSED CON'IRACIORS DECLARATION Q'py ELECTRIC PERMIT FEE 1 hereby affirm her I am Recycled maky,rovidons or Chapter s Qummeneing JOB DESCRIPTION Q=Z in lose ad core, easmeas and Po,fies,ion.Code,ondmylicenu is RESIDFNTIAL WO, i PERMIT ISSUANCE 1,WF, C2o p- ❑SFDWL ❑KITCHEN REMODEL. QUU 1-¢cont-� ':,�� ��Lica //�,,,s e. AI'PLIANCLS-RESHENTIAL ❑ADDITION [I PLUMBING RE-PIPE HQi Dme—/-! Commnoyf� F.stw RCHITECTSDECLARAt'lON PANfils L3 MULTI-UNIT DSTRUCTURAL MODIFICATION OZ=O N..//J �,(9,yp ps gll bqusedm ub' 2.v v DIN ER10R EICHIMNEYR PAIR i1,// ILf!_[ [/r, G1 UPT0200AMPS F=��m Llceroud l'mleum^vl 201-I(fX)AMPS IMPROVEMENT []SWIMMING POOLS ee J OWNER-RUILDER DECLARATION OVER IIIIXIAMPS El BATH RfiMODIiIJkli1'AIR ❑UEh10.ITON C C Q I hereby atfinn that am exempt Irvin the Contractor's License Law far the 3❑% following mrson.(Section 70.11,5,imoloo,s and Prnl'exxionx Code:Any city or county SIGNS Ii1.I URWAh D OTHER O :wl' I p u t t If imp y. I.I r ry,or Yaudtc gg ry pt t I, re y ,tlapplicantt 1 tt M 'g dstatement fo'oEe o CINCUI I/MISC flon(he o licensedl . to the prooisions ofth Contractors 1 (Chapters _ �p�'Q�C (mm�m,u ngwith Seu nn]IXX))n(DvsinnJntlhe Bae nucanA PndessnnsContc)ar 'ICMRMITLRORPOLP.INST. COMMERCIAL: aq yy Ihm he is cxnnpi therefrom and the buds for the alleged exemption.Any violation of D NEW BLDG/ADDITION D DEMOLITION x�N Section 7131.5 by any applicunt fora Note whjersoe applicant to a civil penalty of POWER DEVICES ❑TENANT []FOODSERVICE not more than five hundred dollars($500), IMPROVEMENT =Q ❑1,us owner nllhe progeny,or myemPloyms with verge,uc lheir,olc compensation, SWIMMING POOL ELECTRIC Off will do the work.and the structure is not intended or afferent husule(See.]OYL Business OTHER N 3 m and Prom%sions Code:The Commences License law docs not apply b)an owner of OLTI LHI S-sWITCI{IS-FIXTURES Ir pmpeny who build,,or improves thereto,and who docs arch work h nvolf c r through Ito own employees,provided Ila:such improvement,am urn intended or offered our NEW NFSIDIiNTIAL ELEC:R sale.If,however,the building or improvement is sold withlnone year nframplerico,the SQ.FL FLOOR AREA prnnerhuilder will have the hutden of proving that Iry did not build ar improve for put- e of sale.). ❑I,acuwnerafthepn:peny,amexcluslvelyconaactingwifhlicen%cla)ut etoext,, 9OIAI: c m t t the l I -t(S ]044 l ,a d f n,C )II C t Una L cerise Lawdoes not apply t anto,actofp prty who holds Or lin'revestheretiqry.. PLUMBING PERM I'IFEE wh: trach,f .uchp 1 t: om m, , ,)h,en,ral unatato al tireCnlmekrs 1joano,Iuw, PHItMI'TISSUANCE Dint crop(under See B&PCfor'his reason u Owner Done ACI R-DRAIN&VENT-WATER IRA) VALUATION WORKER'S COMPENSATION DECLARATION BACK FLOW PROVECI.DEVICE Ir JUL 21 1999 I hereby of rin under penally of Iwdury one nf,be following dalamtiom: U.1 have and will mainmin of Certificate of Comem to self-insure for Workers Confirm. DRAINS-I'I.00R,RMrF.AREA,COND, STORIES TYPE O RUCTION ,r,ion,ac Provided for by Section 37M of the labor Coale,for the perfnrnance of the k far which thio permit k issued. FIXTURIS-PER'PRAP I have and will moiamin Workers Canpensininr Incumnce,as required by Section Bv 3 Inf}ttrrhe Loan Code,for the performance ofohc work for whichthis permit is issued. GAS-EEA.SYS'IEM-I INC.40UTLEIIS Ce,C.Xf Guric�X et CCI Nllhlnnl sma lgrlt Policy ngnl�cr:g.Iy50R GEAS-IEA.SYSTEM"OVBR4(RA) My W 111 A!'aOF. 7 071a ✓��l t y Nu.: C OMPE EXEMPT IRAN WORKERS' GRHASHIINUD$'I'ItI.WASTE IN'f17RCHYn)li Cm ho,e oSATIONINSIons fol BUILDING DIVISION PBI?$ ('I ltixscmian need nm ho,e lobe permit is Gnnnolundrcd dollars(MIXR -� ,or less.) OliliASH TRAP PLANCI{ECK PER I cenilythat in thTo,damameoffhe wort hcwhich thin Permit isi.csued,I%hah SEWER-SANITARY-STORM F.A.200 FI'. nut employ any Nr n o in any manner ne ax b:Henn subjeot m the Workers'Camper- ENERGY 14Ji OZ salon lawn of California.Date WATER HEATER WNENT/ELECIR GRADING FEE Z O Applicant NOIICE'10 APPLICANT.If,after making Thin Cocci of Exemption,you should WATER SYST?M/IREATING C^ .N-t hccome snhjecl to the Workers Compensation provisions of the Labor Code,you must SOILS LLE fonhwis comply with such previaions cosi,peon,shall be deemed revoked. WATER SERVICE. 0. � z CONSTRUCTION LENDlNGAGHNCY NEW RESIDENTIAL PLMB. SQ.IT. PAH Dem Up frwhichimnhavhet i issued(Sec.30Rnding agency for the performanced ciPt# tti the work for which this permit is issued(Sec.3097,Civ.C.) u" F' Lender's Name TOTAL: U Lender',Addrm," IMAL: - 1r., unalfy that I Ituvc rend ads application and nuav that the above mo otmion Ix RI111AINC PI?II Fr In ,iamol.Ia,m.In comply withell city vad con radinrncesnnd some law,relining no Q11-y. MECHANICAL PERMIT - FEF. U ,"Z building cnnsrunlon,and hereby rmhorim repreaonoubtS of this city to emerupmt the SEISMIC FIT _ nMrve-noralinnedprapeny for in.cPcmion Pnrpnses. PRIME rISSUANCE (We)agree( ave,indemnify and keep hormle, rti %ole City of Cupeno againd PLECfRIC PER w Emilio,.judgmema..,is and expenses doichnny in by way aremeagainso said Cioy, ALTER OR ADDTO MECH. in asequence of the granting of this permit. PLUMBING PEE APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT' AIR HANDLING UNIT(TO 10,061)CPM) , MECHANICAL ITS, SOU(CHIIAT10N5. t , n / n —k- AIR HANDLING UNIT(OVER I0T00CFM) CONSTRUCION'IA X SgnatumblAppItractContmcmrr Date EXHAUST HOOD(W/DUCI) HOUSING MITIGATIO N PEE HAZARDOUS MATERIALS DISCLOSURE Willtheapplicmmor home buildingoccupanl more or handle haevrdous material HEATING UNI'I'('rO 100.0%)BTU) - o deliwd by file Cupeninn Municipal Code Chapter 9.12,and the Health and Safely Cada Scouion 25532(md i III?ATING UNI'I(OVER 100,0(X)NT U) - [IYex E]No VIIN'I'I LAI'ION VA N I NGLE RUS1 D) PAID Will the applicant or future building occupant use equipment or devices which BOILER-COMP-COMP(3HP OR IIXI,OIXI B'N7 Dom RcccipT coir hamnlau.e air contaminants a%detinW by the Ray Arca Air Quoddy Manugemeno TOTAL: . UimrinP E3 Yet, C]No BOILI?It-COM P(OVER 106,000 BTU) Alit CONDITIONER 1 have rwd the hmaNnuc mamrial.c teyuircmenu umlc Chupmr fi 95 of the Cali- ISSUANCE DATE �j fnmia)]catch&Safety Code,Seniors 8505,25533 and 255M.I understand Thal lithe NEW RISIDEM'IAL MECH. SQ,ET. 7 Z� 7 building docs not currently have a lenano,that it is my respmsibility broadly the rccupono o the rtquirtmemc which must benne,pnmmiseaunee f C ilica,e of c Ownor authnmed agent I Im TOTAL: erO ISSUED BY: OFFICE