Loading...
C 7259 (2)-APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY BU LDING PROJECT IDENTIFICATION APPLICATION &PERMIT PERMIT NUMBER G D ADDRESS ooREss ,G: � BUILDING -ELECTRICAL- PLUMBING -MECHANICAL 7259 OwrvE 'S NAME ,,.� vnoxE .N - 'i': � `ELECTRIC PERMIT : �FEE'� PL ECK VALIDATION corv7NAcaoRs NAME - SWITCHES -RECEP 5.00/1.00 OUTLETS �IN-�/^T1C„ .uc No. (� k. LIGHTING FIXTURES 5.00I1.00 ADOTRAc7on'sDORE PPLIANCES- RESIDENTIAL 4.00 PANELS 5.00 DATE OF APPLICATION ARCHITECT OR ENGINEER ✓��- 1'1 Llc. xo SIGNS 6.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH, OR ENG. aODPE55O SPECIAL CIRCUIT 5,00 PERMIT VALIDATION r ' rrEMP. METER OR POLE INS. 15.00 �•/ 2.nJp64QktQU_M r J a� s APPLICANT Sn/J//11 Ao 14.7a 6 ILc2 Y�-�/D MOTORS SEE FEE SCH. SERVICE CHANGE 10.00 LICENSED CON" TRACTORS DECLARATION I hcrcby,ulfirin Ihm I am licensed under rovieion,ol'Chapter 9 (commencing with Section 9000) of Division 3 of the Business and Profcssioas (p ,dds� J�nyIp e, in full foI- a t. License ClaJr�S-O X49Iic.Number�-7_ 1-4_1r. Date Coal ... ur ISSUANCE DATE BLDG. ❑ ELECT. PLG. MECH. ❑ ❑ ❑ B DING;P,ERMIT,, %s-,4 atTa't�'ik�fv OWNIi R-BUILDIiR DECLARATION I hereby atirsn that 1 on excio t from the Contractors License Law foray ity orcounlywhichle 7031.S,ermit I,, and contra, aians u ...ra permit to construct, alter, Code: Any city or county it any structure, its issuance, also improve, demolish, or repair any structure, prior MISC. - REFER TO ORD 'llViHf���,1n 7-',(/•1 Ol/ PERMIT ISSUANCE 6.00 ELEC. CONTR. LIC. NO. ELEC. n that requires the applicant Darafor such permit to file a signed Contractor's he is licensed pursuant en the provisions of the 7000)fDivision License• rpt Division o and the Law (Chapter 9 (commencing with Section is exempt Business and ProfessionsCode)or that he is exempt therefrom and TOTAL go B QTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.$ ALTER -DRAIN & VENT -WATER (EA.) 4.00 by any applicant for a permit subjects the applicant loa civil penalty of not more than five hundred dollars (5500).): O I, as owner of the property, or my mnployccs with wages as their vole compensation, will do the work, and the structure Is not BACK FLOW PROTECT. DEVICE 2.00 lice. GROUP PES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 4.00 intended or offered for sale (See. 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work FIXTURES - PER TRAP 4.00 SO, FT. FLOOR AREA TOTAL ACREAGE himself or Iloough his own employees, provided that such improve- meutsarealitintendedorofferedforsale,lf, however, the building 'GAS-EA.SYSTEM-11NC.40UTLETS 4.00 r improvement is Sold within one year OI'romNel ion, the owner- builder will hoe the burden of proving that he did not build Or im- prove for purpose of safe.). ❑ 1, as owner of the properly, am exclusively contracting with . .. GAS - EASYSTEM -OVER 4 (EA.) 100 BUILDING USE HES IND CON PS Other ❑ ❑ ❑ ❑ - ❑ INDUSTRIAL WASTE INTER. 20.00 LAWN SPRINKLERS - 1 INC 5 V.B. 5.00 LAWN SPRINKLERS -OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. licensed contractors to construct the project (Sec. 7044, Business and Professions Code "I'he Cnnlmnor s License Law Joei no[ apply to an owner of Property Who builds or improves thereon, and who contracts for such projects with a contractons) licensed pursuant lU the Contractors License Law. SEWER -SANITARY -STORM EA. 200ft/8.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 4.00 - ❑ I am exmnpl under Sec. ,B.dtP.C, for oris reason Owner Date WATER SYSTEM/ 4.00 ;� ACC. DATE ACC. FILE NO. WORK IiRS'COMPIiNSA'1'ION DECLARATION WATER TREATING EQUIP, 4A0 1 hereby affirm that 1 have a certificate ofconsent loself-insure. or a certificate of workers' Compensation Insurance, or a certified Copy thereUll1 780 LAC.) Policy No AlPany_(1_ ❑ Certified copy is hereby l unti AT Cerlf lied cop filed w' 115 "vision. App�l'Cam _ ),,.1 0:) ZONING ENG. SITE NO. a. no FIRESPRINK Y❑ N❑ ENERGY T.24 Y❑ N❑ MISC.- ORD. CIi R'I'119C TE 01' EXEMPTION FROM WORKE RS' PERMIT ISSUANCE O.W ' FLOOD ZONE A.L.U.C. PLO. CONTR. LIC. NO. PLG. rJ7 TOTAL COMPF:NSA'601,1 INSURANCE ("This section need nal be completed if tire permit is for one Y ❑ N❑ Y ❑ N❑ _ - agsst warcN bundreddollars($100) or levi.) 1 artily that in the person, of the work for which this per. mit is issued. I shall nor employ any person in any manner So as to QTY. -MECHANICAL PERMIT FEE EFEE•SUMM ,ARY !GYM BUILDING l� become subject to the Workeri Compensation Laws of California. Dare Applicant NOTICE 10 APPLICANT: IL after making this Certificate of fix- emption, you should become subject to the Worked Compensation ALTER OR ADD TO MECH. 4.00 APPLIANCE 4.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with such provisions or This permit shall M: deemed revoked. FEE " AIR HANDLING UNIT (TO 10p00CF.M.) 3.00 AIR HANDLING UNIT (OVER 10D]OC.F.M.) 5.00 SEISMIC FEE tsa CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.CJ. EXHAUST HOOD (WITH DUCT) 2.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 4.00 HEATING UNIT (OVER 100,000 B.T.U.P.50 ELECTRIC Lender's Name Lenders Add dress 1 certify Iled I have read this application and stare that the above information is correct. I agree to comply with all city and county ordinmees and state laws relating to building construction, and VENTILATION FAN (SINGLE) 3.00 PLUMBING BOILER- COMP(3 H.P. or 100,000 B.T.U.) 4.00 BOILER -COMP (Osar, 100,000 BTU) SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC. - REFER TO ORD. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in an way accrue against s d City in conuquenee of the CONST. TAX PERMIT ISSUANCE 3.00 MECH. CONT. LIC. NO. MECH. TOTAL .' TOTAL this' permit. ti9 Z Si azure of Ap tractor Date, S,;; OFFICE COPY :31 m w rt < a CD n rt 0- r - O LO n rt w m O. ry V. a a Di a n :3 O a O a M w m rt 3 . N 0 O o O M m O rt 1 3 rt El En O m a U=j-ri't g n < r. LO � k r m c� ' `t O rt r TI W (a :31 m w rt < a CD n rt 0- r - O LO n rt w m O. ry V. a a Di a n :3 O a O a M w m rt 3 . N 0 O o O M m O rt n N G o 3 n El En O n°o O rh • � ( a N M H H. n n rt LO D R1 al (D r TI a 0 �i H (D :31 m w rt < a CD n rt 0- r - O LO n rt w m O. ry V. a a Di a n :3 O a O a M w m rt 3 . N 0 O o O M m O rt n N G o 3 n El En O 1 } U r ( a N M H H. n n rt LO D R1 al (D r m cn ❑ • • IN44 nom, i v,nx to N :A u j z!Z' to i A SAT- I ol NvcI u� �I ij el Z 1ku n 0 0 n s I o Iry,!nr T i r Axe 'J i C z v m i D 14 Ned TN r � C, 0 Q4y 2 n 0 0 n s I o Iry,!nr rn z v 1� s�A D 14 Ned TN r � C, [ �- Q4y m U m 4 t7 uto r ^m44s S�i3`eV.Q�� 3 a s n D o2a 4N� k Z a mm n wl y 2 N 111 r N m Z N n I N a r jEc, EFED pq�\ sf to a 2 L 71 w -�-� ; • � rte. d�d�3N �0 (n N � Z rmm L�, IDS O Ary r� mrrn omr,N<X�0U °Drz c r, (A m O O; w m aim 3u .0 Z� mU bu�m v >a ^m+ far r pa r oNti m gA� nt rh 1� s�A 14 Ned TN r y oby�m [ �- • n a U 1 uto r ^m44s S�i3`eV.Q�� 3 ,� a r jEc, EFED pq�\ sf to a 2 L 71 w -�-� ; • � rte. d�d�3N �0 (n N � Z rmm L�, IDS O Ary r� mrrn omr,N<X�0U °Drz c r, (A m O O; w m aim 3u .0 Z� mU bu�m v >a ^m+ far r pa r oNti m gA� nt rh 1� s�A 14 Ned TN r y oby�m [ �- mk `NP2wq 00 ^m44s S�i3`eV.Q�� 3 o:r OZ = o2a 4N� k Z �n2 Sl �2 O N �k U n 70 y2, N x• 1 � U8 I N N � y � r I Nk N� r ZI a r jEc, EFED pq�\ sf to a 2 L 71 w -�-� ; • � rte. d�d�3N �0 (n N � Z rmm L�, IDS O Ary r� mrrn omr,N<X�0U °Drz c r, (A m O O; w m aim 3u .0 Z� mU bu�m v >a ^m+ far r pa r oNti m gA� mk r v O N �k U n y2, W U8 3 a r jEc, EFED pq�\ sf to a 2 L 71 w -�-� ; • � rte. d�d�3N �0 (n N � Z rmm L�, IDS O Ary r� mrrn omr,N<X�0U °Drz c r, (A m O O; w m aim 3u .0 Z� mU bu�m v >a ^m+ far r pa r oNti m gA� • • 0 4 Z a a N N Jj N N N x N k a ti N x N x 4y $ m � z I� 2! C4 r ~ 7 Z D { fn J t N "' ,e U N • • 0 4 Z a a N N Jj N N N x N k a ti N x N x 4y $ m � z r ~ 7 Z D { fn J N U N m A : N fir 0 V4 z o rg rg IV 3 D m O 4y $ m � z r ~ 7 Z D { fn J EFEDIq 0 0 '.%'IVui�l�:�•/��%/��- r i11•�i'j�l 1•.;lam/ ��+=_=__ `\�. .\il� II 1 • {II � ��lr Al, •;-111_ - Ali_ ��,: \�!\� '`• ���I -- _] \\i/ fi'DIPE INSULATION 1 Cao To ullas NOT WATER M HOUSE - HOT TO WATER (ATE VANE HEATER INr,U ATING WAh2- --+NEATER BLANKET i . ^ I (O 1 ! io ExiST1NG \-I "TEQ 1 1 1 I �