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28035 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OE CUPERTINO -ELECTIUCAI. PERMIT NO. APPLICATION/PERMIT PLUMBINO-MEDEN 11FICA 28035 IfUII,UING DIVISION I4UILUING PROIF:C1'LUEN'TIF'ICATION BUILDING ADDRI3SS. 1rA1/ SANI'I'ARYNO. APPLICA'HON SUBMH'I'ALDATE 37 " va ,NIT* LOT S 1.?-11NAMf;: PHONE: O TOR'SNLIC NO: C J NIC CON9'ROI.a ARCIII ' JFW INEER: f� I.ICNO: ADDRESS ❑ K SOo Z3 /Z CON]ACT: PHONE: BUILDING PERMIT INFO QTY. ELECTRICRMIT FEE 18T PLUMB MECH PERMIT ISSUANCE ❑ LICENSED CONTRACI OR'S DECLARATION APPLIANCES-RESIDENTIAL JOB DESCRIPTION ❑yz I hereby affirm that l am licensed underprovisions of Chapters)(commencing with WOO Section 7000)of Division 3.f the Bminess and Pmfessimts Code,and my license is in PANELS /� F WF-. full force and L U QFZtUy License Class YQ...x-�Y LIC.X ��� UP TO 2W AMPS ea� ti=y Dwe Camrac W`�"L• 201-1000 AMPS SQ.FT.FLOOR AREA $/SQ.IT, ZOyz AR 111 CTS BECLARATIO PL OVER Ilp0AMP5 OZ_❑ I and my plana all used public ticordx. _Fm SIL. -6 r .1.�_(/�h SIGNS ELECTRICAL ,soca Lica at P�rnf-esu^nal OWNER-BUILDER DECLARATION SPECIAL CIRCUIT/MISC. K O W U 1 hereby affirm Nm 1 atm exempt from the Convector's License Law for the W 3 a H following aason.(Sutton 7031.5,Business and Professions Code:My city or county TEMP.METER OR POLE INST. which requires a permit to Ormbse',ahcr,improve,demolisM1,or repair any structure prior to its issuance,also requires the applicant fn isuch permit to fileasigned statemrnt POWER DEVICES Mm 0 that he islicensed pursuant to the provisions of the Contractors License Law(Chapter SWIMMING POOL ELECTRIC deCL 9(commencing with Section 7")of Division 3 ofthe Business end Pmfessians Cade) VALUATION Woim or that he is exempt therefrom and the basixfor the alleged exemption.Any violation of Fa /O w Z_attnalty Section 9031.5 by any for a permit subjects the uppllcano a civil peof OUTLETS-SWITCHES-FIXTURES ❑ Y not more than Eve hundred dollars($500). S .FT. K�o ❑ I,asowncrof thepropeny,nrmyempinyenwith wages as theirsolecnmpensadon, NEWRESIDENTIALELEMR Q ORIFS 9'YPE CONSTRUCTION c, will do the work,enddirmucture is.1 intended or offered for We(Sm.7044,Business and Profesalons Cork:The Commetors License law does not apply to w owner of property who builds or improves thereon,and who does such work himWfor through his employees,pnwided that suchimprovCmeats urenm intended orofPorcJ for agile.Ir, OCC.GROUP RES.UNIT'S however,the buildingor improvement is sold withinnne ycuofcompletion,theowner- TOTAL: builder will have the burden of proving that he did not build or improve for purpose of We.)' QTY. PLUMBING PERMIT FEE FLOODZONE APN ❑ I,as owneeafthe property,am exclusively contracting with ieemsed contractors to naetmet the project(See.7(44,Business and Professions Code:)The Contractor's License lawdoesnot apply to an nwnerofpropeny whobuilJaorimproves thereon,end PERM]PISSUANCE whoc^ntracts forsuch Projects with acontfactor(s)limnmd pursuat ttothe Contnetor's Licamc Law. ALTE0.-DRAIN&VENT-WATER(EA) FEC SUMMARY ❑ 1 am exempt under Scc. .B ffi P C far this reason BACK FLOW PROTECT.DEVICE O TSIDE FRES SANITARY Y N Owner Dote DRAINS-BOON.ROOF.ARIA,COND. RECEIP`r# WORKMAN COMPENSATION DECLARATION SCHOOLTAX Y N • .bcr1 hersbyafirm that l haveacentt ificareofeansenoself-insum.m acertificaeof FIXTURES-PER TRAP RECEIPI'N Worked Compensation Insurance or^cenilird copy there00 af(Sec.38 .Let,C.)which PARK FEE N corsalleml drys il. RECEIPI'0 Policyp p GAS-G.SYSTEM-1 INCA OUTLETS BUILDING DIVISION FEES �Cenified copr is herehy fu 'shed. GAS-EA.SYSTEM-OVER 4(EA) PLANCHF.CK FEE ❑ Cenificd copy is riled with the City ins,re ion division. ORIEASFANDUSTRL WASTIE INTERCEPTOR GRADING FEE CERTIFICATE OF EXEMPTION FROM WORKERS' OREASETRAP SOILS ME COMPENSATION INSURANCE (Thiss«tinn need not he completed ifthe peons,is fortune hundred dollars(SIM) RY-SfDA !T. ENERGY IEE m less.) - ICertify that in the reconvene ofthe work for which thispermli,isrool,ishill WATER HEATER W/VENT(L'LECTR not employ any person in anY moaner so ss to bCfDrtie {yet to the Wooten' PAID C.mpcnsati n fCelifomia. t 5�Sa� WATER SYSTEM?REATING Dae RaeiptX Z A licwtps o- "- Da 2 NO'ICIE TO APPLICANT:If,after making this Certificate of Exemption.you should EW RESIDENT IAL VLM B. SQ.FT. TOTAL: 1-" ) become anbjecno the Worker's Compensation provisions of the labor Code,you mus BUILDING PCE forthwith comply with such Provisions or this permit abam ll be excited revoked. 0 d+ a [) CONST RUCTION LENDING AGENCY E SEISMIC FLEE� O.zI hereby affirm that them is aconsbuction lendingageney buthe performat¢ of dU the work for which this retort is'ssued a.jos)7,Civ.C) ELECTRIC FFEELenders Name J iPLUMBING FEE U- r- Lenders Addrcas QTY. MECHANICAL PERMIT 0 U I Certify thin 1 have rend this application and sate that the shove inform tt to is MECHANICAL FEE L21 comet.l agree to comply with all city and county ordinances and stare laws mist gto PERMIT ISSUANCE F' N buildingcommuction.end herebyau0mriu representedveso(this city insurer. .the CONSTRUCTION TAX Vz uMwc-mentioned property for inspection puryoxa, ALTER OR ADD TO MEC i. (We)agree m save,indemnify u keep hartnlcss the City of Cii'mino s most ilii^abbiilpi�lie{a.piu�/J_9g�m��e�mscnsls unit experts hichmayinamywayaccrueagmmstasi ity AIR HANDLING 1'0010.000 CFM) -'--6'+�spthe grentinB Nis a i1 ._ AIR LNG UNIT(OV ER IBM CPM) Sigt)aiurcaf Appl tC n star Pate EXIIAUSTHOOD(W/DUCT) PAID HAZARDOUS MATERIALS DISCLOSURE HHATING UNIT(TO 100,(X10 BTU) Date Receipt It p Will the applicant or future building occupant sum or handle havrdous material HEATING UNIT(OVER IOlJ.f100 BTU) TOTAL: ( a as derined by the Cupemino Municipal Castle,Chapter 9.12,and the Health and Safety Cwle.Section 25532(u)'f V HN'I ILATION PAN(SINGLE RESID) ❑Yes ❑No ISSUANCE DATE Will thea licantorfuture buildin uccu nt use tordevices whichemit BOILER-COMP(3HPOR IM.000BTV) pp e he 9ui,Air hart rJnus air contaminants as defined by the Bay Arca Air Quality Management BOILER-COMP(OVER 100,000 RTU) District'( P A ! p ❑Yea ❑No NEW RESIDENTIAL MECII. $Q.FT. 1 have read the havardous matmals"micmems under Chapter 6.95 of the IA11995 Calilnrnis Health&Safety Code,Sections 25505,25533 and 25534. 1 understand that MA�/ 5 if the building does not currently have a tenant,that it is my responsibility to notify the oceupam of the requirements which must be met prior to issuance of a Certificate of Occupancy. CII r V rcMIINU ` Owner or authorised agent Date TOTAL: ISSUED BY. OFFICE �.......DATE-5J-Y-1 SUB7J^ECT.(epfCjl1L•,[/(¢/. -LC/K �.. Ps fir' SHEET NO.�.S...�/O�F.»Z�/ .._:. CHKO. BY................DATE.................. __fi!ClGaLrL_..1Y�q C1.��.GY�o... •_.«.».. JOB NO.._w!_6_C•1 ...._.. ............._..................................................__ ._.'a'_=.' - .�.-.�c-f- »l"�•__.:r:: KENNETH NELSON' Registered Civil Engineer ReEerences : (1) 199/ Ed. UBC 940 Saratoga Ave. (408)247-2898 Suite 215 Design Load Assumptions : (psf) San Jose.California 95129 LL DL APPROVED Roof ^fes 8 IN ACCORDANCE WITH THE CITY CUPERTINO CODES AND ORDINAP' ES Ceiling _/O ._ _ 7 DAT ' QR13FESS/04, p 9 Sloped Cl'g. SIGNED ur•, ���N NF�� �F� This set of ans and specifications M0.. �c� O ';' V.' 1st Floor _jQ ..,. be kept on the job at all times and it is L' lawful to make any changes or al,. atior w No. 22023 9 7 m 12eGk _.___9_._-on-same without writton permis:i, n ii. n Lic. Exp. 9-30-93 2nd Floor 40....... /O._ -the building Dept., City of Cupertin . CN11, Ext. Walls _= The stamping of this plan and spar, -•.i,,,, T a�\P —1 - SHALL NOT be bald to permit or ! O 0 1 FOQ" Int. Walls -- ? ' approval of the violation of any p . ILrr?�+ -'—" - any City Ordinance or State Lav +\i Party Walls. .. ..--_.. ... ... .. D • MAY 51955 Wind BLDG. INSPECTION DEPARTI$IM Seismic vs =__O.• ___W____ CITY OF CUPERTINQ Timber Construction Design Criteria With G'777^Zi .:'Lumber.`CradinK Rules Use Grade f E x 106 f (repetitive use Struct• Light Framing (4 x 4) 02 1450 1.7 - Strucc. Joists, O1 1500 1.8 1750 Planks t: Rafters Dene 02 1450 1.7 1700 1 . 02 12 1. 1 Light Framing b Std. Studs (4 x 4) Grade 600 1.5 Beams 6 Stringers Dense Sel. Struct. 1900 1.7 Beams 6 Stringers Sel. Struct. • 1600 1.6 Beams 6 Stringers Dense O1 1550 1. 7 • U1 1350 1.6 OMCEmbCOPY Dense U1 b 1400 1.7fb 1200 1.6 ----N��►�1■■■� ■■■■■ pi ONE■, _■■■ °si .� , - ■ - - �' . s■ WAlk NO OWN 1-0111111 ■ riur�r�; ��iiv►i���i► CE; CU MER Sol- ■ w z� r- •=