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27448 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY ) rran1r r4n.CITY OF CUPERTINO /PERMIT PLUMI1NG-AEC1ANICAI BUILDING DIVISION APJaLICATION 27448 WARI,�SMSANITARY NI. APPLICATION SUIINIGAL DAIS UNIT N LOT N PIIUNIi: ) i Mlb i�MLIC No/K& N/C CONIROLN LIC NO: R n�WW ❑ oNIACT: PHONE: , 'lye ?I`�LEC 3�VEf� IIT -,s•c i ; w IPEIdTNFO f BLIM I:LCCT PLUMS MGCiI PERMITISSUANCE El LICENSED CON I RACTOR'S TX:CIARA DON APPLIANCES-RES I DEN FIAT, Diaz Ihembynffirm Oral)an 0censedunder prwiaiumOCImprer 0(commencing with POO❑ Section 7000)a(Diddlort Sof the Buainma and Prnfe"mrs,C rand my!!erre Ta in PANEIS fullfn.ceril UPTO 1fMIAMPS 1k'L.7y) Licca 'Ins I.it.p Us?y Ilam Customer, 201-1180 AMPS EI' S/SV.19. zFyZ Rholl ati,ed DECLARATION OVER IUIO AMPS O OZ— linnlmtand my Plans mallMuseJ as indictments. SIGNS LI,ELTRICAI. 9NE Licensed Pon e.asionel OWNER BUILDER he ARAimelm SPr:C1Al.CIRCUIT/MIS Xo � 1 hereby archm tier 1.m attempt erase me hamractora License Taw ser the w3LLy following mason.ISection 7031.5,Bminess and Professions Cods:Any city mrnunry TGMP.MGI'ER OR LE INS r. ..mien r-luhca a pemail m con.ma,neer,improve,demolish,m m,mi,any anmctare >� pdarinisaisxmme,vlsnrequireathcvpplicntfanucnp innRleaaigneJamtameen POWERDrvi Oaprc IM1m hs is Iicen.mA purawm m the pmviaiona of the Cnmmnur'a License Law(Chapter d eW 9(mnuu,mm,with Section 70XB.f Division l of the 9usirmssod frufemiun^CWe) SWIMMING OL ELIiCI RIC VALUATION yxJ_N m that he is eaanM therefrom and the basis for the alleged exemption.Any violation a! OOTLrrS-SWTfCIiIS-ITXTURIS z G Section 1031 S by any applicam for a Permit subjects the applicam to a civil penalty o! TD or mare then five hundred dMlara 135181). NIiW ftE51UIiN'flAL rl.IiCIR g .1'1. 5Cp$ n❑ LavnwnnnlOx rmpcdy.mmycmployccs with wages aalbcirvdecomixnmdon, Q STORIES UPECONSIRUCIION a will do he work,und lheemncmre is not hnendedorofkreJ for set,(Sec.744,Bminess and Professions Code:The Contractor'a License lAw dues not apply to as owner Or property who builds or impurities thereon,rsoM who dme such work himself or domain his I I dllmtsuchim t ti I A 1 lfcrcd lire mlc.If. OCC.GROUT' RES.DINT'1' bWear a heea,rravhe rravemaneamna men tiara wwa.dx have t eg errden ofpman is hath a didr one......rim rovefin,roe Owe or To rnL: nnahle.will Awe me mm�en err rm.mg mm he did hat nada or impress un purpose or 581e") QTY. FLUWINO aEAMitlhsMIN ❑ I,mnwmrnf the prnpeny,emexcbwivdymnvectingwiTblianudrnmrucmrsm I'LOOU ZONE 'N Lianatruct m�project(gee.ltw4,Business and Professions orale:)The Contractors ...,. cense law Aocaean^rplyprnperlrwbn butdaarinnnprovaa teaant.anA PERMIT SSUANCE: who convects formcn projects with a mnvvcteahl licensed ParmanUr Inc Cmmactar'a License law. ALTER.DRAIN&VENT-WATER(PAT n FERSOMMARY ❑ 1^mu cmin under Sec. .R&P C fonhis mason BACK Fl.OW PROI'1?CT.DLVICP. S 11 SANITARY YN Owner— Dam 5FJlNDirLR R,RWI.ARCA,GOND, RUCUIPI'p WORKMAN COMPENSATION DECLARATION SCIIOOLIAX Y N ❑ Iherehy ef0rm inmlhaveecmi0cme nf<unumto ullimure,orecertircme of R TRAP RECEIPT as Workeri CmnRasatinn lmamnccore cervi ocapy thereof(See,3RW.l.ob C.)which PARK FIA! Y N Purlis Alla I TEM-I INC.40UTLIiTS RliCiillsl'N l iryp BUILDING DIVISION PEES Compun EMOVGR (GI PIANCIIIiCK FCC .-tired copy la hereby famished. ❑ CerviOeAappy is EleJ with the airy inspmiinn Aivisiva L 1 INERCETOR GRADING FEE C12RI I19CA'I'rs 01;EXEMPTION FROM WORKERS' SOIISFEE COMPINSATION INSURANCEAR -STOR R ENERGY Anti m less.) Is-tify that la the pin a.,aen er i,a,for er.m @h remail is i.amW,iahell ER IIIiAT /s .NTAiLECI'0. nm e�nnrmy say peri any r .t as e.Ixeame.��njeoi ver n:e wager.: rare Z C'ompennatitm Lowe of Culifamia, Dem v IiN SYS'fliM/1'RIiA'rING U:ne fteceiptN Applicant z�7P0 NOT ICE TO APPLICANT:If,aOcr making tine Certificate of laemryion,yon should NEW R ESI DENTIAI.I'LMB. SQ.FT. TOTAL: hmoinewbjeamhe WOom,aCan.ren,.Iiun Timsidun^nf The l.RMo Core,yomaile, u mail !!� , forthwith comply with such provisions or this penE. ult^hall be decreed revoked. BUILDING FE W z CONSTRUCTION LENDING AGENCY SEISMIC TFC ort Ihaebyafrrmthal them is a construction unding.prcy for the Pcdmmvnce of L) O the work for which ilia permit is Issued(Sec.31191,Civ.C.) T l ELECTRIC IEE Ir I,cml Name 4 y O [v Lenaaa Atmmaa QTY. :,.`: _. CIidN�CdL PER I'}: a `"t. 'E;'4`hL+ii 'i"�,; PLUMRING TFTs I cemfy that I have read!this^rplicuion end slate that the.Nave information is - s Lit correct,l agree m ish comply wall city and county collimates and time laws relating To PERMIT ISSUANCE. MECIIANICAL FIR Qj building cmdmction.Real hereby authorize represmlallves ollhia city income Aran the CONS IRIICITON'I'AS U 7 aMtvcmemioned proproy for inspection purpn^es. ALTUR OR ADD TO MECIi. C (We)agree ,,save,indemnify and keep Tameless the City of Cupamim vg^ima Iiabilitio.JuJgmema.cab andeapensea which may horsey w^yaceme^geinaT and City AIR I TANGLING UNI I'(1010,1809,� in cnnseyuenerof The gaming n!this permit. AIR I IANDLING UNIT"(OVIi 60 CFM) Signature of APnl mo/Convnam Date EXHAUST UOOG(WA)u ) PAID HAZARDOUS MATCRIAISDISCLOSURIi IWAI'INGUNIrit ),(NO GNI Date Rmeipi0 Will the applicant no future building occupant than or handle hnnmaan.s mmerivl IIF.ATINC UNIT' VIiR 100.0110 111 '1' A . as JefncJ by the Cupertino Mu ll' vl Code,Chapter 9.12,anti the ilealih and Safety Center.Section 25532ay? VENI'ILA'I'IG hAN(SINGLE RIiSIDI 1. �_ ❑Yea ISSUANCE DATE Will the applicam nr lummnuilJingexcupem use equipmemmJevices which emit I)OILGR-C MI'plll'OR IW.gN)RIU) rations air comaminvnu n^Wined by The Bay Area Air Quality Managemem A.V.T/'/ BOILER-COMP(OVER 100,000 R"fU) Dimlal ❑YesA NEW RESIUIiN11Al.MliCll. SQ.Fr. g�� `i 1 hate rend Inc bmnrdoua no'clula regnimallna under Chopmr 6.95 of The California Drills&Svfny da Senium 25505,25533 rf iwnhl nhlJ35505,25N3and5 1unAcm/vm/nadro that u ent.Ihatitismymsptiiibilitylonotifythe (Va JUL I12 19elidNdoeancacehum unge mwHe,to i,s. y/a mcl OneOrn ImmAgGiveh -� OFFICE