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30835 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALLPOINT PEN ONLY ^< CITY OF CUPERTINO'DIBUILDING . r PERM IT NO. 30835 O H V - J BUILDINGVISION APPLICATION/PIIRMIT PLUMBING-MECHANICAL. BUILDING PROJECT[DEN HF'ICPI'[ON BUNDING�Ap DRESS' - SANITARY NO. vpucArION SUBMI PIAL DATE j OIY�i. f4e�� .YM�~l �L�. l OWNER' 1 - '- GONE, • COISTRACTOR6 NAME. LIC NO: - .IA/ 'X' '(,jy7]/C Yf/ .g�rGQ✓ •N/C - CONM.0iK 4HCN Cf/HNGINE 1---Ill��_ LIC N`Oi -• ADDRESS: C NTACT. PHONE. - BUILDING PERMIT INFO AVO Consultant Pines Paid by Applicant(Initial) BLUc I'LECI' PI-UMB MECH LICENSED CON'TRACT IR'S DECLARATION- QTY. - ELECTRIC PERMIT' FEE 1 hereby affon that 1 em licensed under pnomons.f Chapter 9(commencing JOB DESCRIPTION XWZ 00 with Section7")(if Division 3 of the Business and Professions Cale,and my licensees• D in at l force and effect. < � �PERMITISSUANCE.� �WUrLicenu Class Lic.p -� � �s, ' � C1 SPEW], ❑KITCHIiN REMODEL QZ U - APPLIANCES-RESIDENTIAL. ❑ADDITION+ Q� Jut. _ Contractor ❑PLUMBING RE-PIPIT Z8FF.. y ARCIHI'FCI'S DECLARATION PANELS - [IMULTI-IJNIT [:S'I'RU69'URAL. mZ IMODIFICATION pUI'T02BflAMPS " a ❑INTERIOR ❑CHIMNEYREPAIR F— W Licensed l'nd'essional - 201-1000AMPS - IMPROVEMENT 4ltd P'� th,I OWNER-BUILDER exempt fi DECLARATION OVER HHIOAMPS ❑BATH RHMODF-IIREPAIR I]DEMOLITION R•�K W a ]-thereby affirm thw nm exempt Ohm rho Connector's Limnse Law for the xLx 6 U W 3 u•F following reason.(Section 7031.5,Business and Professions Code:Any city or county ,SIGNS ELECTRICAL ElOTHER which requires a permit in construct,alter,improve,demolish,or repair any structure - F'.k.� prior In it,xuaree,tdsoon,imsthe applicma fir..cb pennit fo lila asignN stmanent SPECIAL CIRCU I'T/MISC } that he ending al Sectio IN10)pmvisi0naof them Business License Law(Chaprer9 0.rp0 (commencing exemithrumbeatand of basison3 of OOBuelnex,mp Pr.fe.,o ati for O'IiMP.MITEk OR POLI?INST. ti 6 p�f that rte is exempt Ihercfmm and the basism the alleged exunpnt 1,Any violation of - NEW BIAG/ADDITION E3 DEMOLITION- 2h Scmion]OJ LS by any applicam fora permit wbjeas the applicant mecivil penaky of POWER DEVICES 2NT ❑FOOD SERVICE F$=Qnot more than five hundred dollars($5001 ar'L"� I,es owner of the property.nrmyemployees with wages nv neersolemmpen+mien. SWIMMING M)OLELECTRIC 1 0',MENT .- a+F-F will do the work,and the structure is not intended or offered particle(Sec.](H4.Business ❑OTHER YJ, � and Professions Code.The Contrucm8s License I..,does not apply m nn owner of- flll'PL is-SWITCHES-FIX'I'ORBS �' property who builds or improves mansion,and who does such work himself or through -his own employees,provided that such improvements are not intended or offered for NEN'RESIDENTIAL ELELTR SQ R. sale.If,h.wevcq the building.,ampros,rusept is sold within ane ycuntl a;ntpleainn,me SQ,IT FLOOR AREA 5/SQ.FT.•' owner-builder will have the burden of proving that he did not build or improve for pur- poncofaal - 1,as owneme r of the property,.I exclusively contracting with Ilcca+ed Committees io TO'1'A L: nand the project(Sec,,an Business and city a n,)o ai Cs or it Bc Contractors Li- ' cense Law does not apply man owner of property who huilAs or improves @erenit,and Q'I'Y. r PLUMBING PERMIT 5FEH who contracts forsuchp jects with a contracons)Iicentd pursuum tothe Contractor's License Inow. r f 1"TI IS, ❑ I run ex.ntpt note,sec ,B&P C rot rots ten,aOr efn ' ALTER-DRAIN&VEM Owner Dao '-WATER([A) VALUATION WORKER'S COMPENSATION DECLARATION BACK FLOW PROTECT.DEVICE •-�1 v✓ Y '' I hereby affirm under Penalty of perjury one of Ne follow ing Jmlaratians: - TT -1 I have and will maintain aCerillcnte of C.a,cnun selr-insure for Workers C.mpcn- DRAINS-FLOOR,ROOF,AREA,COND.% sunt m,as provided for by Section 3700 of the labor Code,for the perfmatence of the • STDRIIiS TYPE CONSIRIJCTION work for which this permit is issued. FIXTURES-PER TRAP El I have mW will maintain Worker's Compensionat Insurance,as required by Section 1f 3700of eLahor Cade.f..the performhi performance of the work for wch thispemtitisismedL GAS-HA. M SYSTE -1 INC.4 OUTLF-'FS M liter's Compensation Insurance carrier and Policy number arc: OCC GROUP APN ' artier: 11.Iicy No.: GAS-EA.SYSrrbs VEH4 B:,A) h+ CERTIFICATE OF EXEMPTION FROM WORKERS" r QJ COMPENSATION INSURANCE GREASRENDOSTRL WASTE,INT CEPTOR (This section need not be completed Blue pennit is for one hundred dollars 0100) • BUILDING DIVISION FF.35 GREASHTRAW t. 1 - nAcsxJ PLANCH[CK FEE lecnify hat inthe performance this pennitis issued,Coarser- SEWEiR'-SANITARY- OHM HA.200 'G not employ enyperson in wry manner s0 resm become suM1ject m[lie Warkrn'Compen- O z scion Laws orceithm. Data _ WATER HEATER I:Nf/ELF-C7R +. z 0 Applicant - GRADING FEE NOTICE]'O APPI-ICANT If,after making this Cenifica,of Eiempd0n,you should WATER SYS - /fRISATING become suhjcn m the WnrAcr's Cnmpensvtion provisions of the Labor Cale,you must SOIIS FEE 4mhwith comply with shah provisions or this permit shnllMdeenmJ revnkuf.' WATER ;&VICE , Q CONSTe I,.construction ONLI?iNDING AGENCY NP RESIDF.NI'IAL 1'LMB. SQ.IT. - PAID _ L) I harishichnn lhathcre Tseed(Seekndie. agency fir the perfommnce of Date Itoccipt sl, {L 'heworkNfara which unix'permit is issued(Sec.31MJ],Civ.CJ Lender's Names ,TOTAL: LelLl nder's AJdnsss TOTAL. >i : - •� 1 certify that I have read this application and store that the above information is BUILDING FEE Z) correct.I agree In comply with all city and county ad'mat¢es and state laws relining to QTY. MECHANICAL PERMIT FEE C.1 X� huilJingrnnnwninn,and hereby authorize repreccnmtivo of this city menter upon the -ISMIC FEE C adove-memlaned property lin inspection purposes.. PERMIT ISSUANCE ' (We)spree to save,indemnify and keep harmless the City of Cupcnino against a. ELECTRIC ITE 7d liabilities,judgments,costs and expenses which may in anyway accrue against said City ALTER OR ADD 10 MECH. msequence of me gnmdng of oris permit PLUMBING FEE APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10,000 CFM) SOD CEREGULATIONS. - 'MECHANICAL FEE 7Q �- AIR HANDLING ON]'I'(OVER 10,000 CFM) . CONSTNUC'IION'I'AX S nmurcof Appli.rmCommaof Date EXHAUST HOOD(W/DUCq, HOUSING MITIGATION FEE ' I IAZARDOUS MATERIALS DISCLOSURE , Will the applicant or future building occupant store or handle hannlous material HEATING UNIT fro I00,000 BTU) as(term i by the Cupenino Municipal Calc,Chapter 9.12,and the Health and Safety Cale.Section 25532(a)^ HEA'L'ING UNIT'(OVER 100,000 BTU) ❑Yee C2 Nd / ' - VENTILATION PAN(SINGLP,RES 11)), PAID Date Receipt p Will the opplan. I or future building rccupant ecu cyaipmen!or Devices which r mit hanrdmalair contaminants as defined by the Bay Arta Air Quality Mawgemann BOILER-COM1IP(3HP OR 100,000 BTU) TOTAI: DisvimP ❑Yes ❑Nn 1501LER-COME(OVER 100,(X10 BTU) r - Y I have readthe hanrd.us maenals requirements under Chapter 695 of the Cali- A I R CON DITIGNF,R HiSIZINCE DATE mmia Health&Safety Code,Sections 25505,25533 and 25534 1 understand that if theo NEN'HCSIDENTIAL MECH. SQ.FT mild, Joe t .,cut huvevlcn,int,that it is my mspnneihilhymnotify Naacanpunn .frac u sn,`Cncnwhic It cat PH.,.,;,.ad.of a Ceutii�r2ao Ogsd'ncy. Own a II ]agent [[�' �V//Dupe TO'T'AL: ISSUED BY: OFFICE t1'rR G�e +91 SANTA CLARA COUNTY CONTROL NUMBER CENTRAL FIRE PROTECTION DISTRICT AF, 14700 WINCHESTER BOULEVARD PERMIT NUMBER 3683 LOS GATOS, CA 95030-1818 (408)378-4010 _- rFY:TipN SERVICE SINCE 1947 FAX(408)378-9342 PLAN CHECK Na. PLAN REVIEW COMMENTS CODE/SEC. SHEET NO. ZC{/lEW 7o COE EN<LOS& C)r _ ,C/GN SMAC , F/Res' 5MLL Fe opm-r/c-a /15 k1�GE3Sf," .o ,gLG.m.y©piggy AIELd eon/ST2c�cT/�nJ, 7l4,0f '0q C oh/l C`7-C 77 _ . FE`E'S FOS .ACV/E; �1 P/Z/02 70 €'R f-L1I2 H/a1 Cr IJ fC . T I i n _� l�r�O✓� t Ga,t'�!f -70 /S�a $,, b��l c. �E ?h✓r r��IOIi T D $TINA'L. /A%S�C L T/O.t/ JURIS PLANS SPECS NEW REMODEL AS, CONST.DESCRIP. BY � / DATE PAGE - cup ElLlEll)�3,(�y Ur ��oti 130 -97 / OF 1 SECJFLOOR OCC OCC.LOAD AREA ARCH/ENG/CONTRACTOR/OWNER J A m4.S NAME OF FACILITY LOCATION - - / itn( 6501-1`3 G�,9yu,Lalu� Seruing West Valley Cities of.. Campbell, Cupertino, Monte Sereno, Saratoga, Town of Los Gatos, and Adjacent County Areas • � I � ('aa G i l � r5 NtES SON �b E ' I � � Date ��q�rJ ENGI CONSULTING - EEISRS Prol. dt LY (anTtTtulj51 ' X39 HegenbetgCr Rd.,Suite804 Oakland.CA 94121 (510)568-2110 �u ,w,��,T, �....-_ , i I � � M ea��`F �v aha-���r �•^ �t'r''!�✓° ;77 I� I �_ --i 1 r-'-----I!---- I � } it.I I A F i 1 'j- 17 z ! I 1) r II pp I I ` i'•: i ' --- - .,ff Zu !.�'• t-�� LIQ �I. ��„ I � — —4_ 1 r . s --r U 9tl1. 1 l I � 1I A f_ 'JAN 919I" _ — i BLDt(;itJp QI1-D1- 'P, 1•'•' .l„ I rcl ice. rl _• , r q � IIjFw L I. I f � '. � ' ❑Ir X27' tI I i I y, H 4 �' ��ry 1''n�,1r�� ' . .. III J ......1 I 'I^Y J ..,i�l€�--.,..,r. I•-'dtjE rC''JI uI` ` �_ yN IB�ry'�. �4lAfli. �� � I r a IENGIiVccI I ;lyf� _ !.. —11 Ob 7, r � _ -: - ——G-L I C01,JAMES S. WONG & ASSOCIATES Date CONSULTING • ENGINEERS Project rr,F r, 333 Hegenberger Rd., Suite 804 Oakland,CA 94621 • (510)568.2110 CA L'v f�JG, 1 ItiGiD!eiv"tLf7(' ��-I�S.�tau• rti,��Irro ........... . .,....._.__ .. .......... ... . ......- . . ..._., — .......... .. .. —-- = PYat�'� r i`—t �� I i I .. I —i int r� r � � '�,• . ._... .—._ _ fF7 C { � 1 75.E C r I 02 I � i .__._ - .. � . ..._.. .... ..... .... ... . .. .... Lir. .. _..._ `��� ........ ,.'\I. — _ . i -- of �.�: 1 -•; j u II' . - �� 4i_ I 1�r l '' ''-��ry-d� _ Mc LFi,LAY ROLO tl � � •c 'f V JAMES S. WONG & ASSOCIATES Date �o J• 'L4 19 9 7 CONSULTING - ENGINEERS project Dtr� !T (�NS 333 Hegenberger Rd..Suite g04 Oakland.CA 94621 (S I0)568-2110 M EAOU{Z�C �oRP' Gd PC*nrID . O , i 112 OI ' M�►2 _ o�PlriFi � ' 1 7 -- I j I I'��1'n �IarTC� I ��IL,�I�GGD F�oo►2 t'L,-0�N �fJ Gt l TL lr�sS /1,(�6025� . gf. Cl) JADIES S. WONG &.ASSOCIATES Date 9A-T-1, 14- 19 u i CONSULTING- • ENGINEERS Project cpfl6, r*q.-rlfrdwS 333 Hegenberger Rd.,Suite 804 Oakland.CA 94621 (510)568-2110 Ov l l,V !.w 6n j ` MQA`�SuRG� Go¢P rte (�.trtJO I • � I i a ! 0 ;> goo JolST gJ-2 i StIJ� HT II ! 4 �2 d-=121 S N x LJ K I I ixlsT� JAMES S. WONG & ASSOCIATES Date dtir ( rti ' CONSULTtNG - ENGINEERS Project, 333 Hegenberger Rd..Suite 804 Oakland.CA 94621 (510)568-2110 pJ V I L 71 N (o I I-1 E;A��IZ rG/ aocv Grn"rht2?"i to O �5 S/� sree�.s to n5 2 t�: . 5 ( �.s EYP<c,t-I c,0 . ao <T' &,A LF Gtir 1( IN S.✓I u QiA . }'OWC� �727,,f(iF� �gv(>sihl GR-5 C. ,1 t/v WI ISL -�J PYi s f 0p GoriG- Ft"fL Irt ra.(J K+.s-� -5 i.� f3+1'(• C1.j-a R�74 Ft 'I'�'f G fw"✓f :vf 4•'rC _ —roYp. i�D . FUI.IIHT ("'I Ot,-( As META j. e-TUD TO TtRA6,14- i I `1E�TAL- TIZAGK r ' j aI 5ie� MSTUDG 13 p SUgPENpEb G�.ILIhICOi'-r �— P)<-r lN'; �`( OGS. —y=t =-- �8 G'fP. 3✓. tYPF X P1( Q.p. Lt'Yy.t.� ( 11i r^G7 � �I 0 WALL To ��IUf`lC� D�TP',it✓ �,. ,� ~ • JAMES S. WONG & ASSOCIATES Date JAI) 7,4 CONSULTING • ENGINEERS project J-fT14.0 P*10'vf«+NS 333 Hegenberger Rd.,Suite 804 Oakland.CA 94621 (510)568-2110 G GLAZING ( �) ! ALU ►"l h-JULLIot`, f[HISH TO MATCH W16T - ALUM , irlSULAT i4 ruLLl01� � I �-- aX 1ST& GOLU M N r I I ; I PpctZTj-ttoN � W �rJt7oW 6 . .JANIES S. WONG & ASSOCIATES Date 24 • CONSULTING - ENGINEERS project &pfrce (yrlvrtg..,uS 333 Hegenberger Rd..Suite 804 Oakland.CA 94621 (510)568-2110 (�1J�LpItJCo 1 MC;OC^UF� .O w I No ! I I— — --, --..._ I { �/ -�- -' -- --- ----- -- - - -i- l —Spw0r-t R I+r-Av4 j TYPE : W.&*-6v , TS P I cp5 of= 0W4Fl. GH"Hr-, ?E�(,�LTED G�ILIrIG pLAI� lroNtlf�� C �� r 6 ap ,JAMES S. WONG & ASSOCIATES Oate -JP^-' ti^1 rA, CONSULTING - ENGINEERS project Gy✓rGr� �rt fr (t,h t 333 Hegenberger Rd..Suite 804 Oakland.CA 94621 (510)568.2110 1 M6A5urwtic Govg /.0 ✓Vprl40 CIO t-II'fzEr--S1Or '&TIZUT. T-fPIA-r 1w C�f� STEG'I� U.!p SI'L ,( 5"t-'i[40 ERI C SECURE TO 6orraD 1 GaNTfLTOF2 To 'tzDYi�E GP'LGULp�iDIJS FO(ZyT�J7c; Q / ATTAc,-M GGW2 t2Ol.l.ti0 i CHANNEL To S&MeL- ! CLIP W/5HeST HffTAL � J • , 5 i N OTC44 ENdg To FIT TEeS 4.5 rX1eTINC� S�ISMIL PF-^61f C� FOR G�1LIfJG �A,IZ� a