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99080150 (2) APeLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY q o O vSQ CITY OF CUPE RTINO BUILDING-ELECTRICAL PERMIT NO. BUILDING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL BUILDING PROJECT IDENTIFICATION BUILDING AUURESS'. SANITARY NU. Now WNF.R'SN lna..�k I'110NF.: 5SS I COyRRAC R'S NA'{1� L'C Nv` N/C CONTROL of Cfll'I'F.C'TIF.N(i1NEER: V LIC NO: 7(5A§1� S. 62Q&Z ex OVA fl ❑ CONTACT: PHONE: �+ BUILDING PERMIT INFO ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT PLUMB MECH LICHNS171)CON I'RACI'OR'S DECLARATION ZQZ QTY ELECTRIC PERMIT FGF, I horny mrrm that I am licensed under provisions of chapter 9(commencing JOB DESCRIPTION wlttiS©tion7(XXI)rr Division3of the Business and Pmfeaslorts Cultivated my license is RESIDENTIAL in full force and effect. PERMIT ISSUANCE aUV License Class k ❑ E3Lie. SFDWL KITCHEN REMODEL. � Q,W Dam Contractor APPLIANCES-RCSIDENT(Al. ❑ADDITION [I PLUMBING RE-PIPE, p-Dw ARCHITECTS DECLARATION PANELS ❑MULTI-UNIT ❑STRUCTURAL O Z z000z 1 understand my plans%hull be used as public records MODIFICATION UPT02MAMPS F.ti Lle...cd Pr..sioi.nal F1 INTERIOR ❑CHIMNEY REPAIR ,J 201-10x0AMPS IMPROVEMENT SWIMMING POOLS CaaU OWNER-BUILDER DECLARATION CmdroON OVER 1000 AMPS ❑BATH REMODEL'REPAIR ❑DEMOLITION 6 1 hcrchy affirm that 1 am exempt from the Comunor's License Law far the X 3 d U following of(Section 7031.5,Business and Professions Code,Airy city or.)only SIGNS ELECTRICAL ❑OTHER F^LLO y which requires a permit to consoua,alter,improve,demolish,or repair any swcture prior to its issuance,also requires the applicant lot such permit to file a signed sentence, SP17CIAL CIRCUITOHSC. that he is licensed pursuurn in the previsions of the Communities License Law(Caip(er9 COQ (commencing with Section)fH0).1 Division 3 of the Business and Professions Code)of TEMP.SIFTER OR POLE WST. COMMERCIAL' d i cC that he is exempt therefrom and the basis far the alleged exemption.Any violate.of ❑NEW BLDG/ADDITION E3 DEMOLITION NSection 7031.5 by any applicant for a Permit subjects the applicant to a civil Penalty of POWER DEVICES not mom than Five hundred dollmx($5t0). TENANT ❑FOODSERVICE C] 1.as owner of the porosity,or my employees with wages as their vale compensation, SWIMMING POOL ELECTRI IMPROVEMENT will dothe wmk,arl lac-sial is nm nuendedoroReredfnrsale(Sec 7f_Busincs. ❑OTHER W Roo and Profsaiums Code The Contractor's License Lawdoes not apply to an owner of OUTLETS-SWITCHES-FIXTIJRE$ CFOOOO pmpcny who bi or improves(hereon,and who does such work himself or through his own employers,provided that such improvements are not intended or offered for NEW RESIDENTIAL ELECTR SQ FT. xmn If,however the building mimprovement .x.ld w;thmoneytsarfcompletion,the .Fr. $SQ.FT usenter-locilder will have the burden or proving that he did not build or improve for put- po .f eda.), ❑1,as owner of the property,an,exclusively contracting with licensed contmctnn to ETOTALonswct the project(Sec.]M4,Business and Professions Code:)The Contractors U-c�seLaw does no(apply m an owner of property who hili Ids or improves thereon.and QTY. PLUMBING PERMFEE AUG 2 0 1999 oho contucu for such projects with a convacmr(s)licensed pursuant the Contucmr% License Law. PERMITISSUANCE f (' ❑I am exempt under Sec. ,B&P C for thi%uac.m ALTER-DRAIN&VENT-WAIER(EA) r Dam 1/ VALUATION WORKER'S COMPENSATION DECLARATION BACK FLOW PROTECT.DEVICE L J I hcreh,offne underpunalyoflrerjury onerf the initial doe xmaifms ❑I have and will maintain a Cenificam of Consent to self-insure for IV kers Contpen- DRAINS-FLOOR,ROOF,AREA.GOND. STORIES TYPE CONyIIUCTION sauon,as provided for by Section 37(X1 mf the Labor Code,for the Performance of the ii++�� `N work for which this permit I%issued /V FIXTURES-PER TRAP ❑ I have and will maintain Workers Compensation Insurance.as acquired by Section _ 3700of the lana Code,]or(he peRrnmance tifthe work for which this .it is issued, OAS-EA.SYSTEM-1 INC.4 OUTLETS DEC.GROUP My War Cn {{�� y Inp1ullan�ec mesad Policy numfhCf�SC� Canicr Thr-- C e dict'No.: /?d-�`39Go1 GAS-EA.SYSTEM-OVER 4 ODO CERTIFICATE OF EXE- ION FROM WORKERS' COMPENSATION INSURANCE GREASUINDUSTRL WASTE INTERCEPTOR (This section need not hecompleted if the Permit is parents hundred dollars(SIM) BUILDING DIVISION EVES or IcssJ GREASE TRAP PLANCHECK PEE Loy any Chain the any nmanneof sa,beamehe work for which thisPermitWmiernsC.Ishall SEWER-SANITARY-STORM EA.200 FT. nm employ any peen.)in any mmmner.w a%m became subject to the Workers'Compen- ENERGY ME s� s.ti.a Laws of California,Dam z O Applicant WATER HEATER WNE:gT/EI.ECIR z h NOTICE IT)APPLICANT:If,a0er making this Cenifaute of Exemption,you should GRADING PEE become subject to the Workers Com WATER SYSTEM/fREA'TING j ns or this pmvixions of the Labor Code,you must SOILS PEE � Ibnhwi(M1 unnply wl0t such pmvisiam'orchis permit shall 4Jeemcd revoked. WATER SERVICE. a � CONSTRUCTION LENDING AGENCY Z) Z Ihercby allimnMt there ixanmstmminn lendingu far the rfmnance of NEW'RFSIUEM'IAL PLMB. SQ.FT PAID (� 6n'ncY Pe Date Receipt M � F the work for which thlx permit Is issued(Sec.3r9>.Civ.CJ Lenders Nome O Lender's Address TOTAL: TOTAL: pt 1 unify'tell 1 Imvc rend this application and sats(het the above information is BUILDING FEE to urea.I agree a comply with all city and county ordinances and state laws relining to QTY.=MECH. CHANICAL PERMIT FEE U z buildiugconauainn,and hcrchy aithoriee mpruenativas ofthischy m emeaupon theSEISMIC FEE above mentioned property For inspection putlmscs. NCE (Wc)agree m wee,iodomntly and keep harmless the City of California,againstELECTRIC ME liabilities,judgments,costs and expenses which may in any way.ecme against mid City D'TOMECH. to consequence of the gaming of this nim. PLUMBING FEE APPLICANT UNDERSTAN WILL COMPLY WITH ALL NON-POINT G UNIT(TO 1(1,1X0 CFM)Sf CE REGU 10 MECHANICAL FEE G UNIT(OVER IO,UW CFM) CONSTRUCTION TAX Signa tf 1 ApphcanoCon(vcutr Dam D(W/DUCT)HAZARDOUS MATERIALS DISCLOSUREHOUSING MITIGATION FEE Will the applicant or future building ovarian,save or handle haomous material HEATING UNIT(TO 100,000 BTU) a%defined by the Cupcnino Municipal Coda,Chillier 9.12,and the Health and Safety Cede.Section 25532nd? HEATING UNIT(OVER 100,N)o BTU) ❑Yes 0 N VENTILATION FAN(SINGLE RESID) PAID Will(Iva applicant or future building occupant use equipment or devices which Date Receipt N mit hazardous air contamilea%as defined by the Bay Area Air Quality Mam(gement BOILER-COMP(3HPOR 10(,0(0 BIU) , Disvial 'TOTAL: ❑Yes 0 N BOILER-COME(OVER I up is,BTU) 1 have read the humr inti."aterialsAIR CONDI'T'IONER rrywn nems undo Chapmr 6.95 ser the Call- ISSUANCE DATE folia Ileelth&Safety Code,Sialic 25505,'_5na, and 5534.I undersand thin if the NEW RESIDENTIAL MECH. SQ.FT. building dos me currently hu must h¢matt,that n is my re of Ginty to notify the met pam of the myuimments whish must be mm prior m issuance of u Certificate of(kcupancy. Owner or amhariecd agent Dau TOTAL: ISSUED BY: OFFICE