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S 3353 (2)
APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OF CUPERTINO BUILDING-FI,KCI'RICAL ITt IT NO. BUILDING DIVISION APPLICATIONAIERMITPLUMBING-MICIIANICAL 3353 BUILD ING.i`koxur[DON I'I kICATION BUILDING ADDRCSS: SANITARY NO. AVVIACATONSORMl'I'I'AL DAT OWNEk'S NA. E: PHONE: COST RACIO 'S NAMIi: LIC No) D I q� SG�111C �L`L ^ N/Cp///, CONTROL/a1 qw, C.HITIiCI'/li GINEER: LIC NO: C. M ZC.L DR ❑ / / / CA to/C N"IAC'F. I'IION'L" y BUILDING PERMETINFU Z, CO SUII2OfF2CSP ldnyAllllcd III 1(1311 [it DO 111.13 PLUMB LTJ/- ul�/dL'CII' "TpcM� � , .1 3&g. gL��{ LICENSED CONTRACTOR'S DECLARATION QTY. ELECTRIC PERMIT PEE O a'Z 1 bcrchy minim mat I min fiaemen abler mommaas lir Chapter 9 0amourencing JOB DESCRIPTION with SsaiuI70mbri Division 3slob e Naslnasnnd l'mfessbinm Cale,anA.,ry license is RESIDENTIAL: won 1'1:1tM11'ISSUANCii F-�� mlull force ands I. ❑SI'DWI, ❑KITCHEN RI?MODEL C U F- license Clxvs hie.p 6 U AI'1'LIANCES-RUSH)IIJ'I'IAL ❑ADDITION El PLUMBING kI:-PINh F Z W Dote Cummnr ro<a - � 'ARCUirEi:CCS DECARAI'ION~W�J�`LA�I3ec__'' ❑MUCfI-UNIT ❑STRUCfURAi, F-m 7 I understand my plans shall be amid as public rcnrtJs r�oo IANEIS MODIFICATION OZ�O 11PT0210 Ah1R5 ❑IMfIiRIOR ❑CHIMNIiY k13VA1R Licensed l•ndcsmiannl 21114 IXXlAMPS 0 IMI'ROVIiMI?NT E)SWIMMING POOLS a OWNFR-II1111,DFR DECLARAD ' ON UVI3R 1(XXIAMPS ❑IIAI'I I RI3MOIl1dUkEPAIR ❑DEMOLLFRIN E C 36C Q I hereby affirm that I acue frothe CoinracmrOI HhR s License Law far the X7 following Mammun, m ni Mastic. 7031.5.Business and Profcons Cale:Any city nr county SIGNS ELFICTRICAL ❑ W 1+,vFi which requires a permit to construct,alter,im,n ver demolish or repair any sructme �,., p� prion 'I. 4 IX 37371 tf bps It TI 6 J.nt mcnlJ SPhCIAL CIRCUIT/MISC. uI gyp- man 1 i t. m p nn C n .L 1 ILn pmu COMMFRCIAI, N 0 cOm n mS v lh Section]1x1111 111 11 f tour Ito R ML713R I lk PULE INS'I'. a a than,he is oacmpt thcrcfrom and Ihe Noi, or the,dlegsl exe npl on.Any v r Lnom of ❑III W BLDG/ADUI'UON ❑IlRM01,1'IION x= Section A015 hyany applicant Error permitsubjeas the opEbbi' o a civil penally of POWER DEVICIiS O Ia'fI:NANT ❑FOOD SI:RV10E Sy m marc than five hundred dollars($500),SG Las owner Of the try,or employees with i aslf.ole compensation. SWIMMING MHIL ELFCIRIC IMI'ROVIiM13NT ❑ prop% Y P Y p I o ❑Q11111µ ~m ill dotht,work,and themot is tool intended or, r.sole(set.90.W,Rusines 7e 63 bdP f Come the C I n Lic not pplyt ,wnerO OPI'Lf7S SWITC1nS FIXTURFS 1a,prty hailds or ,,all Imakn ll I,, I m N:W hSIDEN'I'ALPIµ I III, mitintended thence fT ,.It.If,l J.g pct an y a pl l' n the SQ.17.FLOOR n12HA SISQ.FT. e hu ld _ hbrde fp JJ Id p f par po se ( ) p ❑has—act of lice 70,1vincs .�'Jmorn to Lm ,Hamm be prof"1.+ce.vua4,'i:^I. n e IeJ a 'onn:rtu,:a Li- esxw rme Uwdaes, cly munonl'; r who t prove.thereon.and QTY. PLUMBING PERMIT' FF.E who mntmctm' PmjucL r(n11'I p nnlnc Crs License Luw. I'EHM1IIT ISSI NCI: E31 I thi,dais.,all 1 kl Con e AI:IER-URA k .M \VATER(HA) VALUATION Own W l6 I N 1 DI CI, ION IIA CK FLOW I DEVICl3 1 Ih by ll .�rJ J ll �nsu 16J Ik iGmmpen 7J' DRAINS-FLOOR. RLA,Co ] Inuvu,dwll n armin u Ce ., s,IC n S'1'OItII3S 'I'YIIII 5'IR UC 110 .s:nion,as provldcd far by Sco.o„i)t' a the labor OSI,. 0 the perfonnamc of the work for wbicb this permit is issued. FIX'I ORES-f11µ'1 RAI' ❑1 have and will maimnin Workers COmpemation Insurance,ns required by Section GAS-En.SYS'T'EM I INCA UI FES 3700 ofthe Lahr Code,for the perfmmonceofthe work far which 0a peark is issued. TMC GROUT' %/ Zt�N ogtl My III 's Can Ov`a�tis Insulin,`ccatrrr."and Look i , �/� ,^_ b S Came � np�� ILOSVnlicy Nn, � T/— (IAS-P,A.SYSTEM"OVER4Us I IYJ7 \ Cl2l4l'I17]CA'fE0I7EXliMPPIONI�ROMWOIZKERS' GRHAS[%INDUS'1'kh WASTE IN'll?RCI31'l()k COM1`pNSAIIONINSUItANCti BU )INGDIVISIONPIiIiS (T'bomationn,rsl not hemmplemcl iflhepem,it int Rvanchuodreddollafs(SI00) GRCASETRAP or ksc) 1'hANCIIIiC I,%city lhal in the perfnnnanceaflbe work for which this permit is issued.l shall SF'WER-SANITA RY-STORM His.2(X117. QZ ,femploy any psson in any manner so as to became wbject to the Workers'Compen- GRAI GY /) n I'lo f(:antmrl iu.DNe WAICR H13NIHR W/V13NT/ELLCI'R '3 3 �o GIIAUI ( it 3 o Applinmt z (n N(IrICE'10 AI'I'LIGNI':II king XMeCE cats of Exe pliom You mbauld WATEk SYSTFM/I'RIiAI'ING SUITS I' PPI (•' ? ketone subject w er's 411 �m tion poll alI,of mhryr f Cala,you mus d's forthwith comply Ishprvis m I spermit Ill he d�F� revoked. WATER SERVICE Z r I ST'HUCTION LENDING AGI7NC 1 I NI2W RFSIDIiN11AL PLMB. SQ.FT 1`AID UO Incrchymrrir Ilhere kSnp.a� tit fim gLgrte ;r penarmanecar Lae Rcceipta mcoso ""In'lm0 miltays:fd Tse.3rXlz iT`L"J J / rnrnla Ulender's Nlnne �Tp�p ( O } Lenders AddressLLJ Ve IfUll.ill 'EE G Lenity that 1 a read this application and sate thm Ihc ala, inlona tion is F to cornea,l agrees can IYYy��wvv all city and count rdl rlemt uwsrclatinga QTY. MECHANICAL PERMIT PEE SFISM E ' U Z buildings nar,tion, n}d##eh m r rs city mo enter the l uhols-onemioncd pro .....lion pu.� 1.17RMIT ISSIJANCF 13LIi .[[:I, w lam© (We)agree la snot,indvunlly unit much aan ie,,Ibe City it Cticial n ngnlnst Imbilhics.judgmcuta casts and ex Pcnsus which may inany way scenic-,III"'said City r ALTER OR ADD'IU MHCH. r PLO ING FEE n consequence of the graining of this permit. ICAN'I'UYDERSTANDS AND WILL COMPLY WITH ALL NIINd'OINT AIR HANDLING UNIT(TO IO,000 CFM) MEC NICAL FcE OUI CIi RI' )1 Yr10;SS. — �qQ AIR HANDLING IINI'1'(OVER IU,(XXI CPM) CONS'rNUGT10N TAX igmalme ulAT1.1anVCn umor Dolt, HXI RUST 11001) W/DUCI) IIOUMNG MITIGA'I'IUN ITH HA, DOGS MAI FRIALS DISCLOSURE Will[Ile applicant iaure building occupant more or handle hoeunlous maraca IIHATING ON I'I'(10100.000 R'I1/) as defined by the Cupeninn Municipal Code.Chapter 9.12,and the health and Safiay CWe,Scotian 25532my? (� 1]HATING UNIT(OVER 1µ0,11µ013'1'U) n ❑Yes 9-191, VFNTILATION FAN(SING RI?SIU) IAID pas Rttcipla WIIIIhc uppllcanl nr l sun,hoildingoccupant not,cqulpmcm lir devices which HURLER-COME'(31 IT OR 00,000 It'I U) .it huaanlous on,comm amara"ns defined try Ile Huy Are.Air Quulily Management it a DivficC BOILBR-COMP(OVIibi 100,000µ'1'U) ❑Ycs is I have read the hmaNum,nmterials co uirenmemv under Chapter n').Sol the Cali- AIR CONDITIONER ISSUANCE DATE loris Health k Salify CnJc.Scolloo 25505.25511 and 25534.1 under mind thin If'he N13W RFSIDHN'I']At,MI3CH. S 17. It dae h really aa tsw ve nl,IIl:c-1 is Illy rexpnasibiliq la nm «aipm ifydmea ( V Ilemmir who,h roam he Incl prion.l"tral"of a Ccer or " ate of Uccu am tri JOR Date T AL: O ISSupi)IIY: OFFICE