12070224 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10900 N 131-ANEW AVG CONI•RACI'OR:CONSOLIDATED PERMITNO: 12070224
PLUMBING INC
OWNEWS NADIE: PACIFICGAS,AND ELECTRIC CO 3732,CIIAI TEIR PARK DI25'I'IS U DATE ISSUED:07/302012
OWNER'S PHONE: SAN'.IOSE.CA 95136 PIIONENO:(408)978-3093
❑ LICENSED CON I'RACFOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Clnss 6 Lie.H -5-0 0 ;7— r r ri
i\IECII RESIDENTIALCOMMERCIAL
Contractor Date
Ihereby armlhat ieensed ander l he provisions of Cha pier 9 JOB DESCRIPTION: INSTALLATION OF A SANITARY SEWER CLEAN AT
(commencing with Section 7000)of Division 3 of the Business& Profe-,slon5 I'GRL
Code and That tar license is in full force and effect. �.
5
1 hereby:nlTirm ander pertain'of perjury one of the following two Jeclantions:
I have and will maintain a ceni ficate of consent to self-insure for Worker's
Compensation.as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
I hate and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: . Valuation:514500
Section 3700 of the labor Code,for the performance of Ila work far which this
permit is issued. yyy
ANN.Number:31603 U Occupanev'1}pe:
API'LIC.\\I'CISK'I'I II CATION
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes, (We)agrce to save
indemnify and keep harmless the City of Cupeninoagainst liabilities,judgments. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs.and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section �j� �1)/{��
9.18. Issued by: -�N f Ar7 , Y7 Date: 7 30 •J,�L_
Signal Date_JJZ
b J
❑ O\VNER-111I1L11192 DECLARA'T'ION RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed.If a roof is
1 herehy affirm that I am exempt front the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons: inspection.
I,as owner oflhc property,or my employees with wages as their sole compensation_,
will do the work,and the structure is not intended or offered Ibr sale(Sec.7044, Signature of Applicant: Date:
Business K Prolessions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to i
construct the project(Sec.7044,Business R Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BE'1-ITR
hereby affirm under penally of perjury one of the following three
declarations: 1 IL\%.U2DOIIS\I,\'I'F121.\LS DISCLOSURE'
I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,I'or the California I lealth&Safety Code,Sections 25505,25533,and 25533. 1 will maintain
performance of the work for which this permit is issued. Coal pliance with the Cupertino Municipal Code,Chapter 9.12 and the Ilealdi S
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Cute,Section 2553200 should 1 store or handle hazardous material.
Section 3700 ol'the Labor Code,for the performance of the work for which this Addilio oily should I use equipment or devices which emit hazardous air
contaminants as defined by tine Bay Area Air Quality Management District 1 will
permit is issued m mn'tain conn plin nee with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of One work Prue which this permit is issued.I shall I lealih S Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become Subject 10 the Worker's '
Compensation Imus of California. If,aller making this certificate ofexennption,I Owner au riz-
become subject to the Worker's Compensation provisions of the Labor Code,I must EL� Date �7�e
forthwith comply with such provisions or this permit shall be deemed revoked. �`"
COCS-:'RUC`T'ION LENDING AGENCY
\1'1'1-IC.\N'f Clilt'I'IPIC,\"I'll l\ I hereby alfrin that there is a construction lending agency for the performance of wink's
I certify that I have read this application and state that the above inl'omnation is for which this permit is issued(Sec.3097,Civ C.)
correct. I agrce to comply with all city and county ordinances and state laws relating Lender's Name
to building constriction,andhereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnifyand keep harmless the City ol'Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the ARCI I I'I'FCI"S DECLARATION
of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section i understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
CIPERTIN® SANI_1Awx DISTRICT
gECEIV EIS
JUL 3 0 2012
w
wCLEANOUT SHALL BE CONSTRUCTED AT THE
�� PROPERTY LINE OR AS APPROVED BY THE
10-1
I DISTRICT INSPECTOR
o PVC OR ABS PLUG OR CAP SHALL BE TREATED
a I WITH ANTI-SEIZE COMPOUND
PUBLIC RIGHT OF WAY rt CHRISTY G-5 OR EQUAL (PAVED AREAS) OR
CHRISTY F-8 (LANDSCAPED AREAS)
FINISH GRADE
I ;}
WYE FOR RISER ' I ;•
PVC OR ABS SCH. 40
SHORT LENGTH I ;j
RUBBER REPAIR COUPLING KITH /8" BEND
STAINLESS STEEL BAND
� 6" JdIN
6" MIN 2% MIN PIPE SLOPE
3/4" CRUSHED ROCK 95% COMPACTION
6" MINI 6" MIN
CuSD LATERAL SEWER PRIVATE LATERAL SEWER
NOTES:
COMMUNITY DEVELOPMENT DEPARTMENT
1. PROPERTY LINE CLEANOUT TO MATCH LATERAL (49LMI19)JGDIVISION-CUPERTINO
2. PROVIDE 6-INCH CLEARANCE BETWEEN VALVE CAP ANDfiVSIDEGFaM
This set of plans and specifications MUST be kept at the
fob site during construction. It is unlawful to make any
changes or alterations on same,or to deviate
therefrom,without approval from the Building Official.
Pq The stamping of this plan and specifications
of the AL NOT
{�
(1;% 0F
be held to permit or to be an approval
(Erb of any provisions of any City Ordinance or State Law.
BY 3o La
DATE
PERMIT NO.
glpE 248 PROPERTY LINE CLEANOUT DETAIL J
DR. BY: DATE: FF
. BY: DATE:
NDB 08/05/2071 T 08/05/2011 APPROVED. BY: DATE:
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GENERAL PERMIT APPLICATION M E r
EQ COMNIUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 p w I
SC
CUPERTINO (`08)T-3228 • FAX(408)777-3333 • Suildirc0cuoendno.Orc �ev/�
It PLUMBING [IM--04ANICAL ❑ELECi3!C?L ❑NQSCFTTLe N[EE0US
PROJECT ADDRESS /t Q I APNR
OWNER NA:ff 6yrj 12Y.ONE�r� G 51 I E
iRMAD.
S EET ADDRESS Y O / I.C'Y. 57Air, O ^^ � FAX
A'T � l
CONTACT NAME I PHO I E-MAR
STREET ADDRE n CITY,STATE, IIP FAX
❑OwNR ❑ OWNEI-B ERR��❑ OWNER AGENT ❑ CON CTOR ❑CONTRACrORAGENT ❑ ARODTECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAI�(Ew / L'C R LICENSE TYPE I BUS.L'Ctl )
-4tV s 'L
JU /CIA C- �
COWANY NAME =-MAR^ FAX
37=1 ADDRESS 3 7 3 2-- -L I .STATE ZD'� �S/I' I 'HONE2.1-- zZ/
ARCHI i ECT/NGLNEER NAME u� LICENSE NUMBER /�, I BUS.LC#
COMPANY NAME' E-MAB. FAX
STREET ADDRESS I CITY.STA-E,ZIP I PHONE
USE OF ❑SM w DUPL!D( ❑ MULTI-FAMRY PROJECT N WI LAND ❑ YFS PROJECT IN ❑YES IS TtG BLDG wN ❑ YES
BUIIDwc: COMMERCW. I URBAN BNTELACE ARBA NO FLOODZONE 940 I EICL'."1HOMF NO
DESC.Q=ON OF WORK
e-4110 J
tom-
TOTAL VALUATION: / JO I RECEIVED BY:
By my signanue below, ceri:y m each o[the following: I am the pmpc.y owner cr authoriud agent to act=the pmpery owner's behalf, I have read this
application and the infpmui. I have p _ onect [ha Descption of Work and verify it is accurate I ag-ee to comply with all applicable local
ordinmxes and save laws relating tp' ding c y c .a m .,tadves of CupcTTne:c enter dtc above-identifiedprcFe.—'1:or inspection pu:tO=.
Signemte of ApplicandAgeae Dam: 0
S VLCV VLAT ON REQU= OFFICE USE ONLY
v OVER-THE-COUNTER
❑ EMPRESS
U
a ❑ STANDARD
U
Z ❑ LARGE
J
❑ \WOR
AgPhfac4pp_2011.dpc revised 0612JI11