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13060152I CITY OF CUPERTINO BUILDING PERMIT I I BUILDING ADDRESS: 7385 RAINBOW DR I CONTRACTOR: SANFORD ELECT I PERMIT NO: 13060152 1 OWNER'S NAME: CHU PEK S TRUSTEE & ET AL 120888 PROSPECT RD I DATE ISSUED: 06/19/2013 1 OWNER'S PHONE: 4088132377 1 SARATOGA, CA 95070 1 PHONE NO: (408)996 -9797 ❑ LICENSED CONTRACTOR'S DECLARATION License Class C-4 Lic.# !0 4 ? 3 tJ Contractor Tgt N V, U (0 H G Date G I hereby affirm that I am licensed under, the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate 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 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION 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 upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. LJLf s ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate 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 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date JOB DESCRIPTION: RESIDENTIAL u COMMERCIAL A,r-* 3 REMOVAL AND REPLACEMENT OF KITCHEN FAUCET, REPLACE PANEL IN TUB AREA, SHOWER FAUCET, ADD EXHAUST FAN IN BATHROOM Sq. Ft Floor Area: I Valuation: $9000 APN Number: 36231011.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: allfl� Date: tP / % r 3 RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent:_ IL, C K Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 ,, (�� a 4 CUPSf2TCN0 ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # (408) 777 -3228 •FAX (408) 777 -3333 • buiiding(a)cupertino.or PROJECT ADDRESS 3,'S APN # / o- OWNER NAME 4W (f 9 PHONE r 7 E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME PHONE E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -B EP ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRAR -.TORN E�� LICENS7 ER � LICENSE E BUS. LIC # ,9 D COMPANY NAME 9 N FL Fez: � � E-MAIL FAX STREET ADDRES � ^ D CITY, STATE, ZIP - 4 R/a 7C' A PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME EMAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK - O n _L F 1 EXISTING USE PROP ED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KTTCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTALDECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH #DWELLING UNITS: is ASECOND UNrr []YES SECONDSTORY ❑YES BEING ADDED? [-]NO ADDITION? ❑NO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES REW 3B iA „" k `�' "-' .4 TOTA VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorize age to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and erify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b Ming construe ' n. I authorize representatives of Cupertino to enter the above - identified property for inspection purposes. , C Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED Q YPE,. �' O „ilTinC LIPS ._� u a e N _ New SFD or Multifamily dwellings: Apply for demolition permit for Y g PP y Pe �ovER- Tr�corrh (]p ;BU>vDmi� Pi��� -� existing Demolition permit is required prior to issuance of building g P 9 P g ;�"� permit for new building. _ s _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. ❑PUSt7 wo��ts r _ Co of Planning Approval Letter or Meeting with Planning for to g g pi oxx� IsTxI submittal of Building Permit application. asiu?IT�sz: BldgApp_201 1. doc revised 06121111 FM_7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION Mech. Plan Check 10.0 1 hrs $0.00 Plumb. Plan Check 10.0 1 hrs $0.00 Elec. Plan Check Mech. Permit Fee: 1MPERMIT Plumb. Permit Fee: IPPERMIT Flee. Permit Fee: Other Mech. Insp. 0.0 hrs $45.00 Other Plumb Insp. 0.0 hrs L$45.00 Offier Elec. Insp. Li 11kch. Imp. Fee: Plurrnb. hisp. Fee. flee. Insp. Fee: ivu1G: ints esamare aoes not rnctuae fees aue ro orner ueparrmenrs (Ne. riunning, ruauc rrarns, rrre, ourutury oGrvrr ysorraa , _­- 7385 rainbow dr DATE: 06/19/2013 REVIEWED BY: Mendez JimADDRESS: APN: BP #: I *VALUATION: 1$9,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: I Alteration / Repair PRIMARY USE: SFD or Duplex Plumbing PENTAMATION PERMIT TYPE: 1 RPFI A WORK To Clear Code Enforcement Case: SCOPE $20.00 Mech. Plan Check 10.0 1 hrs $0.00 Plumb. Plan Check 10.0 1 hrs $0.00 Elec. Plan Check Mech. Permit Fee: 1MPERMIT Plumb. Permit Fee: IPPERMIT Flee. Permit Fee: Other Mech. Insp. 0.0 hrs $45.00 Other Plumb Insp. 0.0 hrs L$45.00 Offier Elec. Insp. Li 11kch. Imp. Fee: Plurrnb. hisp. Fee. flee. Insp. Fee: ivu1G: ints esamare aoes not rnctuae fees aue ro orner ueparrmenrs (Ne. riunning, ruauc rrarns, rrre, ourutury oGrvrr ysorraa , _­- District, etc). These ees are based on the prelimina information available and are only an estimate- Contact the Dept-for addn7 info, FEE ITEMS (Fee Resolution 11 -053 E . 711112) FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 F-2-1 # Plumbing Suppl. PC Fee: C) Reg. 0 OT 0,0 hrs $0.00 $20.00 IBPFIXTURE Fixture or Trap PME Plan Check: $0.00 1 # Mechanical Permit Fee: $0 00 $23 00 1 IBREMvENF Ventilation Fan Suppl. Insp. Fee :Q Reg. 'Q OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $90.00 Cansir action :Tcxa Administrative Fee: IADMIN $42.00 Work Without Permit? (E) Yes 0 No $133.00 0 Advanced Planning Fee: $0.00 Select a Non - Residential 0 Travel Documentation Fee: ITRAVDOC $45.00 1 Building or Structure i Strong Motion. Fee: IBSEISMICR $0.90 Select an Administrative Item 131.dg Stds Commission Fee: 7BCBSC $1.00 $311.90 $43.00 $354.90 Revised: 04/29/2013 Building Department City Of Cupertino 10300 Torre Avenue 'Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 C O P E RT I N O Fax: 408- 777 -3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: s fj PERMIT# BUSINESS NAME OWNER'S NAME: PHONE # GENERAL CONTRACTOR: ,�N �< 1 oA3 BUSINESS LICENSE ADDRESS: CITY /ZIPCODE: *Our municipal code requires all businesses working in the city to have a City, of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE ,SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE 'OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: 6 f 2-4 Sig re Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing _S Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date KS a u , R f- AP 7 0 Zf C7, (71"" q- rQ O Av 7. 1 cf) < 7VA * I , I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7385 RAINBOW DR CONTRACTOR: SANFORD ELECT PERMIT NO: 13060152 OWNER'S NAME: CHU PEK S TRUSTEE & ET AL 20888 PROSPECT RD DATE ISSUED: 06/19/2013 OWNER'S PHONE: 4088132377 I SARATOGA, CA 95070 1 PHONE NO: (408)996 -9797 I ❑ LICENSED CONTRACT/ORS DECLAR2ATION License Class C —t P Lic. # 6 3 3'odz I -2013 Contractor � Ct N lL L t D NrC� Date` I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate 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 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION 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 upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature �Q r�«�/ Date ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate 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 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner sous to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTHFICATION 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 upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date JOB DESCRIP'T'ION: RESIDENTIAL REMOVAL AND REPLACEMENT OF KITCHEN FAUCET, REPLACE PANEL IN TUB AREA, SHOWER FAUCET, ADD EXHAUST FAN IN BATHROOM REVISION # 1- REPLACE 5 (E) WINDOWS & 1 (E) SLIDING GLASS DOOR - ISSUED 7/9/2013 "EVISION Sq. Ft Floor Area: APN Number: 36231011.00 PERMIT EXPIRES IF WITHIN 180 D X*-O 180D. by: Valuation: $9000 Occupancy Type: 3 NOT STARTED T ISSUANCE OR ;D INSP�E/CTaION. Date: RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 2553,3,, and 25534. p Owner or authorized agent: P a (.0 e B 1R Date: V —t- CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO TTT 10 0rV11A/( A'Tl1D RTTTT ."TT%TP TITVTCT(1N NOTE: This estimate does not inetuae,Iees aue to o[ner veparaiaeiao � ...,.•..,s, _ ..� - -� - _ _. _, _________, District, etc). These fees are based on the relimina in ormadon available and are onl an estimate Contact the Dept)* addn'l info, FEE ITEMS (Fee Resolution 11 -053 E . 711112) FEE • ADDRESS: 7385 rainbow dr DATE: 07/09/2013 REVIEWED BY: melissa 09 I BP #: *VALUATION: Iso APN: Elec.. Plan Check hrs *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY PENTAMATION SFD or Duplex Permit Fee: Hourly Only? ® Yes Q No PERMIT TYPE: USE: Permit fee: C)ther ,Tlec�h. Insp. WORK revision # 1 - add 5 replacement windows & 1 sliding lass door to permit # 13060152 SCOPE $0.00 NOTE: This estimate does not inetuae,Iees aue to o[ner veparaiaeiao � ...,.•..,s, _ ..� - -� - _ _. _, _________, District, etc). These fees are based on the relimina in ormadon available and are onl an estimate Contact the Dept)* addn'l info, FEE ITEMS (Fee Resolution 11 -053 E . 711112) FEE • MISC ITEMS Llec:h. Plan Check. $0.00 Plumb. Plan Check Select a Misc Bldg /Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT Elec.. Plan Check hrs $0.00 PME Plan Check: 4lech. Permit Fee: Plumb. Permil fee: Permit Fee: Hourly Only? ® Yes Q No $0.00 Elec. Permit fee: C)ther ,Tlec�h. Insp. $0.00 Other Plumb Insp. $0.00 PME Permit Fee: $0.00 Other F.lec. Insp. Lj _T_T Conso- fiction Tax: ,1cc Ins /. lee: Plumb. Its l hee: ilininistrative Tree: Elec. Ins} . lee: Work Without Permit? ® Yes (E) No $0.00 Advanced Planning Fee: $0.00 NOTE: This estimate does not inetuae,Iees aue to o[ner veparaiaeiao � ...,.•..,s, _ ..� - -� - _ _. _, _________, District, etc). These fees are based on the relimina in ormadon available and are onl an estimate Contact the Dept)* addn'l info, FEE ITEMS (Fee Resolution 11 -053 E . 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg /Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? ® Yes Q No $0.00 Suppl. Insp. Fee-(E) Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 _T_T Conso- fiction Tax: ilininistrative Tree: Work Without Permit? ® Yes (E) No $0.00 Advanced Planning Fee: $0.00 L Select a Non - Residential Building or Structure I . Travel Docutnentution Fees: Strong .Motion Fee: $0.00 F2.0 h. Inspections $278.00 ISTINSP Inspection, Hourly Bldg Stds Commission Fee: $0.00 $0.00 $278.00 q p a $278.00 Revised: 07/01/2013 �Sa.arss • CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(a1cupertino.org ❑ NEW CONSTRUCTION El ADDITION ❑. ALTERATION / TI f5 REVISION / DEFERRED ORIGINAL PERMIT # r. 3 a 6 6(,> 5­ PROJECT ADDRESS APN # OWNER NAME PHONE E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTZAiL70RNAME �O LICENSE NUMBER . D � LICENSE TYPE BUS. LIC # I V R D L 'V —10 is COMPANY NAME A t �D j ^ EZer E -MAIL FAX `r n 77? STREET ADDRESS _ n'V OPL L-7 R CTIY, STATE, ZIPS A RA ! C o 0 [ PHONE42 ^ 64- 6 ARCHrrECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME EMAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK n ICY, o f EXISTING USE PROPOSED USE - CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA LIDErACH ❑ ATTACH I 9 DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? ❑NO PRE - APPLICATION ❑ YES IF YEs, PROVIDE COPY OF - IS THE BLDG AN ❑ YES TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO - Do �-. By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above- 'dentified property for inspection purposes. Signature of Applicant/Agent: Date: r 20 SUPPLEMENTAL INFORMATION UIRED Q w _ New SFD or Multifamily dwellings: Apply for demolition permit for��� "�� � existing building(s). Demolition permit is required prior to issuance of building OVER THECOUIVTER+ � BUJS,DII�GTLAN'REVTEW�� permit for new building. xr.RESS a �PLAnI.tG L :xlEVw _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sD - L3uslswp •' :' form if any Hazardous Materials are being used as part of this project. T . © G � - _ Co of Planning A royal Letter or Meeting with Planning PY a Approval g g prior to submittal of Building Permit application. ' SA�I'I'ARY�Ew „`R�is xl ��- �=,E = . f �� �OP.ENVIROA'MENT' FF,A.i:TfL Bld.- App_2011.doc revised 06121111 7 s FAIN) BD LO :r�:. 1p it�G 5 SRS l `- lo0R., f/I 5-069 Ms AT►o &LI DINC, DOOR COMMUNI DEVELOP,, NT DEPARTMENT BUILD G DIVISION - UPERTiNO APPIRO ED This set of plans and specifications MUST be ke,ct at the job site during construction. It is unlawful to r-,.1, ,,,;; changes or alterations ors Starne, or fe therefrom, without approva! from the Builds a The s+ , aping of this plan and specifications Si-H4%1_L be held to per an P. Asa1 o lions of !inance or BY DATE �T PERMIT NO. -�• b O Z p�3° �! <n1/;? w•Y C kRAC -, V1 a LU'1' PLAN, CHECKED BY PLANNING DEPT. DATE BLDG. DEPT 7- 91 SE'Cat4t> �ooR *A,;V®S® I 73 ss P,41N3o W DA ,A- /D 7- TRiRL� FLoof,