02060091-FP(C - tTY OF CUPERTINO 0
CUPEkTINO PERMIT APPLICATION FORM,
4DaD 000q
APN # � r _ � Q � D Z �
Date:
Building Address: Lf� * D
Owner's Name:
� ^� )v�
Phone #:
Leo S • � � � ' 4-( 4.Z
Contractor:
License #:
Contact:
�LzO N � D
Phone #:
4-1 �i - �2 • �O�
Applicant/Contrac �ON
Fax #:
uildi Pernllt Info: )
Idg Elect (Plumb Mech
Jo escription:
Residential: Commercial: i L-t�;
Sq.Ft. Floor Area:
5t mva
$lSq.Ft.: (� /
Architect/Eagineer:
ch+t tq661� vt
Valuation:
D r
Type of Construction:
NR
Occupancy Group:
111
BELEC 1000
Quantity
Fee ID
Fee Description Fee Group
BAPPLOTI-MR
Other Appliances I MECHANICAL
BCONSTAX
Construction Tax BUILDING
BCONSTAX
Ind/Off/Comm/Quasi BUrLDIN G
BCONSTAXBQ
Con. Tax for BQ Zone BUILDING
BCONSTAXH
Hotel and Motel BUILDING
BCONSTAXR
Constax—Resi/Mobile BUILDING
BELEC 1000
Elcc 600V <=1000A ELECTRICAL
BELEC1001
Elec 600V > 1000A ELECTRICAL
BELEC200
Elec Svcs 600V <= 200A ELECTRICAL
BENERGX
]Ener g BUILDING
BENERGY.ADD
Energy Add Multi BUILDING
BINVESTIGA
Investigation fee BUILDING
BMITIGATC
Comm. Housing Mit. Fee BUILDING
BMITIGATR
Res. Housing Mit Fee BUILDING
BMNEWMULTI
New Multi -Family Res MECH_AMCAL
BNEWMULTI
New Multi -family Res ELECTRICAL
BNUCOMME
New Comm Electric ELECTRTCAL
BNUCOMMM
New Comm Mechanical MECHANICAL
BNUCOMMP
New Comm Plwnb PLUMBING
I of 3
7 0 -L--
$�/ 0 70
mss;
Qt,t t[[
q 7tJ, i
s -5E
Z C•r�t
OZ -t
Y � ,
�Q •Li
z� J;
CITY OF CUPERTINO
("ONTPACCTOR L\TORAMT1 ON:
OUTLUING DIVISION PERMIT
K41 .7T O�i S•l�t��I
16TAU A`'d
PF:R,�U7 NO.
02060091
�Mfff__: COMPUTERS INC
APruc�Tl�Y�sYz��T�0.02
SANIT-ARY 1;0. CONTROL NO.
BUILULNO PER\(IT R.TO
AROM-15 'Lv:.\ MNEI.3U
'
Bi.W ELCCr F 7J\IH htEC41
-
LICGYSr0 G)NrRACfOR'S Or0.AKXl10.X
I heresy olllrnl Liu I nm lip-pse7 ur.J'r. of C1ir _,T9 (CYnIL'It`Iw7ng
_,j p
'-j'EN.A_V'oIh '�
ptvvisians
null Seettnn 7C►,rtll orlllvis:-un 3 of the Hrinofs and I'mF-aims Cod-, and city license
COMMERCIAL
3�� Mi�NT
is ig t'u0 ('arse tied EFa , / ,_ 5 •7 Q
Lia Y 7 ]
-
— Ccc:ruur !
ARCIU3F.CT'S DEI LkltxnrN, ' -
I umfenurrd my Dlatts shall he used as Ids0on r, ei'nls
laer:serd Ptlytrss3unal
OWNER-TIMWER OECLARATIOS
I haehy niTum That I am exempt ffnT 6, Curw=tcex Licew law• for 6s1:
fnrtiru-htg rtnson. (Sxron 701313. Businew and Yrolessieoe Ccd- Any cin• ar munri
$156100
why:h RJllirrS a Dldrllil 0) C-fllltucl. alter. irnprnv:, deox'115,h, ca rep=' my tarmcum
p whim rare, -fin leflll_'ei1Ll: L4,plicanl for fl0 VuTr3i t0, 61c t Si&,rtLdstalemenr
IYIt Fe is lid-3;.it hi la Ltn.'(Cls
trar•eyt the htivfylvaul'theCunnacmr'xlxenv, .•r9
f.alrpec igjnff)
•3160_V012V
�in?eValuation
, ,
ci dial :r. ty3 rhe-lf(*; rm Of. h111:peJ ekelr„pdra. Any viMatiuu
,
,
- M Scokm 1045•hy nny-upplicanl for o.permi; !orjs `tr he appliant ton civil pewl y
atf not triort: thu, five hursCmJ tluHart (SAM).
101 AFN9%"- AT ION
Occupancy 'type
❑l.as nva•ner pfUloptoptmy,txn;}•csiiDlc';>tcswuh wagesrlhelr p,}Iy reyipclualiorq
102 -
PIERS
103 -
UFER Required InSPeC'IIOnS �-
will- P-3 Ihil uta. find as tur;:ctYe is "lint nttA9.loJ troffered"fair sate fSrc. 70,64,
ProfeKipus Cale: The Coc 'a m&:%Lilte Law r% torts np*. t0, CI
Rufintfs anti ncutf
aa,ter dr prvgcrlp NTn hal lAS or itnprnves thsesxti find u'hu clues sxh wlxl: hinuall
10 4 -
REEA R
cv thaoneh his o u. nnpfn-acct rAwoed Ula! such imm wrneaL fire ant ullendal or
ofraia far 01e TF, 1 afnll cr. the Naldin or imp;iim= is, k2i wldt,tl otic )lar of
_ __ _
1-05 -
ANCHOR BOLTS
n,Ampltticm.0S cru+va-bu'itdw will h:nx the butJnl of pu ing that hedid nil l+uldoo
fsnpra
10 5 -
SEWER & WATER
p rur FtEpace of shiti'l,
❑ 1, as an-,tmaf the Druperty. nm e_iell.;,lvcly o-laamting-.rift licensed cor rnctoas to
202 - -
U DERFLOOR- P�lUMB ING - - - -
enwilGt 1U prtceet (Sgt. 7051. Busi-xm; and 1'nHrb3id= Cale:) The Contincwr'+
203 -
UNDERFLOOR MECHANICAL -
Licenre Iaw 14X3 nes gtply to anawncr of pmQeny wit,) bulls at imluvl es drerratn,
anJ v;hlLm"[eu + ror rwb r.r. xLi_with.a cantramnn0 IIe tipul pursue - 1n .the-
204 -
UNDERFLOOR -Fi A14E
Cl -,.-Liner-,
amtars L> 4-
cmgaundr:r5st'. � -0 C.
❑Ifiutxr &Pfet Nietea:oo
205 -
UNDERFLOOR' INSULATION
Owner note
301 -
ROUGH PLUMBING
_
{YOR{:¢:R'S COSfPL•Yi:1T11;1iV 1?EC1.IiR4710N
3 02 -
TUB & OR SHOWER
f hereto fit nounl?Irr t!ly(!1 perjury aae.af rlpe folh;,.mju dccl:,ruiw.s-
3 3 e
ROUGH MECKZLN I CAL
C I Irlve' =A' wilt walc:nai a Ceniircrne ill' Cattwnl m self-tc;urm lot Woeser's
r0
3 0 4 -
ROUG:1 ELECTRICAL
Cmnpensukunmn, us p, rovidtd for by Sarins 37 CO of rhe tsbar Cala, run r'us
-
FRAME
perfirnca 01'dx ss'oah fc'{ which this permit ib IfF.4d,
,-105
❑ 1 Caste and -•ill utainra;n 1l',MS:e['S Clxrtpentadlyti ldttminr,., fis leyvifeJ by Sxrinn
306 -
HOLDOWNS
TOU dr the L -Sm Or k, rsr the perinr,i&,ic-i'af file work- fa; 9' chi rpfns pacdt;s
307 -
INSULATION
OWN
jasued. by RSxkl:ra nmpenaa oft [murnnr_ hisser hrJ Pul `.cs' nuriilter Eel
C,'
.308
Sl��' TROCit
CSYiicl �C • _ �ihty'No.i C
,ZI tI• CATIO: OP }i)fFMt'f10�RO `�3CKI.KS ' `
30 �� -
I
Elx 1s•t,81 GiC OR LATH
<'fip1P[Nc,�T[AP FN;I,I;AVCtzf
_nn^_
trhiS te_ InI uo:d nut hecnnlf%riad if dtr pert. til is for fine 1'nudrd dczlars
311 -
S CR.ATCH COAT
(S Irdll re list)
313 -
ROOF NAIL.. -
I f%enti;' Out in ahe pft1 •roan:t'nrthe work lot which this pennii k.huied,' 1
1 'Vil not: erwpin9 - any persnn sit any nw'icr`su al In negnl.•n. k,-V)c't to rine S4'rsil:eri-
501 -
r' Ta TZ I -CAL ENERGY'
F I NAL ELECTRICAL
502 -
FINAL PLUMBING ENERGY
iquil�ineL,ms:tMCccirirnia.Ral-
lignnt
11.i." c"ancaieofEvernpd:'n,?'>,,hoaiJ
503 -
FINAL MECIaANICAL ENERGY
hr.: ,irc subjtcty) ib, worker s t:nm,-�,Civd'pros-h: ins of the L*. -t 0.,&.yru m_ t
rAhw,h turply ,a,th %in( -It pru+fsitrs fir W, pertdl than he deemod ctvukrd.
504 -
FINAL BUIT DING ENERGY_
L+rvsrl:vcrterL��rr?lnGArenCi
505 -
FINAf, ELECTRICAL
I hemhy afli:td that ch.cre ra o mit;hnCli'.vd kiitliiit hentnA* I . r dto ptrk.,.Wxe
506 -
GAS TEST
ewfukrcrLhi:hrFavp+rtt i;=i;'saed(:;�_ ::+a) .civ cl
Un
l,ctrder's hal.:
S07 -
-
FTNAL PLUMBING
l.en;ar',AJ>ieas,
508 -
FINAL MECHANICAL
I , ertiN than I hale cosi :h vglplgcadan and.m.w T , rh: ahc v Infartnad,,n Is
5 O -
I NAL GRAD
i ctirvcn, I e„r=c to crrnply with all tiny and nunl:ty vrdirtuncm and tat« litws m_`uing.
luL-uUding torah uctftm,cnJ ban:ly'aC:hcrize ie0mi4atP.:tjo thu,*ily cn enter clpan
5 0 -
!NAL P
cM_ c>1Q•.y ol'G:intY17 plVpt sty fir Ln, peelt'JII F^a:.'� Ises.
,, .NNING
ln'eJ aerie ttl'mt •In&inmfy and I�ayyl itrllns the Cily itI {��}[Illl a� 11L.t
51 -
I NAL BT R KS
htbiitties. tu4�uU:nlsn marc find r_iprnses •uhich,rnpy in any wtypccrx finnhltasaid
-
C,Jra Iu xvmga?fxe of the gymnrihp, rel This permyit.
h CA ^f L-vI RS VAS ,',tc' a ,'ILL COMP-2's"A I I'NALL NON PDMI
SO 3 "F f tlsTlr,,' ti �a�
�Lq
Issued by-
Date
�e'rOOfS
T�-t--."- UC-
1c a AgpCxirtU inituG:Wr
�"—
. lfA7.AlMIUS•3{ATFRdlij,i DISCLOSURE
ti-11't}cappltctmt ryNtwa bnikflA rfomp utt sun^_ ar hardle hmil6111 rrUtval
'no
Type of Roof
V/
asak7xdbyd'e,i4pgtXuiilia, Code. ChnntoRA2,undtheNoplth=JSdety
i
C udl:, SKrintt i75,32(a�^
L; vete;Cp
All roofs shall
be inspected.priot to.my.roofing materi.31 being installed.
�9 & zppltetsnt qr kitum hill 10i,C ccruncvse egvlritkrr11t] acde+2 :eauhich
pa
1
If a roof is installed
without first obtaining an i6spectionr 'I a -Me, to remove
eR�1 ha�ld'_l+'a1r CtM faQllll•;u ILR at derintsl b3' dlt Bay .'treb ,� Ir yIUJILIy � (C7iZC171r1:I
v • C•
V r
�"" ❑ "°
all new materials -for ins ppeection. _Applicant understand,; and w•ill_comply with
all non -pint solace regulations.
I have rend the Ituwdnu: Inatctial; leyalmmentt'ilr1,_ Chapter 6.95 od lho
C'aF,fr<rA W.lci i Stfrl} Cude. Sectian60501. 25333 and 2d57e. 1 rardeasfand rtst '
irihx tui itlny,a9pf^r n�r cntrLnd-y h e a laram, thrt itis my rwr. .,dh,.Ry 47-'tify dle '
-
;� • r of Thr, %ggav merly which ira:.at.lsea:xt'4'qur s•,r i>ssltm of n O:emIL_air of
Ch: u • ncy.
Signature of Applicant
.
Dale
"li"
o• er •,udtur; _ ng uil Vale
All rl�of coverings to be Class or better
OFMCE