S1385 �aAPPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECFRICILPIJy IT H0, 1385
0(j PLUM RING-MECHANICAL
BUILTUNG DIVLSION APPLICATION/PERMIT
BUILDING PROJECT IDENTIFICATION
BUILDINGADDRISS: SANITARY NO. Ali' ON SUHMI'FlAL UAIE
oo m T 4 E- 3 r7 q-4,8
OWN! :S NAME PIIONI? - I't-i" Crt1RS NAME: LIC NO:
N WC CONI'NOL p
I ARCHIMCI'/F,NGINEEH: hIC N(l: ADDRISS. ❑ 2 I
r CONI'A . PI IONI!: BUILDING P RM IT INFO
& O n ry 6-7?02 ❑ Comsultenl Fees Paid by Applicant(Initial) eta IiL[cr PhU❑Ftx nnSC
LICENSED CONTNACI OR;S DFCI_ARALTION Q'fY IiLECfRIC PERMIT' FEE
I herthy anima that I am liceri Under,mvid«.a of Ch.,ta m(commtercin{ JOB DESCRIPTION
{��Z with.SccRoo 7001 of Dlvlsbm 3 ofthe BrIimxv mid l'rnfadons Oak,ruff my lfacnrck O RESIDENTIAL:
FOO in full fmlax aWeBcct. I'I!RMI'I'ISSUANCI! ❑SFDWL 01OTfCHENREMODE1,
,UL LLase Claal IJcN APICIANCIS-H1'tdld' EAI. �ADDITTGN El PLUMBING RI PIPE
�Zzw
IAte C rrocm ❑MULTI-UST ❑STRUCTURAL.
ARCHITECTS DECIARATION
'D y VAN1i1S MODIFICATION
y Z I mdmslaed my,lana clwll he taw d as public rce«d.v
OZ- UPTO?IIUAMPS [I INTERIOR ❑CHIMNEY REPAIR
�:4t:m Liccnv+I Rolncvimml 201-111(0AMPS IMPROVEMENT E]SWIMMINGPOOIS
OWNER-BUILDER DECLARATION OVER 10(HIAMPS ❑RATH REMODEIIREPAIR (]DEMOLITION
C 6 I hereby n fon,that I mo exem,i fir IM Con,.......Licuncc Law Ge the
KOiU firmaatr5 reaam.(Section]UJI.S,Bucitmcs mdI Rnfeaims Cade:Any ciry«county SIGNS E11CfRICAL ❑f7fHIiR
3 tL ,which regmrea m pcmtit m<nn.vrer,u1.,,imprnur,demafih,m oTtaor any omelure
O<' prwrmiu iswartee,Wsn rtquites the o,pliont lar ouch pemtitwfkesigtW sWtenev SPECIAL CIRCUITIMLSC.
`�p, thm he is BccnscA pulxuanRi
nodr provisionsof Be Contrstor's limnwluw(Chapmry
C,C, (cmmtm«ing with Socoon70(tof Dlvivam J ofthn Bminn.mW Prnfeoions Codc)ur TEMP.METER OR IDLE INST.
IL y o y Ihm he is exemp Ihnefrnm and the basis fmtFl ell.ged eaempinn.Any vinlaim N - `❑N�HLDfJAUDRION ❑DIih10LIT1ON
umirm 7031.5 by w11 applicant f«a prom wbi,els Br upplicwi Io n civil pctwlty of MWER DEVICE_% 'IE(SANT LI FOOD SERVICE
F y nR core than live hutdml dmllnns(550(B. {{Y" IMPROVF.MF:T
� [:] wnm pocny o
La,oincrf UPr.ny...... yms with wa,,,rs Ualr oay
lc mrnwinn, SWIMMING IC LHIAECIRIC
wHl do the ad:,and Ur etmmurt is nd inteukd or otbribi tot(Sbr.70e1.Hucini ❑UTHIiR
L'3 m nM Pndcuionx Cole:no,Contmntm'a Lirensu Law doe,ma apply m w owner of (tUfI.HIS-SWITCHES-Il K'ILR ELS D
pmpcmy who builds«Erywvcs U!mvm,min!who ton such ii hilmclf m Introit
own employe«, r ilkm Unitsuch improworcntu nm bor mladcd or oRcIcd I« NEW RESIDENTIAL ELLITOt SG Fr
wk.If,lracwr.Uta building mi mpranrcmis said within one year dmmpletion.Be, SQ.IT.FL(R)HAHIA LSV.FC
Icer luiWm will have iloo,Stamen of proving that M did m4 build or im,rove for par-
as of cal
w
Fj 1,aa
r 'na of elm Iro,ertY,am esclrsisrly Omberting with maorrs licensed cnnuT( L.
A
m,ra,l tlr proj«I N-.70a i.IWsim.and liomr,ictn COik:)'l One Cunwcl-11%I.i-
meLaw dbosnot a,pylo m saner If,Iopcnv wltc WIWI or met thetroo.and QTY. PLUMBING PERMIT FEE
wM crxnrvau for ouch pnycmn w'ehaomlraclnrtglicntad pur.aummiM CainrxhKs
Liccmc I,w. NER HFISSUANCE,
L7 I arta caetn,l aides Sec, .IT&P C Rtrthi"i—n
ALTER-DRAIN k VENT-WATER(FA) VALUATION
fArcr Oma T
WORKERS nder,e aN1PENSATIOr D,the miATI(1N HACK Flow'YN(11LCf.DEVICE D ( 1 � 'LJ
1 hereby dBrm a a penally of Perjury me M ach fallowing da ker's ns: V
❑Ihave and nde!for th Se Ceni firdte of atensenuoCoda.sum o"Worker's Cumpen- URAINS-IH.00H.RIX>P.ARTA,CY)ND, STORIES TYIgC CONSTRUCTION
W Lunt,as pmvidei f«by i, oa J"1(MI of IbC LiMn C«du,f«the p<Armmnrre of the
work for which ill carmaiv order, IIRT'URI'S-I'ER TRAP
I have earl will maintain w«kcfs mm,,(it mo n InvI,,,v ss r i, .1 by Section
9700 of lbn laMr Crde for the,vU�xtiwntt of ltw wnR fur which thio pcnnit oe lrwrrl. GAS-IiA.SYSTI?A1-I INC.i(IVIIJ?IS OCC GROUP AI'N
My Warkes Com,ce,ation Invwrcc corric and Pdiq number 11
Carrico; Poliey Na.: GAS-PA.SYSTEM-OVI!R i(EA)
CERI'IFICA'I'E HE UIENIFIION FROM WORKERS' GREASFIINDU.STRh WASTEINTERCEFIDR
COMFl!NSAFION INSURANCE: BUILDING IVISIONFY_FS
flloivs etion necJ nq ha cuntpincU if the lw nil is fnrxe hwdrd dallurs($lg) GREASI!TRAP
or lei PLANCHI!CK Fl!E
comfy Jim io the lw rfamwrceuf the wirk lox which this permit is osud.I dw11 SEWER-SANITARY-STORM EA.200 FF.
n«em,Iny any prnnn in any mantra tar ss Im become object to Uc\Vorom'Cnmlpen- ENERGY Flt
O z ..rutiom haws of Calilbnlw,Uma WATER HEAU!R WIVIWOE/ LECfR GRADING F0
Z Ap,licent
u NOTICE TO APPLICANT.F racrnwking this CMificvlc of lAcri yor.Would WATER SYSTEM?It'ING
(✓ , Neo a abject Ia Ne W«kers Curo'numion,mvkion,of the Wbor Code.you mull SGIIS \!
Emir,Or OmOidy with eucb,rovisions«thio Eemti l dill W cc +l mvnkW. WATER SERVICE
O. CONSTRUCTION LENDING AGENCY NEW RISIDENTIAI,PI.MB. SO.FT PAID
V O I hmchy alRmnhat thaoisumuwnirxJcomnguge«y Ter the penimnarce of piK
the w«t f«whkh thia,cmtil u instar)fStt.YN"!.Civ.C 1
OLemicr'r Naor TOTAL rtT%7}t'IAI'
rIUk1 tenders Ahlress
y I candy Hrt I have mad III,n,plicadnn mod xm c tbm the show Obirouticn k B I CIJEL" 'p
fn ori lat,i comply with all city and coumy«divrcce warimra laws mlam,to QTY. MECHANICAL PERM IT FEE
U Z WiWingmnsmrtionnm hcmhy authorize mpreeanmtivca ofthis city menter main tM SIiISM1tI'IYE
dove-memiurcd Pnrpmty for Inv,Slion papnses. 1'ERNUT ISSUANCE O .
(Wc)agire to msr,ioft,m afy aM keep hannlcA the City of Caprnin,egainu r ELEC it CELL'
fwbdities,jodgmemx,coca and ex,ei which nary in anyway assru ugaina.mid City AI]ERORADDTOMECIL
PLUNIBI GFEF,
incomeANI II(thc this pcmut.
tOO) CANI'ULATI Ds WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(1010.000 CFM) MECHANICAL FEE
SOL' CI!RF.CULITI e
AIH HANDLING UNIT(OVER I(I,UMI CIrMI CONSTRUCTION TAN
Signamm mac b Duo EXHAUST H000(Wn)UC) HOUSING MITIGATION FL'1!
MATERIALS DUNCLOSURE
❑A" US
Will the u,plicant Of fmtart building«'capant aura«handle hvrrdnusnmtedd I tHATING UNIT GO l ot,gMI BTU)
it,deBlcd by the CupcnitnMWunpd Code.Cha to 9.12 mai!the Hi a1df and Safety
Crdc,Section 25533101'! HEATING UNIT(OVER 100,000 BTUI
ElYca PAID
VENTILATION FAN(SINGLE RFSID) Dam Rttni,,N
WII Om applicunl«[wutc huiWing^¢'upwl uc yulprrnt ar rkviccx whrE DOLLEN-COMP(IfIP(1H IIX1.Ip0 BIL)
I hvamws air cond.iwas ns defined by the Hay Amn Air Vualiry Nlmugemrnl
Dian"? �f g
Dye, Rj`aw H(11LEH-CUMI'IOVEH IOH.(llM18"Nl
I have reulihs imrena under C",kw5 of the Cdi-
AIRCONDITIONER 1 ISSUANCE DATE
forma IInM k Sefcry Call Sertinnn 25505." i 25541.I ondersurd them if Ur NEW HI 911HENT1AL NIECE SQ R.
WrIELtg r.rmrem[yhare. 'my 'rprsvlbiliq to ify Ur pcul'nt't
r aYT
ofthe 'at m of /1'
Oweerr, o
T TAE: ISSUI!D HY:��� -- 1'
OFFICE f