26829 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY '
CITY OF CUPERTINO PMMITND.
BUILDING DIVISION APPLICATION/PERMIT MUMBrSC.MECHANICAL C n (�
_Ve,,BUUBING PROJECT mex(v�lCAnoN5callilYta rr U L J
BUILDING ADDRESS: ,,/y.. �.' SANITARY NO. AIYLICATKJN SUBMITTAL DATE
7 .-`�r'1 I^Tf.�� IrNITx LOT Mil -may
NVNIItSNM1E: JZ PIO�C _ 2 CON•' CIDRKS NAME 2.L CI> LSZ ?-S NIC CONIitOL.
T4sJs-.� : it"
�iCB7iECOENGINEIJt: LIC NO: ADDRESS: ^' El
..f1
CONTACT: PHONE: na v
;A r �jH.ECIRIC PPR1.4i c PEE `11h �•rJ+BU1LDDJG PERMif INFO
BLDG FEFCf PLUMB MEGA J
•S/' V r/ PFRMR'ISSUANCE 2 ❑ E ❑
LYMNSED COMPACTORS DECLARATION APPL)AN�-RFSIDFNf1AL
Lf-
,=Z IMchusffitm dust l am liaenaed undohvisimuor Chsp=9(canunmcm,,a
-J0 Soho ]W01ITDivuim Jaflhe BminessW Polcuiorn Code,Wmyliceue iso PANELS
Tau rmaWel�p 192 S uP To 200 AK1ps
ucmac Lic.a
Disc CmtrKtm LC�L4C 201-IBRD AMPS
n SQ.FT.FLOOR AREA OQ.FT.
JNZ CIIfTECTS DECLARATION OVER 100DAMP5
1 uNenmd or,PWn shall be used u Public rmvda.
F j SIGNS ELEC U
l rood PmfeuionJ
46< OWNER-BUILDER DECLVRATION S
s I hereby sfr Nat 1 sum exempt from the Con 's Limtu lar los the
QfoB ing rtasm.(Sos6nn]031.5.Business"Pofeaiou Code My city a cowry TEMP PO INSf,
which on uires a pcmut to chmo uct,alta,improve,derdwlish,or repair any vrvctwe
fy� prim tom usosta.elm nequire,the applicant fm stu,h pemut to file a signed suseromt POWER
TZ<p this he u IiecruN rutonount to the povidm of the Convaetor's licrnse law ACh sp
� 9(mosmco ttgwith Sadion 7000)of Division Sof the BoslnessW Pofasimu,(Zode) S POOL ELECRUC VALUATION
orad,ho Hacept thaefrm W the Buis for the dkgcdcacotpdim.MYvia%tim so
_Z,� Satim'I0313 by any appliat fora permit sublemstM aMicsm u a civil paWtYof O -SWITOffS-PD(IIIRFS
cot come thin fere hundred dollen($5007.
NEW RESIDENTIAL F1FCfR _SQ.PT.
YF� ❑ I,uowssrarlhcpvprny,Wmyoryloyawith vapesuhsvwkcWoprmado.S STORIES TYPE CONSTRUCTION
'3°_° ll da thew«k.W the ryunum ossa muMrdmo(fad(mark(Sa.TOW,Bvsma , r
W Pof mcsu,Cock:The con.cfs luau laro
w does t apply to m owtav of H 1 �7�'Z �J
popory whobuJdsmisn{mva 1McorA W whodamush wort hiwclfor thsoughhu
ownempbyea,povided theuuch itrtpmverxmxantwtintetdNoroffared lm We.I, $VII E'�y OCC GROUP RFS.UNITS
hose ,the building or impovement Is=16 within ane yarofcompletion,the owns- TOTAL:
bddM w'BI love Ote bander of proving But,to dd not bund m impure fee purpose of
sale.L R V fxo:Asaaus.✓u.;gid i
❑ I.uowtcof the popesty.w anudvrlymivrUng with limtudcaewsmsw Wy1y�: Py�xr• P{�"iy'yNF "OEM -�DzoNE APN
comauo the poja(Sce.TOW,Boston.W Pofca:om Code:)The Cmtrarua PERMIT ISSUANCE
Li¢uelardoatwd apply umowstcof poperty rhobdWs orutpmva Jr�m.W
who emvxcs forsuchpojeaa w ffio tr.eu(s)Lamed psmoom mdhe Conusetcv'x r. -
li¢ou law.
ALTER-DRAING VENT-WATEIt(EA) , E FEE SU-M.-
❑ 1 w oerrsP order Sec ,B A P C far this ram BACK FLAW PROTECT.DEVICE
SANITARY Y N
Owrc Duc DRAINS-FLOOR.ROOF.AREA,GOND. RECF]PTa
WORKMAN COMPENSATION DECUBATION SCHOOL TA% YN
❑ IbeubyaKum thulluvcdevtifole of comeot badf-imuu,maaN(kve of FD07URES PER TRAP RECEIPI'N
-:+ wck cm{rnvlimt lmman c,.adifil copy thomf(g 3800.Lab C.)widich PARK FEE Y N
cover W ce"Aa e's wdo this permit. GAS-EA.SYSIFJN-IM RECEIPT'e
policy a BUILDING DIVISION FEES
co-Pt"'Y GAS-FA.SY 6)VER4(EA) PLANCHECK FPM
❑ Ccni(ted copy,Is beuby funiisbN.
❑ CuufN cgryufikd with the city inspx+lan NvWm. GREASFJIND IJIFR GRADING FEE
CERTIFICATE OF EXEMPTION MOM WORKERS' GREASE SOILSFTF
COMPENSATION WSURASI E
(Dus aavmrsM hod be completed ifthe Permit is forme hundred dollen(SIM) SEIVER ANIT T M ]WET ENERGY FEE
cola )
I mtilYtlw in the perfazmane of the wvkfor which dtif pmnhuitaei.Ishd WA HEN
not mryby any Perm in mY mise w u m berms abjat to dive Werlo,ri; r PAID
z Co op aurin aw o G iformu Due W TER SY EATfNG Ods Receip v
Applicstust
NOTICE TO APPLICANT:V.afro nuking this Ccafi.of Facmption,You should SQ.FT. TOTAL:
y borvoe wbjm w tis WahKs Cmpcoutian Ivovuiau M the labor Cade,yw mon
forthwith comply with such PmvisSom or this permt shall be deemd revoked BUH.DING FEE
1 Q CONSIRUCIION LENDING AGENCY SIdSMIC FEE
z Ihesby of this there u a catmuaiov kMing gamey fee tlteperformaaceof AL' ME=FIMO. the work which this s permit is iso t(Sec.J09I,Ov.C) TOTAL
lotder's Addras s.uoCALrPERhffT 4^rrti �: FEET S% F'l.UMBING FEE
L.] 1 certify tlut I have Rud this application W scot this ftabout infmmuicn a "'"'• MECHANICAL FTE
. C_ correct.lagtamcamply with all my Wcounry mlinutces Wuuc laws ulxting to PERMIT ISSUAN(M
building c'otuaunim ml tetchy xut oize m,,i die utiw of this city to enterupan the CONSTRUCHON TAX
Iz above-tucnumed papa'nv for insertion purl ALTER OR ADD TO MMM
IWe)aloe to ere.Indemnify W keep harmkas the Cory of C., mo agdut
BabBiuu,jodgmrnt emu Weapema whichmaYinmYwYstt^s agaiwuid Ciry AIR HANDLING UNIT(TO M000CF1,11
inrnn'9ue of 1t.,,IkY*\Ypran'�itVnF of thix pcnnit.
AIR HANDLING UNIT OVER 10.tXgl CFM)
Stw oe ApplicantK'mtrutm Wm EXHAUST HOOD IW/DUCTI
PAID
HAZARDOUS MATERIALS DISCLOSURE HEATING UNIT LTO I OMI RTUI Dere Rocco.
N tis apptiand m future building occupant store m hudlen clous mstenzl HEATING UNIT LOVER IW.fpO BTU)
L'
u defwl by the Cupcnino Muninpel Cade.Ch,,,9.12,W the Hwlth W Sdery
Code.Sadi 0:3533(x)' o VF GATIO%FAN(SINGLERESID)
Yn ❑.� ISSUANCE DATE
WiOthe xppliaetorfuonebuJdina mavpnlusryuilmmtmdevimwhichemit BOIFR-COMP(JHPOR IW,t10B BTU)
x'n coo em.u defined!by the B.y Ara Air Qaliry Mwamoodo BOH_M-COW(OVER IW.M0 BTU)
'trkti
❑Ya ❑No NEW RESIDENPAL MEC%. SQ.FT. SEP �. .
'1 Ivw sod the bamduu mucid%mqullmvua under Chdptes 6.95 of the 19g
Cd"tfmid Holth @ S f y Codc,Soctiort,25505,25533 and 25531.1 undvnand thud ¢ .
H the building does w eummtly have a tesum.dust it is my rmpmtubiLty to codify the
.oa+Ts^t of the raryiunlmn which rIIIw be ran Qrior w lumdce of•Cadfica,•of -- r L V:
Orlcor wthorired Ye^t Das TOTAL ISSIB'D BY: