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BUILDING PROJECT I DENftN
-'BUILDING ,
ADDRESS -
- APPLICATION IT
- '
BUILDING - ELECTRICAL- PLUMBING-- MECHANICAL
P 2768
OWNER'S
NAMEQTY- ELECTRIC PERMIT FEE
PHON ¢IS
PLAN CHECK VALIDATION
PLAN
CONTRACTOF1'$ OUTLETS - SWITCHES - RECEP 5.00/1.00
NAME
O/NS COVr� /F1/ - LIC.NO. / LIGHTING FIXTURES 5.00%1.00
-
'
- - ' DATE OF APPLICATION
OONTRACTOR•sAPPLIANCES - RESIDENTIAL 4.00
AODRESS .. •, 9y y ��D
AIZ04 PHON / PANELS 5.00
Z92 to Z�
ARCHITECT 94s9S SIGNS 6.00
OR
ENGINEER
LIC. NO. SIGNS TRANS. 3.00
PLAN CHECK FEE
P.C. NO.
/
ARCH. OR ENG.
ADDRESS SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
ZIP TEMP. METER OR POLE INS. 15.00
APPLICANT'S MOTORS SEE FEE SCH.
.ADDRESS
SERVICE CHANGE 10.00
LICENSED CONTRACTORS DECLARATION 5�rU3d
hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division'3 of the Business and
v ProfessionsCode,&/ny license is in full force d.e t. -
Class Lic. Number O
ISSUANCE DATE. -
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Date / Z ontractor
OWNER-BUILDER DECLAR ON
I hereby affirm that I am exempt from the Contractor's License MISC. - REFER TO ORD
Law for the following reason. (Sec. 703 1.5, Business and,'Professions PERMIT ISSUANCE 6.00-�I-`y
Code: Any city or county which requires a permit to construct, alter, -
improve, demolish, or repair any structure, prior to its issuance, also ELEC. CONTR. LIC. NO. - ELEC.
requires the applicant for such permit to file a signed statement that TOTAL
he is licensed pursuant to the provisions of the Contractor's License
IN ORMA -
yy�
u�(J�je rJn�$/FT.
(/�"',
- PERMIT TO
Law (Chapter 9 (commencing with Section 7000) of Division 3 of the/]
Business and Professions Code) or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE
VV-_
STORIES
TYPE CONSTR.
the basis for the alleged exemption. Any violation ofSeclion 7031.5
by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred dollars (5500).): ALTER -DRAIN &VENT -WATER (EA.) 4.00
/
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❑ I, as owner of the property, or my employeds with wages'as BACK FLOW PROTECT. DEVICE 2.00
their sole compensation, will do -the work, and the structure is not
intended or offered for sale (Sec: 7044, Business and Professions DRAINS -FLOOR, ROOF, AREA, COND. 4.00
Code: The Contractor's License Law does not apply to an owner of
OCC. GROUP
�j
v
RES. UNITS
property who builds or improves thereon, and who does such work FIXTURES - PER TRAP 4.00
himself or through his own employees, provided that such improve-
ments are not intended or offered for sale. If, however, the building GAS - EA. SYSTEM - 1 INC. 4 OUTLETS 4.00
$O. FT. FLOOR AREA , TOTAL ACREAGE
-�---
3
or improvement is sold within one year of completion, the owner-
builder will have the burden of proving that he did not build or im- GAS - EA. SYSTEM - OVER 4 (EA.) 1.00
prove for purposeofsale.). INDUSTRIAL.WASTE'JNTER. 20.00
❑ 1, as owner of the property, am exclusively contracting with
J
BUILDING.USE
RES IND CO PB Ocher
❑ - ❑Fer, ❑ ❑.
licensed contractors to construct the project (Sec. 7044, Business LAWN SPRINKLERS - 1: INC 5 V.B. 5.00
and Professions Code: The Contractor's License Law does not apply
to -an owner of property who builds or improves thereon, and who LAWN SPRINKLERS -,OVER-5 (EA.) 1.00
ASSESSORS PARCEL NO.
contracts for such projects with a contractor(s) licensed pursuant to
the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/8.00
.r
TRACT NO.
PARCEL NO.
❑ I am exempt under Sec. B.&P.C. for this WATER HEATER W/VENT' 4.00
reason
Date Owner-
WATER SYSTEM 4.00
ACC, DATE
ACC. FILE NO.
WATER TREATING EQUIP. 4.00
WORKERS'COMPENSATION DECLARATION
r -
I hereby affirm that I have a certificate of consent to self -insure,
or a certificate of Workers' Compensation Insur ce, or a certified
copy thereof (Sec. 3800, La /�/),-� /l f 1
ZONING
09
ENG. SITE NO.
ny.).
o. Company_/J-d,`Ji- l.. I
'Policy No.-Company.
-
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FIRE SPRINK
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ENERGY T-24
YX No
❑ Certified copy is hereby furnishe �. '-
❑ Certified c is fled with t e city inspection division.
Applicant- 7z0 -
MISC. - - REFER TO ORD.
CERTIFICATE OF EXEMPTION FROM WORKERS'
PERMIT ISSUANCE 6.00
FLOOD ZONE
COMPENSATION INSURANCE
This section need not be completed if the permit is for one
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PLG. CONTR. , LIC. NO.
PLG. -
TOTAL
hundred dollars (S 100) or less.)
I certify that in the performance of the work for which this per-
mit is issued, I shall not employ any person in any manner so as to.
QTY. MECHANICAL PERMIT FEE
-
FEE SUMMARY
BUILDING
/
a60Ifo
become subject to the Workers' Compensation Laws of California.
Date Applicant
ALTER OR ADD TO MECH. . 4.00
NOTICE TO APPLICANT: If, after making this Certificate of Ex-
-APPLIANCE 4.00
AIR HANDLING UNIT (TO 10=C.F.M.) 3.00
PLAN CHECK
FEE
emption, you should become subject to the workers' Compensation
provisions of the Labor Code, you must forthwith comply will,
such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
AIR HANDLING UNIT(OVER 10=C.F.M.) 5.00
SEISMIC FEE
3 �S
I hereby affirm that there is ,a construction lending agency for
EXHAUST HOOD (WITH DUCT) 2.00
-
the performance of the work for which this permit is issued (Sec.
3097,Civ.C.).��.
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 4.00
Lender's Name
Lender's Address
HEATING UNIT (OVER 100,000 B,T.U.)7.50
ELECTRIC
I certify that l have read this application and state that the above
VENTILATION FAN (SINGLE) 3.00
information is correct. I agree to comply with all city and county
ordinances and 'state laws relating to building construction, and
PLUMBING
BOILER - COMP (3 H.P.-or 100,000 B.T.U.) 4.00
gOILER•COMP,'(over 700,000 BfUI SEE FEE SCH.
MECHANICAL
hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
(we) agree to save, Inde n y and keep harmless the City of
Cupertino against ie , j gments,' costs and expenses whichPERMIT
'
g of th'
[may in any we c ag st said City in consequence of the
142
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- MISC. - ' REFER TO ORD.
CONST. TAX
ISSUANCE 3.00
MECH. CONT. LIC, NO. .
MECH.
TOTAL
TOTAL
(p3 J
Signatur of Applicant Datt
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APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY,
BUI LDI NG PROJECT I DENTI FIC IN
.. APPLICATION & Pi IT
BUILDING — ELECTRICAL—'PLUMBING — MECHANICAL
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OWNER'S - ill r
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QTY. ELECTRIC PERMIT FEE:
PLAN CHECK VALIDATION
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DATE OF APPLICATION
COME NTRACTOR'S
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LIGH NG FIXTURES 5.00/1.00
CONTRACTOR•sPPLIANCES-RESIDENTIAL
ADDRESS - [ �,•(/ p
6 Y y U�l V�(fJ( fJ / / .y y�I VC. PHONE ` &Ja d
-4.00
-
PANELS 5.00
ARCHITECT
OR
ENGINEER -
uc.No:
SIGNS 6.00
PLAN CHECK FEE
P.C. NO.
-'
SIGNS TRANS. 3.00
ARCH. OR ENG.
ADDRESS -
ZIP
SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
.
_
ISSUANCE DATE
TEMP. METER OR POLE INS. 15.00
APPLICANT'S
ADDRESS ArS .
fC'OA/ -re AcTefZ _
MOTORS SEE FEE SCH.
s��"I� eI rerrl►s'E _ „' ^^-
LICENSED CONTRACTORS DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and
Professions Code, an'm
dy license is in full force a d (f L/
Class C —� Lie. Number
Date - 2 _r Contr o
OWNER -BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason. (Sec. 703 1.5, Business and Professions
Code: Any city or county which requiresa permit to construct, alter,
improve, demolish, or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that
he is licensed pursuant to the provisions of the Contractor's License
Law (Chapter 9 (commencing with Section 7000) o(Division 3 of the
Business and Professions Code) or that he is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5
by any applicant for a permit subjects the applicant toacivil penalty
of not more than five hundred dollars (5500).):
❑ 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 and Professions
Code: The Contractor's License Law does not apply to an owner of
property who builds or improves thereon, and who does such work
himself or through his own employees, provided that such improve-
ments are not intended or offered for sale. If, however,the building
or improvement is sold within one year of completion, the owner-
builder will have the' burden.of proving that he did not build or.im-
prove for purpose of sale:).
❑ I, as owner of the property, am exclusively contracting with,
licensed contractors to construct the. project (Sec. 7044, Business
and Professions Code: The Contractor's License Law does not apply
to an owner of property who builds orimprovesthereon, and who
contracts for such projects with a contractor(s) licensed pursuant to
the Contractor's License Law.
❑ 1 am exempt under Sec. BAP.C. for this
reason
PoAf 'r Ro8OT 31/;P, /a '?! Fi,w(� a N. t?
Ft ;!-£R 3 NP REPER
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PLG.
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MECH.
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BUILDING PERMIT
. INFORMATION
MISCLWF IDTO ORD
. —
VALUATION $/FT.
"
PERMIT ISSUANCE 6.00
ELEC. CONTR. LIC. NO.'
(� £ /�� �� C—/ O
„/
ELEC.
TOTAL ��
PERMIT TO
r--'- ,
e I G
QTY. PLUMBING PERMIT FEE
STORIES
TYPE CONSTR.
ALTER -DRAIN & VENT -WATER IEA.) 4.00
BACK FLOW PROTECT. DEVICE 2.00
OCC. GROUP
RES. UNITS
DRAINS -FLOOR, ROOF, AREA,COND. 4,00
FIXTURES,- PER TRAP 4.00
SO. FT. FLOOR AREA
TOTAL ACREAGE
GAS - EA. SYSTEM- 1 INC.4 OUTLETS 4.00
GAS- EA. SYSTEM - OVER 4 (EA.) 1.00
BUILDING USE
RES IND CON PB Other
0 0 0 0
INDUSTRIAL WASTE INTER. 20.00
LAWN SPRINKLERS- 1 INC 5 V.B. 5.00
ASSESSORS PARCEL NO.
p_
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
SEWER -SANITARY -STORM EA. 200ft/8.00
TRACT NO.
PARCEL NO.
WATER HEATER W/VENT 4.00
Date Owner
WORKERS'COMPENSATION DECLARATION' •
I hereby affirm that I have a certificate of consent to self -insure,
or a certificate of Workers' Compensation Insurance, or a certified
copy thereof (Sec. 3800, Lab .C.). / / UAL
Policy No. Company G•
❑ Certified copy is hereby furnished.
Certificd� py is filed . iIh the ity inspection division.
pp (Cant
WATER SYSTEM 4.00
ACC. DATE
ACC. FILE NO.
WATER TREATING EQUIP. 4,00
. -
ZONING
-
ENG. SITE NO.
-
FIRE SPRINK
- Y N
ENERGY T-24
Y [:] NE]
MISC. - REFER TO ORD.
CERTIFICATE OEX MPTION FROM WO KERS'.
COMPENSATION INSURANCE,
(This section need not be completed if the permit is for one
hundred, dollars (S 100) or less.)
I certify that in the performance of the -work for which this per-
mit is issued, I shall not employ any person in any manner so as to
become subject to the Workers' Compensation Laws of California.
Date ApplicantBUILDING
PERMIT ISSUANCE 6.00
FLOOD ZONE
Y 0 N ❑
A.L.U.C.
Y o - No
PLG. CONTR. UC. NO.
PLG„
TOTAL.
QTY. MECHANICAL PERMIT FEE
FEE SUMMARY
ALTER OR ADD TO MECH. 4.00
Ex-
NOTICE TO APPLICANT: If"after making this Certificate of Ex-
emption, you should become subject to the Workers' Compensation
provisions of the Labor Code, you must forthwith comply with
such provisions or this permit shall be deemed revoked.
C.ONSTRUCTIONLENDINGAGENCY
I hereby affirm that there is a construction lending agency for,
the performance of the work for which this permit is issued (Sec.
3097,Civ.CJ.
Lender's Name
Lender's Address
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 in any way- accrue against said City: in' consequence of the
grant" of this Pe it,7--
na ure of Applicant/Contractor Date
APPLIANCE' 4.00
PLAN CHECK
FEE
AIR HANDLING UNIT (TO 10,000 C. F. M.) 3.00
AIR HANDLING UNIT(OVER10=C.`F.M.) 5.00
SEISMICFEE
EXHAUST HOOD (WITH DUCT) 2.00
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 4.00
HEATING UNIT (OVER 100;000 B.T.U.P.50
ELECTRIC
a
VENTILATION FAN (SINGLE) 3.00
PLUMBING'
BOILER - COMP (3 H.P. or, 100,000B.T,U.) 4,00
BOILER -COMP (Over 100,000 BTU) SEE F,EESCH.
MECHANICAL
misc.- REFER TO ORD.
CONST. TAX
PERMIT ISSUANCE 3.00
MECH. CONT. LIC. NO.
MECH.
TOTAL
TOTAL
OFFICE COPY
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APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONL_jfnl
BUILDING PROJECT 1 DENTI FI( )N
BUILDING APPLICATION & P IIT
ADDRESS q R
yVP 8 �,4,v� � i. BUILDING -ELECTRICAL- PLUMBING -MECHANICAL
ER BER
OWNER'S _ - Y -
NAME
Q
S h TY. ELECTRIC PERMIT FEE
j0mN6t T45 PRONE
PLAN CHECK VALIDATION
CONTRACTOR'
NAME ,,%iamb.11
, 1%7e/%7Sr,-n 4 tlhs Ic.No.
OUTLETS' -SWITCHES -RECEP 5.00/1.00•
LIGHTING FIXTURES 5.00/1.00
AS .. '-
DDREScroR's
ADDRES-
APPLIANCES - RESIDENTIAL '4.00
PANELS 5.00
PHONE'
DATE OF APPLICATION
ARCHITECT
OR
ENGINEER
' LIC. NO.
SIGNS 6.00
PLAN CHECK FEE
'
P.C. NO.
'
SIGNS TRANS. 3.00
ARCH. -
ZIP
SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
-
TEMP. METER OR POLE INS. 15.00
APPLICANT'S -
ADDRESS
MOTORS SEE FEE SCH.
SERVICE'CHANGE 10.00
�O
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and
Professions Code, and ray.IjCense is in full fort ar r c .p�
License Class L' ✓6 Lic. Number u
'//
\ ISSUANCE DATE
BLDG.
❑
ELECT..
E]❑
PLG. MECH.
Date Z .J F _2 Contractor t
BUILDING PERMIT
INFORMATIONSC.
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason. (Sec. 7031.5. Business and Professions
Code: Any city or county which requires a permit to construct, alter,
improve, demolish, or repair any structure, prior to its issuance, also
requires the applicant for Such permit to file a Signed statement that
he is licensed pursuant to the provisions of the Contractor's License
MI- REFER TO ORD
PERMIT ISSUANCE 6.00
VALUATION
$/FT. .
.
ELEC. CONTR. LIC. NO. _7E
LEC.
TOTAL
PERMIT TO
QTY. PLUMBING PERMIT FEE
Law (Chapter 9 (commencing with Section 7000) of Division 3 of [Ile
Business and. Professions Code) or that lie is exempt therefrom and
STORIES
TYPE CONSTR.
the basis for the alleged exemption. Any violation of Section 7031.5
by any applicant for a permit subjects the applicant toa civil penalty
of not more than five hundred dollars (5500).):
ALTER -DRAIN &VENT -WATER (EA.) 4.00
❑ I, as owner of the property, or my employees with wages as
their sole compensation, will do the work, and the structure is not
BACK FLOW PROTECT'. DEVICE 2.00
OCC. GROUP
RES. UNITS
DRAINS -FLOOR, ROOF, AREA,-COND. 4.00
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractor's License Law does not apply to an owner of
properly who builds Or improves thereon,.and who does such work
himself or through his own employees, provided that such improve-
ments are not intended or offered for sale. If, however; the building
F SO. FT. FLOOR AREA
-
'TOTAL ACREAGE
FIXTURES - PER TRAP 4.00 Ct
% GAS - EA. SYSTEM - 1 INC.4 OUTLETS 4.00 11601
or improvement is sold within one year of completion, the owner-
builder will have the burden of proving that lie did not build or im-
prove for purpose of sale.).
❑ 1, as owner of the properly, am exclusively contracting with
GAS - EA. SYSTEM -OVER 4 (EA.) 1.00 /db
BUILDING USE
RES-' IND CON' PB Other
❑ '❑ ❑ . ❑ ❑
INDUSTRIAL WASTE INTER. 20.00
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code: The Contractor's License Law does not apply
to an owner of property who builds or improves thereon, and who
LAWN SPRINKLERS - 1 INC 5 V.B. 5.00
ASSESSORS PARCEL NO.
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
contracts for such projects with a contractor(s) licensed pursuant l0
the Contractor's License Law,
SEWER -SANITARY -STORM EA. 200ft/8.00
TRACT NO.
PARCEL NO.
❑ 1 am exempt under Sec. B.&P.C. for this
(.WATER HEATER W/VENT 4.00 O6
reason
Date --Owner
.WA
TER SYSTEM e1
4.00 7 0 0
ACC. DATE
ACC. FILE NO.
WATER TREATING EQUIP. 4.00
WORKERS'COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self-igsure,
or a cert Icge Workers' Co pens ton Insurance, or a certified
copy th 38Q0�T/�
ZONING
ENG. SITE NO.
'
Policy No. Company G�kd -Zml _
-
FIRE SPRINK
V ❑ No
ENERGY T-29
Y ❑ NEI
❑ Certified copy is. hereby, furnished.
��Certifie p s � d the CI Ins [ n division.
AppTcant,_; _ �c�-
MISC. - REFER TO ORD.
CERTIFICATE,OF EXEMPTION FROM WORKERS'
PERMIT ISSUANCE 6.00 r
FLOOD ZONE
A.L.U.C.
COMPENSATION INSURANCE
(This section need not; be completed if [he permit is for one
I.
Y ❑ N ❑
"- Y E]N ❑
PLG. /C�O,NTR. _ LIC. NO.
r'! �z - 40�10�-
PLG. PV
TOTAL
hundred dollars (S 100) or less.)
I certify that in the performance of the work for which this per-
mit is issued, I shall not employ any person in any manner so as to
QTY. MECHANICAL PERMIT FEE
FEE SUMMARY
BUILDING
become subject to the Workers' Compensation Laws of California.
Date Applicant
ALTER OR ADD TO MECH. 4.00
NOTICE TO APPLICANT: IL after making this Certificate of Ex-
APPLIANCE 4.00
AIR HANDLING UNIT. (TO 10,000C.F.M.) 3.00
PLAN CHECK
FEE
emption, you should become subject to the Workers' Compensation
provisions of the Labor Code, you must forthwith comply with-
such provisions or this permit shall be deemed revoked.
AIR HANDLING UNIT (OVER 10=C.F.M.) 5.00
SEISMIC FEE
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec.
3097,Civ.C.).
EXHAUST HOOD (WITH DUCT) 2.00
HEATING UNIT (TO 100,000'B.T.U.) 4.00
MICROFILM
Lender's Name
Lender's Address
HEATING UNIT (OVER 100,000 B.T.U.)7.50
ELECTRIC
I certify that I have read this application and state that the above
VENTILATION FAN (SINGLE) 3.00
information is correct. I agree to comply with all "city and county
ordinances and state laws relating lo.btiilding construction, and
PLUMBING
O'O
BOILER - COMP (3 H.P. or 100,000B:T.U.) 4.00
hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
MECHANICAL
BOILER (Over 100;000 BTU) SEE FEE SCH.
,(We) agree to save, indemnify and keep harmless the City of
MISC. - REFER TO ORD.
Cupertino against liabilities, judgments, costs and expenses which
may in any way accrue against said 'City in consequence of the
gr of rs pe nrt'
CONST. TAX
PERMIT ISSUANCE- 3.00
MECH. CONT. LIC. NO.MECH.
-
p 2.
O
TOTAL
TOTAL
Signature of Applicant/Contractor Date
OFFICE COPY
C`I'T'i OF C U P E R T I N 0
Building Division
PROJECT E/`'I o46 L
CONTROL # I �h
ADDRESS
x v cs
PERMIT #
M,GTER Cv6 L"
—7
,'V S L u cr< PHONE
SAN. #
ADDRESS
BLDG. TYPE
REP.
PHONE
OCC. GROUP
ARCHITECT
PHONE
ADDRESS
REP.
PHONE
r1� /�
CONTRACTOR / / O M J E �/ l (j
A1,f PHON-CtL2j5 7ad',5-VA-L. `� , 0 0
ADDRESS
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Z1% ST�RUCT . PLAN CK
REP. GLL n/
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PHONE jJ_4�-7S� 7
BLDG.PII/O�k
PLAN CHECK HOURS
PERMIT FEE o2 lv S�
CAP FEE
CONST. TAX
ENERGY FEE
TOTAL FEES
DATE REC.
DATE RET.
/ of
-- --- — — - .. -
BLDG. DEPT.
ENG. DEPT.
PLAN. DEPT.
STRUCT. ENG.
CENTRAL FIRE DIST.
-HEALTH DEPT.
-SAN. DIST.
•EITERGY
-HANDICAPPED
C.I'.CY Or.CUPF.RTINO I11SPI.:CTIOV RP.CORD (Office Cony)
2768 10889 Blaney Ave.
PL'P1ti,r NO. SANITARY DIST. NO. LOT NO. ADDRESS
Remodel Evelyn Sluck
PROJECT OWNER JOB SITE P11014E NO.
PERMIT ISSUED Date ELECTRICAL
Building _ 11-24-82 Date Insp.
Electrical i,4 Y27- Power Pole_ _
1'111mhinfi Underground
Ifechanica1 Rough Wiring_
Temp. Gas/llect. [laF1s
Solar Ceiling
Fire Sprinkler Fixtures.Int/Ext
Sign Etotors
Grounding
hist. Temp. Power
FINAL INSPECTIONS
Date Insp.
s
Electric
Plumbin fy,
Mechanical
Solar
Pool
Gradin
Planning
Fire Dept.
Ilealth Dept.
B U i I d i n
Other
1
BUILDING
Date Insp.
Pad Certification
Founda.ti.on
Pre-Gunite
S lab-Itemb rane
Bond Beam
Underfloor Girders
Floor Steel
Tiedowns
Diaphrams
;seismic Bracing
Ualls-Panels
Frame
].a t h
Uallboards nt Ext.
Firewalls
Other
Not Approved
.,, fWazi SKo.�..va.-
Other
Not Approved T
PLUMBING
Date Insp.
B ckflow
U er ,round
d rfloor
Parti'a-1 Rough
Rough Complete
Solar Rough
[dater & Insulation
Main Drain
R/of/S Drain
Gas . 2.— —�Z
Other _
Not Approved
MECHANICAL
Date
Underfloor S.N.
Insp.
Ducts & Insulation
Fire Dampers
_
Fireplace
Grease Duct & Hood
One flour Shaft
_
Condensate Drain
_!
Equipment Anchorage
Flues & Comb. Air
Other
Not Approved
BUILDING
ELECTRICAL
PLUMBING
MECHANICAL
MISCELLANEOUS
Outlets for ducts serving eithr-- Type I or Type II
hoods must extend through the ro< Mess otherwise ap-
proved by the building official. It can be anticipated that
designs employing a- horizontal run to the exterior wall
and thence vertically on the exterior will be submitted
for approval particularly in multistory buildings because
vertical shaft construction is both expensive and reduces
usable area of floors above. In deciding the merits of ex-
terior grease duct locations, the existence and location
of openings in the adjoining wall, access for fire -fighting
equipment at grade and the exposure of -adjoining
buildings or structures will be important considerations.
DUCT SYSTEMS -CONSTRUCTION AND ENCLOSURES
See requirements
for motors and
fa ns, see Sec.
2002 (i) and
Exhaust termination -10' minimum from adjacent 2004(a).
building, adjacent property line, air intakes,
and in' above adjoining grade level
Bottom horizontal discharge
- T-0- minimum ahove roof '
Sha it separation minimum one-hour or Brea ter as
rrquirrd by the Uniform Building Code \/
Roof {
Inclwiilual shaft is required exclusively Ventilated Shaft
for each exhaust system. This shaft shall.
be spaced asvav from the duct a minimum
of 3" and a maximum of 12"
It xtm Velocity l Solo F PM
�. ❑
�I I Minim .
Slope due I to hood minimum
(W.r lineal foot for ducts less
than 75' in horizontal length.
If duct exceeds 75'. slope is
t" per foot.
Cleanout doors in ducts shall be equipped with a
substantial method of latching that can be opened .
without the use Df tools.
Protect outdoor ducts against corrosion, see
Sec. 2002 (a I.
Provide 111" between ducts and comhustibles
or 3" minimum from protected comhustibles.
1. No vibration isolation connectors shall be installed except metal
sleeve joint packed with asbestos rope and whose design is acceptable
to the building official.
.2. Provide adequate. cleanout openings for thorough cleaning of (lust
system.
.3. Provide adequate make-up air for proper operation.
4. Provide a separate duct system for each hood (see Exception).
5. Thickness of ducts shall be:
Ducts Serving
Mfg. Std. Ga.
Type Ihood
16
If stainless steel
18
Type II hood
See Tables Nos.
10-A and 10-B
6. Weld or braze all duct joints and seams on the external surface.
7. Support the ducts as required by Table No. 1(}E. Do not penetrate
duct walls with screws, nails, etc.
R. Sections of duct shall not contain grease pockets.
MERCIAL HOODS
CANOPY TYPE
(Front View)
4.-0"
Maximum
Cooking Surface
CANOPY TYPE
Minimum volume of air exhausted:
Q = 150A —Open 4 sides
Q =100A—Open 3 sides
Q = 50PD—Alternate
A=Sq. ft. surface area of hood
P = Ft. open perimeter of hood
D=Ft. distance from lower lip
of hood of cooking surface
Q =Cubic feet per minute.
Minimum Clearance .
from Combustibles 1R"
Minimum Clearance
from protected
COMhUStlhl('S 3"
Hood shall overhang
cooking surface at
least 6 inches on
all open sides
NON -CANOPY TYPE
Minimum volume of air exhausted:
Q 300
L = Feet (Front lineal-fetdt of
cooking equipment)
Q =Cubic feet per minute
GENERAL REQUIREMENTS
Type I — Grease Hoods:
Galvanized steel to be minimum No. 22 Manufacturer's Standard gage.
24 oz. copper or .030" stainless steel.
Type II—General Kitchen Hood:
Galvanized steel No. 24 Manufacturer's Standard gage, 24 oz. copper or
.030" stainless steel.
If gutters are provided, they Shall drain to an accessible. receptacle.
See Table No. 20-A for minimum distance. between lower edge of grease
filter and the cooking or heating surface.
Grease filters shall be installed in frames or holders with handles and
readily removable for cleaning.
All joints and seams substantially tight—use solder only for. sealing
joints and seams.
Approved fire -extinguishing equipment required for duct system, grease
removal devices, hoods and cooking equipment, see Sec. 2004 (h).
COMMERCIAL HOODS
NON -CANOPY TYPE.
(Side View)
Minimum Clearance
from Combustibles 18"
Minimum Clearance
from Protected
Combustibles 3"
Rc quired
capacity
300 cfm per
foot of
length
Cooking Surface