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APPLICANT TO FILL IN: INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONL��n�
�BUI LDI NG PROJECT 1 DENTI FIC/ 4
.BUILDING - APPLICATION & PE IT -
ADDRESS_ wAnA ' //�) BUILDING — ELECTRICAL— PLUMBING — MECHANICAL
OWNER'S -
NAME
�'` QTY. ELECTRIC PERMIT FEE,
c�Q- s ,�NE�SJ-o9a o
ER TN BER
- • 2 X21
-
PLAN CHECK VALIDATION
-
ANrRAcroRs
N�
NAME
. OUTLETS -SWITCHES - RECEP5.00/1.00
LIGHTING FIXTURES 5.00/1.00
LIC. NO.
DoR•s
ADDRESSDRESS
A
APPLIANCES - RESIDENTIAL 4.00
PANELS S.00
PHONE
DATE OF APPLICATION
ARCHITECT
OR
ENGINEER
LOC. NO.
.
SIGNS 600
PLAN CHECK FEE
P.C. NO.
0 w
SIGNS TRANS. 3.00
ARCH. OR ENG. -
ADDRESS
SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
TEMP. METER OR POLE INS. 15.00
ZIP
a /�
APPLICANT'S
' ADODRESS
MOTORS SEE FEE SCH.
SERVICE CHANGE 10.00
LICENSED CONTRACTORS DECLARATION
FRTI UISSUANCE
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 my license is in full force and effect.
Class Lic. Number
Date Contractor
DATE
-
-..BLDG.
ELECT.
❑
PLG:
❑
MECH.
El
AUGtoj�
AU8 982
BUILDING PERMIT
INFORMATION
OWNER -BUILDER DECLARATION
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 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) of Division 3 of the
Business and Professions Code) or that he is exempt therefrom and
.�"
MISC. — EFER TO ORD
VALUATIO l� S/FT.
vim,/
PERMIT ISSUAN _. . --� 6-00_
ELEC. CONTR. ,LIC. NO.
-
ELEC.-: •
TOTAL
PERMIT TO '
CITY. PLUMBING PERMIT FEE
STORIES
TYPE CONSTR.
the basis for the alleged exemption. Any violation of Section 7031.5
by any applicant fora permit subjects the applicant to civil penally
of not more than five hundred dollars(SSOO).):
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,C•OND. 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
F IXTUR ES - PER -TRAP 4.00
SO. FT. FLOOR"AREA
TOTAL ACREAGE
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
GAS - EA. SYSTEM - 1 INC.4 OUTLETS 4.00
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
GAS - EA. SYSTEM - OVER 4 (EA.) 1,00
BUILDING USE
RES IND CON PB Other
❑ ❑ ❑
INDUSTRIAL WASTE INTER. 20.00
licensed contractors to eonstruct the project (Sec. 7044, Business
a Contractor's License Law does not apply
and Professions Poop: property
to an owner of ro ert who builds or int roves 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 to
the Contractor's License Law.
SEWER -SANITARY -STORM EA. 200ft/8.00
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'COA1PENSATION DECLARATION
�--
�-�
I hereby affirm that I have a certificate of consent to self -insure.
or `a certificate of Workers' Compensation Insurance, or a certified
NING
ENG. SITE NO.�1
copy thereof (Sec. 3800, Lab.C.).
Policy No. Company
•
-
FIRE SPRINK
NE]
EERGY T-24
NQ
'❑ Certified copy is hereby furnished.
❑ Certified copy is filed with the city inspection division.
Applicant
MISC. - REFER TO ORD%
CERTIFICATE OF EXEMPTION FROM WORKERS'
PERMIT ISSUANCE 6.00
FLOOD ZONE
�LiLGp
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one
Y[:]
p -w C1
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, 1 shall not employ any person in any manner so as to
OTY. MECHANICAL PERMIT FEE
FEE SUMMARY
22p s
JO. 1
become subject to the Workers' Compensation Laws of California.
Date ApplicantBUILDING
ALTER OR ADD TO MECH. 4.00
NOTICE TO APPLICANT: If, after making this Certificate of Ex-
APPLIANCE 4.00
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 (TO 10=C.F.M.) 3.00
AIR HANDLING UNIT(OVER10=1C.F.M.) 5.00
SEISMIC FEE
71
CONSTRUCTION LENDING AGENCY
1 hereby affirm (hat there is a construction lending agency for
the performance of•the work for which this permit is issued (Sec.MICROFILM
3097,Civ.C.).
EXHAUST HOOD (WITH DUCT) 2.00
'
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 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 slate laws relating to building construction, and
PLUMBING
gQILER-COMP(3 H.P. Or 100,000 B.T.U.) 4.00
hereby authorize 'representatives of this city to enter upon the
above-mentioned properly for inspection purposes.
BAILER -COMP (Over 100,000 BTU) SEE FEE SCH.
MECHANICAL
(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
CONST. TAX
PERMIT ISSUANCE 3.00
®r,n h15 permit.
MECH. CONT. LIC. NO. -
MECH.
TOTAL
TOTALture'of
Applicant/Contractor a e
OFFICE COPY
C I T Y O F C U P E R T I N O
+ Building Division
PROJECT _Z1 Z,� Q
/ c A,� �iy��
CONTROL f#
ADDRESS /(�> S ah
AJ. �� �INz a �L ✓�
PEM1IT ##
rWNER -o u,¢
QE�aae_ S' ry1
PHONE -P r _oyev
SAN. N
OCd73/
ADDRESS
BLDG. TYPE
/
REP. LFA"
PHONE
OCC. GROUP
ARCHITECT
PHONE
ADDRESS
REP.
PHONE
CONTRACTOR
PHONE
VAL. $
ADDRESS
STRUCT.PLAN CK
REP.
PHONE
BLDG.PLAN.CK
PLAN CHECK HOURS
PERMIT FEE
� ✓
CAP FEE
CONST. TAX
ENERGY FEE
TOTAL FEES
.L.j
6 D
DATE REC.
DATE RET.
s`
BLDG. DEPT.
ENG. DEPT.
p
PLAN. DEPT.
STRUCT. ENG.
CENTRAL FIRE DIST.
-HEALTH DEPT.
-SAN. DIST.
-ENERGY
"HANDICAPPED
• C.I1'Y OG GUI)EIRIMO IIISPECTIOt' R[;GORD (Office Copy)
w^ Y
2321 10500 N. De Anza Blvd. / \
PEMIT P1O. SANITARY DIST. NO. LOT NO. ADDRESS
Handicap Ramp Four -Phase Syst.
PROJECT OWNER
PERMIT ISSUED Date
Buitdins -18-82
Electrical Power Pole
1'111mhinr Underground
Nechan ical Roup*h Wiring
Teml. Gas/Elect. halls
Solar Ceiling
Fire Sprinkler Fixtures Int/Ext
Sign Hotors
Grounding
Hisc. Temp. Power
FINAL INSPECTIONS
Date Insp.
Electric
Plumbing
?leclianical
Solar
Pool
Gradin
1'.lannin
Fire Dept.
Ilealth Dept.
P,,uildin
BUILDING
Date
Pad Certification
Insp.
Foundation C. 'T_
Pre-Gunite
Slab-Heribrane
Bond Beam
Underfloor Girders
Floor Steel
Tiedowns
Diaphrams
Seismic Bracing
halls -Panels
1- rame
Ln t
Uallboards Int/Ext.
Firewalls
Other
Not Approved
Other
JOB SITE PRONE NO.
Date I Insp.
Not Approved I
PLUMBING
Date
Backflow
Insp.
Underl;round
Underfloor
Partial Rough
Rough Complete
Solar Rough
[dater & Insulation
Main Drain
,t/of/S Drain
as
Other
Not Approved
HECHAN ICAL
Date
Underfloor S.N.
Insp.
Ducts & Insulation
Fire Dampers
Fireplace
Grease Duct & hood
One (lour Shaft
Condensate Drain
F.quipment Anchorage
Flues & Comb. Air
Other
Not Approved
BUILDING
ELECTRICAL
PLUMBING
11ECHANICAL
MISCELLANEOUS
( 6 ) Asiied Hiatlem 217706. te.raad�
Eei-9eed:attev--Rempe-hevte;-z}epee
e:esedte;-eee-veretee}-ee-43-hert-
sevee}-ehett-Neve-heedre!}e-ee-re-
qel:ed-der-seelrwe�•T-e:eepe-whew
the-leeereed!•ee-Aeedrel4e-she}}
woe-be-regelr•dv
83EA8P4iAMr-ReEerd}eee-e�-a}epeT
ramps-le-Areep-i;—Alv!•!ve-!
Aeeepeeele•-she}}-be-prevlded
' y1A-Aeedreltev
,}�?BModrail• shall bi placed on each side - of a eh "'an, •hall!
�Ee con C mous the fu an t o - t• Tao a e T • t0 31
i� ^-he• 2 to 8 4mm above the ramp •eclat• shall ext--r-
ana
imus of 12 !echos]OSmm ba7ond the top an bottom of the
.m and the and@ she be returns Sia• an onscloo o
handrails shall comply with Section -
,(T)1•Nhsra the ramp surface is not bounded by -• wall or fames '
and the ramp exceeds 10 last 30 0mm in length, the ramp.$hal,.
eomply with one of the following requirementes
(1)_A curb a minimum of 2 inches (Slam) In height &ball b•- _
provided at each side of the ramp, or,
(2) A wheal guide rail shall be provldsd; c•nEer•d 3 inches
(76mm) plus or minus one inch (23mm) above the surface of the
ramp • r.
ng)l"R.urfaces of ramps shell be slip -resistant an d•serlbed
in Section 2-3323.
ET:•iw�TA'amDn shall be constructed an required for stairways. "• •.4;`'�'•
�• .' ro ftp"�s'""''"eE`foe•_"ihs11;`3'tS�''1 ,'w :w � '
t
i insAul'lditias ,excipt who otheryl-007.regUlradx'nnd j .conditions a001iC'!
.
s a_.to. access or t en s ea sa c� ♦" �i in'oncit- tap v
h sletin'sbulld'in s shall. conform- to Sectlon, HC - an 'the fG14.'
' - t., -, :�: titer:, " ,r -•.`"y -
pe having elope ezc@ediog one vesticli to 13 horisom[al;,�
ahlt'11-have-handrails as required for stairways, except that inter- " .i
mediate handrails shall not be reguirada
t• j
4 fGSyil:andinas shall be provided at the too and bottom of -each
exceeding 30 inches (IbZmm) of vertical rise and at each chang
of directiop for ur ose of rest and sates Landin s are not
conal era n &term m mg oh
a max mum orizonta letenea o e
temp.
Slope Max. Hine Max. Horizontal Projection
in (ft)
1:12 30 (762mm)- 30 (9140mm)
1:16 30 (762mm) 40 (12190mm) 1"CHPTI08s Regardless of slope. ramps In Croup I; Division 1 %.
upancles shall be provided with handrails.
1:20 30 (762mm) SO (15240mm)
miry entrances to buildin
more shall have a minimum
may be 36 inches (914mm) clear width when the occupant load is
of 48 inches
In no cede sh
Doors n
the aiaogo t
the required
open. -
' (• � ��t 'sa dim
o@ition shall not reduce the minimum dimension
'door or ate sys
swinge onto any
-F dimension of 60
° an shall as
he strike alas
pe es
,H he ed a with eh
mm. nterm
lf the run of th
anarnas and an
�}
degree 9-shal 1 he
as measure in t
t "r
t F r
Lou of a top landing, measured In the dltncti
shall be not lose then 60 !nches(1324mm) who
age towardo a t the an
n . era a mor or ate
landing, such ae to s a have a minimum
tm o width &Ioa ed a vi the
!paha 132 m t th
s )
ten sot es& t an Z ne as mm to the a
of the door or ate at exterior rem • and not
mm at n erior ramp... ih. v1 th out from
e o snin ehall be the door width plus Inc
a ata an ings she!! have • !mansion a em
a ramp of not less than 60 Inches (1324mm) Ho
CVCCipa e[ coo ramp., it =•
A=18
-
i
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a t; til
o %t,.. ,+ZI ,_ .-Ts•C•� .a�. .r.. 'IN •�' - ��..�'R)
r
' �4'. U •.` G.}• -w fir;:
}
M
r^�`, .f.�.i��'! - ;R ���•.TY' .:h �..1.C•. x�+!rv.t .tea �'W:. �.. .Y '�T t TY�"4:1d.� .C'�xx. '?'•• arL�•_'w
..i.' ,.-h,..: E`:' .. I L:.' • �, F,'Y��'��-,.,+'�'. il• S �:'.,
.>t, �ryft `i �:••rv- (sl,y`
Fr':�..: �.. � .{` r. zit:G�'t,'7 • ':-J,i. t• I'I f Y - - Vie,'•'. .i�=il "'Y ..3... ..f:.
• `aux- n,•' Jr,",,� y
�;`F# ); �.. .i t'r".:..0 a., - -�;., _rte �: `'�; ;_f. •'.5�-4��'�^iy':c�.
•J-
~i' Wit.- - !. ,fi^-`:' _ 'j•>':� } ':d :'l" "�'+ �>'t
p£ '•i•L �. - .i.' tL,..:'- .�ri .•i').".- :�i,.•:'"';,-`I' -iis4`" .J. ..a".>�;� 7 i• •.g
MT
,•f- :. s. ::i!- .yl�•. fn' ,S '} `••'-f;' •.:.5'•i'ti'ytu. �:N+ }�,�. �q 'Y': rcr-„,. rt. .=�i.. ...
- y . .,.�� C ^ - _ .:l s' tl'T,�•t? � C!!=. rt. 3.. �:"i:• :.�.Al.:r l.�,J.� Yh• T�W'i'�`J4r•,. Y -�.. ,Y
^e;i .y e `+f=' XS"•1 '. -�t - ;'`:'dt "' ;:'�•',�y"•;...`;�Lr .•i -a.i � {4'�'�}Jw i�„ S•yf��'�.:.'
r.l, fs.;•t� V .A ✓ -,Y�P` ca *' F� � �'�, r;"•p 'n �'n�'t�r
,�' � L.� ' j of . _ >', � • f ti I ,{, 4;�` •�'�fu�.��„� � z {
When no door swings ---T When door swings
' on lending 60min onto landing
Z
3Mr Interes! max 142' min Door Md' Is
8144 mm' 1067 mm '
1524 m
360' Intel max
8144 mm
72' mM
1929 mm
Re"i"W
Straight Ramp Run
60" min
1524 mm
Batton Level Platform
Nota:
Maximum Horizonral Ols'tanoss of each
ramp and run vanes. Sae chary under
27308 1 360"' Internal max
9144 mm
360" Internal max 802
9144 mm 1324 m mm
72' min
1929 mm
Intermediate Level
Platform
Too platform
,J sin
mm 72" min
> 1928mm
As ibquirml
Ramp With Intermediate AMrampanwnrneathandreuand owb
Switch -Back Platform
IAe RaQtri.ed
Irrtermedlate .. �
PleYtorm .
72" mill
1929 mm
J- &r min
Intermidlatt'Turninq - I r f 1524 mm
'
Mattoon.As Amwb;ad
24" min. 1610 mml exterior and d ths/8'•-
min. 1460mm1 interior beyone rike
edge of a gate or door on the skis toward
which it swings.
IE
10
CL
ta'1??
'9»3?ri. i q - 61y`I- 9• —ti
C 5 SMI .. s Yn 3tY ai' Mhz;�
Ramp With Turpin PlatforrTt
/�'C`' ' ;;r3i. I _ yW. 1. �' '�i .` `'� -air Y+'ri• fr y F -w y y •�# i:.isl�iii.'yl� :'ra ,7•' y,� f.
I_ l• ',, .T}, , 1, t aL..•R �r{ys �� �y Srth�.�Y�l�'1. ^r
4 .. � �.1 s11 ... J,. 1.V .. nSic•.;'. i- i-•- ^;�[ Y � 31:%Y..'•'+"a :2- ' .X. `�4�t`a' he -M „!.
;.4r' .a.. � e..:' :;-v. "�.. t°-•7. h. .s-y'�s;.x+:�'aj'k=:?:.'.`..F�d,�i�kr�.
-
Ol -:n`' it J-
MaxMi • nr nprl - I
Ja"�..'
•
When no door
remp and nrn raNaa. SN chary urldiv
swings onto landing
/
When door swings
W min
onto landing
1524 mm
Door width plot
6 min
�1.
601524
1067 mm �a�
i y
Ramp With Intermediate AMrampanwnrneathandreuand owb
Switch -Back Platform
IAe RaQtri.ed
Irrtermedlate .. �
PleYtorm .
72" mill
1929 mm
J- &r min
Intermidlatt'Turninq - I r f 1524 mm
'
Mattoon.As Amwb;ad
24" min. 1610 mml exterior and d ths/8'•-
min. 1460mm1 interior beyone rike
edge of a gate or door on the skis toward
which it swings.
IE
10
CL
ta'1??
'9»3?ri. i q - 61y`I- 9• —ti
C 5 SMI .. s Yn 3tY ai' Mhz;�
Ramp With Turpin PlatforrTt
/�'C`' ' ;;r3i. I _ yW. 1. �' '�i .` `'� -air Y+'ri• fr y F -w y y •�# i:.isl�iii.'yl� :'ra ,7•' y,� f.
I_ l• ',, .T}, , 1, t aL..•R �r{ys �� �y Srth�.�Y�l�'1. ^r
4 .. � �.1 s11 ... J,. 1.V .. nSic•.;'. i- i-•- ^;�[ Y � 31:%Y..'•'+"a :2- ' .X. `�4�t`a' he -M „!.
;.4r' .a.. � e..:' :;-v. "�.. t°-•7. h. .s-y'�s;.x+:�'aj'k=:?:.'.`..F�d,�i�kr�.
-
Ol -:n`' it J-
MaxMi • nr nprl - I
Ja"�..'
•
remp and nrn raNaa. SN chary urldiv
Figut-6 33.11A
P This figrlri It Illustrative only of the applicable Building Siandards and doe not
;
f,^� delineaa the only means of complying with such standards.
Nh.
J, 18'FIS
1 `�L �.t
r, •} .. �
-i
moi`= �s
, .
5'�
- ref ,'Y .yj At '}•• >.'.� r •q •'.: i.L. ,u' r«i`'?rd_-','S
1:��; .. .�:. -:�. �,>"-✓si';i ,, �.�, ,�:,t. ? }i.
;Y2rt ,�'Yfi$�}•d:7! y,: fIQt1H'.�.��18
ThW figure is iilustsuiw Doty of the applieabl� BuUdinq Standaridi
/ lneate tfN only means of complying with such standards.•
I( '.•1':' = . ! . _ . , t,• � mss_ :•y-.
14j"A� 19
�v'...... nom.,
.. r