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P13288 fiii' �.IC EaIr17 � la.L'ill (ttit~ J)iCv1A'i(( IJ 1'bi'ThiIN Itiwl.7 LFiJ _. U:zf` OW Li13ING PROJIFCT IDIOM FICATION F ""' Pf dlilfaT kufutkr: �nauaa AFPLICA"";ON& PERMIT }1 IBUILOING-ELTCTRICAL-•PLUMBING MECHANICAL 13288 Lrjttt. .. PLANCIstICKYaLi sett "Oftr g Q TY. ELECTRIC.1098MtT �:. FEtf I " ,f UTLETS_BVYiTCaf ti•aSCEP tp.tk9/1.W f 4 1 a V J �- ! t LIGHTING e-IXfURIES 10,0011,06 j �rrt3gaa (1414 PPLIAN1,18•RESIDEN TIAL 4.00 . ANELS.. 5 G ti ,.�•.---- oAlf, r A .I^ATLGN tn3wi4a PANELS(OVER 2i0 AMP) :IO.OQ LA N r.tC N0: SIGNS TRANS, 3.00 AW1HEdMl SPE CIAll,C3R;U1T r+ofd Pt 0T_YALIJ; 'J7Aj �cicA -«rit•g zrr EMP.METER OR FOLE INS. 20,00 _ w -•--.•--^^• 0401111111116$ MOTOR.a: SEE FETE SCH. . w SEfiVIf;E CHANGE X20.00 t.�/+�f/ -s�3 egg LtC'tell$II3CAKfPAC'Pf3RS01:CLARATION p�/ I hereby xlnrm le lines t am arrscd urkier pluritnnu of C'huptar'3 -- C (commorwi"wilh Soelam 7QOpi or Division 3 of she business and _� i E DATE s Yrufeuraa C and my Ir snsr is in full 111 god rf(urin ,-Oil s Lieerne Lk.Nunlhrr_.7 r`i (�v 840ti. £Lf�T Pt ME N, P 1 t DfteW C'ontracror �'. a OWNFR-BUILDER DECLARATION �M� J BU{1,DIIdO PERMIT x I henby afflrm that I am exempt from II,Crrrttractor'sLiccose MtSG. - REFER TO ORD IMPORMATION t:.. "o Law fat the following raarAn.ts'ec.-1031,5,Hutiaess and livofessione ALUAi h PERMIT ISSUANCE .+ L N IRT. W y Ct dt;Any city or county which ivyuirtsa Ixmtis taconslrucf,allrr, 10.00 6� It Me triprote,demolish or repair any utrueturv,prior to Ili issuance,aho EC CO -A Llc.NO. t`3`"` J V X requires Ihr rpptkont for such petaiil to file a signed statement ilea ELEC. ix$ ha h Ile list pui,Waat to Linc prov,sions of the Contractor. s Llc'snw f+�i�� iraAWilt. c j71•1. TOTAL � Law!Clwuier B("llmen,wft with&�ctiom 1000)of Dr Wwi 3 out lie Hsnir,eu and Ptofs•rpiirex Code)or dot he is citcmpl tlterodunt and oTY, PLUMBING PERMIT pErE /4eZJ;_& N '� ISe baa,for file 4lkfrd Ta mpiwo,Any violation of Soctsoa 7O31.S A.;t by tvty adspficarit for a permit subKctt theappbcant loacird penalty S ORM YPE CONUR, of nu.nwre than five huadrM dolfars(SS001,) ALTER-DRAIN 8t VENT-WATER IEA-) 9.00 D i,as uwrsrr of the property,or my empk)yees wltii wgAt as BACK_FLOW PROTECT,DEVICE 4.n0 shcir.pie comppeenaatiots,will do thr work,mid tie ttruclurc is not fi RES_UNITS intended or otlered for wk that:. 7044,Bus n,+%d and Yrafesaioru DRAIN$fWOR,ROOF,AREA,CONfi 5.00 Code:The Contractor's Lkxase Law doer IMA Apply to ailowner or Ftoperbuilds ty who or improves thereon,and who does such work F I XTUR ES-PER TRAP 6.00_ bumacif or Ihrotgth his owa ewpiuyeas.Provided that such iniprove• iia FrFTfiaOit ARIA t rAL ACRt t E � , mends are rot Intended or pfferad for ink.If,huwawrr,the buildin,f GAS•E � .A.SYSTEM•1 INC,4{]UTLETS 6.00 4. or improvern al is sold wishia one veru of completion,the owner - prove wllt here the butd"of poring thal lie did not build ut uo. GAS-EA.SYSTEM•OVER 4(EA,) 2.00 t)iL tN 4 U51 prove 171 porpose of%*,f, INDUSTRIAL WASTE INTER.vu 30.00 AL-11 INO 6xilu PS 9rna d d contractors owner of tlu progeny,he rojecirSe .1044cling with _ © licensed c :crrCaturl the project(Sec.1W4,Uusimess LAWN SPRINKLERS•1 INC 5 V.6, 6.00 and Pnrfataiorro Code:lyw Contractor's Licenseiorpro Law duct not apply A S PA C L N to an owrrtn of ptol,eny who iwiids or bnproYes Ihercon,and who LAWN SPRINKLERS-OVER 6(EA.) 1.00 .�. contracts(Or such Pfck tt wilt a oe(racl*Ks)licensed pursuant tp theContrsewr'sLicarwLaw. SEWER-SANITARY-STORM EA.200ft/10.00 TgwcTNo, PaACELaf 0 i mi exempt ruwkrSee.�,,8AP.C.rot uus WATER HEATER W/VONT reason 8.00 Owner, Uatr _ - WATER SYSTEM WORKERS'CYEWATER OMNSATK)N DECLARATION RE ATTING t:QUtP, 6.00--- 5.00 ACc.DATA ILE N0. FEW TTRE I hereby affirm,Bial 1 have a ixrtificato of cunscnr w sell'-insure• or it ccair ads or Worken'C'ompentntion insurance,or a cert i" copy thereof iSitc.3800.Lah.0 I 2 NIN ENG.SITE NO, Policy No. Company._ G 0 ertified copy is hasiby funnichud. �.s Cerli fs fi with i* citcl' division, FIRE SPNtNK ENERGY t-14 O Appdcamt MISC.- REFER TO ORD. Y Q HE] Y Q No � t'diRTIFICA1 OF EXF, PTION FROM WORKERS' PERMIT ISSUANCE �10,00 t.'OMPtNSAT OIH INSURANCE' PLG.CON A. FLOOD SONE O UC NO. PLG, IThlt wcaoti need not is eompkwd if the permit is for one TOTAL Y© NL„3 Y C NO Y hundred drAWs(f 100)or k•A:d 0 a I certify that in lilt p rformiatee of the work for which this Per- IL mit h issued,i shah nut employ any person in auy manner w aFEE SUMMARY s to CITYMECHANICAL PEPAWIT FH$ D belomo subject to the Workers'Compirut lion Laws of Cslifernia. Date _rLApplicant _ ALTER OR ADD TO MECH, 5.00 BUILDING �/C ,�- � NATICE TO Af F4tCANT ff,afro snaking this Ccriifttalo of La- f.. -2 emplroa you should beiome sollika to the Workers'Compensation APPLIANCE provisions or the Labor Crete,you must roghwilh comply with 5_. 00 PLAN CHECK V such ptovnrons or this portrait shall be deemed rrrokcd. AIR HANDLI Ca UNIT ITO 1Oj1W OF,M)_4.00 FEE CONSTRU(TK Ai LENDING AGENCY AIRIIAMOL1yCaUNIT(OVER 10,Op(1C.F.K) u.00 SEMAIC FEE Q s 1 hereby affirm that there&a coilltruelnm lending agency fur EXHAUST MCoCD!WITH DUCT) 5.00 the pr rfwtnsnoo o she work for which that potmir is issued thee, 3097,Cir.C.). HEATING UNIT(TO 100.0008.T.U.) 8.00 lA(CF10FILM Lrndcr i Nara IL)tt�@- _ Lender's Address-- _ HEATING UNIT(OVER 1)0,0008.T.U.)9,60 f 'CIV -�� ELECTRIC l"(14 that I have read Chit appitcalion and stoic that the above VENTILATION FAN($I('rC)LE) 4,00 information is correct 1 ajrec to"Imply will 411 city and courtly wchnancvs and state laws iclating to building ;onstruc6un,and BOILE.'4-OOW(3 H,P.or;00,0008-T,U.) 6.00 PLUMBING ✓ hereby authorize representatives of this city to enter npon,the _ above mentioned property for neipaction purposes, E 0_1LER-COMP(Oy#t 1,,r10A00 BTU$SEs-FEE$CH. MECHANICAL (We) y p y -�-' agrca to wvo, indemnify and lees hannlets We Cu of M!SC.• REFER TO ORD, Cupertino agairrst lirbditics,judtuicnls,4urls and exlxnsrs wldch �- ^^- --- �may in ray way ae', said city to colw•yuritce of the PERMIT ISSUANCE 1000 CONST.TAX n f chis pertnaL MECM•CONT- LIC.NO. Mi of Applicant TOTAL dytr� TOTAL S �