18294POST THIS CARD NEAR F:RONTOF BUILDING
PERMIT NUh18lA-` ,
:CITY -OF- CUPERTINO:' .,
18294•
INSPECTION DIVISION
JOB INSPECTION RECORD
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INSPECTION DATE INSPECTOR
INSPECTION RECORD
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FOUNDATION -
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NOTE:-. ` ' •''
;ANCE;OR 180"DAVS FROM
LLEDINSPECTION.
UFER ' ,
`ACL+GRADING AND DRAINAGE SHAUL' BE INSTALLED
LAST
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P.REGUNITE
SO'COMPLY•WITH THE APPROVED LAnNS, AND CITY OF.
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
HEATING .
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ELECTRICAL, RELEASE
PL(nlD ONE .
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INTERIOR SHEAR
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GRADE
FE ESUMMARV
EXTERIOR LATH
BUILDING "i 1
INTERIOR LATH
TEMPORARY APPROVALS '
BUILDING
361/37
SCRATCH COAT -
ELECTRIC,,
PLAN CHECK
GAS
FEEcu
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NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED.
OCCUPANCY.. - :''i
SEISMIC FEE
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OCCUPANCY,OFBUILDING ISNOTPERMITTED UNTILBUILOING FINAL ISSIGNED BY BUILDING INSPEvr,CTOR.
CROFILM
---
` AR'RANGE FORANSPECTION BY PHONING 252-4505,
ELECTRIC I"
�� ONE WORKING.DAY BEFORE REQUIRED INSPECTION.
2PLUMBING.''•'
0 " PLEASE GIVE JOB ADDRESS WHEN PHONING.
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— SEE PERMIT FOR EXPIRATION DATE:' '
MECHANICAL '
-
IMPORTANT!..
CONST: TAX
-'
PLEASE READ REVERSE SIDE BEFORE--
TOTAL
Hl�7,JV
CALLING FOR FINAL INSPECTION.,
OFFICE COPY:
PLICANT TO FILL.IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY`
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BU I LDI NG PROJECT IDENTI FICATION
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APPLICATION & PERMIT
. BUILDING - ELECTRICAL- PLUMBING - MECHANICAL
PERMITNUMB-- N-,,
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RUIREDING,
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OWNER'S I� • I�K�/ Q/41 i�/
NAME �r
_ tPHONE
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OTY. ELECTRIC PERMIT - FEE
PLAN CHECK VALIDATION
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:IRATE OF APPLICATION
CONTRACTOR'S,
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NA 60,07:574
Ca%'(�Q// / uc.uo (/
UT
UTLETS--'SWITCHES-'RECEP 10.00/1:00
TI10.00/1.00
CONTR ACTO I'S,
A Ress /j' r
APPLIANCES -RESIDENTIAL: 4,00'
PANELS 10.00
O c �e'r�
C.
PANELS (OVER 200AMP) 20.00
PLAN CHECK FEE P.c.No.
p�•% •7Z')
SIGNS TRANS. 3.00
ABC 0.7$6//1 {
ZIP Q.
SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
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ISSUANCE DATE
BLDG. ELECT. PLG. MECH.
Ibl ❑ ❑ ❑
EMP. METER OR POLE INS' 20.00
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AD eEss?s� CYYIJ/
a
MOTORS - SEE FEE SCH.
SERVICE CHANGE 20.00
LICENSED CON'I'RACI'ORS DECLARATION
I hereby alliin1 that I am licensed under provisions Of Chapter 9
IfomseJons g wills Section mlicense 700 i of Division San the Business and
License Gla COdI', anll my U IS m full fOfCC and effect.
License Class Lia Number
Date Contractor
- -.
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MISC. -' EFER ft
OWNER-BUILDERamexam t from RATION
' I hereby uNinn that I am exempt from Om,Conl raclor'sLicense
Law far the following reason. (Sec. 7031.5, B usinessand Professions
Code: city10.00
Andmol erectility which requiresap riot to U'msuanca hcq
improve, structure, prior to its issuance, also
requires, demolish, nd repair any permit
requires shed mustrult t such permit to ofle signed statement i that
he is licensed pursuant en the provisions Of the Contractor's License
Buw(Chand Profomms Code) or Section 7s 00) exempt herefon oof the
Business and Professions Code) or that he is exempt thereG 70 and
ttherefrom
the basis for the alleged exCmplian. Any violation of Section 7031.5
. by any applicant for a permit subjects the applicant ton Civil penalty
of not mom than flW, Immured dollars ($5001):
❑ I, as owner of the property, or my employees with wages as
their sole compensation, will do the work, and,tirestructure Is not
intended Or offered for sale (S,,..7044, wdueBusiness and Professions
Code: The Contruc[or's Licen. Law does nil apply toon owver oC
property Who builds or improves thereon; and who docs such work
hiniself,or through his own employees, provided that such intpr ve-
-cuts are not intended or offered for saler ll', however, the building
or. improvement is sold' within one year of completion, ilio owner -
builder will have,the burden W proving that he did not build or no-
Rmse for PERP'. af"d1).
❑ 1, as owner of the property, am exclusively in n lucling with
licensed Contractors to construct the project (Sec. 7044, Business
and Professions Code:' I' he Contractor's License Law does not apply
to an owner of property.who hands or improves thereon. and who
contracts ]or such projects with a contractor(s) licensed pursuant to
(lie Cont moor's License Law.
❑ tum Exempt under Sea ,B.&I'.C. for this
reason
. BUILDING PERMIT
INFORMATION
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PERMIT{ISSUANCE
VALUATION
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S/FT.
ELEC. CONTR. LIC. NO.
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ELEC.
TOTAL
PERMITTO
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OTV. PLUMBING PERMIT FEE
STORIES
RIE
TYPE
TYPE CONSTR.
A _ I He-
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ALTER 5.00
BACK FLOW PROTECT. DEVICE ., 4.00
DEC. GROUP
RES. UNITS
-
DRAINS -FLOOR, ROOF, AREA, COND. 5.00
FIXTURES - PER TRAP 5.00
-
GAS-EA.SYSTEM-11NC.40UTLETS 6.00
so. PT PLOOR AREA
b
TOTAL ACREAGE
' GAS - EA. SYSTEM -OVER 4 IEA.) 2.00
BUIL ING USE -
R S IND ' CON Pa Our.,
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-
INDUSTRIAL WASTE INTER: 30.00
LAWN SPRINKLERS- 1 INC 5 V.B. 6.00.
ASSESSOR SPARGE L NO..
LAWN SPRINKLERS - OVER 5 (EA.) 1.00
SEWER -SANITARY -STORM EA. 200tt/10.00
TRACT NO.
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PARCEL NO.
WATER HEATER W/VENT 6.00
Owner' Date'
WORK ERS'COMPLNSAI ION DECLARATION
f,heieby affirm That I have a evrltfWate ofcareent lo scif;insure,
(It a certificate of Workers' Compensation Insurance, ora certified
Copy thereof (See 3800, Lxh,C).
Policy No. Cnnmany -
WATER SYSTEM 5.00
ACC.DATE
ACC. FILE NO.
WATER TREATING EQUIP. a 5.00
ZONING ;'
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- ENG. SITE NO.
-
-
b Cert [I opy is hereby (uinished.
erHls(p�.' ry is c4 t /Iy.' city inspect iom Jivisinn.
Appli�-b•5�-/i�CYL1.
FIRE SPR(NK
y _ N
- ENERGY T-24
V N�`
MISC- - REFER TO ORD.JEE
CERIIFICA'Ili OF F-XF.MPfION FROM WORKERS'
COMpliNSAIION INSURANCE .
(This section need mol be completed if the permit is for one
certify that in the performance of the work for which this per-
mil is issued, I shall not employ any prson in any manner so as to become subject to the Workers' Compensation Laws of Carl ori is.Date Applicant
PERMIT ISSUANCE - :1000FLOOD
ZONE
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A.L.u.c.
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PLG. CONTR, ❑C. NO.
PLG,
TOTALv
OTV MECHANICAL PERMIT
- FEE SUMMARY
ALTER OR ADDTO MECH. 5.00BUILDING
NOTICE TO APPLICANT: If, aft cr making Ihis Ce it ifewc Of 1:s-
amption, you should bennno subject to the Workers' Compensafi'n
provisions of the labor Code, YOU must forthwith comply will,
such provisions or this Permit shall ne deemed revakul.
CONSTRUCTION LENDING AGENCY•
I hereby affirm that there is a construction lending agency for
the Perin nuance oA `the work for which this permit is issued (Sec.
3097, Civ.C). Iv Ung
Lender's Name_
APPLIANCE , 5.00
-
PLAN CHECK
FEE
I y�N] d -
AIR HANDLING UNIT (TO 10=C.F.M.) 4.00
AIR HANDLING UNIT (OVER IQOOOC.RM.) 6.00 -
SEISMIC FEE
8'LT. 06,
EXHAUST HOOD (WITH DUCT) 5.00
'
MICROFILM
HEATING UNIT (TO 100,000 B.T.U.) 8.00
Lender's Address
I certify that I have: read this application and slate slab the above
information is corricC 1 agree to comply with all city and county
... d munces and stoic laws relating to building construction, and
hereby authorise representatives ec this city to enter upon the
herebymentio rve property for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of
Cupertino against liabilities, judgments, costs'mul expenses which
may in.imIY, way accrue against. said City in consequence o the
gra j got' lis pernY s
3
HEATI NG UNIT (OVER 100,000 B.T.U.) 9.50
ELECTRIC
'
VENTILATION FAN (SINGLE) 4.00
PLUMBING
- BOILER,- COMP 13 H.P. or 100,000 B.T.U.) 6.00
BOILER -COMP IOver 100,000 BTUI SEE FEE SCH.
MECHANICAL
MISC. - REFER TO ORD. -
PERMIT ISSUANCE 10.00
•CONST. TAX
MECH. CONT. - LIC. NO. -
MECH.
DIAL
-
TOTAL
/CP M
Signature (Applicant/Contractor - Vale
OFFICE COPY .,% .
•
CUPERTINO SANITARY DISTRICT.—
SANTA CLARA COUNTY
DISTRICT MANAGER-ENGINEER 30085 STEVENS CREEK BOULEVARD, BLDG, C BOARD OF DIRECTORS
MARK THOMAS E CO. INC. COPE RTINO. CA 85014 WENDECURTIS LHARRIS N.sEcR. FS
(4081 359.7071 CURTIS B. HARRISON. BROWN N, seov
DISTRICT COUNSEL RICHARD JOSEPH F.
PHILIP D. ASSAF OF RIGH M.RUSHTON
STURGIS. NESS. BRUNSELL h ROY M. RUSHTON
SPERRY ..•.. ,,.-,
rzr•-_° November 7, 1989
File: CuSD - MOP
IYUY vo Building Department
(Cupertino)
&111 UF, 0P€RTINU
Higgins & Root, E1lmdaik&P &ECL
Titus, Architects
400 Blossom Hill Road
Los Gatos, CA 95123
Re: Northwest Y.M.C.A. Addition,.
20803 Alves Drive, Cupertino
(APN 326-32-039)
Gentlemen:
In our letter of Aril 25, 1989 to the Building Department of
the City of Cupertino, we advised that it would be necessary
for the existing sanitary sewer lateral to be Televised prior
to the discharge of wastewater from the new facilities into
our system. This existing lateral was constructed without a
permit being obtained and without inspection or approval by
the Cupertino Sanitary District.
The lateral has been Televised and we find that it does not
conform to District standards. The connection at the main
has offsets and there is an area with water standing in the
pipe. In view of this, we find it necessary to require that
the lateral in the street be replaced.
Please have a sewer contractor stop by our office to obtain
a sewer lateral permit and also arrange for inspection of the
construction.
Yours very truly,
MARK THOMAS & CO. INC.
District Manager -Engineer
by C. A. Auf der Heide
CAA:lw
cc: Building Department, City of Cupertino
Control #5202 Permit #17470
Public Works Department, City of Cupertino
SUPPLYING SANITARY SEWERAGE SERVICES FOR:
CITY OF CUPERTINO. PORTIONS OF THE CITIES OF SARATOGA. SUNNYVALE AND LOS ALTOS
AND SURROUNDING UNINCORPORATED AREAS -
CITY OF CUPERTINO F I L
10300 Torre Avenue., a Telephone 252-4505
INSPECTION NOTICE
BUILDING DIVISION
JOB 11 N J,1t75T DATE M7_/3_
ADDRESS 9O' ae TIME 3-/S
DAILY REPORT ❑ CORRECTION NOTICE ❑ VIOLATION ❑
TYPE INSP.: BLDG. ❑ ELEC. ❑ PLBG. ❑ MECH. ❑ i
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WEATHER _CZINSP.
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