26653 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO - NfrECRCTRICZI. PERMITNo.
HUILDINO.DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL 26653
RWOJE67 IDENTIFICATION
BUILDING AgQRESS: �+LDINC PR _ SANITARY NO. APPT1LICA�0/N�SII/BrgMHTAL DATE
LOT It
DWNr N E: a , �g E: CONTRA 'g NAME: LIC NO:
N� /)�{��'L/COy�NTROLk
S
•ARCHITF:CTBiNGINELR: LIC NO: ❑NIC L �.. vr1
CONTACT: PHONE: 'f - BUILDING PERMIT INFO
QTY.: ; r ELECTRIC�PERb1IT FEE
BLDG ELECT PLU M[C
�PERMITISSUANCE �
LICP.NSEDcenCONTRACTOR'S
unerpmviionsof DECLARATION APPLIANCES-RESIDENTIAL ']OB DESCRIPTION
O OO I h7").fem tha t am lice Business
n ss add irofes ions Code 9(co mmecensewith
Ia00 Section]OOID of Diviaian3oFlhe Business and Professions Code,and mylicemeis in PANELS
FF Bta1tr- full License
Clndeffecl. UP TO 200 AMPS
<ZUz,E Licmu Class LIC.N V- YYY
1-62 Dale Conrm 201-1000 AMPS
Z O,mn� ARCHITECTS DECLARATION OVER 1000 AMPS SQ.Ff.FLOOR AREA S/SQ.FT.
1 undersand my plans shall be used m public rccaNs. ^ O Q Q t
Oz-ppp SIGNS ELECTRICAL
CCQ Y1y Licensed Professional
OWNER-BUILDER DECLARATION SPECW.C[RCUIT/MISC. —7
NEI- I hereby affirm Net I um exempt from the Conaactore License Lew for the
NEI-
0.ya fallowing reamn.(Section 7031.5,Business and Professions Code:Any cityorcounty TEMP.MEfER OR POLE INST. 5
which"aims Permit o consumer.alter,improve,demolish,or repair any structure
EC Y,7 prior to its issuance,also requires the applicant forsuch permit refile a signed summer POWER DEVICES
ty C
<O that he is licensed pursuant to the provisions of the Contractors License law(Chapter
a P�4.o�' 9(commencing with Section 7(100).(Division 3 of the Business and Professions Cade) SWIMMING POOL ELECTRIC //��/VALUA
Worn orthatheisexempt Therefromand the basis for the allegedaamption.Anyviolmon.f OUTLETS-SWITCHES-FIX'URES ^ 8(., �
Z} Section]031.5 by nnymplicant far n pamitaubjects theopplicannoe civil perWty of L VV ��77 I
qr�. mm
n., c than Eve hundred dollars($500).
EQ ❑ I,asow°aroftheprope Y.Ormyemployemwithwagmmtheirsolecompemauon, NEWRESIDENTIALELECTR —SQ.FT. STORIES TYPECONSTRUCfION
3� will dolhewons and the he Contractor's
ontLaw
not apply to an owner
of O
and Professions Code The C s therson,License Law does not num m an owner of
ownpropertywyecsho ,pmvidedphmsuchimpmve ntsd asuctend hmfef froughhf, OCC.GROUP BES.UNITS
ownemployees,providedchatsuchimprov sold
witinnot inendedorolfcrcdforsal n rL
however.the buildingthorimprovement is sold within one year of reprove f r thepose of
builder will have the burden of proving tha he did nm build or improve for purpose of
sale.).
❑ I,ea owneroftha property,enexdusivdymntreding wiNlicensedcunuacmm to QTY. "PLWMHIIS- P RMIT FEF. FLOOD ZONE APN
curunaa the project(Sec.7044,Business end Pmfmsions Cede:)The Commnors
License Lawdceanor applymanownerofproperry who builds orimprovas thereon,add PERMIT ISSUANCE si'
whommacafursuch projects,with ammractor(s)licensed pursuant the Conwmory -License Law. AL'TER�D%-; 's'+TER IEA) �` FEE SUMMARY
C] I um exempt under Sm. ,B&P C for this reason p oCK PLO PP -� • D ES
�� SANITARY YN
p
Owner - Dole DRAINS-FLOOR, OOP, RECEIPT
AR_ st\�s~"• yy
WORKMAN COMPENSATION DECLARATION SCHOOLTAX YN
❑ I hereby afrm that l have a certificate ofconsent to selbinsure,or a certificate of •w '�, RECEIPTN
Worken'Compensation Insurance oreeertifieJ copy Hereof(Sec.3800,Lab CJ which FIXTURES-PER ` '+.. PARK FEE Y N
covers all employee's under thio Permit. GAS-EA.SYS .4OUTLETS7\b
Policyg 1 IN IV VyR))N FEES
Company GAS-EA.SYSTEM-OVER4IEA) \ ' \ PLANCHEC O
❑ Certified mpy is hereby furnished.
❑ Cmifed copy iv fled with the city inspersion diviaiem. GRE.ASFIINDUSTRL WASTE INTERCEPTOR GRAD
CERTIFICATE OF EXEMPTION FROM WORKERS' GREASETRAP SOILS rW "as-
COMPENSATION INSURANCE - (�
(This vecticnieedn.lbe completed ifthe permit is fmorce hundreddollaa($IW) SEWER-SANITARY-STORM G.200FT. ENERGY FEE I
less)
I certify that in the performance of the wart forwhich this permit is issued.l shill WATER HEATER W/VENT/ELECTR
not employ tiny person in any mermen a.m m Famous subject to the Workers PAID
Co-Kiran ion laws.(Calimmie. Data WATER SYSTEMTREATING Dae Receipt
O Z Applicant
Q NOTICE TO APPLICANT.If.alter making this Certificate of Exemption.you should NEW RESIDENTIAL PLMB. SQ.FT. OTAL:
rte-. hecome subject to the Woduces Compensation p xvici°m ofthe Labor Cade,Inumust a
af.mhwirM1 comply with ouch provisiona.nhia permit shillbeJeen¢d revoked. BUILDING FEF a�'a
CONSTRUCTION LENDING AGENCY SEISMIC FEE O
Z I hereby effort that there is a construction lending agency for the performance of F„6 M IC
U O the work for which this Permit is issued(Sm.3097,Civ.C.) rl V
Lenders Name
C Lenders Address QTY. MECHANICAL PERMIT FEE L I OFEE
CUL) 1 certify that I lave read this ii i mdon and stere Bad the above information is
correct.l agree to comply with all city and county ordinances and state laws relating to PERMIT ISSUANCE ME NICAL FEE
buildingcommuction,and hereby authorise representatives ofddschy roarer upon the CONSTRUCTIO •AX
UZ, above-mentioned property for inspection purposes. ALTER OR ADD TO MECH.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
liabilitiesjudgmcnb,cams and expenses which may in my way accrue against said City AIR HANDLING UNIT(TO 10,000 CFM)
in consequence of rhe granting of this permit.
AIR HANDLING UNIT(OVER 10,000 CFM)
Signature of Applienn4CoMoscmr Date EXHAUST HOOD(W/DUCgg PAID
HAZARDOUS MATERIALS DISCLOSURE HEATING UNIT(TO IN,"BTU) D e Receiptp
Will the applicant or future building occupant store or handle haxard.us material
as defined by the Cupertino Municipal Cwt,Chapter 9.12,and the Health and Safety HEATING UNIT(OVER 100,000 BTU)
Code,Section 25532p)? VENTILATION FAN(SINGLE RESID)
❑Yea ❑No
PISS CE DATE
Will the applicaromfuturcbuildingaccupanluseequipmemordevicmwhichemit BOILER-COMP(3HP OR IW,IXIO BTU) ,N+ ,n 0
hazordom air connmmuna as defined by the Bay Area Air Quality Management BOILER 100,000 RTU) W CY
imim, Fp.
❑Yes ❑N° NEW RESIDENTIAL MECIS. SQ.FT. /t
1 have mad the haaurdous materials requirements under Chapter 6.95 of the Cp y` 2 19gq
California Health&Safety Code,Sections 25505,25533 and 25534.1 understand and
if the building does not currently have a tenant,that it is my responsibility to notify the �f'•(
o
occupant of the requirements which must be met prior to issuance of a Certificate of ///�
Occupancy.
Owner or amhom.ed agent Data ISSUED BY;
OFFICE
t
I
WESTFALL ENGINEERS INC.
. Consulting Engineers
14583 BIG BASIN WAY
SARATOGA, CA 95070
TEL: (408) 867-0244
FAX: (408) 867-6261
November 3, 1994
PROJECT:
NEW CONSTRUCTION
11350 Bubb Road
Cupertino, CA
To Whom It May Concern:
This is to confirm that the foundation layout for the above referenced project complies with the
approved Site Plan and Foundation Plan.
Further, this is to confirm that the building pad was graded per the approved grading plan.
4 � _
No.4953
Harry Babicka tw
L.S. 4953 d,'
3, lF OF C AL%V (•.. .
ryD E
GHWE ;D
10 31994
BLK INSPECTION DEPARTMUR
. CITY OE CUPERTINO
SURVEYING CIVIL STRUCTURAL
•ocit.v nl' 10300 Torre Avenue
Cupertino, CA 95014
Ctipei t1.1' o Building Division
(408)777-3228
(408)777-3333 (fax)
May 8, 1996
Homeowner
11350 Bubb Rd
Cupertino, CA 95014
Re: Expired permit, #26653 (copy attached)
Dear Owner:
According to our records, the referenced permit has not been finaled by a City building
inspector.
. A permit is considered to be valid only six months from its last inspection date. If your
permit shows that the final inspection has been completed, please send a copy of the
permit along with this letter to: 10300 Torre avenue, Cupertino, CA 95014, attention:
Building Department. Our records show that the final inspection(s) only is missing.
If your permit has not been finaled, please contact the building department (408) 777-
3228, so we may arrange to extend your permit and schedule a final inspection.
The City of Cupertino requires a response within ten (10) working days from the date of
receipt of this letter. If we do not hear from you within this time, the building department
will have no other recourse but to resolve your permit as expired and discard the records.
Thank you for your cooperation,
Building Department Staff, City of Cupertino
Pnnren on Recvded Piper
__. •O
POST THIS CARD NEAR FRONT OF BUILDING 2 Gb„(„ 7RrH
CITY OF CUPERTINO ocft' r�
INSPECTION DIVISION
JOB INSPECTION RECORD
• — PERMIT EXPIRATION
JOB ADDRESS���� r66_L�P —UNIT Jk—_ _LOT# -
PERMIT EXPIRES IF WORK
UWNFH CONTRACTOR / / IS NOT STARTED WITHIN
SSU-
INSPECTION /DATE INSPECTOR INSPECTION RECORD 180 DAYS 8 DAYS FROM ANCE OR 180 DAYS FROM
FOUNDATION NOTE: LAST CALLED INSPECTION.
LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
TO COMPLY WITH THE APPROVED PLANS AND CITY OF ''t"^"T`'nl'Onl
PREGUNITE CUPERTINO STANDARDS.
GARAGE SLABS
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB
PLUMBING
ELECTRICAL i$SUANCt OAif
nwo f�tcr w:, of c„
MECHANICAL ❑ O L3
00 HOT POUR FLOOR UNTIL ABOVE HAS B�flN SIGNED BUILDING ER 1
. W►pIq�ATIDN—
WOOD FLOOR vn�unrinN SnT
PLUMBING
MECHANICAL rt„N„, TO
ELECTRICAL
FRAMING
Yla'nf5 rvvt q(ia Sr„
INSULATIONIfff ton1
urc raw'i„ R�$ .,NI Ts
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED cryo 11; IT
ROOF NOTE:NO FINAL INS BEFORE
. DIAPHRAGM THE CONSTRUCTIONT INC use
ROOF SHEATHING 'aS nr LON l '1'....,
1, 0APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS Dl INSP.
n5A S5UHS,•aH[EI \O
ROUGH SAN.# '
PLUMBING ELECT.ENERGY -' /O-
fNnl:l � 1 Pn Rf.'L Vfi
TUBS 8 SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGV
ACC DAt! nCC GILV.NO
ELECTRICAL BUILDING ENERGY
FRAMING ELECT.FINAL TEST n, wl FAG Sart No
INSULATION PLUMBING
GAS TEST GAS
flHf$f HINn ENf H(i' i]0
MECHANICAL
CO"RNO1111ONIf UNTII'YI ” $IQNlD”' HEATING
yC
EXTERIOR SHEAR ELECTRICAL RELEASE p -
INTERIOR SHEAR FIRE DEPT. t❑ N0 ❑ NL3
SHEETROCK GRADE O—C/ FEE SUMMARY
EXTERIOR LA1H BUILDING O^
INTERIOR LATH TEMPORARY APPROVALS BUILDING
COAT ELECTRIC PLAN CHECK
FEE
GAS
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC
F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING
o PLEASE GIVE JOB ADDRESS WHEN PHONING.
Z� • - SEE PERMIT FOR EXPIRATION DATE -
MECHANICAL
IMPORTANT! CONST.TAX
PLEASE READ REVERSE SIDE BEFORE TOTAL
CALLING FOR FINAL INSPECTION.