27259APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
CITY OF CUPERTINO
BUILDING DIVISION ' APPLICATION/PERMIT PLUM ROJECTFIDENTIFIC
BUILDING PROJECT IDENTIFICATION
PERMIT NO.. �,�
BUILDING ADDRESS- + _
2'2 GUN 1. Or LI
SANITARY NO.
APPLICATION SUBMITTAL DATE
TR
OW:
E S AMB: PHONE:
CO RACTOIX$NAME: LIC NO
S M I IL
N/C
CONTROL#
IARCHITECT/ENGINEER: s LIC NO:
AD SgSisa o 344 s. 9S
f
CONTACT: PHONE:
-
QTY. ELECTRIC PERMIT FEE
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
t'1�f 0,
l�J
PERMIT ISSUANCE
LICENSEDCONTRACTOR'SDECLARATTON
SeDE DECLARATION
I hereby offirLICENSEDCONTRA CONTRACTORS
(commenemg with
pppLIANCES- RESIDENTIAL
- .I 0B pgSCyfpT1ON
"feV'yV'
Section 7000)of Division3mthe Business and Professions Code, and my Hama, is in
ful and effect. n
PANELS
y\ vVC.J,nI
V
ttnse Close . N i •1' '}�
Lic
Dem 1j'4l—a%{� Convector
UP TO 200 AMPS
,VM` •' `♦
201-1000 AMPS
ARCHITECTS DECLARATTON
I undereraid my plans shall be used as public records.
OVER 1000 AMPS
SQ. FT. FLOOR AREA
$/SQ. FT.
SIGNS ELECTRICAL.
it -
_
Licensed Professional
OWNER -BUILDER DECLARATION
SPECIALCIRCUIT/MISC.
1 hereby offrm that I am exempt from the Commewea License Law for the
,
TEMP. METER OR FOUR INST.
following reason. (Section 7031.5, Business and Professions Code: Any city or county
which requires a permit in construct, alter, improve, demolish, or repair my structure
priormin issuance, also requires the applicant for such permitto file a signed statement
POWER DEVICES
that he is licensed personal o the provisions of the Contractor'a License Law (Chapter
9(Commencing with Section 7000) of 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 to a civil primly of
-
SWIMMING POOL ELECTRIC
VALUATION
OUTLETS - SWITCHES - FLXTTIRBS
not mom than five hundred dollars ($500).
❑ 1,asownerofthepropeny,ormyemployeeswithwagesastheirsolecompensatim,
NEW RESIDENTIAL ELECIR _$Q. FT .
STORIES
TYPECONSTRUCTION
wil l do the work, and the swcture is not inrended pr offered for sale (See, 7004, Business
and Professions Cade: The Contractor's License Law does not apply to an owner of
prapeny whoeuildsorimpmves themon,and whadoes such vemkhirrselforthmughhis
n employeu;provided0setsuchimprav ante me notin¢ndedorotfered fmsale. If,
OCC.
RES. UNITS
h wever, the building or improvement is sold within one yearofcompletion, theowner-
builder will have the burden of proving that he did not build or improve for purpose of
TOTAL:
QT' PLUMBING PERMIT FEE
sale.).
❑ Las oveneroftheproperty, am exclusivelymntracting with licensed coneractorsto
FLOOD ZONE
APN
corawct the project (Sea 7044, Business and Professions Code:)'Me Character's
License Law does not applym anownerofpropeny whobuildsorimproves thereon,and
PERMIT ISSUANCE
who contracts forsuch projects with scoutmemr(s) licrosedpursumt to the Contractors
License Law.
ALTER WATER (EAI
FEE SUMMARY
❑ 1 am exempt under Sec. , B & P C for this reason
BACK FLOW PROTECT. DEVICE
OUTSIDE
Owner DamORAINS
- FLOOR,ROOFAREA,COND.
,
SANITARY Y N
RECEIPT#
WORKMAN COMPENSATION DECLARATION
❑ I hereby affirm that l have a cenificute ofmnseat to sel6msure, ora cenifiwm of
Workers'Compereatim insurancem acertified copy thereif(Sec. 3800, Lab C.) which
SCHOOL TAX YN
RECEIPT#
FIXTURES - PER TRAP
PARK FEE Y N
GAS - EA. SYSTEM -I INC. 4 OUTLETS
covers all employee's under this permit
Policy #
RECEIPT #
BUILDING DIVISION FEES
Company
PLANCHECK FEE
ElCertifiedcopylaherebyfumdishe
❑ Certified copy is Bled with the city inspection division.
GREASFANDUSTRLWASTHYN'I_
GRADING FEE
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
_
-'GREASETRAP u
SOILS FEE
Y
ENERGY FEE
(This section need nothe completed ifthe permit is forme hundred dollars($1-S
or less.)
I certify that in the performance of the work for which this permit is issued, Isha1
WATER HEATER W/VENT/ELECTR
not employ any person do my manner so as to become subject of the Worker%
Compensation Laws of Camilomia. Date
Applicant
WATER SYSTEM/TREATING
PAID
Date cipt #
NOTICE TO APPLICANT: IL after making His Cenificam of Exemption, you should
become subject to the Workers Compensation provisions of Ne Labor Code, you must
NEW RESIDENTIAL PLMB. SQ. FT.
,
TOTAL:
forthwith comply with such provisions or this permit shall In deemed revoked.
BUILDING E .
CONSTRUCTION LENDING AGENCY
SE 1
1 hereby affirm fiat there is a construction lending agency for the performance of
TOTAL:
E E
the work for which this permit is issued (Sec. 3097, Civ. C.)
Lender's Name
Lenders Address
QTY. MECHANICAL PERMIT FEE
PLUM N E
I coolly that I have read fins application and state that the above information is
correct. Iagace to comply with all city and county mdianne. and state ].a .]an., to
PERMIT ISSUANCE
MECHANICAL FEE
building construction, and hereby authorize representatives of this city to order upon the
abovementioned property for inspection purposes.
ALTER OR ADD TO MECH.
CONSTRUCTION AX
(We) agree to save, indemnify and keep harmless the City of Calendar, against
liabilities, judgments, costs and expenses which may in any way seems against said City
AIR HANDLING UNIT (TO 10,000 CFM)
in ton. ace of the granting of Nis permit.
ueCr`
/J/I. t3
�jL(/
AIR HANDLING UNIT (OVER To," CpbD
I— Det
Signature of ApplicanUC mctor -
EXHAUST HOOD(W/DUCD
'
PAID
HEATING UNIT ITO 100,000 BTU)
HAZARDOUS MATERIALS DISCLOSURE
Date Receipt#
Will the applicant or future building mcupam store or handle hazardous material
as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety
HEATING UNIT (OVER IW,ODO BTU)
IOTA:
_ VENTILATION FAN (SINGLE RESID)
Code, Section 25532nd?
❑ Yes ❑ No
Will thea licmtorfuturebuildin occu antus a ui
pp g p y pmir Quality whichemit
YazeNous air contaminants ea defined by the Bay Area Air Quality Manegemem
mdct7
BOILER- COW (THE OR 100,000 BTU)
ISSU CE DATE
pp
P „
BOILER - COMP (OVER IW,f100 B'rU)
❑ Yes ❑ No
I have read the hazardous materials requirements under Chapter 6.95 of the
n,
OMOV - 31994
NEW RESIDENTIAL MECH.—SQ. PT,
California Health & Safety Code, Sections 25505, 25533 and 25534. 1 understand that
' V
if the building does not currently have a tenant, that it is my responsibility to notify the
occupant of the requirements which must be met prior to issuance of a Certificate of
y�
CITY Uf UUIat1 Ve
5
Occupancy,
4 1 1
ISSUED BY:�
Owner or authorized agent Date
TOTAL:
CA -Hut
WOOD DESTROYING PESTS AND, ORGANISMS INSPECTION REPORT
This is an inspectioM report.only -- not a Notice of Completion
ADDRESS OF PROPERTY INSPECTED
ING NO. STREET CITY ZIP COUNTY DATE OF NU
CODE INSPECTION PA
65 CARTA BLANCA ST. CUPERTINO 95014 43 10/26/94 2
S TERMITE AND PEST SPECIALISTS, INC.
. Box 3449
Jose, CA
3 95156
77212(4)84Fg )
791-7722
4 25-812
PR0227
BY:
SENT TO:
Y OWNER:
9483C
-/�. Affix stamp here on Board copy only
A LICENSED PEST CONTROL
I OPERATOR IS AN EXPERT IN
HIS/HER FIELD. ANY QUESTIONS
RELATIVE TO THIS REPORT SHOULD,,
BE REFERRED TO HIM/HER.
a 1687334T ESCROW If 101035
PARTY IN INTEREST: FOX & CARSKADON 289 S. SAN ANTONIO RD, IAS ALTOS CA 94022 MARY STAIGER "-
ORIGINAL REPORT [] LIMITED REPORT SUPPLEMENTAL REPORT ®• REINSPECTION REPORT�W
•Sraginet
P 1687379T
Date
10/11/9
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GENERAL DESCRIPTION: THIS IS A SUPPLEMENTAL REPORT TO
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#6A & 6B OF OUR PRIOR REPORT
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DATED 10/11/94 & 10/19/94 ING STATE STA
BEARMP
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NSPECTION TAG POSTED: NONE — LTD INSPECTION
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JTNER INSPECTION TAGS: SEE PRIOR REPORT
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I ZRc4teu Uy _�buy 4ense No,.CA7g26 Signature �^
NOTE: Questions or problems concerning the above report should be directed to the manager of the company. Unresolved questions or problems with
serOlt
vices performed may be directed to the Structural Pest Control Board at 12131 8977838, 14151 5579114, or (916) 2632533.
You are entitledf$to ostein copies of all reports and completion notices on this property filed with the Board during the preceeding two years upon
^Ppayment of a 52.00 search fee to: The Structural Pest Control Board, 1422 Howe Ava., Ste. 3, Sacramento, California 95825-3280.
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2nd PAGE
OF STANDARD INSPECTION•REPORT ON PROPERTY AT:
22265 CARTA BLANCA ST. CUPERTINO
BLDG. NO. STREET CITY
1687334T 10/26/1994 9483C
i
STAMP N0. DATE OF INSPECTION CO. REPORT NO.
ABUTMENTS:
".„Item 6E:
Per Item #6C of our prior supplemental report and at the request of the
";.
concerned parties we submit an alternative correction for the conditions
found;
REOCNMENDATION: Remove a strip of stucco between the column for the arch and
the stucco fence. Replace the damaged framing in the column. Isolate the
framing of the fence from that of the column with masonry and restucco this
1`
area. Treat the ground next to the arch and drill and treat by the living
room fireplace using Dursban T.C. for the control of subterranean termites.
Restucco the column and fence and by the fireplace. No painting included.
a
Note: It should be recognized that these measures will not correct any
damage
or infection in the stucco fence.
****** This is a Section 1 Item ******
Item 6F:
We opened the stucco on the column immediately adjacent to the arae wall
g g 1
and no infestation or damage was visibly evident in that portion on this
.. ,• s('.
date.
RECOMMENDATION: Restucco this area.
'�•,,,•!'A`"
****** This is a Section 2 Item ******
NOTE: A PERMIT IS REQUIRED FROM THE LOCAL BUILDING DEPT. PRIOR TO COMMENCING
THE WORK RECOMMENDED IN ITEM # 6E. IF THEY REQUIRE ANY CHANGES OR ADDITIONAL
WORK BEYOND THAT SPECIFIED HEREIN, THERE MAY BE ADDITIONAL CHARGES ABOVE THE
ATTACHED BID.
REINSPBCPIONS: "A reinspection will be performed if requested by the person
who ordered the original inspection. The request for reinspection must be
made within four months of the original inspection. The reinspection will be
Performed within ten working days of the request. The fee for a reinspection
shall not be more than the orig1jiAl inspection fee. If an estimate or bid
was not given with the original inspection report, or thereafter, then a
registered structural pest control company shall not be required to perform
a reinspection." WHERE APPLICABLE, OPEN FLOOR/OPEN WALL INSPECTIONS ARE
NECESSARY IF A "CERTIFICATION' IS DESIRED, REINSPECTION FEE IS $85.00 PER
TRIP.
TREATMENTS AND REPAIRS COMPLETED BY TAPS ARE GUARANTEED TO REMAIN EFFECTIVE
FOR ONE YEAR, EXCEPT FOR PLUMBING, GLASS, LINOLEUM, CAULKING, OR OTHER
REPAIRS FOR THE CONTROL OF MOISTURE WHICH ARE GUARANTEED FOR THIRI Y DAYS.
"State law requires that you be given the following information: CAUTION -
PESTICIDES ARE TOXIC CHEMICALS. Structural Pest Control Companies are
registered and regulated by the Structural Pest Control Board, and apply
pesticides which are registered and approved for use by the California
Department of Food and Agriculture and the United States Environmental
Protection Agency. Registration is granted when the state finds that based
on existing scientific evidence there are no appreciable risks if proper use
conditions are followed or that the risks are outweighed by the benefits.
The degree of risk depends upon the degree of exposure, so exposure should
be minimized."
"If within 24 hours following application you experience symptoms similar to
common seasonal illness comparable to the flu, contact your physician or
immediately. 11
center (408-299-5112) and your pest control company
iat
y,"
"For further information, contact any of the following: Your Pest Control
Company (408-259-5900); for Health Questions -the County Health Department
(408-299-5955); for Application Information -the County Agricultural
Commisioner (408-299-2171) and for Regulatory Information -the Structural
Pest Control Board (916-263-2540), 1422 Howe Ave., Sacramento, CA 95825.11
REFER TO ATTA(iHED WORK AUTHORIZATICN FOR BID BREAKDOWN.
PLEASE CALL IF WE CAN BE OF FURTHER SERVICE,... THANK YOU.
TAPS TERMITE AND PEST SPECIALISTS, INC. --- License No. PR0227
WOOD DESTROYING PESTS AND ORGANISMS INSPECTION REPORT
f. This is an inspection report only -- not a Notice of Completion
ADDRESS OF PROPERTY INRPFrTFn
CARTA BLANCA ST. ICUPERTINO
NAPS TERMITE AND PEST SPECIALISTS, INC.
-N.0. Box 3449
;Sun ))Jose, CA 95156 ((gg �)
;,408) 778-2124 (40R� 251-8142 FAX 791-7722
CODE INSPECTION IPA
95014 43 10/19/94 13
Affix stamp here on Board copy only
A LICENSED PEST CONTROL
OPERATOR IS AN EXPERT IN
HIS/HER FIELD. ANY QUESTIONS
RELATIVE TO THIS REPORT SHOULD
BE REFERRED TO HIM/HER.
REGISTRATION # REPORT # STAMP #
PR0227 9483E 1828885T Escaou # TA101035
ORDERED BY:
+1
REPORT SENT TO:
PROPERTY OWNER:
PARTY IN INTEREST:
ORIGINAL REPORT E]
rvviulvlu "cu. W6 AUVOS CA 94022 MARY STAIGER
LIMITED REPORTS SUPPLEMENTAL REPORT ®" REINSPECTION REPORT ❑" "siempn#11687379T Date 10/11/--
1 N F S O F O D E F
GENERAL DESCRIPTION: THIS IS A SUPPLEMENTAL REPORT TO
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ITEM #6A & 6B (PARTIAL) OF OUR PRIOR REPORT #9483A
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VENTILATION
.ABUTMENTS
.'ATTIC SPACES
:GARAGES
,DECKS -- PATIOS
.'OTHER
OTHER -- INTERIOR
_OTHER -- EXTERIOR
DIAGRAM AND
'.2rid PAGE
OF STANDARD
INSPECTION,REPORT ON PROPERTY AT:
•
2226.5
CARTA BLANCA ST
C PERTINO
BLDG. NO.
STREET
CITY
1828885T
10/19/1994
94818
STAMP NO.
DATE OF INSPECTION
CO. REPORT NO.
ABUTMENTS:
Per Item #6A, areas have been opened and findings are as follow;
Item 6C: A faulty grade, drywood termite and subterranean termite damage was found in
the stucco arch column and wall by the :.garage.!
fireplace. Subterranean termites and
drywood termites were found in the 'stucco',surround for the living room
RECOMMENDATION: Correct the faulty grade,`._in stucco arch column wall' by
installing one row of concrete blocks ,at:;,the base. Replace all damage.
reclose stucco walls at living room 'fireplace and arch column wall per
current regulations. Match texture as best practical. No painting: included
in bid. Treat the soil adjacent to the"stucco arch and wall and living room
fireplace using Dursban T.C. (chlorpyrifos), for control of subterranean
termites. Refer to Item #lA of original; report for control of drywood
termites.
****** This is a Section 1 Item ******
Item 6D: Per Item #6B of our original report, only the family room chimney area was
• opened and no infection or infestation was noted on this date. The stucco
columns were not opened on this date..
-
RECOMMENDATION: Reclose and match texture as best practical. No painting
included in bid.
****** This is a Section 2 Item ******
NOTE: A PERMIT IS REQUIRED FROM THE IWAL BUILDING DEPT. PRIOR TO COMMENCING
THE WORK RECUMMENDED IN ITEM # 6C.'IF THEY REQUIRE ANY CHANGES OR ADDITIONAL
WORK BEYOND THAT SPECIFIED HEREIN, THERE MAY BE ADDITIONAL CHARGES ABOVE THE
ATTACHED BID.
REINSPECPIONS: "A reinspection will be performed if requested by the person
who ordered the -original- inspection. The -request for reinspection must be
made within four months of the original inspection. The reinspection will be
performed within ten working days of the request. The fee for a reinspection
shall not be more than the original inspection fee. If an estimate or bid
was not given with the original inspection report, or thereafter, then a
registered structural pest control company shall not be required to perform
a reinspection." WHERE APPLICABLE,: OPEN' FLOOR/OPEN WALL INSPECTIONS ARE
NECESSARY IF A "CERTIFICATION11 IS DESIRED. REINSPECTION FEE IS
TRIP. I , $85.00 PER
TREATMENTS AND REPAIRS MMPLEI'ED BY.TAPS'ARE GUARANTEED TO REMAIN UT=IVE
FOR ONE YEAR, EXCEPT FOR PLUMBING,,- GLASS;. LINOLEUM, CAULKING, OR OTHER
REPAIRS FOR THE OONTROL OF MOISTURE WHICH ARE GUARANTEED FOR THIR'T'Y DAYS.
"State law requires that you be given the following information: CAUPION -
PFSTICIDES ARE TOXIC CHEMICALS. Structural Pest Control Companies are
registered and regulated by the Structural Pest Control Board, and apply
pesticides which are registered and approved for use by the California
Department of Food and Agriculture and the United States Environmental
Protection Agency. Registration is granted when the state finds that based
on existing scientific evidence there are no appreciable risks if proper use
.conditions are followed or that the risks are outweighed by the benefits.
The degree of risk depends upon the degree of exposure, so exposure should
be minimized.,,
"If within 24 hours following application you experience symptoms similar to
common seasonal illness comparable to the flu, contact your physician or
poison control center .(408729975112) .and yourt control
immediately. 11 l company
"For further information, contact any of the following: Your Pest Control
Company.(408-259-5900);.for Health Questions -the County Health Department
(408-299-5955); for Application Information -the County Agricultural
Commisioner (408-299-2171) and for Regulatory Information -the Structural
Pest Control Board (916-263-2540), 1422 Howe Ave., Sacramento, CA 95825.11
TAPS TERMITE AND PEST SPECIALISTS, INC. --- License No. PR0227