27569 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO APPLICATION/PERMIT "" PERMIT ND. 2 7 5 6 9
BUILDING DIVISION PLUMBING-MECHANICAL
B IILDING PROJECT IDENTIFICATION
BUILDING ADDRESS
2 q) (,p 'NyI'��../y[� / 1/�1 • SANITARYNO. JAPPUCADONLSUBNUTTALDATE
-1 0� ✓, I `�•��(„i '✓�INITM LOT# ` Z 1 �
OWNERS NAME: PHONE: CONTRACfORs'S NAME: LIC NO: N/C CONTROLM
6®C6E scoilN -rj�P rn rfE
ARCHITECTIENGINEER: LIC NO: ADPRESS'
.0, 130n T449 see CR grist
CONTACT: PHONE: "q"V a T� +°_* BUILDING PERMIT INFO
QTY.r, n4 ELEETRIC PERMIT FEE
'#"u a 6Rr� BLDG ELECT PLUM MECH
PERMIT ISSUANCE KY El
LICENSED CONTRACT'OR'S DECLARATION APPLIANCES-RESIDENTIAL I--� (O�
0042 I hembyaffon deadm litt
I onudurdler provisiansm'Chapta9(commcem
en ,with JOB DESCRIPTION
[x100 Section 70N)of Division 3 of the Business and Professions Code,and my license is in PANELS
tF UE full force and effect.
<V" License Claws Lie.# ?go :1,1} UPTO200AMPS
LL
r L Dote COntractm 201-IOW AMPS
FOy3'ZARCHITECTS DECLARATION OVE0.1000 AMPS SQ.FT.FLOOR AREA S/SQ.FT,
0 Z IO 1 understand my plans shall be used as public records. SIGNS ELECTRICAL
Q� Licensed Prof-ssimal
Ly OWNER-BUILDER DECLARATION SPECIAL CIRCUrEMISC.
p GlyU 1 hereby affirm that I was exempt from the Contractors License Lew for Ne
LL OO1 following reason.(SttGoa7031.5.Business and Professions COde:Any city or county TEMP.METER OR POLE MST.
which requires a permit requires
the
alter,improve,demolish, repa'u any strunme
>V patheisscensed,also required moviv applicant for such esigned mammrnt POWER DEVICES
y'j K p p thin he is licensed pursuanuo the proviaiom of the nor's Wee Lew(CTepter
°'Ee�' 9(commencing with Section TOW)afDivision]O eBusiness end Pro siom Cade) SWIMMING POOL ELECTRIC VALUATION
tai m ardmmhe iseaempt Ncmrmm end Nebaais for eallegedcxcmption.Any ]ad..f OUTLETS-SWITCHES-FlXTURES
�¢ Section 7031,5 by any applicant for apermi bjecis the applmm6 pacivil Ity of
� � not more than live hundred doll.15W ''��a NEWRESIDENTWLELECTR _SQ.Ff. STORIES TYP CONSTRUC1lON
❑ LisowneroOhepraperry,Ormy a toy egno III ecompentax ,
L _ will do thework.and the itmctu.ia linen ffered for e( c.70*LBu ess
and professions Code:The Com cora Lo �s t apply men o in of
propertywhnbuildsorimprove odoes e{m�lm�pd himselfm ughhia
ownemployms.provided th uc amenex ggtoreadermoffered rsslalf, OCC.GROUP RES.UNITS
however,thebulliing or
pro Id with%i yearofemaphom theowner- TOTAL:
builder will have Ih n Of pmvi t the did not build or improve r purpose of
sale.). -„ `
13Z' acrofthep try,am exclusively convecting with Beer comnowrsto QTY'i� " ').„ PLUMBING PERMIT FEE FLOOD ZONA APN
minstuct Ne project(Sec.7 usanProfusiCa Contractor's
License Lew does not applyto onown i.e. d ons oda ropertywhnbvildsml oveathmrm. nd PERMIT ISSUANCE -
whommocNfofsuchpmjectawllltaeonur r(s)licmWpu Ito the Contractor's
License Law. ALTER-DRAIN&VENT-WATER(EA) FEE SUMMARY
❑ I stn exempt under Sec. B&P C far this reason BACK FLOW PROTECT.DEVICE
SANITARY YN
Owner Dam RECEIPT#
DRAINS-FLOOR,ROOF, GOND.
WORKMAN COMPENte ofoo DECLARATION SCHOOL TAX Y N
❑ ers'Co affrmlheJhave
rance oniceateedcopynersof(Sec.38,Oraccnificineof Fl%TURES-PER TRAP RECEIPT'#
Worked Compcnsesnder Bigemecenified copyQNcrcof(Sec.JSW,LebCJwhich PARK FEE Y N
coven all employee's under lhia pcmti}rsy///Q6 ,9y GAS-EA.SYSTEM-I INC.4 OUTLETS RDIVISI N
Policyp [l I l BUILDING DIVISION FEES
Company-__021M .� - — GAS-EA.SYSTEM-OVER 4(EA) PLANCHECK FEE
❑ Certifiedcopy is hereby famished.
❑ Cmified copy is filed wiN Ne city inspection division. GREASERIDUSTRL WASTE INTERCEPTOR GRADING FEE
CERTIFICATE OF EXEMPTION FROM WORKERS' GRBASETRAP SOILS FEE
COMPENSATION INSURANCE
(This section need not beeompleted ifthe permit is forane hundred dollars($IN) SEWER-SANITARY-STORM EA,200FL ENERGY FEE
or leas.)
I terrify that in the performance of the work for which this permit is issued,l shall WATER HEATER W/VENT/ELECIR
not employ any person in any rammer so aw to become subject to dm Workers' PAID
Compensation Lawaof Cvlifomia. Data WATER SYSTEM/IREATING Data R eipt#
O Z Applicant
O NOTICE TO APPLICANT:If,after making this Cenificme of Exemption,you should NEW RESIDENTIAL PLMB. SQ.ff. TOTAL:
uy become subject to the Workera Compensation provisions of the Labor Code.you must
�i forthwith camply whit such Provisions or this pcmdtshall he decmad invoked. BUILDING PER
0. Q CONSTRUCTION LENDING AGENCY SEISMIC FEE
V z 1 hereby affirm Net them is a construction lending agency for the performance of
the work for which this permit is issued(Sec.3097.Co.C.) L: ELECTRIC FEE
Lenders Name
k' C~ Lender's Addrcsa QTYs 11v MECHANICAL PERMIT -FEE PLUMBING FEE
r
U
1 certify Nat I have red this application and state Net the stove iws mtuing i6 ", ` s4 - "` MECHANICAL FE
ndin tennict comply withall
aunho and county
omentainancuand state lawsmi
sting the PERMIT ISSUANCE
U 7 above-gcnimand construction,saidhercbyaoetionrercsawas. tivu o(Ihia cirymrnter Ulanthe CONSTRUCTION
[, about-menlinne,property purposes. ALTERORADD TOMECt1,
(We)edg e nt save.indemnify and keep harmless Ne City of Cupenino against
liabilities,judgmcnts,coontindexprsper it. may in any wayecerueegeinm said City AIR HANDLING UNIT(TO IO,IXNI CFM)
sss��`///��///aaaaaq///qq fthe graining of this pemtil. G'/ AIR HANDLING UNIT(OVER 10,f100 CFM)
is con �����"/7
Signature of Applicant/ ctm Date PJ(HAD$T HOOD(W/DUCT)
PAID
HAZARDOUS MATERIALS DISCLOSURE HEATING UNIT(TO I010,000 BTU) Duro Receipt#
Will the applicant or future building Occupant store or handle haurdous material
as defined by be Cupertino Municipal Code,Chaptef 9.12,and the Health and Safety I[RATING UNIT(OVER I W,M BTU) T
Cade Seniors 25532(a)?
El Yes 1:1 No VENTILATION FAN(SINGLE REBID)
BOILER-COMPOHPOR IN,"BTU) ISS k CE DATE
Will the applicantorfutumbuildingmcupaat usamuipmenmrdeviceswhichemit j}� ' D
araMous air contaminants m defined by the Bey Area AG Quality Manngement BOILER-COME(OVER RILOX B'Tlp
nn?
❑Yca 13 No NEW RESIDENTIAL MECII. SQ.FT. DEC 19
��
re
I have ad the ha ndous materials mquirements under Chapter 6.95 of the
California I lealth&Safery Code,Sections 25505,]5533 end 25534.1 understand that
!1Y Ut Lou
if the building tinea net currently have u tenant,that it is my responsibility to notify the
occupant of We requirements which run be con prim to issuance of a Conifuln of
Occupancy.
Owner or authorised agent Dine TOTAL: ISSUED BY:
OF510E
WOOD DESTROYING PESTS AN ORGANISMS INSPECTION REPORT
This is an inspection report only -- not a Notice of Completion
ADDRESS OF PROPERTY INSPECTED N EE pFF 88
BUILDING N0. 5T0.EET CITY 21P C�WETY 4NSPECTION PRGESR OF
.0672 CHERYL DR. CUPERTINO 95014 43 12/15/94 12
TAPS TERMITE AND PEST SPECIALISTS, INC. =}t,t�W,,F'�"�' Affix stamp here on Board copy only
P.O. Box 3449 A LICENSED PEST CONTROL
OPERATOR IS AN EXPERT IN
San))Jose, CA 95156HIS/HER
( HISIHER FIELD. ANY QUESTIONS
(408) 778 5124 259-5900 (408) 258 0145 II'A ) 791-7722 RELATIVE TO THIS REPORT SHOULD
( )( BE REFERRED TO HIM/HER.
REGISTRATION /f PR0227 REPORT k 9599B STAMP At 1828795T ESCROW a 1401072
ORDERED BY: HOGIN & ASSOCIATES 10680 S. DE ANZA BLVD. #B CUPERTINO CA 95014
JUDY HOGIN
REPORT SENT TO: NORTHAMERICAN TITLE 20520 STEVENS CREEK BLVD. CUPERTINO CA 95014
TERESA WOM
PROPERTY OWNER: GEORGE SLOAN 20662 CHERYL DR. CUPERTINO CA 95014
PARTY IN INTEREST:
ORIGINAL REPORT ❑ LIMITED REPORT ❑ SUPPLEMENTAL REPORT ®• REINSPECTION REPORT E]* *Sta Dnp( 1829000T Datell 07 94
I N F S D F O D E F C E S
N O U U R U T A A A E X H
GENERAL DESCRIPTION: THIS IS A SUPPLE+ NPAL REPORT TO A T R B Y N H M R U L c D
C T T W G E P T L L E W
ITEMS #2C & 10A OF OUR PRIOR REPORT #9599A c N H E D U R W H T U S E
E E R O S O , Y L 5 R
DATED 11/7/94 BEARING STATE STAMP #1829000T. e R R R D D o D G D L
S E I A T R O D W R S V E
I C N N E O T O A E E A
IN
TAG POSTED: SUBAREA E E P N M R e R D E E O S
SEE PRIOR REPORT A O C T T R S M O L R S
IER INSPECTION TAGS: R T E E O T T N E I T
E I R S T S E T V 5 U
A O M S A E R
S N I C L E
T T
E B
S
1.SUBSTRUCTURE AREA SEE PRIOR REPORT X
2. STALL SHOWER SUPPLE!4WrAL INSPECTION See 2D 2E X
3 FOUNDATIONS SEE PRIOR REPORT x
4 PORCHES -- STEPS SEE PRIOR REPORT - x
5. VENTILATION SEE PRIOR REPORT x
B. ABUTMENTS SEE PRIOR REPORT x
7. ATTIC SPACES SEE PRIOR REPORT X
8 GARAGES SEE PRIOR REPORT x
9 DECKS-- PATIOS SEE PRIOR REPORT X
. 0. OTHER -- INTERIOR SUPPLII"gNPAL INSPECTION See10E
11. OTHER- EXTERIOR SEE PRIOR REPORT x
DIAGRAM AND EXPLANATION OF FINDINGS (This report is limited to structure or
structures shown on diagram)
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Ell cirY cuP ri�Rr� is
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JOtIN`:G. C 0 7826
rispected by LI ansa Na, Si nature
g
NOTE: Questions or problems concerning the above re ort should be directed to the manager of the company. Unresolved questions or problems with
services performed may be directed to the Structural Nat Control Board at(213) 897-7838, (415) 557.9114, or (918) 263-2533. �
You are entitled to obtain copies of all reports and completion notices on this property filed with the Board during the preceeding two years upon
payment of a $2.00 search fee to: The Structural Pest Control Board, 1422 Howe Ave., Ste. 3, Sacramento, California 95825-3280.
Ind PAGE OF STANDARD INSPECTION REPORT ON PROPERTY AT:
• 20672 CHERYL DR, CUPERTINO
BLDG. NO. STREET CITY
1828795T 12/1$/1994 9599B
STAMP NO. DATE OF INSPECTION CO. REPORT NO.
STALL SHOWER:
Item 2Dc During the course of repairs to thd-master-bathroom-floori-damage was--found--:�
to=ezt nd-into'the subflooring and wall plates behind and below the stall
'shower. --
RECCIMRSIDATION: Remove all wall tile, backing materials and pan from the
shower. Replace the damaged subflooring. Reinstall existing pre-cast pan,
moisture resistant backing and all new ceramic tile set in mortar. Note: Bid
does not include any cleaning, painting, texturing or repair of adjacent
wall or ceiling surfaces that may or may not be needed after new tile is
installed.
****** This is a Section 1 Item ******
Item 2E: It will be necessary to remove glass door enclosure to perform the repairs.
RECOMMENDATION: Upon completion of the tile installation, reinstall the
existing enclosure. (Note: Bid does not include cleaning existing unit.
Owner should direct water away from the enclosure when bathing and have the
unit frequently caulked/sealed. If this unit cannot be properly reinstalled,
a bid for replacement will be issued.)
****** This is a Section 1 Item ******
HER- BVTERIORS:
item 10E: Per Item #10A, we have removed the dishwasher and the damage to the wood
underlayment extends out under the linoleum floor covering.
RECOMMENDATION: Remove all linoleum and wood underlayment from the kitchen.
Install all new wood underlayment and standard grade vinyl linoleum.
****** This is a Section 1 Item ******
NOTE: A PERMIT IS REQUIRED FROM THE LOCAL_BUILDING_ DEPT_. PRIOR TO COMMENCING
LTHE WORK RECOMMENDED IN ITEM # 2D.fIF THEY REQUIRE ANY CHANGES OR ADDITIONAL
WOMC-BEYOND-THAT SPECIFIED HEREIN, THERE MAY BE ADDITIONAL CHARGES ABOVE THE
ATTACHED BID. IF SMOKE DEFECTORS ARE REQUIRED, WE WILL SUPPLY AND INSTALL
STANDARD, BATTERY OPERATED UNITS FOR A CHARGE OF $25.00 EACH.
REIINSPE=CM: "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 WAIS, 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 PLL)MBING, GLASS, LINOLEUM, CAULKING, OR OTHER
REPAIRS FOR THE CONTROL OF MOISTURE WHICH ARE GUARANTEED FOR TH3MY DAYS.
REFER TO ATIMIED WM AUTHORZZATICK FDIC BID BREAICDOfrTI.
PLEASE CALL IF WE CAN BE OF FEWTHER SERVICE.... THANK YOU.
TAPS TERMITE AND PEST SPECIALISTS, INC. ---License No. PR0227