S 1850 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OFrCUPERTINO BUILDING-ELECTRICAL PERS IT NO. a� H O
NIDI LDINC 7TIVISION APPLICATION/PRRMI•f PLUMBING-MECHANICAL J 1
BUILDING PROJECT IDENTIFICATION
DING AADDDSIR: SANITATAPPIATION SUBMITTA�LpDATI
77 C1 E�Zr�6la AD ERS NAMEVNNy / 1'HON;:! ��ro CDO ZtACrOR'L NAML: hy � e-''4e) 4. NICONFROLM
RCHITIiCTNNGINEIiR: LIC NO: f�RF3r71/Gb.G/ 9'e 7 I2 ❑ O
CO TACT: �i PIIpN�53_,/ave F BUILDING PERMIT INFO
x 13 ❑ Consultant Fees Paid by Applicant(Initis? Batt' ELECT PLUMB MECH
LICENSED COSTRACIOR:S DECLARATION QTY ELECTRIC PERMIT FEE
I hereby amrm thin 1 am licensed under provtions of Chirac")(commencing _ JOB DESCRIPTION
OIZ with Sation 7(I(111)ofDivision3ofthe Business and Professions Cmdc.and mylicen.ce is RESIDENTIAL
WOO in PI:RMI'1'ISSUANCIi Q
I-�,I fall force and effect ❑SFOWL ❑KITCHEN REMODEL
IOU License Class Lic.M APPLIANCES-RESIDENTIAL. ❑ADDITION []PLUMBING RE-PIPE
F Q W Date Comet
y a ARCHrrEC'1'S DECLARATION ❑MULTI-UNIT ❑STRUCTURAL
F.D ran PANELS MODIFICATION
Z O m Z 1 understand my plans shall he used as public records
CZ4o UPTO200AMPS ❑INTERIOR E)CHIMNEY REPAIR
F�.F.W Licensed Profcssioml 201-1000AMPS 1 PROVEMENT C]SWIMMING POOLS
Y7� OWNER BUILDER DECLARATION OVIiR IINNIAMPS + ATH REMODEUREPAIR ❑DEMULITION
yC m Q 1 hereby affirm that I um exempt Gom L.Comer ors License Law for the
pxx.O a.V following reason,(Section 7031.5,Business and Professions Code:Any city or county SIGNS HLF,CI'RICAL OTHER
W 3 LL yQ which requires a permit m construct,alter,improve,demolish,or repair any svumure
mi prior to its issuance,also reforms the applicant lot such permit m file a signed statement SPECIAL CIRCUIT/M ISC.
F„!jy Ibm he is licensed porsuanto the Ionskimetafohe Coninaps,License law(Chapter 9 COMMERCIAL,
3a�pC (eommcncing with Section 7000)ofDivision 3ofthe Business aid Professions Ctde)or TF1@/ER OR POLE INST.
6 ye y that lines cecmpt therefrom and the basis for the alleged exemption.Any violation of ❑NEW BLDG/ADDITION C1 DEMOLITION
Semon 7031.5 by any applicant for ape.it subjects the upplicu ?sta
mm a civil ll,of 1' ICES ❑TENANT ❑FOOD SERVICE
of more Iban Use hundred dollars($500). IMPROVEMENT
C`Z"Q EJI,us owner of ohe pnopeny,or my emptnyees with wages as Weir sole compenation, SWIMMING I.E :C RIC
Will do he work,and the structure is not intendeduraRertd for sale(Sec.7044.Business ❑OTHER
M
and Professions Cod, e Cmnmetor's License Low does not apply to an owner ml' UIITLF�$ SW S- URES
property who huilds or Improves thereon,red who datesoch work himself or through
his own employers provided them such impowereems am not intended or oliemd for NEW REST 1,ELICTR SQ Fr.
sale.IL however,the building or i mpmwmeenr is sold within.,,,.year of completion.the SQ.F,FLOOR AREA VSQ.PT.
x�",Lrw
boilder will hove the burden of proving that he did mm build or improve for For,
f sale.).
as owner of the property,um exclusively contracting with licensed contractors to AL. r1
con net the project(Sec.7044,Business and Professions Calep The Contractor's I., ✓v)
does nor apply to an owner ofpmpcny who builds or improves lhereem,and QTY. PLUMBING PERMIT FEE
who contracts moment Imials with u eommctmLs)licensed pursuant m the Contractors
License Taw. PERMIT ISSUANCE
l am exempt under.Sec. ,B&P C for mason
ALTER-DRAIN&VIiNI'-WATER(I✓1) VALUATION
Doe
WORKER'S COMPENSATION of gin, n DECLARATION HACK FLOW PROTECT.DEVICE
ri jp
ve and Will Mai under penMryaftof uryonctdthe ff-ins re for decimations:
o 6
❑Ihave end willmuinmm uCenidicateof Cnmtscnnnself-insrrefor Workers Compcn- DRAINS-PLOOR.RWP,AREA,COND. $TORICS TYPE CONS'18UCT101
.tion,as provided for by Section 3700.1 the Labor Code,for the poformaner of the 5
k fm which Ibis permit is issued. FIXTURES-PERTRAP /
1 have and will m0inmin Workers Comrynewion 1n.u,,ruree,ns required by Seaton
700 ofthe LaborCole,for the performance ofmhe work for which this tremor is issued. GAS-EA.SYS'I" - .E OCC GNpNA APN
y Worker's Compensation Insurance currier and Policy number are:
Cormier. Policy No.: GAS-G 'I'P.M-O ' 4(BA
CF.RTIFICATEOFEXEMPTION FROM WORKERS' REA JINDUS'TRLWASTEINTI R
COMPENSATION INSURANCE
1 LDING DIVISION FEES
(Thissection need not he completed tithe permit is hoon,hundred dollars($I00) iRF. 1 9
PLANC BE
or less.)
I comfy that in the Performance Mum work for which this pentut is issued,I shall SEW -SANITARY-S9'ORM EA. If.
nom crployany Pc,,a in any smnnersoas to become subject nm dm Warkers'Comper- ENER'V --E e /
O Z sation laws of Califamia.Date WATER DEAVER WNENT/ELT:CTR
7 Q Applicant GRA NG PEE
a NOTICE TO APPLICANT:If,after making this Cenificute of Exemption,you should g
F^ N become subject to the Workers Compensation provisions of me Labor Cade,you m..% S LS FEL:
Lail .�,d forthwith comply with such provisions or this permit shall M deemed invoked. WATER SERVICE.
a'
CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMR. SQ.DTI'. YAI Receipt b
V Ihumbyeffinn tbut there iso construction lending agency l'or d¢I-ahmwnce of
2 00
Bre work for wlu'lido,permit,e. dIScc.3099 CIv.C.) D
QU Lender's Name w Ae^ �� —
RI Lenders
Addressr/ is ` /�
0. 1 certily dm 1 leave Cad this application and stain that he above indon new. BUILD G P. 2
► ran comm.I agree m comply with 11 city and county aNinanccs and state laws remtinp m QTY MIiCHANICAI.PERMIT FEE SEI. IC EE Q
building comloation,and hereby amhonte representativesnfthisciry loenl,,.,n the
above-mentioned property for inspection purposes. PERMIT ISSUANCE
(We)agree Io save,indemnify and keep harmless the Coyof Cutworm,against ELL IC FEF.
Iiabilirics,judmisids,co..andespouses which miry roar way aceme.timmi said City / ALT ER OR A&TO MECH. PLUM NG FEE O
in mnsrynP
he grant Orthis permit.
A'PI.1 ERS )S ANI WILL COMPhY WITH N.L XON-POINT AIR HANDLING UNI'1'0''0 Lq(XN)CPM) MECHA ICAL FEC•
St IR rl'1( b.
/f/ 1 AIR HANDLING UNIT(OVER 10,010CF) CtJNSTRUCTION TAX
Signature of Appli,mUCon r ctur )ate EXHAUST HOW(W/DUCTI HOUSING MITIGATION FEE
I IAZAR DOUS MATERIALS DISCLOSURE/
W,Dhe applicam offumre bei Ming.,eemeird soon or handle hazardous matedm HEATING UNI I'GO I N),000 BU)
as defined by the Cupertino Municipal Cade,Chapter 9.12,and the Health and Safety
Cade.Section 2553200? IDEATING UNIT(OVER 100,000 BTU)
❑Yea No - VHN iLAr1ON FAN(SINGLE RESID) PAID
Date Receipt x
Will the applicam or fu arc building occupied use equipment or devices which BOILER (311P OR 100.(X0 BTU)
emit hmallous air contaminant as defined by the Bay Area Air Quality
Management
TOTAL:
District? ROLLER-COMP(OVER IN),"BTU)
❑Yes �Nir
I have rend the breams. macrlalsrequirement under Chaprerfi95 of the Cali- ALR CONDI'f1ONER ISSUANCE DATE
uniixcal Sats Gdc.Satinna 25505.25533 unJ 25534.I OndcmwnJ Wm If rhe NEW RESIDENTIAL MECH. SQ.FT.
r rc dy .tenon,that it is my rcsp.,nelairly 1. miry themccupica
's is st meanoisuunm ofd Cesti�iuofAce
TOTAL: �•/-v ��
' Owne am r age Dam ISSUED BY:
OFFICE
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11/01/1999 12:50 4082556015 SUWYVIEW PAGE 01
RECEIVED OCT 2 8 1"S
• ' 10300 Torre Avenue
Cupertino,CA 95014
I Of
CUPEkTINO Building Division
5!9 (408)777-3333(fax)
October 28, 1999
Sunnyview
22399 Cupertino Road
Cupertino, CA 95014 Lr�l n v
�Go 1 .s
� SUBJECT: Permit# S 1850
Owner/Manger:
We have been going through our files in the Building Department, and contacting those .
people with permits remaining"open".
According to our inspection records,the subject permit has not been signed off by the
Building Department. Many times an inspector will sign the permit in the field,but
overlook reporting all of the information to the clerical staff for input into the computer.
If this is the situation and your permit card shows the final sign-off,would you please
contact us so we may complete our computer records?If the permit is not signed off,
please call to schedule an inspection for final closure of the permit.
Because of the large volume of paperwork within the building department, we cannot
separately monitor the progress of each permit. We ask that you give this notification
your immediate attention. If we do not hear from you within ten(10)working days we
will remove the records from our computer.
Tharnk-yotirfor your assistance.
Sincerely,
CITY OF CUPERTINO
Christy Akatiff`, Administrative Clerk
Pdmed w RarlaW Paper