30328 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY -
CITY OF CUPERTINO BUILDING-ELECTRICAL. PERMIT NO. 2
O
3 O 3
,BUILDING DIVISION APPLICATION/PERMIT PLUMBING,-MECHANICAL J J G o
BUILDING PROJECT'IDENTIFICATION
BUILDINGADDRESS: SANITARY NO. APPLICATION SUBMITTAL DAPI
S . q6 .
(xWNF,HS AMC: - I'1{OHI?: CON'1'RAC' N. LICN(1
NIC CONTROL
ARCHITECT/ENGLNHER: LIC NO: ADDRESS:
JNTA(TU PHONE ,,//a�� BUILDING PERMIT INFO
9 96 -..244/V �) Congul[an[Fees Paid by Applicant(initial) ECT PLUMB METH
Izz
LICENSED ON'1'RAC OR'S DECLARATION QTY. ELECTRIC PERMIT FEE Jr��l\ IPpf\
1 hereby nitirm ohm I um IicemN under pnrvisiom of Cluptcr 9(commen<ine JOB DESCRIPTION
�s'Z wirhSmion7(XYO of Divisionlofrhe liusinesu roil l4dcs:innu Code,and myliccnxc is -
F,00 full foreems!elcer PERMIT ISSUANCE RE 1
gin. - •DWI. ❑KITCHEN REMODEL
QF.UU urcnse Cleats Lic.N APPI:IIANC85-RIiSIUliNT1AL
N W Dam Contractor []ADDITION ❑PLUMBING RE-PIPE;
1„py
ARCHITECTS DECLARATION PANELS ❑MULTI-UNIT ❑STRUCTURAL
Zphz 1undewnnd my plan,shall beaxedaxpublic records MODIFICATION
O Z� UPTO 201 AMPS
F r3-W Licensed ProfessionalElINTERIOR ❑CHIMNEY REPAIR
OWNER-BUILDER DECLARATION 201-1000AMPS IMPROVEMENT
I hereby ml that I am exempt from the Contractors License Law for the OVIiR I(1W AMPS ❑BATH REMODEL REPAIR I]DEMOLITION
x 3 S FU fallowing mason.(Section 7031.5,Business and Profession,Cade:Any city ur cnunlY SIGNS ELECTRICAL []OTHER
41 2 y which requires a permit In construct,alter,improve,demolish,or mpair any succlum
FLL�4 prior to itsissuance.also met,ims the applicant for such permit to file a signed statement SPECIAL CIHNIT/MLSC,
E�} that he in licensed prrstion to the pmvi.sions of the Contractor's License Law Chapter
tY�Q� (commencing with Sa110n700()of Division 3 of the lousiness and Profexslons Code)or TEMP.METER OR POLE(NST.
6% 60' that he is exempt therefrom and the hunts for the alleged enemptimt.Any violation of //��
W,•,m Section 70315 by tiny applicant tis a{ermit subjects the applicant m a Civil penalty of POWER DEVICES �N'PjANT )ION EI DEMOLITION
>• m mom than five hundred dcllerx(SMILE. ❑ F:NANT ❑FOODSERVICE
Lunownerofthcpropeny,orniyentpinyccnwilh wugex as theirsnlecnmpenxaion, SWIMMING POOL ELEC IC F �nX♦a♦
will do the w.,k,and the nwctum is not imelWcdoraffemid for sale See.7011 Business
`J and Pmentions Crde:she Contractors License Law does not apply to an owner of OUTIAll s-SWI TCUTS-41X9'URES
property who builds or,mproven Ihemm,and who does such work himself or through f r UUrCh I
his own employees,provided that such improvements em not intended or offered for NEW RESIDENTIAL ELECTR SQ FE
vale.If.however,the building I,nFo,,e snt'ismld within nneycarnfv ridetion,'he �1g SQ,
�IT.FLOOR AREA $/SQ.
moseponcfT.
builder will have the burden of proving that he did not buil)or nsimprove far par dZS
-
ol ilde
❑ 1,us owner of the property,stn exclusively connecting with licensed contractors to
construct the pryat(Sec.7044.Businens and Pmfgxionn Code:)The Contractor's Li-
cersa Law does not apply to an owner of property who builds or improves thereon.and QTY. PLUMBING PERMIT FEE
who roomers for such pmjectx wird•comracmgO IimnsN punuanuMitt,Comraaors
License Law. PERMIT ISSUANCE
❑1 um exempt under Sec. ,B K P C for This reams
ALTRI(-DRAIN Ac VENT-WATER LfA)
nw VALUATION
WORKERS
WORKER'S COMPENSATION DECLARATION BACKFLOWPR V DEVICE �I] `y ��N
I hereby union under p<nallY of pajmy one of the Fdlowing declarations: 0.``
Harmandwill muinWina Cenilicataof Consenttoulf-insurefm Workers Compen- DRAINS-fol— R STORIES TYPE onsaa,IIa CONS'fRIlCf1pN
m provided for by Secti37 W hu thof the Labor Cxd<, e performance 9f the
%,k for which this s til in issued. FIXTURES-PERI RAP
❑I have and will restrain Workers Compenxudon Inxursnce,as rencired by S.M.
370X)of the Lulnr Coda,lin thclerfonMince of the work for which th is permit is issued. GAS-EA.SYS'117M-I INC.4 OUTLETS OCCG APN
My Worker's Compa Mar
enmtion Lmirram tie,and Policy number arc:
Currin: Policy Na; GAS-EA.SYSTEM OVER 4(En)
C17R'I IFICA'rE Oil EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE GREASIVINDUSTRI.WASTE INTERCEPTOR
This section nsW nm be rote I t 1[the tin 6xnnc hundred dollars lSIIXI l.DI DIG[)[VISION FE
( p e m pi )
czah. or lea..)Lcertify ohminthe ryHomancco n workfor t s all
GREASFTRAP PLAN6,Q7FEE `L{
not employ any mmtm:r so ato becomcsubje1.the Caroni SEWER-SANITARY-STORM G.200 F' FNER F£E
o
Znation Laws of California.Date
Z O Applicant WATER HEATER W/VF.N'I'/hiLEC'1'R GRADING FE
y NOTICE TO APPLICANT:If,afar making this Cemliane of Enemplion,you shouldWATER SVSTLM?BEATING
a ; become subject to the Worker's Compensnlion provisions of that Lobar Code,you must SOILS FI?F.
> frnhwithcomply with such pmvinim,o,this PCmdt shall be thermal mocked. WATER SERVICE
0. Q
CONSI'RUCI ION LENDING AGENCY NEW RESIDEM'LAl.PLM B. SQ.FT PAID
U p (hereby affirm that hem in a Contraction lending agency for the performance of 'Dat Ci
{LFthe w,,,it ` which thispennif is iss.W(Sec.3097,Civ.C.)
U Lender',Name
B.l lenders Address O
gy I certify that 1 have mad this application and tram the the aMrve Imfomatinn is BUILDIN( FE
h correct.I agree to comply with all city and county orninaneex and state laws mlatingto QTY. MECHANICAL PERMIT FEE
U Z building construction,and hereby uehorirc representatives of thin city tosser upon the SEISM 'EE
above-mentioned property fist inspection purposes. PERMIT ISSUANCE
(We)agree In save,indemnify and keep harmless the City of C.,nern n agaiaa Fur: I F. LT�
liabilities,judgments,costs and east which may in anyway ucerm again said City ALTER OR ADD TO MECH.
in onxequence of the granting of this permit. PLUMBING REI
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10,11(X1 CFM)
SOURCE REGULATIONS. MECHANICAL IEE
n
AIR HANDLING UNIT(OVER IOIIW CPM) CONSTRUCT )NTAX
Signaare of Applicant/Convacmr Doc EXHAUST HOOD(WIDUCI7 MII
HOUSING MI ]CATION FEE
D,mm,MOUS MA'1rAe, ha DISCLOSDR[
Will theapplicantm(teen,building wcupamstoreor handle hmassamn matcdal HEATING UNIT GO 100,051 BTU)
ussin,Sed io the Culenine Municipal Coda Chapter 9,12,soil the IloJlh and Sully L Cr
Cade,Section HEATING UNIT(OVER 100.000 B'N)
E3 Yen Fl No
VI?NTRATION FAN[SINGLE.RESID) PAID
;oft
applicant or future building occupant use equipment or devices which Date Rao N
%ihm�
titoft ir comeminuntsCir defined by the Buy Area Air Quality Management BOILER-COMP(31{P OR 10),01X1 BTU)-
nMOILER-COMP(OVER 15),WB BTU) N3 L
C]Yen ❑No
I have mail Ne hv:Wous materials ren,ircmcnu uak,Chapter t95oflhe Cali. AIR CONDITIONER ISSUANCE DAT'F,
brims Health R Safety Code,Sections 25505,25533 and 25534.1 umdetvaed that it Its NEW RESIDENTIAL.MECH. SQ.IT.
building cost not currently have a tenant.that it is my rcurymsibiliry to notify the accupam
of the rtyaiaments which most be met prior to issuance of a Ucmficale of Occu,sury
Owner or authonxd agent Duo, ISSUED BY:
OFFICE
Inspection Query for a Specfic Permit 12/1/97
PERMIT#. IT,US"ST ISITUS"STREET Lot# LINSDESCRIP,1:.- ,i InsT DATEDESIRE DateDorie
e 30328 21901 DOLORES FOUNDATION LIFER 11/25/96 11/25/96
30328 21901 DOLORES FLOOR JOIST 12/3196 12/3/96
30328 21901 DOLORES MECH 12/3/96 12/3/96
30328 21901 DOLORES PLBG=R 12/3/96 12/3/96
30328 21901 DOLORES WATER AP 1214/96 12/4/96
30328 21901 DOLORES ROOF NAIL 12/26/96 12/26/96
30328 21901 DOLORES SHEARWALL 12/26/96 12/26/96
30328 21901 DOLORES EX LAT H 1/6/97
30328 21901 DOLORES FLOOR INSUL 12/3/96 12/3/96
30328 21901 DOLORES ELECT-R 1/23/97 1/23/97
30328 21901 DOLORES PLBG-R 1/23/97 1/23/97
30328 21901 DOLORES MECH-R 1/23/97 1/23/97
30328 21901 DOLORES FRAME 1/23/97 1/23/97
30328 21901 DOLORES INSULATION 1/28/97 1/28/97
30328 21901 DOLORES IINSUL 1/30/97 1/30/97
30328 21901 IDOLORES SHTRK NAIL 2/4/97 2/4/97
30328 21901 IDOLORES STUCCO WIRE 2/4/97 2/4/97
30328 21901 IDOLORES GAST 2/4/97 2/4/97
30328 21901 DOLORES LOT FOUNDATION 3/13197 3/13/97
30328 21909 IDOLORES LOT ELECT PANEL 4/17/97 4/17/97
30328 21909 IDOLORES LOT ELECT PANEL 4/18/97 4/18/97
30328 21909 IDOLORES LOT ELEC PANEL 4/21/97 4/21/97
30328 21909 IDOLORES LOT BLDG-F 4/29/97 4/29/97
30328 21909 IDOLORES LOT ELECT-F 4/29/97 4/29/97
30328 21909 IDOLORES LOT PLBG-F 4/29/97 4/29/97
30328 21909 IDOLORES LOT MECH-F 4/29/97 4/29/97
30328 21909 DOLORES LOT BLDG ENERGY FNL 4/29/97 4/29/97
• 30328 21909 DOLORES LOT BLDG-F 5/1/97 5/1/97
30328 21909 DOLORES LOT BLDG ENRGY-F 5/1/97 5/1/97
30328 21909 IDOLORES LOT MECH-F 5/1/97 5/1/97
30328 21909 IDOLORES LOT ELEC-F 5/1/97 5/1/97
30328 21909 DOLORES LOT PLBG-F 5/1197 5/1/97
fix. Z
/ Ae >1
Pagel
Inspection Query for a Specfic Permit 12/1/97
Iris ec"to"' UAIts Pass/Fiil[Code't
O S 4P
cc 1P
CC 1P
Cc 1P
JB 6P
D 2P
D 2P
D 2F
DS P
S 2P
JS 2P
S 2P
S 3F
cc 1 N
S 2F
S 2P
S 2P
O 2P
CC 2F
B 2 N
JB 2P
D 2F
D 2F
D 2F
D 2F
D 2F
• D 2F
D 1F
D 1F
D 1F
D 2F
•
Page 2
' v 10300 Tarte Avenue
Cupertino, CA 95014
Citi' of
11perti110 Building Division
408)777-3228
(408)777-3333 (fax)
January 30, 1998
Homeowner
21901 Dolores Avenue
Cupertino, CA 95014
SUBJECT: Permit # 30328, permit for single family dwelling
Dear Homeowner:
We have been going through our files in the Building Department, and contacting those
people with permits remaining "open".
According to our inspection records, this permit has not been finaled by the Building
® Department. Your last inspection was 5/1/97 where the building, electrical, plumbing and
mechanical inspections failed. 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 dispose of the file and remove the records from our computer.
Thank you for your assistance.
Sincerely,
CITY OF CUPERRTTIINNOO
Christy Akatiff, Administrative rk
P,wee on Rec voc Pacer