26909 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINOPERMITNO.
APPLICATION/PERMIT PLUMBING.MECHANICAL ^^ 9 O
BUILDING DIVISION BUILDING PROJECT IDENTIFICATION L o `V
BUILDING ADDRESS: SANITARY NO. APPIICATIONSUBMHT'ALDAIE
UNRx LOTx Z y
Ow S NAME: PI IONS: CO 1) 'S NAM LIC NO:
3 NIC CONTROL,x
�ARCIFFECTAl1GINIHR: LIC NO, ❑
NNTACI': PHONE: BUILDING PERMIT INFO
QTY. ELECTRIC PERMIT FEE
r� PERMIT ISSUANCE BLDG ELECT PLUMB DCII
❑ ❑ ❑
LICFNSEniic CONTRACTOR OF,CLARATION APpLIpN -RESIDENTIAL JOB DESCRIPTION
rocIlt7")effDidcul iol3 of cenudunder Pruvnfimofm;Co&, od my jie is i1
=00 Smlim]000)of Uirisien J of the Bufircs4 sew Rofemi«u Code,sod my Ilceme i.in PANFl$
FY-Zw full f«nefdctfy� &/I
I6F.Zfu Dzrlt eCWs Lic.N - UP T02W AMPS (,/.`//
fFn�?vai Dnde CmtJrrm 201-1000 AMPS Sfl,FT.FLOOR AREA S/SQ,FT.
:CIA ION OVER 1000 AMPS
OZNO ludm s u rm«d.
Q- _J SIGNS EIECIItIGU.
Y 1' b
i K�V ER-BUILDFR DECLARATION SPECIAL CBtNR/h1LSC.
x O y crc - II 1 em c.acmlg from the Conlreclale Licmu V W f«dte
1+13 L`i following T03IS,Bmi.em sd Profmsi«u Code:AnY cry«rounry TEMP.METER OR POU INST.
C 1=0g which rtyuien it lu emstrvrl,nita,im
prove,eemohd,,nr
rt�h.ny umclwe
4n>7 pnnrto itsi ,WwtWuim Ne sppfunt r«soca pvmitwfik.sigircd uunmu POWER DEVICES
,<O Nu he is licemd P11TIndll to dte povivasts Of the CantMOn s Ucm.-V W(Chelgm
{{aa ss 9(1uhuncrcingwish Sttithm7 ).f Division Jof dx Bulinus and Prof.i«u Code) SWIMMING POOL ELECTRIC VALUATION
�yKj'4—'N er lhu W is esempl ds efmm ud dm buffs f«tine.Ikgd chunn"«n MY viol of
�Z¢ Snvim]OJ1.5 by any applir.ntfir af,nit subj24 the epplirnnt lnscivil pmWry f OUTLETS-SWITCHES-FIXTURES
—V .ulm«c than five Whi Mi.(&R()f !I
❑ I,mowovofllrprop nY,r.mYcmdoYem wish wttgwulhc'v.ole NEW RESIDFMIAI,PLEGIA _SQ.PI'. f RIPS TYPE CO UCIIO
a3— willanM1e wohsnd theswcwrc i.nOl inl<Mnl orotferd fm.wle(Sas] B
sd Profeuiau Code:the Control«'.Li.Lew dom n«spill to of
prcrsnn WWilds«improveslhctmn,endwhodomsucM1 wmt in gM1hie
own"loyem.,th ihdthetsuchhtprmenrnle imc f «for OCC.GR P RFS.UNI
M1owevm.the Wilding«imprwmrnt ulaNd within y bion,fhe owns TOTAL:
WilJcrwill havclM1eWNrnofpmvittgthu he 'd oortZ(
uk.).
❑ iiho iroftW pnrlcny,un ea<luxivcly coningi iCl:)Td ohm QTY PLUMBING PERMIT FEE PLO pZONE APN
Licso-l the cs i(5 ea.]0W.Buun¢i en Ro(cai Cale:)The 1.a'Inls
Ilanre Lr.WEom.t«epplYfo sithacofpopeny who Wilds«im tovm Commo,m's PERMIT ISSUANCE
Li Lov,(«cocaprnjccuwhM1.antratatfr)Bhnsd pursuant to d¢ContrenmS
urrnx I�w. ALTER-DRAIN&VFM-wATFR(IA) FEE SUMMARY
❑ Ism e.acmpt aMn Sec. ,H&P C fw tM1i.maven
J. BACK FLOW PROTECT.DEVICE SANITARY Y N
Owtmr Dun DRAWS-FLOOR ROOF.A .COND. RECF,IPTIt
WORKMAN COMPENSATION DECLARATION SCHOOL TAX Y_N
❑ IM1aeby efMntWtl hve•a.tifibse of caurnttn self-Insme,«•emlfuse of FIXTURES-PER TRAP RF:CEII'I'N
wmtill sh mmlion lminatce«ecmifidrnpytM1c.eM(Sa.31IW,Isb C.)wM1ich PARK FEE Y N_
Tyro,# aY/'JV((/ ` GAS-EA.SYSIF,M-I INC.4 OUTLETS � RF,CEIPf N
^ y 1 I� BUILDING DIVISION FIiFS
Co,❑ OAS-EA SYSTIcM-OVER 4(EA,) PLANNECK FFL
Cmlfd wily is filed-with the city impeclian div�srcm. GRFASFi/INOUSIRL WASTE INTERCEPTOR GRADING FEE
CERTIFICATE OF EXEMPTION FROM WORKERS GREASETRAP SOILS I2E
COMPENSATION INSURANCE
This salionrc not bemmdad lfthe pumit is for.htvWN dollm(SIW) SBWER-SANITARY-STORM Es.2G)Ff. F.NFRCY FF.H
«km)
l artily that in de perfmoena of the wort fawhrh Nl.pmnit is lssud.l sM1W WATER HEATER W/VEJPLI CTR
n«emd-Y sny pbem in soy mumu w u m b cos abjas to Ihn Workvs'
PAID
z Conlpcnmtiun l�W5 of C.lifomie. Due WATFA SYSTEtMRFATWG Due Rcceidis
Apdirw
z O NOTICE TO APD-]CANT:If.Nm mating this Cmificue M Eaemptir.you should NEWRESIDENTIALPLMB, SQ.FL.
f" (n b .uwbjcct to the Warta'.Cvmpmutim pmmthe
uisioofl s,,,Co,.you TOTAL
mw
a faNwilh mm ply with such p.ovisims a this ptnomn lW dtwrld mord BUD.DINGFEr.
per„ CONSTRUCTION LENDING AGENCY SEISMIC FEF,
Z Il by.flimt thu lhae is.c«u ho lvtling,to,the perfarmencc of
(� O the wnh(m which this pbmlt is ibud(S ,JW],Civ,C.) TOTAL: r1ECTRIC FEE
1,rcl Name
O F Imhor's Address QTY. MECHANICAL PERMIT FEE PLUMBING FEE
I artily dW 1 hevc rind this K Ai soiml.nd.find the.bout infonlunm is
mrteuL legrm 10 comply widt.11 ci,m,t moony adonsi and Of.,l.wa lel ding to PERMIT ISSUANCE MECHANICAL FEB
Wilding Lvnnrucfun,and hucby eulhariu rep.brnm,vn of tai.city lomtm upm the
U Z si mentrotntl Property for town, ALTER OR ADD TO MECH.
CONSTRUCTION TAX
(WOetVice to a.uc ' i!y en emticv 11e City of Cupertino eguml
liabillllb,judgmm chmsyin.nywsysccrvcsgsinnuidC AIR HANDLI,IG UNIT(TO 10,IIW CFM)
avm, bthi It.
AIR HANDL W G IINTT(OVER IO,OOp CFM)
Si 'anlnmm E%IIAUSTHOOD(W/DUCT)
PAID
HAZARDOUSMATPRTAIS DISCI ASU HEATING UNIT(TO IW,fpD OTU) Wte RaeiptN
Wi the lC-ent«fmu2 Wildingoccupenlel9,«I�dlcltuerdotmdS.fi al
Is defend io d i Cupenino Mwiclpal Cade,Clupm 9.12,ed tM1e HNIh sound Sefety HEATING UNR(OVpt 1 W,000 BTI!) TOTAL:
Code,Sav1125532(t)]
❑Ym ❑No VENTILATION FAN(SINGLE RFSID)
Will theopplicnnt«fulum buildingompenl us W BOILER-COMP(JHP OR I W,000 BTU) IWXCE DATE
ry t Air m Olity MWhkM1emil PAI
herudau su Wntnmimnle m defimd by dx Bsy Arta Air Quality Muugcment BOLTER-COMP(OVER I W.0(10 BTU) �
Di4 l
❑Yn ❑No NEW RFSIDFNTIAL MECH, SO,FT. -1 A Q ����
1 havA e IM1e huudus m
uaimre
s, quirtmmu usMy m Chs,, 6.95 of thY
e M FI
Cslifamis 1"IN&Softly Code.Seeliam 25NI5,25533 vm 25534.1 undauend this (� 'fes/1
iftl buildingdc.uhmtly M1avc uerumt,Nn spweibility i�k my rth,mNify dm ./'1I y(- �; '
a<upant M Bre nwitemrnu which mnsl be met prior to i,wwnc of s cenlr�a¢of
(xa,atil
Owmcr or sudxxlxd wnt Due TOTAL ISSUEDBY: _
OFF
�1.
CA-113ETth1O
10300 Torre Avenue
Cupertino, CA 95014
Buildin-Division
(408)777-3228
Fax (408)777-3333
November 28, 1995
Resident
7563 Dumas
Cupertino, CA 95014
Subject: 7563 Dumas, Permit# 26909 - Waterheater
Dear Resident,
• According to our records the above mentioned permit has never 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.
If your permit has not been fmaled, please contact the Building Department by
calling (408) 777-3228, so that we may arrange to extend your permit, and schedule a
final inspection.
In an effort to control the number of expired permits, the City of Cupertino
requires a response in ten working days from your day of receipt of this letter. If we do
not hear from you, the City of Cupertino's Building Department will have no
alternative but to resolve your permit as expired and discard the records.
Thank you for your assistance.
Sincerely,
City of Cupertino
P^OICd un Por.yrled P.wcr