2161 CI'T'Y OF CUPERTINO INSPYCTIOL RECORD (Office Copy)
2161 1139 Elmsford Dr.
PEP31IT MO. SANITARY DISI. NO. LOT NO. ADDRESS -----
• Solar Gerald Johnson
PROJECT OWNER JOB SITE PHONE NO.
PERMIT ISSUED Date ELECTRICAL
BuLlding _ 8-10-82 Date Insp.
FlectrLcal Power Pole_
Plumhing - - Under ,round _
Mechanical Rough Wiring _
Temp. Gns/Elect. Ual.ls _
Solar Ceiling
Fire Sprinkler Fixtures Int/Ext _
Si ,n Notors
Grounding
Hisc. Temp. Power _
Other
FINAL. INSPECTIONS Not Approved _
Date Insp.
"5 PLUMBING
Electric
Date Insp.
Pliimbin , Backflow _
Nechanical Underground
Solar Underfloor
Pool Partial Rough
Gradin, Rough Complete
• P1,inni.n p Solar Rough
Fire Dept. Water & Insulation _
Health Dept. "lain Drain
Building R/of/S Drain
Other Gas _
Other
BUILDING Not Approved
Date Insp.
Pad Certification MECHANICAL
Foundation Date Insp.
Pre-Gunite Underf.ioor S.H.
Slab-Hembrane Ducts & Insulation
Bond Beam Fire Dampers _
Underfloor Girders Fireplace _
Floor Steel Grease Duct & hood
Tiedowns One (lour Shaft
Di.aphrams Condensate Drain
Seismic Bracing Equipment Anchorage _
11al..ls-Panels Flues & Comb. Air
Frame Other
Lath Not Approved
Uallboards Int/Ext.
Firewalls
Other
to Not Approved
'APPLICANT TO•FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN O
BUILDING PROJECT lDENTIFICATION APPLICATION & PERMIT UTNUMBER
' T 2161
auaolNc
ADDRESS
3 ��m� hrd �., BUILDING - ELECTRICAL-PLUMBING -MECHANICAL
OWNER'S
NAME PLAN CHECK VALIDATION
^C TV. ELECTRIC PERMIT FEE
PRONE o
CONTRACTOR OUTLETS-SWITCHES-RECEP 5.00/1.00
rtlL
/1') -1C k-6/0WIC.NO.J�(..�'yJ� LIGHTING FIXTURES 5.00/1.00
CONTRACTORS
ItODRESS NTRA PPLIANCES-RESIDENTIAL 4.00
72 ? /l p
`Q/YZ nC ONE�t�- PANELS 5-00 DATE OF APPLICATION
ARRKCHITECi SIGNS 6.D8 - PLAN CHECFEE P.C.NO.
ENGINEER
OLIC,NO. SIGNS TRANS. 3.00 aor
ARCR'E s5 ENG, SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ZIP rrEMP. METER OR POLE INS. 15.00 ���/-'•�
APPUCANT'S
ADDRESS MOTORS SEE FEE SCH.
SERVICE CHANGE 10.00
D ¢ i
Foo LICENSED CONTRACTORS DECLA kA'TION
a i w I hereby al tion Ihut I um license) under provisions OI Chapter') ISSUANCE DATE
H ¢n (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
] Professions CgqlIjj.... y7�/�(in full fort Ia�f��-
i o w z License Class(r_ �Number -(J� �/ ❑
2 m E Date Cmm,.eU, Mj,iN%^An-G
¢ m s SOMA BUILDING PERMIT
¢ 0 i tj
a OWNER-BUILDER DECLARATION INFORMATION
w 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD
LL 0 a Law for the following reason.(Sec.7031.5,Businessand Professioles PERMIT ISSUANCE
VALUATION 5/FT.
Code:Any city or county'which reyuiresa permit m ecnstrucl,alle'. 6'00 2 0 i
QQ ¢ p improve,demolish,or repair any structure,prior to Its issuance.also ELEC.CONTE. LIC.NO. ELEC.
C a, requires the applicant for such permit to file a signed statement that TOTAL PER IT TO
wm he is licensed 9pursuant r- the Provksecti of the Cant nmtur'a License ��� �
rza Law(Chapter Profusions Code)th Section 7000)i"s,inf Dtheren3 of the
s 4 o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE
2 r$ the basis for the alleged urrot subjects
Any violation of Section malty STORIES TYPE CONSTR.
u ; _ by any applicant fore permit subjects theapplicanuoacivil penally ALTER-DRAIN -WATER (EA.) 4.00
of not more than five hundred dollars I SS00),I:
❑ '1,as owner of the property.or my employees with wages s BACK F LOW PROTECT. DEVICE 2,00 OCC.GROUP RES.UNITS
their sale compensation,will do life work,and the stn¢to ne is not
intended or offered for sal, (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 4.00
Code:The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who docs such work FIXTURES-P 4.00 SO.FT.FLOOR AREA TOTAL ACREAGE
himself or through his own employees.Provide)that such improve- %ftw ..�-
meatsare not intended oroffered for sale.If.however,the budding GAS-EA.SV$ =1 t 4.00
or impooemenl is sold within one year of completion, the owner- GAS-EA.SVST V R 4(E 1.00 BUILDING USE
builder will have the burden of proving that he did not build or in,
I.,purpose of sale.). INDUSTRIAL W RES IND CON PB Ocher
❑ I,as owner of the property,am exclusively'contracting with 20'00 ��❑ ❑ O
licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 5.00 ASSESSORS PARCEL NO.
and Professions Code: The Contractors License Law does not apply � _ N
to an owner of pr+p,rY who builds or improves thercon.undwho LAWN SPRINKLERS' .IEA.) 1,00 OY
conlmcts for such Projects with a contrucum(5)licensed pursu.nt In
the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/8.00 TRACT NO. PARCEL NO.
❑ I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 4.00
Date I UwnC, WATER SYSTEM 4.00 ACC.DATE ACC.FILE NO.
WORKIiRS'COM PIiNSA'TIO N DEC LA kAT10N
WATER TREATING EQUIP. 4.00 ~--
I hereby affirm that I have a certificae oI......ent to sell-insure,
or a certificate o1Workers'Compensation Insurance,or a certifiedNING ENG.SITE NO.
copy'there00,onmany - /Lab.0
c ' ^ - _4& -J INS • ,
I'oli<Y
O ❑ Cll L p S ll,reby lurni,hed. FIRE CPRINK EINERGV T24
Z ZPp Cer c p ciI- t i�division
O . MISC.- REFER TO ORD. Y>< N�
A licanl
~ rn LU CiRTIFIC EXEMPTION ROU WORKERS' PERMIT ISSUANCE 6.00
� FLOOD ZONE
W C MPENSTION ISURANCi
PLG.CONTR. LIC.NO. pLG. DO
0- Hhis section need not he completed if the Permit is for one TOTAL
Z v❑
hundred doll...($100)or less.)
U O_ 1 certify that in the tedormnnce of the work fur which this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL I- mil is issued,1 shall not employ any person in any mxnn,r so us to
O w become subject to the Workers'Compensation Laws of California.
ED Dam Applicant BUILDING
} W NOTICE TO APPLICANT: If,after making this Certificate of I*,. ALTER OR ADD TO MECH. 4.00
Z eruption,You should become subject to the Workers'Compcnsaliun APPLIANCE 4.00 PLAN CHECK
U such provisions the this or Code, you must forthwith comply wit11 FEE
permit shall he deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 3.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 5.00 SEISMIC EE
I hereby affirm that There is a construction lending agency for EXHAUST HOOD(WITH DUCT) 2.00
the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.) HEATING UNIT(TO 100,000 B.T.U.) 4.00
Lender's Name *iQ-F_S p_-G HEATING UNIT 100,000 B.T.U.)7.50
Lcndurs Address— - ELECTRIC
I certify that l leave read this application and stain list the aboveJBOI
ENTILATION FAN (SINGLE) 3.00
. information n correct I agree to comply with all city anJ countyPLUMBING
oNinonms Lod stain laws re tc to building costruction, andOILER-COMPI3 H.P.or 100,000 B.T.U.) 4.00hereby autlion/c representatives of ts city laLet. uponLER-COMP (Over t00,0008TU1 SEE FEE SCH.above-mentioned ro erI for ins ection MECHANICAL
P P Y P Purpasa.We) ree to save, indemnify and keep ImUDI,a9 the City ofISC.- REFER TO ORD.
Cuperti gains) liabilities,judgments,costs and expenses which PERMIT ISSUANCE 3.00 CONST.TAX
may i way accrue against said City in consequence of the ..�t
u 1 tis permit. F MECH.CONT. LIC.NO. MECH.TOTA �V
_$.DRd�A.M11 TOTAL
,ignal fAp icanl/Contractor Date
OFFICE COPY
r
• Citi of Cupertino
March 21, 1983
10300 Torre Ave
(408) 252-4505
Ext: 228,229
Mr. Gerald Johnson
1139 Elmsford Dr.
Cupertino, Ca. 95014
Dear Mr. Johnson:
After reviewing our files, we find that permit no. 2161
• issued on 8-10-82 for solar for hot water
has exceeded the maximum alloted time of 180 days since:
a1. ) Permit was issued.
2. ) Last called inspection.
Options for renewal are listed under Sect. 303(d) 1979 Uniform
Building Code. (enclosed)
In order to close our files, your cooperation would be appreciated.
CITY OF CUPERTINO
John Busto,
Building Official
JB:jj