29185 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-ELECFRLCAL PERMIT NO. Q1 I^�
BUILDING DIVISION APPLICATION/PEPNI1T PLUMBING.-MECHANICAL 291H5
BUILDING PROJECT IDENTIFICATION
BUILDING ADDRESS: SANRARY NO. APPLICATION SUBMITTAL DATE
7417 LLEAJLERG
&10"
NA±E: ��Drn PHONE COMRACI'OR'In fE: ��2 LICNO: 5� e
CS„ "' NIC CbMROLN
RCHTTECI9ENGINBER: UC NO: ADDRESS: ❑
s e D= vim. u_
CONTACT: PHONE,, BUILDING PERMIT INFO
❑ Consultant Feta Paid by Applicant(Initial) BLDQ ELECT PLUMB MECH
❑ ❑ ❑
LICENSED CONTRACTORS DT:CLARAIION QTY ELECTRIC PERMIT FEE
1 hereby.Dir.abet 1 oro licensed arvjcw m,,aimis a CFaper 9(camrrctring JOB DESCRIPTION
I^DOZ wiNSation1000)ofNviurm3ate Btry %s Rofcuionx Cndc,v m licem is
�O Y FGRMff ISSUANCE RESIDENTIAL
�FU Nt Gori ll li,rceaN eRat.v. les F 3. D !J ❑SFDWL C1 KITCHEN REMODEL
NZw Dsm94Spr_e Y11—yam Camnctar APPLIANCES-RESIDENTIAL, OADDD70N - El PLUMBING RE-PIPE
[_may ARCH[T`VTS DECLARATION PANELS (.1MULTTUNIT ❑STRUCTURAL
Zpv2Z I UMemarand nny'l...xhatual be imcd is Public accounts MODIFICATION
OZ—Q . UPTONX)AMPS
F y(,,,W Tirc��rcwi� ❑INfER10R CHIMNEY REPAIR
S
Ix
2(11-1000AMPS IMPROVEMENT YW� OWNER-BUILDER DECLARATION OVER I(gg1AMP$ ❑BATH REMOUIiVREPAIR ❑DEMOLETION
L l W 6 1 hemby affirm thw 1 am exempt tnnn the Com.cmrd License Law for ne
x p 6 U Iolbwing masun(Section 10315.Business and Pmfevxirw Codec:Any city or aunty SIGNS FJ.ECIRICAL ❑OTHER.-
THER. QF.PQ12- EJQoM
LLI LL O WhiO nquiten a permit to ctmwuct,eIt,,impro.e,demolish,a ac,:1 any structure 0
prim In its i.auen,e.also m,mass the epplicarmt for uucM1 p,tnit to rite a xigrcd.rrmement
y SPECIAL CLRCUTOM LSC.
�}
chat
rmsewiemd pmumn tothe of Division
or Ne B,,i.tsUPrifieLow(C odc),spair 9 COMMERCIAL
y'p0 that k is
xewi4 Sceienl0(p)t Didsion J oftleel exemptond My
Cmstof TEMP.MBTER OR POLI?TNST.
y that he is exetnp tmy app W the breis in the sts s exemption.Any violation of ❑NEW BI.DCJADDRION O DEMOLITION
LL^•c{ Smiom 10lI36Y anYsppli,sau fmspen,tit wbjecxa Oe aPpliwnmacivil Penalty of POWER DEVICES ❑TENANT ❑FWD SERVICE
y mrtoe,than rive hundred dollars MMCF).
(] I.uowrcrof de popcny.mmy empoyen wlN wegexn Neir sol,comwenwtiam. SWIMMING POOL ELECTRIC - IMPROVEMENTwill do the work,end d e mocrute u mat moss l 1 sir uffemd for sal,(Sev.]Ore.But.. ❑OTHER
and M,fccnicn.x Codcu Tac Conlraaor'x Liccosw Law dors not apply to an awrcr of OU71XI S-SWI TCHES-FIXTURES
Forest,odto Itu"or Improves tncta,rt,snd who Jon ash work himself an r Edb
his own empoyeca,povlded than such improv, can ere not intended m oRemd for NEW RMIDl IAL ELECiR SQ Er.
sale.If.however,the huiWingm i.psovrnm.m sold wi tame yeerofema,lefi..the SQ. T.FT.FRAREA SISQ.Fri.
owrcr�mildcr will have the burden of posing tint kdid ora build or impmvc for Pur- r`.� �!
pose of su e).
1,as owner ofde p ray,am exclusively romiceding with littr sed mtmixtors to TOTAL [/1
carsauct the Inoa mar
jcet(Sec.1004,Busieesx sand Pm(e.axiorte Castle)ThatComrstNe L- � O 1996
erv,Law& t atria a,an o ,a
wr of pnm impro
,erty who builds ves dwrcon,end QTY. PLUMBING PERMIT FEE MAY ^
who cmtrecu f«such pojexn wiN•cntlmctnrts)linmd pursuant m de CwIMoIs
License Lsw. PERMIT ISSUANCE
❑ In.,x,mpt under Scc. ,B&PC for Nis mcvm 011Y Ur kxUfL'IYIIIVV
Omer Lha ALTER-DRAIN&VENT-WATER(EAI VALUATION
WORKERS COMPLNSATION DECLARATION BACK FLOW PROTECT.
I hneby sly under penalty ofperjory one of the following decimations: ICJ/ l/v
CI IMveairs]will maintain Ccnifica¢nfGmmnunrclf-insum fu Wmtets Camlcn- DRAINS-ILWR.ROOF.ARIIA. N STORIES TYPE CONSTRUCTION
samon,u provided fire by Section 311X1 of the labor Code.for the pMomu,ee a Ne
wont far which this Permit is ia..M RKTURES-PER TRAP
❑I have rend will,mimicin Wohcr's Compenxama In.xumnc,,as teyuimd by Section
3100 uflhe lattxxr CsJe,fmde pisfomurccofthe wank fmxvhich this permit is usual. GAS-EA.SYSTEM-I INC.40GIl.ETS
MY Wial�f'e�x�xryry�E,ee tion 1�ryw M Policy�n�uQh�'''f rig OCC.GROUP APN
CumcnS,11SLRJ na NATIO r wile,Nn.;u/[�c �nO 6G GAS-HA.SYSIEJN-0VBR4(EA)
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE GRFASEANDUSfRL WASTE INTERCEPTOR
(ITla sextant recd not he contpkxed if the pmmit is for ore hurdrv.I dollars($I W) BUILDING DIVISION FEES
a ext.) GREASE TRAP PLANCHECK FEE
1 ccnifythatmthe crR.an of Nc wort Grxxhlch this permit it Issued.I CUII
nm person
employ soy In any manner xo ax w hcmm,wbj,cl to Nc Warton'Compen. SEWER-SANITARY-5rORM EA 2(111 Ff ENERGY FEE
Z anion U.,aCJia.Dm
ifor Dam WATER IiPATF,R WNENT/GLECIR
Z � APolicem � GRADING FEE
y NOTICE TO APPLICANT.if,utter making this CenOicra,or Exemption.you shored WATER SYSTEWFREATI NG
bttwrle wbjat to tan Wtnker's Com,smanion pm.,isims of Je Lsbur Cade,you must SOILS FEE
WW Gxthwith comply with such pmvisitns or Itis .it shill Is,deemed carolled. WATER SERVICE
is In
CONSTRUCTION LENDING AGENCY NF•W RESIDENTIAL.PLMIU SQ.FT. PAID Z 1hcrca of!drat ancon is a mnstructim lending far Inc Due Rccci M
U O r gagercy perrnntmw,nr p
_O E" the wont for which this PermmusedSex
d is mused( .J091.Civ.C.)N.
,
Lender's N
'� Lrotlefa Adlmu TOTAL:
�•x sgy I ratify dux 1 has,rred Nix application end some that III,al iammmion is BUILDING FRE
pi cmrexL l aeras e,comply w0h all city and coumy mdinatwcv and hone low.mleting u' QTY. MECHANICAL PERMIT FEE
U xZ building cowroctlon,and hereby euNvirc rtlre'ssicu x of this city to ertcr upon the SEISMIC FEE
'� above-trcmioml popery for imp,ction Wrpows.
(WO agree e,save,indcm if,and orep hmmle.the City of Copeman ogvost PERMIT ISSUANCIx. ELECTRIC FET?
Iiabiiitin.j Wgneas,rocs eel capemes which nmY in enY wvY serve agsinso said City
in consequence of the I;mnting of Nix pcnnit. ALTER OR ADD TO MECH. PLUMBING FEE
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINY AIR HANDLING UNIT(TO 10."CFM)
SOU REGI ATIO MECHANICAL FEE
_ _ AIR HANDLING UNIT(OVER 10,000CFM) CONSTRUCTION TAX
Si ore aAPpli uC 4 L
ne Dam EXHAUSTHOOD(W/DUCIT HOUSING MI'TLGATIUN FEL
HA RDOUS MAIRkIA1S DISCLOSURL
Wil the Iicant o future WiNing oc'ctlpant same m handle lurndm,x materiel HEATING UNIT"I W."BTU)
ea deGrod by the Cu,m.Municipal Calc,Chapter 9.12.and the ILeith and Safety
Code.Section 255J3p)1 HEATING UNET(OVER 100,000 BTU)
Dyes r-INo
VENTIIAIION PAN(SLNGhG RES]D) PAID
Will the applicant ne future building occupant use equipmom or deviax which Ila, Receipt g
'mit banrdnas
or cmumimms.dcrired by tM Bay Ate Air Quality Mevgene, BOILER-COME(JHP OR 100.000 BTU)
District/
❑Yea ❑No BOILER-COMP(OVER IW,M BTU)
I Imvc sol Oe hacank,ux IrwtcriuLr mquim. tx ottdc,Caaptcr 6.95 of tat Gli-
AIR CONDTTIONLR' ISSUANCE DATE
Dnlie Ha1N&Safety Coda,have
temp 25585,2.SSJJ std 3511.1 undvvaal the urtn, NEW RESIDENTIAL MECH. SQ.FT.
of the rgduestImcwhich love Istaunt,Natit iimYrcN,d.Celilrto unifythe trxviwm
a the rcylummrnss which mart he met Prim w iswmee ofe Certiflnt,of Occupancy.
Owner or authorimd ugeni Dam TOTAL: ISSUED BY:
OFFICE
STEVEt1 a. LIPNOUD Ong 226 2017 P. 02
. STEVEN A. ARNOLD — Civil Lnguteer, rnc. --- —
1r,71 —,PIE ALA%T0A.SUITE 33-, - SP.N,Ip.^-.E,CALIFORNIA f?5129 . TELErl-ONE (408)2Ffr9111
City of Cupertino 17 May 1916
Building Inspection
1.0430 S . Do Anna Blvd.
Cupertino, Calif . 95014
Subject: Enclosed masonry chimney at
7478 Fallenleaf Lane
Cupertino, Calif .
Gentlepece.ons :
on the 16 th of May !096, 1 inspected the fireplace
and the fireplace shoulder for the subject site.
The fireplace chimney was built without benefit of
reinforcing steel in the chimney .
The chimney may be rebuilt without removing t:he brick
below the shoulder provided the rebar is epoxyied into
solid mortar between the firebrick and the exterior brick .
Z have attached a sketch depicting the reconstruction
of the masonry chimney.
Should you have any questions regarding the chimney
replacement_, please feel free to contract rte.
Respectfully < :a I Lued ,
joy
/Steven A. Arnold
Civil Engineer
CE 22301
cc Jones Masonry
""n ant nFrlr. J . LA :'_".E"NC, PJILr NG 'N ;PECTICN
CALCULATED By _ -- lEN A t"' OLD +C� R'U.:
CHECKED BY Civil Engineer ------ --
1671 -rhe Alamoda Suite 305 DATE; - +R?
SIGNED BY SAN JOSE, (-AL.iF0RN1A. 95126
RCE N0. ______- _-- °RUJEr,1' 7Y7Q Fo%`•dGs n PAGE:__L_OF_�_--
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STEVEN A. ARNOLD — Civil Engineer, Inc.
1671 THE ALAMEDA,SUITE 305 • SAN JOSE,CALIFORNIA 95126 • TELEPHONE(408)286-9111
RECEIVED
MAY 241996
City of Cupertino 17 May 1996
Building Inspection By;
10430 S. De Anza Blvd.
Cupertino, Calif. 95014
Subject: Enclosed masonry chimney at
7478 Fallenleaf Lane
Cupertino, Calif.
Gentlepersons:
On the 16 th of May 1996 , I inspected the fireplace ,
and the fireplace shoulder for the subject site.
The fireplace chimney was built without benefit of
reinforcing steel in the chimney.
The chimney may be rebuilt without removing the brick
below the shoulder provided the rebar is epoxyied into
solid mortar between the firebrick and the exterior brick.
I have attached a sketch depicting the reconstruction
of the masonry chimney.
• Should you have any questions regarding the chimney
replacement, please feel free to contract me.
Respectfully s fitted,
Steven A. Arnold
• Civil Engineer
CE 22301
cc Jones Masonry
•
STRUCTURAL DESIGN . LAND SURVEYING • BUILDING INSPECTION . .
/ GENERAL CIVIL ENGINEERING SERVICES
CALCULATEDBY_=_ STEVEN A. ARNOLD JOB,NO.:
CHECKED BYCivil Engineer.
1671 The Alameda Suite 305 DATE: 7 qG
SIGNED BY _ SAN JOSE, CALIFORNIA 95126.;
/
C/ PAGE:`L_OQ__
RCE NO. PROJECT: 7�/.79
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