28087 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINOI. u-ELLE CAL PIRMITNO. 008 1
7
APPLICATION/PERMIT PLUMBING-MECHANICAL
BUILDING DIVISION PROJF,CI'IDENTIFICAll ION 8
U NGADDDDRFSS: F SANITARY NO. APPPLICAT1ONSUBMI TTA�LDATE
• 9-41 • 6 1 kc'mak`a i e-' UNIT# LOT# YI�`
O MSN PHONE: CI OR'S NAMg� ' LIC NO: N& •l CO`M'ROLM 7
n i O,fWS-riWaILIt,
RCIIrrECT/FNGINFFR: LIC NO:
SL ❑
CONGACP'. PHONE:
QTY. ELECTRIC PERMIT FEE BUILDING PERMIT INFO
Cf PLUMB MECH
PERMIT ISSUANCE, 11 E]LICENSEDCONTRACTORS DECLARATION APPLIANCES-RESIDENTIAI, 1 DESCRIPTIONpyy EherebyeRnnthml an liccosed trailer povl.slonrofCTam9 r (c«urcrcing wits �'S
[s00 Sell force
7000)of Divi 3 d the Bmioca said Pmfeva«s Coal vd my licenss k ie PANEI9 ,pOO
full and eRccl.
FdF.% Uv—Clan Liu.X UP TO 2110 AMPS
In<N Date Cnmract« 201-[000AMPS
7 F0Nz ARCHITEECPSDECIARATION OVER If100AF1P5 SQ,Ff.FLOOR AREA $)SQ.FT.
Oz—p I utdmwd my glass,xMI W used m Public rec«ds.
P t SIGNS ELECTRICAL
Q a'' L;�vee Ron rhnnl
KK OWNER BUILDER DIICIARATION SPECIAL CIRCUIT/MISC.
XO. 1 hereby af(ron thm E sm eeemps(rain W Contmcut's License Law r«We
W LLy folbuing..(Seedon 7031.5.Bulini and Prefdiom Code:Any city ex eaunry TEMP.METER OR POLE INST.
7E�-0.1 which rcquira'a Pemtit to comooct,eller,iml!rove.dennlish.«repair any rwenoe
>-:� prior to in i000mee,.h.mquimthen,licmm larauah poral w flee mgmud alelCt i POWER DEVICES
wa�pp Nu he is llcenxJ Pusuanl to the govui«u'ofrhe C«umctNa License law(Chager .
LL 9(c«mmrring with Bastian]0001of DivivonJoJthe Bmircv and Pmfeviom Cade) SWIM)4ING POOL ELECTRIC VALUATION
ly�j'g_'en «tlw he is exempt thcrtfvnard the hari.f«dr alleged eaRllPl1«I.Aay,.I.Uwof I
FZQ
Section 7031.5 by say sppllcanl Or a P it whjecls the isplkamuo a civilprnJry of OUTLETS-SWITCHES-FLC]TRPS
C,�,lec nit mum than five hundml Jnllur(5500). _ NEW RFSIDF IALP.LECIR SQ.FT.
y5°p Orrs
l do tk work.aM the sauawmisdorntpin I
«rRTced f«sek(Secc]04a.Buchrsa STORIESTYPICONSTRUCTION
and Pra(esri«w Cade:The Conllxle/a Li.law dors..,]Y la an owner of
noo my wWbuilde«improves thereon,and who dm such wmk himselfor Through his
cmpayan,Pnrvitkdlhelncn lmpavetremseanot imcndcdnro[[«W f«eda 11', OCC GROUP RIS,UNITS
however,the building or lmprovetrcnl is sold within«r yrarofconspleum,the ow«r- T
builds will have Ile burden of paving that k slid rl«bWW«Impove nor IwPose M
We.).
❑ I,nrowrcranhe Empathy,mneaduilvelyconlreningwiNlicrnvdcontnaomw QTY. PLUMBING PERMIT FEE R DL NE APN
nrlmal the gojeet(Sec.70a4,B-,a d I4of mans Codeq The Centmvwds
liana L,twd«sm owly wanownerofptrgeny who holds«Imporadrmn.ami PERMIT ISSUANCE
whomnrects for such gojecis wtthac«mrcam,)li«nsesl Purr..,,to dr Cmtr.n«a ALTER-DRAIN&VFM-WATER(FA)
Boma,law. FEE SUMMARY
❑ I um eaemq under SecB&P C f«thin rearan BACK MIE
,OW PRO' Cr.DEVICE O F.
• SANITARY Y N
WORKMANCOMPENSATIONDECIARATION DRAINS-FLOOR,ROOF'AREA,COND, SCHOOLTAX YECEEPr# N
�❑ Ihcreb n Natlhaic emaB iFi cosy tf(Scc.380).Labdfaar,ch RECEIPf#
Wexten'Compenwiwlnsunm'e«attnifieJ copy lheeof LSea.3800,lab C.)which MKfURPS_PER TRAP PARK FEE YN
ewe«all employee"umec this Permit. GAS-G.SYSTEM TLE
-I INC.4 OUTS RECEIPf#
Policy# BUILDING DIVISION Fif
ComPory GAS-FA SYSTEM-OVER 4 EA) PIANCHEC-K FEE
❑ Certified pryry is hereby fumishcd.
❑ CcriGied copy is GlN with the tiny im,,cetim division. ORI?ASEANDUSfRL WASTE.INIERCEPrOR GRADING FHIi
CERTIFICATE OF EXEMPTION FROM WORKERS' GREASETRAP SOILS FEE
COMPEJSATIO.'INSURANCE.
(Iles section reed nos be mwlpMNi Izrsnit isf«oro but�@cd dolWr(SI00) SEWER-SANITARY-STORM EA.20OF-r. ENERGY FEF.
or le')
I eenifylhal in the PeHmnte I f«w n this is iss«d,Ishan WATER HEATNR W/VENT/ELECIR
nor e^lPI^Y Y Pe*.an in Y u t bjat w the Wetkur' PAID
Compemwi WATER SYSfENMEATTNG Der, Receipt
O z Applicant o
z � NOTICE If.OcrwkiieC Pcmgion.yousa l NEWRESIDENTIAI,VIAT SQ,fT. TOTAL
r y becoose,.b ic% pnvidomnfthelabor Cade,youmun
7 Jeetnwlth e y 'th s« m his peram shall be dcrnFd revokm BUILDING FEE
Z CONSTRUCTION LENDING AGENCY SF.ESMIC IEE
I thereby alTrm il,il how iso canswnLn k+ding agrnuy for the peH«memce of TOTAL ELECTRIC FEE
L) O the work f« hicpe
wh this mur is Issued lgw.309],Civ.C.7
U"'rc� I�r•Name
O (, I<naeL Address QTY. MECHANICAL PERMIT FEE PLUMBING FEE
I certify Not 1 have mod this application ud rtete that the nWvc Imfurmmton is
>, W correct. I agree wnmlply with all city nndcounty nrdinmxxx and star,laws mlaing to PFRMI'1'ISSUANCE MECHANICAL IZQ
buildingc« fi=,Whmbyeuthon=mlM mudvoarNuciVwenteup Its, CONSTRUCTION TAX
L) z above- bred popusy f«impaction quporu ALTER OR ADD TO MECH.
(W ) to save,itdcmtdfy and keep harmless the City of Cupeniro agaimr
liabiliti . jud mens,c«ssmdes,.t which n yway«cmcagaiwsaid Ciry AM HANDLING UNIT(TO 10,OfO CFM)
urtvey e u grcminf1 W, oni t.
W AIR HANDLWG UNIT(OVER 10,1)00 CFM)
lgnatwe V
licanu'Contrecr« Due EXHAUST HOOD(W/DUCn
PAID
I IAIARDOUS MATERIALS DISCLOSURE HEATING UNIT(PO BOB."B I'U) Dole Reaiq#
Wilt iW.pplicum or Janine nodding.,,sat More,o,herdle h.nrdoue muend INATING UNIT(OVER 100.000 BTU) OTAL
as degrrd by the CuP ino Munkipal Code,Chgcr 9.12,ud We Health artd Sandy
Code,Section 25532(.)?
C1 Ye, 11 No VENTILATION PAN(SINGLE RISIU)
WilltheappB mfuw Wlldingoccu( turccquipmcm«devic whichemir BOILER-COMP(3HPOR 100,000 BTU)
Dw ] I$$ DATE
au cwtvmlwm u defined by Ibe Bay Arm An Quality MsoagerovCR u BOIL -COMP(OVER 100000 AISSUANCE BTU) P ^ a D
❑Ycs ❑No NEW RCSEDFMIAL MECH.—SQ.TT. ���
I have read rhe hararm
dous mccials requinemrnu tack Cmpser 6.95 of the 12 1995
Gliformia Health&Wary Code,Seen.25505,25533 son!25534.1 uodcrwrd that y
Ifthe rWag timettootments ly whavea'i ocanct itis mympnndbil. ononny the CIVY
Ooa u,nl ar the mgtrirmmam,wnkn mtret rte lost psi«to i�aana are cemratn ar V OF GUF'EH
fX:trp.rtny.
Owty«authadssJ agPr
es D. TOTAL: ISSUED BY:
OFFICE
cit, sr
Cupert-10
10300 Torre Avenue
Cupertino, CA 95014
Building Division
(408)777-3228
Fax (408) 777=3333
November 29, 1995
Resident
7984 Folkstone J
Cupertino, CA 95014
Subject: 7984 Folkstone, Permit# 28087 - Door.
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 finaled, 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
Pnnrod an Aecycled Pape,