S 4423APPLICANTTO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
CITY OF CUPEQTINO BUILDIIa ".ELECTRICAL
BUILISING DIVISION APPLICATIONIPERMIT PLUMBING -MECHANICAL
PERMIT NO.
S 4423
BUILDING PROJECT IDENTIFICATION
BUILDING ADDRESS ���� D�
77 fd�gj
SANITARY NO.
APPLICATION N DATE
7-13-519
OWNER'S NAME: PHONE: '
+
CONTRACTOR'S NAME: LIC NO:
NIC
❑
CONTROLN
AR HITF,C/ENGINEER: LIC NO.
ADDRESS:
CONTACT: PHONE:
BUILDING PERMIT INFO
❑ Consultant Fees Paid by Applicant (Initial)
BLDG ELECT PL MECH
LICENSED CONTRACTOR'S DECLARATION
I hereby elfirm that I em licensed under provisions of Chapter 9 (commencing
QTY. ELECTRIC PERMIT FEE
JOB DESCRIPTI
with Section7001gof Oiskion3ofthe Businesannd Professima Cede,and mylicemcis
in full farce and effect.
License Class Lic.p
Date Contractor
RESIDENTIAL:
❑STOW El KITCHEN REMODEL
DrDON ❑ PLUMBING RE -PIPE
LTI-UNIT ❑STRUCTURAL
MODIFICATION
PERMRISSUANCE a SO
V V
APPLIANCES - RESIDENTIAL
ARC] [ITECTS DECLARATION
1 understand my plans shall he used m Public records
PANELS
11PTO 200 AMPS
❑INTERIOR ❑CHIMNEY REPAIR
IMPROVEMENT L]SWIMMING POOLS
❑ DEMOLITION
'
Licenxed Profession]
OWNER-BUILDIiR DECLARATION
I hereby affirm that 1 um exempt from the Contractor's Liceme Law far the
following mason. (Section 7031.3. Nosiness nit Professions Crile: Any city or county
which requires a permit m tonsvuct. nlmr, inopnwe, demolish, or repair any xwcture
201 -IOW AMPS
OVER 1000 AMPS
SIGNS ELECTRICAL
❑ R
�.
prionoit issnnce. also req.iresthe vpplicantfar such perminn Blea signedxtarement
SPECIAL CIRCUIT/MISC.
that he H licensed pursuant m the prnvlslom of the Cnntrucrod License Low (Chapter 9
TEMP. METER OR POLE IN
+^ ^
(commencing with Section 7(100) of Division 3 ofthe Business and Professions Code)or
that he is exempt Nerefram and the basis far the alleged exemption. Any variational
❑ W BI. 1 0
�� 5.1 FlY}II
POWER DEVICES
Section 70315 by any applicant for a permit subject the applicant to a civil penalty of
not mom than Eve hundred dollars 18500).
❑1,ns ownenff the propeny, or my mnpinyees with wages as their tole compensation,
will do the work, and the gmcture is not inmrdcd oraffereJ for sale Sea. 71344, Business
❑ NANT ❑FOOD E
IMPROVEMENT
.pp�a
p
SWIMMING POOL F,LECfRIC
end Professions Coda: The Cormacme, License Law dies not apply man owner of
OUTLETS-SWITCHPS-Fl
propeny who builds rr improves thereon, and who does such work himself or through
his own employees, provided that such improvements am not intended or offered for
NEW RESIDENTIAL ELECTR Q
SQ. FT. FLOOR AREA
VSQ. F3'.
sale. If,however, the buildingor improvement is sold within one yeardcompletion,the
rbuilder will have the burden of proving thea he did not build or Improve for pur-
co serf cath
E-1 1, as owner of the property. am exclusively contracting with licensed contractors to
TOTAL:
,mtma the pr jeer (Sec. 7044, Business and Ihofussinm asleJ The Comnsmr's Li-
cense Law does not apply to an owner of propeny who builds or improves thereon, and
QTY. PLUMBING PERMIT FEE
whocomructs (crime projemswithacomractor(s) I'memed put rnuanuo the Ciantram's
PERMIT ISSUANCE:
License w
xe t Jer See ,B& P C for this rumor
ALTER - DRAIN & VENT - WATER (CA)
Dae
LUATION
BACK FLOW PROTECT. DEVICE
WORKEkK C ON DECLARATION
/ �11�/\
coo
1 hereby.Bina under penalty mfperjury and, of Ne folhwing dalamtiom,
DRAINS- FLOOR, ROOF, AREA, COND.
❑ I have and will maintain a Cenillcme arcomenno self -insure for Worker's Compen-
satirn, as provided for by Section 37M of the Labor Code. for the performance of the
work far which this permit is issued.
STORIES
/
UCTION
jr
FIXTURES - PER TRAIT
❑ 1 hive and will maintain Worker's Compensation Insurance, as required by Section
37011 of the Labor Code, for the pedbrm.nea of the work for which this permit is issued.
My Worker's Compensation Insurance currier and Policy number are.
Carrier. PolicyNo.:
CERTIFICAT17 OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed allot permit Is Ramat hundred dollar 5100)
nr less.)
GAS - EA. SYSTEM -I INC. 4 OUTLET
OCC.GROUP
_33
APN
ti
O
GAS - EA. SYSTEM.OVER4(EA
GREASOINDUSTRL WASTE TERCEPTDR
BUILDING DIVISION FEES
GREASETRAP
PLANCHECK FEE
I certify dorm the penbrmanceolthe work for.hash this pendt is isw.L Ishall
not employ an "n mann ilo become xubjem to the Wod:eri Co.,.--
er�
SEWER -SANITARY TORN EA. 200 FT.
ENERGY FEE
Wq'fER IfFATF.R ENTIELECTR
arta
It laws m . D� ���
pplica '•
GRADING FEF.
WAl'ER SYST /TREATING
SITE ANT. f( making this cam of Exemption, you should
bac .object to the Worker's Cn ntpenc tion provisionsof the hnhnr Code, you moat
SOBS FEE
R ith comply with such provisions or this permit shall he deemed revoked.
WAIERSE ICE
CONSTRUCTION LENDING AGENCY
I hereby affirm that hem is a construction lending agency for the performance of
NEN' BESTIAL PLMD SQ. FL
PAID
Da ReceiptN
the work for which this permit is issued (Sea 30G. Civ. C.)
Lenders Name
TOTAL:
Lender's Address
TOTAL:
1 certify that I have mad this application it stem the the above information is
BUILDING FEE —
mcct.legreemcomplywituallcityundttmsyoNinnnesunJsmmlaws relmin8 to
building construction, and hereby ruthorize representatives oRhisciry to emcruponthe
QTY. MECHANICAL PERMIT FEE
SEISMIC FEE /• ZQ
PERMIT ISSUANCE
ELECTRIC FEE
.have -mentioned propeny for inspection purposes.
(We) agree in save, indemnify and keep harmless the City of Cupar ins against
ALTER OR ADD TO MECH.
PLUMBING FEE
Iiabili0e.judgments. costs and expenses which may in anyway accrue admin said City
in asequence of the grunting of this wanot.
AIR HANDLING UNIT (TO 10,00() CFM)
MECHANICAL FEE
APPLICANT INDERS NDS AND W.erCOMPLY WITH ALL NON -POINT
SOURCE .ULAT 5.
AIR HANDLING UNIT(OVER I0,000CF
CONSTRUCTION TAX
EXHAUST RUOD(W/IIUCD
5 w plicmu/Cn Date
HA SCLOSURE
HOUSING MITIGATION FEE '
HEATING UNIT (TO 100.(X10 BI/
mea.1
or future building occuntamre or handle hazardousn
Will maripplicam pn
as defined by the Cutworm Municipal Code, Chapter 9.12, and the Health and Safely
Cde, Section 25532(a)'t
❑ Yes ❑ No
Will the applicant or future building by the Bt use equipment or devices which
us air comaminant s defined by the Buy Arcu Air Quality Management
mit District?
DishicR
[3 Yes C] No
HEATING UNIT (OVER I X BTU)
///
PAID I�
Dam �t
TOTAL:
VRNTILATION FAN t GLE RESID)
BOILER - COMP P OR ]00.100 BTU)
U) BOILER -C P(OVER IOBW BT
I have read the hmardoas materials reyuiremetns under Chapter 6,95 of the Cali-
AIR CO I HONER
SUANCE DATE
NE ESLDENT IAL MECH. SQ. Cr
forms Health Safety Crile. Sestina 85(15.25533 and 25534. I understand that flow
building Jan nmsat f lows not currently havetenant, thus it is my responsibility to notify rite
of nq im as, which must be met pdo, to ED ... c of a Canniest. of occupancy,
-
ISSUED BY:
thorned agent Date
TOTAL:
OFFICE
i- - - - -- - - /=
• KENNETH NELSON
Registered Civil Engineer
940 Saratoga Ave. Suite 215
San Jose, California 95129
(408) 247-2898
June 29,1999
Job No. 996040
Building Inspection
City of Cupertino
10300 Torre Ave.
Cupertino, CA 95014
Subject: Exi
v
Gentlemen:
Department
PLOT PLAN
CFECKED BY
DA TE 7)
story wood framed -residence at.74
Dr.Cupertino, Ca. APN 359-28-050
At the request of The Owners, Mr & Mrs John Hendricks, an
inspection of the subject property was made by the undersigned.
The inspection was made on June 23,1999 to examine the
construction of the subject residence. The existing one story
residence was built approximately 40 years ago and appears to be
in very good condition. The wood framed roof system is 2x4
• rafters @ 24"o.c. with a L/W concrete shingle roof over 1/2"
Plywood sheathing. The stud walls are 2x4 @ 16" o/c with 1/2"
gyp board interior finish and stucco exterior. The floor is
raised wood framing with perimeter footings.
In 1979, the property was in the City of San Jose and the owner
believes that permits were taken out by the Contractor to add
approximately 325 square feet to three bedrooms and to enclose a
portion of the entry porch as a Kitchen Dinning Nook, approx. 50
square feet. Since the remodeling was done, the property has been
taken into the City of Cupertino. Research of the City records
does not indicate any permits for these areas.
My inspection and documentation of the additional space has
verified that the addition to the Bedrooms is within the side
yard setback requirements. The three bedrooms have sliding
windows which provide the required light, ventilation and
emergency egress in accordance with the UBC. The electrical
outlets and underfloor access also meet the UBC requirements. No
additional plumbing was included in the addition. The Nook area
extends under the original existing porch roof.
In my opinion, the additions were constructed in accordance with
the Uniform Building Code and all other applicable City or County
ordinances in affect at that time. All construction appeared to
have been done in a workmanship like manner. I therefore
recommend the issuance of a permit and final approval for the
additions.
4
•
0
/.
Page two
Job No. 996040
My services consist of professional opinions, conclusions, and
recommendations made in accordance with generally accepted
Engineering principles and practices. I have made reasonable
efforts to ensure that this report is accurate, however I cannot
assume any liability for damages which might result from it or
for any conditions which this report might fail to disclose.
If there are any questions regarding this subject, please contact
my office.
Very truly yours,
QsoFESSID,yq
�F0 SH
Ken eth Nelson
Registered Civil Engineer #22023 �Y8609
KN/kn
cc: Mr & Mrs John Hendricks
-- '--------- 8 • . - -
^�-£J_,r�
G A
N
N "r
fES
�5-� �—------_.-- & KENNETH
BQistered Civil ~�@�aQn�jHs�og��y�
fA,l,F� �...�"'rw`•_e-.,.-yi � ' � ����\ a/�'''''" c�,,�fwRffllfH '
(108)217-2898 910 Saratoga Ave. Ste. 215
fax (408) 7 2899 S 129
' 8k 21 en Jose CA 95 �
. TA�Op �RUF�Pa\r
ee. 4e
_SCALE: �/ d=M' APPROVEDBY :1. ___.. ,_. _. _.__...�._ DRAWN BY -Ie,.4,4�
DATE: 'I uA 1t-0 1. 331999,�,� _f REVISED
46,
7-11
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