00010057 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY ODOIO J i
CITYO CUPERTINO BUILDING-ELECTRICAL PERMIT N0.
• BUILDING DIVISION APPLICATIONMERMIT PLUMBING-MECHANICAL 50001
BUILDING PROJECT IDENTIFICATION
BUILDINGADDRESS: SANITARY NO. APPLICATION SUBMI'17AL DA'.
2 ,v,✓ �s o
OWNER:SN I.Aldh 1'Ho CONTRACTOR'S Ahfta `_ LIC NO,
TCO/A`
NIC CONTROL
qW HCHITECI'/ENGINEER: LIC NO: ADDRESS: ��� / ����/N/r ❑
F
n /�,•. w PHONE ��� 0 IV BUILDING PERMIT INFO
D ❑ COItSUI[3n Fe¢S POid byAppl 'ant(H i31) BLDG ELECT PLUMB MECH
v LICENSE;[)CONTRACTORS DECLARATION QTY. ELECTRIC PERMIT FEE
eby alum ran 1 ant ivmwdaderprom.ioa,or Chapmr 9leommendng JOB DESCRIPTION
"Z 7010)of Di vWon 3 oftbc Business and Professions Code.;mdmy license i. RESIDENTIAL:wor, and d}ed. PERMIT ISSUANCE;CUF � � 9� � � ❑SFDWI. ❑KITCHEN REMODEf
UVs Contr APPLIANCES-RESIDEN9'IAt, ❑ADDITION ❑PLUMBING RE-PIPE
g& Camra. rr
)..Dm ARCHITECTS DECLARATION PANELS El MULTI-UNIT ❑MODIFISTRUCTURAL
Z O�'Z I understand my plans shell he used as public mcoN.a MODIFICATION
OZ.`--Q UP TO 200 AMPS F1 INTERIOR ❑CHIMNEY REPAIR
W ficanecd Is In..innul 201-11x0AMPS IMPROVEMENT
-J OWNER-BUILDER DECLARATION ❑SWIMMING FOOLS
Q I In mby affirm that I am exempt fmm he Como carr.License Law far the OVER Iq0 AMPS ❑BATH REMOUEf/RI;PAIR DEMOLITION
40.x13 M F following reason.ISorhon 7031.5.Business and Professions Code:Any city or county SIGNS LL1iCI'RICAI. ❑OTUER
ad O,& which myai e,a permit 1.eonnmct,alter.improve,demolish.or repair any structure D G
tn
paiortoit% ssuance.also9 'Ili 'pplix tf h"mad s,fl '.'g edaatciand SPECIAL CIRCUIT/MISC.
�)yTdeal he licensed pursutt the provisioncofflet Commemes License Lw(Cha,mr9
4) 00
(commencing -th5ect )0107 fD' isio 3 fed B s dProf .ons Coddor TEMP METER OR POLI;[NST. COMMERCIAL:
0.0.o C that he is exentpl ffirmhmm and the basis for the alleged exemption.Any victim..of ❑NEW BLDG/AUDITION ❑DEM01,1'I'[ON
W14m Section 7031.5 byany.pplinmm lour a permit mlooCts the applicant to a civil penally of POWER DEVICES ❑TENANT ❑FOODSERVICE
=Q
not marc than five hundred dollars(5500). IMPROVEMENT
F11,m owner fthe propery,or my employees with wages a.their sale cormaruatian, SWIMMING POOL ELECTRIC
F. will dolhework.adthe.nitcmmisnot intended.rcffered fmsale(Sec.ALLa.Business []OTHER
Wm and Probessi.nx Code:The Contractors License Law does not apply to an owner of OUTLETS-SWITCHPS-PIXTU S
LL progeny who buildv or impmves Ibereon,and who docs such work hinwelf or tN'ouglt
his own employees,provided that such improrerm nts am not intended or ofli rid for NEW RESIDENTIAL ELECTR Z IT
sale.11:hnwescr.IM1e building orimpmvemenl iz sold wiNin one year of completion,Nc SQ.FT.FLOOR AREA S/SQ.FI�
c,larilder will have be bardpro
nol vin,mat he did.,it build nr improve for par- .
pn c af.wlc.).
1I,as owner of the property,am exclusively contracting with licensed contractors to '10 nL:
tmlmct the pmjcut(Sec WM,Business and Professions CedcJ The Cuntraato c,Li-
.c Law does not apply to an owner of property who builds or improves thereon,=it QTY. PLUMBING PERMIT FE
who summer,for oath pmjoa,wit a eommamd.)licensed pursuant to the Contractor,
License Law. PERM1'IISSUANCE
l at.exempt once,Sm. ,B&P C far this reason
Dae
ALTER-DRAIN&VENT-WAITER(EA) VALUATION
WORKER'S COM PENSATION DECLARATION BACK FLOW PROTECP.DEVICE L'�O
water l hse,thereby penally of perjury one of the following declaration J (h/
Ih;rve xnJ will maintains Cenilicmeof Cnnsenuoself-morose for Waders CmaN.- DRAINS-FLOOR,ROOF,AREA,COND. STORIES TVPIi CONSTRUCT[(
nation,as provided for by Section 3700 of the LMperformance uc Code,for the pemance of the
work for which this From,is i....J. FIX9'URES-1'ER'IRAP
❑ 1 have and will on.intain Worker.Comps ,.rico Insurance,as required by Section
3)00oflhcl.uMuCWafo he fate wnrkfuurywIth�aicr�h�(tyhr�is/permit is issued.h GAS-EA.SYSTEM-I INC.4 OUTLETS (KC.GROUP APN
Camcr:rkcr, fir. n nrec�� ard Policy Ncyl, 7 .7 GAS-EA.SYSTEM OVER4(EA) 3 / 9D�
CERTIFICAT12 OF EXEMPTION FROM WORKERS' .Sr J
COMPENSATION INSURANCE GREASE/INDUSTRL WASTE INIERCE,PTOR
(Thisrection need not line rplded ifNc psarat is foronc Imadreddollan IS 10B) BUILDING DIVISION FEES
or leu.) GREASE TRAP
PLANCHI!CK FEE
Ioyainythat inshe perfouraanyinannr so the as tworkfar which his permit irken'C. Nn-hot] SEWER-SANITARY-SI'OHM EA.201 FT.
trot employ any Canon in any manner so as to become mhje<m m the Workers'Compcn- ENERGY FEB
O ZApini Laws of CalRnrnia.Dam WATER HEATER WNENf/EI.ECI'R
` Applicant GRADING f9iE
y NOTICE;TOAPPLICANT:the Wokr'%aftCo pensati this Certifcmf the
Exemption, ,yshould
st WgTEH SYSTEM/1'REATING
a ; hecomc subject 1.the Woder.Compensation permit
steal of the Labor Code,you moa SOILS FBE
�
forthwith comply with such provisions or this permit xhellh seemed invoked. WATER SEHVICP,
Q
7 z CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL YLMIt. SQ.FC YAlll
V O
[Z. ildifhff Dam HeceptN
Fthcwork m,which this permit is loused(Sec
7097,Civ.CJ
Q WU Lcndcr,Name TOTAL:
� LcnJc Address t '1 OTAL:' S 1 1 certify that I have mad thisapplicationand county un and sine that the shave osmatic.is BUILDING FFiE
Z buildigconce ar.,complyad weed all city ane ne,cesoNianoes and sine thaw Iran the QTY, MECHANICAL PERMIT PTE
V z absovengcruiumationart hereby uuttionmrlsons.ntnivex of this city to cmcrupenthe SEISMIC FEF,
aMwc-(We)ogre property for inspection pkeep ha' PERMIT ISSUANCE(We)agree m save,indemnify and keep harmless the City of Cupcninn again. ELECTRIC FEE
Iiabilines.judgmenn,costs and expenses which may in any way accma against said City ALTERORADDTOMECH.
in am.eyue.ce of the granting of thin pe...
m. PLUMBING FEE
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT' AIR HANDLING UNIT(TO IO,IMO CFM)
SOURCE REGULATIONS. MECHANICAL FEE
AIR HANDLING UNI'r(OVER 10,010 CFM) CONSTRUCTION TAX
Signature mApplieaMCormacor Date EXHAUST HOOD(W)DUCT)
HAZARDOUS MATERIALS DISCLOSURE, HOUSING MITIGATION FEE.
Will the applicant or future budding ocapant more or handle haraahm,material HEATING UNIT(TO Ift(sm BTU)
as defined by the Capetian Municipal Code.Chapter 9.12,and the Health and Safety
Code Section 25532000 I[EATING UNIT(OVER 10B MMI BTU)
❑Yes ❑N.
VENTILATION FAN(SINGLE RP,SID) PAID
,doWill An upplicam or[mum building occupant ane e t or devices which Date Receipt M
yuipmcn BOILER-COMP OR 100,(MO BTU)
emit haunfou,air cuntaninum.as defined by the Bay Arca Air Quality Management
Disuict? TOTAL:
El yea ON. BOILER-COMP(OVER I00,000 B'PU)
[have read the h ort,Sc tcamnalk...2505.2533m(Firmants au2der 553Chapmr6.95 r,hand the Cmi- AIR CONDITIONER
ISSUANCE DATE
mamma Hcoes&Safety Code,Sections 25505.is my and 25534.I nndelity I that if the NEW RESIDENTIAL MLCH. SQ.FT.
building Amu,nm currently have a tanto P Nat it is my responsibility to notify the ocatpem
of the myuirements whicM1 Inure 0.mm prior to isuance of a Certificate of Qcupacy.
Owner m e.1hon,ed agent Date TOTAL eeg::
ISSUED BY:
OFFICE
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
• BUILDING PERMIT INVOICE OPERATOR: chris[ya
Sec: Twp: Rug: Sub: Elk: LOC:35613048.00
INVOICE DATE... ...: 01/12/2000
REFERENCE ID N ...: 00010057
SITE ADDRESS .....: 21865 HYANNISPORT DR
SUBDIVISION . ......
CITY .......... . ..: CUPERTINO
IMPACT AREA . . . . ...
OWNER ............ : CALLENDER E D 3 AND MARILYN S
ADDRESS .......... :
CITY/STATE/ZIP ... : CUPERTINO CA, 95014-4015
CONTRACTOR .......: GUSLANI, CHRIS LIC # 21311
COMPANY . . . .......: HOT WATER INC
ADDRESS . . . .......: 2531 GRACELAND AVE
CITY/STATE/ZIP ...: SAN CARLOS, CA 94070
TELEPHONE ..... ...: (650)298-8494
FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE
--------------- --- --------- ------------ -----------
BPWHEATER P 9.99 0.00 9.99
PPERMITFEE P 35.52 0.00 35.52
--------- ------------ -----------
45.51 0.00 45.51
ID DESCRIPTION ...... VOICE ID DESCRIPTIONa
6 SEWER 6 WATER 202 UNDERFLOOR PLUMBING
301 ROUGH PLUMBING 302 TUB 4 OR SHOWER
502 FINAL PLUMBING ENERGY 506 GAS TEST
507 FINAL PLUMBING
•
LTRN.10.2000 10:42AM MIETCLERK INC !,(•10.897 F..20
.i
CITY OF CUPERTINO
BUILDING PERMIT APPLICATION
ry 10.900 Torte Ave. Cuperfhwr Ce.W14
(408)7"4228
PROJECT ADDRESS;31665 HYANNtSPCRT DR
BLDG# SUITFJAPTI6_ �
PROPERTY OWNER
OWNERS NAME DAVECALLENDER CONTRACTOR
S MAM6hot GADD r
MAILMADDREShw,�W666g3
Ztee:fleyANNt6PORTDR AIUNADDRES6:
Clfl'f6TATE/YWA CUP dtTINO3691 S�aelerd aw
CA eeDta cmT9TATETyP: asn tstbe
PHONE 7:( 4011)767 11L1 PAX N f ) PHONE et( CA 04070
EMAIL ADDRESS: PAX A: ( 66xg9 &M
EMAIL ADDRESS:Ipllelar4aol.aorn
3 y BUSINESS LICENSE �t611
UPLAIN WORK TO BE PBUOAMED: REPLACE WATER HEATER
SUQ,DIhrot BLBCaTUCnL
XDCNAtaCAL
RuOOfl RAL%pM e70t8ARLL VW, T40_
auhfesaaw ID�Osrrl4a aooP coveaaaDa:0
TYPEOttEXITINGROWCOvarr�l ---
NUIMEROFZXM714GROOPCOv8AD=REMOVED, D PAOP088DAOOPCOvBRIIda:
1WI•SSR OP E=lN0 ROOF COvpytDM RE DMM D
PROVIDS LCAO.RBPORT NO,
VALUATION; •� SOe.00
GW
• IMPORTANT NOTICES NOTICE To APDL '
APPUCANra CEFI IPICATION I herby Nunn wider PeIIaIQ,of PedWy one erfhe 001014
no CERTIFY THAT I HAVE READ THIS APPLICATION nS d•d■rctlon■:
ABOVE INFORMATION 16 CORRECT.GREE THAT APERMIT IsSTATE T13 THE 1 1 L reau +t t+Md a Sealm
SUED FOR THE DEMOL.ITIONDESCRIED13THIS APPLICATION,ALL THE aUb.ore ontMaet37MOfenrbeotCodeetedopnpmm.
PROVISIONS OF THE PERMfTAND ALL LAWS AND ORDINANC76 i1'1���`Iswsot a�Laeaeoda.rxMpetrwmam=
THERTO WILL BE COMPLIED WITH, f`1'A I have end WRI erindln warkew C.Peneeeon I
HOLD HARMLESS CL USE.The peat sloe arae War owe,a the neatamares a its erg dde�
eAr")b)ndamMy and held hennlm theeC y a Ouppno■dew and 6eranC d Mrweemte'tbrroensaUan Yrutinaa e.nIn and patlaynum.
a9eetet Wty and e6 dalme,demWde end aatione ono than And Cerbr SUM Lund
gmmuane t■der thle Pwm?L for detne9a ruuNnS tom
eS■Mt a6 such paints,demands er ad*ne. �et the C14,of Cucalt9re hMq NWebw 1548386
In COnrafrn I 1 b 71re aoud6re Mme cab b Nae Or wl
State of tarda,the GWCNM shah have cavoega9e uld� �p�ry�e f 1 x I'or**cut M 6r Mrlamm�a of the work ter Wgd AY
fl§Wbcbworshe66tdloweh„�S011).of M. � ahWnavnoloynboaraonMeym■nnerea~oilspanytRhWwa,I
It ho.wrar qph ITV)mt 4 MOduwr b eppttwble. We'enmPaa.da+■rw a vlear L I
M I■Checked Barr V*ad to MMA.
a7papdeh Mae"ata:Mnpaenae. dwrJred of wI.Merle Irks durin th...Me,tlwr I eMuk eocom. rather eaknawledpa as 1 uMenrmd
aatdauaaraleborcod.a waecbrheworlwra•aomP.,yey,,,
LMSIOND aalbe4of deD'Cands'.bCamay bAleeQhvela
ermen r4ogael"i.+ 'un l b D da=areA�a elnf tr eebrwd eyq of the
�teorCwle,Net the Penn■hwNn app4a for
se Oft
eeex ran7atWlor�mrormhad.oaam..adrouoasrhq t > V. I�aadya TageeeeatarMewalerlhd,.twbrn■narasle
Lbruer76861���—Mw call 6/912001 wIII' wbn•ea rklar%N0 to ;.o Ye0.lMlnomNal�teerwnomroaae
Mwe at:uapnle and who
�— ttwnaarwMa■Iryw■rk eW fila a aonrPlebd ""a•gbrb the sari.
PAYAIENTPenna Swear. aapyatrrr:krrn wa me CM trol
ACCOUNTN 11,11, On as
CREDIT CARD TypS a
EXPIRATION DATE:
a TuaE:
wrME oN cARD�r P 63 t Is/on,
AMouNTtD
DEC 411999
99
• eMrearAb,lloeM As ,e WS
OATS RYtoeNanreaAtveo.as
LTRN.10.2000 10:43RM INETCLERK INC &v.697 F;ii
Netc,lerk, Inc. : e-Solutions for the contracting Industry asuenn saMira�dl M CA $4090
(999)N CLIRR
Building Permit AppUcation
rom; NetClerk Inc 1b: Buildichr. ng & Planning Department
Coats et Namer Scott Waftbwy
cupe�o
Pboner (6S0)6z4-UM Phoney
28
Fax Nomber. I-(877)84&S888 (408)7773333
Fax Number. (408)7773333
Permit Handling Instructions
Please Fax Permit W. 1{877)846.9888
I will pick permit up at the Be Deliver to job site at brat Inspection
1ld�g nepartmeot in:S days X
Otherr Please mall otigloW to Contractor addren below
Contractor Information
Company: Hot Water Inc.
Contractor.
R'orkeYe Comp 4h 1548386 State Ptiwd
State COatraetor's License M 76MU C36
Addrou: 2531 Oraceland
7C-ardftmber,
Card Information
Ci4 r San Carlos.Ca 94070 Pboae: 650298-849463115.OI17.2578
Chris P.otrslaai
650-298-849306M
Mastercard �]
Comments
Fax
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