26619 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY �/
CIT)r OF CUPERTINO - '- ' ' - PERMT o.
APPLICATION/PERMIT PLUMBING-MECHANICAL. � 0093 2 6619
BUILDING DIVISION BUILDING PROJECT IDENTIF'ICA'ION
BUILDING ADDREESSS:�/� SANT ARY NO, AI/'1'1.1 TI ONSUUBMMIIITI'ALDATE
(t UNIT# _ LOT# z,-7Al
OWNERS,A E:ijb� PHONE: CONE TOR' NA LIC NO: N/C `O CONTROL
'A .H11F.CI'/ENG, t'
1.120. ADDRESS:
-lo9SZ 3 wf-IoL -A F El
CONTACT: PHONE: BUILDING PERMIT INFO
QTY. ELECTRIC PERMIT FEE
q®U gqZ-x`15/0ELECT PLUMB MECH
1 PERMIT ISSUANCE �
LICENSED CONTRACTOR'S DECLARATION APPLIANCES D pL �.
Cortez lherebyaffimt NatlamlicensedunderpmvisionsofChapter9(commenciagwah JOB DESCRIPTION
�u00 Section 7000)of Division 3 of the Business and Professions Code,and my license is in ppNpJS
full forte and effect.
F Z,m Livens Clava Lic.# UPTO A 5
rn Q at Dae Contractor 2 1-1 MP
L�inZ ARCHITECTS DECLARATION E S SQ.FT.FLOOR AREA SSQ,P..
OZ-0 1 understand my plans shall be used as public records. -
F� -730 � C2
r Ktt,
Licensed Profussinnal NS CfRICAL
�yd'Q OWNER-BUILDER DECLARATION SPECIALCIRCUMMISC.
kOafJ 1 hereby affirm that 1 ran exempt from the Contractor's Lic nam Law f t e 1
w 3 a os following mason.(Saban 7031.5,Business and Professions Code:Any cityor on TEMP.METER OR POLE INST. 7 O l
I=�O 1 which requires a permit to construct,eller,improve,demolish,or repair any s chi
E 2>-� prior to its issuance,also requires the applicant for such parol to file a signed s mm t PO EVI
�rL<O thin he is licensed pursuant to the provisions of the Contractors License law( ter
4 9(commencing with Section 7000)mf Division Sof the Bueinessand Prmfeacioos Code) IMMING 0 ELECTRIC VALUATION
,no,, or Section
7031.5
031.e is byanympt therefrom
cam f the buisfor the tstgedexemptioo. civiny lPnaltym ^O Q�
FZQ Section than
five
dontfore permit subjects the applicanno acivil penalty of IITLETS- GHES-Fl%TURES �' {/
�S❑ not mom than five hundred dollars(E500).
��m ❑ I,asownensf theprnpcny.ormycmployeeswiN wagesutheirsolecompemation NEW RFSID R _SQ.FT. STORIES TYPECONSTRUCION
i3— will do am
the work, dthe muctute isnot intended proffered forsale(See
. .,at
and Ptmfessio s Gale:The Contractor's License Law does not apply to an owner f
pmpeny whobuildaorimpmvesthereon.indwhodcessucM1 work himsclfoI lhmugh is
employe.,provided that such imprsevememsam not intertdedoroffesdl forsale. L OCC.GROUP RES.UNI LS
however,the building or improvement is cold within one yearof completion,the own - T
builder will have the burden of proving that he did not build or improve for purpose o
ale).
❑ uct[be prject(Smpeny,am usinsivelycanuactiions Clt The Comdorsto I�KY. PLUMBING PERMIT EEE FLOOD—ZONE npry
icewct the project(Sec.'Irmo Business and professions Code:)The Contractor's
Licenstl.awdoes not aparects ooh news rotieny who
nsedPsorimpro dm C.reopp��aady
ahoconessels
w.for such prnjecrswithacmntramorts)licensedpursuantm Ne Con lm tr=r � A ENT-WA iR(FA)
License Law. bbYY.�`` FEE SUMMARY
❑ 1 nm exempt under Sec. ,B&P C for.,is«Oso
BACK Fl.O OTECT.DEV E O T IDh Ml—S
SANITARY Y—N
—
RECEIPT
Dat° DRAINS FLOOR,ROOF,AREA,COND. RECEIPI'
- p
WORKMAN COMPENSATION DECLARATION SCHOOLTAX YN
❑ Ira'Cri port that Insurance or aficau ofcoventtoarf(Sesure,oraccnifinm of Fl-ORES-PER TRAP RECEIPI'p
_ Workers Compencntiun Insurance oracmified copy Netrof(Sa.38W.Lab C.)wbich PARK FEE Y N
coven all employeda under his permit. GAS-EA.SYSTEM- INC.4 OUTLETS REC PTa
olmyp
CBUIL ISION FEES
ompa❑
C1 Cay GAS-EA.SYSTEM-OVER 4(EA) PLANCHECK FEE Certified copy is hereby fumiahW.
❑ Certified copy is filed with the city inspection division. GREASFJINDUSTRL WASTE INTERCEPTOR GRADING FEE 1
CERTIFICATE OF EXEMPTION FROM WORKERS' CREASE TRAP SOILS FEE
COMPENSATION INSURANCE
(Thisseciion need not be completed iftheparmakisforonehundreddollars(5100) SEWER-SANITARY-STORM EA.200FT. ENERGY aaaaa
or less.)
I cenify that in the performantt ofthe work for which this permit is issued,l shell WATER HEATER W/VENTTELECTR
not employ any person in any manner so as to become subject to the Workers PAID
z Compensationlswsof California. Date WATER SYSTEMIEREATING Date Be t#
Applicata
z 0 NOTICE*10 APPLICANT:If,after making this Cenifi.te,of Exemption,you should NEW RESIDENTIAL PLMB. SQ.FT.
(•-' mTAL:
LO become subject to the Workers Copensation provisions of the labor Code.you must
FC > forthwith comply with such provisions or this peril shall be deemed resokW. BUILDING F'
p, Q CONSTRUCTION LENDING AGENCY SEISMIC F a }s
=) z I hereby affirm chat hem is a construction lending agency for the performaae of V
U O the work for which this permit is issued Ser.3097,Civ.C.) T ELF, IC E
Iander'x Name
Q U lenders Address QTY. MECHANICAL PERMIT FEE PLO FEUJ E
1 certify Nat I have read this application and sus thin she above information is
correct. I agree to comply with all city and county ordinances said state laws relating to PERMIT ISSUANCE MEC ICAL FF,E
F"' N building construction,and hereby auNoriu apresenutivesoftbiscity,In toleration the
V z uM1ove-mentioned property for inspection purposes. ALTER OR ADD TO MECH. CONSTRUCTION
(We)agree to:ave dcmmfy and lorepittabalexx the C agaimt r—
Indslares,judgme sent deapenses nn said Ciry AIR HANDLING UNIT(TO 10.000 CFM)
incon. therom
AIR HANDLING UNIT(OVER IL000 CFM)
gnomic of ApplicanUContmcmr Dine EXHAUST HOOD(W/DUCt
PAID
HAZARDOUS MATERIALS DISCLOSURE HEATING UNIT(TO IO ,"BTU) Date Recti
Will the applicant or Ihture building occupant stare or handle haurdmw nutedal
defined Fy the Cupcnin.Municipal Cade,Chapter 9.12,and the Health and Safety HEATING UNIT(OVER 1 W,OW BTU) TOT,L:
Ctvle,Section 25532(u)Y
El Yes 0 N VENTILATION FAN(SING LE RESID)
'W ill Neapplicant or future huildingoccupant uxecloqu rn oodeviceawhmi
ielet
BOILER-COMP(}HP OR 100.000 BTU) ISSUANCE DATE
h- rdous air contaminant ex defined by the Bay Arta Air Quality Management BOILER IW.000 BTU)
ariefr r, 1p1,
❑Yea ❑No NEW RESIDEN'T'IAL MECfI.
I have mad the hasardous materials requirements under Chapter 6.95 of the AUG
t�
California l Italia&Safety Cost,Sections 25505,25533 Zid 25534 1',-n&stun p�u ���
if the building docs not currently have a tenant,that it is my resptmsibiblytm Land y di A
occupam of the requirements which must be met prior to issuance of a Certific `f
occupancy. ` Cl(y Ur 4
Owner or atu rmieed agent Data
TO L: ISSUED BY:
OFFIC
HOMETEC RICHARD A. HARTIMAN
ARCHITECTURE A.I.A.
EGG# WE
JAN 181995
BLDG; INSPECTION DEP
January 17 , 1995C1TY OF CUPERTIN0TMfNT
City Z
Cu
Buildient10300ue
Cup I014
e: Gesidence2Lane
PleaIngitems have been revised on the job copy
theion drawings for this project :
1 . A corner of the header between the kitchen and family room
• may be notched per my sketch.
2 . The rafters may overlap at the ridge beam in the family room
per my sketch. The tie strap can thus be omitted.
If you have any questions regarding this information, please don' t
hesitate to contact me at 408/995-0496 .
yEp erely,
A.
vV C'�1T��ha d Hartman, AIA
* Q REN. HOM ARCHITECTURE
LP�
�D 9
OF CA1./F
OFFICE po�y
1314 LINCOLN AVE., SUITE F• SAN JOSE, CALIFORNIA 95125 • TEL: (408) 995-0496
r v-
• of,
eclix
10300 Torre Avenue
Cupertino, CA 95014
Caper t hl.o Building Division
(408)777-3228
(408)777-3333 (fax)
May 23, 1996
Homeowner �� r✓j
20626 Kirwin Ln `C/(
Cupertino, CA 95014
12
Re: Expired permit, (26619, copy attached) 5/s
Dear Owner: /95�
According to our records, the referenced permit has not 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 (408) 777-
3228, so we may arrange to extend your permit and schedule a final inspection.
The City of Cupertino requires a response within ten(10) working days from the date of
receipt of this letter. If we do not hear from you within this time, the building department
will have no other recourse but to resolve your permit as expired and discard the records.
Thank you for your cooperation,
Building Department Staff, City of Cupertino
F,;wec on Recvc�ed P:iDer
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY �/
CIT)r OF CUPERTINO - '- ' ' - PERMT o.
APPLICATION/PERMIT PLUMBING-MECHANICAL. � 0093 2 6619
BUILDING DIVISION BUILDING PROJECT IDENTIF'ICA'ION
BUILDING ADDREESSS:�/� SANT ARY NO, AI/'1'1.1 TI ONSUUBMMIIITI'ALDATE
(t UNIT# _ LOT# z,-7Al
OWNERS,A E:ijb� PHONE: CONE TOR' NA LIC NO: N/C `O CONTROL
'A .H11F.CI'/ENG, t'
1.120. ADDRESS:
-lo9SZ 3 wf-IoL -A F El
CONTACT: PHONE: BUILDING PERMIT INFO
QTY. ELECTRIC PERMIT FEE
q®U gqZ-x`15/0ELECT PLUMB MECH
1 PERMIT ISSUANCE �
LICENSED CONTRACTOR'S DECLARATION APPLIANCES D pL �.
Cortez lherebyaffimt NatlamlicensedunderpmvisionsofChapter9(commenciagwah JOB DESCRIPTION
�u00 Section 7000)of Division 3 of the Business and Professions Code,and my license is in ppNpJS
full forte and effect.
F Z,m Livens Clava Lic.# UPTO A 5
rn Q at Dae Contractor 2 1-1 MP
L�inZ ARCHITECTS DECLARATION E S SQ.FT.FLOOR AREA SSQ,P..
OZ-0 1 understand my plans shall be used as public records. -
F� -730 � C2
r Ktt,
Licensed Profussinnal NS CfRICAL
�yd'Q OWNER-BUILDER DECLARATION SPECIALCIRCUMMISC.
kOafJ 1 hereby affirm that 1 ran exempt from the Contractor's Lic nam Law f t e 1
w 3 a os following mason.(Saban 7031.5,Business and Professions Code:Any cityor on TEMP.METER OR POLE INST. 7 O l
I=�O 1 which requires a permit to construct,eller,improve,demolish,or repair any s chi
E 2>-� prior to its issuance,also requires the applicant for such parol to file a signed s mm t PO EVI
�rL<O thin he is licensed pursuant to the provisions of the Contractors License law( ter
4 9(commencing with Section 7000)mf Division Sof the Bueinessand Prmfeacioos Code) IMMING 0 ELECTRIC VALUATION
,no,, or Section
7031.5
031.e is byanympt therefrom
cam f the buisfor the tstgedexemptioo. civiny lPnaltym ^O Q�
FZQ Section than
five
dontfore permit subjects the applicanno acivil penalty of IITLETS- GHES-Fl%TURES �' {/
�S❑ not mom than five hundred dollars(E500).
��m ❑ I,asownensf theprnpcny.ormycmployeeswiN wagesutheirsolecompemation NEW RFSID R _SQ.FT. STORIES TYPECONSTRUCION
i3— will do am
the work, dthe muctute isnot intended proffered forsale(See
. .,at
and Ptmfessio s Gale:The Contractor's License Law does not apply to an owner f
pmpeny whobuildaorimpmvesthereon.indwhodcessucM1 work himsclfoI lhmugh is
employe.,provided that such imprsevememsam not intertdedoroffesdl forsale. L OCC.GROUP RES.UNI LS
however,the building or improvement is cold within one yearof completion,the own - T
builder will have the burden of proving that he did not build or improve for purpose o
ale).
❑ uct[be prject(Smpeny,am usinsivelycanuactiions Clt The Comdorsto I�KY. PLUMBING PERMIT EEE FLOOD—ZONE npry
icewct the project(Sec.'Irmo Business and professions Code:)The Contractor's
Licenstl.awdoes not aparects ooh news rotieny who
nsedPsorimpro dm C.reopp��aady
ahoconessels
w.for such prnjecrswithacmntramorts)licensedpursuantm Ne Con lm tr=r � A ENT-WA iR(FA)
License Law. bbYY.�`` FEE SUMMARY
❑ 1 nm exempt under Sec. ,B&P C for.,is«Oso
BACK Fl.O OTECT.DEV E O T IDh Ml—S
SANITARY Y—N
—
RECEIPT
Dat° DRAINS FLOOR,ROOF,AREA,COND. RECEIPI'
- p
WORKMAN COMPENSATION DECLARATION SCHOOLTAX YN
❑ Ira'Cri port that Insurance or aficau ofcoventtoarf(Sesure,oraccnifinm of Fl-ORES-PER TRAP RECEIPI'p
_ Workers Compencntiun Insurance oracmified copy Netrof(Sa.38W.Lab C.)wbich PARK FEE Y N
coven all employeda under his permit. GAS-EA.SYSTEM- INC.4 OUTLETS REC PTa
olmyp
CBUIL ISION FEES
ompa❑
C1 Cay GAS-EA.SYSTEM-OVER 4(EA) PLANCHECK FEE Certified copy is hereby fumiahW.
❑ Certified copy is filed with the city inspection division. GREASFJINDUSTRL WASTE INTERCEPTOR GRADING FEE 1
CERTIFICATE OF EXEMPTION FROM WORKERS' CREASE TRAP SOILS FEE
COMPENSATION INSURANCE
(Thisseciion need not be completed iftheparmakisforonehundreddollars(5100) SEWER-SANITARY-STORM EA.200FT. ENERGY aaaaa
or less.)
I cenify that in the performantt ofthe work for which this permit is issued,l shell WATER HEATER W/VENTTELECTR
not employ any person in any manner so as to become subject to the Workers PAID
z Compensationlswsof California. Date WATER SYSTEMIEREATING Date Be t#
Applicata
z 0 NOTICE*10 APPLICANT:If,after making this Cenifi.te,of Exemption,you should NEW RESIDENTIAL PLMB. SQ.FT.
(•-' mTAL:
LO become subject to the Workers Copensation provisions of the labor Code.you must
FC > forthwith comply with such provisions or this peril shall be deemed resokW. BUILDING F'
p, Q CONSTRUCTION LENDING AGENCY SEISMIC F a }s
=) z I hereby affirm chat hem is a construction lending agency for the performaae of V
U O the work for which this permit is issued Ser.3097,Civ.C.) T ELF, IC E
Iander'x Name
Q U lenders Address QTY. MECHANICAL PERMIT FEE PLO FEUJ E
1 certify Nat I have read this application and sus thin she above information is
correct. I agree to comply with all city and county ordinances said state laws relating to PERMIT ISSUANCE MEC ICAL FF,E
F"' N building construction,and hereby auNoriu apresenutivesoftbiscity,In toleration the
V z uM1ove-mentioned property for inspection purposes. ALTER OR ADD TO MECH. CONSTRUCTION
(We)agree to:ave dcmmfy and lorepittabalexx the C agaimt r—
Indslares,judgme sent deapenses nn said Ciry AIR HANDLING UNIT(TO 10.000 CFM)
incon. therom
AIR HANDLING UNIT(OVER IL000 CFM)
gnomic of ApplicanUContmcmr Dine EXHAUST HOOD(W/DUCt
PAID
HAZARDOUS MATERIALS DISCLOSURE HEATING UNIT(TO IO ,"BTU) Date Recti
Will the applicant or Ihture building occupant stare or handle haurdmw nutedal
defined Fy the Cupcnin.Municipal Cade,Chapter 9.12,and the Health and Safety HEATING UNIT(OVER 1 W,OW BTU) TOT,L:
Ctvle,Section 25532(u)Y
El Yes 0 N VENTILATION FAN(SING LE RESID)
'W ill Neapplicant or future huildingoccupant uxecloqu rn oodeviceawhmi
ielet
BOILER-COMP(}HP OR 100.000 BTU) ISSUANCE DATE
h- rdous air contaminant ex defined by the Bay Arta Air Quality Management BOILER IW.000 BTU)
ariefr r, 1p1,
❑Yea ❑No NEW RESIDEN'T'IAL MECfI.
I have mad the hasardous materials requirements under Chapter 6.95 of the AUG
t�
California l Italia&Safety Cost,Sections 25505,25533 Zid 25534 1',-n&stun p�u ���
if the building docs not currently have a tenant,that it is my resptmsibiblytm Land y di A
occupam of the requirements which must be met prior to issuance of a Certific `f
occupancy. ` Cl(y Ur 4
Owner or atu rmieed agent Data
TO L: ISSUED BY:
OFFIC
HOMETEC RICHARD A. HARTIMAN
ARCHITECTURE A.I.A.
EGG# WE
JAN 181995
BLDG; INSPECTION DEP
January 17 , 1995C1TY OF CUPERTIN0TMfNT
City Z
Cu
Buildient10300ue
Cup I014
e: Gesidence2Lane
PleaIngitems have been revised on the job copy
theion drawings for this project :
1 . A corner of the header between the kitchen and family room
• may be notched per my sketch.
2 . The rafters may overlap at the ridge beam in the family room
per my sketch. The tie strap can thus be omitted.
If you have any questions regarding this information, please don' t
hesitate to contact me at 408/995-0496 .
yEp erely,
A.
vV C'�1T��ha d Hartman, AIA
* Q REN. HOM ARCHITECTURE
LP�
�D 9
OF CA1./F
OFFICE po�y
1314 LINCOLN AVE., SUITE F• SAN JOSE, CALIFORNIA 95125 • TEL: (408) 995-0496
r v-
• of,
eclix
10300 Torre Avenue
Cupertino, CA 95014
Caper t hl.o Building Division
(408)777-3228
(408)777-3333 (fax)
May 23, 1996
Homeowner �� r✓j
20626 Kirwin Ln `C/(
Cupertino, CA 95014
12
Re: Expired permit, (26619, copy attached) 5/s
Dear Owner: /95�
According to our records, the referenced permit has not 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 (408) 777-
3228, so we may arrange to extend your permit and schedule a final inspection.
The City of Cupertino requires a response within ten(10) working days from the date of
receipt of this letter. If we do not hear from you within this time, the building department
will have no other recourse but to resolve your permit as expired and discard the records.
Thank you for your cooperation,
Building Department Staff, City of Cupertino
F,;wec on Recvc�ed P:iDer