25489 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO LDBPG-P.I:ECTRICA L PERMIT NO.
APPLICATION/PERMIT PLUMBING-MECHANICAL.
BUILDING DIVISION BUILDING PROJECT IDENTIFICATION 25489
BUILDING ADDRESS: I s `�I SANITARY NO. APPLICATION SO BMOTAL DATE
L1 , ✓ L UNIT# IAT# [
(,.. OWNESNA PHONE: CONTRA R'S NAME: LIC NO: ]SIC CONTROL#
/� heALt
oY
0.CHITECULNGINEER: LIC NO: ApDRESS: uD—'� ,/ ❑
CONTACT: PHONE: QTYELECTRIC PERMIT G[ FEB BUILDING PERMIT INFO
BLDG ELECT PLUMB MUCH
PERMIT ISSUANCE ❑ ❑ ❑
LICENSED CONTRACTOR'S DECLARATION APPLIANCES-RESIDENTIAL LOB DESCRIPTION
CZ IherebyafOrm tint l am licensed underprovisions,dCTepter9(ammencing whin00 Seem.
70001 of Division 3 oftehBusiness and Prer fessioCadan
e. d my license is in PANELS N
ry��utzLLfF—.. full forte endeffect.
6FyU License Class—Liap UP TO2 AMPS C� 10 1Lse ESP"
1 P .w
F.<y Dvre Convector OVER
IM
. rF��- �(A�I'f.
ZOyZ ARCHITECTS DECLARATION OVER 1000 AMPS SQ.PI'.FLOOR ARIA S/SQ.PI'.
O Z^� I understand my plans shall be used as public records.
r4
SIGNS ELECTRICAL
9� V Lic<nxd Professional OWNER-BUILDER DECLARATION SPECTALCIRCUTT/MISC.
,�4Oa 1 hereby from that 1 am exempt form the Contractors License law for the
u13QL�i following reason.(Section 7031.5,Business and Professions Code:My cityor county TEMP.M RO
which¢quires a permit to construct,atter,improve,demolish,or repair any atr me
fcoY� prior to iuissuance,also requires the.pplicantfar such permit to file.signed statement POWER DE
y�j p
that he is licensed punuanuo the provision of the Convector's Lima—law(Chaptm
d o�' 9(commencing with Section 7")of Division 3 of the Business and Professions Code) SWIMMING POOL ELECTRIC VALUAnO
or that he is exempt Netefmm and the basis for the alleged exemption.Any violation of
LZG Smile.7031.S by any applicant fore permit aubjecd the.pplianOUTLETS t0 a civil pessahy of RES 1 ��
not more
than five hundred dollars(5500). NEW RESIDENTIAL EL
pro ❑ I,esowneroftheprogeny.ormyempioyeeswithwmcsavtheirsolee mp mation, SQ FC STORIES TYPE CONSTRUCTION
a will do the work,andtheslanture isnot intended misfired forade(Sm.7044,Businm,
and Professions Cade:The Contractors License law does not apply to an owner of
property who bui Ids aro improves thereon,and w ho does such work himself or through his
con employees,prvided that suchimprovements taroenotimendedorofferedforsnle.If, OCGGROUP ----RES.UNITS
however.the buildingor improvement is sold within one yearofcompletim.the owner. OTAL:
builder will have the burden of proving that he did nm build or improve for purymae of
sale.). TY. PLUMBING PERMIT
❑ I,ss ownerofthepropeny,am exclusivelycommeting with licensed contractors to Q FEE 1'1000 LONE AYN
construct the project(Sec.7044,Business and Professions Code-) Ile Contmcrora PERMIT ISSUANCE
License Law does nam apply loan owner of propeny who ankir or improves thereon,and
whomntrmu forsuch projects with a conrsactor(a)Iicensedpursuanumhe Centnetors
PEMARYLicense Lew. ALTER (EA)
❑ 1 sea exempt under Sec. ,B&P C for this reason BACK T TDE
BACK FLOW PROTECT.DEVICE SANITARY Y_N
Owner Date RECEIPT'N
WORKMAN COMPENSATION DECLARATION DRAINS-FLOOR,ROOF AREA,COND. SCHOOLTAX Y_N_
❑
]hereby.
from that l have a certificate ofconsent to self-imure,or a certificate of FlXTURES-PER TRAP RECEIP #
Workers Compenaadonfns..oracenified copy,thereof(Sec.3800,LabCJ which PARKFEE Y N
coven dl emplo se's er is it. RECEIPT
Poll yGAS-G.SYSTEM-I INC.4 OUTLETS BUILDING DIVISION FEES
Company GAS-EA.SYSTEM-OVER 4EA
[3Cmifiedcopyishembyfumished. ( ) PLANCHECK FRE
❑ Ccrtifiedcopy is filed wiN the city inspection division. GREASFFJINDUSTRL WASTE INTERCEPTOR
GRADING FEE
CERTIFICATE OF EXEMPTION FROM WORKERS' GREASETRAP SOILS FEE
COMPENSATION INSURANCE.
Chis section need not be completed ifthe permit is forma handreddollan($EX) SEWER-SANITARY-STORM EA.200FT. ENERGY FEE
or less.)
I anify that in the performance ofthe work for which this permit is issued,Ishall WATER HEATER W/VENT/ELECTR
not employ any person in any mannas so u to become subject to the Weaken' PAID
Campensationlawsof Cdifomia. Date WATER SYSTEM/IREATING Dore ReceiptN
Q z Applicant
z�-s NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should NEW RESIDENTIAL PLMIC SQ.PT. TOTAL:
pbecome subject to the Worker's Compensation provisions of the labor Code,you most
ai 7 foMwith comply with such provisions or this permit shill be deemed revoked. BUILDING FEE
W Q CONSTRUCTION LENDING AGENCY SEISMIC FEB
z Iherebyaffmtm that there iso construction lending agency for the performance of
V O the work for which this permit is issued(See.309],Civ.C.) TOTAL: ELECTRICFEE
E Lenders Nam.
Q Lender's Address QTY. MECHANICAL PERMIT FEE PLUMBING FEE,
1 certify that I have mad this spplication and mute thv the above information is� MECHANICAL PEE" C correct.l agree m comply with dl city and ordinances and state laws relating to PERMIT ISSUANCE
F" V) buildingconsouction,and hereby authorize represcnutivesofthiscity to constrain the CONSTRUCTION TAX
U z above-mens m property for inspmtion puryosea. ALTER OR ADD TO MECH.
(We) g to save,indermmi(Y emf keep humlas Ne City of Cupertino against
liabilities, mcos,coessindearmse 'ch inmywe accmeagdnst dd Cit AIR HANDLING UNIT(TO 10,000 CFM)
in c mast sof Ning
egermofri it.
AIR HANDLING UNIT(OVER 1(1,000 CFM)
`517 Appli Cont Date EXHAUSTHOOD(W/DUM
PAID
(AZAR OUS MATERIALS DISCLOSURE HEATING UNIT(TO 100,000 BTU) Data Receipt#
WItdo,applicant or future building occupant start or handle havrdous materiel HEATING UNIT(OVER IW.WO BTU) TOT
u defined by the Cupcnino Municipal Code.Chapter 9.12,and the Health and Safety
Coda Section Y332(e)1 es ❑No VENTILATION FAN(SINGLE RESID)
Will the applicarumansuas building occupantme Area rant Quality
ranagement
BOILER-COMP(3HP OR IM.W BN) ISSUANCE DATE
�haramoa9 u'u contaminunu ns defined by the Bay Area Air QueliN Management
District? BOILER-COME(OVER 100,000.000 BTU)
❑Ycs ❑No NEW RESIDENTIAL MECH. SQ.FT. QSl A ' D
I have reed the hazardous materials # 1� K
requirements under 34, fur understand
of the
if the buil Ingdo&Safety
ur Code,Sections 25505,25533 and 25534. Iity to unit that AUGif the of the
and currently w hive.urns,.that prior my responsibility of a t0 unity of f[/kl ��atCj�1
orccupant of the nequiremcnla which man be met prior m issuance aro a Cenifipte of
e�,Pa,rey.
Oenti-maulh00zcda$anI Date TOTAL: ISSUED BY I k .f IIIV/l
k
- ROMA TILE, LTD.
ROLANDO 'ROLAND" NEGRINI, President
License No. 380846
5087 Lone Hill Rd.
Los Gatos,CA 95032
)408)266-9444
MAY 11, 1989
CRESTWOOD CONSTRUCTION
335 McGLINCY LANE UNIT D
CAMPBELL, CA 95008 377-0822
RE: MR: & MRS. PORAT — — - -
22001 LINDY LANE
CUPERTINO, CA 95014 255-5165
TO WHOM IT MAY CONCERN,
TO ASSURE ALL PARTIES INVOLVED REGARDING THE TILE WORK DONE AT 22001 LINDY LANE,
CUPERTIN09 CA, THE TILE WORK WAS DONE ACCORDING TO THE CUPERTINO BUILDING CODE.
THE BUILDING CODE FOR CUPERTINO IS CRAFT PAPER, FERRING NAILS ON STUDS WITH 18"
GAGE WIRE MESH AND MORTARS A THIN—SET BONDING COAT & TILE.
• ALSO TO EASE SOME MINDS ROMA TILE, LTD. WILL GUARANTEE OUR WORKMANSHIP FOR
FIVE YEARS. THIS GUARANTEE IS CONDITIONAL TO ANYTHING BEYOND OUR CONTROL, LIKE
EARTHQUAKES, TREMORS AND NORMAL EARTH MOVEMENT, ETC.
1 SINCIRtELY,
i t A
ROIANDO D. NEGRIN , PAES. FOR
ROMA TILE, LTD.
a