21064 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
Building Project Identification PERMIT NO.
s Bu Od log Address:
VIS -f�a /2- ( pullri0 CA-. qs-0 21064
ante: /� Gone' ar
C-rwon GI'
LO OGh /�✓' /y4�' EITY OF CUPERTINO-BUILDING DIVISION
ntrad.rs Name:� y� Lac.No: APPLICATION /PERMIT `C V r4' 4/Is,vnf, Co ncrt-t'c /'111$Ono STq 39 6 BUILDING fMFCTRICALPLUMBING-MFGFIANICAL CATEGORY CONTROL I
Ami luct/Engineer. Lic.No:
L<I It L-T—t+A K, G O 4 o g 3 BUILDING PERMIT INFO
QTY ELECTRIC PERMIT FEB
Addre,s 25T't;l 5. 34540,4 *11 , * I 0-L,
PERMITISSUANCE ❑ ❑ ❑
L m that ED CONTRACTOR'S DECLARATION
Thereby offirmthat) n,isiolicensed 3.ftheunder pessand so(Chapter
oide,and
APPI-IANCESRFSIDENTIAL JOB DESCRIPTION
Inense I I.
7000).!Dlvlelon3 althe Buelneaeand Protessl.naCade,and my
license bin fuB forepyn e!f PANELS
I.Icense Clava C�4 c,c �8 P/b
Date�(— QyCHITEC7LARATIPS
\\\ 111 ♦♦`
WJIF
AmaH U CPSDECLARATION OVEOIODO AM
O7OC Iunderebnd my pians ehaBbe uaetl sspublic rerorda OVER 1000 AMPS SQ.FT.FLOOR AREA 5/SQ.Fi.
Licensed Pmfembvl SIGNSELECTRICAL
OWNER-BUILDER DECLARATION SPECIAL CIRCUIT/ ISG
ZF' Iherebyatfirm that lam exempt from the Contractors License Law for the
Oppp following reason.(Section 7011.5,Business and Professions Code:Any city or
GS'"' c ntywhlchrequlresapen ttocmaatmu ,alter,lmpmwdemolbh,orrepair TEMP.MLTGR OR4 I
g < nystructur,prlorto its Wuance,also requlresiheappRcent for such permit to Ii9WFR DEVICES
R i� U file a signed statement that he Is Isocamd pursuant to the proWiow of the
Q63O Cont.d.ea License Law(Chapter 9(commencing with Section 7000)of Divi- SWIM POOL EL
ftW cion 3 ofthe Buslneesand ProfessionsCode)orthat be la exempt therefromand VALUATION
G the basis for the alleged exemption. Any violation of Section 70115 by any t7
a licant fora mit sub' the applicant to a dull nal of not more than OUTLE l'C ^ �f'ya�
PP per I� PP penalty
c, live hundred dollarshe pr.
QQ I,as owner of property, NEW RESID AL ECTR SQ.ASTORIES TYPECONSTRUCTION
�n ❑ p perry,ormy employees r their
compensation,will do Business work and theaWdumisnot Intended orcensoffered Lfor
O ,ale(Sec.7 py to show owner
f property who
builds:The Contractors thereon law
$$ doesnot appy.oars ownerofthroug his. nemoree,,pr provided
that
ryuch OCC.CROUP RIS.UNITS
and
who does such work hlmsel(orthrough his own employees,provided that such
improvements are not Intended oralfered for sale.If,however,thehullding or TOTAL:
Improvement b sold within oneyearofcompietlon,the owner-bu0der will have
tt as owner
of proving that he did not build or improve for purpose ofsals.). QTY. PLUMBING PERMIT FEE FLOOD ZONE APN
�j L as owner of the properly,am exclusively contracting with licensed PERMIT ISSUANCE
contractors to cm aimct the project(Sec 7044,Business and Professions Code:
The Contractors License Law does not apply to an owner of property who ALTER-DRAIN&VENT-WATER(EA)
Wilds or Improves thereon,and who contracts for such projects with a FEE SUMMARY
y(ad.r(s)licensed pursuant to the Contrador'•License Law. BACK FLOW PROTECT.DEVICE
c t_f I am exempt under See. B&P C for this reasonTES
Owner DRAINS FLOOR ROOF,AREA,COND. SANITARY Y N= .
Date RECEBT
WORKMAN tAN COMPENSATION DECLARATION FIXTURES.PER TRAP SCHOOLTAX Y N
❑I hereby affirm that I have o lmumne of consent to pythemof ora RECEIPT a
cediticeteo(W.rken CompensaHon[nsurence oracertlfled copythereof pec. GAS EA.5YSTEM-1 INCA OUTLETS PARK FEE Y N
policy p GAS EA.SYSITM.OVER 6 MA) RECENT X
Com any BUILDING DIVISION FBES
❑]Certified copy is heed with he ed.city GRFASE/INDUSTRL WASTE INTERCEPTOR PLANCHECK FEE
Certified copy b filed with the city InepMlan division.
CERTIFICATE OF EXEMPTION FROM WORKERS' GRFASETRAP PAID
COMPENSATION INSURANCE SEWEILSANITARY-STORM EA.200FT. Date RCoei I#
RNssection need not becompleted R the permit b forms hundred dollars
(f100)orfWATER HEATER Wr/VENT/ELECTR ENERGYFEE Y N
(certifyy that In the performance.(the work tarwFlch this permit is issued,
I shall not employ any person In any manner a,u to become subject to the WATER SYSTEM/TREATING
Workers Compensation Laws of California.Date PAID
O Z Applicant NEW RE9DENTIAL"ll. SQ.FT. Dale Recei t#
ZQ NOTICEco APPLICANT:to
orkefterraCompking beathst Certificate of Exemption'you
CC Code,shoulyou
amrthwit the ply with
Compcma/ionproWiopermit Labbe TOTAL:
S N deemed
muetlorthwlth comply with each provblons.rthb permit shall be BU ING
W deemed revoked.
d f]
CONSTRUCTION
ruciDING AGENCY SEISMIC FEE L
I hereby afOrm that there i a ermwdssu lending agency for the perform, ELECTRIC FEE
D Z once of the work(or which this construction
(See 3097,Civ. TOTAL:
02 Lender.Name PLUMBING FEE
LL F Lender',Address QTY. MECIIANICAL PERMIT FEB MECHANICAL FEE
OLUI certitythat I have read thisappllration and statethalthe above Information
C Is correct.I agme to comply with all cityand county ordinance,and state laws PERMIT ISSUANCE FEESPAID:
>. N relating to building constructlo^,e^d herebyauthorlu representatives of this
F U) city to enter upon the above-mentimed property for Inspection purposes. ALTER OR ADD 7O MECH.. Dale Re[CI t#
— (We)agree to save,inden= and P harmi,ss the City of Cupertino P
against Rabilitic, jadgmenb,cones a penes whichnaylnanywayacaue AIR HANDLING UNIT(TO 10,000 CFM) SUBTOTAL'
I s 1 In cona.quenre of a anling a(thb it
AIRL� CONSTRUCTION TAX
AIR HANDLING UNIT(OVER IO,000CFM)
Signature. plicant/Tontfinctor Date FXHAIISTHOOD(W/DUCT) CONSTRUCTION TAX PAID:
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building occupant.mrs or handle hazardous HEATINGUMT(TO100,000BTU) Date RC[CI f#
material as defined by the Cupertino Municipal Code,Chapter 9.12,and the
ITeahh and Safety Cod,Section 25532(a)7 HEATING UNIT(OVER 100,000 BTU) TOTAL:
RYes No
illthe applice^tur urebuildingottvpantuseequlpmentordevices VENTILATION PAN(SINGLE•RISID) R1/IWNCE DATE
which.ManaementsalMmnb ae defined by the Bay Area Air CQ`34NJ
Quality Management .,aDistrict? BORER-COMP OHP OR 100,000 BTU)
Yes No SEP
p (]
have read the haze ons materials requirements under Chapter 6.95 of BOILER-COMP(OVER 100,000 BTU) SE 24 jw990
the Calilomia Health&Safety Cade,Sedions 25505,75533 and 25534. I
understand that lithe building don not mrmntly ave atenan4 that ltbmy NEW RESIDENTIAL MEC!-I. SQ.ET. xasa{{p
roporulbllitytono cIle.mvpan,.(the mqul mentewhich must be t esE}4u l n
to enc a0� FBFrpanry.
Ownccl'or autholend agent Date ISSUED BY\,1(��f W xj,f}J
•metas
TOTAL: :
OFFICE COPY
pk POPA - KIHLTHAU
STRUCTURAL ENGINEERING CONSULTANTS
September 11, 1990
C.J. Bocchieri
10353 Mira Vista Road
Cupertino, CA 95014
Re: Living Room Fireplace Repair for Residence
at Above Address, Cupertino, CA
As per the request of Pat McTighe of Paramount Concrete and Masonry, Inc.,
I made a site visit to visually observe the condition of the existing
fireplace and the repair required for the chimney stack for the above
referenced fireplace. The area below the throat of the removed chimney
stack appeared to be unreinforced masonry. However, this base of masonry
did not appear to have any cracks as a result of the October 17th, 1989
earthquake. Therefore, it is my opinion that rebuilding the chimney stack
with four #4 bars (one at each corner) vertical, dowelled and epoxied into
the existing base masonry (6" minimum) tied with #3 ties and strapping the
chimney stack at the roof level with FHA straps per standard details will
suffice as a repair for this fireplace.
If you have any ions regarding this matter, please do not hesitate to
call thi office.
QROF ESS/O,y
imoth M. i It
M k1
R.C.E. 40834 5�
cc: Paramount Construction Na. C0408. G A APPROV�D
409 Alberto Way
Exp.�„ IN ACCORDANCE WITH THE CITY OF,
Los Gatos, CA 95032 / y� CUPERTINO CODES AND ORDINANCES
�rgfFOF CAUF���\P
SIGNED O' cation ST
This set of pans and QPe
be kept on the lob ac5`1 times
eas ot nd it is Un-
atter Uons
InWful to make any t}
on same Without Wiidcn permission from
he building Dept., G:ty of Cl,pertino.
COMany
the stompn8of ih� pca anJ Specifications
Firm
[t" Et1ALl ;OT
be be d to permit of to be as
II�,Ya ,rr�e,,;tl n( tha u�laticn r,I Prava,'iof+b
'It rile f i $1tv 0 ,:a:" cr tc
GOLDEN VALLEY OFFICE CENTER
2542 South Bascom Avenue • Suite 102 • Campbell, California 95008
Phone: (408) 559-4202 FAX: (408) 559-3628
rBk ) • POPA - KIHLTHAU
• STRUCTURAL ENGINEERING CONSULTANTS
September 11, 1990
C.J. Socchieri
10353 Mira Vista Road
Cupertino, CA 95014 I!L 14-197390
CITY OF, CUPERTINO
Re: Living Room Fireplace Repair for Residence BUILOINO DAP]',
at Above Address, Cupertino, CA
As per the request of Pat McTighe of Paramount Concrete and Masonry, Inc.,
I made a site visit to visually observe the condition of the existing
fireplace and the repair required for the chimney stack for the above
referenced fireplace. The area below the throat of the removed chimney
stack appeared to be unreinforced masonry. However, this base of masonry
did not appear to have any cracks as a result of the October 17th, 1989
earthquake. Therefore, it is my opinion that rebuilding the chimney stack
with four #4 bars (one at each corner) vertical,' dowelled and epoxied into
the existing base masonry (6" minimum) tied with #3 ties and strapping the
chimney stack at the roof level with FHA straps per standard details will
• suffice as a repair for this fireplace.
1f you have any ions regarding this matter, please do not hesitate to
call Chi office.
QROFESSION
4imoth M. i It
R.C.E. 40834
cc: Paramount Construction �9 No. C0408, IN ACCORD'4I'PROVED
409 Alberto Way. Exp'�/f11 � CUPERTINO ANCE WITH THE CITY OF
Los Gatos, CA 95032 p�q IVI 4 �P DATECODES AND ORDINANCES
OF CALIFOQ�,. —
SIGNED g%
bels set of Sand spaoificatinn� MUST
kept make an- at, a.I un•
lawful to limas and itis
on same changes or alterations
g[ it llrittcn permission from
, C
the building De t.,
The stain P City of Cupertino. m
THIS PLAN SHALL P101Rn of the p,a-ri and specifications
1'HE JOB AT SHALL REMAIN 014 3PProval of the violati n
ALL TIMES C1 Permit or to is an
PaRIMG °f any City Ordin,nco Ot any Provisions
CONSTRUCTION. or State Law,
GOLDEN VALLEY OFFICE CENTER
2542 South Bascom Avenue III, Suite 102 • Campbell, California 95008
Phone: (408) 559-4202 FAX: (408) 559-3628