27625APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
CITY OFCUPERTINO
1111.11L MING ECHANI
APPLICATION/PERMIT PIAMBING CI SDEAN1
UUII,UING DIVISION nUu.mrvc rlxo.lECT wx,NT1
FEF,
FEESUMMARY
PERMIT ISSUANCE
OUI1Lr,E1E
LICENSED CONTRACTOR'S DECLARATION
APPLIANCES - RESIDENTIAL
OCZ
I hereby affirm that l am licensed underpmvisions o'Chopler9(commencing with
of Division 3 of he aiProfession?ede and Ylicenu is in
PANELS
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fulltion forcc and)cffBusiness
Liters .11 Lic.# G9a 72
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ARCHITF.C'I'S DECLARATION
understand my plans shnllbc uud as Public reemads.
UP 2TO WAMPS
201-1000 AMPS
OVER 1000 AMPS
SIGNS ELECTRICA \
Licensed Prolcssional
ER
OWN -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the
following reason. (Section 7031.5, Business and Profession, Code: Any eiy m county
which requires a pemti no construct. aher,improve, demolish, or repair any structure}� prior to its issuance, also requires the applicant for such permit to file a signed statement
hist he is licensed pursuant to the Provisions of the Contractor's License Law (Chepmr
9(commencing with Section 7000) of Division 3 ofthe Business and Professions Cede)
or that he is exempt therefrom and the basis for the alleged t n An 'olationof
P 8e Pio. Yvt
Section 7t13L56ya ive hundred (S 51 rmit euhjccm lM1e applicanttoucivil penalty of
nm me than rofthndr ny.ors(ycmp.
❑ l.asoche wrk,andeproperty, Drmycmpfndedorthwed forafesafe (Sec. 70aH, Brmion,
will dothssions and the structure is not is offered 7044,wner os
SPECT CUIT/MISC. \
TEMP. METER OR POLE INST.
\
POWER DEVICES
WIMMING POOLE
O ELS -SW TO
NEVRESID L _SQ. FT.
TOB DESCRIPTION
ntapply.
Contractors License La not apply if an owner of
and professions Cede: Law
PAID
SQ. FT. FLOOR ARRA
$/S0. FT.
iThemproves nd who such
propenywho b.pmviiibs dmp
iesthemnt,.ndw tsd n intwork oroffthroughfre.I .
If.
employees,providedtprovehimPis
TOTAL:
sold ithinneyewdcdoopledfed det own
however, lderwtheavetngnrimprovement issoldwithinoneyamofcomple0on,theownan
builder will Lout the burden of proving That M1a did not builA m improve far purpose of
QTY. PLUMBING PERMIT
Sal,),
❑ I, as extlus s torso
C
the pr jethe Sec. 70.1. and Prof ssio s de) Th Coin
I1mswn the project (Sec. 7044. Business and Professions Code:) The Cen en.
iccnsc how does nm apply to an nwncndpmpery wbobuildxorimprovcs thereon,and
PERMIT ISSUANCE
who contractsforsuch PmjeOx with acontractor(s) licensed pursuznuo the Contractor's
License Law.
ALTER - DRAINBe VENT - WATER(EA)
❑ 1 am exempt ander Sec. , B & P C for this ma. n
BACK FLOW PROTECT. DEVICE
Owner Dote
WORKMAN COMPENSATION DECLARATION
DRAINS- FLOOR. ROOF. AREA. GOND,
FIXTURES - PER TRAP
❑ I hereby affirm that l have. certificamofconsem ulf-ins c, fain o!
Workers Compensation insurance or a cerified copy the d(, c. B( nb C.)which
GAS - EA. SYSTEM -I INC.4 OUTLETS'
covers all employ., under this .it.
Policy #
Company
GAS - EA, SYSTEM -OVER 4(IA)
❑ Certified copy is hereby Limited.
❑ Certified copy is filed with the city inspection division.
GREASILINDUSTRI, WASTE INTERCEPTOR
CERTIFICATEOFE—EMPTION FROM WO KERS
GREASE TRAP
COMPENSATION INSURANCE
phis tithed need not be completed ifthe Permit is for one hundred dollars($IW)
SEWER -SANITARY- STORM HA. 200111'.
less.)
WATER ItFTER WNENT/ELECYR
Iccrtifythat in Neper(carersnfthe work forwhich Nis permit isissui l shall
ZCompc,mi2e
7� 0
not employ any Persian in any manner so as in become subject to the Worker
awsof Celifomi.. Date
Applicant
NOTICE: TO APPLICANT: IL abet making this Certificate of Exanpdon. you should
WATERSYSTEMRREATING
NEW RESIDENTIAL PI -MB. S FT.
Q
(--i Co-
become subject to the Worker's Compensation previsions of the Latin Cede, you moat
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fnrhwith comply with such provisions or this permit shall be deemed revoked.
4 F
CONSTRUCTION LENDING AGENCY
V O
F
0
F'
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1 hereby affirm that them is a construction lending agency for the performanm of
the work for which this permit is issued (Sec. 3DD, Civ. C.)
lenders Name
TOTAL:
QTY. MECHANICAL PERMIT
lenders AM..
1 certify that 1 have fend this application and state that Ne above information is
convict. I agree to comply with all city and county ordinances and state laws refiling to
building construction, and hereby uuthurim representatives of Niscity to enterupon the
above -m rtmood pro,smy for inspection purposei
We) agree to save, indemnify and keep horelas the City of Cupertino against
liabi titles. judgments, costs and expenses wInch may in any way accrue against add City
PERMIT ISSUANCE.
ALTER OR ADD TO MECH.
AIR HAN DLING ON IT (TO 10,000 CFM)
in conseque a of the granting f e, permit.
AIR HANDLING UNIT (OVER 10,000 CFM)
EXHAUST HOOD(W/DUCI)
Signa Applicant/Cu rat n tc
HEATING UNIT (TO thin U BTU)
HAZARDOUS MATERIALS DISCLOSURE
_
Will the applicant or future building nec.panl,mreer handle h.rardous mmedal
us defined by Ne Ca,rino Municipal Code, Chapter 9.12, tints the IIax11M1 and Safety
HEATING UNIT (OVER IW,fXXI BTU)
_
VENTILATION PAN (SINGLE RFSID)
Cede, Senior 25532bb?
❑ Yes ❑ No
BOILER- COMP(3HP OR 100,(10) BTU)
Will them Ii am orfmme building ' moue mrdevice, whi,hcoil
PP 6rccup.m 4uipmcn
BOILER - COMP (OVER 100.000 BTU) -
aeustZ nit communities us defined by the Bay Arca Air Quality Management
U,,mel?
NEW RESIDENTIAL MECH. SQ. FT.
❑ Yea ❑ No
1 time mad the hmardme, materials requirements under Chapter 6.95 .1 the
C.lifomin Health & Safety Code. Sections 25505, 25533 and 25534.1 understand that
if the building does net currently have a mount. that it is my responxibiliry to nmify Ne
cepam of the requlremems which mast he met prior ,,issuance of u Ceni tocithe of
Occupancy.
Owneror aulhori ed agent Date
TOTAL:
FEF,
FEESUMMARY
-_„.... ..._ 27625
OUI1Lr,E1E
SANT Y
SANITARY
NO.
APPLICATION SUBMITTAL DATE
I� 13�S
SCHOOLTAX
Y N
N/C
❑
CONTROL It
PARK FEE
FTE
BUILDING PERMIT INFO
BUILDING DI VISION "I
BIILLD�DGrr
e�
ELECT PLUMB MECH
❑ ❑ ❑
GRADING FEE
SOILS IEE
TOB DESCRIPTION
PAID
SQ. FT. FLOOR ARRA
$/S0. FT.
FEF,
BUILDING FEF-
SEISMICFEE
ELECTRIC ME
PLUMBING FTI:
MECHANICAL FEE
CONSTRUCTION TAX
PAID
Dale
ILJ
✓AN 13
19
C!lY Ur• LLU,.gri
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\
UED BY: v F P
FEESUMMARY
7
OUI1Lr,E1E
SANT Y
Y N
RIiC IP`p#_
SCHOOLTAX
Y N
_
RECEIPT#_
PARK FEE
Y N
RECEIPT#
BUILDING DI VISION "I
PLANCHECK FEE
GRADING FEE
SOILS IEE
ENERGY FEE
PAID
Date
Receipt #
TOTAL:
BUILDING FEF-
SEISMICFEE
ELECTRIC ME
PLUMBING FTI:
MECHANICAL FEE
CONSTRUCTION TAX
PAID
Dale
ILJ
✓AN 13
19
C!lY Ur• LLU,.gri
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UED BY: v F P
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of,
Cupertino
10300 Torre Avenue
Cupertino, CA 95014
Building Division
(408) 777-3228
Fax(408)777-3333
December 4, 1995
Resident
10481 Oakville Court
Cupertino, CA 95014
Subject: 10481 Oakville Court, Permit # 27625 - Foundation Repair
Dear Resident,
According to our records the above mentioned permit has never been f haled 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 by
calling (408) 777-3228, so that we may arrange to extend your permit, and schedule a
final inspection.
In an effort to control the number of expired permits, the City of Cupertino
requires a response in ten working days from your day of receipt of this letter. If we do
not hear from you, the City of Cupertino's Building Department will have no
alternative but to resolve your permit as expired and discard the records.
Thank you for your assistance.
Sincerely,
City of Cupertino
i
1-IJJ'1�
P'infee en Pc`CVC!ee Paver