S 0631 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY lk%CUPERT'INO BUILDING-ELECT RECAL PERMIT NO.
BUubING DIVISION APPLICATION/PNRMI'r PLUMBING-MECHANICAL S 0631
BUILDING PROJECT IDE\11FICATIO\
BUILDING ADDRESS: SANT TARN NO, PPLICATION SIIHMITIAL DA[
! X 6 ��� r Z-4 . Q z�
DWNCN'S NAME: PHONE: C( RA ORIS NAMit I.IC NO:
NIC CONBOLp
4 RCHITECl/ENGINEER: LIC NO: ADDRESS: ❑
CONTACT 1111ONE: BUILDING PERMIT INFO
❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT PLUMB MECH
El 1:1
LICENSED CONTRACTOR'S DECLARATIONQTY. ELECTRIC PERMIT FEE
1 hunch,affirm arm I am hee.se l ander provilmol or Chaps,9 cmmnendng JOB DESCRIPTION
�aZlh Section 7111NH(,f Dl vision 5ofine Bmim,and Pmlbs.iotu Codu.mdmy license is RENTIA
woo W' PERM])ISSUANCE
ESIDL'
CLLmfullfon:cnndcffccl. ❑SPOWI. ElKI'rcHEN REMODEL
NtLicense ClassLic.it APPLIANCES-RF_SI DENTIAL ❑ADDITION El PLUMBING RE-PIPE
yQi pule Cnnlmena []MULTI-UNIT ❑S'FRI1CfURAL
Fly ARCHITECPS DECLARATION PANELS
OZv,Z I understand my Plan,hall he meth as puhllc records UI'T02(N1AMI's ❑INFERIOR ❑MODIFICe\TION
CHIMNEY REPAIR
F 4)t:W Licensed professional 201-ANNE AMPS IMPROVEMENT SWIMMING POOLS
SY S OWNIIR-BUILDER DECLARATION OVER I000AMPS ❑BATHREM FU PAI )EMOLI' N
C ¢ I nercbr nfiimt that I am exempt from me cominwor',License Law for theis
XO WU ❑OTfiF:H
X d followin6 rcamn.Section]DJ LS,Hminess tied I'mfessinns Gyle:Any mly or county SIGNS ELELT'NICnh
W 3 LL y whicM1 rcyuires a peen::In nmslma,ulrer,improve,demnlisM1,or repair any nmame Pit iiiiii
I=0¢� prior m its issuance.also requires the applicant(orsuch permiunfilco signed sta¢menl I SPECIAL CIRCUION1ISC.
} mal he is licensed pursuennnlhe pru,womofthe Connector,License I,..(Chapter9
w00 (annmencingwish Sectin.7000nf Diemen 3..fmc lfusiness and Pmfirs,i...Crack)Or TEMP.METER OR PULP INST. COMMERCIAL;
Q.L oC that he is exempt Ihercfmm and the basis for me alleged exempt Any violation of ❑NEW BLDG/AUDITION ❑DEMOLI'I"]ON
X^_G Section 70]1.5 by any applicmn for.permit sabjecl,the it,,Iicum a u civil pcnuhy of POWER DEVICES ❑TENANT ❑FO(1)SERVICE?
W
not more than five hundred dollars($500).
1-=Q1,mowncrof the n.nrm talo ocxwiihwa es usihcirsnlccoin tion. SW[MMINGPOOLELECTRIC IMPROVE?MGNT
� 0 � Prope Y Ye P Y g' pens° ❑O'I'HIiN
F will do the work,nnJ lM1c nmaurcnnm:mended nr nRcrcJ for vle(SecABJJ,Bmines,
63 m and Profession,Cade:The Cmu.h6 License Law drcx ern aPNY s0 an uwncr of OUTLIiTs-SWITCHES-PI%Tl1R"
pmpeny who builds or improves demon,and who does such work hunself or through
hiss tun em,inyor,,provided that such improvements arc not intended or offered for NEW RESIDENTIAL ELECT S
sale.If.howeverthe building or improvement is%old within one year of comps-,......the SQ.IrpL.Ri AR EA 4/SQ.Pr.
owner will have the harden of pawing ibut he did not build or improve for pur- A i"' D
I rtef th pony m du. IY c r i t Ih I' I 1 act n p 2
ml uh p 1 1(Sse 70,14.Bar,imc,andP f..-'a Cod :)Th ComracwrsL p�
mve1 J r bPso t leer Fpr pony h 6 Id p : d QTY. PLUMBING PERMIT FEE
/Tj,Vr �/IawA
ho<(,nlracu fnruchpm7swdwh u
tcnnvamrR)huW punsuu tt iM1 Ccomoo':cmrx
Liocmc Law. PERMIT ISSUANCE UNr ry
❑lam exe underse ,B&PCRalm,narnn H/ I
ALTER-DRAIN&VI?M'-Wal'ER(CA) VAL '1'I(lN
weer Dmc
. WORKER'S COMPENSA'DONE DECI.ARATRI HACK FLOW PROTECT.DEVICE
I herchy a1Rnn muter penalty of perjury,one of the following decHations:
I huvcund will maintain a Certificate Of Comwntsn wif inure for Worker's Compen- DRAINS-FLOOR.HOOF,AREA.COND. STORIES 'TYPE CONSTRUCTION
,union,as provided lire by Section 3000 o1'the Labor Cade,for the pertommnce of the
work for which this permit is issued. FIXTURES-PER'I'RAP
1 have cod will maintain Nbrkers Compenwtion Insurance,as retained by Section
3700 of the Lubar Ode,for the perfonnunee of the work for whlchdl,prontus issued. GAS-EA.SYSTEM-I INC.4 OUTLETS (ICC GROUT' APN
My Worker's Compensation Insurance carrier and Policy number art: GAS-EA.SYSTEM-OVER 4(IEA)
Canner. Pnlivy Na.:
CERTIFICATE OF EXEMPTION FROM WORKERS' GREASERNDUSTRL WAS TE INT1TRCI?PfDR
COMPENSATION INSURANCE BUILDING DIVISION FEES
(This need no Ireianplcard iflhe pcnnit is femme hundred dollars($100) GREASI?'[RAP
� PLnNCIIECK PER
nr less 7
rtif that in the rformnceoflhe work for which this permit is moue),Ishull SEWER-SANITARY-S OHM HA.21X1 FI'.
not employ any penton in uny...ono sa as m hcaame,uhNII 1.'he WIn ers'ComPe.- ENERGY PI?li
OZ satin.Law,of California.Dam WATER HEATER W/VENT/EI.ECIR GRADING FEE
Q Applicant
z .Na NOTICE TO APPLICANT:If,.ther making this Certificate of Exemption,you should WATER SYSTEM?RFATING S
OILSE
a ' bwarm%object m the Worker,Cumpen,lion Provisions of the L3hrt Code.you onto
W forthwith comply whh,ach provisions Or dis pcnnit,bull be demnul revoked WATER SERVICE!
y
7z CONS'TRUCT'ION LENDING AGENCY NEW RESIDENTIAL PLMN. SQ.IT. Data k
U O nmreby anion that mea is a consimcaon lending agency fon the performance Or
W. t+ the wok rnr wni<n mix pemrir is�ssucd(Sec.JtNI.civ.c.)
C) F' Lxu&is Name 'IMA1.:
U lenders nJJrczs IDEAL:
�' 017 1 cenify thin 1 have read this npplicminn and sate that the aMwe infunnation is
IEEn' B TY. MECHANICAL PERMIT FEEUZ baiI,m[agrcemromply 1wreh,leitycnd anmtymativeccsa.d raym ensrelulin m Q PI?EU z huilAingconslactioq and hereby authorize represumative,..(This cityso coat upomhebus,normi(,ned property lar impcdio.pmPowl. PERM[I ISSUANCE C tF(We.).gree nr save.indemnify and keep hmodr,the City of Cupertino againsthahilities.judgments,cons and wx,rees which may in any way oceme against said City ALTER OR ADDTO MECH. G THEincomcyucnceof the grantingof In,permit.APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT CFO IaTphCFNU ICALIESOSLy�-' / AIR HANDLING UNIT(OVER IO,fID11 CIT1) CII( 'TAXSignature ofApplicmUCmtmctor etc EXHAUST HOOD(W/DIJLT) Mf[CATION FEE
HAZARDOUS MATERIALS DISCLOSURE
WII IM1c applicant or future building«cupal,tom
re(,,handle haruralm, aronal HEATING UtNITOO 10GAR)11'HH
es defined by the c1.i,mmo Municipal Gale.Chapter 9.12,and the[Icahn:tad Safety HEATING UNI',(OVER 1001X0)BTUs
Code,Section 25532o0P
El Yes 0 N VENTILATION I-AN(SINGLE BESIDE PAID
Date Rcfdpta
WII the vardnus aepplicam or future building occupant use eyuipmenl or devices which BOILER-COMP(3HP OR 100.000INp BTU[
emit hiir comaminin s m defined by the Bay Arca Air Quality Management tYfA
District! BOILER-COMP(OVEK 100.(NIf1 BTU) is
El C]No
I have rend the hvaNuus materials requirements Icer- t,under Cha h95 of the Cali- AI R CIN UITHINI.R ISSUANCE: )ATfi
fmmiigCalth does&scurrydy hasetons25505,i,u,,and 25534.1 torerslalul that ifthe NIiW HISIUENTIAI.MEGA. SV I'LL
building does not aurrcntly havcamnunt.ihm'n i,my m,pmsibility wnmiry the«cuPam
of the ruyuircmcms which must M tact pnm a issuance of a Cenificac Of OecuRncy.
Owner or amhurizeJ agent Date TOTAL: ISSUED IIY:
OFFICE
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Sent„by: JAKES ELECTRICAL 7295379 09/19/97 12:43 Job 600 Page 1
v
;fake's- Electrical P 922” a ox .� _ •
tilatr Liccnu Number C-10 #679321 408-729-5:400 FAX 408-729-5379
e-mail jakes(d,pacFcll.nrt
DATE: 9/18197
PROPOSAL #97-32069 ff
TO: David Stearns TFL: 409-446-99190" II
10866 Pear Tree Lane FAX:409-446-9919 fT�
Cupertino,CA95014 MAPGRID: 832-f7 t'llsa �r1'th
a
WM;PROPOSE. TO FURBISH AL1,LABOR AND MA'1'ERIAIS NECESSARY TU: o^-
I. Kemovc(3)nona:odc switches outside of the rear door and install a 2-gang junctian box inside The house in
the same location with junction boxes,conduit,wire and miscellaneous fittings as required and one switch for
u new customer furnished patio light fixture and the 2'"T switch wired to a junction box in the underfloor crawl
space for the pool light, pslimatd cost S148.12.
2. Disconnect existing pool light circuit,remove the existing pool side deck jrnetion box-slot dock back to the
brick mmining wall,instal naw schedule#80 PVC conduit from the existing bronze pipe coming up from the
light Niche to the planta bod, install a new above grade pool light junction box,continue the conduit through
planter bed,slut the deck ftom the retaining wall to the pool equipment area-inslall schodule#90 PVC conduit
under retaining wall and on over to the pool equipment area,install a GFCI(Ground Fault Circuit Interrupter)
in:I weatherproof junction bon with a spring cover on the brick face,bore through IITe brick into the equipment
room and route a 012 gauge non-meWhi;cable through the underfloor crawl space back to the junction box in •
the underfloor crawl space mentioned above. Estimated cost$296.32.
. Inaall new GFCI protected circuits for the pool sweep and pool filter pump with a separate circuit breaker in
the main service panel, non-mcallic cable run through the underfloor crawl space and utilization of existing /
time clocks and pool equipment wiring as required. Estimated cost S187.16. n �ANe3
4. Install grounding type receptacles in the loratiOlLx bpOdfred in the rear bedrooms with a separate wt-in box,
duplex receptacle and cover in each bedroom and a 0012 gauge non-mctalic cable through dltc underfloor
crawl spuce too scparate circuit breaker in the main service panel. Estimated cam S 155.87.
TOTAL ESTIMATED COST: S 787.47
NOFEe PRICY. RA&PJI ON ALL WORK IMI NU DONE AT THE NAMr TIME,D A JOB IS DROKEN UP IN 10 aEYARATE PARTN
rlMAV DI:NPAMS.xARV TO ADD A SERVICE.CALL MINIMUM CnARUV.'rn I rry V311 T 1E ADDITIONAL.TRAVEL EXPENRP.
EXCLUSIONS:
1. Permit fees and permit related costs. If a cusloma does not wish to assume permit responsibility we will Inkc
out the permit and coordinate inspections with the understanding that the cost of the penuit fees and time
required to deal with the inspection department will he added to the total coal.
2. Touch up painting and a guarantee of an exact match to existing textures when wall surfaces must be opened
to facilitate our work. While our worker&have been lustructed to exercise reasonable care in patching wall
surfaces, in critical areas the services of a drywall,stucco,or painting contractor may be rocplircd to obtain art
exact match IB existing textures.
CON'T'INUED
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Sent, by: JAKES ELECTRICAL 7295379 09/19/97 12:43 Job 600 Page 2
PROPOSAL N17-32059 CONTINUED •
!. Guarantee to restore patio stones. landscape plants and/or lawns fo an as original condition following the
installation of the underground conduit and wire. While our workers have been instructed to exercise
reasonable care to minimize damage landscape plants and lawns• in some casts the services of a professional
gardener may be required to vesture landscape plants and lawns to original condition.
4. Return trip to cover underground conduit runs following approval by the inspection department.
5. Work other than described including the correction of any existing electrical discrepancies or code violations
not related to our work which may be discovered during the course of the job. As licensed electricians it is
our professional responsibility to advise customers*I*potential hazards and non-code oomplumm items•
however no repairs resulting in extra cost will be made without authorization.
WARRANTY: (5)Years on all workmanship and those materials not otherwise covered by a specific
manufacturer's warranty such as circuit breakers and ground fault protection devices.
GUARANTEE.: All work is to be done in a neat and workmanlike mannet and in aUUordancoe with all l.oall,State
and National Electrical Codes.
TERMS: Pavment in ILII on completion of work.
EXTRA WORK. if requested,is to be done on a cost plus ha&ix with Labor cop at S38.%per hour and nmterial
cost at end colunm or the standard contractor wholeAale cost,plus 1M overhead and 9%profit.
SCHFDITIANG: Work is to be scheduled st the convenienoc of the customer during norrrual business hours in our
neat opening following aaxpts=and continue until job has been completed.
l
PROPOSED BY: �'� '""i) NOWT FRUY09AL MAY Irk.WITHDRAWN IF
JAKE JACOBY DATE NUIACCKPITDWITIRN(14)DAYS.
If the scope of work,price and terms are acceptable,please sign in the space indicated below and
return a copy as soon us possible to insure that the work can be scheduled on the date regpcsted
<)�9
ACCEPTED BY: �K_X�'— N(ll'M.: Cl1K'1•(IMERMAY CANCF,\.WI'1'NIN
OWNER IAOkNT DAT[ (1)DAYS OF THE DAM ACCEPTED
wf1'jux:r PENALTY.
171ETTI//OW1NC'WONDIN['IS1t5'OUINCD UN.LL/ y0AfE1MYROV£,A/6NTCDN77t((7SBYSTATELICEMSe Moor
(.YINTRACIORS ARK REQUIRED BY LAW'10 BE LICENMID AND REIiVLATBD BY THE CONI MACIORS'A al'Al'L LICENSE.
BOARD.ANY QUESTIONS CONCERNINC A CONTRACTOR MAY BE REFERRED TO THE REGISTRAR,CONTRACTORS
STATE I:Ir7NVE BOARD,903 GOETDF.ROAD,SAC1tA1RP.NTO.CALMORMA 95427(MAIIMM AmrROM.PO BOX 26000,
SACRAMENTO.CALIFORNIA 9SU71 '
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