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12406o ¢ z Foo QUU ~ wD y z o T z O z F o wt Q YZ a ¢pwu X A. F - NO 4 i w > ca ¢ O0 ca m S. W E i o A. 3 _ O Z P: O Cr LU _ ao 7z UO LL U Ow ♦-N z. LS 3 .APP!_ICANT TO FILL IN INFORMATION WITHIN RED LINES- USE BALL POINT !"EN d.%JLY 6 1UILDING�?!OJECTIDENTIFICATION. LI APPLICATION&PERMIT UILDING- ELECTRICAL- PLUMBING - MECHANICAL aER3M3IT NUMBER 1240 6 W160ING\ s OM or;, OWNERS N" a reD OTYELECTRIC PERMIT FEE PLAN CHECK VALIDATION ` co TAcrOR NAME UTLETS- SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 LIC. NO. /(p� CONTR ADDREACssroR's opRE APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 PRONE DATE OF APPLICATION ARCHITECT O OR ENGINEER LIC. NO. PANELS (OVER 200 AMP) 26.06 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 aA HE OR ENG. :IP' SPECIALCIRCUIT 5.06 MIT VALIDATION r % Ok, l? EMP. METER OR POLE INS. 20.00 ADDRESS ADDRESS - MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 p �s' 'y Cu 1n0 CAJ LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. Number ISS NGE DATE BLDG. ELECT. PLG. MECH. ❑ Date Contractor ' OWNIi Rtl U1LDF.R DECLARATION I hereby affirm that I am exempt from the Cons and Contractor's License Professions Law forth):ity owiounty which requires a,tlmit no Code: Any mulish cor my it any structure, permit to consuanc , ter,SISO improve, demolish, or repair any structurq prior to its issuance, also requires tiro applicant for such permit to file a signed statentent that he is licensed pursuant to Ilia provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or Ilial he is exempt therefrom and BUILDING PERMIT INFORMATION [MISC. REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION S/FT. 3 HiQ nA..1 ELEC. CONTE. LIC. NO. - ELEC. TOTALC''� PERMIT TO S�� - OTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars (55001.): ALTER -DRAIN (EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve. ments are not intended or offered for sale. If, however, the building BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP K 3 RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. '5,00 FIXTURES - PER TRAP 5.00 GAS - EA. SYSTEM - I INC.4 OUTLETS 6.00 SO. FT. FLOOR AREA / u!" TOTAL ACREAGE or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or im Prove for purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 aulLatNG USE RES IND CON PB Omar ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 3000 . licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply toan owner of property who builds or improves thereon, and who LAWN SPRINKLERS -I INC 5 V.B. 6.00 LAWN SPRINKLERS -OVER 5 (EA.) 1.00 ASSESSORSPARCELNO. 3 -3�- QOS contracts for such projects with a contractor(s) licensed pursuant to the Contra icenre xw. ❑ Ian pt un'c ,or this BAP.C. f reason SEWER -SANITARY -STORM EA. 200ft/10,00 TRACT N0. PARCEL NO. WATER HEATER W/VENT 6.00/Q Owner Date WATER SYSTEM 5.00 / 1QaRKERS OMPI:NSATRATION ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 1 hereby affirm dual I have a certificate ofconsent to self-instim, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copyahereof(Sec. 3800, Lab.C.L Policy NO, Company ❑ Certified Copy is hereby furnished. • Applicant Certified copy is filed with the city inspection division. FIRESPRINK Y ❑ N ❑ ENERGY T$4 I Y ❑ No, MISC. REFER TO ORD. CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10,00 FLOOD ZONE A.L.U.O. COMPENSATION INSURANCE. o (This section need not be completed if the perma it for one V ❑ N ❑ V ❑ N ❑ PLG. CONTE. LIC. NO, PLG, TOTAL hundred dollars IS 100) or less.) I certify that in the performance of the work for which this per- RED is issued, 1 shall not employ any person in any manner so as to CITY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers' Compensation Laws of California. Date Applicant 'f0 ALTER OR ADD TO MECH. 5.00 NOTICE APPLICANTr If, after making this Certificate of Ex. emption, you should become subject to the Workers' Compensation - APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 FEE AIR HANDLING UNIT(OVER I0)000C.FM.) 6.00 SEISMIC FEE a CONSTRUCT ION LENDING AGENCY 1 hereby from that there is A construction lending agency for EXHAUST. HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued (Sec. 3097, CIv.C.), I MICROFILM " HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lenders Address HEATING UN IT 100,000 B.T.U.)9,50 ELECTRIC VENTILATION FAN (SINGLE) 4.00 I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and slate laws relating to building construction, and PLUMBING BOILER -COMP(3 H.P. or 100,0008.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL hereby au0rorire representatives of this city to enter upon the above-mentioned property for inspection Purposes. (We) agree to save, indemnify and keep harmless the City of C! Cupertino agai st liabilities, judgments, costs and expenses which i ay c e against said City' 1in1 consequent f the granti ( pe W (J �I14 W MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX 99 p A O MECH. CONT. LIC. NO. MEETAHL TOTAL /c�„ j Signa u pp, c t DEC r Date vFFlce cvPr 110S'f THIS CARD NEAR FRONT OF BUILDING CITY OF CUKRTINO -' INSPECTION DIVISION JOB INSPECTIO�N- RECORD JOBAODRES/S., 21890 RAINBOWAbA&*ECIk UNIT# OWNER FID CONTRACTOR FOUNDATION — Ip -f3 -sr% TO I-V UFER PREGUNITE / - S 'McC." . — v 'j'LJT OK 1 LATH—EXTERIOR SHEETROCK SHEAR INTERIOR SHEAR EXTERIOR L SAN C 1.E PLUMBING GAS MECHANIC HEATING ELECTRICP FIRE DEPT. GRADE BUILDING I li-T PERMIT EXPIRATION LOT# 21 ... \. PERMIT EXPIRES IF WORI IS NOT STARTED WITHII i 180 DAYS OF PERMIT ISSU L ANCE OR 180 DAYS FROA LAST CALLED INSPECTION u IT VALIDATION ��raa (Ii `)I �rU(SSUAIDAIE NLU ELECT. PLG. I MEC RES FIRE SPRINK ENERGY T )< Y ❑ N ❑ V ❑ N FLOOD ZONE A,LUC, Y❑ No Y❑ N i BUILDING OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUIL Nd SPECT NiICRO ARRANGE FOR INSPECTION BY PHONING 252-45b5, E' TIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. p I o PLEASE GIVE JOB ADDRESS WHEN PHONING: -SEE PERMIT FOR EXPIRATION DATE - E HANICAL IMPORTANT! CONST. TAXA4 low PLEASE,READ REVERE sIbE.BEkbht TOTAL CALLING FOR FINAL INSPECTIbN. OFFICE COPY UNDERGROUND PLUMBING ELECTRICAL MECHANICAL i NOT,, Re VILTl U U 1fff On WOOD FLOi PLUMBING MECHANICAL ELECTRICAL IL FRAMING INSULATION ROOF DIAPHRAGM%A14 �G' h ROUGH PLUMBING GAS TEST MECHANICAL ELECTRICAL LATH—EXTERIOR SHEETROCK SHEAR INTERIOR SHEAR EXTERIOR L SAN C 1.E PLUMBING GAS MECHANIC HEATING ELECTRICP FIRE DEPT. GRADE BUILDING I li-T PERMIT EXPIRATION LOT# 21 ... \. PERMIT EXPIRES IF WORI IS NOT STARTED WITHII i 180 DAYS OF PERMIT ISSU L ANCE OR 180 DAYS FROA LAST CALLED INSPECTION u IT VALIDATION ��raa (Ii `)I �rU(SSUAIDAIE NLU ELECT. PLG. I MEC RES FIRE SPRINK ENERGY T )< Y ❑ N ❑ V ❑ N FLOOD ZONE A,LUC, Y❑ No Y❑ N i BUILDING OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUIL Nd SPECT NiICRO ARRANGE FOR INSPECTION BY PHONING 252-45b5, E' TIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. p I o PLEASE GIVE JOB ADDRESS WHEN PHONING: -SEE PERMIT FOR EXPIRATION DATE - E HANICAL IMPORTANT! CONST. TAXA4 low PLEASE,READ REVERE sIbE.BEkbht TOTAL CALLING FOR FINAL INSPECTIbN. OFFICE COPY 7Cit-4 of Cuptil 10300 Torre Avenue P.O. Box 500 Cupertino, California 95014 Cupertino, California 95015 Telephone: (408( 252-4505 DEPARTMENT OF PLANNING AND DEVELOPMENT September 9, 1991 SUWECI: 21690 Rainbow Court Ho residence Permit(s) #14168, Swimmninq Pool 12406, Single Family Dwelling 16264, 81 fence The following information is per Jim Jones, Building Inspector, regarding the aforementioned permits. Re: Permit #14168: There were no insections, according to our records, on the swimming pool. They did call for a i "final" on the pool, however. Permit #12406: Single Family dwelling. This was not finaled as there were some problems in the basement area. The problem existed with the firewalls of the mech/electric room. Permit #16264: 8' fence. There was never a footing inspection on this fence to any recollection. Again, this inspection permit information is per Jim Jones, Building Inspector. These statements were compiled for informational use only, to be docLmlented in the City of Cupertino building file of 21690 Rainbow Court. In July, 1991, Sandra Vasques of the'building division had conversation with Mrs. Ho of the subject address. Ms. Vasques informed Mrs. Ho that none of the above permits (3) would be "finaled" by the City of Cupertino. Mrs. Ho acknowledged the fact, and co=ented that she understood they would not be finaled with the City. Building Division Documented September 6, 1991. "' LTR-H0-R1Bf4(BLDG2)