21840 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
Bulldln Pra'ed IdentificationPEILMIT NO.
Building Addrms: �7-y�-' 21840
rcr. f r�` e CFIY OF CUPERTINOLBUILDING DIVISION
Contractge.Name, �LLiic.No: APPLICATION / PERMIT
97_1 BUILDING—alr RICAGPi,UMBINGMECFIAMCAL CATEGORY CONTROL N
Arohftect/En Luc Nex
BUILDING PERMIT INFO
QTY ELECTRIC PERMIT FEE /
Address Lublo
PERMITISSUANCE
LICENSED CONTRACTOR'S DECLARATION I� LJ L7 U
I hereby+ffirm that l am licensed u Mer provhicros of Chapter 9(mmrnmc - APPUANCESRESIDFNIAL JOB DESCRIPTION
Ingwlth5edlon7OOD)of Diddm3ofthe BudnmandProfe wsCo andnV
Ifocnx tile full force and disci. 'PANELS
License .a Ch4
DC.t ix,a
C •��� -
Me ifuct. UP TO 2DOAMPS /JOU
- ARCHITECI'SDECLARATION 201-1000 AMPS
q�v of Iunderstand my plam+heB be,used as public records. OVER I UDO AMPS : .SQ.FI'.IFLOORAR—EIA S/5Q,FT.
6i [j Lleeeed Professional SLGNSELICI A
< OWNER-BUILDER DECLARATION SPFAALCJRC y /
owing causes. ttutlamexemptlromaa CaMr+doraCode.Any fart he "�
oil P t-
following y reason.( a p 7 to Bu+inm and r,Professionsp , e=l Any city or TEMP.METQt }z
F� county which n,quWaa pemdt to mmtrud,alter,tmproa,demoReh,or repair r'j3 7
y anynrodun,prier to ltebsuaricq ala requhnthe appBantra such permit t° POWER DEVILS J7ll
tG file a dined statement that he h Ilanaed pursuant to the provhlam of the
a G Contrtdofs Llceeve L w CIwpter 9(mmmendng wfth Section 70=of Dlvl- SIVE.fh91VG IDOL DECIRI VALUATION
SOS slan3 ofthe Business and Pofedoru Code)orthat he is exempt therdmmard
the blab for the alleged exemption. Any Violation of See lora 703IS by any
<�
applicant for a permit subjects the applicant to civil penalty of net mon,than OVILETSSWIICJiFSFIXCURES
five hundred dolhn(SW.
�I,,s owner or Hie Property,or my employees with w+gm as thetr sole NEV:RESIDENTIAL EEE{:"IA SQ.FT. STORIES TYPECONSTRUCTION
C < pensaBon,wllldothewwrk+nd the etrudurt 6.haerdedoroffered for
5 0 e,4(Sec 70K Bu,Ircu and Profmlome,Code..The Contndota(Jame Law
PF does not apply to an owner of property who bal"or Improves thereon,and OCC.GROIRs RES ANDS
whodoessuchwork hlms,lf awn
through hiaoemployess,provided that such
Imp awentme are not Intended orafen,d faeale.It however,thebullding m TOTAL
Improv mere,hsold wlthinoneyearofmmpletion,the owrcr-0ullderwW have
t as
of proving that he dnot build or improve la d purpose sale.). QTY. PLUMBING PERMIT FEE
LI,es owner d the property,am exclusively contracting with licensed FLOOD ZONE APN
contractors to construct the pm)ect(Sec.70K Be slum and Profeubn+Code: PERMIT ISSUANCE
The Commcme.Lkerm Law dm not apply to an owner of property who
builds or Improve thereon,and who contracts for such p(skets with a ALTER-DRAINk VENT-WATER IEA) _
lcensed pumunt to the Contractor's License Law. BAt7(FLOW PROTECT.DEVICE FEE SUMMARY
U I am exempt under Sec B k P C for this reason0ITTSIDE FEES
DRAINS FLOOR,RODF,AREA,GOND. SANITARY Y_ N
Owner Date =
WORKMAN COMPENSATION DECLARATION RECEIPT a
❑I hereby affirm that I have a certificate of consent to self-Ince,or a FIXTURES-PER TRAP SQiOOL TAX Y N
cenNate ofWorken Cwnperunlon Insurance ora entified copy thermf(See. GAS IA.SYSfFAf-1 ING40[IrIEIS PARK FEE ��•
380,hbCd
PCdak, GAS EA.SYSTEM-0VER{(EA) RECF #
y ed mpyhhereby fumished. BUILDING DIVISION FEES
ertNed ropy h filed with the city Inspection division. GREASE/1NDU5TRL WASTE INTERCEPTOR PLANCHECK FEE
CERTIFICATE OF EKEMPTION FROM WORKERS GREASE TRA PAID f�
COMPENSATIONINSURANCE
SEWER-SANITARY-STORM EA.20RrT Date Recel ttl
((tile sectbn need not he complded Bthe SURA h/m one hundml dollars
(SI00)orless') WATER HEATER W/VENT/EL.ECrR ENERGY FEE Y N
I certify that N the pcdomunceof the work lorwhuch this permit i,hated,
1shall no employ any person In any runner ro as to become subject to the WATER SYSTESI/TREATING .
Wapem+
k.'Comtlan Lwsof Califomh. Date PAID
z Z Applicant NEW RESIDENTIAL PLMB. SOFT. Date Recef t#
Z p NUTICEro APPIR'ANT:If,after making thh CeMriate of Exemptlon,you
shmld become subject to the Workers'Compenertbn pmvlabne o the Labor TOTAL:
~ _H Code.you mrnfathmthmmplywlthsuchpmvhbruorthhpemdshallbe
LU > deemed rtvoked. •.
aCONSTRIRCTION LENDING AGENCY SEISMIC
IheebyafRrmthat them hammtrudlon 4rdmg,genry for the pedam.
z —TOTAL. ELECTRIC FEE O, 5
7 ane of the work for which this pedt h tiered bee ere3097,CW.C.)
02 Lender's Name PLUMBING FEE ;7a.
LL F Ierdee.Add. Qn. MECHANICAL PERMIT FEE
O w hmmVn,e
Icent"+tIhave mad DdsappLicatlonardnatethat the above lnform+tion MECHANICAL FEE//��(/////�� e•JS
.I,gto comply with Wdrd mm
tyacounty nate Laws PERMIT ISSUANCE F� ba/Jx7b
} (L relating to building mmtrudlon,and hereby authcrtce representatives ofthis
(— cityve
to enter upon the abo -mentiorud ER
property fee Inspection purposes. ALTORADDTOMBM
Z
— (We)agree to save,IndemNfy an d keep l armlm the Cray of Cupertino Date Receipt#
against BabWtb,jadgenees,cons d expenars which may In an way.. AIR NDLING UNIT CFO 10I000 CFM) SUBTOTAL: .
againstsald Cona a Ming of thus permk.
AIR HANDLING UNIT(ovFLt to,000crnf) CONSTRUCTIONTAX ,8
Slgn+tureofant/Cmtnctor h E)(TIAUSTIIOODM'/DUCT) C4 T CFION TAX PAID:
HA!ARDOUSMATMIALSDISCLOSURE ^ �y 9� �yg7
Will ppllcant or future Wilding occupant non,or handle hazardous HEATING UNIT(70 100"0 BTU) Date Revel I#
material as defined by the CupenM
lso Mucipal Code,Chapter 9.12,and the nn
I al1YesM Safety Code,Sectioon 25532(a)? ((EATING UNIT(OVER IMAM BTU) TOTAL: S-08
0mMm
l the appBtun,building oaupant use equipment or devices VENTILATION FAN(SINGLE RFSID) ISSUANCE DATE
which emit h nJousair mntamunaons as defined by the Bay.Area Ab
• QualityManagement DhJtrkt7
IlOaXCOMP OFIP OR 10,0,0(0d BO ER-COMP(OVRIWODBBUhavereadtheha .anruteria4rtquremntsunderChapter6.95of TU) .
the GlBomh Ft lithe
i t h h Safety Code,not cum 75505,have
a tenant,
and 25530.I
mdentardyt.. Ifythdingp.Mdtmnentlyh t,tenent,thatitbmy NEW RESIDFN77ALMC(7i. SQ.FI' FEB 1' " 1991
maporulbllfty to nalfy the oavpaM d the requirements which must be mat
prior to Lwarue d a CMIBcate of Omrpamy.
.T
Owner m authorlud agent Date ISSUED BY�
TOTAL
OFFICE COPY
JUN-17-93 THU 7:30 RUTH AND GOING INC FAX NO. 4089431900• P, 02
�g
Ruth and Going, Inc. AM
June 17, 1993 .
I7095B
' Eng mnPiiOg
Mr, Joseph Antonucci A,chil?clm2
Building Department
CITY OF CUPERTINO 2160(A,ndy 1,,,,,
10300 Torre Avenue s.,n Jose
Cupertino, CA 95014 CA 951;11.,833
(4019)943 1640
FAX(408)9.13-191
Subject: Construction Phase 913
Lot,20
F 6 Hew 61itiG0
' .•. San JQ:Q
Tract No. 7994, Seven Springs Unit 3 CA 95161-1,;,DC)
Dear Mr.Antonueci:
On Wednesday, June 16, 1993 Ruth and Going, Inc. field survey crews conducted Geld
verification of the horizontal and vertical location of the building forms for the above
referenced lot.
v
This is to state that die building setbacks for the lot is in general in conformance with the "
Ruth and.Going, Inc. plan entified "Plot Plans;5,000's Models, Construction Phase 9B, Tract
No. 7994;, Seven Springs Unit 3", dated 8-21=87, revision 4 done on 6-22-92, with a last
worked on`dalc in ,the lower right corner of 9-21-92.:In.no:case.are-th'e front;or's(di'yard" '
setbacks les's char' the minitu6m'dimeitsion shown on dre lana'
side yard setbacks labeled as "+/-" on the plan generally match the corWe responding dimensions
foundinthe 'field. In addition, the elevation of Ole forms match the building finish floor
shown',on the plans..
We trust this, provides you the information you require in order that the Gregory Group can
continue \nstrucUon of this house.
Please call'me at (408) 943-1640 ext. 331 if you have any questions or require. additional.
information.
Very truly yours,
. Michael C. Sheehy
Project Manager
cc: Chris Gatley/Gregory Group
Reid Jlastins/Gregury Group