30622 .APPLICANTTO FILL IN INFORMATION WITHIN"RED'LINES-USE BALL POINT PEN ONLY
CITV OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO. /� O 2Z
BUILDING DIVISION AP,P CATIONWERMIT PLUMBING-MECfuNICAL
(l BUILDING PROJECT IDENIIPICATLON J
ILDINGADDRESS: ` SANITARY NO. APPLICATION SUBMITTAL DATE
e(tc q X26
ER"NAME f MONLE CO ACTORS NAME LIC NO:
L4� M < 1 NiC CONTROL#
RL'HffECf/CNGINEFR: LIC NO: ADDRESS: 1, ❑
of o g �L Gee=
CONTACT. PHONE: - BUILDING PERMIT INFO It
/71� ry ❑ Consultant Few Paid by Applicant(Initial) BU)G ELECT PLUMB MECH
7-7
LICENSED CONTRACTORS DECLARATION QTY ELECTRIC PERMIT FEE
I harahy affirm ihv 1 am hcansd under povisiuru of(Taptn 9(commencing JOB DESCRIPTION
1y,I5.0 50 with Sclie.WK)( .I'Dilkion]oflc hHusircss and Rofcaums Coda,ad my Ji is
Fin full foot rod cB'm. PERMIT ISSUANCE
F�U U License C"uu Lic.N WL ❑KITCHEN REMODT•1
N<a Dme Comrmt« APPLIANCES-RESIDENIAL ❑AD (TION ❑PLUMBING RE.PLPE
v� ARCHITECTS DECLARATION ❑MULTI-UNIT ❑STRUCTURAL
Z O R'6 I udnatad my plena sMll 4 urd u WMic rmwd.r PANELS
UPTO M)AMPS MODIFICATION
rr4�lgla Licatxd Professional []INTERIOR ❑CHIMNEYREPAIR
..1 201-IM)AMPS IMPROVEMENT
OWNER-BUILDER DECLATION
�C W 6 ARI hcrtby norm that 1 am asset,from Lha Oe m oo,'s Leem,c Lew fur Inc OVER I"AMPS O BATH REMODEL,REPAM/O DEMOLITION
�pgo55 a U following moos.(Section 70313.Buunm ad Pmfexateses Cad,:Any city or co mry SIGNS PLECI'RICAL ❑OTBER
a+3 LL H which r,quires a pcmri,m cnnnmc,,cher,iinpnry.Moolikh,or rcpmr uny.wvmo, _
f'u•�� pains In is isaunrcc.afn reqm uiaa,npplicam for nch Pcntdt to file a ugncd ivatammt SPECIAL CIRCIFTMIESC. V
{yy{yy} that ha is lkaron punom,mTo,foovi"oe,afth Ctooverurs Licenw Law(Che"ar 9 r 7 'In•Cw_
Y�Q (comanciez oth Scrtion 1000)x(Division 3 ofth,Busirlai and Pmfcuivnr Cd,)or THMP METER OR POLE INS('. COMMERCCIAL; 'duo
a e a din be is exempt bercfmnt nml Or Msis for 0s ulkgcd excmginn.Any violuuoo of ❑NEW BLD( ADDITIO ❑DEMOLITIONIc Srstim 703 1_5 by any vfcfafi mor.permit svbj,c.do,"i.to a clod pcmly of POWER DEVICES UI
not mm,than five hundral dollen(SSW). _ ❑TENANT ❑FOODSERVICE'
'36 myempleyc
Q Iuowrcrof Nepncistr « a with wa / IMPROVEMENT
gnutMrwk mmlcnsxtion. SWIMMING POOL[LECIRIC_
will d,,he wort,ndic: ha C.ix mai meccrasa nf(ndf«wlapply 7044,Hnna,of 1-1 OTHER
C end Promatt,who S Cade:Tnc C r,lha h.and.1 law don amt apply to an vwmar of. OUTLETS-SWITCH2S-Fl]fTURES
a 3^ progeny who builds fa irynnvn t sorch i and who nts such work himself m dough
his own employees,kitchnd c such iminovemmu art mr intcodcd m oRacd f« NEW RESIDENTIAL ELF.CIR SQ FT.
aak.ILhrnwcr will a Wilding«impruvemen,is nldwid mea laddcrecolvnlforthe ` SQ.FT.FLOOR AREA SISQ.4T.
owrcabuildcr will hnva the burdco of"ming that k did na build«impmva for for,
ssist
p11,asoal.
❑1,uowns of the
>,m,ruca Y. exclusively contracting 1Ilceramn ' m
Njcc,(Sac.7(x ,Busircss and!Pofmacw0,eJ lira Co.,,
Li- /1
�
name Law doom apply to anawrtaof pinpeny who builds m im"ovcx,hmmn,ad QTY, PLUMBING PERMIT FEE /�
who crntmcu for such"ojats wiN•mnvact«(O Ikmucd pug.,�,r 10 the C«wnm's (Y
I Law. PERMU'ISSUANCE
I am nam"luxkr Sec. ,B P C for Nis rrawn
ALTER-DRAIN k VENT-WATUR(EA) �.�'•VALL�UATIONNNN
w KERS COMPENSATION DECLARATION BACK FL 0 f.DEVICB /- 9� ►�'
1 bareby aR miler Fatally of perjury ena of the following deellualwart � �D
t ❑Ihar,and will maintain a CmificamofConunt m adGinmmfm W'orker's Compos DRAINS ,.ISOO F7.,�oN STORIES TYPE CONSTRUCTION
wino,u pmvihal f«by Seetim 37M of th,Isbra Cork,f«Je parfomarce of Cls, s
wort for which this panni,is I.M. FIXTUR -I' f P
❑1 hal ad will myon son Wortar'<C«openati«t In..u naryird by Sectio
3700af Na Lahrf!d fi«IM1e perbrmneccofthe wnh f«whicn this Fannin is iuud. GAS-EA.SYSTEV I AA A&A J OCC.GROUP APN
My Workn's Com amerism Invuarce cant and Policy number art:
Carrier. Policy No.: GAS-IA.SYSTEM OV ER d(EA)
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPP.NSATION INSURANCE GREASPIWDU,STRL WASTE INTERCEPTOR
This rection and nos be complmd if Ne Permit is f««chudrdddlan(S W) BUILDING DIVISION FEES
or lam) GREASE.TRAP
PLANCHECK —.�
Joy my Ratiothe Parfornocrianymaecraofnrwmkfmw lje Nu Refot),aWueo'Cooface- SEWER-SANITARY-STORM EA. FT.
txNanU, a 4personiaanymannerell us wbreons mFj«tmdw Workerw Cnmpan- ENERGY FEB S'�a
O Z section taxa MCdif«hw.Dale WATER BEATER WNEWf ELF,CI1f
z� Tlirnnt - GRADING FEE
N
ay OTICG TOAPPWCAM':If.Coon,rking this Cenif R of FLcmpdmlo.you men WATER. :M/fltEAl1N0
fort ma secaml y the Wurktrxvivk cor this arrmi ionh n[dr labor Culu,you mot SOILS FEE
aO fonhwiNmmplywiN web"o.inioasm Nirinmi,alWlbe dmmeJmakd. 'TER SERV
01
CONSTRUCTION LENDING AGENCY SQ.FT PAID
UQ Iherchy aTrm lMllhart is aconuructinnlemliag ugurcY lor,he perfomurce err Dme Reaipte
tha work for which this permit is osood(Sec.]1197.Civ.C.)
pU unle"s Nano
V Lrndm'r A ldrass _ TOT L:
M I e,niI Na,I has,read Nir
Ty y applkviun and stvc Na,th abav<in(wrratinn is BUILDING FEE
UzZ holdingce ttcwnply wlN all chyatoeountyuNivrca,ndsivela eiuItingm QTy. CAL PERMIT FEE
batwo,-gcoinerst ion,and for
or hy irve fio FurToesentvivn d'thiscity tocn,crupon 0c SEISMIC FEE ��
` above-meairard pmprrry farirspmdan.)opuses, PERMIT ISSUANCE
. -(WO ugrm to anvc,indcmnify and lsep Mrmkv dr City of Cupcnivo ageinv ELECTRIC FEE
v fiabJitin,judgmams,cm,a and expan.wa which may in any way accrue spinal mid City ALTER OR ADD TO MEC
conacaaerce of Ura graving of this permit. PLUMBING FEE
APPLICANT UNDERSTANDS AND WILL COMPLY VRNIIKLL NON-NyNT qIR HANDLING UNIT ,( )
sa
SOURCE REGULATIONS. /, /w, MLCHAMCAL FEE
r{1,`y�a{/I—,/IF AIN IIANULINO UNIT ,DTXI CFM) CONSI'RUCIION TAX
Sigru,me NAPplicvnl/Cnnrtam« _ I EXHAUST HOD(WMUjz HOUSING MITIGATION FFR
HAZARDOUS MATERIALS DI.SCL SU E
Will BmaP"icanlmfuturt huilJing«<upanwrxc rr handkhvaNnus lnvcriol HEATING UNIT(TO IW.
u dennd by the Cuprnino Municipal Code.Coal 9.12,and Na Hud 1N aSofoy
Cada'. cGm 8532(.)! IIFAIINGUNIT(OVE K(M ) -
❑Yn ON. VENT BATON FAN(S LEN 11 PAID
Will Ne - Data. Raei"#
applicmt m fumrt Wilding occupnt n,tsuiParcnt«davkn which BOILER-COMP(IIiP ORI BI
emit harvdwa air commenams m defined by the Bey Arco Air Quality MnfaIctomt TOTAL:
Usaal7
❑Yn 7 N BOILER-COMP(OVER 100,M)B
I haw and Lha lrvuJiuv na,oialy AIR CONDITIONER ISSUANCE DATE
r5.M533
an urulm .1 crarsom ardr Gli-
forJagdots&Safety Cela,eatcmasea 8ostit L%myand8ilada1 unkxmmd Natif Bc NEW RESIDENTIALMECH. SQ.FT.
building dotsmorcvrrtmllY last aIctan4Nvn ismyrapxtsibdoricsmlify Neoccolnot forn,
of the�grtrrrlal8yflich most ba,M protein i[WanrY M a Cmineate a(IJavfurcy, r•
Owrcr«vu, Jegcnl Dem
_ ISSUED BY:
OFFICE
CKL NNIETa NIELSOO N
940 Saratoga Ave. Suite 215
San Jose, CA 95129 (408) 247-2898
September 27, 1996 �. \�
Emily Chen gyp
10190 Bret Ave. /
Cupertino, CA 95014 I
Re: 11641 South Stelling Road Cupertino, CA.
Lot 1
Dear Emily;
Per your request we have reviewed the subject property to check the construction of
the graded pad and formwork for the building foundation. We find the pad and forms
have been constructed to accommodate positive drainage away from the building
foundation in accordance with the Grading and Drainage Plan prepared for this site.
Top of form elevation varies no more than 114" from true elevation. The pad and top of
foundation elevations are more than adequate to provide better than minimum
clearance required for the crawl space. Also, the building foundation as located on
the subject site falls well within prescribed setback lines and there is no potential for
any encroachments. Thank you for this opportunity to be of service.
*ery,
QPpFES;lO,y,
Sid Nash Quo ,STH N �,
F 'eel-
Project Manager
i No.22023 "
Lk-Exp.930.97 yy
e1 neth Nelson, RCE # 2023 rrgrFOFCAUF�P�\P
cc: Dave Scannell, Cupertino Building Dept. ®T� E C®
CIVIL ENGINEERING'STRUCTURAL DESIGN'SURVEYING`LAND PLANNING