23119 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
`, tlulldln Pro est Identification LetPEi MITNO.
Building Address:
Lu 23119
rte . l^'�/�-U f� j ` A
CITY OF CUPERTTNO-BUILDING DIVISION �y
Contra eorOY Name: Lic.No: APPLICATION III PERMIT �t 6a- It f
BUILDINGELECTRICALPL BINC MECHANICAL CATEGORY CONTROL a
Archtte t/Engineer•, Lk.No:
QTY ELECTRICP FEE BUILDING PERMIT INFO
Address: PERMITISSUANCE Y � _]
LICENSED CONTRACTOR'S DECLARATION
I hereby affkmthat l am licensed under provisions of Chapter 9(comment, APPLIANC D NTIAL ) IOB DFSCR"TWA
Ingwlth5di..7000)ofMvblon3ofthe Buslnessand ProfessionsCode,andmy fp� �s1 /
license Is In full force and effect. PANELS / ess.r��
Llcenss Class Lk.N `\.7 {F�
Data Contractor
ARCHITECTS DECLARATION 1- AMPS
a 7 I understand my plans shall be used as public records 000 AMI'$• SQ.FT.FLOOR AR 3/SQ.FC.
6 LicensedPrdemiovl SIGNSELECTRICAL
Ab
6 N OWNER-BUILDER DECLARATION SPFLIALCE(CUIT/MI
'1.,� Ihereby a(0rmtOWNE exempt ER the DECLARATION
Law for the
qq following reason.(Section 7031S,Business and Proressbm Cade:Any city or 1
�y county which requires a permit to corsouc%alter,Improve,demolish,orrepalr TEMP.METER OR POLE INST. 6
$'� ❑ anystmcture bnes prior to it.Issuance,ao recto Itheapplicant for such permit to POWER DEVICES
ryG Tile a signed statement that he li licensed pursuant to the provisions or the
SOSContractors License (ChapterLaw 9(comnancdn with Section 7000)of Divi- VA
sloR3o(the Buslnessand Profelor Code)orthat helsexempttherefromand SWIMMING POOL ELECTRIC LUATION
O e the halls for thealleged exemption. Anyviolationtolacivi of penalty
7orm re any OUTLEISSW17CF3ESFLYIVRES
the halls fora eerMted exe ption.the applicant vioation penalty.703 more than
five hundred donna(1500. NEW RESIDENTIAL ELECTR FT.
gym. ❑I,ae owner of the property,or my employees with wages as their sok _SQ.FT. TYPE CONSTRUCTION
compeneatlon,wllldothe work and thestructure,is not Intended or offered for
0 sale(Sec.7044,fhagnemand Prnfesslom Cade:The Contractors License Law IIS'
$ docs not apply to an owner of property who builds or Improves thereon,and /C,GROUP^ — R S
who doessuchwork himselforthrough hisownemployeas,provided that such ` —
Improvemnnmart not Intended oroffered(orsale.IL however,thebullding or
Improvement u sold within oneyearofcompletion,the owner-builder will have
snot provingthath,did not build or improve for purpose of sale.). Q7`y. PLUMBING PERMIT FE"
as owner of the property,am exclusively contracting with licensed TE
tractors to construct the project(Sec.7044 Business and Professions Code: PERMIT ISSUANCE �, I- —
Contractor's License Law does net apply to an owner of property who DRAIN k VENT
builds or Improves thereon,and who contracts for such p(ujetts with a ALTER-DRAIN -WATER(EA) FEE SUMMARY
cgR(actor(s)licensed pursuant to the Contractor's Lt...Law. BACK FLOW PROTECT.DEVICE
LJ I am exempt under Sec, B k P C for this Mason
OUTSIDE
Owner Date
DRAINS FLOOR ROOF,AREA,COND. SANITARY Y NRECEIpTN
WORgNAN COMPENSATION DECLARATION FIXTURES—PER TRAP SCHOOL TAX Y_ N_
❑I hereby affirmorlum that I have o Insurance
ate or conacerent to op thereof
ora RECEIPT M
certificate of Workers Compensation Insurance oracertl(kd ropy thereof(Sec.
3600,Lab C.) GAS F.A.SYSTEM-1 INCAOUTLETS PARK FEE Y N
RECE
Polity N GAS.FA.SYSTEM-OVER d(EA) DING D1I M
Cam any - - BUILDING DI VISION E'I:ES
O Certified copy is hereby filed
the city CREASE/INDUSTRL WASTE INTERCEPTOR PLANCHECKFEE
Certified copy li filed with the city Irupextlmn division. V� .7
CERTIFICATE OF EXEMPTION FROM WORKERS' GRE-ASEIRAP PAID
COMPENSATION INSURANCE SIEWEILSANITARY-STORM EA.200FT. Date Recei ted
(This section need nut Mcompleted thepermitIone hundred dollare
(510rrilyt.) WATER HEATER W/VENT/ELELTR ENERGY FEE Y
I certify that o the person
in anof y
mannerhework
so as to
this permit c hoed,
I shall not employ any person In any manner eo u to become subject to the WATER SYSTEM/TREATING
Workers'CompenvHon Laws of California.Date PAID
O Z Applicant NEW RESIDENTIAL PLMB. SQ.FT. Date Recei tit
)Z O NOTICE TO APPLICANT:If,ekes raking this Certificate o(lacmptlon,you
FCC
should become subject to the Workari Comperuetion provtalom of the Labor - TOTAL:
N Code you rwatforthwith comply with such provisions or this perout shall be B I
LU 9 deemed revoked. '
CL CONSTRUCTION LENDING AGENCY SEISMIC FEE
I hereby afBrmthat there Isa construction lending agency for the perform ELECTRIC FEE
Z ante of the work(or which this permit is Issued(Sec.3097,CIV,CJ
O 0 Landers Name - - PLUMBING FEE 1
ly 4— Landers Address QTY. MECHANICAL PERMIT FEE MECHANICAL FEE
U Imnlfylhatlhavereadthiaappli.tbnandmatethatthea boveinrormationor
0 W Is correct.I agree to comply with all city and county ordinances and state laws PFRMITISSUANCE I �� FEES PAID:
} IL relatingtobullding construction,and herebyauthorlaempresentativeso!this
In cltytoenterupon theabovomentioned propertyformspectlon purposes. ALTER OR ADD TO MECH.
Z (We)agree to save,Indemnify an d keep harmless the City of Cupertino Date Revel #
O against liabilities,judgments,cosmand expenses which may In anyway accrue AIR HANDLING UNIT(TO 10,000 CFM) SUBTOT L:
galrst Bald City In ronsequence of the granting o(thla permit.
6 o AIR HANDLING UNIT(OVER lo,tnocEM), CONSTRUCTION TAX
Sig w.of Applt t Contractor D to EXHAUST HOOD(W/DUCT) CONSTRUCTION TAX PAI
H RDOUS MATERIALS DISCLOSURE - w/
Will theappllcantor future building mavpant stow or handle hazirdmus HFATINGUNIT(TO 100,000BTU) 1.
materlalasdefined by the Cupertino Municipal Code,Chapter 911 andthe Date Recel ta/�r1sk
Health and SafetyCode Section2S531p)? HEATING UNIT(OVER 100,000 RTU) TO V/
❑ Yes
Will theappliesm'RtNo
urc building occupant use equipment ordevices VENTILATION FAN(SINGLE RESID) ISSUANCE DATE
j which emit haaardous air contaminants as defined bythe Bay Area Air
Quality Management District? BOILER-COMP OHPOR 100,000 BTU)
Yea QNo �'
have madthehazar�i mus materials requirements under Chapter 6.95 of BOIf.ER-CONP(OVfR 1olim BTU) p q
the California Health Lt Safety Code,Sect In.15505,25533 and 15534.I - - cal Y
understand that l Rhe building does not currently have a tenant,that it a my NEW RESIDENTIAL MECH. SQ.FI'
resporeibllity to notify the occupant of the requirements which must be nut / , O
Prior to issuance or a Certificate of Occupancy. V/A,II
Owner or authorb<d agent Date _ ' h Ru YWO
T
OFFICE COPY
J A N'- 1 1 - 9Z M O N 1 6 : 4 0 D A L E F . -TONES S . E . P . 02
w Dale F. Jones
Structural Engineer
622 Webster Street
�y Fairfield, CA 94533
(707) 422.3469
`����•���� RECEIbgp
January 11 , 1993 41!'111 1993
Cin OE CUPERnrl0
Rod Spray Construction 110"M Del
rLane
San
Santaa Cruz,
, CA 95060
Re: Kuruma Residence
Lot 191, Subd. 7993
Cupertino, CA
Mr. Spray,
This letter is in regards to the notching of the 6 3/4" x 15" glulam over
the garage (FB1) , the 3 1/8" x 11 1/4" glulam over the garage (FB7), and the 10
3/4" x 11 1/4" glulam over the kitchen (FBS).
• Regarding the 6 3/4" x 15" glulam over the garage (FB1) ; The 3/4" x 3/4"
notches on the bottom and approximately 5 inches up each of the sides of the
glulam do not compromise the integrity of the glulam and are structurally
acceptable.
r
Regarding the 3 1/8" x 11 1/4" glulam over the garage (FB7) : The 1/2" x
1/2" notch on the bottom (adjacent to the support) does not compromise the
integrity of the glulam and is structurally acceptable.
Regarding the 10 3/4" x 11 1/4" glulam over the kitchen (FBS) : The 3/4"
x 3/4" notches on the bottom (approximately four feet from the end„of the glulam)
do not compromise the integrity of the glulam and are structurally acceptable.
Sinc,Brely,
Dale F. Jones, S.E.