26472 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO 11 ILDIN,- .LL FRI AL PERMITNO.
I p APPLICATION/PERMIT PLUMBING-MECHANICAL 26472.
A\�xmx,s DIVISION BUILDING PROJECT IDENI'IF'ICAI'ION
1 u{I SANITARYNO. APPLICATION SUBMITTAL DATE
_....._.DDAFSS'.
—u - UNIT# LOTH
O NEMS NAMI?: PHONE: CONTRACTOR'S NAME: LIC NO: NIC CONTROL#
O
�A HI'1'1? 'NGINBER: LIC NO: ADDRESS:
CONTACT: PHONE: BUILDING PERMIT INFO
QTY. ELECTRIC PERMIT leli8
BLDG ELECT PI UMP Mali
PERMIT ISSUANCE ❑ ❑
LICENSED CONTRACTOR'S DECLARATION APPLIANCES.RESIDENTIAL
gtyz Ihereby after Nes l an licensed underpmvisionsof Cbaper9(commeneingwith JOB DESCRIPTION
000 Section 7000)ol'Division 3 of the Business and Professions Code,and my license is in PANELS
K W full force and o f ct
FQ.,u LicenseClm — pLic.kL2 IIPT02W AMPS W
m ti Dare Count 201-1000 AMISS SQ.IT.I1.00N AR!A 8/SQ.FT.
Z~b� ARCHI'I ECPS DECLARATION OVER TWO AMPS
O Z^Q I understand my plans shall Is,used as public words.
F'.i W SIGNS FLECTRICAL
st ,"1-I Licensed Professional
K aQ OWNER-BUILDER DECLARATION SPECIAL CIRCUIT/MiSC.
gOlyO I hereby al'lirn That 1 an exempt from the Cnrmebr's License Law for the
on followmil ceason suction 701 Is,Business and Professions Code:Any city or eounsy TEMP.METER OR POLE INST.
SSS�
which requires a Permit to construct.alter,improve.demolish,or repair any structure Y� prior to irs lnsuuncc,also rc (lieu ureal for such no file osl dsmannem POWER DEVICES
ym the
pp gamin gLa
Too�C�pC 9(comthat he is IntimalPSecriomtheprfDivimsaf he Cenuanm's License Law SWIMMING IDOL El-ECTRIC
o that he s t,se wird$odoura in the Division 3ofthe Business and Professions Code) VALUATION
uz_y tnthut 7031. by
applicant
for a baspermits bect&medesemptt to civil#natty of
�ZG Section 103L5 M1y any applicant(orapermit subjects the epplicannoacivil penalty of OUTLET'S-SWITCHES-Fl%TURES
Z of more than five hundred dollars($500).
Q NEW RESIDENTIALF.LECIR _SQ.FT. STORIES TYPECONSTRUCTION
p ❑ Lthe wrk,and eestructyce isa intioyeeswithwed fiar Nei Sce.compensation,
a o0 will do the C d e:The mrehnor's Lan we Law
not
apply to an,Business
and Profcssiom Cade:The Contractor's Lic<nse Law does nm apply to an owner of
property whohuildsorimprovec Nrreon,and whodsns such workhimse forlhrough bis
ownemr,the
r iprovemmproeememsvre not earofccoplero,31heo ri If,
(ICC GROUP RES UNITS
however,the building or improvement is sold within one year ar improve
omm a for torposc r- TOTAL:
builder will have the burden of proving that he did not build m improve for gangosa of
sale).
❑ Las ownerofthe pmpertY.amexclmivelycontractingwiNlicensW contnctorsm QTY. ' 'PLUMBING PERMIT FEE FLOOD ZONE APN
comvuct the preact(Sec.1044,Business and Professions Cade)The Contractor's
Littnse Luw Jresnot apply mannwnerol'pmpeny whobuilJsnrimpmves thereon.end PERMITISSUANCE
who contracts for such pmiects with acommam(s)licensed pursuant o the Convectors+e Law.
Licence
ALTf:R-DRAIN&VP1JT-WATER(FA) FF,F.SUMMARY
❑ l um exempt under Sec. ,B&P C for this reason BACK MOW PROTECT.DEVICE O DC iTMs
SANITARY Y N
Owner Date REC P`F#
• co DNAINS-PLOOR.ROOF.AREA.CONII.
WORKMAN COMP N
u
I hereby affirm that I have a certifcats eam of COMPENSATION SCHOOL TAX Y ofconsrnt to wlGinsum
FlXTURFS-PER TRAP
kart Cnmprnsmion lnsuranccoracertifedcopy Hereof(Sec.3gW.l.ab CJ which PARK FEE. Y N_
nolle I hispernn. GAS-EA.SYSTEM-)INC.4 OUTLETS RECEIPT#
Pot cy p / BUILDING DIVISION FEES
Company J H 1t./ GAS-EA YSTEM-OVER .A) PLANCHECK FEE
[I Certified copy is hereby furnished.
Certified copy is filed with Ne city inspection division. GREASHA RLW S RCEPfOR GRADING FSE
CERTIFICATE OF EXEMPTION FROM WORKERS' GREA I P a, SOILSFEE
C04IM1,1$ATION INSURANCE
Midssectinn need notbaotorlreadiffhe permit k krone hundred dollars JIM) SEWE - NITAR a OMEA.2WFT. ENERGY FEE
orless.)
I cmifythat in the pefoimance.fthe work far whichthis prnnh is issued,]shall WAT FATER / /ELECIR
Pers
not employ any on in any manner so m to become subject to the Workers' PAID
Compensmion 1.,,i 0 Califomia. Date - SYSTE iATINO Date Receipt#
O z Applicant liv
O NOTICE TO APPLICANT:ILaBer making this Cerifcaeuf Exempdomyoushauld ENTIAL PLMB. SQ.FT. TOTAL:
rAbecome subject to the Workers Compensation provisions of the Labor Code,you most
�
> foMion
with comply with such provisions.,,his permit shall be diamond revoked. BUILDING FEE
PW. O CONSTRUCTION LENDING AGENCY SEISMIC FEE
7 z 1 hereby affirm that there is a convection lending agency for famformence of
the work for which this t is issued(Sec.3191,Civ.C.) ELECTRICFEE
U mi
Lenders Name
kL. �
O F Ixnde/s Address QTY. MHCIIANICAL I'IiRiMl9' PEE PLUMBING PEC
GVT-I I certify that 1 hove rend this application county
state that the above information hearing is
correct. lagree ni comply wird all city and county ordinvncer and state laws relating to PERMIT ISSUANCE MECHANICAL.FF.0
building construction,and hereby vuthorise representatives ofthis city to enter upon she CONSTRUCTION TAX
L) z above-mentioned progeny for inspection purposes. ALTER OR ADD TO MECH.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
Iiabiliiiw,iudgmcnts,easts aodexpemes which may inany way accrueagaidst said City AIR I IANDLING UNIT(10 10,000 CPM)
c (the granting of this permit.
AIR HANDLING UNIT(OVER FLOW CFM)
Signstuare(�
Siconsrpleo ppireanVConuuctar o Dam EXIIAUST HOOD(W/DUCH PAID
HAZARDOUS MATERIALS DISCLOSURE HEATING UNIT(TO IWJW BTU) Uam Receipt#
Will the applicant or future buildingoccupant store or handle haxandous material HEATING UNIT(OVER 100,000 BTU) TOTAL:
as defined by the Cupertino Municipal Cuda,Chapter 9.12,middle Health and Safety
Cade,Section 23532(e)?
❑Ycs Nn VENTILATION PAN(SINGLE RCSID)
Will Ne upplicmitnr furore building«cupem use equipmrnt or dwices which emit
BOILER-COMP(31 IF OR 100,000 BTU) ISSUANCE DATE
htrarlous air contaminants as defined by the Day Area Air Quality Management BOILER-COMP(OVER INEW RESIDENTIAL MECH. SQ.FT.
100,000 BTU) pp�� (� pTi
Disvict? ❑yes 1yVo Y A
I have rend(he hazardous materials requirements under Chace,695 of the ��� y] ,i( q
California Health&Safety Cole,Sections 25505,25533 and 25534. 1 understand that $ to
if the
���building does not currently have a tenant.that it is my responsibility to notify Ne
Oc of( ements which must he met prior no issuance of u Certificate of
sq Cil l y I r r
Owner or suihoriaed agent Date TOTAL: ISSUED BY:
OFFICE
' &- CltN
()I'Cupertino
10300 Torre Avenue
Cupertino, CA 95014
Building Division
(408) 777-3228
Fax(408)777-3333
September 26, 1995
603 Stendahl Lane
Cupertino, CA 95014
Subject: 603 Stendahl Lane, Permit# 26472
Dear Resident,
According to our records the above mentioned permit has never been finaled by a
• City Building Inspector. A permit is considered to be valid only six months from its
last inspection date. If your permit shows that the final inspection has been completed
please send a copy of the permit, along with this letter to 10300 Torre Avenue,
Cupertino, CA., 95014, Attention Building Department.
I
If your permit has not been finaled, please contact the Building Department by
calling (408) 777-3228, so that we may arrange to extend your permit, and schedule a
final inspection.
In an effort to control the number of expired permits, the City of Cupertino
requires a response in ten working days from your day of receipt of this letter. If we do
not hear from you, the City of Cupertino's Building Department will have no
alternative but to resolve your permit as expired and discard the records.
Thank you for your assistance.
Sincerely,
City of Cupertino
Pnntea cn pacic:nd P-!pnr