00010114 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY U
CITY OF CUPERTINO BUILDING-ELECTRICAL I'ECAL BRMI'1'NO,
BUILDING DIVISION APPLICATION/PERMIT I.UMBING-MECHANI
BUILDING 1'RfIJECT IDENTIFICFIC
ATION
I
BUILDING ADDRESS: SANT I'ARY NO. APPLICATION SUBMIII'Ah DATE
Q9 o '_b R,1 V e_ rL a
VNIi�s',NA"ME: "JE, CONTRA R'SNAM& LIC NO: NIC CONTROL#
C�F�►201_ b 7-3 22.4 11
lil
�CIII'I ELTI lNGINEEW LIC NO. ADDRF,SS: ❑
CONTACT: PHONE: BUILDING PERMIT INFO
❑ Consultant Fees Paid by Applicant(Initial) HLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION QTY ELECTRIC PERMIT FEE
I hereby affirm that I am licensed under Provisions of Chapter 9(commencing JOB DESCRIPTION
DMZ with Section 7")of Division 3 ofthe Business and Pmfessiun.Cmdc,md my license is PERMIT ISSUANCE RESIDENTIAL,
1-ad. in full force and effect. ❑SFDWL Fl KITCHEN REMODEL
aVU Liver,Class hie.# APPLIANCES-RES IIIF,NTIAL ❑ADDITION ❑PLUMBING RE PIPE
F Z W Darn C'mdowo
o,i MULTI-UNIT ❑STRUCTURAL.
AHCIII'1'IiCI"S DECL.AHA'1'ION
F m Z 1 understand my plans shall be used-public records PANELS MODIFICATION
OZ -M UP10200AMPS
❑INTERIOR C1 CHIMNEY REPAIR
W Licensed l'rufe..ional 201-1000AMPS IMPROVEMENT SWIMMING POOLS
OWNER-BUILDER DECLARATION OVER I(Nx1AMY5 ❑BATH REMOUIiI/RHPAIR ❑DEMOLLTIQN
C C Q I hereby million that I am exempt limn the Contmcmr's License Law For the ik F D
Any city or county SIGNS ELECTRICAI. THIiR
X d U which re rre equires
a. eaaiioit 703 L5.Business improve.
Professions Code:repair
t I A'�IXI l' )I
103ay which its issuance,
anpoen manes the alar,It forsuh perm fi,ore a sifanyswcturc ^
FLL�Q priorwits issuance,also requires the applicant sn such peri'.Lice se La.(Chapt amt SPECIAL CIRCUIT/MISE.
f } that he is licensed punoatfuthe pmnaima of the Cnntmcmr's License (Chapter COMMERCIAL:
WC, (commencing with Section 7000)of Division 3 of the Business and Professions Code)or TEMP.MITER OR POLE,NST.
d a W that he is exempt thcrefmm and the hasis lin the alleged exemption.Any violation of ❑NEW BLUG/ADDITION ❑DEMOLITION
Section 703 LS by any applicant for a permit subjects the applicant to a civil penalty of POWER DEVICF_S
W^m xy than flue hundred dollen(ESIxB.
[I TENANT C1 FOOD SERVICE
^ZQ Lasowner of the property, loses with wages a.their sole compensator, SWIMMING POOL ELFc TRI IMPROVEMENT
=Q trope y y corp Y g ps, ❑OTHER
w I I di,(lie wad,imdr:Th Comre i_rnal,1,cendrte.e.dos r sale not
loan,Bonn if
3 m mal,in,who
Cade:The C^nlrucmo landw Luw dose nm apply house un owner of WThP.TS-SWI'fClll'.S- S
popery who byes,or aided th thsuchi Lind who doents a such work dedor or errough
his own employees,provided that such improvements arc nm encoded or offered for NEW RESIDFN'I'IAL ELIiLTR FT
safe,If.hmwever,the bulldimgor improvenern is sold within on=year ofcompletion the SQ.ET.IL,DDR AREA $ISQ.lT.
e-builder will have the burden of proving that he did not hila or improve for par.
'oe of sale.).
1,as owner of the property,am exclusively contracting with licensed corrosion to OTA,:
construct the project(Sec.VUW,Business and Professions CWep The Companies Li-
ntsLaware.nmapplYmanownerofpmpertywoobuildsorimprovcsthereon.and QTY. PLUMBING PER FEF.
who contracts for such projects with a contrad n(s)licensed p...arm to the Contmetor's
License Law. PERMIT ISSUANCE
I um exempt under See. .B&P C lot this reason
ALTER-DRAIN&1.11'1'- (E VALUATION
Pear Dat= m
14
WORKER'S COM PENSAI'ION DECLARATION BACK FLOW PRO)PC DCVI% �D
1 hereby affirm under penally of Perjury one of the following declamtionu ��ii��J!''
❑I have and will maintain a Certificate of Conant to self-insure for Worker's Comp=n- DRAINS-FLOUR.ROOF.ARTA.COND. STORIES TYPE CONSTRUCT ION
,tion,as provided for by Section 3700 of the Lahr Code,for the performance of the
ark for which this perp is issued. FIXTURF_S-PER TRAP n y /
I have and will malnmin Workers Compensation Tmsomnce.ac respect by Section L —1 v
37110 of the labor Code.forth.performance of the work for which this petit is issued. GAS-EA.SYS'fFA.i INC.4 OUTLETS ICC.GROUP APN
My Workers Compensation Insurance career and Policy number are:
Cartier: Policy No.: GAS-EA.S\'STEM-OVER n(EA) —
CERTIFICATE OF EXHMPUON FROM WORKERSGREAST/INOIJSTHL WASTIi INTERCEPTOR I�
COMPENSATION INSURANCE BUILDING DIVISION FEES
.1'his section need not be completed It the Peril is for one hundred dollars($100) GREASE THAI'
ar PLANCHECK Flili
Icu.l
Iccrud,that in lhcperlinmanccofthe wok fimwhichthla permit iskcycd,l shall SEWER-SANITARY-STORM EA.200 FT.
not employ any person in any mm�ner sat as hiausme Wn ktax'Contpen- ENERGY FEE.
Q Z -tion La , Le AHa{, ; WATER HEATER W'N1EIAELECTR GRADING FEE
z 0 Applicant ��/J O
N. NOTICU'ro'OPLICANT:If,after making this Certificate of EsemlNum,you should WATER SYSTENITREATING SOILS FEE.
a > became subjat m the Wmkers Compensation provisions of the Labor Code,you must
fredwith comply with such provsmns or this permitshall h deemed revoked WATER SERVICE
n' CONSTRUCTION LENDING AGENCY N////T NEW RESIDENTIAL PLMB. SQ.FT. fly
U O I hereby affirm that here is a candroo nlendingagencyfnrthl p=Annnuneeof Data\ Hecdipt0 I^
nn . 1
U F rhos work I'ur which flus Innen s dsmA.Sec.3119].C v.C.) I I'
OULenders Nano II 'I'(YI'AL'.
W Lnudce'sAddress TOTAL: 200
r t1 I cerdy the,I have read this Tfilicullnn and stem mal the above inf^nnati^n is UILDI L
Hy cootct.I agree to comply with all clay and comay ordinances and state laws relming to QTY. MECHANICAL PERMIT FIiE ISMIC FEE
UZ bui lding conntmetlon.and hereby authorise representatives of this city to enter upon the
" abrve-mentioned property for inspection purposes PERMIT ISSUANCE. ELECTRIC FEE
(We)agree to save,indemnify and keep harmless the City of Cupertino against _
liabilities,judgments.costs and expenses which may in any way avenue against said City ALTER OR ADD TO MECH. L MBING FFb
in ,sequence of the granting of this peril.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10.000 CFM) MECHANICAL FTiE
SOU REGULATIONS.
0211/1` 1 „�„ 0 AIR HANDLING UNIT(OVER 10,000 CFM) CONSTRUCTION TAX
Sign um ul Appl'muMCnnvndnr /� IKim EXHAUST HOOD I W/DUCT) HOUSING MITIGATION FEE
HAZARDOUS MA'T'ERIALS DISCLOSURE
Will the applicant or l mum huilding uccepant spire or handle hooter]........anal HEATING UNI'I'(10100.00 BTU)
n,I&ned by the Cupertino Municipal Calc,Chapter 9.12,and the Health and Safety
' ' HEATING UNIT LOVER OO,Ofq BTU)
Coda Marian 25532m)?
0Yes XNo VENTILATION PAN(SINGLE RESIDE PAID
/` Date 01 Rttcipt N
Will the applicant m future building occupant use equipmem or device which BOILER-COMP OHPOR 100.000 BTU)
nit hawdous air contaminants as defined by the Bay Arca Air Quality Managem=m TOTAL:
District? Yes *NoBOILER-COMP(OVER I0y"BTU)
❑
I have mad the havnNous materials requinemcros under Chapter 6,95 of the cal;- AIR CONDIT ION1.R ISSUANCE DATE
hoot health&Safety Gyle.Sections 25505,25533 and 25534.I undemOmd that if the NEW RESIDId'"[AL MITCH. SQ.FT.
hilae rlercs erncurrently nave area,mfmal it la my resln'sibilitymnollfymnavvpaa _ Z_ LY
mens whlcb e ct ami Cer�z it Oc
Ow aumorrzcdagent atomic TOTAL: ISSUED BY:
OFFICE
J ,
• Atwood Residence
Oak Valley Development
10849 Sycamore Drive
Lot 5-7, Neighborhood One
USE OF SECOND STORY DECK
Request: Applicant would like to use the second story deck.
Problem: Setback is not sufficient on the west side of property. Deck meets the 35'
front setback requirement from the street (4' wide deck set back 36' from curb) and the
15' requirement on the southeast side. The deck protrudes into the 15' side yard setback
requirement on the northwest side by 3' 4" (15' setback less 10' + 1'8").
Proposed Solution: Resident will construct a permanent railing restricting access from
the northwest comer of the deck. This railing will prohibit usage of that portion of the
deck currently within the 15' Setback.
See attached drawings for details
• Approved: Za ( fa& 6=
�Bob Cowan, Director of Community Development
q
Date: Iy�p•.ci
� 4R9
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INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
• CITY OF CUPERTINO
. BUILDING PERMIT INVOICE OPERATOR: karenb
Sec: Twp: KOS: Sub: Elk: Lot:34257028.00
INVOICE DATE.:....: 01/24/2000
REFERENCE ID # ...: 00010114
SITE ADDRESS .....: 10849 SYCAMORE DRIVE
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OWNER ............: CAROL ATWOOD
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
CONTRACTOR .......: LIC k -OWNER-
COMPANY ..........: CAROL ATWOOD
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
TELEPHONE ........:
FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE
-""-"'------- --- --------- ------------ -----------
BPERMFEE P 77.00 0.00 77.00
--------- ------------ --------"'
77.00 0.00 77.00
VOICE ID -- DESCRIPTION-----.--- VOICE ID -- DESCRIPTION
..... ...... ........ ..... ..............
FOUNDATION 102 PIERS
103 UFER 104 REHAB
105 ANCHOR BOLTS 106 SEWER 4 WATER
202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL
204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION
301 ROUGH PLUMBING 302 TUB S OR SHOWER
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
305 FRAME 306 HOLDOWNS
307 INSULATION 308 SHEETROCX
309 EXTERIOR LATH 310 INTERIOR LATH
311 SCRATCH COAT 313 ROOF NAIL
501 FINAL ELECTRICAL ENERGY 502 FINAL PLUMBING ENERGY
503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERGY
505 FINAL ELECTRICAL 506 GAS TEST
507 FINAL PLUMBING SOB FINAL MECHANICAL
509 FINAL GRADE 510 FINAL PLANNING
514 FINAL PUBLIC WORKS
•
Ory. i/ Applicable Fee ID Fee Description Fee Group
�BPERMFEE ISLOG PERMIT FEES BUILDING
ISCONSTAX 1CONSTRUCTION TAX JBUILDING
JBENERGY JENERGY BUILDING
BENERGYADD JENERGY ADD MULTI 1BUILDING
JBOVERTIME JINSPECTION OVERTIME IBUILDING
BTEMPPERM ITEMPORARY BLDG PERMIT 1BUILOING
BMITIGAT HOUSING MITIGATION FEE IBUILDING
JBPLANCHK PLAN CHECK FEE BUILDING
BPLANCKADO PLAN CHECK ADD MULTI BUILDING
BPLANCKREP PLAN CHECK REPEAT FEE BUILDING
SREINSPECT REINSPECTION FEE BUILDING
BSCBLVD SCB SPECIFIC PLAN BUILDING
BSEISMICOM SEISMIC COMMERCIAL BUILDING
BSEISMICRE SEISMIC FEE RES BUILDING
ESPECIAL SPECIAL INSPECTION BUILDING
BSWIM - SWIMMING POOL BUILDING
ZADDCHG ADDRESS CHANGE BUILDING
EPERMITFEE JELEC PERMIT ISSUANCE ELECTRICAL
BELEC1000 ELEC 600V r_1000A ELECTRICAL
BELEC1001 ELEC 600V>1000A ELECTRICAL
BELEC200 ELECT SVCS 600V 4=200A ELECTRICAL
BNEWMULTI MULTIFAMILY RES ELECTRICAL
BREMBUSWAY REMODELBUSWAYS ELECTRICAL
• BREMFIXT LIGHTING FIXTURES ELECTRICAL
BREMMISC MISC APPARATUS ELECTRICAL
BREMNRAPP REM NON-RES APPLIANCE ELECTRICAL
BREMPOLE POLE/PLATFORM FIXTURE ELECTRICAL
BREMPOWER POWER DEVICE/APPARATUS ELECTRICAL
BREMRECEPT RCPTL, SWITCH &OUTLETS ELECTRICAL
BREMRESAPP REMODEL RES APPLIANCE ELECTRICAL
BREMSIGNAD iRMOL SIGNS ADD BRANCH ELECTRICAL
BREMSIGNS REMODEL SIGNS, MARQUEE ELECTRICAL
BREMTHEATR THEATRICAL LGHTNG FIX ELECTRICAL
BSF&2FAM SINGLE&2 FAMILY ELECTRICAL
BTEMP TEMPORARY POWER ELECTRICAL
BTEMPSVCS TEMP DIST SVCS ELECTRICAL
MPERMITFEE IMECH PERMIT ISSUANCE IMECHANICALI
BAPPLOTHER OTHER APPLIANCES IMECHANICALI
BBOILER1 BOILER <= 100,000 BTU MECHANICAL
BBOILER2 BOILER>100KTO500KBTU MECHANICAL
BBOILER3 BOILER>500K TO IM BTU MECHANICAL
BBOILER4 BOILER>1M TO 1.75M BTU MECHANICAL
BBOILERS BOILER> 1.75M BTU MECHANICAL
BREMAPPLI APPLIANCE INSTALL MECHANICAL
URF-MMhAl 1HE.ATER INSTALLATION MECHANICAL
BREMVENFAN IVENT FAN SINGLE DUCT MECHANICAL
. BMNEWMULTI INEW MULTI-FAMILY RES MECHANICAL
BMNEWSF&2F INEW SF&2F RES BLDGS MECHANICAL
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Rind I1e/99
9REMACOVER QAC UNI T>IGCOGCF?a ��tEC-ANICAL!
jBREMAIRHAN JA/C UNITS <= 10.00CCFNI JMCCHANICAL
ISREMFURN 1RELOCATION OF FURNACE IMECHANICAL
BREMFURNOV IRELO FURNACE > ICK S i U IibIECHANICAL
SREMINHOOD JINSTALLATION OF HOODMECHANICAL
BREMRELOCA RELOCATION OF HOOD MECHANICAL
BREMREPALT REPAIR/ALTER HEATING IMECHANICAL
BREMVENSYS IVENTILATION SYSTEMS IMECHANICAL
IPPERMITFEE JPLUMBNG PERMIT ISSUE PLUMBING
BNUMULTI NEW MULIFAMILY RES JPLUMSING
BNUSFD NEW SINGLEFAMILY RES PLUMBING
BPBACKFLOW ATMOSPHERIC VACUUM PLUMBING
BPCESSPOOL CESSPOOL PLUMBING
BPFIXTURE PBLG FIXTURE PLUMBING
BPGAS GAS PIPING SYSTEM FEE PLUMBING
BPINTERCEP IND WASTE INTERCEPTOR PLUMBING
BPREPIPE REPIPE OF FIXTURES PLUMBING
BPSEWAGE SEWAGE DISPOSAL PLUMBING
BPSEWER SEWERS PLUMBING
BPSPRINK LAWN SPRINKLER/BACKFLO PLUMBING
BPSTORM STORM/RAIN WATER PLUMBING
BPTRAP KITCHEN TRAP PLUMBING
BPVENT ALT OF DRAIN &VENT PLUMBING
BPWATER INSTALUALTER WATERPIP PLUMBING
BPWHEATER WATER HEATER/VENT PLUMBING
BPWSVCS MAIN WATER SERVICE PLUMBING •
ZDEVAGREE DEVELOPMENT AGREEMENT PLANNING
ZDIRTM DIR TENT MAP PLANNING
ZFULLHR FULL APPL BASE+HR PLANNING
ZFULLTM FULL APPL TENT MAP PLANNING
ZFULLUP FULL APPL USE PERMIT PLANNING
ZFULLZONE FULL APPL ZONING PLANNING
ZGPAMENO GENERAL PLAN AMEND PLANNING
ZUMAMEND LIMITED AMEND PLANNING
ZLIMTM LIMITED TENT MAP PLANNING
ZUMUP LIMITED APPL USE PERMI PLANNING
ZMATEMPUP MIN AMEND TEMP USEPERM PLANNING
ZMINHILLEX MINOR APPL HILL EXC PLANNING
ZMINSIGNEX MISC SIGN EXCEPTION PLANNING
ZMINTM MINOR APP TENT MAP PLANNING
ZMINUP MINOR APPL USE PERMIT PLANNING
ZMISCASA MISC ARCH SITE PLANNING
ZMISCEXT MISC TM AND UP EXT PLANNING
ZMISCFENCE MISC FENCE EXCEPTION PLANNING
ZMISCGEN MISCELLAPPL GENERAL PLANNING
ZMISCPCINT MISC PC INTERPRETATION PLANNING
ZSIGN 1SIGN PERM[ PLANNING
ZTEMPSIGN ITEMPORARY SIGN PLANNING
ZVARIANCE IDIRECTOR VARIANCE PLANNING •
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0.e.ised Ll0199