27920APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE SALL POINT PEN ONLY
CITY OF CUPERTINO
BUILDING DIVISION APPLICATION/PERMIT
BUILDING. ELECTRICAL
PLUMBING -MECHANICAL
IIUILDINI: 1•x(1.1 N.CI' IDRR'I'IFII;AT'1t1R
FERMI 'I'NO.
27920
BUILDING ADDRESS:
SANITARY NO.
APP1_ICA37ON SSUUBMHTAL HATEna,,
\)
LOT#
��
(3W E NA I? w PIiO:
fVl Ll.�
CO
'OR'S NAME:,/'• C /Y IJCNO:
ll�I Ir\i
N/C
❑
CONTROL
ARCHITECURNGINFER: WC NO: ADDH "S: `�
^ �
CONTACT: PHONE'
QTY.
BLECTRIC PERMIT
FEE
BUILDING PliIiMIT INFO
Fy Cry PL MCCH
��yl[�
PERMIT ISSUANCE
LICENSED CONTRACTOR'S DECLARATION
I herebyaffirmthat l am licensed under powislonsofCTapter9(commencing with
Section700nof Division 3 of the Businessand Pmfessim, Curia, and my license is in
full tounA effect n �ab
Li-.LIc.X ao
Dae Cnmm b� S�
ARCNITECI'SDECLANATION
1 understand my plans shall he used az public records.
APPLIANCES - RESIDENTIAL
PANES
UPT02MAMPS
201-I(IODAMPS
OVP-R HXXI AMPS
JOB DESCRIPTION
\s
SQ. FT. FLOOR ARTA
5/SQ. FT.
SIGNS ELECTRICAL.
Licensed Professional
OWNER -BUILDER D ECLARA'I'ION
SPECIAL. CIRCUIT''/MISE.
I herehy attire Nm 1 am emmps from the Contractor's License Law for the
and Profession Co de: Any city mcuture
TEMP. METER OR POLE INST.
whicwreanim..a.
.Permdoa]03LS,Business
aper, improve, demolish, n repair any structure
which requires rn permit 9.re
uireww,
thevisiosoat f 1.or's
POWER DEVICES
licensed purso«qui the La(enterer
Chit he the ContractLicense
w pursuant m the pmviai isi of the the Business s s License Lew ns oun r
9(c he la (commencing tion]000)he Division Sof the Professions Calc)
cng
9(co[hc
SWIMMING POOL ELECTRIC
VALUATION
II m,am
11,tha exrmptlon. Any violation of
nrlhalhe 131.5 by nhcrcfromund the basis for bjects the
y any app panni 1 PP Pene y o
Scctlon]0316h licem for taubbcp thea liconuoocivil 11 f
not more than fivehupmNmy, rxlSSW).
❑othe%m,adeproputy,orraainte, yea wiNwedfoua]a (Selecumpensotioo,
will dmhamians and the sha tumoris 70,14. B.6.
Ou'TLETS-SWITCIIFiq-FIXTURE
NEW RESIDENiALELECfR _SQ. IT.
STOH ES
TTPE CONSTRUCTION
and Code: Thr Co.,,Comr ars saw dna not apply lf rt owner of
saw do . not ,Iy
property wholo is
cwrcnm,oa.,p..irimproves the n, whodoessuch wink himselfm Nnmghhis
employees, provided spats chitn mnnnsarenot intendc ffered fur sole. If,
OCC.GROUP
RE -S. UNI'T'S
howevegthehuilng ori w n is sold within one ye �/' lesion, the owner.
builderwillhnve a ren roving shut he did of hui Im{rove for purptse of
sale')'
y.aexclu ly III., with licensed contractors to
❑ Lnsown openm
QTY,
T
PLUMBING PERMIT
FEE
FTAODZONE
APN
nssmn the proja I c. Jp� Nusineu pan, Basions Cade:) The Comnoa'a
License Lawdcwsno p ly to an property who builds or impmve"It,mon,and
PERMIT ISSUANCE
whocontroeolinsucl jacsl ntmcmr(s) licenaod mosuanno the Convector's
Lianm Law.
AL T'IiN-UItA1N&VENT-WATER EA
( I
FEE SUMMARY
❑ I um exetnpl under, Sec. , B & P C far this reuaon
BACK FLOW PROTECT'. DEVICE
OUTS. ,.
SANITARY Y N
RECM P #
Owner Did
WORKMAN COMPENSATION DECLARATION
DRAINS- FLOOR, BOOKAREA, COND.
SCHOOL TAX Y N
❑ Ihereby affirm that lhave acenifiuuenfcoreettonelf-inaure,oracenificamalFI%'TUNIS-PER
Workers'CnmpenamionlnsumnceorucenifiW c�pyNmenf (Sco.3g00,Luh CJwhich
TRAP
RECEIPfp
PARK FEL? YN
crs all engdnyec'x under(.hir pemtih
Policy N
GAS - EA. SYSTEM- INC. OUTLIH S
RECFIPT #
BUILDING DIVISION FEES
Company
❑ Cenifielcnpyishereby Rtmished.
OAS - EA. SYSTCM-OVHR 4 EA
PLANCHECK FEE
GRADING FEE
❑ Cenifial spy is pled with the city inspwsion division. GRHASF/INDUSTRL WASTE. INTERCEITOR
CERTIFICATE OF EXEMPTION FROM WORKERS'
GREASETRAP
SOILS FEC
COMPENSATION INSURANCE
ENERGY FTI?
(Thiasection neednolbecmaplmcd iUhepernp isfornne hundreddollurs(SI00) SEWER - SANITARY - STORM EA, 200FT.
arias.)
I anifyflut, ape performance.(Ne work far which this permit is iasuW, l shall WATER HEATER W/VENT/L•LECTR
not employ any person in any manner so az to become subject to the Worker'
PAID
Compe... tinnlywsof Celifomia. Dutra
WATER SYSTEMITREATING
Data Receipt#
Applicant
NO' ITCH TO APPLICANT:IT, after making this Certificate of Exemption, you should
NCW RESIDENTIAL PLMIL SQ. FT.
'TOTAL:
hecome suhjwt In the Worker's Comp.m. ion,oAkinn of the L .boa Code, you meat
forthwith comply with such provisions or Ihis permit shall be dame) revoked.
BUILDING PEC
SEISMIC FEE
CONSTRUCTION LENDING AGENCY
I hereby affirm shin them is a canewction lending agency for the performance of
the work for which this permit is issued (Sec. 3097, Civ. C.)
's
ELECTRIC IEE
UnderName
Lender's Address
QTY.
MSCI [AN [CAL PERMIT
MR
PLUMBING FEE
I certify Nut 1 have read this application and state that this .hive information in
tet. l agree to comply with all city and county ordinances and state laws relating m
`
PERMITISSUANCC
MECHANICAL. FEE
building construction, and hereby pmhoon reprtsenmtiveu of Nis city mercer upon the
above-propertyumses
ioned property for inspection pf.
AUBER OR ADD TO MECH.
CONSTRUCf10N TAX
nify and keep hmmlem Ne Ci o o against
eagermsuidCity
(Ui
AIR HANDLING UNIT'(TO 10,000CFM)
n mtit.inat
S' namreof Apppc.VComrzImr a Data
AIR HANDLING UNIT (OVER )0,000 CNN)
EXHAUST HOOD(W/DUCT)
PAID
HAZARDOUS MATERIALSDISCLOSUR
1 IEAfING UNIT(TO 10!1,000 BTU)
Date Receipt#
TOTAL:
Will the applicant or fucose building «c.para store or handle hazardous malarial IIHATING UNIT (OVER 100,000 BTU)
as defined by the Cupenion Municipal Cale. Chapter 9.12, and the Health and Safety
Cade, Section 25532(.)?
CI Yes ❑ No
VENTILATION PAN (SINGLE RESID)
ISSUANCE ATE
POILER- COMP(3HP OR 100,000 BTU)
cupmseequiptordevittswhich emit
Will the applieanmrfumre building«anmen
haca dour an contaminants as defined by the Bay Area Air Quality Management
District?
BOILER- COMP (OVER 100,000 BTU)
❑ Ye's ❑ No
NEW RESIDENTIAL MECII. SQ. IT.
1 have read the hazardous materials requirements under Chapter 5.95 of the
Cm a Core
& Safety Code, and
25505, 25533 and 25534. 1 understand N.I
Cthebuildingd«s
R
if buil ingHealthdo not currently have
hoveatenant,that it is mramify the
«cupam of the reyviremems which mus bo ten prim so issuance of a Cmificmc of
Occupancy.
-
ISSUED
Owner or.mhnri'eeJ .,,at Date 1..
OFFICE _ _ =Wjlr -Y
10300 Torre Avenue
Cupertino, CA 95014
Building Division
I� r� (408) 777-3228
Fax (408) 777-3333
December 4, 1995
Resident
1132 Yorkshire
Cupertino, Ca 95014
Subject: 1132 Yorkshire, Permit # 27920 - Kitchen Remodel/ Window
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.
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
V