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31242 (2)APPLICANTTO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY CITY OF CUPERTINO BUILDING - ELECTRICAI. PERMIT NO. BUILDING DIVISION APPLICATION/PERMIT PLUMBING - MECHANICAL 'LJ Bnn Tawe is.... Tmm�rrsmnsmm�v W ❑ Consultant Fees Paid by Applicant (Initial) FEE FEE 0 BUILDING PERMIT INFO ELECT PLUMB MECI NOB DESCRIPTION LICENSED CONfRACI'OH;S DECLARATION QTY. ELECTRIC PERMIT 1 hereby a1Erm that ].at licensed under provisions M Chapter 9 (cntmnencing mSmIi.n70O0r.fDivisism3of Buzinesa FOLX the and l'ofcssionsCNe, and mylicemcis PERMITISSUANCE W= �UF in full force an��rfM�p G'G/ ❑STRUCTURAL Licere, C� Lie.N Ome—�/n— Conner APPLIANCES—RESIDENTIAL yah O ARCHITECTS DECLARATION PANELS Z in 1 codemm�d my plum -hull TV used as public vacuous 024-0 UP TO 201 AMPS F 4 t W Licensed Prolessionol 201-IOIMIAMPS OWNER -BUILDER DECLARATION CC w Q O A. U License Law for e OVER Iak1AMPS 1 hereby ufrrm That 1 ant exempt from the Comranarx th following reason. (Section 7031.5, Business Professions ?0.5, and Cade: Any city ur county SIGNS ELECTRICAL FfsIj 0� which requires a permit to mmuma, alter, improve, demolish, or repair any .from prior to its issuance, also requires the applicant for such Permit o file a signed ovement SPECIAL CIRCUIT/MISC. � Y Nm he is licensed Farman,In the provisiorsofthc Comreters Lienton Le, (Chapter 9 (commencing with Section 700C) Division 3 Business 'I I+w 0 Or afthe and Professions Code)or TEMP. MEE. R OR POLE INST. 0. a c 'hot he is exempt rhenium and the basis for the alleged exemption. Any violation of _ Section 7031.5 by any applicant fora prour subjects the applicant m a civil penalty of POWER DEVICES 7, Z Y nut more than five handout udollars ($5(10). i❑1, as owner ofthe properly. or my employees with wages as heir sole compensation, SWIMMING POOL ELECTRIC If isnot WF willdnthc work, undbentmclum intended orofl'arcd mrsale(Sce.70I4. Business 'g— and Professions Code: The Cernacmrs License Law due. not apply to an owner of OUT LEI SWITCHES —FIXTURES properly who builds or improves therm., and who revs such work himself or though his own employees, provided that such improvements an, not inrt.ded nr oRered for NEW RESIDENTIAL ELECIR SQ PLl .sale. If, however, the huilding or impr venter is sold within one year of completion, the mer -builder will have me burden of moving that he did not build or improve for put. pose of soled. ❑ 1. its owner of the property, am exclusively contracting with licensed mnnactors to TOTAL: construct the pojttt (Sec. 7034, Business and Profusions Cad_ The Commamr's Li - cause, Law dev, not apply to an owner of property who builds or improves thereon, ant] QTY. PLUMBING PERMIT who contracts for such prtjects with a contractor(s) licenced pursuant in the Commerce's License Law. PERMIT ISSUANCE p lamexemptunder. Sec. ,B&PCButhisrcacon Owner Date AUTER & VENT— WATER (EA) WORKERS COMPENSATION DECLARATION BACK FLOW PROTECT. DEVICE +.7not I hereby afftrm under penalty of perjury one of the following declarations: I have and will maintain a Ccnilicam of Consent to self -insure for Worker's Compen- DRAINS— BOOR, ROOF, A REA. COND, ion, as provided for by Section 3700 of the labor Code, for the performance of the rk fur which this permit is issued. FIXTURES — PER 'TRAP 1 have and will maintain Workers Compensation Insurance, as required by Section 0 ofthe Labor Code, for the performance of the work for which this permit is issued. GAS— LA. SYSTEM-] INC. 4 OUTLETS o Wor i" m -tion dPolic • as raft /✓ Oq/iUTCI rtier. /O/• OFl/cora Policy Na: GAS— EA. SYSTEM-OVHR 4(LA) CERT119CAfL' OF EXEMPTION PROM WORKERS' COMPENSATION INSURANCE GRGSFIINDUSTRL WASTE INTERCEPTOR (•ITisw6onneWnotbecompletdifthemcnnit is Emacs hundmddollan(ERN) in".) GREASETRAP I nattily do, indoepa,fannantaufthe work l'or which this permit is owed, Isball SEWER—SANITARY—STORM IA. 209 Ff. employ any person in any manner sr as m become subject the Workers' Compen- or laws of CWifmnia. DateWATER HEATER wNENT/ELECfH TICE TO APPLICANT: IL after making this Cenificete of flaampum. you should WATER SYSTEMnRRATING ome subject m me Workers Compensation provisions of the Labor Code, you must hwith comply withsach this be deemed �. provisions or permit shall revoked. WATER SERVICE as 7z, CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMB. SQ. PT. U C) I hereby affirm that mere is a construction lending agency forthe performance of [Jan f•-' the work for which this permit is issued (Sec. 3097. Civ. C.) Lenders Name lender's Address TOTAL: yU I certify that 1 h.vc read this application hand stare that the above informmion is rA UX, correct. I agree a. comply with all city and county ordinances and state laws relating to QTY. MECHANICAL PERMIT building construction, and hereby authorise representatives of this city In enter upon than above-mentioned property for inspection purposes. (We)hgrec to save, indemnify and keep harmless the City of Cupertino against PERMITISSUANCE liabilities, judgments, costs and expenses which may in any way acemc against said City ALTERORADDTO?t in consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT AIR HANDLING UNIT (TO TOM) CFM) SOUR EGULATIONS. pp AIR HANDLING UNIT (OVER 10.000 CFM) Signet Ap tcaryContractor Dare EXHAUSTHWD(W/DUCI') HAZARDOUS MATERIALS DISCLOSURE! Will the applicant or fume building Occupant store or handle hamrdous material HEATING UNIT (TO I W,(MM) BTU) hs defined by the Cupertino Municipal Cede. Chapter 9.12. and the Health and Safety Code, Section 25532(.)^ HEATING UNIT (OVER 100,000 BTU) - ❑Yes nNO VENTILATION FAN (SINGLE RESID) Will the applicant or future building Occupant use equipment or devices which tit haamdous air comaminamsas defined bysha Bay Arca Air Quality Management BOILER— COMP CUP OR IWAOO BTU) ,met? L] Yes C1 No BOILER — COMP (OVER IOO.0f BTU) 1 have read the haeallous materialsAIR CONDITIONER requiremcros under Chapter h95 of the CWi- broom Health & Safety Code. Sections 25505, 25533 and 25534. 1 understand that if me NEW RESIDEN'T'IAL MI CH. SQ. Pf. building does not currently have a larval. ma it is my responsibility m mnify the Occupant Of the requirements which rand Tactual prior to issuance of a Canlfiette of Oeeupancy, Owner or aumonced agent Data TOTAL OFFICE FEE FEE 0 BUILDING PERMIT INFO ELECT PLUMB MECI NOB DESCRIPTION RESIDENTIAL• ❑SFDWL ❑ KITCHEN REMODEL ❑ ADDITION ❑ PLUMBING RE -PIPE ❑MULTI -UNIT ❑STRUCTURAL M IFICATION ❑ INTERIOR IMNEY REPAIR IMPROVEMENT CI BATH REMODEUREFO R ❑ DEM LITION []OTHER COMMERCIAL- 0 OMM RCI ❑NEW BLDG/ADDITION [I DEMOLITION ❑TENANT ❑ FOOD SERVICE ^IMPROVEMENT SQ Pf. FLOOR AREA VSQ. IT. PA 11) r1B A,rn,. BUILDING DIVISION FEES PLANCHECK FEE ENERGYFEE GRADING FEE SOILS FEE PAID DRee TOTAL: BUILDING FEE FEE SEISMIC ME ELECTRICTEE PLUMBING FEE MECHANICAL FEE CONSTRUC'HON TAX HOUSING MITIGATION FEE PAID Data Rmaipl a BY: ISSUANCE J (e) 2x-1 -Irusses X 2x -/ &k_9 w/ 2x -/ j' /ony not lea 6/,E y bo11 51 x!'ly s4 f 4 p 4-6 S I IOY�Q W� Z `lil¢ tti�u 71x WaIs �W ) 11 Ofwnmj I2�4r /nJ'O Sho u %efe Z -a EXIs1 Shoulcler Sec X- X i W10 c�..,,ney ✓UN j 80G. 1gg? IN C/7yG CU FRT/ RT4j�hT 0 /on -/o Affo/a« /ynsahr'y 41Aw.iey Date /z STEVEN ARNOLDSheet CIVIL ENGINEER -/ - -_ ,,�/ 2/52 9 Edu�o ro/ W40 y/ Pior e.? -/40 eAfScale fir 1611 The Alameda, Suite 305 San lose Caliilomin 95126 An"OVEDI . (408) 286-9111 of (e) 2x-1 -Irusses X 2x -/ &k_9 w/ 2x -/ j' /ony not lea 6/,E y bo11 51 x!'ly s4 f 4 p 4-6 S I IOY�Q W� Z `lil¢ tti�u 71x WaIs �W ) 11 Ofwnmj I2�4r /nJ'O Sho u %efe Z -a EXIs1 Shoulcler Sec X- X i W10 c�..,,ney ✓UN j 80G. 1gg? IN C/7yG CU FRT/ RT4j�hT 0 /on -/o Affo/a« /ynsahr'y 41Aw.iey Date /z STEVEN ARNOLDSheet CIVIL ENGINEER -/ - -_ ,,�/ 2/52 9 Edu�o ro/ W40 y/ Pior e.? -/40 eAfScale fir 1611 The Alameda, Suite 305 San lose Caliilomin 95126 An"OVEDI . (408) 286-9111 of Job No. ��- STEVEN A. ARNOLD RCE 12301 STEVEN A. ARNO • • }Civil Engineer, Inc. `gg 1671 THE ALAMEDA, SUITE 305 . SAN JOSE, CALIFORNIA 95126 . TELEPHONE (408) 286-9111 June 12, 1997 City of Cupertino Building Inspection 10300 Torre Avenue Cupertino, CA 95014 SUBJECT: Masonry Chimney for the residence 21529 Edward Way Cupertino, CA Gentlepersons: At the request of Jones Masonry, I made an on-site inspection of the existing single story masonry chimney located at the subject address. The existing chimney had been removed down to the shoulder revealing the fact that no structural steel was placed in the chimney. I have attached a sketch that depicts one method of re- installing the masonry chimney and attaching to the wood frame wall of the existing residence. Should you have any questions, please feel free to contact me. Respectfully submitted, Steven A. Arnold Civil Engineer CE22301 cc: Jones Masonry ffflc� ca" Boo I&Sp , 171997 CIry0" CG pFpgATMr.,. 0 C., ct:`Y :iVSI• Or GA1 �&a STRUCTURAL DESIGN . LAND SURVEYING • BUILDING INSPECTION . GENERAL CIVIL ENGINEERING SERVICES 1(r STEVEN A. ARNOLD — Civil Engineer, Inc. • 1671 THE ALAMEDA, SUITE 305 • SAN JOSE, CALIFORNIA 95126 • TELEPHONE (408) 286-9111 June 12, 1997 City of Cupertino Building Inspection 10300 Torre Avenue Cupertino, CA 95014 SUBJECT: Masonry Chimney for the residence 21529 Edward Way Cupertino, CA Gentlepersons: At the request of Jones Masonry, I made an on-site inspection of the existing single story masonry chimney located at the subject address. The existing chimney had been removed down to the shoulder revealing the fact that no structural steel was placed in the chimney. I have attached a sketch that depicts one method of re- installing the masonry chimney and attaching to the wood frame wall of the existing residence. • Should you have any questions, please feel free to contact me. Respectfully submitted, Steven A. Arnold Civil Engineer CE22301 cc: Jones Masonry STRUCTURAL DESIGN . LAND SURVEYING • BUILDING INSPECTION . GENERAL CIVIL ENGINEERING SERVICES STEVEN A. ARNOLD — Civil Engineer, Inc. 0 e 1671 THE ALAMEDA. SUITE 305 -SAN JOSE. CALIFORNIA 95126 • TELEPHONE'(408) 286-9111 June 12, 1997 City of Cupertino Building Inspection 10300 Torre Avenue Cupertino, CA 95014 SUBJECT: Masonry Chimney for the residence 21529 Edward Way Cupertino, CA Gentlepersons: At the request of Jones Masonry, I made an on-site inspection of the existing single story masonry chimney located at the subject address. The existing chimney had been removed down to the shoulder revealing the fact that no structural steel was placed in the chimney. I have attached a sketch that depicts one method of re- installing the masonry chimney and attaching to the wood frame wall of the existing residence. Should you have any questions, please feel free to contact me. Respectfully submitted, Steven A. Arnold Civil Engineer CE22301 cc: Jones Masonry STRUCTURAL DESIGN . LAND SURVEYING . BUILDING INSPECTION . GENERAL CIVIL ENGINEERING SERVICES