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27789 (2) J APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY / CITY OF CUPEUII.DINf�-F.LP,CTR PERMIT NO. APPLICATION/PERMIT PLUMBING-MECHANICAL BUILDING DIVLSIO NO ION HA_ BUILDING PROJECT IDENTIFICATION BUILDING `ADDRESS: /���� ,./� SANITARY NO. APPLICA'II((IXJ SUBM�f(IT'Ay��L DA'lti 0 7 �J &e/RJld C' UNITt • LOT# I —7 O O"ERS NAME. e PIIONE: CONTRACTOR S NAME: LIC NO: NtCCONTROL� 'RCHI'1 .CI'pNGINEIiR: LIC NO: ADDRESS: ❑ CONTACT: PHONE QTY. ELECTRIC PERMIT FEE BUILDING PERMITINFO BLDO ELECT PLUMB MECH PERMIT ISSUANCE ❑ ❑ ❑ LICENSED CONTRACTOR'S DECLARATION APPLIANCES-RESIDENTIAL OKZ I hereby affirm that l am Been l undo povinomofCM1apn9(mrmr,ve;ng with HOB DESCRIPTION POO 9sv1Ioo 7")of Dvidon 3 of the Burin%%"l',afnsiotu Cade,and my lkesue is in PANELS �bB full fora and effect. <zw Lccnc Clns Lic.at UPTO2 AMPS sca) G co<y Dmc Comodor 201-1000 AI11P$ Z O,o z ARCHITECTS DECLARATION OVER 1000 AAfPS SQ.EL FLOOR AREA SISQ.FT. O7_n lmdersuM my plum shell IT,turd as public accords, SIGNS ELECTRICAL an L.icemed Founde«ml E:=2'6< OWNER-BUILDER DFiT.SRATION SPECIAL CIRNIT/MISC. �O6u I hereby nfllrm Nes 1 and cxeind from the Contractus Liame law for IN, 3li fallowing reason.(Swim 703iS.BuNev and Pmfusiav Code:Any dry orc«elry TEMP.METER OR POLE INST. C u'Og which acquirer a pernut to construct,.her,Timmons.demolish.«repair any structure fsD}7 prions its issuance.9lw mquina the applicant for such pennluo file a aigned statement POWER DEVICES W C O<p Nor he is I;anxJ purawnt m the Poviu«u of Be Cvnurt«'a Ltcrnx I�w(Chap« . cixo� 9(cammmcingwith S,nim TOIXll of Division lof the Busiesed Rofsowu Code) SWIMMNG POOL EIECIC[C VALUATION W�so or mat be in cacmpl Neacfrnn till the Buis for me alleged exemption.Any violation of CZQ Section 703 l 3 by any apPliwm far psmit.ubjcu the applicant ba civil Pity of OVIIfTS-SWITCHES-FTXTURFS ra more dun five hundred de W(S50o). NEW RESIDFMIAL ELECITt _SQ.PT. C ❑ I,asawrcraflM1cpnpcny,nrmycmpinywwilM1 wagnutheir.snleampanariwl, STORIES I YPE CONSTRUCTION y will doProddismk,eM de suuaweiswsimLi. offered!«u le(Sx.mlf4,Buairl of old erty w1a;au Code:The ves th con. sod who ocw don tat apply ton r0 former is propmy who bit ilm or Improve.dammer,sera who sora aaeM1 wall mmxuor naoagn his employen,prov;ded des suchimpoverrcwvemlinerdedmoRaedf«vle.B, OCC.GROUP RFS.UN however,the building or impoverrent is sold within ae yearofcmnpled9n.Be ownn- Iwllder will have die burden of proving that M did not build«improve for W rpose of TOTAL: e). ❑ I,uowrinofth popeny,am exclusivelymnvacting with lixmaed rontmanm QTY- PLUMBING PERMIT FEE FLOOD'/ E APN ansvun,be pmkm lace.9094.Businae aM Peufm4«u Coded Tie Co...'. Liana L�wdms n«apply menowrcrof popmywho buildaorhnpovn Bvml,ard PERMIT ISSUANCE IJerncasex I wu,rte ouch prolccu with amu,nano(s)liamcd pinwnt to Be Conmactas es. ALTER-DRAIN&VENT-WATER(Ftp FEE SUMMARY ❑ I am manp,miler Ss,. ,B&P C f«this ruvon BACK FLOW PROTECT.DEVICE SANITARY Y N OwnerDere SCRECEIPT M ONS-FLP.A,OOR.ROOF.ARCON WORKMANCcmirt COMPENSATION DECLARATION RAHOOLTAX Y N Me ❑ Iby allium Narlhasxacenihrue of arxnsmxlf.imwe.oraceruhrem of RF.CEEIPIT'x Workm Com fIX'11JRFS-PER TRAP pavation lmuretcea•emiBM ropy thaeallSa.38(gl,l�b C.)which PARK FF:E YN coven all empbm yes'•under this ynit. OAS-FA.SYSTEM-T WC OUTLELSN REC-EIPT0 Polity 0 BUILDING DIVISION FEES Company GAS-EA.SYSIP HR4(HA) PLANCHECK FID ❑ Coifed espy is M1cacbY fundaM1ed. ❑ CmiCW copy isfded wild Ne city l,uprcBorl division. GRFASEJIN WASTE INCERCEPTOR DWG FFR CERTIFICATE OI'EXEMPTION FROM WORKERS' O ,TRAP SO FEE COMPENSATION INSURANCE (Thisawinn aced n«bccinmidaBde permit u fa con hmArcA ddlm(5100) SE R-SANITARY-STORM IA,2001ENERGY FEE or leu.) Icrafy But in do perforr®e<af Be work for wtich this permit u seemed.l abHl WA HEATER W/vFN1'/p.ECIR not employ,my prom in any manner so as to laecone wbjar to the WokmPAI z Cumprnetian l�wa of CelifmBa. Date WATF SYSTENUTREAW TG Dare Receipt A,Plicsm 'z 0 NOTICE.TO APPLICANT:If.after making this Ceradde a Eaernption,you ahould NEWR' AL B. SQ. TEETOTAL yBemra.wbjectm the,Worker.C«nvpori.i.of Nar e LubCode,you twat � > forthwith mmply with such pwviaiom en this,peond,That be deemed revakal UIIDINO TEE 1 L CONSTRUCTION LENDING AGENCY MASMICFEE Z) z IIlenbyaRrm thv thveisacorumucBm leMirg aBe^cY fm the paf«nwec of V O 15e workfsr which thi.p,rmit is isued(Sec.3097,Civ.C.) TOTAL: EI.ECfRIC IEE O ..r LsMcr's Name rV t<mer'a Addrrn QTY MECHANIC PERMIT FEE PLUMBING FEE. I certify that I have wall this application and.rue wt The above mans mYm is anted. I ance mcnmply with all city ardcounlymdinarc®and sem Wws mWingto PLRMIT ISSUANCE MECIIANICALFBE 7. F-' 7 xbo,c gconswnim,ser horby awh«v<rtpnvBativn ofNudtyto enw upon Bx ahovcmmti«IM f NNSTRUCI'ION TAX V 7 popaty indemnify ALTER OR ADD TO MECH. .7 (We)egac In eeve,inacnm�fy eM keep may ma th City of Cupeniat against liabilitin,judgn,mgaxuaMcxp:raan whicM1 may many way serve age'uw geld City AIR HANDLING UNIT PTO IO,IXp CFM) in crosequeree of de grvlBng of th'a Permit. K T D AIR HANDLING UNIT(OVER I0,000CPM) lql�yall` SI mfA 4Cmven arc EXHAUST GOOD(W/DUCn PAID IAZSRDOUS MATERIALS DISCLOSURE IfFATING UNIT(TO 100.000 BTU) Oar, attempt Will the gsplinm or faun bai",y occupn,t son m hat ha'urdorn muaisl IIFATING UNIT(OVER I(p,1X1p MTU) TG'1AL: A �0 as dchml by the Cupcnino Munic'i pal Core,Chapter 9.12.rando ar d] Ileelm m Safety Cob,Sectio 25512(x)7 ❑Y15 ❑No VENTILATION FAN(SINOLE RESID) r Will The appliran«fume building occapwt useequipmcmmdevicawhichemit BOILER-COMP OHP OR 10.0(1(1 BN) ISSUANCE DATE hand°as ass cmumirenm as refined!by Be Bey Am Air Quality Menagcmcot BOILUE-COMP(OVER IM.Nott MTU) P A 1 D ds,dd7 ❑Yex ❑No NEW RESIDENTIAL JQPCH. SQ.PT. I have read IM1e bermdoua mueria]s regoinemrnte u,dm Cheper 6.95 of N, MAR 10 1995 California health&Safety Coffee.Seetiou 25NI5,2531 and 25534. I mdemard that if the building does not cunemly have.tmum,Nor itis my acPoscoblhty to mBfy dor , NU eupem of the odlmocnema which nos,be m,t prig m issuance of a C,nifcire of (kcupvey. ' Ownermeuthaimd egcm Doc IUTA1.: ISSUED BY!4r a- Dale & Mary Newcomer 20671 Gardenside Cir. , #3 Cupertino, CA 95014 February 27, 1995 Gardenside Circle Homeowners Association C/O Gina Gorman, Community Assoc. Mgr. Professional Association Service Newark, BaCA tine9456 Drive, Sta. 150 COPY Newark, CA 94560 Attn: Board of Directors Architectural Control Committee RE: Approval Request for Installation of Vent Cap Dear Board of Directors/Architectural Control Committee/Mgr. I 'm writing to request the Association grant permission for us to have a vent cap installed above our kitchen window on the exterior wall . The aluminum ,vent cap has the advantage of lightness and it 's placement will be some what concealed by the roof eves. The cap will be. pai4ted to match the finish on the rest of the house. There will be careful coordination and planning for it 's visual appeal while the permit will ensure the integrity of the S installation. Enclosed is a full and complete application showing drawings, specifications and location of the aluminum vent cap. The Association's timely repl eeds-to be in writing, so there is documentation of I an for your consideration. Yours very truly,Mary ewcomer10�cc: Doug TimewellNicole GuntherMike NielsonEac:Application with DraPolicy for Gardensid "Architectural Controls Regulations And Procedures" •