S 2983 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY "I CUPFWFINO BUILDING-ELECT RICAL. PI!RMI"1'NO.
nuudllNGD1 VISION APPLICATION/PERMIT PLUARING-MECHANICAL
- BDu.DIN(i PRo.Irsc'r mENIIFICATTON-
BUILDINGAODRESS SANITARY NO. A PLLIICCAATI(l 1M '1'3 DA'I'1'.
7--Z-7- 26-
N
W HSAMp"I IONH: GONTRACIOR'S fill,: LIC NO:
(LAL13 91 7 NIC CON'I'ItOLX
.cl'llI'1'-"IIENGINIEE \ LIC NO'. AUUIIISS: •YNL ❑
)NTAC PHONE. BUILDING PERMIT INFO -
a� �.N ` f 1�\�g..�r, �`�,' ❑ Consullanl pees Paid by Applicant(Initial) xLD ELECT Plr�J MP.c}y
1T N'^rLICE sSEDCON "ION'SDDEC'ILARA'I11OONhJ (/ Q'PY ' ELECTRIC PERMIT PEE rLfJi
I hereby amna and I am licenam ander pro,-i.,owd afebapter 9(atntmencing JOB DESCRIPTION
C:'aZ wire,Setlloa 11011ofDIvl,lol13aflheli in and Pn IeWon,Code.und niy liuon.ca is pp TI
OO '" I'ERMI'I'ISSUANCE
CCu'F in full forceline effect. SI93W1. ❑KI'ICIIHN REMODEL
aUU License,Clam Lic.N APPLIANCES-RESIDENTIAL. ❑ADDITION ❑PLUMBING RE PIPE
Nab DWe Courretnr
ARCHI'ILCIS DECLARATION ❑MULTLUNI'r ❑S'I'RUC'I'URA[
.
F-O y2 PANE S
Z O.'P I underaumd my plan,shall to used as public neo..l, MODIFICATION
OZ=- UP TO 21x1 AMPS _ ❑INTERIOR El Cl IIMNHY REPAIR
a4�; Licclrscd Prolmaional 201-10M3AMPS IMPROVEMENT SWIMMING POOLS
OWNER-IIIJILDER DECLARATION OVER IgxIAhf l'S All . ' 10UF.IJHIEPA 112 DIEMOLI'HON
C W a I hereby,frnn mal 1 ant c,empt fate he Conlmn..r',License Law for the
!�p$..O t1 U Inllowing leasrm.(Sssdion 1111 IS.11 C,,and Professions Code:Any city nr rvnnty SIGNS ELECTRICAL HER
W 3 U.ye which requires a permR to Construct.alter,improve,demolish.or repair any stmnmrc
I'll s ne,0s,regnirex me applkunr Hrtsuch l"ooilto Fill,..signal aatemcnt SPECIALCII2CU1"rIMISC.
bar be Iwersedp tl,,,hep of do,Cooloreau,urt,n,La.IChair,9
t�V^CSO
i,annuan,ift, ')h5 t 10(B f Di,mda loldhe Rti,mes,andl t ..ar,Cositlar TEM P M 1.1 ER OR MIX INST I{�
t1 k w that he pt thC,Cf d e e basis t da,s lage,l C-aniption.Any violation of ] I'DIANA DON'.q DE 0 ION
Seel 111315 by'rY applicantfra peai hl Is me appl' t 'ail pen,ay of LOWER DEVICES 1J
W^m 'I PROV P :RVICE
FYY ono,than ltvchundrnl Jnl1na15501». �IMPROVFEMIENT
se, ❑hubevv k,roddanot, vemyemployce,wish wages us thcinolC cnmpnnmion. SWIMMING 1'001,ELIECI'RIC _
will do ghc wntk and 0e agmaurC is lmtimm�ded oroffercJ for rule lSec.1044,Busineas O'I'LIER
L3 m and Pral sauna,Cale:The Co ono,ad's Lwra,c Law does not apply it un owner of OU'I'hETS-SWITCHES-FI%'1'IJRES
property whit build.,... fupn re,ibeaen,and who etre„uea work himself nr garnish
his awn nnployces,provided Ilam such impnrcemenr,:rte not intended or oder d for NEW RESIDENTIAL EI,CTR SQ ET.
sale.If,hdxevcu the building or lmpmvemmnt stroll withinonc Y°er of cnntpletion.Ihe �� Q 2r T SQ.FEPLOORAIIHA SISQ.ET.
ciLitt M1udd,will have the huNmn of paving that he dd nor bull)or improve for par- T
t,owne q S 2
I,m owner or the Patpclty,ten caala,i dad contacting wish IEcen,W atmmnotx re, 4 3 O
addict me project(Sec atwa,naame„ane,rrore„iana cadC)'r¢cmnm„ar',1.i-
Cease Low does notpplyg Carrier ofl pony who build..tit iroprovesber-Con,and QTY PLUMBING PERMITFEE. f
whit t t;1' 1 f l t. cant s (O i ,cdpr tt Be,C tmuas Q
Lice Ie, PERMIT ISSUANCE
f�,k
n can der , ,B&PC frit(.rca,on
ALTER-DRAIN&VENT-WATER IP,A) VALUATION
All
r me
O 1CIIR'S _ IPENSATION DECLARATION HACK FLOW PROIEC'11.DEVICE 3 `3 7 r� tN
I heaF add, edally or perjuryone of the Whorring declamgicns: CJ 11
uvoanwill maintainuCe,ifie.nal Consunuo self-innurcfn.Work,,Gnnpen- DRAINS-PLOOR,R00F,ARIEA.COND' S'IY)RIIES 'f VPE CONS'I'RUCI ION
,as provided for by Sward 3100 of the labor C de,for me permmwneC of me
lin which this permit In issrmA. FIX'I'USES-PER TRAP
Q I have and will maintain Worker's Contpn,nion Insurance.as dapiral by S,Cllnn
311x1 of the Labor Club,It me perfroutnal ofrhe work far w hinh ghis permit is issued. GAS-EA.SYSTEM-I INC.4 OUTLETS OCC.GROUP APN
My Work� Cpmperyyuoii lnrimnce Cuvier and Policy numlmr ate:
Carrier:' 1L 1NMti[� Policy No.: I GAS-EA.SYS'IIEMOVER 4(I7A)
CIEILrIFICATE 017 EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE GREASEIINDUS'IRL WASTE INTIERCF,P'IOk
('LTi,felonneodn..I be CumplCned iUhC permit is for one hatulrealdallna IS 100) BUILDING DIVISION PINS
GHIiASE'I'ItAP - � - -/0 ,12-
nor
Z O
or lea.) I'LANCHCCK PI!I!
I certify that in[lie perfommnceoflhe work fafwhich lhLs pemtir isi„ued,(shall SEWER-SANITARY-STORM EA.200171'.
nor employ any Pe ,inmy manner at us to hecnn¢nuhj,C,In the W..kea'Ci EN
ENEIIG ''.5 S f
Z ,mien laws of Califnmiu.Ila¢ WAIER HEATER WNIENUE-LECfR GRAlll�l
Go
z C) Applinnn _
h 7-
NOTICE TO APPLICANT.If,uf¢r making his Certilieae of IExemplinn,you should WATER SYSTEMOBEA'I'ING
become suhjCC,m the Worker's Cn apem,mien provisions of he Lubar Cade,you must SO].
lkI Eaddo,lh comply with such provisions nr this permil stall be deemed revoked. WA'IERSERVICIE
A
CONSI D thatto RlICT10NLENDING AGENCY NEW I2ESIIlEN'I'IAl.PhMH. SQ.FI'. PAID
U Q Iherchy affirm manhere invcnndmetion len ding agency for perfnmmnee of Dwe Recdptd
H mewerk for whichpermit ie I„uaJ(Sec.31191,Civ.C.)
a
ULender's Name
Lender',Addre,, O1 :
F1 I Certify that I havc read thio application and stele dmf the above adnnnxdon is e BUILDING ITT, 93 ,7
h Correct.Iagaemamtply'that City and county onlitmmce,and state law%reining to QTY. MECHANICALPERMI', ITE •,-z 70
U Z bnlldingcomsunctiun,nnd herebynuthornpi
.en, ,eninivu,of this City taunter upon the SEISMICITIE d
above nmtalcon l property far inspection Purposes. PP.RMIT ISSUANCE
Q
(WC)agree m save,indemnify; I kap butene'the City it cupertino ugzinm ELECTRIC PER 1) f 7 S
Iixbilities,pol,rrtis,,lel,and expense,whid,may inany way acarueagainstand City ALTER OR ADD'IO MECH.
co
nsequenceofi grin t dapemit, PLUMBING FF.Ii r
APPhICANT ON P ."I' AN WILT.COMPLY WITH ALL.NON-POINT AIR HANDLING UNI'I'1'IOIO,IXxICPM)
MECHANICAL h1iIE
SOUHCF.1;" ,U O
✓ 2/_ Alit HANDLING UNIT(OVER 10,000CPM) CONS'rRI1CIION'I'AX
Slgnamr unuct, n D, , EXHAUST HOOD(WIDUCD HOUSING MITIGATION PEE,
HA' R IIIJSAINHIRIN,SDISCLOSURIi
Jlrheapplic orfdurebuildingoccvpaotsmre..r, handle haaanlous mamrinl I IEA'1'INC.UNIT(To i(M. 1(ITU)
:m defined by Iho Cu Winn Municipal Ctde,Chuen 9.12,and me Ilculm line Safety
AIIIOde,SccOom 255321x)° HIEATING UNIT(OVER[08.1x)0 H'IU)
CRsP1,N
VIEN'rILA'fION VAN ISINGLI:RESIII) PAID
Will the u liC,Cl nr fit, buildin g use er ui t ie device,which Dae - RCCC”(
p
PP dbythevn l it Ga BOILER-COMP CHIP OR 100,000 BTU)
Emil i'll us air cannminunt,as dclinw by the Hay Arca Air Gaudily Manvgcmem TOI'AW
i_sVi,99
❑Yas BOILER-COMP(OVER 100,0 ]1 CB�j No N1 .
AIR CONDITIONER
have mad mo M1uenWans mat eii.d"C"pdremcnt,under Chupmr 695 of the Cali- ISSt1ANCF. ATF.
tfomia Health&Safely Je, xi,25505,25533 and 25534.1 undcmmd mm Bthe NEN'RESIDENTIAL MECH. SQ.IW.
buildimsdoesnom e y I tam mnitarn,respomihilif,in Ofy tae nmupmt
oldie - Cn 'el y n priarmismanecamcaff of 0 fainly �Q .
Ow�mr< t / / Z lore >'1' Y ISSIJEDIIP ( "�
OFFICE
POPA ENGINEERS Inc.
STRUCTURAL ENGINEERING CONSULTANTS
CITY o- CUF�EkTINO
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No.0038645 R,
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• GOLDEN VALLEY OFFICE CENTER
2542 South Bascom Avenue • Suite 102 • Campbell, California 95008
Phone: (408) 559-4202 FAX: (408) 559-3628
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D
ey
• GOLDEN VALLEY OFFICE CENTER
2542 South Bascom Avenue • Suite 102 Campbell, California 95008
Phone: (408) 559-4202 FAX: (408) 559-3628
� ZA.
DATE JOB NO,
Consulting Engineers;4621
n r c !C, •99
425 ROLANDAy PROJECT
OAKLAND, CA �t (fin k
(510) 568-4 01 'ZZ� C� TION
ACTOR OWNER
�� C(•'C WEATHER TEMP. ,
Date Or 4�r,l+�+' I� I , r 9 Y r�G/ °at AM
Hours Charged To Project 2 Nuclear Density Tests PRESENT AT SFE
Field Task Number------ Concrete Cylit ders, #
T
THE FOLLOWING WAS NOTED: rr
' f�,+ -`.), F C �� ". !rCi_r , r',I-'C� t_I::' YP i, ��,`k:C(7 4� • C.I- �f f:1�,✓+r !, ^�. , �r {' 'a l•U2
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COPIES TO
SIGNED / � f
AGENCY
JZZA
• 0
DATE JOB NO
Consulting Engineers and Scientists _ , 3 .17 ,
425 ROLAND WAY PROJECT
OAKLAND, CA 94621 (C I I r. thPs.cl hr, I
(510) 568-4001 LOCATION
r l ..� "pf - 11
TO �r_1 ITC-r rr'1 P a♦ CONTRACT R OWNER
J1 �f e l f . +c,I
Date /�1'�r'.I ,y\" 1�. t.. IC4� (,,�OYIjCCGV WEATHER TEMP. A ;—at AM
/ �r� �5- at PM
Hours Charged To Project :Z - Nuclear Density Tests �/' PRESENT AT SITE /'
( r rC(Q L1
Field Task Number r
z Concrete Cylinders_ +'4-+
THE FOLLOWING WAS NOTED: ((''�
0.1 Fey e c—, rp QLi I'-ll•Pr' P"(- Fr✓11�✓1(i I.-.S-la.e l r' ♦ T 1'11r+- l � l H (�T r�p
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COPIES TOFIELED o Cep L
- -- �� - �
SIGNED
.- - AGENCY
OCT-20-99 WED 00 :07 Am P. 02
MARVIN D. KIRKEBY
• 2397 FOREST AVENUE
SAN JOSE,CA 95128
(408)984-0331
October 19. 1999
Job No. 96061
Building Department
10300 Torre Avenue
Cupertino, CA 95014
Re: Hammond Way
Lot 2, Tract No. 9054
Gentlemen;
Please be advised that the foundation forms for the subject house have been inspected for
compliance with building setbacks as shown on the approved plans. I herchy state 0INT
the forms are as shown on the approved plans.
If further information is required please contact the undersigned.
Y urs truly, o0 d0
IWO
h arvin D. irkeby FO%lE/E'dX3 y
Registered Civil Engneer aY 40^vl. 'aN SS
1
•
OCT-20-99 WED 08 :06 PM P. 01
MARVIN D. KIRKEBY
2397 FOREST AVENUE
• SAN JOSE,CA 95128
(408)984-0331
October 19, 1999
Job No. 98061
Building Department
10300 Torre Avenue
Cupertino, CA 95014
Re: Hammond Way
Lot 2, Tract No. 9054
Gentlemen;
Per Section 7014 of the Uniform Building Code, we have inspected the rough grading tett
the subject lot and hereby state that it is in substantial conformity with the approved
grading plan. Finished building pad was measured to be with 0.2 feet, plus or minus, u;'
the approved design grades.
If further information is required please contact the undersigned.
•
Ypti�'111 d0
AO& a�0 �tA1O ��rs
Marvin D. Kirk by
Registered CiviLFngineer T 1.0041 'ON f y
oy 3y, �a ,
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•