24979 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO 1vf;-.sacra PERMITNO.
BUILDING DIVISION APPLICATION/PERMIT DING FROG CT IDENNIFIC 24979^ 9 7 9
BUILDING PROJECT IDI:N'1'IF'ICA'1'I(aN G L�
BUILDhk ADDRESS: u SANITARY NO. APPLICATIONSUBMITTALDATE
NuryllsO AVt. UNIT# LOT# ",i,t(0-Zj3
OWNI' NAME: PHONE: CONTRACTOR'S NAME: LIC NO: WC CONTROL#
C= rIf
RCHITECI'/F:NGINB R: LIC NO: ADDRESS: ❑
CONTACT. PHONE:� BUILDING PERMIT INFO 1 1 a QTY. ELECTRIC PERMIT HE
SOS s �C�
pulp ELECT PLUMB MECH
iT SV-%m PERMIT ISSUANCE 0 E 11
LICENSED CONTRACTOR'S DECLARATION APPLIANCES-RESIDENTIAL LOB DESCRIPTION
I lumebyaffinn that l am licensed underprovisions of Chepter9(commencing with
tc100 Saltine70pi Division 3ofthe Business and Professions Code,and my license is in PANELS
Fa Ub full force and affect. w, 1
ba„ZW License Claus Lic.# IIP TO 200 AMPS
rn=y Data Contractor 201-IOW AMPS
Z FOr`,Z" ARCHITECTS DECLARATION OVER 1000 AMPS SQ.IT.FLOOR AREA $/SQ.FT.
0Z O I understand my plans shall be used as public records.
Licensed Professional SIGNS ELECTRICAL
lag
OWNER-BUILDER DECLARATION SPECIAL CIRCUITIMISC.
R U I hereby./firm Out 1 am exempt from the Conrwou'a Licens,Law for the
ft40zFii following reavnn.(Sidon 10IL5,Business end Rvfessions Code:Any city or county TEMP.METER OR POLE INST.
I" Ioj which requires a Permit.consumer alta,,improve,demolish,m.,an anyswctu.
¢7 prior to its issuance,also requires the applicamfor.such Permit to rile a signed statement POWER DEVICES
G 0 that he is licensed pursuant to the provisions of the Connector's License Law(Chapter
�- o�' I-
9(commencing with Section 7")of Division 3 of the Business and Profusions Code) SWIMMIN PO L IQ n VAW
=y rnhet he is exempt thertfromand the buisfar the alleged exemption.Any violation of
L-.Za Section 7031.5 by any applicant for a permit subjects the applicant m o civil Penalty of OI1TLEf5 SW CHES-FlXTURES �- � ���
^�^�s�G not mom thin five hundred dollars($50B.
K props y,ormynnployxs withwageaestheirsolecompewedon. NEW RESIDE E ECIR
Eo ❑ Lesowncmfthe n l I ' �T I STORIES TYPE CONSTRUCTION
will do the work.end the—come is--UnUoded.roffe.d fmintle(Sx.7044,Business
and Professions Code:The Contractor's License Law does not apply to an owner of
propertywhobuildxor improves therenn.andwho draw such workhimselforth.ugh his
wnemployces,provided that such improvements are notimmmded oroffend frrasle.If. OCC.GROUP RES.UNITS
however.the building in improvement is sold within moyadr ofcompletion,the owner-
builder will have Ne burden of proving that he did not build in improve for purpose of TOTAL'
❑ I,asowner ofthepropmy,am exclusively convecting with licensed contractors to QTY. PLUMBING PERMIT FEE FLOOD ZONE qpN
construct the project(Sec.7W,Business and Professions Code:)The Convutors
License Lawdoes not applym anownerofpropeny who builds or improves damse,and PERMIT ISSUANCE
who cormocta for such projects with acrnou,nar(s)licensed pursuant to the Contractors
License Law. pLTER-
DRAIN&VENT-WATER(G) 1717ESUMMARY
❑ 1 vn exempt undo Sm. B&P C for Nis reason BACK FLOW PROTECT.DEVICE SID
SANITARY Y N
Hff—
Owner Date DRAINS-FLOOR,ROOF,AREA,COND. RECEIPTp
WORKMAN COMPENSATION DECLARATION SCHOOLTAX Y N
kI herebyaf urn that l haven cenificateofconscn to.lf-fume.or a canificate ofFl%TURES--PER TRAP RECBIPP#
kers Compensation mentons,ora cariried copy thereof(Ses.38W,Lab C.)which PARK FEE Y N
'or
m all employee's under this permit GAS-EA.SYSTEM- INC.4 OUT RECEIPT#
Policy# BUILDING DIVISION FEES
Company
❑ CrnifiM copy is hertby famished. FEGAS-EA.SYSTEM-OVER PLANCHECK E
❑ Certified copy is filed with the city inspection division. GREASFJINDUSTRL WASTE INTERCEPTOR GRADING HE
CERTIFICATE OF EXEMPTION FROM WORKERS' GREASETRAP SOILS FEE
COMPENSATION INSURANCE
(This aenianneW not be completed ifth<permit is fraud,handrtddollan(SIM) SEWER-SANITARY-STORM FA.201IFE ENERGY FEE
or less.)
I cenify that in the perfn.ceofthe work fire which this permit is issuM,Ishell WATER HEATER WNflbMLECTR '
not employ any person in any summer so ss to become subject.the Worker'
Comprnsationlassof Califomia. Date WATER SYSTEIATREATTNG PAID
ApplicantDa. Rariptp
Z C NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should NEW RESIDENTIAL PLMB. SQ.f. TOTAL:
became subject to tM Workers Compensation provisions oftfte labor Code,you must
�i ; foMwith comply with such provisions or this pevait.ball Ise deemed revoked. BUILDING FEE
yQ CONSTRUCTION LENDING AGENCY SEISMICFFE
2 I hereby affirm that Here is a consumc0on lending agency for the peciomtanx of
V O the work for which this pcmdt is issued(Sx.3097,Civ.C.) TOTAL: ELECTRIC HE
U. (r Lender's Name
LU lenders Address QTY. MECHANICAL PERMIT FEE PLUMBING HE
L.) I cenify that I have.ad this application and ata.that the above ammunition is
comet.l agree to comply with all city and county aNinance,and a=laws teladng m PERMIT ISSUANCE MECHANICALFEE
,t building construction,and hereby adieux representatives ofthis city toe upon the CONSTRUCTION TAX
U z aMrve-mentinn,d property for inspection puBosev. ALTERORADDTOMECH.
(We)agmc[cause, ify end kip harts of Cu nn ngeirut
liabi)ities,judgme ,ape swhic a ysx. aimt.id City AIR HANDLING UNIT(TO 10,000 CFM)
in runscquenc r e in sie
as
AIR HANDLING UNIT((WER 10,1301)CFM)
'ignmu pplicanVContrsc. D EXHAUST HOOD(W/DUCT)
PAID
If AZ OUS MATERIALS DISCLOSURE HEATING UNIT(TO IOEMD BTU) Date Receipt#
Will the applicant or future building occupant store or handle hazardous material
as defined by the Orper ino Municipal Code.Chapter 9.12.and the Real and Safety HEATING UNIT(OVER IM.Wd BTU) 1.:
Cade,Section 25532(a)7
❑Yes ❑No VENTILATION FAN(SINGLE RfSID) Gilt) Itzil
Will thea licnat orfutumbuildin ossa BOILER-COMP(3HP OR IMIOM BTU) ISSUANCE DATE
pp g panto.Area int Quality
Management
h bill air contaminants as defined by the Bey Area Air Quality Management BOILER-COMP(OVER IW,UW BTU) P p
orrice PC
❑Yes ❑No NEW RESIDENTIAL MEEK. SQ.IT.
I have rtad the homfdous materials requirtmena under Chapter 6.95 rf the �# ,k
CaliforniaalHealth&Safety Code,Sections 25505.25533 and 25534.1 undandoodthat AFR
r/K {)
if the building Jxs not canen0y have u tenant,that it is my responsibility.notify the
occupant of the requirements which must be met prior to issuance of a Certificate of -I'IY 111- L j IIVV
Occupancy. LIZ
Owner or authorized agent Date TOTAL: ISSUED BY:
CAI.NO.NNO0133
TO 53012.831•CLTA Gumnto F.cs P090
d
Lot Book Guarantee
IW-iabifity Fee
$100.00 $ 100.00
Your Reference
No. 36114
Ticor Title Insurance Company of California, a corporation, herein called the Company, Guarantees
The County of Santa Clara
herein called the Assured,against actual loss not exceeding the liability amount stated above which the Assured
shall sustain by reason of any incorrectness in the assurances set forth in Schedule A.
LIABILITY EXCLUSIONS AND LIMITATIONS
1. No guarantee is given nor liability assumed with respect to the identity of any party named or referred to in
Schedule A or with respect to the validity, legal effect or priority of any matter shown therein.
2. The Company's liability hereunder shall be limited to the amount of actual loss sustained by the Assured
because of reliance upon the assurances herein set forth, but in no event shall the Company's liability exceed the
•liability amount set forth above.
Dated: April 2, 1993 @ 7:30 A.M.
,�• � � P\P\ryyl•ili4gy;
c�yp� � Ticor Title Insiirance'Company,of California
14
by
SIDENT
Aueu: ......... 1mG�
• �1f1' ISif SECRETARY
Please note carefully the Liability Exclusions and Limitations and the specific assurances afforded by this
guarantee. If you wish additional liability, or assurances other than as contained herein, please contact the
Company for further information as to the availability and cost.
i;A I.NU.NNOJ I J2 _
TO 590-A 12-891 California Land Title Aeaocialion Gaemntee Form No.12
Schedule A
LOT BOOK GUARANTEE No. 36114
The assurances referred to on the face page are:
That, according to the Company's property records relative to the following described real property (but without
examination of those Company records maintained and indexed by name):
A. The last recorded instrument purporting to transfer title to said real property is: GRANT DEED
Doc. recorded AUGUST 26, 1992 Doc. No. 11513388 in Book M344 Page 1975
In favor of Anthony R. Proni and Rebecca A. Proni, husband and wife as community
property
B. There are no mortgages or deeds of trust which purport to affect said real property other than those shown
below under Exceptions.
No guarantee is made regarding (a) matters affecting the Beneficial Interest of any mortgage or Deed of Trust which
may be shown herein as an exception or, (b) other matters which may affect any such mortgage orDeed of Trust.No
guarantee is made regarding any liens, claims of lien, defects or encumbrances other than those specifically
provided for above, and, if information was requested by reference to a street address, no guarantee is made that
said real property is the same as said address.
Exceptions:
1. A Deed of Trust in the amount of: $150,000.00
Trustor Anthony R. Proni and Rebecca A. Proni, husband and wife
Trustee Pacific Inland Bank, a California Corporation
Beneficiary PIB Mortgage Company
•
Recorded August 26, 1992 Instrument No. 11513389 Book M344 Page 1977
2. A Deed of Trust in the amount of:
Trustor
Trustee
Beneficiary
Recorded Instrument No. Book Page
Additional matters (as requested):
None
DESCRIPTION:
All that real property situated in the County of Santa Clara, State of California, described
as follows:
.Portion of Lots 66 and 72, as shown upon that certain Map entitled, "Map of Subdivision A Monte
lista", which Map was filed for Record in the Office of the Recorder of the County of Santa
Clara, State of California, on April 11, 1917, in Book P of Maps, at Page 20, and more
particularly described as follows:
CONTINUATION IN EXHIBIT "All
"EXHIBIT A"
Beginning at the point of intersection of the Southerly line of Hermosa
Avenue with the Easterly line of Lot 66, as said Avenue and Lot are shown
on the Map above referred to; running thence Southerly along the Easterly
line of Lots 66 and 72, for a distance of 144.62 feet; running thence
Westerly and parallel with the said Southerly line of Hermosa Avenue, 50.075
feet; running thence Northerly and parallel with the said Easterly lien of
said Lots 72 and 66 for a distance of 144.62 feet to a point of the said
Southerly line of Hermosa Avenue; running thence Easterly along said last
named line, 50.075 feet to the Point of Beginning.
•