S 1579 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUI'F.RTINO RuaDBvc,.ELECTRICAL Pe IT NO
RUILDINGAIIVISION APPIACA'1'IONA'ERMIT TING PROJECT IDEN"i IFICCAL 1579
IfU11.DIN1:I'ROJI!(YI'IDEN'IIFICAI'll)N
RU1LUINGADDRESS: SANL'L'ARYNO APPLICAIONSURhrll'1'ALOA Iii
//8 h�`' v 4r-w� w,•y �-�
OWNERISNAM1i �f / PITON+: RACTOR'SNAh1H: LIC NO:
Se A �'. G_[SG P V/ 1 11 g NIC corvrxoLX
nkcen'L-I'/ENrmpcR: S LIC NO: ADD S �KA Q, S ❑
. Gas ,4aµ'
JNI)\CT; V PIIUNI{: B
UILDING PERMIT'W'O
8 ❑
Consultant Fees Paid by Applicant(Initial) ELECT PLUMB MLC❑
LI('IiNSII)CONI'RAC I OR'S UECLARA i'I ON Q (QTY. IiLFC'ARRC IIFRMPP FEE
I ncmby m0mr III,, am K-u,cd under provhians afebl'p.cr 9 onnonene;ug JOB DESCRIPTION
MWZO wllhSc,,inu 701X)of Division 3011,cluva—and poll..... Coee.un Il ay licunw i,, YIiRMI"r ISSUANCE RAI'
5WF in fill l occaal shit � _ ❑ ❑KI'1'CIIIiN RLh10Dli1,
aVV
Lice nw Cf sc C..��''7� Lie APPLIANCES-RIiSIOIiN'I'I Al. ❑ADDR ION ❑PLUMBING R1>PHT
Z W 6 m�Cnmracar
A CHITLCI'S DEC ❑h1U1.T1-UNIT Ll STRUCTURAL
OZ=Z Iundcmm�J mY pians.hull be used as pumanAs UP T02 'S MOD119CA1'ION
❑IN'FE 0R ❑ HIAINI.YRPIIAIR
W LiamvcJ 1•rnfe,u....I NII-1 I hMPROVCh11 NT IMhIING POOLS
x Q I hereM1y uflim,We 1 amNER exempt
rot he G nE�r
)N 'for EI IXX h11'.S ❑BAfll REh10DFIlkEPA1 DEh101,ITION
V followin,reason.(Sechon 7031.5.Bminee and pride I, y S N''L' DOTHER
1+131 F* which Isiaht commact. B P Jy In prod I l: 4 'th ppl tt hdsr I h UITI Sl'th:th I :JI II h p ftb C I (C a9��p O B,nnaangwth Swion 7MXIIof Dlvlxoo Sol lbu B, ru da TEM('. if' ORI' COMMERCIAhya (hat he is exnnpl I ntelrnin unJ the hmi.hothe allegevs tion NEW BLDG/AUDITION ❑DEMOLI'UON
Scc,ion 70315 by an,,,ricat ka.pe,no- rod,lhcnahyn POWER DEVICES ❑'I'IiNAN'I ❑FOODSERVICE
mI marc than tin:hwld"'i dallam 03500). IMPROV EMEN'I'
UL'esuwnO'oldlep..... .urmYc+I+Plnyccs wilhwuge.nslbell nolocnllq+e l'ifian, SWIMMING POOL EI.Ii01'I11C
$y�L.W wJl du lhcwnrk.un:l lhcnvucmmisno,imm�Jcdnra0crnl fol s:Jc(Sm.7044,B-inels 001'1117R
W w i I Prale.vin 1,Coale: ]he Cammeais Licence Law docs nol apply fam,owner of OU'11.IiTs-SWI'(CITES-IIX"MRCS
1 property who builds or imprnvc,dulneon,and who docs such wod Irima-0 nr in fir
his own employees.provided that such impn,vements are ma in,ended of ollcmd lot NEN'RE;SIDEI'IAI,E:1. C!'R SQ ET
xvlu.il;b:nvever.the M,ilding ur impnrvcmem ix sold within une ynv
I.the SQ.IT FLOOR AREA S/SQ171'.
owner-laoilder will have We burden of proving that be did not build or improve for PuF
Irene al cele.). OTAL:
L a owner of the propcny,.l exclusively professions
with liaised Contractor"
a,
nnswn dprojmpply7011Businessandity who
C%or inohcvesthereon,and
scl.aw'Jtea not apply to an owner of propcny who built.or inrpnrvce thereon,and QTY PLUMBING PL' 1 FEF
who conaacts for such projecn with a mmraturP)licensed pursuant o the Cmaracrox
License Lax'. PERMIT ISSUANCE by
C] I all,esempt under Sec. ,R k 11Cf this..,,,a
ALTER-OHAINffi VENT-WAFER IEA) ��� VALUATIO
Owner Date
WORKER COMI'F.NSATION u[ChANAI'ION BACK PLOW PNOITC'f.UIiV1Oi
I lia,hY m6ror node,penuity of pc Jury une of the f ollowing Jeclaradnnx: r
Ibuvc and will inainain a CcnOicaaoi"Cnmcll,,clf-insnm fur Worker.Cnnq ar- IJRAINS-FLOOR,ROOK AREA.GGND Ur S'I'ORII15 TYPE CONS'I'Ii IICI'ION
Lit I' 'I If I,S B 370X1 I"Ih La G 1 'I ofdw li
wolkl i' III :( , . J. TJX I'URIS fiat I'ItAI' rChl//VU
(] I have and will nuoullainWorker's C P I' Iin-mank,a,c,unred M1y So,1on
3700llhe Labor Cale,Int the pclookunce ofthe work lot which this lunn'I issued, GAS CA S\SILM-I INCA I LG OCC.GROUP AVN
My wader's Cafnpcnsation Insurance carrier and policy number urc:
�Cmnel: Polity Na: GAS-EA.SYSTHM-OVlilt 4(EA)
!!!
CERTIFICATE OF EXEMPTION FROM WORKERS' GRI7A$FIINDUS'1'RI.WASTE INDiHCEI
COMPENSATION INSURANCEAle
BUILDIN( VISION FEES _
I'166'seaion neat not l+ernmplmnJ ifthepemnd i0manchmWmldollars(b IBB) GREASETRAP
' or lees.) I'LANCHLCK ITE
L eenifythminthe pedormancc of ',kforwhi<h tltispennit is issued.l shall SEWER-SANITARY-STORM EA.200 Fr.
nm employ un -aunt man so a. Sg uAh \YtYk 'ttnpcn_ ENERGY FEE
Z sminn Lnws,' ` WATER HEA1 FR W/VENT/HLECI'R
z Q to in �- skAO1NG ITE
N(YI'ICH' AI'1'LICAN: atter making Wis Cenitica c of lisnnptian,Y^u shoulA WATER SY$TIiM/1'RIiA'1'ING
rio, SOI(S ITT!
. hecmnc sub kit m Ibc Worker's Conrpenschan Provisions of Tho Labor Cods,you must
ag ? lirnh-ah can,ly with snch......inns or this permit shall be deemed revoked. WATER.
Z. 0
ZD z CONSTRUCTIONI,IiNUINGAGI?NCY NEWRESIDEN'HAIAILMB. SQ,Fr. PAID
I hcby n01r..I flat Were IX a unommtionlim
n Iemhn,agency fuic perloankr of
�� mach,
be warI lbr which Hostler I,.,inxned(Sec.3097,Civ.C.)
O l-' TOl'AL:
Lender's Nanfc TOTAL:
r W [,,,,at s Address
1. 1 ccnily that 1 have read this application unit state that life above idiounuum is
BUILDING FEE
y c nced.lagrccto c...old, all all city and enemy ordinances and stnm laws rclaingm QTY MFCHANICAI,PIiRMIT FEF SEISMIC ITC
U Z building construction.and hereby aulhorim mprecealatives of mix city to enter upon'he
aMrvomeneornal propcny far inspection Impose', PIiRMIT ISSUANCE; ELECTRIC 1TH
(se)agree in save,indemnify and keep harmless the City of Cupertino against
Imi ihitin.judgments.costs and expenses which may in any way came against said City ALTER OR ADDYL)Ni PLUMBING IBI
in con"warn,of the granting of an,permit.
APPLICANT UND' TANOS AN 1, COMPLY WI'TII At.[.NON-POINT AIR HANDLING UNI',TO 10.000CFMI MECHANICAL iP,
SOURCE RE(" NS.
AIR HANDLING UNI'I(OVER 10.(XMI CFM) CONST RUC( TAX
Signature ofAppllcanl/Conmcmr 7 fDat{o KJ EXHAUST HOOD(W/DUCT) HOUSINOMI"f lATIONITE
HAZARDOUS MATERIALS DISCLOSURE
WpllhcappBcvm nrtarot,huidingnccupanL,nrc or handle Loc"oosm:verial BEATING LINE'I'('10 10,000 BT U)
in defined by the Cupunlno Municipal Codo,,Cha,uer 9.12,anA,hc ileal,h Ind Sufny
Cola Scmiall 255321:Uf HEATING UNIT(OVER❑XI,by,11'111) Y
0Ves ❑NnI'AIU
Vp 11I.AI'IONFAN(SINGLERI'SIO) Dam Rccciptb
ha W111jou
air applicant or furore building occupant use equiplm'm m'Jcviau which BOMER-COM('LFIII'OR 100000 BTU)
PP
. ' inalydnants as defined by Bre li:ry Arca Air Vualiry Management TOTAL:
District? BOILER-COMP(OVER 100.000 13 1 Go
❑Yes El No
Ihave Bad the hvardom bound,reyuinv,mnts undc,Chapter 6.95 of the Cali- AIR CONDII'I(INGH ISSU1ICE DAT,
fumin Halm X Safely Csxk.Seldom,25505.25533 and 25534.1 urklmobnd dot if the NEW RGSI DE1,G IAL MECI I, SQ.Ff.
building docs not comendy have a tenant,that it is my respmsiblllly Io notify the oecupeol
of the re4uirn„enry which last be met poor to issuance of a Carolina,of Wcupancy.
Owner or authon/rd.,.of Date TOTAL: ISSUED BY:
OFFICE
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01citv
10300 Torre Avenue
Cupertino, CA 95014
Ik�� of
uperthio Building Division
(408) 777-3333 (far)
February 23, 1999
Homeowner
11849 Upland Way �
Cupertino, CA 95014 Vi,
SUBJECT: Permit# S 1879/Swimming Pool
Dear Owner:
We have been going through our files in the Building Department, and contacting those
people with permits remaining "open".
According to our inspection records, this permit has not been signed off by the Building
• Department. Many times an inspector will sign the permit in the field, but overlook
reporting all of the information to the clerical staff for input into the computer. If this is
the situation and your permit card shows the final sign-off, would you please contact us
so we may complete our computer records? If the permit is not signed off, please call to
schedule an inspection for final closure of the permit.
Because of the large volume of paperwork within the building department, we cannot
separately monitor the progress of each permit. We ask that you give this notification
your immediate attention. If we do not hear from you within ten (10) working days we
will remove the records from our computer.
Thank you for your assistance.
Sincerely,
CITY OF CUPERTINO
Christy Akatiff, Administrative Clerk
•
Primed on Recvcled Paper