25594 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDINGG-F.Lh TRI AL PERMIT NO.
BUILDING DIVISION APPLICATION/PERMIT PING P OJECT MECHANICAL
25594
IBIll.U1.N61'ROJRC'1'IDF:N'1'IN'ICAI'ION
BUILDING ADDRFSg: SANITARY NO. APPLI•CsTIO'N'SUBBMETTALDAIti
UNITN LOTH
OW SN E: PHONE: CO CT R'S N 8AC LIC NO: NIC CUNIRRbOOLLNSJ
}II'TECI' N'1 L C : ' AD RESS: •s/ 7)-- ;� ❑ L.
rt 7!
TACT: PHONE:_ BUILDING PERMIT INFO
QTY. ELECTRIC PERMIT FEE
T L E QCT PLUMB MECH
PERMIT ISSUANCE 1:11:1
LICENSED CONTRACTORS D IARATION APPLIANCES-RMIDEMIAL
Qwz I herehyaffitm that l am licensed underprovisionsof Chapter9(cotmnencingwith LOB DESCRIPTION
V400 Section 7")of Div'inn Sofda Business and Pr�fessionsGNC,and my license u in PANELS
{I�r�CCCC full force and affix
6yuy Liccnas asX UP TO 200 AMPS MD?
ren<S DNe
an
201-I"AMPS
Z FOyF4 TECPS DECL O OVER IOIp AMPS SQ.FT.FLOOR AREA $/SQ.Ff.
0 Z_G I understand my plans shell a used as Public records.
rn ; SIGNS ELECTRICAL DD
Licensed Professionalh < OWNER-BUILDER DECLARATION SPECIAL CIRCUIT/MISC.
Nu 1 hereby affirm That 1 am exempt from the Cmmacau,License Lew furtive
LL N following reason,(Section 7031.5,Business and Professions Code:Any city or county TEMP.METER OR POLE INST.
E a 0 which requires a Permit to construct,aline,improve,demolish,or repair any structure
WYE m its issuance,also re the applicant for such Permit file a signed statement POWER DEVICES
prior quires pp pract g
W CAO that he 9(commencing
comisncinxdpursuannoMe 000)of provisions Contractors License Law(Chapter SWIMMING POOL ELECTRIC
9(atm he is cxmithereinnnandthe basis
Me alleged exemptio .ess and Anyvi Professions Code) VALUATION ate—
onhmheis 1.5 by aherefromand thePeristfar
subjects thedexemption.Anyviolmienof OUTLETS
N Sem ion70315by anyapplicantfor apermit subjects the applicmnoa civil penalty of
g T 0 nm more than five hundred dollars($500).
tc-]i76Cp ❑ I,asnwncrnfthc Property.nrmyemployceswith wagesus theinolecompensauon. NEW RESIDENTIAL EL[CTR _SQ.PT. STORIES TYP+CONSTRUCTION
a will do the work.andthesuumureisnot intendedoroffcred foreale(Sa.70C4,Business
and Professions Cafe:The Contractor's License law does not apply to an owner of
propenywho builds orimproveuhemcmand whodoes such workhimselfor through hisOCC. ROUP RFS.UNITS
own employees,providedthat such improvements ameot inteadedoroffered for sale.If,
however,theboilding or improvement is sold within one yearofcompledon,the owner-
huilder will have the burden of proving that he did not build or improve for purpose of
We.).
❑ I,as ownero(the praperty,amexdusively coniraning wiNlicemM contredonm QTY. PLUMBING PERMIT PEE FLOOD ZONE APN
construct the project(Sec.7644,Business and Professions Chep The Contractors PERMIT ISSUANCE!
License Law does not apply toinowncrofpmpeny,whotamidsarimproves thereon,end
whocomraces forsuch pmjeces with aconimchomod IicevW pursuant to the Contmctofs pLT1:R-GRAIN&VENT-WATER License Law. IRA) FEE SUMMARY
❑ I am exempt muter Sea. ,B&P C for this reason BACK 5,14 PROT .DEVICE OUISIDEPETIS
SANITARY YN
Owner Date D INS-FLOOR.ROO AREA,GONDRECRII'TN
WORKMAN COMPENSATION DECLARATION . SCHOOLTAX Y N
(hereby atfinn that l have o cenifi,in of consent to self-inmrt,or a certificate of FlXTUR[5-PER TRAP RECP.IPI'N
dm era'Compensutionlmvmnecorucenif clot 'M....f(Seo 39W Lab C.)whieh PARK FEE V N
covers all employa's under this unit. RGCI3 p
K GAS-FA.SYSTEM-1 INC. OUTLETS
Policy X ODI IONFIRES
Company GAS-EA.SYSTEM-OVER4 A) PLANCHECK E
❑ Certified copy i.a hereby fu is ed.
Cenificd copy is filed with the city inspection division. GREASF/INDUSTRL WASTE IiRC[PTOR GRADEE /�
CF.RIIFlCATEOFFXEMPI'IONFROMWO ERS' GRPAMITRAP SOILS LIE �'
COMPENSATION INSURANCE
ffhiasation nadnot Ncompleted ifthepermit isfora handualcoltimOSIIN)) SEWS SANIT .2WIT. EN C E �•s
or less.) Cie
I certify that in the performers the work for which th spennit is issued, H TP.Ry!/V dI1.I4 'R
not employ any person in any it ea m become object m the Workers' PAID
Compensation Laws of Culifomia. abate so TEMYfT PATING Date
zQz�-INOTICE TO APPLICANT:ILafter making this Cenifice¢o Extort YOU Nut. NP.W F P IAL PLMB. SQ.Pf. TOTAL:
become subject the Workers Compemiumn provisions ofth Lnhm Cr ,yo m t
FKi ; forthwith comply with such provisions or this permit shallN mad mvo BUILDING FE
kk] CONSTRUCTION LENDING AGENCI SEISMIC
�- z I hereby affirm that there is a consnuction lending agency rthe perform of
IJ the work for which this t is issued(Sec.3097.Civ.C.) ELE IC PEL
O p mt
Lender's Numc
Lander.Address QTY MECHANICAL PERMIT FEE PLUMDIN ere
V I certify Otat have twit thio applicdcou and stats that theV.,oinf.misdonadieMECHANICAL.TF.L+enneI lagrceto comply withal)city And ryordinances andinn to PERMIT ISSUANCIIrA buildiagconsraction,and hereby audience representatives ufthisrupontheCONSTRUCDONTabovcWnfimyDforimpectin rposes. TERORADDTOMECH.( ave,indemnify k p harmless the City n a atsar
liabilitcost.=;w
mayinan ayacCity AIR HANDLING UNIT(TO 10,000 CPM)
in rongranAIR HANDLING UNIT(OVER 10,000 CFM)
Ear ly
Data EXHAUST HOOD(W/DUCT)
PAID
HAZARDOUS MATERIALS DIS GSURE HEATING UNIT(TO 100.0f0 BTU) Data ,lad N
Will the applicant or future building rmeatem,store or handle hsenrdous material HEATING UNIT(OVER 1W,Of10 BTU) OTAL:
as defined by the Cupeninn Municipal CNB,Chapter 9.12,and the Health and Safety
CNe,Section 25532(n)'1 VENTILATION FAN(SINGLE?RESIDE
❑Yes j\ Pro
V BOILER-COMP(3Hp OR 1010,01M BTU) //NUANCE DA
Will theepplicend or ranamatu building by the Bay Areequa Aen Quality
cs Management
t (,'a R sea(n�
om air romnminanllts�'ns defined by the Bey Area Air Qutllity Management BOILER-COMP(OVER 100,000 B-I'U) V
o 11Yes I>+I No NEW RESIDENTIAL.MECH. SQ.FT. �r 1997
I have M the ha All materials requirements under Chapter 6.95 of the
Cnlifuroie He h it Cale,Sections 25505,25533 and 25534. 1 understand that
ifthe buildi doe ntlyhuveare I.,.1dsmyreaponsihilitymnmifythe
occupant he ret cuts which mu. met Or to issuance of a Cenifieata of
O cup
Ow am . agent Data L: � ISSUED DY:
OFFICE
Ciuv ur
Cuperthio
10300 Torre Avenue
Cupertino,CA 95014
Building Division
(408)777-3228
Fax(408) 777-3333
September 26, 1995
Betty Wallace
23200 Via Esplander
Cupertino, CA 95014
Subject: 23200 Via Esplander, Permit# 25594
Dear Ms. Wallace,
According to our records the above mentioned permit has never been finaled by a
City Building Inspector. A permit is considered to be valid only six months from its
last inspection date. If your permit shows that the final inspection has been completed
please send a copy of the permit, along with this letter to 10300 Torre Avenue,
Cupertino, CA., 95014, Attention Building Department.
If your permit has not been finaled, please contact the Building Department by
calling (408) 777-3228, so that we may arrange to extend your permit, and schedule a
final inspection.
In an effort to control the number of expired permits, the City of Cupertino
requires a response in ten working days from your day of receipt of this letter. If we do
not hear from you, the City of Cupertino's Building Department will have no
alternative but to resolve your permit as expired and discard the records.
Thank you for your assistance.
Sincerely,
City of Cupertino
Pnnleo an r ecrc(eer Paom