26694 (2) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING-KLETRI AL PERMIT NO,
APPLICATION/PERMIT PLUMBING-MECHANICAL. [SC
v
BUILDING DIVISION BUILDING PROJECI'IDENTIF'ICATo
ION 4
BUILDING ADDRESS. SANITARY NO. 1 APPLICATION SUBMITTAL DATE
11
O.43E t UNIT# LOT# _
OW F A r e PI CONT OR'S NAME LIC NO:
010 ' T O NIC COM'ROL#
RCI TE' INEER:: V LIC NO: ADDRESS: ❑
CONTACT: PHONE:
- QTY. ELECTRIC PERMIT FEC BUILDING PERMIT INFO
ELECT PLUMB MECH
PERMIT ISSUANCE ❑ ❑
LICENSED CONTRACTOR'S DECLARATION APPLIANCES-RESIDENTIAL.
pcez Ihembyaffim,Nallamlicrnsedunderpmvisionsnf Cbapmr9(commencingwith LOB DESCRIPTION
4100 Section 7000)of Division 3 of the Business and Professions Cade,said my license is in PANELS
ge{{uu{I''' folfameundeffcet.
<ziy Loon.Class Lic.N UPTO200AMPSIL
In<aDate Connector 201-1000 AMPS �A
AREA S/SQ.
F ARCHrrECI'S DECLARATION FT.FLOORl FT.
7.Om� OVER ItXq AMPS SQ.
O Z�pp� I undersand my plans ehdl he used as public records.
W SIGNS ELECTRIC
Q �J� Licensed Professional
LL
OWNER-BUILDER from
mDECLARATION SPECIAL CIR R 115
PX
t,V 1 hereby affirm that I em exempt from l Pr Contractors License Lew far the
1+131'-ren following reason.Section 7031.5, t, III,,
Professions Code:Any cityor coumy TEMP.M R PULE INST.
which its issuance.
msoit mcores the aEflic improvuch Permit
erorepuiranyswrrom
K 1Ni1�f to iasunnce,also the titan,for each ser file aai ed smtemem POWER DEVICES
prior quires pp potwo gra
W Op thanheisncing wpursuant 7theprovisionsmile,the Braces License Law(Chapter SWIMMING POOL ELECTRIC Fs
0.y�� 4(commencingwith Section 7000)of Division3ofthe Business and Professions Code) //���V.A.�L/UA�TION
X)y,_y cribs,he is exempt therefrom it the basis forth,alleged exempiun.AryvioletimOf OUTLETS-SWITCHES-FIXTURE$ yql_ /I sr^-
Eya Section 7031.5 by cony applicant for a pcmsit subjects the appliwnno acivil penmryof VV�V7�O
Id
rot mme he.five hundred dollars(S5M)' NEW RESIDENTIAL ELECfR —SQ.FT.
WFm ❑ I,asownerofthepmKny,ormyemployewithwdgesutheirsolecompensadon, STORIES TYPE CONSTRUCTION
ea
will dothe work,and the swaum isnot intended reoffered foreak(Sec.9044,Business
.it Profcasimis Code:The Contracmrs License law does not apply to an owner of
property who builds m improves thereon,rand wharves such work himself or through his
manempicyces.provichadthat such improvements art not intrndM oroffercd for ale.If,
OCCOROUP RES.UNITS
however,the building or improvement is sold within one yemofcompledon,the owner- T
builder will have the burden of proving thin he did not build or improve for purgree of
le.).
❑ I,uownerofthepropeny,amexclusivelycoatectingwi licenc con=lomm QTY. PLUMING PERMIT FEE FLOOD ZONE APN
amsmmt the prnjen(Sec.7044,Business and Professions Cotte:)The Conectorn PERMIT ISSUANCE
License law does not apply to an ow nm of property who builds or improves thereon,and
who contracts forsuch projects with aconnactods)licensed pursuant to the Contruetors pLT1iR-DRAIN VENT-WATER LA
License Law. & HUG FEE SUMMARY
❑ 1 mai exempt under Sec. - ,B At P C for this reason BACK FLOW PROTECT.DEVICE O 'FE
SANITARY Y N
Owner Date RECEIPTN
DRAINS-FLOOR,ROOF,AREA,C
WORKMAN COMPENSATION DECLARATION SCHOOL TAX Y N
❑ Iherem
byufftnhmlhxvemm�ifcnm rf conaenuovelf-insure,...rcnifcuteof RECEIPT'J!
WmInsurance
ken'Compensation oracenifad copy tbereof(SeeJg00,Lob C.)which FTXTURFS-PE0.TRAP PARK FEE Y N
coven all employees under this permit. GAS-EA.SYSTE ETS RECEIPT4
Policy N BUILDING DIVISION FEES
Company GAS-EA.
ER4(EA PLANCHCCK MEElCertified copy is hereby famished. eJd
❑ Cenifed copy is fled with the city inspection division, GREASGI RLWAS 1 .R OR GRADINGFEE
CERTIFICATE OF EXEMPTION FROM WORKERS GREASETRAP SOILS FEE
COMPENSATION INSURANCE
(This section need not be,completed ifthe pemsit is for one hundred dollars($100) SOWER-SANITAR -STORM MFT. ENJOY FEE
orleu.)
I certify than in the performance ofthe work for which this permit is issued.I shall WATER HEATER W/VENT/ELE
not employ any person in any manner so as m become subject to the Workers
Compansatian Lawaof Celifomia. Data WATER SYSTEM/TREATING Dam Receipt
AMP-
0 z Applicant
z 0 NOTICE TO APPLICANT,If.doer making this CeniOcamof Eatontown,youshnuld NEWRESTDENTIALPL TOTAL:
pLn become subject to the Worker's Compensation provisions of the labor Code,you must
04 > forthwith comply with such provisions or this pemdrahall he deemel revoked, s7 BUILDING FEE
fads CONSTRUCTION LENDING AGENCY SEISMIC FEE
tz Ihereby affirm that here is a construction lending agency for to Performance of
V 0 the work for which this permit is issued(Sec.3097.Civ.C.) TOTAL: ELECTRIC FEE
Lenders Name
D. U Leredcfs Address QTY. MECHANICAL PERMIT FEE PLUMBING FEC
1 ecnlfy that I have read this application unit state that the above infotmddon is
cores, lagreemcomply with all city wdcoumy rNinanca enJ suu Iowa relatingm PERMITISSUANCE MECHANICAL ME
15, building construction,and hereby authorize reprosentutives ofthiscity to enter upon the
V Z alrove-mentioned propeny for inspection proposes. ALTER OR ADD TO MECH. CONMUCION TAX
(We)aorto m save,indemnify and keep hurnlesa to City of Cupertino against
liahilitia,judgmrnu,cosuand ex may in wayeacruesg osis dCiry AIR HANDLING UNIT(TO 10,"CFM)
ennseyuen uof the n,ing of is
.7. d �a AIR HANDLING UNIT(OVER 10,000 CFM)
Sign .r..f Ap ant FtcrD ate/ EXHAUST HOOD(W/DUCI)
PAID
HAZARDOUS MAT ALS DISCLOSURE HEATING UNIT(TO 100,000 BTU) Dam Reccip,p
Will,he applicant or future building rccupem store or handle hazardous material
as defined by the Cupertino Municipal Cale,Chapter 9.12,and the Health and Safety HEATING UNIT(OVER 100,000 B'M) A
Cale,Senior 25572(,)?
❑Yes C1 No VENTILATION FAN(SINGLE RESID)
Will theapplicwimfuturcM1uildingoccupanmxeequipmem ordeviccawhich emit
BOILER-COMP(3HP OR 100,001 BTU) ISSUANCE DATE
Instant sir conwminanD as defined by the Bey Area Air Quality Mansgcmcm BOILER-COMP(OVER 100,(W BTU)
Dhidir7 (�
13 Yes 11 No NEW RESIDCNTIAL MECH. SQ.Ff. P A a
1 have rad the feu Code,materials rc05,2553.1 under Chapter 695 of theCal �\
Hite uildingdh&Safety Cody,ave ansunt,tht it
my nd 25534.
Iunderstudtom JUL
fU m Nh 199 ,
Hite tipato of the res not currently have he that d is my muance of u Cor amity the Qlf l(�f16 a
cecupw,rf,hc reyuiremems which must he mm prior to issuance of a Cenilicme of �$
Groagency.
Owner oramhodzed agent Dae TOTAL: ISSUP.D�Y� U 'moi V
OFFICE
City oI,
Cupertino
10300 Torre Avenue
Cupertino,CA 95014
Building Division
(408)777-3228
Fax(408)777-3333
September 26, 1995
K.C. McElligott
10438 Vista Drive
Cupertino, CA 95014
Subject: 10438 Vista Dirve, Permit# 26694
Dear Sirs,
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
- zz-9 �k
o;irked un her•.re :i';c ei