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31514 AFFLIUAN I I U I-ILL IN INI-UHMAIIUN WITHIN HED LINES-USE BALL POINT PEN ONLY CITY Or, CL,rPERTINO BUILDING-ELECTRICAL PERMIT NO. ^J{q11 5/ 4 w BUILDING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL 'y BUILDING PROJECT IDENTIFICATION BUILDING ADDRESS: SANITARY NO. APPLICATION SUBMITTAL DAT 1 OWTJWS NAME: ` PHONE: C TRACTOR'S N E: IC NO: r= �1 J y ` N/C CONTROL# ARCHITECT/ENGINEER: /` LIC NO: D ` ❑ CONTACT: PHONE: BUILDING PERMIT INFO_ ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT MECH LICENSED CONTRACTOR'S DECLARATION QTY ELECTRIC PERMIT FEE ❑ I hereby affirm that I am licensed under provisions of Chapter 9(commencing JOB DE CRIPTION W a z with Section 7000)of Division 3 of the Business andprofessions Code,and my license is RESIDENTIAL: W W in full force and eff7l �C (�'t PERMIT ISSUANCE Q U U License Class L t: Lic.# A� ❑SFDWL EJ KITCHEN REMODEL y CL WDate- Contractor APPLIANCES-RESIDENTIAL El PLUMBING RE-PIPE F.<y ARCHITECT'S DECLARA I PANELS LJ MULTI-UNIT ❑STRUCTURAL O t/�Z I understand my plans shall be used as public record§ MODIFICATION Z.,'•" UP TO 200 AMPS �F q ❑INTERIOR El CHIMNEY REPAIR W Licensed Professional 201-1000 AMPS IMPR�RE77 .a OWNER-BUILDER DECLARATION OVER 1000 AMPS ❑BATH ❑DEMOLITION W Q I hereby affirm that I am exempt from the Contractor's License Law for the L3O CLU following reason.(Section 7031.5,Business and Professions Code:Any city or county SIGNS ELECTRICAL ❑ L WO y which requires a permit to construct,alter,improve,demolish,or repair any structure aprior to its issuance,also requires the applicant for such permit to file a signed statement SPECIAL CIRCUIT/MISC p, that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 r�O (commencing with Section 7000)of Division 3 of the Business and Professions Code)or TEMP.METER OR POLE INST. COMMERCIAL: - LL o a that he is exempt therefrom and the basis for the alleged exemption.Any violation of ❑NEW BLDG/ADDI MOLTTION k1 fr. Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of POWER DEVICES W to El TENANT FOOD `CE not more than five hundred dollars($500). F Z> IMPROVEMENT x Q ❑I,as owner of the property,or my employees with wages as their sole compensation, SWIMMING POOL ELECTRIC will do the work,and the structure is not intended or offered for sale(Sec.7044,Business ❑OTHER 3 0-o and Professions Code:The Contractor's License Law does not apply to an owner of OUTLETS-SWITCHES-FIXTURE property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for NEW RESIDENTIAL ELECTR sale.If,however,the building or improvement is sold within one year of completion,the SQ.FT.FLOOR AREA $/SQ.FT. owner-builder will have the burden of proving that he did not build or improve for pur- pose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to TOTAL: construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and QTY, PLUMBING PERMIT FEE �� 719 6 who contracts for such projects with a contractor(s)licensed pursuant to the ContractorV Contractor's License Law. PERMIT ISSUANCE ❑I am exempt under Sec. ,B&P C for this reason t Owner Date ALTER-DRAIN&VENT-WATER(EA) _VALOATIONN WORKER'S COMPENSATION DECLARATION BACK FLOW PROTECT.DEVICE I hereby affirm under penalty of perjury one of the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- DRAINS-FLOOR,ROOF,AREA,COND. STORIES TYPE CONSTRUCTION sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. FIXTURES-PER TRAP ❑I have and will maintain Workers Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. GAS-EA.SYSTEM-I INC.4 OUTLE OCC.GR APN My Work Compgfgy. Ins carrier and Policy nu rare' y,� Carrier: i j 9I Pl��1�V1 Policy No.: t•' GAS-EA.SYSTEM-OVER 4(E FICA OF TION FRO W COMPENSATION INSURANCE GREASEANDUSTRL WAS71NTERCEPTOR (This section need not be completed if the permit is for one hundred dollars($100) GREASE TRAP BUILDING DIVISION FEES or less.) ANCHECK FEE I certify that in the performance of the work for which this permit is issued,I shall SEWER-SANIT -STORM EA.200 FT. not employ any person in any manner so as to become subject to the Workers'Compen- ENERGY FEE zZ sation Laws of California.Date WATER HEA WNENf/BLECTR O Applicant GRADING FEE ►r f% NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should WATER SY M/I'REATTNG ; become subject to the Workers Compensation provisions of the Labor Code,you must SOILS FEE WH forthwith comply with such provisions or this permit shall be deemed revoked. WATE ERVICE A CONSTRUCTION LENDING AGENCY NE/RESIDENTIAL RESIDENTIAL PLMB. SQ.FT. PAID U O I hereby affirm that there is a construction lending agency for the performance of Date Receipt# w H the work for which this permit is issued(Sec.3097,Civ.C.) TOTAL: O U Lenders Name Lender's Address TOTAL: aI certify that I have read this application and state that the above information is BUILDING FEE .. V) correct.I agree to comply with all city and county ordinances and state laws relating to QTY, MECHANICAL PERMIT FEE U 7Zr building construction,and hereby authorize representatives of this city to enter upon the SEISMIC FEE above-mentioned property for inspection purposes. PERMIT ISSUANCE ,��+ �] (We)agree to save,indet less the City of Cupertino against ELECTRIC FEE liabilitizuienigments,costs a pemes which may n any way accrue against said City ALTER OR ADD TO MECH. in consequence of the g this permit. j PLUMBING FEE APPLICANT UND S AND WI OMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10,000 CFM) MECHANICAL FEE SOURCE RE .i AIR HANDLING UNIT(OVER 10,000 CFM) CONSTRUCTION TAX re o ARDOUfor Date EXHAUST HOOD(W/DUCT) HAZS MATERIALS DISCLOSURE HOUSING MITIGATION FEE Will the applicant or future building occupant store or handle hazardous material HEATING UNIT(TO 100,000 BTU) 2 . as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? HEATING UNIT(OVER 100,000 BTU) D ❑Yes F1 No VENTILATION FAN(SINGLE RESID) PAI Date Receipt# Will the applicant or future building occupant use equipment or devices which mit hazardous air contaminants as defined by the Bay Area Air Quality Management BOILER-COMP(3HP OR 100,000 BTU) istrict? ? TOTAL: � ❑Yes F-1NoBOILER-COMP(OVER 100,000 BTU) �ZI I have read the hazardous materials requirements under Chapter 6.95 of the Cali- AIR CONDITIONER I ISSUANCE D forma Health&Safety Code,Sections 25505,25533 and 25534.I understand that if the NEW RESIDENTIAL MECH. SQ.FT. building does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements which must be met prior to issuance of a Certificate of Occupancy. Owner or authorized agent Date TOTAL: ISSUED BY: OFFICE ® 10300 Torre Avenue Cit"c- of Cupertino,CA 95014 C-aperthi.o Building Division (408)777-3228 (408)777-3333 (fax) June 18, 1997 Homeowner 7604 Newcastle Drive Cupertino, CA 95014 SUBJECT Permit#31514 Dear Homeowner: We have been going through our files in the Building Department, and contacting those people with permits remaining"open. According to our inspection records,the subject permit has not had a final inspection. 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 dispose of the file and remove the records from our computer. Thank you for your assistance. Sincerely, CITY OF CUPERTINO Christy Akatiff, Administrative Clerk Printed on Pecvcleo Paper PERMIT NO BUILDING PROJECT IDFJU KATION BUILDING ADDRESS SANITARY NO. APPLICATIO 14 OfL OW 'S NAME: \ PHONE: CQ►�1 ACTOR' 1E: ` ItlC N_O:_ NIC CONT CHITECT/ENGINEER: IhJI LIC NO: l( D1 S: F i�-f ( L/\ ❑ BUILDING PERMIT E 1NSPECTIbNS DATE WSPEC. ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT FIE FOUNDATION/PIERS/H.D.S. INSPECTION RECORD C3 0 UFER GROUND NOTE: ALL GRADING AND DRAINAGE JOB DESCR[PTlO RESIDENTIAL: PAD/SETBACK-CERT SHALL BE INSTALLED TO COMPLY WITH ❑SFDWL �f ❑KIT( THE APPROVED PLANS AND CITY OF DADDI ❑PLUI GARAGE SLABS/PREGUNITE CUPERTINO STANDARDS. ❑MULTI-UNIT El Moo POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNEDMon ARRANGE INSPECTION ❑INTERIOR ❑CHIN UNDERGROUND/SLAB CALL AFTERNOONS (12:30 PM - 4:00 PM) IMPROVEMENT ❑BATH RE ODEL/REPAIR ❑DEME PLUMBING 777-3228 MONDAY TO FRIDAY 24 HOURS BE- p ELECTRICAL FORE REQUIRED INSPECTION. JOB ADDRESS DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED AND PERMIT#ARE NEEDED WHEN PHONING. PLUMBING ATTENTION CONTRACTORS: EW BLCOMERDG ADDO Mc MECHANICAL NO PERSON(S)SHALL PERFORM WORK ON ❑TEN ANT FOOD THIS JOB SITE WITHOUT BEING IN COM- IMPROVEMENT G- , ELECTRICAL PLIANCE WITH WORKERS'COMPENSATION OTHER FRAMING VENTS INSURANCE REQUIREMENTS. ' INSULATION INSPECTION SPECIAL INSPECTION REQUIRED ❑ DATE PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SHEATH/DIAPHRAM PLUMBING TUBS&SHOWER PAN MECHANICAL NOV 27 199 ELECTRICAL/POOL BOND FRAMING/STAIRS/E.EGRESS C111 Ur Uf-Lr 1 i4, INS ULATIONN ENTILATION COVER NO WORK UM71LABOVE HAS BEEN SIGNED EXTERIAL SHEARIHOLD DOWN INTERIOR SHEARMOLD DOWN SHEETWROCK/SHEETROCK SHEAR EXTERIOR LATHIW-SCREED SHOWER LATH NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED SCRATCH COAT SEWERIWATER TEMPORARY APPROVALS OCCUPANCY EL T�iCAL AS GAS TEST FIRE HANDICAP ELECTRICAL r PLUMBING MECHANICAL � ENERGY CERTIFICATE OF OCCUPANCY VISUAL FINAL ONLY ❑ BUILDING IMPORTANT: ISSUANCE DtTE � d1§NOTPERMITTEb PLEASE READ REVERSE SIDE BEFORE #►fs#S f� I3 RY.RUfLDIf4d CALLING FOR FINAL INSPECTION!! / ISSUED BY: APPLICANT'S POSTING COPY