14060201CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21604 CASTLETON ST
CONTRACTOR: PELLE HEATING & AC
PERMIT NO: 14060201
INC
OWNER'S NAME: SHEKHAR & APARNA VARANASI
3751 D CHARTER PARK DR
DATE ISSUED: 06/30/2014
OWNER'S ONE: 2244201814
SAN JOSE, CA 95136
PHONE NO: (408)978 -7060
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
INSTALL (N) A/C UNIT IN SIDE YARD AREA (SETBACKS
G
License Class Lic. # " 91
MET, 6' FROM UNIT TO PROPERTY LINE)
Contractor C Date C
I hereby affirm that I am licensed under the provisions of Ch ter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self - insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
Sq. Ft Floor Area:
Valuation: $5350
ave and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 35620045 00
Occupancy Type:
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAY IT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
180 D O CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
6 76
granting of this permit. Additionally, the applicant understands and will compl
pe
with all non -point source regulations per the Cupertino Municipal Code, Section
9 18.
RE- ROOFS:
Signa _ Date %/�
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ OWNER- BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self - insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 25 , 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent Date: Li0 /
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9 18.
Signature Date
CUPERTINO
GENERAL PERMIT APPLICATION EP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 ` O misc
(408) 777 -3228 • FAX (408) 777 -3333 • building aecupertino.org
❑PLUMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS
PROJECT ADDRESS l b D I
APN # Q
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OWNER NAME "I
P NE
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STREET ADDRESS g , a
TY, STATE, Z'PQ ®
FAX
CONTACT NAME _
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PHON®
E -MAIL
STREET ADDRESS y�
CITY, S , ZIP
FAX
❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT XCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER
❑ TENANT
CONTRACTOR NAME t
L[CE
SE NU ER
LICENSE E TYPE
BUS. LIC #
IL 'jj
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COMPANY NAME
E -MAIL
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STREE DRES
-i
CIT STATE ZI
PHON
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ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL,
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or DUPLEX ❑ MULTI - FAMILY
PROJECT IN W I.DLAND ❑ YES
PROJECT IN
❑ YES
IS THE BLDG AN
❑ YES
BUILDING: ❑ COMMERCIAL
URBAN INTERFACE AREA ❑ NO
FLOOD ZONE
❑ NO
EICHLER HOME?
❑ NO
DESCRIPTION OF WORK
to
silaw
TOTAL VALUATION: `� 1ti2
CEIVED BY:
By my signature below, I certify to each of the following: I am the property owner ortl5orized agent to
a
f6y,, read this
application and the information I have provided is correct. I have read the Description of Work and ve it is accurate ree
ply with all applic
ordinances and state laws relating to ldin constructio . aut representatives of Cupertino to enter the abo
I led property fo nspection purposes.
3
Signature of Applicant/Agent: Date:
SUPPLEMENTA&ANFORMATION REQUIRED
ogrEiluY
ER 1ITE COIINTElt
w
w
C� EXPRESS
❑ STANDARD
❑ LARGE
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a
❑ MAdQR
MEPMiscApp_201 Ldoc revised 06121111
CITY OF CUPERTINO
Fw-R-W 1171P]17 F4Z9r11%4ATnR — RIT11.11ING DIVNION
ADDRESS: 21604 CASTLETON ST
DATE: 06/30/2014
REVIEWED BY: MELISSA
APN: 359 20 045 --FBP#:
Plan Check Fee:
*VALUATION: 1$5,350
*PERMIT TYPE: Mechanical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Duplex
USE:
I
PENTAMATION FURN/AC
� PERMIT TYPE: 'Al
WORK
INSTALL (N) A/C UNIT IN SIDE YARD AREA (SETBACKS MET, UFROM UNIT TO PROPERTY
SCOPE
LINE)
APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES
A/C Units (<=10K cfm) 113REMAIR 1 # $70_
TOTALS: 0 $70.00
Mech. Plan Check 10.0 1 hrs $0.00 lliuwb. Plan Chef.,A I I k I
1—mech. Permit Fee: IMPERMIT lumb, Permit Flec "w"
Other Mech. Insp. 1 0.01 hrs $47.00 Other Aluinh fruP. dw% L. 1(:(,
14ecw, Pluwb, hz�q), Fee: 1"le", ins!",
NOTE: This estimate does not include fees due to other Departments (i.e.,Ptanning, runic worKs, rare, 3annary,3ewerutszrtct, acuum
Contact the Dent for addnl info.
FEE ITEMS (Fee Resolution 11-053 fff 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
Plan Check:
$0.00
77PME
S?ippl I lr�-isp Fee
PME Unit Fee:
$70.00
PME Permit Fee:
$47.00
. T
Ctrilcllon
Administrative Fee: 1,4DMIN
$44.00
Work Without Permit? 0 Yes 0 No
$0.00
(uning
Travel Documentation Fee: ITR,4VDOC
$47.00
Strong Motion Fee: IBSEISMICR
$0.54
Select an Administrative Item
1
Bldg Stds Commission Fee: IBCBSC
$1.00
Ix . .... . -off
Re TIM,
s
$2 09.54
$0.00 �TQTAL,-- -1,
F5
$209.54
Revised: 04/01/2014
STATE OF CALIFORNIA
MANDATORY MEASURES SUMMARY: RESIDENTIAL
4s � a,,
EC-i MF -1 Ri (Revised 0$/08) CALIFORNIA ENERGY COMMISSION
Mandatory Meas tnres Sum#n4ry MF -1R
Residential (Page 1 of 3
Site Address: Enforcement Agency: Date:
NOTE: Low -rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed,
regardless of the compliance approach used. More stringent energy measures listed on the Certificate of Compliance (CF -1R,
CF -1 R ADD, or CF -I R -ALT Form) shall supersede the items marked with an asterisk(*) below. This Mandatory Measures
Summary shall be incorporated into the permit documents and the applicable features shall be considered by all parties as minimum
component performance specifications whether they are shown elsewhere in the documents or in this summary. Submit all
applicable sections o. the. MF 71R Form with dens.
DESCRIPTION
Building Envelope Nl sores:
§ 116(a)]: Doors and windows between conditioned and unconditioned s aces are manufactured to limit air leakage.
§116(a)4: Fenestration products (except field- fabricated windows) have a label listing the 'certified 'U-Factor, certified Solar Heat Gain Coefficient
SHGC , and infiltration that meets the requirements of ']0 -111 (a).
§117: Exterior doors and windows are weather- stripped; all joints and penetrations are caulked and sealed.
§118(a): Insulation specified or installed, meets Standards for Insulating Material. Indicate type and include on CF -6R Form.
§11 8(i): The thermal emistance and solar reflectance values of the cool roofing material meets the requirements of § 118(i) when the installation of
a Cool Roof is specified on the CF -I R Form.
* §150(a): Minimum R -19 insulation in wood - flame ceiling or equivalent U- factor.
§150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R- Value.
* §150(c): Minimum R -13 insulation in wood -frame wall or equivalent U- factor.
* §150(d): Minimum R -13 insulation in raised wood -frame floor or equivalent U- factor.
§150(0: Air retarding wrap is tested, labeled, and installed according to ASTM E1677- 95(2000) when specified on the CF -1R Form.
§I50(g): Mandatory Vapor barrier installed in Climate Zones 14 or 16.
§ 150(1): Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3 %; water vapor permeance rate is no
rester than 2.Q,.2,2m, 4i ch anti shall be protected from. h.,sisal dame a and I. li ht deterioration.
Fireplaces, Decorative Gas Appliances said Gas Log Measures:
§ 150(e)IA: Masonry yr factory-built fireplaces have a closable metal or glass door covering the entire opening of the firebox.
§150(e)1B: Masonry or factory- built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped
with a with a readily aeces ible operable, and tight-fitting damper and or a combustion -air control device.
§ I50(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the
building, rohibit
Space Conditionin Water Uenil antl.Plutnbn S ,stein 1lleasulres:
§ 110-§ 113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy Commission.
§ 113(c)5: ` Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release valve,
backflow revention puMp isolation valve and recirculation loop connection re uirements of § 1 13 c 5.
§ 115: Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances (appliances with an
electrical sqp& volt a Connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool ands a heaters.
§ i50(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA.
§ 150(i): Heating stems are equipped with, thermostats that meet the setback requirements of Section I I2(c).
§1500)IA: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with
insulation having an installed thermal resistance of R -1.2 or greater.
§1500)IB: Unfired storage tanks; such as storage tanks or backup tanks for solar water- heating system, or other indirect hot water tanks have R -12
external insulation or R -16 internal insulation where the internal insulation R -value is indicated on the exterior of the tank.
§1500)2: First 5 feet of hot and cold water pipes closest to water heater tank, non - recirculating systems, and entire length of recirculating sections
of hot water pipes are,insulated er Standards Table 150 -B.
§1500)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot water tank
shall be insulated to. Table 150 -B and Equation 150 -A.
§1500)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table 123 -A.
2008 Residential Compliance Forms August 2009
r'
'1
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -2R- ALT -HVAC
Climate Zones 1 and 3 - 7
Site Address:
Enforcement Agency:
Dat •
permit #:
I bQ
i
30 14
Conditioned
Duct insulation
Equipment T e'
List Minimum EfficiencY2
Floor Area
requirement
Thermostat
• Packaged Unit
Over 40 ft of ducts
• Furnace
• Indoor Coil
q AFUE
13SEER�
D COP
13 HSPF
Served by system
added or replaced in
etback
(/fnot already present, must be
RCondensing Unit
0 EER
CI Resistance
sf
unconditioned space
❑ R 6 (CZ 1, 3 -5)
installetd)
❑ Other
1
/. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -I R- ALT -HVAC for each system,
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this
Certificate of Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts I and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable
compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name:
Signature:
Company:
Date: 30 /
Address: — �
r
License: q
I so
City /State/Zip: r4
I
Phone: o
2008 Residential Compliance Forms March 2070
INSTALLATION CERTIFICATE CF- 611- MECH -04
Space Conditioning Systems, Ducts and Fans (Page 1 of 2
Site Address: Enf rcement Agency: Permit Number:
Space Conditioning Systems
Heating Equipment
Equip
Type
(package-
heat um
CEC Certified Mfr. Name
and Model Number
ARI
Reference
Number 2
#of
Identical
Systems
Efficiency
(AFUE,
etc.)' .3
(zCF -1 R
value a
Duct
Location
(attic,
crawl-
space,
etc.
Duct
R -value
Heating
Load
Btu/hr
Heating
Capacity
Btu/hr
it
�.
Cooling Equipment
Equip
Type
(package
heat
um)
CEC Certified Mfr. Name
and Model Number
ARI Reference
Number 2
# of
Identical
Systems
Efficiency
(SEER
and EER)
1,3
( >_CF -1R
value) °
Duct
Location
(attic,
crawl-
space,
etc.)
Duct
R -value
Cooling
Load
Btu/hr)
Cooling
Capacity
(Btu/hr)
it
�.
1. If project is new construction, see hbotnotes to Standards ]'able I J I -H and fable 1 J l -U jor duct ceiling alternative
compliance.
2. ARI Reference Number can be found by entering the equipment model number at http: / /ia,ww. aridirectory. org /ari /ac.php#
3. Listed efficiency on this page must be greater than or equal ( >_) to the value shown on the CF- I R form.
4. When CF -I R is reference it is also applicable to the CF -I R, CF -I R -AA or CF -I R -ALT
ALL BOXES MUST BE CHECKED TO BE A VALID FORM
❑ §I 10- §113: HVAC equipment is certified by the California Energy Commission.
❑ §I50(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA, or ACCA.
❑ § 150(1): Setback Thermostat on all applicable heating and /or cooling systems meet the requirements of § 112(c).
❑ § 1500)2: Pipe insulation for cooling system refrigerant suction, chilled water and brine lines meets minimum
requirements of Table 150 -B and includes a vapor retardant or is enclosed entirely in conditioned space.
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF -6111- MECH -04
Space Conditio . ning Systems, Ducts and Fans (Page 2 of 2
Site Address: Enforcement Agency: Permit Number:
Ducts and Fans
§ 150(m): Duct and Fans
1. All air- distribution system ducts and plenums installed, sealed and insulated to meet the requirements of CMC
Sections 601, 602, 603, 604, 605 and Standard 6 -5; supply -air and return -air ducts and plenums are insulated to a
minimum installed level of R -4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape
or other duct - closure system that meets the applicable requirements of UL 181, UL 181 A, or UL 181 B or aerosol
sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the
o bination of mastic and either mesh or tape shall be used; and
1. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other
than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities
and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to
cause reductions in the cross - sectional area of the ducts.
4 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive
duct tapes unless such tape is used in combination with mastic and draw bands.
440f 7. Exhaust fan systems have back draft or automatic dampers.
❑ 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually
operated dampers.
N ❑ 9. Protection of Insulation. Insulation shall be protected from damage, including that due to sunlight, moisture,
equipment maintenance, and wind. Cellular foam insulation shall be protected as above or painted with a coating that is
water retardant and provides shielding from solar radiation that can cause degradation of the material.
10. Flexible ducts cannot have porous inner cores.
DECLARATION STATEMENT
• I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
• 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized
representative of the person responsible for construction (responsible person).
• 1 certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation)
conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the
enforcement agency.
• 1 reviewed a copy of the Certificate of Compliance (CF -I R) forni approved by the enforcement agency that identities the specific
requirements for the installation. I certify that the requirements detailed on the CF -I R that apply to the installation have been met.
• 1 will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building
permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. 1 understand
that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to
the building owner at occupancy.
Compan Name: (Installing Subcontractor or General Contractor or Builder /Owner)
QM
Respon ' e Pe n' Nam :
Responsible Perso i nature:
C'91B License:
Date Signed:
Positron With Com any (Title):
b is
2008 Residential Compliance Forms August 2009
Address
fl
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
FIL
PURPOSE
This affidavit is a self - certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION
Existing single - family and multi- family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon
Monoxide Alarms be installed in the following locations:
AREA
SMOKE ALARM
(408) 777 -3228 • FAX (408) 777 -3333 • building oecupertino.org
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
# of Alarms Smoke:
Permit No./ 6
Carbon Monoxide:
PURPOSE
This affidavit is a self - certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION
Existing single - family and multi- family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds
$1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon
Monoxide Alarms be installed in the following locations:
AREA
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above - referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
I have read and agree to con?pl C wit(t the terms and conditions of this statement
Owner (or Owner Agent's) Name:
S NC 1K Nis t= V iA Nt'1S1
Si nature .............................. 7� i41 t 4
..................................................... ............................... Date: .................
Contractor Name:
Signature.................................... ............................... Lic.# ....... ............................... Date:...................
Smoke and CO form. doc revised 03118114
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COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION - CUPERTINO
APPROVED
Th is set of plans and specifications MUST be kept at the
job site during construction. it is unlawful to make any
changes or alterations on same, or to deviate
therefrom, without approval from the Building Official.
The stamping of this plan and specifications SHALL NOT
be held to permits hof the violation
off"' or State Law.
PERMIT NO.
CUPERTINO
Building Department
JUN3D 2014
REVIEWED FOR CODE COMPLIANCE
Reviewed By:
D
�r