The URL can be used to link to this page

S0483APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY 'CITU (TF CUPERTINO BUILDING - N:LECT RICAL IT . IT No, CAL BUILDING DIVISION APPLICATION/PERMIT PING PROD CT IDENTIFICATION DENTIFIC S 0483 BUILDING PROJECT IUBNTIN'ICATION PHONE: ❑ Consultant Fees Paid by Applicant (Initial) LICENSED CONTRACIUR:ti ULILAIIAn)ry QTY 1 hereby affirm Thal 1 am licensed under provisions of Chapter 9 (commencing 'OaZ with Section 7") of t„ea�ipgss soil Profes,yij,s Cyglq )it my license FSO is in roil force and ellecL W U U hiccnsc Class ' Lir. p .Q W D' - ate Comment, a.ARCHITECPS DECLARATION Fy Z 1 understand my plans shall be used as public records OZ=O F• E' W Licensed Professional OWNER-BUILDEk DECLARATION CC Q 1 peachy altos that I am exempt from the Contractor's License Law for the O y V following reason. ISmiton 90315, Business and Professions Crile: Any city of County W 3 L. y which requires a permit to construct, alter, improve, demolish, or repair any xtmclurc Oil prior to its issuance, also requires the applicant fur such Permit o file a signed statement �.y'' that he is limin,ad pursuant to the provisions of the Contractor's License Law (Chapter 9 W�00 (commencing with Section 700R) of Division 3 of the Business and Professions Cartel or 6 q W that he is exempt therefrom and the basis for the alleged exemption. Any violation of X oto LL Section 7031.5 by any applicant for v permit subjens the applicant m a civil Penalty of conares,honfvchundreddoll ($500). EO -1I, as owner of the property, or my employees with wages as their ole compensation. p., will do the work. cardiac sanctum anot mandimorollmed forode tSee.7( .Busine� s x _ m and Professions Code: The Contractor's Licence Law docs not apply ., an owner of a property who builds or Improves there.., and who does such work himself or through his own employees, provided that .such improvements are no, intended a offered for sale. IL hawcver, the builNng or improvement is sold within one ycm til mmplcti.a. the covin, -builder will have the burden of proving that he did nrn build or improve for pur- asse of sale.). ❑ I. as owner of the property, am ,m usividy contracting with licensed carderemrs an nsWet N. pmj,,l (See, 7(044, Bunl-c„ and Protcssint, Cook :)'Phe Conanalar, LF cense Law does not apply to an owner of property who builds or impmvc% thereon, and QTY. who rea rows fm,rch projects with n emtructm6) Ileunxed purztiamto Ibe C.mmnnr's License law. I an exempt node, Sri. . B & P C Tashi. meson ELECTRIC PERMIT PERMIT ISSUANCE APPLIANCES - RF,SIOEN'HAI, PANELS UPTO200AMPS SIGNS ELECTRICAL SPECIAL CIRCUIT/MISC. TEMP MITER OR POLE INST POWER DEVICES SWIMMING POOL ELECTRIC OUTLETS - SWITCHES - FIXT NEW RESIDENTIAL ELECFR PLUMBING PERMIT PERMIT ISSUANCE. ALTER - DRAIN & VENT- WATER (EA) OFFICE '2L el"vidw 0 I BUILDING PERMIT INFO I Owner Date WORKER'S COMPENSATION DECLARATION , 11 BACK FLOW FIX FEE 1 hereby an irm onde penally of pct cry ane of me following de lar lions: three andwill maimaina Ceniliemeuf Conscm teself-insure for Wurkers Cnmpen- lion, as pnnidc 1 for by Su lion 3700of the Lu Nor Gmc, for the alloomme of the I�wyyofrk far which this worat is issued. J]W oro, ad f the lah,rllCadc. tsar the perlinmane'anM1e work for whic�h}Jlh�� 1 CMy �Wfnk Co t�eYatian lnXmunfc caµ olcy .V'uyn�'" / DRAINS - MOOR. I�N, q IIXTURES - PER TRA C GA�-A. SYS fEM-OVER pIHA)LE'I'S GRIiASMNUUS'1'RL WASTP IN'fF.RCi[VI'OR CrRRTIIFICIATIC:OFF X :M TPION FROM WORKERS' COMPENSA'L'I(3N INSURANCE GREASE I'RAI' (This section need not be completed ifthe canto is for one hundred dollars 1$ 100) z Ics,J pero Ne anypandurniwhich hit tinePermit,kers dlshall Ins any Ohio erof towork become not en,Ploy any person in any intoner so un to promo. aubJeon. the WorkersCumpen- sNimo Lawsof California. Date SiiWER- SAN ITARY-STORM HA. 21X1 FT'. WATER BEATER W/VIWI'/ELECTR ZO y W d UO V. (~ U %' fist .H. V1 U Z A,plicam NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should the Labor Code. you cast hcmme subject,, he Wmkcr's Cm:fanodion P111111111-1 of us forthwith comply with such prM' n or,hie Permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby alinn'hatthere is a commadnn(endue, ngcocy for,hc Felfuraranccof the work far which Of, permit is ls.nOff (Sec 3097. Civ. C.) lander', Name Lenders Address WATER SYSTF.M/IREATING WATER SERVICE NEW RF_SIDLN'1'IAL PCMB. SQ. Ff. TOTAL: QTY. MECHANICAL PERMIT I ccail Y,c, l lave rad this appla,u an and are that the above imonn-toms cmtc"I agamto comply with all city and county ordinances and state law%refining to building conswc,ion, and hereby warrants iparsetnmives of this city,,, color upon the mornc-ca noosed property for inspection purpoml. PERMIT ISSUANCE (We) agree m save, indemnify and keep hatmless,he City of Caperton" again" liabilities,judgments.costs and expenses which may in any way accme again,, said City ALTER OR ADD TO MECH. in consequence of the granting of this permit. APPLICANT UNDERS WILL COMPLY I r LL NON -POINT AIR HANDLING UNIT' GO 10,W11CFM) AIR HANDLING UNIT (OVER 10.000 CFM) SOURCER GULA S. EXI MUST HOOD(W/DUCT) Si,ratremApplicaVCa emr Date IT " BEGUS MATF.RI IS ISCLOSURE Will the app 3111 Or future building we tstme or handle hicardeas mnicrial a, dehnN by the apeman Municipal Code, Chapter 9.12, and the Health and Safety HEA 'IING UNIT(I 01(g,000 RTI) HEAPING If NI I' (OVER I00,0N) BTU) Cade. Section 255. (a)' VENTILATION PAN (SINGLE RESIDE El Yes -1 No Will the applicum or future building am.ford use equipment or devices which it bu;,rdoti, nir cnndamic ll a, definnl by the Bay Area Air Quality Mwtagcmmn BOILER (3111' OR IM,(XX)BTI) BOILER - COMP (OVER I W,000 BTU) mixt? ❑Yes El No I M1m'e rcaA the A:rrnrdnus mn,eriuh re9nimmnn, under Chapter h95 of theCali- hadis Health&Sme,y Code.Secdom25505. 25533 and 255A.IuMemanm d Nm if Ism building docs not currently base a tenant, that it is my resloorol ihty notify the c.panl of Ne requirements which most be mel prior to issuance of Cetificme of Occupancy. AIR CONDITIONER NEW RESIDENT IAL. NIECE I. SQ. FT. OFFICE '2L el"vidw 0 I BUILDING PERMIT INFO I FLOOR AREA PAID 'JAN 26 AK CITY Uf VAL A VVrCftfn.V PLANCIIECK FEE ENI.RGY FEE GRADING FEE SOILS ITE PAID Dote Receip" BUILDING FEE FEE SEISMIC FEE BLECfRICITE PLUMBING FEE MECHANICAL ITE CONSTRUCTION TAX HOUSING MITIGATION FEE PAID Date R111104 ss/SQ. .❑ ❑ ❑ FEE JOB DESCRIPTION RESIDENTIAL: ❑SF'DWL ❑ KITCHEN REMODEL ❑ADDITION [I PLUMBING RE -PIPE ❑MULTI -UNIT ❑STRUCTURAL MODIFICATION El INTERIOR El CHIMNEY REPAIR IMPROVEMENT EJSWIMMING POOLS ❑ BATH REMODEUREPAIR ❑DEMOIA ILO [I OTHER _ rt- _ _50 COMMERCIAiL�:. El NEW BLDG/ADDITION [I DEMOLITION ❑TENANT' ❑ FOOD SERVICE IMPROVEMENT ❑ OTHER FLOOR AREA PAID 'JAN 26 AK CITY Uf VAL A VVrCftfn.V PLANCIIECK FEE ENI.RGY FEE GRADING FEE SOILS ITE PAID Dote Receip" BUILDING FEE FEE SEISMIC FEE BLECfRICITE PLUMBING FEE MECHANICAL ITE CONSTRUCTION TAX HOUSING MITIGATION FEE PAID Date R111104 ss/SQ. 10300 Torre Avenue Cupertino, CA 95014 P!! �-City of' upel`t1110 Building Division 2 (408)777-3333 (fax) February 9, 1999 Homeowner 21174 Lauretta Drive Cupertino, CA 95014 SUBJECT: Permit #S0483 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, 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. CJ 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 Pdnlad on Re, vuled Paper