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04020045 CITY OF CUPERTINO BUILDING DIVISION PERMIT4C0! RAeT BUILDING ADDRESS: SEQUOIA LANDSCAPING & CONT PERMITNo04020045 OWNER'S NAME: PERMIT ISSUE DATE CORD ONE: SANITARY O. ONTROL NO. ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH p �rOp LICENSED CONTRACTOR'S DECLARATION Z C the by afarm that 1 am licensed under provisions orChapter 9(commencing 706 Description aU with 5cc6on of Division 3af Ne Busifred Pf}rofcsuomfyCqodc.and myliccnscis HIn full fDmea fa`b 2 Lklg�vsgy987 REMOVE SEPTIC TANK/CONNECT TO PUBLIC SEWER E(a Z Licence 1 C O Dem Cool r ARCHITECTS D ON igland my phos shall E u used public records as U rad Licensed Professional OWNER-BUILDER DECLARATION 1 hereby reaso a1Brm that 1 1. exempt from Nc Cmdramor's License Law for No x O D following ream-.(Section FD I.S,Business and wn.d ions Code:Any city or county K$ which inquires a permit in mics tet,ahaa improve,h Permit t Or mash any statement FAL^ tpoor hat its issuance,pursu requiins thapplicant forsucthe Cohpctor'sices Law(Chapter �a Nat me ccenmd pursuant to Ron,provisions Or theContractor'sBuri nth License Law sCode)9 Sq.Ft.Floor Area Valuation $ (hot he exempthherefromon DO)of and the nithoegedexeand pt Professions Code)or Nat Ile h exempt therefrom and fie hints for the alleged exemption.Any violation of ...�sv,,nnw'i�IrTyT�u.�..1s,, Section 7031.5 by any applicant for a Permit subjects the applicant to a civil penally of 3 6II•IPJItM*gr0 0. Occas e not ream Nen five hundred dollen($500). Occupancy Type ❑i,m ownm of the prvpcny,or my employees NiN wages m Neirmle mmpenmdon, will do the wok and thestructuin is notintended or offered forsah(Sec.7044.Business nS Required Le and Profcmions Cade:The Contractor's License Law doh nut apply to an Owner of q D property w ho bui lds or im proves thereon.and who does such work himself or through his own employees,provided Natsoch improvements are not intended mortared for sale.if. FEBowever.the building or improvement is sold within one year ofmmplatlos the owner- F1 O qoo builder will have the burden of proving that he did not build or improve for purpose of O G 4 mlcd. 0 1.as Owner of the property,am exclusively contracting with licensed convectors in ��ILDI N convect the project(Sec.7044.Business and Professions Code:)The Camnclar's Lb G ' coma law Orion not apply to an owner of property who builds or improves thereon,and ' who contracts for such projects with a contractor(s)Iiccnsed pursuant to the Contractor's License Law. O l am exempt under Su. ,B&P C for this reason t,37wl Dam WORKERS COMPENSATION DECLARATION 1 hereby affinm under penalty of perjury one of Ne following declarations. ve and will maintain aCcnificam ofConsenl mself-imum for Warl erSCompen- as provided for by Section 3700 of the labor Code,for the performance of the r which this permit is issued, ve and will maintain Worker's Compensation Insurance,m required by Section dm Labor Code.for Ne peRarmance of the writs rwhich Nis permit is Issued.rk(�'s CCoompensation Insurance senior and Policy n r are::.lg RT� up PoIICY "f .. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Obhucfion need nmhccomplcted if the permit is formic hundred dollars(SIM) less.) I comfy that in the performance of the work for which this permit is issued.l shall not employ any person loony mannerso m in become subject to tM Workers'Campemathm Laws of Califamia.Data Applicant , NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become Subject he the Worker's Compensation previsions of the Labor Code,you must 0 0 raMMilt comply with such provisions or this Permit shall be deemed mvmaed. z CONSTRUCTION LENDING AGENCY [+� I hereby or0rm dentin.is.c...tructlim ending go.,for Ne performance or " lYi> the work for which this permit is issued(See.3097.Cih,C.) QLentln's Name tom- z Lender's Add. U 0 1 codify that I have mad Nis application and ah¢that the be.information is LL fes+ correct.1 agree in comply with ell city and county ordinances and state laws rotating to 0 U building construction,and hereby amhoriu representatives of this city to enter upon the above-mentioned property for inspection purposes. (We)agree to save,indemnity and keep harmless the City of Cupertino against y liabilities,judgments,costs and expenses which may In any way accmc against said City V"Z inc min,tencc of the granting of this permit. /C r-t APPLICANT UNDE TAN S A D WILL COMPLY WITH LL ON-POINT Issued by: Date 1../ SO EGULA W_ Re-roofs ;,t!MWcird1'*s uinofApplin omruror DateAZARDOUS MATERIALS DISCLOSERType of ROOF Will Ne applicant or future building oceupantstem m handle hazardous material ned y the Cupertino Municipal Code,Chapter 9.12.sed Ne Health and Safety Sccdan 25532(a)7 All roofs shall be inspected prior to any roofing material being installed. Dyes ;Nu Wilthe applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove nunirconhminents m Jcfincd by the Bay Arca Air Quality Management all new materials for inspection. t? ❑Yea �hU I have mad the h xandoi,matcluls requimmcns under Cheptcr6.95Ortho Califor. Oda Health&SafetyCode,Seetims 8505,25533 ud8534.1 understand thmirtho Wilding docs not currently hoc a tenon dim is my responsibility m ne0fy the Occup t rir dtc req Which me be tpd missamcconceniOmmOraDpm Signature of Applicant Date o ream AI ant Dat All roof coverings to be Class"B" or better t DER: CHB: CV: • File: CUPERTINO SANITARY DISTRICT 20065 Stevens Creek Blvd., Bldg. C Cupertino, California 95014 (408)253-7071 "ON-SITE REQUIREMENTS-OVER THE COUNTER REVIEW" Date: %%6WA Otr 1 '204- File: CuSD MOP Building Dept-Cupertino Community Development Department-Building City of Cupertino 10300 Torre Ave. ��r rq� Cupertino, Ca 95014-3202 - o RM W5 `I've IG 4PVV RE: Subject: AND allotO"r 'rV �� Name: spat mt�/ ,4W Approved For Issuing APNess3 Q5µ tbwv► W ► � Building/ Plumbing Permits Control/Plan Ck No.: Permit No.: GU,GJ,�' �eN�ct1�►� OmT# 16W The Cupertino Sanitary District has reviewed the plans for the subject project: ❑ No additional conditions/requirements by the District. ❑ Sanitary sewer is available and the existing building is connected to sanitary / sewer, see conditionstrequirements listed below. �7( Sanitary sewer is (01) available, see conditions/requirements below. u Sanitary sewer is not provided by the District, please contact the City of Sunnyvale at(408) 730-7510. The following Conditions/Requirements are made: ❑ Install new Property Line Cleanout or locate and raise to grade an existing property line cleanout. Cleanout shall be the same diameter as the street portion of the service lateral (Minimum gravity lateral is 4" diameter). VVideo Inspection of the Property Line Cleanout, Point of Connection and Street Lateral is required prior to passing The City of Cupertino Final Inspection. Owner to call District 48 hours prior to video inspection to schedule a District Inspector. District to provide Building Department with Written Notification upon completion of Inspection. Pagel of 2 "ON-SITE REQUIREMENTS-OVER THE COUNTER REVIEW' 1n UPON 16>U5,0t1G �it: 51 RE: subject: AN9 6-006(-f TO Name: Address: ZiObt;� MfiJ�DdVaV��W �/ APN: ;W_ 45l'07i7i Control/Plan Ck No.: Permit No.: & 0 aNKVToN "Tt 1667 ❑ Inspection of Street Portion of Sanitary Sewer Lateral by the District, Please Do Not Inspect and onsite construction prior to clearance in writing by the District. ❑ Owner to have a Civil Engineer fix the lowest finished floor elevation, with plumbing, to the rim of the next upstream manhole. If the lowest floor with plumbing is less than(1') foot above the rim, a Sewage Pump may be required. ❑ Cupertino Sanitary District Fees or Permits are required for the subject • improvements Please Do Not Issue any building permits. ❑ Plans shall be reviewed by the Industrial Waste Division of the San Jose/Santa Clara Water Pollution Control Plant Phone 945-5121 for questions and to schedule a plan review appointment. Please Do Not Issue permits until pretreatment recommendations have been forwarded to you by the District. ❑ Verify existence and serviceability of an existing backflow protective device. o Break areas authorized minor electrical appliances only. (No commercial disposal or commercial dishwasher installations.) o Other: Storm water form surface or roof drains, other general surface runoff water or condensate form any residential HVAC equipment shall not be discharged to the sanitary sewer. NOTE: Contact CuSD for"OFF-SITE REQUIREMENTS" By: Dunn 7 of 7 .y w.. '.M w .V fk'^" - S � 4,� •t{ -:ya,._„+v.,.o_� _ _ - ... }X 6k� X44 ZP1 �� Yi}�. s.• ' . PERnrT r-166,73 CUPERTINO SANITARY DISTRICT , Santa Clara County 20065 Stevens Creek Boulevard, Building C Cupertino, California 95014 Telephone 408-253-7071 CONNECTION PERMIT / Date APN:'Book Pae Jarccl 07-0- )L' A) ROS/PM/Tract No. Lot No. Cor�Ii ,X11U0 PropertyOwner: ' Mailing Address t /Vt'-/ 4- ),being townmakli (UWehe owner(s)(owners agent),hereby e application for connection of the at. ^kil d�pW.06W �Ji61APr11iN.o 'consisting of Ih'followmg Type of Buildings: Residential: Single Family Dwelling; Multi kmily Dwelling_; No. Units F Commercial ; Industrial Other ; No.Units • Do hereby requests permit to connect the sewer system of the Cupertino Sanitary,District. t IN CONSIDERATION OF THE GRANTING THIS PERMIT, THE OWNER AGREES: 1.To comply with all existing Ordinances,Rules and Regulations of the Cupertino Sanitary District as now or hereafter amended. 2.To maintain the House Sewer that portion of the sewer within private roe �. ( p p p p rty);which includes a serviceable cleanout to grade and accessible located within five feet(5')'of the point of connection with the Lateral Sewer(that portion of the sewer in the street right-of-way of District easement. 3.To acquire a Plumbin Permit from the ITY of �tBuilding Die artment and obtain the required Building Department inspections and approval prior to use. g i p q .4.To expose and inspect for serviceability the Lateral Sewer prior to starting construction of the House Sewer, q,,, 5.That this permit does not constitute a request for the issuance of,an encroachment permit for sewer construction in the- street/public right-of-way of the agency having jurisdiction thereover. 6.To connect to sewer within one(1)calendar year from the date of issuance of this permit. 7.To,call UNDERGROUND SERVICE ALERT(USA �)g�1�800-22ss7'-'2600,,atleast488 hhours prior to starting construction. 8.SPECIAL PERMIT CONDITIONS: __� �►{�/��UIQ K�C(1(U � 1 A BACKFLOW PROTECTIVEDEVICE shall be installed to protect the above property by the owner. Type of device and installation shall comply with the Plumbing Code Requirements of the jurisdiction shown in 3 above. t Fees: . . Serer Service Cparges to Ju e 30,200 No. Units-tt—x$�/month x_�no. months i f/I f)1. (31010) Backflow Protection Device Inspection Fee (31020) Connection Connection Permit Fee: .(31020) . Additional Connection Fees ( ) + Total: Considerations and Considerations of this Sanitary Sewer Connection Permit with attached Exhibits,are hereby agreed to and acknowledged by the undersigned Owner(or Owner's Agent). Failure to comply may result in termination of permit. _ Acknowledgement: _ Owner's Agent: (If Signing fo O ner Please Print Your Name) Receipt'of&166 t :;'O'acknowledged and permit granted. MARK THOMAS.& CO.,IN .,district Manager-Engineer f By. Revised 5/00 NOTE: See Details on other,side of this permit rt TYPICAL CLEANOUT FOR LATERAL SEWER Distance from Property Line to be as close as practicable, a, not to exceed five(5') feet. c J T a Removable Cleanout Plug Ia 0 o_ Finish'Grade Wye for Riser Sewer Cleanout Boz with Lid to be accessible and maintained by property owner. Short length Riser Pipe Adaptor coupling 1/8 Bend �--- FLOW m- Lotera� House Sewer Lateral Sewer slope House Sewer slope determined by District determined by building department —CLEANOUT TO BE SAME SIZE AS LATERAL SEWER— Notes: D • 1. Distance from the property line not to exceed five (5')feet. 2. Property Line Cleanout, Lateral Sewer Cleanout,to be same size as Lateral. 3. The maintenance of the Lateral Sewer Cleanout is the responsibility of the Property Owner. 4. House sewer minimum slope determined by local Building Department plumbing code requirements of the agency having jurisdiction thereover. TYPICAL BACKFLOW PROTECTIVE DEVICE INSTALLATION TYPICAL BACKWATER VALVE TYPICAL KELLY VALVE INSTALLATIONS INSTALLATION dudeeinidnal Raet rictiam Accepted By All Juritaiclions FIGURE I FIGURE 2 FIGURE 3 Mailed Below Grade Inemlled Below Grade Inetallea Above Grade Shown Between Street Right-i0i and Building Shown At Properly Line Cleonaul Shown Adjacent To Building R equine Regular Mainlenante uifleauine Minimum Maintenance Reouirea Minimum Maintenance z Valve To Be Removable Valve Should Be Removable • 2 I VALVE ACCESS BO% FINISH FLOOR wimlVemed Cover o mel at FIN ISM FLOOR KELLY VALVE A. nigh Grade rv4i VALVE ACCESS BO% KELLY VALVE Flnieh Grade Flnieh Grade P F � \ � F BACKWATER ^ ' VALVE FLOW aY FLOW Al FLOW A/ Notes: 1. The Backflow protective device to be located on site in the house sewer. 2. The type, location and installation of the Backflow Protective Device shall comply with the local Building Department plumbing code requirements of the agency having jurisdiction thereover. 3. Device to be accessible and maintained by the Property Owner. 4. If a Kelly Valve is installed at Property Line, it is to be readily removable for Lateral Sewer Maintenance. CITY OF CUPERTINO D REPIPE/SEWERS/MAIN SERVICE cin of CUPERTINO PERMIT APPLICATION FORM APN# ��/ Date: Building Address: 2/ ggS P1&A ,>0w diCw L.N . Owner's Name: Phone#:yo S 60TZ1>V L.L Axacsoni 725-02S'r( Contractor: Phone: (050 ?h9- SL/o_Z License#: S gN9 g 7 -60itorA Wj>- °f4Aja . Contact: Phone: toSo-76t • v Cupertino Cupertino Business License#: �1LL HEENI< Building Permit Info: Bldg ❑ Eleci" ❑ ?Plumb Job Description: Residential -JZL Commer ial ❑ Cost of Project: ©D J�� Qty. if ArWable Fee ID Fee Descn tion Fee Group PPERMITFEE Plumbing Permit Issuance PLUMBING BPREPIPE Re i e of Fixtures PLUMBING BPERMFEE Bldg. Permit Fees BUILDING BPFDCTURE Pbl . Fixture PLUMBING BPWSVCS Main Water Service PLUMBING BPSEWER Sewers PLUMBING BPSEWAGE Sewage Disposal PLUMBING BUSLIC Business License BUILDING z4�33 D i { 04 .p� FEE-17-2004 09: 17 MARK THOMAS CUP 4062535173 P.01i01 r RICT MANAGER-ENGINEER BOARD OF DIRECTORS MARK THOMAS&COMPANY,INC. CURTIS B.HARRISON DAVID E.ROSS JOHN M.GATTO ff10" I S H E� ,9� DR.JOSEPH F BROWN DISTRICT COUNSEL WILLIAM A.BOSWORTH ATKINSON•FARASYN, LLP 20065 STEVENS CREEK BOULEVARD,SLOG.C WENDELL H.KERR,JR. HAROLD S.TOPPEL CUPERTINO,CALIFORNIA 950142350 (408)2537071 PHONE 0 (408)253.5173 FAX File: CuSD• MOP Building Dept. —Cupertino Community Development Department—Building City of Cupertino 1.0300 Torre Ave. Cupertino, CA 95014-3202 Subject: To abandon existing Septic system and connect to Sewer Name: Cordell Axelson Address: 21885 Meadowview Lane APN: 326-45-022 Control/Plan Ck No. Cu SD Permit No. 16673 7 aAe:qe)' Sf • Videotape and Property Line Cleanout inspected. No additional giditionshequirements by the District. Inspector: ..`.:.:�e......�::�s................... Date: ...... '5'� .`� . cc: Homeowner � U� SIIVOI TIN/. 4NiR&el AFWFR&OF SFRVI(FS FOR: Off O/ CUPWINO. PORTIONS OF )NI CIl ES OF S1R&iO Ga, SUNNTVALE, LOS ARDS An SURROUNDING UM XLOR/DRRIFO AREAS TOTAL P.01