26831 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINOLDING-LERCTRI A. PERMITNC...
BUILDING DIVISION APPLICATION/PERMIT PPUMBING-MECHANICAL. �L<O 1p� �l
BUILDING PROJECT'IDBNTIPICA'1'ION O
BUILDING ADDRESS:(` �J //� 173 �r � \/J , O SANITARY NO, APPLICATIONSUBMITTALDATE
2�/ L4�� �e• — UNIT# S LOT It
OW ERS NAME: ��HQ/ryp CON RACf '$ LIC NO:
Og / /9^ 1 N/C CONTROL#
�ARCIII I ECUUJxGINEER: / D LIC NO: ADDRESS: ❑
FD --
PHONE:
QTY. ELECTRIC PERMIT FEE BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
PERMIT ISSUANCE ❑ ED El
LICENSED CONTRACTOR'S DECLARATION APPLIANCES-RESIDENTIAL TOB DESCRIPTION
Metz affirm that l am licensed under provisions of Chapmr 9(commencing with
t 00 of Division 3 of the Business and Professions Code,and my license is in PANELS
F ellen. UP TO 200 AMPS
a
FZ Ws Lia#
y<yContractor 201.1000 AMPS
z On'LZ, ARCHITECTS DECLARATION OVER 1000 AMPS, SQ.FT.FLOOR AREA $/SQ.FT.
0 z—A I undersand my pWns shall ba used as public records.
v�F; SIGNS ELECTRICAL
4a�dd Licensed Professional
Ray Q OWNER-BUILDER DECLARATION SPECIAL CIRCUIT/MISC.
O U I hereby affirm that 1 am exempt from the Contractor's License Law for the
W 30th following mason.(Station 7031.5,Business and Professions Code:Any city or county TEMP.METER OR POLE INST.
m J which requires a permit to maximal,slier,improve,demolish,or repair any structure
} prior,.its issuance,also requires the applicant forsuch permit to file aligned statement POWER DEVICES
OOthat he is licensed pursuant to the provisions of the Connector's License Law(Chapter
W 9(commen' with Section 7n00 f Division 3 of the Business and Professions Cade SWIMMING POOL ELECTRIC
o (commencing )o ) VALUATIONS
ly�y Sectionor that 7131.5 by
yapplimandrtPecisfor abject.thedexempti to civiny l pinion of OUTLETS-SWITCHES-FIXTURES
F } ur1`01lvI n by any apdmlltfur apernit aubjecu the applicant eeivil penalty of
no than five hundred dollars($500).C NEW RESIDENTIAL ELECTR S .Pf.cop scantproperty,ormyemployceswithwegce aztheiuolecompeneadon, Q STORIES 'TYPE CONSTRUCTION
i rand
dothe work,and the structure is not imandedoroffind forsale(Sea.That Business
Professions Cele:The Contrctors License Law does not apply to an owner of
perty who builds or improves thereon,and who does such work hirrselfor through hie
employees,providedthatsuchimprovementsarenotimendedoroffcmdforsme.If, OCC.CROUP RES.UNITS
however,the buildingor improvement is sold withromm yearo(completion,theowner- - TOTAL:
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑ I,as owner ofthe property,an exclusivelyconnecting with licensed commensals, QTY. PLUMBING PERMIT FEE FLOOD ZONE APN
construct the project(Sec.7t ,Business and Professions Code)'Me Contractor's PERMIT ISSUANCE
License Law does not apply to an owner ofpmNmy who builds or improves thereon,and
who contracts forsuch projects with acontracmre)licensed pursuant mine Contractor's ALTER TER(BA)License Law. FEE SUMMARY
❑ 1 am exempt under Sec. ,B&PC for this reason BACK FLOW PROTE EVICE OUTSIDE FEES
SANITARY Y—N
—
Owner Dare RECEIPT a
DRAINS-FLOOR OF,ARPA,COND.
WORKMAN COMPENSATION DECLARATION SCHOOLTAX Y N
❑ Iherchy effvm thmlhuvenrerificam ofconsem ao self-insure,ora ceni0ca[a of FIXRECEIPT#
Workers'Cmatunsatior lnsuranceoracertifiedcop,therenf(Sec.3800,Lab C.)which TURES- RTRAP PARK FEE Y—N
—
caverns all employee's under his permit. GAS .SYSTEM-1 INC.4 OUTLETS RECEIPT#
Policy# BUILDING DIVISION FEES
Company GAS-P.A.SYSTEM-OVER 4( PLANCHECK ME
❑ Certified copy is hereby famished.
❑ Certified copy is pled with the city inspection division. GREASF/INDUSTRLW EPTO GRADING FEE
CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE TRAP SOILS TLE
COMPENSATION INSURANCEis
(This section need walls,completed lithe Permit is forams hundred dollars($IOU SEWER- Y-SjrTIJZWPE. ENERGY FEE
or Imes.)
Icertify Bonn.the performance of the work for which this permit is issued,l shall WA .RW/VHR
not employ any perwn in any manner so as to become subject to the Workers' PAID
Compersmion Lawsof Califomia. Dam WATER SYST /IRFATING Date Receipt
0 z Applicant
NOTICE TO APPLICANT:If,eBer making this Catifcate of Hxemption,youshould NEW RESIDENTIAL PLMB. SQ,FT. OTAL:
Ln hecomasuhjsct to the Worker's Compensation Provisions of the Labor Code,you mus[
forthwith comply with such provisions or this permit shun be deemed revoked BUILDING FEE
W
CONSTRUCTION LENDING AGENCY SEISMIC ME
z
^a I hereby affirm that there is a construction lending agency for the performance of TOTAL: ELECTRIC FEE
V O the work for which this permit is issued(Sec.3097.Civ.C.) Z.
Leader's Name
0 U lender's Address QTY. ECHANICALPERMIT FEE PLUMBING FE-
1 certify that I have read this application and site that the above information is
W correct.I agree to comply with all city and county ordinances and slate laws relmn,an P MIT ISSUANCE MECHANIC
En buddingeons[ruction,and hereby authorize representatives ofthis city literacy upon the CONSTR AX
V Z above-mentioned property for inspection purposes. ALTER OR ADD TO MECH.
(We)agree Ir save,indemnify and keep harmless the City �{,aopffqt�dA
liabilities,' gmems astsandexpensesw ichmayinanyway 'fsp#4d AIR HANDLING UNIT('1'O UL"CFM)
in cons en egranting of thio '1. —
AIR HANDLING UNIT(OVER 10,000 CFM)
SigaiLliFempplicintsCormacton Data EXHAUST DODD(W/DUCD PAID
IIAZARDOUSM ALSDISCLOSURE HEATING UNIT(TO 100,000 BTU) Data Re ipt#
Willthe epplicum or fuwre building occupuntamre or handle z loos material HEATING UNIT(OVER InO,OW BTU) TA :
as defined by the Cupertino Municipal Cade,Chapter 9.12,endth eallhand5afety
Collo,Senior x)7
Yes ❑No
VENTILATION FAN(SING LE REBID)
❑Yes
BOILER-COMP QHP OR 1 W,000 BTU) ISSUANCE DATE
Will theapPlicant orfmure buildingoccupant useequipmem ordevices whichemit P
beurdoas ah contaminants as defined by the Bay Area Air Quality Management BOILER-COMP(OVER 100,(M BTU) t
Dindm7
❑Yes ❑No NEW RESIDENTIAL MECH SQ.FT. 'AUG
UG -4 1994
I have read the hazandous materials requirements under Chapter 6.95 of the FJI� 1 a^p `
California Health&Safety Cade,Sections 25505,25533 and 25534. 1 undersand Oat
lithe building does not cumemlyhove nm CITY 1
rant,that it is my responsibility tonality the V I Ur UUrr�Id�jply
cupant of the requirements which must be met prior to issuance of a Certificate of
Occupancy.
Owner oradhorized agent Data TOTAL: ISSUED BY: V W 1 1
OF 1
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' NOISIAIO NOI1O3dSNI
ONIld3dno d0 Alio
(�il.c of
Cupertino
10300 Torre Avenue
Cupertino, CA 95014
Building Division
(408)777-3228
Fax (408)777-3333
September 26, 1995
Ernesto Yamez
8173 Presidio
Cupertino, CA 95014
Subject: 8173 Presidio, Permit# 26831
Dear Mr. Yamez,
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
11unted ort Recycled Freer