00020109APPLICANTTO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILDING - ELECTRICAL. �Y( - PERMIT NO.
BUILDING DIVISION APPLICATION/PERMIT PLUMBING. MECHANICAL.
-- BUILDING PROJECT IDENTIFICATION
BUILDING ADDRESS»SANITARY NO. APPLICATION SUBMITTAL DATE
^7 `1 fX RPllii6e J ,pAa dc- I CvPc12;lriso L� 1G _ 00
DWNER'SN 11� � sZ4S-1'i1o3 CON'I'RACTORS NAME:
�O�r LIC NO:
C N/C CONTROL.»
II ARCHITECT/ENGINEER: LIC NO: ADDRESS: ❑
OFFICE
CONTACT PHONE
BUILDING PERMIT INFO
QWp,rea
❑ Consultant Fees Paid by Applicant(Initial)
BLDhECI' PLUMB MECH
WOOwith
F-00
y u)E,
iDam
LICENSED CONTRACTORS DECLARATIONQTY.
1 hereby affirm Thal I am licensed under pon.mo.s of Chapter 9 (commencing
Section]000) of Division 3 ofthe Business and Professions Cale. and my license is
in fueffect. ll force and effe
License Class
Cmar ECrr
ELECTRIC PERMIT FEE
]OB DESCRIPTION
RESIDENTIAL:
❑S WL ❑KRCHEN REMODELaUU
ITION ❑PLUMBING RE -PIPE
PERMIT ISSUANCE
APPLIANCES - RESIDENTIAL
v
F.7m
Oun>
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to F -O
y�;
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C. U
OF
Jct
ARCHITECTS DECLARATION
I m nano nd my plare shall bo iverl. ahliu records
PANELS
UP TO 200 AMPS
MULTI -UNIT ❑STRUCURAL
MODIFICATION
EPAIR
[I INTERIOR ❑SWIMMINGNEY POOL
IMPROVEMENT (]SWIMMING POOLS
[I BATH RCMODEVItEI'AIR (] DEMOLITION
ElOTHER
Licen+ed Professional
OWNER -BUILDER DECLARATION
1 hereby affirm amt I am exempt form the Contmemrs License Law for the
fallowing mason, (Section 703).5, Business and Professions Code: Any city or countySIGNS
ermit m which requires a pconstruct, alter, improve, demolish, m repair tiny stmcmre
prior to its issuance, also requires the applicant fa such perminn file a signed alinementSPECIAL
201-100OAMPS
OVER I(KKIAMPS
ELECTRICAL.
CIRCUIDMISC.
ray
LL CIO
X o
that he is lbpuren
vnved vn In theth visionsof the Contractor', Licensu latw(Chapter 9
(commencing with Section 91100) of Division 3 of the Business and Professions Cade)or
that he is exempt therefrom and the basis for the alleged exemption. Any violation of
TBAIP.METERORPOLEINST. S
COMMERCIAL
[I NEW RLD(EADDITION ❑ DEMO1.1'1'ION
POWER DEVICES
w^y
F -=O
F
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
t more than five hundred dollars ($501).
0?1, as owner of the progeny, or my employees with wages as their sole compensation,
will do the work, and thesuucmre is not intended malfbaed for We(Sec.]044. Business
[]TENANT❑FOOD SERVICE
IMPR VEMENT
SWIMMING MCI. ELECTRIC
I'd
C
ad Professions Gale: The Contractors 1 icense Inw does not apply m an owner of
property who buildx or'unpmves thereon, and who does slech work M1intmlf or through
his awn employees, provided that such improventonts &a not intended or offered for
Of1TLEf5-EWITCHP.S- FIXTURE .
f
NEW RESIDENTIAL ELIiCM SQ PI�I IIsli
RAREA
$/SQ. FTweer-builder
sale. If,however, the building or improvement is sold within one year ofcncephaion,the
�I
will have the burden of proving that he did not build or improve for pur-
farm of sale.).❑ 1, as owner of the property, am exclusively contracting with licensed contractors to
` �.
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construct the pmject(Sec.91WI, Business and Profession, Cak:) The Contractors Li-
cam Lave tadoes not apply man owner of prop
perty who builds or immveadereon,end
- 1
Q'rY. r PLUMBINGPEA T FEE
who contractsfor -such projects with aamtractons) licensed pursuant to the Contactors
-
PERMIT ISSUANCE: I res
Liccrre Law.
E]I an, c Sec B & P C for this reason
nwa. a
ORKERS COMPENSATION DECLARATION
ALTER - DRAIN &VE NT -W A RyEA]
VALUATI N
l l �72v
BACK FLOW PROTI (7L DEVICE
1 hereby affirm under penahy of pc jury one of the following declamatns
DRAINS- FLOOR, ROOF, AREA, COND.
❑ I have and will maintain a Certificate of Consent to self -insure for Worker's Compen-
fownce of the
sation, as provider] for by Section 3900 of the Labor Code, for the perm
STORIES
TYPE CONSTRUCTION
work for which this permit Is issued.
FIXTURES - PER TRAP
Fl I have amd will innimmis Worker's Gompco'noon Imurmi m required by Section
3700 ufthe Labor Gale, for the perfnrmanceof the work for whiehthis permit is ism ed.
My Workers Compensation Insurance carrier and Policy number am:
Cameo: Policy No.:
GAS -EA. SYSTEM -I INC. 4 OUTLETS
OCC. GROUP
APN
� /
3�'1 �1 {/��
GAS- EA. SYSTEM OVER 4I EA)
CERTIFICATE OF EXISIPTION FROM WORKERS'
COMPENSATION INSURANCE
(this section need not be completed if the permit is for one hundred dollars ($100)
nr Ie,i.)
OREASE/INDUSTRL WASTE INTF,RCEP Cut
BUILDING DIVISION MES
GREASE TRAP
PLANCHECK THE
SEW Hµ -SANITARY -STORM EA. 200 Fr.
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I certify that in l he ish-inmanwof the work fur whichthia permit is ixsrad, Isbell
not employ nn in y mevnu xo ox a M1cen�ygs b Workers Compete
sation Laws /�� U^�e
Applicant
NOTICE TO A .he Worl If. Caen making this vikim, fof Exemption, you should
become subject to the Workers Compensation provisions oethe Lehr Code, you man
forthwith comply with such provisions or this Permit shallhdeemeJ revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that is a construction lending agency for the perlinrmanee of
the work for which this permit is issued (Sce. 3097, Co. CJ
lenders Nanta
ENERGY FEE
WATER HEATER WIVIiNT/ELELTR
WATER SYST[M/1'RPATING
GRADING ME
SOILS FEE
Wp'TEµ SERVICE.
PAID
'\\ Date Receipt#
NEW RESIDENTIAL I'I,MB. SQ. 1t
TOTAL:
lenders Address
r Ar . nn
BUILDING FEE 8�
1 codify that I have read this application and state that the starve information is
correct. l agree to comply with all city and county oNinanas and state laws relating it)
building construction, and hereby authority representatives ofthis city to enter upon the
..
QTy. MECHANICAL PERMIT`/ ,' EFy'•
r .�
S ISMFE
IC E
/
abm
ovo-eminned prom xevperty fill inspection Tartaric,
(We) after e, 'mderni ty and keep harmless the City of Cupmoral
V�
PERMIT ISSUANCEertino
EEE✓ IC F.
/
OR ADU'1G MP.CIj.
r
Ptiu (N FF.g
liabilities.judgmcnts,croslxandexperms which may in anyway arerueaguinsl mid CityALTER
nmquenceofthegrantingofthispernnit.
AIR HANDLING UNIT GO 10,060 CFM)
/,,;
EQIeN19AL TIT.
APPLIC NI RSTANDS AND WILL COMPLY WITH ALL NON -POINT
SOU T T
AIR HANDLING UNIT (OVER 10,001 CFM)
CONSTUCTION TAX
Z n 1000
'U
Signal dpplicant/Commctor Date
I IAZ RDOUS MATERIALS DISCLOSURE
EXHAUST HOOD(W/DUCT)
HOUSING MpGGyG ION FEE
H HA'L'ING UNIT (IT) I00J00 BTU)
Will the applicant or furore building occupant store or handle ha'enrdrm+ material
as defined by Che Capenina .Municipal Gv1e, Chapter 9.12, end the Health and Safe,,
Code. Section 25532(a)1
HEATING ON]] (OVER 1110,1100 BTU)
❑Yee �No
Will the air commitments
tee futurnts a building try the p use equipment or devices which
emit hazardous air contaminants os dellned by the Ray Area Air Quality Management
Dlsuictp
E] ye, tyF"�/
"
PAID
Dale Receipt#
VENTILATION FAN (SINGLE RESOD)
BOILER -COMP LBIP OR 100,000 BTU)
TOTAL
HOILER-COMP (OVER 101,000 BI'U)
AIR CONDITIONER
I have raW the hmumous materials enryirements under Chapter 6.95 of the Cali-
ISSUANCE DATE
NEW RESIDENTIAL MECH. SQ, FT.
fomiC Health & bony Cade, Sections 25505. 25533 and 25534. 1 understand that if the
building t -tiny have a leaned, that it is my responsibility m notify the occupant
o
of there s he met poor m issuance ofa Cerific9mnf(160ncy.
Engen q11��-ggOO %�uJJDam
ISSUED BY.
Ownerm
TOTAL:
OFFICE
O
(`•.pTHE CoNRADoiP
CUSTOM•BUILDERS I
February 1, 2000
Joe Antonucci
Building Official
City of Cupertino
10300 Torre Ave.
Cupertino, CA 95014
RE: Hart Residence
7985 Rainbow Drive
Cupertino, CA 95014
Dear Mr. Antonucci,
On January 29, 2000, I inspected the subject residence's two non -permitted
additions. These consist of a breezeway converted to a laundry room and a
bedroom addition.
Mr. Hart provided me with pictures of all phases of the construction, including
• foundation, framing, rough plumbing, and electrical wiring. Combined with my
own visual inspection, I found no violations of the Uniform Building Code. The
work was done in a professional manner and obviously, with a great deal of
pride.
The foundation is a standard spread footing, with horizontal rebar. The
structural framing members had relatively short spans. The laundry plumbing
system was operational and in use, as was the heating system. The electrical
plugs were grounded and also being used.
The two additions meet the intent of the Uniform Building Code and have no
visible violations.
. cc: Sean and Robin Hart
14363 SARATOGA AVE
OFFICE: (408) 867-2095
SUITE 206 SARATOGA, CA 95070
LIC. B-575965 FAX: (408) 867-2097
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