28528 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
Y OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO.
'✓" IUILDING DIVISIONAP LICATION/PERMIT PLUMBING-MECHANICAL28528
p-' 1BUILDING PROJECT IDENTIFICATION "
DINGADDRESS: SANITARY NO. APPLICATION SUBMI'ITAL DATE
O Ll
AIL
T7 3b/
IER'S NAME: PHONE CO RACTOR'S NAMC: .�s� LIC NO:
Aysto
B G sus/L�I� NIC C( Ol.tt
..HITECI'/ENGINEER: LIC NO: ADDRESS: ❑
Z8 /V/o /.Yl M
or4TALT. PHONE: BUILDING PERMIT INFO
❑ Consultant Fees Paid by Applicant(Initial) BLDG , ELECT PLUM ECH
LICENSED CONTRACTOR'S DECLARATION QTY. IiI,CCTRIC PERMIT FEL?
1 hereby affirm
Nat I ani licensed under provisions or Chapter 9(commencing JOB DE$CRI ON
�QWZ wish Section 7")of Oiviaooa3 of the Business and Professional Code,and my license is
0 0 in full force and effect. PERMIT ISSUANCE RESIDENTIAL:
EM
���''''
IU t' License Class Lie.all ❑SFDWL ❑KITCHENRODEL
LF.. R�
Data Connector APPLIANCES-RESIDBNTIAL ❑ADDITION ❑PLUMBING RE-PIPE
I,,�m ARCHITECTS DECLARATION PANELS ❑MULTI-UNIT ❑STRUCTURAL
Z O P1 Zk, 1 understood my plans shall be used as public records MODIFICATION
O z UP TO 200 AMPS
TVI -C ❑INTERIOR El CHIMNEY REPAIR
gj Licensed Professional 701-1000AMPS IMPROVEMENT
pW, that I a exempt ER m Ce Conti ON' OVER 1000AMP$
xy�0.�� 1 herby affirm um I am exempt from the Contractors License Lew for me ❑BATH REMOOBVREPAIR ❑DEMOLITION
W 3 tL U following reason.Sodium 7031s.Business and Prnlessions Cale:Any city or county SIGNS ELECTRICAL ❑OTHER
F.LL.O which requires a permit to conswcr,alar,improve,demolish,or repair any snacmre
snsit Prior to its issuance,also rcgnirealoe applicant for such#nonan file atmement SPECIAL CIRCUIT/MISC. �J
y ourommislice with
Ne of Division 3 the eBusin ss License loons Could or
GAO that he is exempt
pth Section and
basisun3Mshe Business and Professions Could or TEMP.METER OIL POI.Ii INS'(. COMMERCIAL:
q m C oboe he is exempt therefrom and the basis for the suballjects
the exemption.Any violation ly of ❑NEW BLDG/'ADDIT`^IO/N.y,❑#RTD:E�7MOLITION
a.'SacMm
than
7031.3 by any
undredicamrs($50for a Permit subjects the applicant toe civil penalty of )WGR DEVICES OIMPRO I, 6� ,• _
u] r� nm more than five hundred dollars(SSIX).
^ Q ❑1,es owner of the popeny,or my employees wish wages as weir so"cnmp"unim" SWIMMING POOL ELECTRIC IMPROVE
will du the work,anJ the swcwre is not imm�deJ ororf,red
for sale(Sec.](144,Business ❑OTHER
and Professions Code:The Convacmr's License Law does not apply m an owner e( UTLETS-SWITCHES-FIXTURES
property who but Ids(it improves thereon,unit who does such work hrmxlf or through -�
his own,mployecs,provided Nat such improvements are not intended or offered for DRPDGAL ELIiCTR SQ Fr.
art.If,howevenue buildingor improvement ie sold within'one year of completion,the SQ.FT.FLOOR AREA $/SQ.FT.
owner-builder will have Ne burden of proving that he did two build of impose for par.
pox o .).
1 [1'L as f solaowner of the progeny,am exclusively connecting with licensed commute.m
cox" the
project(See
.IT Businessand Pmfessomns Cod,:)The Cn.....
ceas'a Bow d......
s not applymnn owner ,P_progeny whobuiW.aorimprovex[bureau. it QTY, LUMBING PERMIT FEE
whocomirwG fmmch pmacha wish no
contnnogs)licensed pursuant to the Cantracmts �®
License Law. PERMIT ISSUANCE
/ ❑I em exempt under Sec. ,B&P C for this reason
Dote ALTER-DRAIN&VENT-WATER(E.A) Giss as VALUATION
-t WORKF..R'SCOMPENSATIONDECLAItATION BACK FLOW PROTECT.DEVICE
ef8rm ander Cwific of perjury ane of Ne fnsumfi)g d eclat inns:
a)Iha as
rlfur bynetion 37M ofComm�nnCarteinsure forerrnrthou Compen- DRAINS-FLOOR,ROOF,ARE CON
eon,nt pvvidd for by Section JlW of Ne Tabor Cade,for the p:rfomance of the, STORIES TYPO CONSTRUCTION
w h far which itis Permit is isxed. FIXTURES-PER]RAP
I have and wll maintain Worker's Compensation Insurance,as required by.Semimn '
3 of the Lasoccal for the performance of the work for which this#emit is issue, GAS-EA.SYSTEM-1 INC.4OTTLETS
My
Works Cmipensmion ncecarrier stet Policy CC> K UPs qPN
Cartier. Policy No:��r-t : GAS-HA.SYSTEM-OVER 4(FA)
CERTIFICATE OF HXIMPDON FROM WORKERS' O
COMPENSATION INSURANCE GREASMNDUSTRL WASTE INTERCEPTORlhajPlIVEW LI N ISION PEES
(Thilworaocadmin Mcnmpleted ifchapemh is for one hundred dollars(S lan GREASETRAP K
or IessJ ,p. GHFFC f I l
Loy any from
in performances as t work for which this thepermitWrkesued,I shallCowpr- SOWER-SANITARY-STORM PA,21X)FT.
nut employ any prxn in any manner so as m became sublevel she Workers'Cowper- ENERGY FEE
,� salion Lows of Glifomin.Date
D - WKI'GR HGATIiR W/VENq'/ELECI'R
os gn
An GRADING FFP.
4 2 NOTICE 0 APPLICANT:IL ager making this visio cae mf Exemption,d you should WATER SYSTFM/TRHATING
k IZ become au ounp m the Worker's Qions or this provi shot of the Labor Cuda you most SOILS FEE
� forthwith complywiu such provisions or this#emit shell4deemed revoked. WATER SERVICE
z CONSTRUCTION LENDING AGENCY NEW RPSIDBNTIALPLMW SQ.FT. PAID
V Q Ihemby nffinn uauhcrc isvconswction lending agency for the performance of Dole Receipt#
{L the work for which his permit is issued(Sec.3119'/.Civ,C.) TOTAL:
p U Lenders Name a
yy U Lenders Admeaa AL.:
L, (� 1 ceni(y ohm I hove reuJ This application unit sec¢Lha the above infomation is BUILDING FEE
(A comet.I agree to comply with aft city and county ordinances and state laws relating to QTY. MECHANICAI.PERMIT FEE
V building construction,and hereby alumina,representatives of this city to enter upon the SEISMIC PCG
move-mentioned property for inspection purposes. PERMIT ISSUANCE
(We)agree to save,indemnify and kcep hamless the Ciry mf Cupertino againn ELECTRIC FEE.
liahilitiex,judgments,c�lb expert^RWhich may in any way accrue against suit City
ALTER OR ADD TO MECII.
inconsequence clueo sp,mit. PLUMBING FIR APPLICANT ON AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT LTO 10,1X10 CFM) MECHANICAL FEE
so CRF',
AIR HANDLING UNIT(OVER 10,0(10 CFM) CONSTRUCTION TAX
Si,.t pyl caMCon=, ' me EXHAUST HOOD(W/DUCT)
A(J HAZARDOUS MATERIALS DISCLOSURE HOUSING MITIGATION FEE
theapplicam or furore building occupaat store or handle hmallous material HEATINGONIT(TOIOO,000BTID
as ]]of ed by uc Cupertino Municipal Cale,Chapter 9.12,unit the Health and Safety
Code,Section 25532(a)'1 HHATING UNIT(OVER IIXI,000 BTU)
❑Yes [:1 No VENTILATION PAN(SINGLE RESID) PAID
Date Receipt#
Wromm.ll the sit contntorfmnre building arhe bayularat use Air nt or Quality
Manages ement
ant BOILER-COMP(3HPOR 100,000BTU)
mil hazallom it contaminants m defined by the Bay Area Air Quality Management TOTAL:
)isaict7
❑Yes ON. BOILER-COMP(OVER 100,000 BTU)
'l have read the hazardous materials requirtmcros under Chapter 6.95 of she C.E. AIRCONDITIONER ISSUANCE
(oris Health&Safely Code,Sections 25505,25533 and 25534.1 ondmanad that if the NEW RL+SIDLN'1'IAL MECfI. SQ.1"f.
building does not cumten
ntly have a ant,that it is my resm
psibilityto built,the occupant
of the requirem,nte which must he met prior to issuance of a Cenoricate of Occupancy.
Owner ter euuorixd
an, Date ISSUED BY;
OFFICE
® f' 10300 Torre Avenue
Cupertino, CA 95014
Citv of
Upei tll10 Building Division
(408)777-3228
(408)777-3333 (fax)
May 8, 1996
Homeowner
22068 Wallace Drive
Cupertino, CA 95014
Re: Expired permit, (copy attached)
Dear Owner:
According to our records, the referenced permit has not 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(408) 777-
3228, so we may arrange to extend your permit and schedule a final inspection.
The City of Cupertino requires a response within ten (10) working days from the date of
receipt of this letter. If we do not hear from you within this time, the building department
will have no other recourse but to resolve your permit as expired and discard the records.
Thank you for your cooperation,
Building Department Staff, City of Cupertino
Printed on Recycled Paper
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
Y OF CUPERTINO BUILDING-ELECTRICAL PERMIT NO.
'✓" IUILDING DIVISIONAP LICATION/PERMIT PLUMBING-MECHANICAL28528
p-' 1BUILDING PROJECT IDENTIFICATION "
DINGADDRESS: SANITARY NO. APPLICATION SUBMI'ITAL DATE
O Ll
AIL
T7 3b/
IER'S NAME: PHONE CO RACTOR'S NAMC: .�s� LIC NO:
Aysto
B G sus/L�I� NIC C( Ol.tt
..HITECI'/ENGINEER: LIC NO: ADDRESS: ❑
Z8 /V/o /.Yl M
or4TALT. PHONE: BUILDING PERMIT INFO
❑ Consultant Fees Paid by Applicant(Initial) BLDG , ELECT PLUM ECH
LICENSED CONTRACTOR'S DECLARATION QTY. IiI,CCTRIC PERMIT FEL?
1 hereby affirm
Nat I ani licensed under provisions or Chapter 9(commencing JOB DE$CRI ON
�QWZ wish Section 7")of Oiviaooa3 of the Business and Professional Code,and my license is
0 0 in full force and effect. PERMIT ISSUANCE RESIDENTIAL:
EM
���''''
IU t' License Class Lie.all ❑SFDWL ❑KITCHENRODEL
LF.. R�
Data Connector APPLIANCES-RESIDBNTIAL ❑ADDITION ❑PLUMBING RE-PIPE
I,,�m ARCHITECTS DECLARATION PANELS ❑MULTI-UNIT ❑STRUCTURAL
Z O P1 Zk, 1 understood my plans shall be used as public records MODIFICATION
O z UP TO 200 AMPS
TVI -C ❑INTERIOR El CHIMNEY REPAIR
gj Licensed Professional 701-1000AMPS IMPROVEMENT
pW, that I a exempt ER m Ce Conti ON' OVER 1000AMP$
xy�0.�� 1 herby affirm um I am exempt from the Contractors License Lew for me ❑BATH REMOOBVREPAIR ❑DEMOLITION
W 3 tL U following reason.Sodium 7031s.Business and Prnlessions Cale:Any city or county SIGNS ELECTRICAL ❑OTHER
F.LL.O which requires a permit to conswcr,alar,improve,demolish,or repair any snacmre
snsit Prior to its issuance,also rcgnirealoe applicant for such#nonan file atmement SPECIAL CIRCUIT/MISC. �J
y ourommislice with
Ne of Division 3 the eBusin ss License loons Could or
GAO that he is exempt
pth Section and
basisun3Mshe Business and Professions Could or TEMP.METER OIL POI.Ii INS'(. COMMERCIAL:
q m C oboe he is exempt therefrom and the basis for the suballjects
the exemption.Any violation ly of ❑NEW BLDG/'ADDIT`^IO/N.y,❑#RTD:E�7MOLITION
a.'SacMm
than
7031.3 by any
undredicamrs($50for a Permit subjects the applicant toe civil penalty of )WGR DEVICES OIMPRO I, 6� ,• _
u] r� nm more than five hundred dollars(SSIX).
^ Q ❑1,es owner of the popeny,or my employees wish wages as weir so"cnmp"unim" SWIMMING POOL ELECTRIC IMPROVE
will du the work,anJ the swcwre is not imm�deJ ororf,red
for sale(Sec.](144,Business ❑OTHER
and Professions Code:The Convacmr's License Law does not apply m an owner e( UTLETS-SWITCHES-FIXTURES
property who but Ids(it improves thereon,unit who does such work hrmxlf or through -�
his own,mployecs,provided Nat such improvements are not intended or offered for DRPDGAL ELIiCTR SQ Fr.
art.If,howevenue buildingor improvement ie sold within'one year of completion,the SQ.FT.FLOOR AREA $/SQ.FT.
owner-builder will have Ne burden of proving that he did two build of impose for par.
pox o .).
1 [1'L as f solaowner of the progeny,am exclusively connecting with licensed commute.m
cox" the
project(See
.IT Businessand Pmfessomns Cod,:)The Cn.....
ceas'a Bow d......
s not applymnn owner ,P_progeny whobuiW.aorimprovex[bureau. it QTY, LUMBING PERMIT FEE
whocomirwG fmmch pmacha wish no
contnnogs)licensed pursuant to the Cantracmts �®
License Law. PERMIT ISSUANCE
/ ❑I em exempt under Sec. ,B&P C for this reason
Dote ALTER-DRAIN&VENT-WATER(E.A) Giss as VALUATION
-t WORKF..R'SCOMPENSATIONDECLAItATION BACK FLOW PROTECT.DEVICE
ef8rm ander Cwific of perjury ane of Ne fnsumfi)g d eclat inns:
a)Iha as
rlfur bynetion 37M ofComm�nnCarteinsure forerrnrthou Compen- DRAINS-FLOOR,ROOF,ARE CON
eon,nt pvvidd for by Section JlW of Ne Tabor Cade,for the p:rfomance of the, STORIES TYPO CONSTRUCTION
w h far which itis Permit is isxed. FIXTURES-PER]RAP
I have and wll maintain Worker's Compensation Insurance,as required by.Semimn '
3 of the Lasoccal for the performance of the work for which this#emit is issue, GAS-EA.SYSTEM-1 INC.4OTTLETS
My
Works Cmipensmion ncecarrier stet Policy CC> K UPs qPN
Cartier. Policy No:��r-t : GAS-HA.SYSTEM-OVER 4(FA)
CERTIFICATE OF HXIMPDON FROM WORKERS' O
COMPENSATION INSURANCE GREASMNDUSTRL WASTE INTERCEPTORlhajPlIVEW LI N ISION PEES
(Thilworaocadmin Mcnmpleted ifchapemh is for one hundred dollars(S lan GREASETRAP K
or IessJ ,p. GHFFC f I l
Loy any from
in performances as t work for which this thepermitWrkesued,I shallCowpr- SOWER-SANITARY-STORM PA,21X)FT.
nut employ any prxn in any manner so as m became sublevel she Workers'Cowper- ENERGY FEE
,� salion Lows of Glifomin.Date
D - WKI'GR HGATIiR W/VENq'/ELECI'R
os gn
An GRADING FFP.
4 2 NOTICE 0 APPLICANT:IL ager making this visio cae mf Exemption,d you should WATER SYSTFM/TRHATING
k IZ become au ounp m the Worker's Qions or this provi shot of the Labor Cuda you most SOILS FEE
� forthwith complywiu such provisions or this#emit shell4deemed revoked. WATER SERVICE
z CONSTRUCTION LENDING AGENCY NEW RPSIDBNTIALPLMW SQ.FT. PAID
V Q Ihemby nffinn uauhcrc isvconswction lending agency for the performance of Dole Receipt#
{L the work for which his permit is issued(Sec.3119'/.Civ,C.) TOTAL:
p U Lenders Name a
yy U Lenders Admeaa AL.:
L, (� 1 ceni(y ohm I hove reuJ This application unit sec¢Lha the above infomation is BUILDING FEE
(A comet.I agree to comply with aft city and county ordinances and state laws relating to QTY. MECHANICAI.PERMIT FEE
V building construction,and hereby alumina,representatives of this city to enter upon the SEISMIC PCG
move-mentioned property for inspection purposes. PERMIT ISSUANCE
(We)agree to save,indemnify and kcep hamless the Ciry mf Cupertino againn ELECTRIC FEE.
liahilitiex,judgments,c�lb expert^RWhich may in any way accrue against suit City
ALTER OR ADD TO MECII.
inconsequence clueo sp,mit. PLUMBING FIR APPLICANT ON AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT LTO 10,1X10 CFM) MECHANICAL FEE
so CRF',
AIR HANDLING UNIT(OVER 10,0(10 CFM) CONSTRUCTION TAX
Si,.t pyl caMCon=, ' me EXHAUST HOOD(W/DUCT)
A(J HAZARDOUS MATERIALS DISCLOSURE HOUSING MITIGATION FEE
theapplicam or furore building occupaat store or handle hmallous material HEATINGONIT(TOIOO,000BTID
as ]]of ed by uc Cupertino Municipal Cale,Chapter 9.12,unit the Health and Safety
Code,Section 25532(a)'1 HHATING UNIT(OVER IIXI,000 BTU)
❑Yes [:1 No VENTILATION PAN(SINGLE RESID) PAID
Date Receipt#
Wromm.ll the sit contntorfmnre building arhe bayularat use Air nt or Quality
Manages ement
ant BOILER-COMP(3HPOR 100,000BTU)
mil hazallom it contaminants m defined by the Bay Area Air Quality Management TOTAL:
)isaict7
❑Yes ON. BOILER-COMP(OVER 100,000 BTU)
'l have read the hazardous materials requirtmcros under Chapter 6.95 of she C.E. AIRCONDITIONER ISSUANCE
(oris Health&Safely Code,Sections 25505,25533 and 25534.1 ondmanad that if the NEW RL+SIDLN'1'IAL MECfI. SQ.1"f.
building does not cumten
ntly have a ant,that it is my resm
psibilityto built,the occupant
of the requirem,nte which must he met prior to issuance of a Cenoricate of Occupancy.
Owner ter euuorixd
an, Date ISSUED BY;
OFFICE
® f' 10300 Torre Avenue
Cupertino, CA 95014
Citv of
Upei tll10 Building Division
(408)777-3228
(408)777-3333 (fax)
May 8, 1996
Homeowner
22068 Wallace Drive
Cupertino, CA 95014
Re: Expired permit, (copy attached)
Dear Owner:
According to our records, the referenced permit has not 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(408) 777-
3228, so we may arrange to extend your permit and schedule a final inspection.
The City of Cupertino requires a response within ten (10) working days from the date of
receipt of this letter. If we do not hear from you within this time, the building department
will have no other recourse but to resolve your permit as expired and discard the records.
Thank you for your cooperation,
Building Department Staff, City of Cupertino
Printed on Recycled Paper