30315 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTIN0 BUILDING-ELECTRICAL PERMIT NO. 0
BUILDING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL
BUILDING PR1I,IECI'IDENTIFICATION
BUILDING ADDRESS SANITARY NO. APPLICATION SUBMITTAL DATI
OW :S NAME I'HON CONI O '- ME: LIC NO: /
�'�AiNO v fi �� �d /19y � �O N/C COOC
iCT/EN L ADDRESS;
C //fig PHONE: BUILDING PERMIT INFO
P u/�/ ��/�1I ❑ Consultant Fees Paid by Applicant(Initial) BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION` QTY ELECTRIC PERMIT FEE
I hereby affirm that 1 nm licensed under previsions of Chapter 9(commencing JOB DESCRIPTION
CMZ with Section 700B.I'Division 341he Business and Pmfessinds Cade,and my license is
0,0- in PERMIT ISSUANCE FDWL [I KITCHEN REMOUEI.
full farces effect.
�UU License Class LiaN APPLIANCES-RESIDIEsTIAL ADDITION ❑PLUMBING RE-PIPE
Ga Date Commaor
Fly ARCHITECTS DECLARATION PANELS EI MULTI-UNIT (:]STRUCTURALZO $ I undersand my plans shall records MODIFICATION
O - h used.,public ZUPTO 200 AMPS [I INTERIOR El CHIMNEY REPAIR
F.tri 6q Licensed Profeasiunnl 201-1000AMPS IMPROVEMENT
J OWNER-exempt our the RATION OVER IWOAMPS ❑BATH REMODEUREPAIR ❑DEMOLITION
Q L hereby.(firm that 1 am exempt Business an the Convenor's License Law,for me
v following Haamm(Sea to construct,alter,
Profusions Code:Any city or county SIGNS ELECTRICAL ❑OTHER p
tfuv R. which requires a permit m convect,aacq improve,demolish or repair any structure
E LyO
thatTmlin@capplicant permit signed nSPECIALCIRCUIT/MISC.
t he islicensed amount totheprnvilinr.fthc Cmdrino'v License aw(Capboi)
GC (commencing wiNSection7")of Doixion3ofthe Businessand Pmfessinns CARDar TEMP.METER OR POLE INST.
Q.p,M dor he is exempt thertfmm and the basis for due alleged exemption.Any violation e( [INEW BLDG/ADDITION ❑DEMOLITION
ikC1
Section 7011,1 by any applicant for a pemuitsubjecu the applicant to o civil pcnaltyof POWER DEVICES f',) OD SERVICE
not more than five hundrtddollam($500), F {f1"Cf111Y!'.�
C ❑I,us nwnerof the pngxny,onny employees with wages turheir sole cnnpenintion. SWIMMING POOL CLEM RIC
will do the work,and the structure is not intended or offered furmle(Sec.]614,Nosiness ❑OTHER
and Professions Cade The Conductors License law does not apply m an owner of OUTLETS-SWITCHES-FIXTURES /
propery who builds or improves queen.and who does such work himulf or through
his own empinyws,provided Nat,sell reprevemetns arc not intended ce offereA for NEW RRSIDEMGAL ElECTR SQ FT.
sale.If,however,the building nrimprovcmrntis sold within one year of completion,the SQ.T.FLOOR AREA EI$Q.PT.
owner-builder will have rhe blamed of proving that he did not build or improve outem. w T�
pose of sale.). t, Will
❑ 1,as owner of Ne property,am exclusively contracting with licensed contractors to
construct the project(Sec.7046,Business and Rofessions Code:)Thc Convenors Li
-
eneelawdoesnorapplytaanuwnerofproperty who hold,m improves thereon,and QW,, PLUMBING PERMIT FEE
who contracts for such projects with a commemr(s)licensed pursuant m the Contractor's
License U. - PERMIT ISSUANCE
1 am,xempt under Sec. .B&P C for this reason
Owner Date ALTER-DRAIN&VENT-WATER HLA) VALUATION
WORKER'S COMPENSATION DECLARATION BACK FLOW PROTECT.DEVICE01
5�
1 hereby action under Penalty of perjury one of the following declarations J"`000�� (033
I have and will maintain a Certificate of Consent to self-inaure for Worker's Compen. DRAINS-FLOOR,ROOF,AREA,COND. STORIES TYPE CONSTRUCTION
,afire,as provided for by Station 37W of the labor Code,for dic performance of rhe
work for which this permit is issued. FIXTURES-PER TRAP
❑1 have and will maintain Worker's Cnmpens.don Insurance,as required by Section
37M of the Lahr Code,for the perfomanee of the work for which this permit is issued. GAS-EA.SYSTE10-IINC.401-TLFTS OCC.GROUP APN
My Worker's Compensation Insurance currier and Policy number are:
Carrier. Policy Neu: GAS-EA.SYSTEM OVER 4 HA,)
CERTIFICATE.OF EXEMPTION FROM WORKERS'
-
COMPENSATION INSURANCE GREASMISDUSTRL WASTE INTERCEPTOR BU VISION FEES
(This 1coinues.d me beoompleted Rise permit is for one hund,MdollimOSIW) GRFASCTRAP
or less.) - PIANCHEAKFEfl
Lcenify that indoperform.ed Newark Ro hich thopermit is issued,i shall s, witsm
SEWER-SANITA0.Y-STORM EA
not PI'.
not employ any person in any manner so as to become subject to the Workers Co.,.-
OZ sadmn lawsof CalifomiaDam
WATER HEATER WNFNT/ELECTR
ENERGY FEE
Q
Applicant GRADING FEE
N NOTICE TO APPLICANT.If,after making this Cenificam of Exemption,you should WATER 5YSTEMII'RHATING
become,ohject to the Worker's Cnmpcnaatime provisions of the Labor Civic,you must SOILS FEE
WW forthwith comply with such provisions or this permit shall be deemed revoked
WATER SERVICE
Q 7z CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMB. SQ.FT. PAID at, M
L) 0 I f r whichhy
that there is s ed(Socl TI .Cil
agency forthe performance of
{la t•+ the work for which this permit is Issued lSec.3W].Cie C.)
0 Lender's Nome TAL:
Lenders Address T A
y I lenity that I have Hand this application and nam thauhe above infmtwtion is BUILDING FEE
V) correct l agree to comply with all city and county oubsonas and state laws relating to QTY MECHANICAL PERMIT FEE
.0 building eon,minion,end hereby umhnrizercpresentmives mfthis city to enmrupnn the SEISMICFEH 0
above-meminned property]or inspection purposes. PERMIT ISSUANCE
(We)egreea.save,indemnify and keep batmless the City of Cuperttno against ELECTRIC i
liabilities.judgmenu,costs and expenses which may in any way twerueagaimt said City ALTER ON ADD TO NIECE.onseqen
in uce of tloaning anting of this pemuit. PLUMBING :E `
APPLICA PUNDERST ND. N WILT.COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO l0,01XICFM)
MLCHANICAI.FE
SOURC EGULATION . 77
r /U ZAIR HANDLING UNIT(OVER 10,000 CFM) CONSTRUCfiO AX
Signalt afApplicanVCommm Data EXHAUST HOOD(W/DUCT) HOUSING MITA FEE
HA7AR MATERIALS DISCLOSURE
Wllhhe opplicunt lar fm Mnliingwenpere noreorhandlehe...do.romrial BEATING UNIT TO IIN0,0(q BTU)
as defined by the Cupertino Municipal Cole,Chapter 9.12,and the Health noel Safety
Cod.,Section 25532(.):' HEATING UNIT(OVER 109,0011 BTU)
❑Yes FIN. VENTILATION PAN(SINGLE RESID) PAID
Date Receipt p pa
Will the applicant or future building occupant use equipment of devices which
nit hazardous air rnnaminnnts as defnod by the Bay Arca Air Quality Management BOILER-COMP CHP OR 100,000BTII) i
'TOTAL:
ustnmC]Yes nNo BOILER-COMP(OVER 109,000 BTU) Y
I have read the hoarded,matedoLs AIR CONDITIONER ISSUANCE DATE
requirementsunder 1 understand
if
fomes Health A,Sidney Code,have
tens 255115,is my sin 255341 i ndersmnd mm if the NEW RESIDENTIAL MCCH. SQ.Fr.
building does not duren0y hove a tenant,that it is my rcapmsihility m notify the occupier
of the tequiremmxas which must be met prior to tomer ce mf a Certiicane of Occupancy.
Owner tar authorized agent Dale I
t'N-V ISSUED BY:
OFFICE
Inspection Query for a Specfic Permit 1/13/98
PERMIT#: I,TU$sSTs SITUS STREET Lot# INSDESCRIP�T Ins "DATEDESIREt U'ateDorie
• 30315 10251 PRADO VISTA UNDLIF PLBG 11/25/96 11/25196
30315 10251 PRADO VISTA MECH 11/25/96 11/25/96
30315 10251 PRADO VISTA UNDRFL E H 11/27/96 11/27/96
30315 10251 PRADO VISTA UNDRFL FRAME 11/27/96 11/27/96
30315 10251 PRADO VISTA UNDRFL FRAME 12/2/96 12/2/96
30315 10251 PRADO VISTA UNDRFL MECH 12/2/96 12/2/96
30315 10251 PRADO VISTA UNDRFL PLBG 12/2/96 12/2196
30315 10251 PRADO VISTA UNDRFL INSUL 12/3/96 12/3/96
30315 10251 PRADO VISTA UNDRFL INSUL 12/4/96 12/4/96
30315 10251 PRADO VISTA ROOF 2/5/97
30315 10251 PRADO VISTA EXT SHTRK NAIL 2/5/97
30315 10251 PRADO VISTA R FRAME 3/7/97 3/7/97
30315 10251 PRADO VISTA R PLBG 3/7/97 3/7/97
30315 10251 PRADO VISTA —&ELECT T 3/7/97 3/7/97
30315 10251 PRADO VISTA R MECH 317/97 3/7/97
30315 10251 IPRADO VISTA SEWER/WATER CON 3/7/97 3/7/97
30315 10251 PRADO VISTA INSULATION 3/13/ 7 3/13/ 7
30315 1 251 PRAD VISTA TUB/SHOWER PAN 3/19/9 3/19/ 7
30315 10251 PRADO VISTA SHTRK NAIL 3/24/97 3/24/97
30315 10251 PRADO VISTA EXT LATH 3/24/97 3/24/ 7
30315 10251 PRADO VISTA CRATCHCT 3/27/97 3/27/9
30315 10251 PRADO VISTA SHOWER LATH/2 4/30/97
30315 10251 PRADO VISTA CRATCH COAT 5/l/97 5/1/97
3 315 10251 RAD VISTA —GAS TEST 9/9/97 /9/97
30315 10251 PRADO VISTA ELECT-F 9/15/97 9/15/97
30315 10251 PRADQ VISTA P B -F 9/15/97 9/1 /97
•
30315 10251 PRADO VISA ME -F 9/15/97 9/15/97
30315 10251 PRADO VISTA BLDG ENERGY FINAL 9/15/97 9/15/97
30315 10251 PRADO VISTA —BLDG FINAL 9/15/97 /15/97
30315 10251 PRADO VISTA PLB -F 9/18/97 9/18/97
30315 10251 PRADO VISTA BLDG-F 9/18/97 9/18/97
30315 10251 PRADO VISTA MECH-F /18/9 /18/97
30315 10251 PRADO VISTA ELECT-F 9/18/97 9/1 /97
I
•
Pagel
Inspection Query for a Specfic Permit 1/13/98
• In. 1p E o j H-MI.IRW IFe11 Code
B 2F
B N
D 2
D 2F
cc 1P
CC 1P
CC 1P
D 2F
S 2P
D 2P
D 2P
D 2P
D 2P
D 2P
O 2P
O P
S 2P
2P
O 2F
D 2P
D P
O
D 2F
D 2F
• D F
D 2F
D F
D 2P
D 2F
D 2P
D 2P
•
Page 2
10300 Torre Avenue
• (/'t` 1, Cupertino, CA 95014
Cupertino Building Division
S' (408)777-3228
(408) 777-3333 (fax)
March 20, 1998
Homeowner
10251 Prado Vista (Granny unit)
Cupertino, CA 95014
SUBJECT: Permit 9 30315, Permit for building of Granny Unit
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 finaled 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.
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 dispose of the file and remove the records from our computer.
Thank you for your assistance.
Sincerely,
CITY OF CUPERTINO
Christy Akatiff, Administrative Clerk
Printed on Recycled Paper