31182 APPLIGANTTQFILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY '' •- '
CITY OF CUPERTINO BUILDING- !LECPRICAL PERMIT NO, 311 L
BUILDING DIVISION APPLICATIONfl-ERMIT PLUMBING-MECHANICAL: J<
BUILDING PROJEC'V IDEN'T'IFICATION
BUILDINGAIIIIRUSS: - tSANITARY NO. APPLICATION SUBMltFAk
60,=
OWNER'S NAME - 1'110NE: I ,(/^ C,O/N/T�RA-IIB SSNMEn+ - .LIC NO. -
�. 11]�• I ,^ .11 kr5 1. _l l •:NIC Cf OLp
ACHITECP/ENGINEER: LIC N0: AV ❑ or
CONTACT: .',PHONE: BUILDING PERMIT INFO
Q Consultant Fees Paid by Applicant(Initial)' PLIHi ELELT P U MECH
❑ ❑ ❑
LICENSED CONTRACTOR'S andeDECLARATION QTY EI:IiCE'RIC PI?RMI'F FEE
I hereby alarm that 1 3 licensed Bu under provision..of Chapter n nfylmrwba1 JOE OESCRI ION
W,FZ with Section i0(Bof 1' `ion Jldthe Business dProfesci"p.Code,upd lay license in PERMIT ISSUANCE
I Ub-- infull peace eRec`` �ulll{I7- Gw1L1J•—C/IIS. DWh ❑KITCHEN REMODEL
TIAL-
HUU Licca Class Linob. .ys APPEANCES-RIISIDEN'fIA1, ' .
FZuI Date 1�Conlrunnr ❑ADDI'T'ION r ❑PLUMBING RI:PIPE
mQq tl�l �� �ARCHI'r F.CTS DECLARATION
PANELS' ❑MUCI'b UNIT ❑STRUCTURAL
Z,
'z
H Z I understand my plans shall be used us public recent MODIFICATION
Z� UPT0200AMPS + ❑INTERIOR ❑CHIMNEY R17PAIR
IacenxeJ Prohssmnal - - 20161000AMPs
OWNER-BUILDER DECLARATION - IMPROVEMENT -•
G q'SSS Q 1 hcrcby'affrm that 1 am exempt from the Contractor's License Law for the - OVIeR I(N10 AMPS ❑ ATH REMODEUREPAIR ❑DEMOLITION
following reason.Election 701 L5,Business and Prepessions Code:Any oily.'county
SIGNS ELECTRICAL f OTHER
-W 3 B•~ which rcyuires a Permit to consamet,alter,improve.demolish,or repair ony,stmc ore
F'�O prinrm its lasuanec.Nao mfiuirex the apPliennt for such pinninn Bhatti 1 tt t • LI�QT e 1
y goer saenten SPECIALCIRCIP UMISC.
y`�p. tom he is licensed Pmammm�re pmvisi..ns idtha Cnmmcuv's License Law(Chapter) - LIJII '�-✓�
Oaf (commencing with Section loco)nf Divisi.a3.f Ne Business and Professions Code)or
l)0 TI?MIt METED OR POLE.INST. OMMER IA
bha be is exempt therefrom and the basis for the alleged exemption.Any vi.lai.n of
.W^ Seetion 7031.56 an applicant for El NEW BLDG/ADDITION ❑DEMOLITION "
Y Y permit subjects the applicant to penuiry nl S M]WIiR DEVICES
not mora then rive hundred Jnllurs($500). ,❑TENANT El FOOD SERVICE?"
F' 6 ❑ I,us owner nllhe property,arm toecs wish wa•ea ox their sole tom IMPROVEMENT
o yimp ) b ,Buss est SWIMMING 1.001,ELECTRIC ❑OTHER - -
willsothework,ande: he Cont isnotLaw doesal not
apply to an Rosiness
Lam tendert who ho Code:The Commcme Licemelawdocsnutrk hirmanowner of Olfl'LETS-SWITCHES-fl%TURES
property who builds or improves to thereon,and who aces such work himself fferedugh ev
his own oweveiem,Provided that such mentis cold w thin not intevdctl or offered the NI3W RESIUCN'1'IAL ELECTft SQ PT
sale.If,however,the have
building or improvement is cold h within one yeah of completion,the
Q.FT.FLOOR AREA LSQ.FT.
owc idsod .).will hove Ne bunko of proving that he did not build or improve for pur-
pose.fsale.).
❑1,as owner of the progeny,urn exclusively contracting with licensed contractors to 'TOTAL:
construct the project(Sec,9144,Business and Professions Code)The Commends 1i: 1
use Lawdoes not apply to an ownerofpropeny who builds or improves Ecome,and QTY. PLUMBING PERMIT PEE 5
who rommeD for sten projects o ith a contracmrEd licensed puove.0o the Contra....'.
License Law PERMIT ISSUANCE -
❑ lumexemptunderSec. ,11&P C for thi'mmonr
Owner AI.TER-DRAIN&VENT-WATER(CA)
Date _ VALUATION
WORKER'S COMPENSATION DECLARATION BACK FLOW PROTECT.DEVICE "
• I hereby affirm under penuhy of perjury one of the following declarations:" .- -
❑ I baso and will mainurin v Comifiemc ol'C.owa loself-imam for Won.,Compen- DRAINS-FLOOR,POOP,AREA.GOND,
san...........idol nor by Section 37N of the labor Code,lot the pert rnance of the S'I'ORIBeDIVISION RUCTION
k for which this permit is issued. FIXTURES-PER'TRAP
SUFI have and will maintain Wnrkcr's Compensaion Insurance,es required by Section
J]fX)of th b°(C/Kle,fm ane rfnrmtnce ofthe work for which thix permit is is.cued GAS-EA.SYSTEM-I rNC.40UTLETS OCC GRO
My Wer re Coal r.tion In rtw raGGG��rrg5AAl���u�and P.lio lyylkBt +C�/n,
Cartier: QIOC^ h11`C Yobby No.: I GAS-EA.SYSTEM-OVER 4IRA)
CHITIFICATEOFf: MPTION FROM WORKERS' -
COMPENSATIONINSURANCE GREASEANDUSTRL WASTE[INTERCEPTOR
(Thio section neW nut M annamed if Ihe.crndt Is for one hundred
d.11ara($11H0 BUILDING
so Ica:) GREASE TRAP PLANCHECK FFE
I rify Neu the Ped nceefda, LIr hch Edificationmuster.Isbelll SEWER SANITARY STORM EA.21q 14.
of employ y period in y n so as to became subject to theW rke. C pent ENERGY FEF. -
,� tion Lt i ofCt panto DateAppli t - .1 WATER 11lor 3R W/VENT ELECTR GRADING FEE
bjaborsWATER SYSTniatrREATING Become mhjea m the Wnder'a Cnmpensminn Pmvisians nllhe Labor CnJe,you must SOILS PEE,
forthwith comply with such provisions or this Permit shall be demned rev..ked. WATfiR SERVICE7. CONST RUCTION LENDING AGENCY' NI3W NESIDEN'1'IAI.PLMB. SU.19'. PAID 'U0 Thereby efhirm thenhereis acnnsw..inn lendingagency lbnhripen.....or. f CCU. ('-' toeworkforhichthis permitis issued(Sec.JIIY],Civ.C) -
0ULendcla Name Lender's Address" - 5' TOTAL //��4 I ccnify that I navcread link d,plicalion and able that Bra shove Information ix IIUILDyy]JI113 ..�
IA commit.l agree to comply with all city and'oomily ordinances and state lawx relating to 'QTY. MECHANICAL PERMIT FIiE
U xZ.a building construction,and hereby authorize representatives of his city to enw,ripon the SPISMIC FEE
above.me.eoncol progeny for notation purposes, e
PERMIT ISSUANCE!
(W) gn t : aande.mfymahi ph sat the CitymCupen u+ Citf. ELECTRIC FIi9 '
incofemanc t ratting ex Pens es whth y' any way creme ego netsaid City -
mcnn Inc to f permi AM ER OR ADD TO MECH, � Q
come,mance granting the t PLUMBING IEEE
SOURCAPPLICE
REGULATIONS.
AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT GO 10,000 CFM) r
SOURCE REGULATIONS. MECHANICAL FEE '
-
Alit HANDLING UNI'1'.(OVRR 10,000 CFM)' CONSTRUCTION TA%
ingnawm of ApplicanVConuactor Dam EXHAUST HOOD OVIDUCT) HOUSING MITIGATION FEE
HAZARDOUS MATERIALS DISCLOSURE .
Will the applicant or future building occupant store or handle hazardous material HEAPING UNIT(TO 100,000 BTU)as Cook.
Sect by the 32(.)Y no Municipal Cade,Chapter 9.1^_,and the Health and Safety
Cale,Section 255R(ul] HEAT LNG UNIT(OVER I W,1%q BTU) -
❑Yes LJ No -
VENHLATIONFAN(SINGLERESID) PAID
Will then locant or forum buildin - - Dole Receipt p
PP goccu.ant use eyuipmem mdevicu which
:mit hazordous air emanninmis BOILER-COMP as defined by The Bay A.Alr Quality Management OHP OR 100,0l
District?
00,0 BTIpDistrict? - TOTAL:
El Yea, FlN. BOILHR-COMP(OV FR If%LOW BTU) -
AIRCONDITIONERI z�
I have read the nooddon,umtrati,mummannome,andeachad,,E95ol ine Cali- - ISSUANCE DATE
f mm H alE Safety CKI lions 25505,2551) d 25514,1understand that if the NEW RESIDENTIAL MECH. SO Fl: �/� Q y
b ddi d sot cum then 0th ny po iblty my th pant '- l/ /
fNe n ..uanceafa Cen
O n cath..zed giroi1m. ' T'O'TAL: i--�✓ s .
ISSUEU BY:
OFFICE
10300 Torre Avenue
0c,
I. Cupertino,CA 95014
Cupertino Buildin,* Division
(408)777-3228
(408)777-3333 (fax)
March 20, 1998
Homeowner
21602 Regnart Road
Cupertino, CA 95014
SUBJECT: Permit# 31182, waterheater replacement
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
pgntea on Rocveleo i�.laer