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S 1251 APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY I-WNfk ITY OF CUPERTINO BUILDING-HLECIpRICAL PE IT NO ,t BUILDING DIVISION APPLICATIONIPERMIT PLUMBING-MECHANICAL. 1251 BUIIAING PROJN.CT WENI'IFICNPION UII.DING ADDRESS: SANITARY NO. APPLICATION SUBMITTAI,DATE 34 C alba NAME:/s�AA�� PHONE: CON TRACTOR S NAME: LIC NO'. k I //f A d 0,1116 ZS /133 _ NIC CONTROI.p -5 TEC'AlNGI�nNhA.A�n�' I C-1LIC ?Z2O/ Allll ESS: � I ❑ CONTACT: (f PHONE: •.J BUILDING PERMIT INFO ❑ Consultant Fccs Paid by Applicant(Initial) BLDG ELECT' PLUMB MECH 9 © . ❑ ❑ LICENSED CONTRACTOR'S DECLARATION QTY ELECTRIC PERMIT FEE I hereby uRmt that 1 am licensed under provision.of Clout,9(commencing JOB DESCRIPTION aZ thSeminn7(VMof Division 3arde,ituxmcs,rnd Prufessinn,Code,rndory license is RESIDENTIAL: Fob mfull force end eRec PENMI'I'ISSUANCE C-F p 7�'] /J ❑SFl)WI. �KITCI{IiN REMODEL azw LicrnmC 1'alal `- Lic.p APPLIANCES-RESIDENTIAL. ❑ADDITION ❑PLUMBING RE-PIPE y7a to Dara T'SDcmr W ANCHRECI'S IIECLANATI(l ❑MUI:1'I-UNIT ❑STRUCTURAL F. '6 PANELS MODIFICATION Z O H Z 1 understand my plans shall be aunt as public ranNn O Z—q UPTO2W AMP$ INTERIOR IB CHIMNEY REPAIR F-a,F'W Licence .na d Prnleoil 201-EXIDAMPS IMPROVEMENT [DSWIMMINGPOOLS y,y C C I hereby Off nn OWNHR-B that I am UIn DER DECLA ATIONr's License Low for the OVER 10(10 AMPS BApt from the TH REMODEUREPAIR ❑DEMOLITION p(36 U following reason.(Section](131.5,Business and Professions Come:Any city or county SIGNS ELECTRICAL HER Yu1l Y. which requires a permit to construct,alten improve,demolish,or repair any swcmre priorto iE),mmea.also requires the applicant forsuch pennitm fileusigned stn¢mcm SPECIAL CIRCUIT/MISC. ,E y that he is licensed pursuant to the provisions of the Carra a Licence Law(Chapter 9 W IyQC) (cmnduatimg with Scene.7")of Division 3 nfihe Hadncesand Professions CakTor TEhIP MFTEH OR POLE INST. a ry� K that Int is exempt therefrom and the basis for the alleged exemption,Any violation of BLS/AD N ❑DEMOLITION Ic 4, Section 7031.5 by any applioum for a permit subjects theupplicum to o civil penalty of POWI!R DEVICES TENA'GY'//��� �'Zy net more than five hundred dollars($50D). O PROVEt015NT FOOD SERVICE 6 ❑ Lus owner ofthe progeny,or my employees with wages as their sale compensation, SWIMMING POOL ELECTRIC Mildothewnrk.and hommeum is not intandedurnffered farsele(See A(d4,Business OTHER 6 3 m and Professions Calc:The Conrracmrs License Law dines not apply 1.un owner of OU1`LHTS-SWITCHES-Fix TURFS progeny who builds or improves thereon,and who does such work himself or through his own employee,,pmvead that such improvements are notintended or offered Int NEW RESIDENTIALELECTR SQ FT. sale.If.however the building or impmeme vm is sold within one year nfemaphrion,the SQ.F?11. Rr111+d &SQ.IT. rtimbEr will have the lumen of proving that he did not builder improve paper, poe cof out.) TOTAL: ❑1,iiowner of On pramy,um exclusively counseling with licensed contact.,In comtruct the project(Sec.7044,Business and Professions CameB The Contractor's Lt- 17 na c solar.doc,om apply t.an..Berm progeny who hulldaor intptovcs mcenon,roti Q'I'Y. PLUMBING PERMIT FEE C1/}Y OO who contracts for such projects with a enntrvemr(s)licensed pursuant tothe Cmmm�ors Uf Vyr License Law. PERMIT ISSUANCE Cry(Ifvu ❑ I:an exmnpt under Sec. ,B&PC for this reason ALTER-DRAIN&VENT-WATER DM) VALUATION Dole �� WORKER'$unity IEN ria,ago DECLARATION BACK ROW PROTECT.DEVICE 1 handy affirm under penalty of ofjury enc of doe fnsumfor declarations: ❑Iheve anmsvillmaintainfibn Cion 37nnf Consent toCodlensure for Worker,ce of h- DRAINS-DOOR.ROOF AREA,COND. STORIES TYPE CONSTRUCTION actino,r which this fpr by Ss I... 3]IXI of the Lnhpr Gvlq for the Performance of rho worI for which this permit is tsar W. Il%TURES-PER'I'RAP 37 I have and will maintain Worker's Com rte. ,it for which h required by Section 3700 of the Luha CnJq for the perfannuna of the work for which this permit is i,,snW, CAS-EA.SYSTEM-I INCA OUTLETS OCC.GROUP APN My Worker' CJ.yn do insyy�co� n Lcarer and Policy"um-1 um Carrier5U 76 NH're Policy No.: L ra A903o-f 1 GAS-EA.SYSTEM-OVER 4(EA) CF.RI'117ICNI 11 OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE GREASUINDDS'I RI.WASTE INTERCEPTOR BUILDING DIVISION__FEES (This sectinnneN not be completed fare permit is force hundred dollars($100) GREASETRAP or Ices.) PLANCHIECK FIER I ccnily ohm in theperlisrmanceof the wnrA fnrwhich thispermit is icsnem,]shut 1 SEWER-SANITARY-STORM n m EA.200 PI'. not employ any Fears in any manner sas t.becae mbject to the Workers Co.,.. ENERGY FEE or O Z motion Law'.4 California.Date WATER HFATFIT WNENT/ELECFR GRADING Z 2 Applicant FE y NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should WATER SYSTEM11TREATING SOILS FEE I-� become suhjea to the Worker's Compenmition provisions a1'the Labor Calc,you must Wim fonhwidt complywith such provisions in this noritshall be deemcdrevnked. WAFIiR SERVICE aQ s7. z CONhem iRUCTION LENDING AGENCY NEW RESIDENTIAL PI-MB. SQ.IT PAID Date Receipt p LJ lfor whihret Permute sacon.dec.30loading agency forth.'perlinmance of the work for which this permit is issue)(Seca}Pry].Civ.C.) C) Lenders Noone 'TOTAL: Lenders Address TOTAL: BUILDING FEE I codify that 1 have nail this application and state that the above information is rFa to correct.l agree to comply with all city and county ordinance.'and ,are laws relating to QTY. MECHANICAL PERMIT FEE (� Z building coronation,and liewhyadicatr,representatives alibis city toemerupin the SEISMIC FEE .hove-mentioned property fur impectimn purpose.,' PERMIT ISSUANCE (We)agme to save,indemnify and keep not the City of Canadian against ELECTRIC FTSE Iimilities,jm,mems,costs and expenses whichmayin any way ascent,against said City ALI PIT OR ADDTO M ECIL ons mpicnea oe graning of this permit PLUMBING FEE APPLICANT OERSTANDS ND WILT.COMPLY WITH ALL NEIN-POINT AIR HANDLING IINTF(To III,ifin CEM) MECHANICAL FEE S LA'flOoyS. AIR HANDLING UNIT(OVER 10,"CFM) CONSTRUCTION TAX SigC�pplicrnl/Cpntmctor Date BXHAUS'THOOD(W/DUCT') HOUSING MITIGATION THE HAZARDOUS MA'I'ERIAIS DISCI- RF: Will he applicant or future building aceepum store nn handle hazardous material HEATING UNIT(To IIA,M)HN) nc defined by the Cupertino Municipal Code,Chapter 9.12,anti the Ilerlth and Solely Coca,Section 25532(x)? HEATING UNIT(OVER IBO0 0 BTU) p Yet ON. VENTILATION FAN ISINGLE REST D) PAID Date Reoeipt Or Will the applicant or home building cection,use emd,arcnl.r devices which can huv.ardous air conmminams as defined by the Bay Area Air Quality Monagemem BOILER-COMP(31 IF OR Billion ROD District?, BOILER-COMP(OVIER Rio.oOlo B'I'U) ❑Yea ON. I hnvc read the hnxanlnus muterinb reyuiremunn ander Chapter 6.0.5 of the Call- AIR CONDI'T'IONER ISSUANCE DATE fnmia Health&Safety Came,Sections 25585,25533 amt 25534.1 understand that if the NEW RESIDENTIAL MECH. SQ.Fll building dees not currently have a tenant,that it k my ocNimebility to notify the occupant ol'the requitennenkv which nnni be ma prior to Iv,tiame al a Certiticuto of Leonetti Owner pr authorized agent ().to TOTAL: ISSUED BY: OFFICE Y 1 -STEVEN A. ARNOLD — Civil Engineer, Inc. 1671 THE ALAMEDA,SUITE 305 • SAN JOSE,CALIFORNIA 95126 • TELEPHONE(408)286.9111 ones Masonry 12 February 1998 1088 Dell Avenue Campbell, Calif. 95008 Subject: Masonry chimney Replacement 19736 Vicksburg Dr. Cupertino, Calif. Gentlepersons: I personally examined the masonry fireplace referenced above. The chimney had been removed and the shoulder of the fireplace exposed. The original mason did not use reinforcing steel to construct the chimney. In order to reconstruct the chimney the void on either side of the burning chamber of the fireplace must be grouted full and reinforcing steel epoxied into the shoulder of the fireplace. I have provided a sketch that depists one method of replacing the chimney and ensuring that the replacement • meets the intent of the Uniform Building Code. Respectfully submitted, (�(�� Q� //(fin tl�L1l ,EII��lEBUJ Steven A. Arnold EB 17 1998 Civil Engineer CE 22301 F BLDG.CiN OF CUpDEP -ESS/SBIN A.qq 0<! 2� q�ol y ;. 1 r0 C m s �P w m . s& IVIS qT OF CAL\ STRUCTURAL DESIGN • LAND SURVEYING • BUILDING INSPECTION GENERAL CIVIL ENGINEERING SERVICES Fc-c,,H LCULATED BYYSTEVEN A. ARNOLD JOB NO.: ECKED BY Civil Engineer . 1671 The Alameda Suite 305 DATE: �.71e6 f f NED BY SAN JOSE, CALIFORNIA 95126 / PAGE:_ OF 3 RCE NO. PROJECT: himnQ 1�p a kzeme Vi.c:..5':. qr9 ................... ................ ..:............:.. ..,........... p QQ71 .... .......... rn ................:.......... ` .j :.. ... . : . .:.. ... P4✓!!4/ IC/Oor /�/q it T9j, ............ y. .: . .. rurr ................: .:... . g °a. . i e _ .A.. .. 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