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29540 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY Cj'jg mlw CjJpgR'p]NO BUILDING-F.LF.CTRICAL - PERMIT N029540 . ^ a.., e O BDIIamNc m%""0 APPLICATION/PERMIT PLUMBING-MECHANICAL L�9 LVA 4 a BUILDING PROJECT IDENTIFICATION BOILDING AUORF.SS: - - SANITARY NO. APPLICATION SUBMITTAL DATE Lk le OWNER'8 NAME: PHONE _ C RACI'O 'S NAME: LIC NO: C ickCONTROLp R HI'TECT/F:NGIN:ER: LIC NO: ADD2ESS. PJ wi 1640 W�'k r Ca CONTACT.' PHONE: BUILDING PERMIT INFO ❑ Consultant Fees Paid by Applicant(Initial) BJ.oc ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION QTY ELECTRIC PERMIT FEE I�`F�'` 1`Cf� ❑ ❑ 1 hereby affirm khat I am licensed under Provisions of Chapter 9(commencing JOB DESCRIPTION w,i th Section 11g1o).f Division 3 of the Business nM Professinm CNe,and my license is O O PERMIT ISSUANCE RESIDENTIAL' is full farce and �V License C�lens/•-��Lic,p Iwo ❑SFDWL ❑KITCHEN REMODEL FF..z DatcJ�C.mractor APPLIANCES-RESIDENTIAL ❑ADDITION ❑PLUMBING RE-PIPE rO=iG P�� 4 44�T// ARCHITECPSDECLA A O - MULTI-UNIT ❑STRUCTURAL vt2 Z mm I miand my plans shall be used as public records PANELS MODIFICATION OZ— UPT02MAMPS ❑INTERIOR - ❑CHIMNEY REPAIR � Licensed Professional 201-10WAMPS IMPROVEMENT 5,44 OWNER-BUILDER DECLARATION rye P4 1 herehy¢from that 1 am exempt from the Conuactnr's License Law Soothe OVER I"AMP5 ❑BATH REMODEL/REPAIR DEMOLITION Sd 3 d U following,arida.(Section 1031.5,Business and Professions Coda.Any city or county � _ ❑OTHER - u1 LL. SIGNS F.LECTNICAI. O which requires a permit a cornwa.aloe nt form,demolish.w repair any statement rw y pad he isscensece,alsorequitheres the applicant for Contractor Licefils Law hafer9 SPECIAL CIRCUIT/MISC. a 9th- thanhe is licensed pursnam to th"ofDivina 3the the License potent Cap¢r9 ��CC (commencing withSection lOgj)of Division3 of the Business and Pndessi.nsCNe)or TEMP.MEI'GR OR POLE INST COMMERCIAL, - - L y m K that he is exempt therefrom and Be basis for the alleged exemption.Any violation of [3 NEW BLDG/ADDRION [I DEMOLITION W V. Section 9031,5 by any applicant for a permit subject,thenpplicam to a civil penaltyaf POWER DEVICES y t mote than rive attracted!dollars($50111. El TENANT El FOOD SERVICE ^r Q 01,as owner of Ne property,or my employees with wages as their side compensation. SWIMMING POOL ELECTRIC IMPROVEMENT ��.. will do the work,and the swcmru is not Intended or offewd for sale(Sec.]044.Business El OTHER 3 and Professions Cade:The Commetor'a License Law does not apply to on owner of OUTLETS-SWITCHES-FIXTURES 6 property who but[&or improves there..,and who does such work himself or through his own employees,provided thin such insprovenmnts are not intended of offered far NEW RESIDENTIAL ELECTR SQ FT. sale.If.however,de,building or improvement is sold within one year ofc.mpletion,the SQ OORAREA $/SQ.IT. owner-buildcr will have the burden of proving that he did not bund or improve for put, QO Pose of sale), /►Lia., '0 1.as owner of the property,am exclusively contracting with licensed cantmcton to construct the Project(Sec.9044.Business and Professions CNet)The Commences Li- �1. g•�, -ease Law does not apply to ua owner of property who builds or improves thereon,and QTY, PLUMBING PERMIT FEE °® �` �• who canines for such projects with.corousemn.)licensed Soma m rao the Caines,', License law. PERMITISSUAN e� ❑ lam exempt under See B , &PCfor this reason ALTER-DRAIN ATER TEA) VAL A wiser Data Cllr ii _ t o,O �• WORKER'S COMPENSATION DECLARATION BACK FLOW TELT.DFZV 1 hereby al firinnasi under penalty teperjury one of the following Workeetinns: ❑These and will mainmina Cenificmeof Conserv mself-insure fm Workers Compcn- pRAINS-FLOOR,ROOF STORIES TYPECONSTRUCTION smion,as provided for by Section 3100 of the Labor Code,for the Performance of the - - work for which this Front is issued. FIXTURES-PER TRAP r ❑ 1 have and will maintain Workers Compensation Insurance,as ox,mo d by Section 37M.fm.Labor CNo,fordo,perfsrommee.fthe work for which this permit is issued. GAS-EA.SYSTEM. INC,40UTL OCC.GROUP APN My Workers Compensation Insurance carrier and Policy number are: Cartier. Policy N., GAS-EA.SYSTEM-OVER 4 WA) ' CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE' ' GREASFJINDUSTRL WASTE INTERCEPTOR' ('1'hissecti.nncednotbccompletedifthe permit is(orcin hundred dollars(1100) EUI IN ]VISION FEES or less.? I GREASETRAP PLANCHE FE I cenify thq perfnrmm�c ol'thewnrkfmwhicl11ld Termini'issued,lshall SEWI?R-SANITARY-STORM EA.2(10 FT. not employ any P� y mann to b Dole sub' m the Workers'Compero ENERGY z sn '¢tion Laws of f a I. WATER HEATER WNENT/ELECIR is Appllcunt N�� GRA FEE y NOTICBT APPLICA :Ifit ter ma in isc7rtificam of Exemption,you should WATER SYSTEMUREATING a �^ become subject to Ne Workers Compensation provisions of the Labor Code, t SO ry forthwith cam I th such you mux pYwi provisions or this permit shall he Aeemed revoked. Wq'TER SERVICE 0 {ryryS❑,,x CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL.PLMB. SQ.PE PAID U f Iherchy affirm nictitate is.construction lendingagcncy online performameeof i ate ReeciptN {F+ !+ the work far which this permit is issued(Sec.3091,Civ.C.) Q V Lenders Name TOTAL: 411 Rendc,Addrer. TOTAL: y 1 cenify that 1 have reed this applica0on and sure then the above infsimatinn ix - BUILDI G FEE IA comma.I agree to comply with all city and county ordinances and state laws relating to QTY. MECHANICAL PERMIT FEE SEISMf FEE U ,7a. M1uilJing ennstmcni.n,and hereby authorise represenntives of this ciry toenner upon the above-mentioned property for inspection purpnxes. PERMIT ISSUANCE CL[ RIC FEE (We)agree to save,indemnify and keep hamdess the City of Calandra against liabilities,judgments,costs end expenses which nmy in any way accmeagainn said City CO ALTER OR ADD TO MECH. PLU BING FEE in consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO 10,000 CFM) SOURCE REGULATIONS. MECIIIANICAL FEE AIR HANDLING UNIT(OVER 10.000 CFM) CONST 'CTION TAX Sig nature of Applicam Contractor Date EXHAUST HOOD(W/DUCD HOUSING DATION FEE HAZARDOUS MATERIALS DISCLOSURE Will theapplicant.,furore building occupant store mhandie harallous mmedal HEATING UNIT DO Hi ETU) as defined by the Cupertino Municipal Code,Chapter 912,and the Health and Safety - C e.Section 25532(.)? T10O ,..,,( HEAING UNIT ffO BTU) ❑Yes Dano VENTILATION FAN(SINGLE REBID) PAID Dote ReceiptN Will the air contaminants iinantsor e buildefureg occupby Dayse Area Air mlity or Management BOILER-COST GHP OR 100,000 BTU) which— 1 harardous air comeminanrs az defined by the Bay Aree Air Quality Management T isrnct? BOILER-COMP(OVER IIXI NDS)BTU) ❑Yes ' 0, I have read the havanlnus materials requirements under Chapter 6.93 of She Cali- AIR CONDITIONER ISSU NCE DATE Taenia Health&Safety Code,Sections 25505,?3533 end 255J4.1 undemanJ then i(We NEW RESIDENTIAL MECH. SQ.FI'. b.ildingdoes nm currently have a manor,Shut it is my responsibility to notify the occupum of Ne requirtments which muu be mer pri.noissuance nfe Cenifcme of fJccupancy. Owner ar authorized"on' Dam TOTAL: ISSUED BY: ' OFFICE ®.� .,, � 10300 Torre Avenue Cupertino, CA 95014 ('ilv 0f C1llJ)crtil10 Building Division (408)777-3228 (408)777-3333 (fax) January 15, 1996 Homeowner 11300 Canyon View Circle Cupertino, California 95014 SUBJECT Permit: #29540 Dear Homeowner: We have been cleaning out our files in the Building Department, and contacting those people with permits which have remained"open". According to our inspection records, the subject permit has never been finaled. Many times an inspector will sign the permit in the field, but neglect to report all of the information to the clerical staff for input into the computer. If your records show the subject permit as finaled, would you please contact us so we may complete our records? If the permit is not signed off your permit can be reactivated and an inspection could be scheduled for final closure of the permit 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 � , 1 C , Christy Akatiff, Administrative Clerk " • 19 January 1997 City of Cupertino Building Division 10300 Torre Avenue Cupertino, CA 95014 Attention: Christy Akatiff SUBJECT: STATUS OF BUILDING PERMIT 29540 REFERENCE: Your Letter Dated 15 January 1997 Requesting the Status of Building Permit No. 29540 Dear Ms. Akatiff, The garage storage loft covered by building Permit No. 29540 dated 2 April 1996 was completed in approximately late May 1996. The "Applicant's Posting Copy" of the Building Permit which was posted at the construction site during the construction period was signed on 9 May 1996 by an inspector with the initials of "EE" or "CE" or "EC." It is hard for me to read the initials of the inspector, they are written in lower case • cursive. The items inspected were "Electrical/Pool Bond" and "Framing/Stairs/E.Egress." I do not know if this is the final inspection or not since I know nothing about construction or building inspections. The contractor, a Mr. Bob Stone, verbally told us that the construction had past all inspections. The garage storage loft is great and we are most happy with it. If I have not answered your questions or if another inspection is required please call me during normal working hours at 408-974-3060. Thank you, �� ae Allen 11300 Canyon View Circle Cupertino, CA 95014 •