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28755 APPLICANT TO FILL IN INFORMATION.WITHIN RED LINES-USE BALL POINT PEN ONLY CITY OF CUPERTINO RUH,DING-ELECTRICAL PERMEF No. BUILDING DIVISION APPLICATION/PERMIT PLUMBING-MECHANICAL. /.8 7^5 BUILDING PROJECT IDENDF'ICATION LtI v BUILDING ADDRESS: , ' - SANITARY NO. APPLICATIONSUBMI}TALUAfE ��� s �v Ct �a . OWNER'S NAME: PHO\E: CONT CIYI NAME: ' �� IC N0: - cy NIC COM'kOL 11 RC I .CI' NEER LI No ADDRESS, ❑ CONTACT. PHONE: BUILDING PERMIT INFO � +/( ❑ Consultant Fees Paid by Applicant(Initial) LD ELECT- PLUMB MECH -LICENSED CONTRAC'IUR'S DECLARATION QTY. ELECTRIC PER FEE I hereby affirm that 1 am licensed under provisions of Chapter 9 Rommencins - JOB DESCRIPTION a�Z with Section7000)ofDivimm 3ofthe Busmew,ml Professions CMe.and my license is RESIDENTIAL: W o p PERMIT ISSUANCE 1-ty� in full force and effect. ❑SFDWL '❑KITCHEN REMODEL Up License Class Lic.It LIANCES-RESIDENTAL ❑ADDITION ❑PLUMBING RE-PIPE .y 4 W Datc Convenor ARCHI'I ECfS DECLARATION - ❑,MULTI-UNIT ❑STRUCTURAL FwZ I understand my plans hall he used as Public records PANELS MODIFICATION zo n_ Pu OZ_a UP TO 2W AMPS 0jNTERIOR [ICHIMNEY REPAIR f.N.I-; Licensed Prole nal 201-HgOAMPS IMPROVEMENT ofd OWNER-BUILDERDECLARATION OVIiR AVAMPS/ TH REMODEUREPAIR (]DEMOLITION y ag 04 6 Ili by ff nn that,] I exempt f th C r t ':L L f the �,Qv I}RE DEMOLITION X 3 c.F following (S coon 7031.5,business J ProfessionsCoda:Any city r n unty SIGNS ELECT CAL OTHER _ y wbch reymrcs a permit m ronswct,alar.Improve,demolish,I r repair any waurc F�Oa pfior to its issuance,also requires the applicant for such Permit file a signed sammen SPECIALC CULT/MISC. fpdly yJ that he is licenmd Pursuant the provisions ofthe Conevions License Law(Chapter9 if7�'�O (commencing with Stenion 7IXMq of Division]of the Business and Profusions Crde)or TEMP.METER RPOIX IN. COMMERCIAL:, a e C 'hat he is exempt therefrom and the basic for the alleged exemption,Any violation of ❑NEWIBLDG/ADDITION ❑DEMOLITION 4• Section 7031.5 by any applicant fora permit subjects the applicant to o civil penally of POWER DEVICES W-•y ❑TENANT ❑FOOD SERVICE nm more than rise hundred dollars 14500). � r -! FZY OTHER IMPROVEMENT Sp ❑Lo the work. ndthe smactummycmployee,with red as Noir vele compensation. SWIMMING POOL ELE IC will do the work.andtheswaure is nor immndcdorottcnedforak(Scc91]Ls,Business [I OTHER . .13^ and Professions Code:The Comment's License law does not apply to an owner of OUTLETS-SWITCHES-pIX RF_S property who hudds or improves thereon,and who docs such work himself or Ihrnugh _ his own employees,provided that such improvements are not intended or offered for NEW RESIDENTIAL 1?LECTR SQ PT sae.If,howcvcuthe buildingor imprnvemenl ixsnld within one year)'completion,the $Q.FT.FLOOR AREA® LSQ.IT. ter-builder will have the burden of pevlmg flat l e did not build or improve for pur- pmm of sale.). ❑1,as owner of the property,um exclusively contracting with licensed contmemrs n TO //�.(] '/ (� answer the project(Sec.7044,Business and Professinna CaR:) Coewcror's Li EP 19 1995 whcerise Low docs not apply to an ownerof property who builds or inmoses thereon,and QTY, PLUMBING PERMIT FEE /� " Ik7y1J• o commets for such projects with z cono scums)rcensm pummor t m thc Conwcmrs tifl-Y`r O License law, PERMIT ISSUANCE U1'L151 I am exempt under Seo. ,B&P C for did,...a (�U Owner ALTER-DRAIN&VENT-WATER(EA) VALUATION Date Wm under COMPENSATION DECLARATION lowing RACK PLOW PROTECT.DEVICE I handy affirm under penalty operjury one of the followingWarkee ions: ❑Ihave and will maintain sion7Certificate of the LavoCode.to, WorkersCompthe DRAINS-FLOOR,kWIr.AREA,COND. - STORIES TYPE CONSTRUCTION moon,as provided for by Section 3700 of the Labor Code,for the perfomance of the i•. work have and this maintain issued. FlXTURFS-PER TRAP Fl 1 have and will m le.lor Worker's Compensation Insurance,as his pa by Suction - ' 3700 of the labor Glde,fur the perlbmmnce ofthc work for which this pcnnit is issued. GAS-EA.SYSTEM-I INC.4OUTLETS OCG GROUP APN - MyWo s bap nsmian ark J Policy number arc: ' Carrier L-•(.dam Policy No.: GAS-LA.SYSTEM OVER 4(EA) CRT OL1EXEMPI'ION FROM WORKERS' COMPENSATION INSURANCE GREASEFNDUSTRL WASTE INTERCEPTOR BUILDING DNIS10.(FEES (This section need not Mcompleted if Ne pcnnit is for one hundaddellers(S I(NB GREASE TRAP or loss.) PLANCHECK FEE , I certilythat lathe perfornanceuflhe work forwhich da%,enak i—sued,l shall SEWER-SANITARY-STORM EA.2dI IT. not employ any person in any manner so as m become subject to the Workers'Compen- ENERGY FEE OZ sation Laws of California.Data WATER HEATER WNENT/ELECfR GRADING FEE Z Q Applicant " rte// NOTICE TO APPLICANT:If,after making this Certifican of Exemption,you should WATER SYSTEM/TREATING f"^ beeman-boat In the Worked,Compensation provisions of the Labor Code,You mast SOILS FEE forthwith comply with such prnvkions or his pcnin,hill be doonacm,mod. WXI ER SERVICE CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMB. SQ.FT. PAID a ' U O (hereby affirm that them is a combustion lending agency for the performance of D RcecipM the work for which this Not is issued(See.3097.Civ.C) ULender's Name TOTAL: Lomat,Address I«nify that I have read this application and stile that the above information is DI Fy correct.l ugrecm comply with all city and county ordinances and sine laws elating to QTY, MECHANICAL PERMIT FEE U Z building convection,and hereby authorize reprsontatives of this city to enter upon the S.I. above-mentioned property fur inspection pagmse,. PERMIT ISSUANCE (We).,me to save,indemnify and keep hunmlesthe City of Cupertino ag.i not ELB RI E liabilities,judgments,os is and expenses which may in any,wayaccnm against said City AU ITR OR ADD'10 MECI3. " ' consequcnce oft rantlog of this permit PLIJMBINGP E APPLICANT DERSTA >S AND WII -CO Y WITH ALL NON-POINT AIR HANDLING UNIT(T010,0110 CFM) MECHANIC LFEC SOURCE RF LATION . -7 AIR HANDLING UNIT(OVER IQOQ9 CPM) CONSTRU IONTAX Siincident jt c ort c ale ' EXHAUST HOOD(W/DUCT) HOUSING ITIGATION FEE HAZARDOUS ERIALSDISCLOSURE Will teapplicamnrimmeh Jing cecupam.sure or hanJk hazardous material HEATING UNIT TO 101.000 BTU) as defined by the Cupertino Municipal Cade,Chapter 9.12,and the Health and Safety Code,Section 25532(.), HEATING UNIT(OVER 100,000 BTU) ❑Ye., ED N VENTILATION PAN(SINGLE RESID) PAID Dan eceipla Will(lie applicant car home b ld g(cecap.....v e'ai'aricat devices ve,h emit h mdous air contan ina us as defined by the Bay Area Air Quality Management NOII,ER-COMP(JHP OR lIX1,IXq BTU) TOTAL: Dlstnct BOILER-COME(OVER L00j0M BTU) ❑Yes 0 N ' I have need the hauaomaterials nequinemts under Chapter(i9 r5 of the Cali AIR CONDITIONER Nus meISSUANCE DA E forma Health&Safety Code.Sections 25505.25533 and 25534.1 understand that if the NEW RESIDENTIAL.MUCH. SQ.FT. buildingdce nntcurently have.laread,don,itisny responsibility mnntifytheoceupanl ' of the equimments which must be mel Poor to issuance of a Candidate of Occupancy. ` Owner or authorized agent Data TOTAL: ISSUED 6Y: OFFICE ., a hTEr; .,...........__.-. _. ..... , , . '• i V1 ,;,I";'-•WOOD DESTROYING PESTS AND ORGANISMS INSPECTION REPORT a This is an inspection report only — not a Notice of Completion §y ; ADDRESS OF PROPERTY INSPECTED BUILDING NO. STREET CITY ZIP COUNTY DATE OF HUMBER OF CODE INSPECTION PAGES 10387 LAS ONDAS IVAYII � CUPER•1'INO 95014 43 9/11/95 Y7'q d o q Affix stamp here on Board copy only C_Jtl A LICENSED PEST CONTROL Termite and OPERATOR IS AN EXPERT IN Pest Control, Inc. HIS/HER FIELD. ANY QUESTIONS General Contractor Lic.#572865 RELATIVE TO THIS REPORT SHOULD 10078 Impenal,Cupertino,California 95814 BE REFERRED TO HIM/HER. REGISTRATION 0909 REPORT TM-8237 I STAMP 2587058T ESCROW# ORDERED BY AIARILYN CHAMPLIN , 10387 LAS ONDAS WAY , CUPERTINO REPORT SENT TO: SAME PROPERTY OWNER: SAME PARTY IN INTEREST: ORIGINAL REPORT ,FTS LIMITED REPORT SUPPLEMENTAL REPORT ❑ REINSPECTION REPORT �• 'Original Stamp# Date TWO STORY SINGLE FAMILY DIVELLNG N E S O P O O E P c E N O U U R U T A A A E E H M GENERAL DESCRIPTION: ) I , n T R B v N R M R u L c D FIJI2NIS[TED AND OCCUP ED , ATTAcC I ± E o u a w T T u s E EN E R O 5 O Y L 5 R GARAGE, STUCCO EXTERIOR. A D o 0 0 ' c 5 V L IE I N T R O W R E E E WALL I i B C N E E D T O A A GARAGE IVALL L T S A R D E O O D M K E E P N M R P R D E E O S INSPECTION TAG POSTED: D E I v E M B 1 NONE NOTED A c T T S I C L R SR T E E R T T OTHER INSPECTION TAGS: o E 1 T E I R S O S E N V S U A O M T S T E R 5 N IA L E T C S E T 5 S 1. SUBSTRUCTURE AREA NO'I' INSPECTI.:1) X 2. STALL SHOWER SEE BELOW X 3. FOUNDATIONS NOT TNS1)ECPE1) X 4. PORCHES—STEPS NOT INSPECTED x1- 5. -5. VENTILATION NOT INS PI CTE 1) X s. ABUTMENTS NOT INSPECTED X 7. ATTIC SPACES NOT INSPECTHD 8. GARAGES NOT INSPECTED X 9. DECKS—PATIOS NOT INSPECTED X- 10. OTHER—INTERIOR NOT INSPECTED X 11. OTHER— EXTERI R NOT INSPECTED X DIAGRAM AND EXPLANATION OF FINDINGS This report is limited to structure or structures shown on diagram) ��.P 1 S 91995 OF ICUPERIlNOI ©m Inspected by V I RG I L L. 111 GDON LicenseNor8071 S gnaww YOU APE ENTITLED TO OBTAW COPIES OF ALL REPORTS A4p COMPLETION P&OTICES ON THIS PROPERTY ILEO' TN THIS BO DURING I•: PRECEDt1t4i TWOYEARS I i PAYPAWT O6 A 02 DO TEE TO STRUCTURAL PEST COrctROL BOARD. 14301.10,14 IE,SACRAMENTO.CA 95825. - I I w, 3RD PAGE OF STANDARD INSPECTION REPORT ON THE PROPERTY LOCATED AT: Ad dross of pm.med 10387 LAS ONDAS WAY CURERZINLO Bldg.No ca, 9/11/95 258705ST _ 11030 Date of Iespwipe Sm,No. Company Repoli No. THIS IS A LIMITED REPORT, AS IS ALLOWED UNDER TML'- PEST CONTROL RULES AND REGULATIONS, AND IS AT THE. REQUEST OF THE OWNER, MARILYN CHAMPLIN. THIS REPORT IS LIMTED TO THE SECOND STORY BA'T'HROOM SHOWER. AS INDICATED ON THE DIAGRAM. NO AUTHORIZATION HAS BEEN GRANTED TO INSPECT ANY OTHER PORTIONS) OP THIS STRUCTURE OTHER THAN THE AREAS NOTED. STALL SHOWER ITEM 2 . FINDING : EVIDENCE OF EXCESSIVE MOISTURE ENTERING INTO THE ENCLOSED WALL AREAS AS INDICATED BY ITEM 2 (EM) ON THE DIA'- GRAM IA-GRAM . RECOMMENDATION : REMOVE CERAMIC TILE FROM THE WALLS OF THE STALL SHOWER-70 EXPOSE THE INNER WOOD MEMBERS . REMOVE AND REPLACE SHOWER DRAIN AS NECESSARY . REMOVE AND REPLACE SHOW- ER CONTROLS WITH NEW SHOWER CONTROLS. UPON COMPL:E'TION, IN- STALL NEW CERAMIC TILE SET IN MOR'T'AR THROUGHOUT THIS SHOWER. INSTALL NEW SHOWER ENCLOSURE. li