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19481 O. PEILMIT N POST THIS CARD NEAR FRONT OF BUILDING 19481 ` CITY OF CUPERTINO A INSPECTION DIVISION- JOi INSPECTION RECORD c' JOB ADDRESS , / 6'% 6 E! �� UNIT# LOT#,� CATEGORY CONTROL M V OWNER 9/''///,11A1GS CONTRAC70R �LS� S •E-�t/i BUILDING PERMIT INFO INSPECTION DATE IINSPECTOR INSPECTION RECORD FOUNDATION/PIERS NOTE ALL GRADING AND DRAINAGE �❑ El UFERGROUND SI[ALL BE INSTALLED TO COMPLY WITH JOB DESCRIPTION THE APPROVED PIANS AND CITY OF PAD/SETBACK-CERT CUPERTINO STANDARDS. 2.� r �,y �,,,•• GARAGE SLABS PREGUNITE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB INSPECTION DATE INSPECTOR PLUMBING ELECTRICAL MECHANICAL DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED WOOD FLOOR PLUMBING MECHANICAL ELECTRICAL FRAMING VENTS CLEAR INSULATION ' PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROUGH PLUMBING TUBS&SHOWER PAN MECHANICAL ELECTRICAL/JACUZZI BOND FRAMING STAIRS INSULATION/VENTILATION EMERG.EGRESS • SEWER WATER COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED EXTERIOR SHEAR HOLD DOWN INTERIOR SHEAR/HOLD DOWN SHEETROCK/SHEETROCKSHEAR EXTERIOR LATH/W-SCREEN SHOWER LATH SCRATCH COAT NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIC N D NOTE:NOWNAL INSPECTION SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID FINALS DATE JINSFECTOR. SAN.# ELECT.ENERGY PLUMBING ENERGY MECH.ENERGY BUILDING ENERGY ELECT.FINAL TEST PLUMBING GAS TEST MECHANICAL HEATING ELECTRICAL RELEASE t1 RE DEPT. GRADE -t- OCCUPANCY TEMPORARY APPROVALS ELECTRIC GAS BUILDING OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL ISSUANCE DATE BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR PAIL) . ARRANGE FOR INSPECTION BY PHONING 252-4505 BETWEEN JAI 1 p 9 19' 12:30 PM AND 4:30 PM MONDAY THROUGH FRIDAY,24 HOURS 90 BEFORE REQUIRED INSPECTION. JOB ADDRESS AND 44f PERMIT# ARE NEEDED WHEN PHONING. n lrlJQRI m IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION ISSUED BY: OFFICE COPY APMLICAN I TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY Building Project Identification PF:RMITNO. "d:T=j af)7-E- 19481 .era ams: Phone: �/J/,//ti/G ZS`L'�7q CITYOF CUPERTINOBUILDING DIVISION • Contrador'a Name: Lk.No: APPLICATION I PERMIT�y'��TS ��T y73�� BUILDING-ELECTRICALPLUMBING-MFOI IAMCAL CATEGORY CONTROLX Archltect/Engineer. Lk.No: QTY ELECTRIC PERMIT F BUILDING PER IT INFO Addreuc.2y 5e/,174,lsf_ Sf' s-, PERMITISSUANCE LICENSED CONTRACTOR'S DECLARATION I hereby affirm that l am licensed under provisions of Chapter 9(commen APPLIANCESRESIDE..NTIAL JOB DFSCRB'I'ION IngwithSedion7000)of DIV W on3ofthe BuslneaandProfe.i.ndCodgand my license is in fu(;tt daffect 3 f 1 PANI75 License�ba�sd�� __yy��LIc,X Data A ContracTorUP TO 2DOAhM ARCHITECPS ECLARATION 701-IODOAMPS ax I understand my piamdhall be used as public recon L. OVERIOWAMPS SQ.Fr.FLOOR AREA $/SQ.FT. CO Licensed Professional SIGNS ELECTRICAL 6 OWNER-BUILDER DECLARATION SPECIALCBiCl11T/M15C Thereby affinntlutlam exempt from the Cmtracor.License Law lm the F. following reason.(Section 70313,Business and Professions Code:Any city or O � TEMP.METER OR POLE INST. cwsty which requireaapermit roconstrucL siren improve,demolish,orrepalr SYY any structure prior to its hunts me,also requires the applicant for such permit to POWER DEVICES K file a signed statement that he Is licensed pursuant to the provisions of the O k. Contractor's License Law(Chapter 9(commencing with Section 7000)of Divl- F,�OS don 3 of the Business and Profectona Code)or that he b exempt themlmmand SWPdh9NG POOL ELECTRIC VALUATION Q the bash for the alleged exemption. Any violation of Section 7031.5 by any OUTLETSSWITCHESFI%7URES applicant fora permit subjects theapplicanl to a civil penalty dnot more than R fivo E]1,as owndoler o(tars(epm NEW RF_SIDPI-MAL ELECTR SQ.Fr. SIORIES TYPECONMUCTION GG11 �I,as owner ll the property,or my employees with wages r thele dole C compensation,will dothe work and the strudure In notintendedor offered for �. 5 O I.(Sec.7044,Bueinca and Podembw Code:The Contranore Llanse iaw t-� $ does not apply to an owner d property who builds or improv.thereon,and 40 LJ,.OP 0 4 0 OCC,GROUI' RES.UNITS who does such work himself or through hisown employees,provided that such 9 e 5� Improvements are not Intended oroffered for sale.I(however,thebuliding or TOTAL: improvement could within oneyearolcomplati.,theowner-builderwillhave the burdenof proving that hedld not build or Improve for purpose ofsaleJ. QTY, PLUMBING PERMIT FEE FLOOD ZONE APN L,J L as owner of the property,am exclusively contracting with lim a xi pERM1TISSUANCE contractors to construct the project(Sec.7044,Business and Prof.dons Code: 71.Contrador's License Law does ml apply to an owner of property who builds or Improve thereon, and who contra for such p(ojects wish a ALTER-DRAIN&VENT-WATER(EA) roygfador(s)licensed pursuant to the Contractors License Law. FEE SUMMARY LI I am exempt under Sec. B &P C for the moon BACK FLOW PROTECT.DEVICE cluTsiDE FEEL'S DRAINS FLOOR ROOF,AREA,GOND. SANITARY Y N_ Owner Date RECENT X WORmthat I haw a gSAT10N DECLARATION FD(7VRES PER TRAP SCHOOLTAX Y N ❑f hereby affirm that I have a codiRcate of consent to self-Hare,ora RECFE'1'� certificate ofWorkers'Compensationlosurance ora certified copy thereof(Sec. GAS EA.SYSTEM-I INCA OUTLETS PARK FEE Y N 3800,LabC) p PnIIcyX ��_ « ^ (/ I RECE(IRX lCom any efLi��ix/ CAS EA.SYSTEM.OVER4BEA) BUILDING DIVISION FEES ertified copy b hereby furnished. GREASE/INDUS[RL WASTE INTERCEPTOR PLANCHECK FEE CertEled copy b filed with the city Inspection division. CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE TRAP PAID COMPENSATION INSURANCE SEWER-SANITARY-STORM EA 7WFI• Date Reeel fA (rhlssedlonneed notbecomploted Rthaperndt bforom hundred dollars ENERGY FEE Y_ N_ ($100)or iev.) WATER HEATER W/VENT/ELECTR I certlfythat In the performance of thework for which this permit is csuod, I shall not employ any peraon In any manner so as to become subject to the WATER SYSIPM/TREATING Workcre'CompemationUwsof Callfmoia. Date PAID 0Z Applicant NEW RESIDENTIAL PLMB. AFI'. Date Recel t# Z O NOTICETO APPLICAM:If,after making this Certificate of Exemption,you should brume sobject to the Worknn'Compensation provisions of the Labor TOTAL: N Codem,you=at forthwith comply with such provisiau or that perit&hall be BUILDING FG W > deeed revoked. CONSTRUCTION LENDING AGENCY SEISMIC FEE CL C m Ihereby affirthat there la a construction lending agency forthe perform TOTAL: ELECTRIC FEE 7 Z onceof the work for which this permit is esued CSm 3097,CIv.Q OO Lendar.Name PLUMBING FEE !- Leeder.Add.. QFE TY. MECHANICAL PERMIT E OW ' I cnrtRythatl have read thbappiiatiunand statethattheaboveinfommtion MECHANICAL FEE IL isconect.l agree to complywith all cityand county ordinances and date laws PERMRLSSUANCE FEES PAID: :l, relating to building constroaton,and hereby authorize representatives ofthe H N city to enter upon the amen mentioned property for Inspection purposes. ALTERORADDTOMECH. ? (We)agree to save,Indemnify an d keep harmless the City of Cupertino Date Receipt# V against liabilities,judgments,cortsand expenses which may In anywayaccme MR HANDLING UNIT CID BLOW CFM) SUBTOTAL: aga Wt said City in consequence of the granting of this permit. i AIR HANDLING UNIT(OVER IO,WOCTM) CONSTRUCTION TAX Signature of Applicant/Contractor Dat. EXHAUST HOOD(W/DUCT) CONSTRUCTION TAX PAID: HAZARDOUS MATERIALS DISCLOSURE Will the a pplicant or how re building occvpact store or ha rad to hazardous BEATING UNIT(TO 100,000 BTU) Date Reeei to material as defined by the Cupertino Municipal Code,Chapter 9.1Z and the Health and SafetyCode Section 25537(.)7 HEATING UNIT(OVER 100,01)0 BTU) TAL: ❑ Yes [�No as, Wllltheappilcant orfutum building occupant usecfuipment ordevic. VENTILATION FAN(SINGLE RESID) I D occupantATE which emit hazardous air contaminants as de0nad by the Bay Area Air Quality Management District? BOILER-COMP OFR'OR 100,000 BTU) JAN 0919911 Yea nn No V have ad the hazardous materials requirements under Chapter 6.95 of BOILER COMP(OVER 103,000 BTU) the California llealth&Safety Code,Sections 75505,75533 and 75534. I (d a.{a understand that if Mebulidingdoes notcumentlyheve atenant,that itismy, RESIDENTIAL NEW MECH. SQFf. � p�7tUPAIVQ responsibility to notify the occupant of the requirements which=at be nM ' prior tm iseuanco ole Certl(icate of Occupancy. Owner or authorized agent Data TOTAL: ISSUED OFFICE COPY