00080120 w .
{' CITY OF CUPERTINn >.• f - -
IBUILDINGDIVISIONpERVIIT'; CONTRACTOR INFORMATION:
BUILDING ADDRLSS'. " - y t PERMIT NO.
I' a
Ll�j DRAW
' OWNER'S NAME, F bI " - - • APPLICATIONrSUB DATE -fr
,. .. . i
ry
40NE: E. 1 L SANI'1'ARVNO. '661,17RULTIT
OM se Z AI2CIII'U C'IIFNOINFCR .-. .' _- BUILDING PERMIT INFO -r
q BLDG PI.PCT PLUMB MICIi
aFF�iG� _ I
L O 6N y LICENSED CONTRACTOR'S_DFCLARATION 0 ]Ob!Deserlptlon,
O Z�� I I hY ft' rh l I I eens,d J P r. f Clatter)( ''ng . J
F fce 11S I ]BOB) fD 3 fm R dP r.' Ca rd try hearse
z� ai fill f 1 affect. - t '
z w a License a d ftI - INT REMODE ®
3> Urtr ARCHIL DECLARATIONto t �����®
C toI aral,riandarry PI w shall Ire.,a lla,ahliVree m1s }{ 1
ce Lia IProfessional : - - y -- '�k NVV o`3. MCI
CI � •�f A ���
o. OWNER BUIIDCR DECLARATION
hail,ah r r her l fair e npr fi n die Cn maawn' L'k c Law for rhe
tallow ng racer (Sal' 70315 p , d P' f ':' C L A Y city - t, s } P
ft�G ,u'hn 1 Partial r r ralt r- 1 :h pr' y.r r
p r r r .I q (he ppl' Lr alp li I I g d,la r r NO
;
^ far l dP I rl p n frh C Ii r t L I Charter9 ; '(Sq, Ft FIOOCArea - YaIU'llOn
(n g 'll S 7000) ID 3 Ell B IP 1 C I) _ .y ., r
rdll Pr 11 f It n r t Ilgl pr Any Ir
k i
Section 7031 5 by Yapplicantt' M 1.uhteae the spin I I it ail P Ity n.
Oral rn.lna,r.enraacnnu,n(gsnn). AP,NNumber' - ,,, Occup nU`
h ,. N -
41 EI 1,r ,at he pmPerrY n-ny inphy e- `th wayes:s rl ' ...I crmPinati r,
will d Ili k" I tl e e f IT r d 1 r ll r 0-t' (S 70449=
Ba 1 r 1 : Core Thec License' law i I pply r an ,Required°Inspections
ow rp P rY wl n Id p' n d I 'n kr 1rr , , -i
o'Ili gh h': pl y e'. Provided rh f. c '.p I rintended S"
offeredI, 'I It,h Inn 'wny p u ll Wim' )Garet —, FOUNDATION
mnpl In wnerh ld will hew then J fBolin, airhedid i Ibuild -
is
Irlrnsanr I1, 102 ,— PI.EPSI
I rmnp p ry I .' I> r n s with o 1 .. 1.03. UFER .
Der'
poi 'I(See 7044 Brs ar r: Cod,)TI Contractor -
Liia n w d r piny a fp p ry a n Id: initiatives11 �.IT4 — RF_BAR
a dI er r 1,for eh pnsda.r, win rm„eaml E d prr9aanr r :lire - ,. ".1 05 'ANCHOR BOLTS' rh` s„
"Ell a,,Law B&PC fat this n sed ] 06' — 'SE41ER 'R'. WATER'
Data ^�=Q 202, - UNDERFLOOR PLUMBING
WORKS S MFCNSAI'ION DECLARATION'., �' +' t-
, n•rrnyaB�aareas penalty rfpi r rerrnnerdl 'Ing nanamnrhs ,. 203 —' 'ONDERF'LOOR MECbIANICAL i
•I -d 3n a c n ar f-c r r ra If f w k 's ` 20,4 UNDERFLOOR..FRAME
.ca I ,aria r: tiro d d I ly S•r 3mB r m Labor Code; for he x'1715 — UhIDERI-DOOR:`.-INSULATION• a
- part' cofibewakf wDbfIr,, r . send ' Y
❑u a `iI r w k :c p :'r 1 . GoySection,
- 301.7— •ROUGH 'PLUMBING
noo if the I n :L I 1 the p f - fn -work 1 hu'. tenant.'s . - 30�' TUB R• OR, SHOWER '
"issud.MyW kersC p ur Insuranceand Policy Irher arc L '
'•cl„ei. Talley N..:: , 30.3 = {ROUGH •'.MECHANICAL-,:
CER'I'INCATION OF EXEMPTION FROM WORKERS'; f ', 304 `—i.ROUGH EI_ECTR3 GAL ."+r,, '
•COMPLNSA910N INSURANCE ,•
s. . .,3 _ 309- ,—`FRAME • .
Illi r' a head rat no consider f rl' peonit 1, e l r hdred doll
(s ugh rl ss.) - '306 H01_DOWN,r'J '. .
I...61,m5rnml`p e nn workfwhichm' = d Ii d i 307' — INSULATION,
Shall r ply y pe y r hecnae subject Io the Workers - '
C op : r Lwsmcrr Dr° 308 _ SHEET.ROCK"
NOTICI TO AIIIICANI Irafterth CertificatefF adi Y should j 309 T E'X TE RIOR!''LATH
1 hu hl n theW k C ,c 'r provisions,flh L'n C I y .t; r
O r_ni 'Ili ally„'m np��; ra.,,'(hp „rshaunerenselo. ,k,.k _ ilk!. v4 INTERIOR LAThI
ZZ r 311. — 'SCRATCH COAT'i
'fa'• CONS IRUC I ION LEN DING AGE NCV
ther nyarr tttt a totalitarian dig apiary fnhe perfomrance - 31.3 e—' .ROOF ,NAI�_ f - • .
.ofIli kr -Illicitm p rs eased(So,.3097 Cb C)
i e . bend N' r 501 : FINAL ELECTRICAL ENERGY
end Address
mrn an:application e r that n 502 `- FINAL' PLUMBING ENERGY.
cz street.Iagree' r n ry I ry r 503 — FINAL_ MECHANICAL ENERGY
(� lob id 6 o I II by d P rl . I(his cayt ewer pot -
'� men I ryf p + p takes 504 — FPNAL BI IILDINO ENERGY,
(W) ber 1 if, dkat,h I.. fIeCar fC pn 6 :( .
rn ;Rrrnlr ....is r: r: asp hmm'y any 'v e:gaanl, d 505 — FINAL_ ELECTRICAL. .
U z elry ceyaeace or me dram,g cr In' nr.r,r�i. • , 5
f' r APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT 506 — 'GAS .TGST r � .
' SOURCE REGULATIONS. �' ,p - Issued by:. ;'Date
Signature rfApplw,UG tracts D'nc 'Re-roofs - 1 .,
HAZARDOUS MATERIALS DISCLOSURE 508 . FINAL°MECHANICAI ”
,•.sdel dhythopcp�i r,la Its Munieare l lCood Charter 9:12stoic or,'
He'Wr+rasets nlhiy Type ofRoof ry09 '.. F.IhIAL GARDE ".
CM Seaton 25532() y ifs r
11 Cl No All roofs shall 012'pectec�,pfiffla'�r �1� ��enHl being installed.
W h rn npE' r r t n a b p r : r1r p I d e. h If a roof Is Instal�b'rdvitfiou4 t>�{ tanwvwkspWARW$agree'to-remove
Fath 1 car a'd'hndhy rh ByArmA QallyMnag i - 1
'.I I - :'i all•new materials for mspecti6n. Applicant understands Ind'will comply with'
11 °" all'non-point'source regulations:
I k u listened 'r 'I' Iia errsl to,chillier
li 695'bf the e 'st
Cul Poria Hen &Mfr CodeSarlon 55115.25533 and 25534, rder,andmnr I
ifrheh 'dln nal ' ally h' le rlhl r yip 'htyr Ify lh. _ -
xc I rretinaeh I. nsrh Ip' noise f. Cerrlcr f.
Oc P' Y
' Signature of Applicant - „ { 'Date ,
Ow a r err,edaycra [)are "All roof covenngs to be Class-"B" or better °
t �'. •E ,.w OFFICE„ a, '
CITY OF CUPER'CINOx",.."x'r«° I`' • w -,�"`ve" g(
BUILDINGDIIVISION- PERP ' T CONTRACTOR-INFORMATION -y
BUILDING ADDRESS: '• r, - PERNIIIno
OWNER NAM1ICl. I'I 1 11 :-+ ,u_IdF I:'r' 1, L'If!iL.I'MO`I 1',;T"JI`I!,3-I PI 0"'T I[{y'I'IP��IIygIp4Yl V:"F14Y�+1(,IGY'1 i"4?
ONE: I-J r ,t _ r 1, !?Ir: f lf'Ri'?fl UEY-I 4'' HF,�F21Y1�;(t"1 1J11-IV SA.NIT%RY Nn
ARCHITECT/ENGINI:BR: PIInNE n f "1f9i'( .:;r.d"I'I J I.{Y'. nuILDING m::RMIT INFO
III (p P.LEC'f PLUMB midul
u '�INSPECTIONS��ax) (e / r DATI y 11451 PC$ TO ARRANGE..INSPECTION ,JOB DESCRIPTION
Nim :$ CALL TTI-3228 MONDAY-FRIDAY 24 HOURS
RESIDE TI Al„
kFOUNDATION/PIERS/H.D.S. - BEFORE REQUIRED INSPECTION.JOB ADDRESS ❑ SFDWL LlKITCHEN RF.MODEI
z r,oAND PERMIT#ARE NEEDED WHEN PHONING. C ADDITION El PLUMBING RE-PIPE
j APER GROUND ❑ \Illl;l'I-UNIP ❑STRUCTURAI.
PAD/SETBACK-CERT RESIDENTIAL CO.\I\IERCIAL_OTHER MODIFICATION
GARAGE SLABS/PRECUNI'pE CJ LN'fBRIUR G CHIMNEY REPAIR
IIA7ARDOUS FIRE ARJ A
7-C< p, o .. , - - "0 IMPROVEMENT ❑ SWIMMING POOLS
--POURNO CONCRETEUNTIGo\80V8'H�S BhEN STONED=/-'- cc
- ❑ 13A1'I I RHMUDGJREPAIR❑ DEMOLITIONEQ` UNDERGROUND/SLAB ❑ YES Ify�s I�Wcnr IInlaClnssA ' f '.�ohly'n uc mJ.
��i� rI CYI'fIER'
PLUMBING
❑ NO Initi,l LC.B.O # —
`'o ELECTRICAL
` - . . ` s',"'h EM TING ROOF COATI.LING CObUIER4fa7.:
3a c�DO NOT:POUR FLOOR UNTIL'AHOVE.HASBEUN SIGNED':. ❑ NEIVRLDWADDIDON ❑ DEMOLITION
PLUMBING —3�"
Numher of exiling ttnronngs ❑ TENANT ❑ TOO()SERVICE
MECHANICALg jj-.J.a IMPROVEMENT
ELECTRICAL. _ T,he removed Tn be retained ❑ OTHER
FRAMING VENTS
INSULATION h 'w
"`- "--' " "
izPTYPE OF ROOF COVERING
LACE NO SUBF100B�UNTII:'ABOVE`HAS'BFEN SICNP:D%:;'?'at;
ROOF SHEATH/DIAPHRAM EXIS,rlSSO. PROPOSED,
PLUMBING Cl Baill-Up Roal' ❑ Railt-Up Ronf
TUBS&SHOWER PAN ❑ Asphalt Shingle, O Apphall Shingles
MECHANICAL ❑ Wond Shaken 0 Wnod Shake, - -
ELECTRICAL/POOL BOND ❑ N Shingle, ❑ Wnod Shingles,
FRAMING/STAIRS/E.EGRESS ❑ Other(Specil'yl FO Other(Specify)
SULA'PION/VENTILATION Provide I.C.B.O.Repos Nt,.
OVER'NO;WORK;UNTIL`ABOV&HAS-BEEN SIUNED tp't3i:);-;'4I';k Provide Mfgr.Installation Spec.,.
EXTERIAL SHEAR/HOLD DOWN
INTERIOR SHEAR/HOLD DOWN
SHEETROCK/SHEETRO(:K SHEARINSPECTION SPECIAL INSPECTION REQUIRED 171DATE INSP
EXTERIOR LATH/W-SCREED
SLOWER LATH
?ND.TAPE DRIPLASTER-UNTH;'ABOVE`HASBEEN SIGNED'k',r,,
SCRATCH COAT
SEWER/WATER
TEMPORARY APPROVALS
OCCUPANCY
iz PLANNING 777-3388
zQ GAS TEST '
GRADE(P.W.777-3154)
FIRE
ZHANDICAP
(J Q ELECTRICAL
OE PLUMBING
w MECHANICAL —00 O
rF. y ENERGY
VISUAL FINAL ONLY —eO0
BUILDING
'.00C�UPANCY)OP BUILDING IS NOT PERMITTEDh
[7NTIL BUILDING E1NAL IS SIONFD BY BUHEANO ;IP --
.iNSPECTOR"'A' n,T*, a_i'm - --.,:;int_, `^"'� I =3 CERTIFICATE OF OCCUPANCY❑
RE-INSPECTION: PLYWOOD: IN-PROGRESS
INSP. DATE INSP._ DATE-__ INSP _ DATE
TEAR OFF INSPECTION: BATTENS: FINAL:
INSP. DATE INSP. DATEINSP. D,\'fE
NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION
APPLICANT'S POSTING COPY'