24583 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPERTINO _ ELECTRICAL PERMIT NO.
BUILDING DIVISION ,APPLICATION/PERMIT PLUMBING-MECHANICAL 24583 p 5 8
BUILDING PROJECT IDENTIFICATION - L [� a 3 3
BUILDING ADDRESS: SANITARY NO. APPLICATIONSUBMTITALDATE
177 r. I f �me(4ft Ccl 45014-
OWNERS AME: - PHO LIC NO: - 1 �+
y� �(, 0�.!/nQH• __N/7C CONTROL#
• ARCHITECT/ INFER: II lQ T' I ¢' I '� ADDRESS:
CONTACT: PHONE:
' QTY. ELECTN7C P FE8 BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
PERMIT ISSUANC ❑ ❑ ❑
LICENSED aDCONTRndmrpmSDECLA"TIONhapmr9 APPLIANCES RE DL TIAL B DESCRIPTION
pyZ '1 hereby afBrLICEN aEDCONT uACTORvinDECLOhapter9(commencing with CA/`TION
OO Section 7000).f Division 3 ofthe Business and Professions Code,and my license is in PANELS
V ICpy! full force and effect.
yy License Class Lic.# wqOWMIPS
F'60. DateContramor AMPS
ARCHITECTS DECLARATION IWOA S SQ.FT.FLOOR AREA �s$/SQ.FT.
ZOy
OZ—C I understand my plans shall be used as public records.
-
SIGNS ELE A
Qz Licensed Professional
gp CG OWNER-BUILDER fo rn the C ATIONea.I a SPECIAL C TSC.
ryxa4,,O d F I herehy affirm that I am exempt from the Contractors License Law for the I•
{v1 it IL m followinga son.amait(Section construct,
Business and Professions Cade:Any city or county TEMP.M R POLE(NST.
❑a which requires a permit to construe,alter,improve,demolisM1,or repair any atrumure
tY�Q� priorto as issuance,also requnce,im applicant for such permirto fleasigned statement POWER DEV( ES _
that he is licensed puauea00 the provisions fthe Contaut0rs License Law(Chapter
Ie� me
9(comncing with Section 9000)of Division 3 oftbe Business and Professions Code) SWIMMING POOLELECTRIC VALUATION
mat orthat he isexcmpttherefrom and the basis for thealleged exemption.Any violafionof
GSection 7031.5 by any applicant for a Permit subjects the applicant to a civil penalty of OUTLETS-SWITCHES-FIXTURES Z1fQIJ
p t more then flue hundred dollars($500). NEW RESIDENTIAL ELECIR S .FT. J X11
p� I,as ownsrofthepropeny,ormyemployeeswith wages asthelrsolecompeneation, Q STORIES TYPECONSTRUCTION
the work,and the structure isentloeadedoroff rcd fxesale(Ser.7044,Business
���d Rofess ns Cade:The Contractor's License Use does not apply to an owner of
properly who builds or improves thereon,and who don such work himarelfor through his
wnemployees,providedthatsuchimpmvementsaronatinwndedorofferedforsele.IL OCCGROUP RES.UNITS
however,the building orimprovement is sold within oneyearofevmpletion,ihner-
eow - TOTAL:
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑ I,asoearrotlhe properly,emexclusively contracting with licensed conuecmam QT' PLUMBINGP FEE FLOOD ZONE APN
consumer the project(Sec.70,41,Business and Professions Code)The—olow ore PERMIT ISSUANCE
License Law does not apply m an owner ofpmperty who builds or improves thereon,and
who contacts forsach projects with a carman,O licensed puauentmthe Contractors ALTER-DRAIN&VE A E ( ) FEE SUMMARY
License Law.
❑nl am exempt ander Sec. ;B&P C for this reason BACK FLOW PROTECT.DCV-Z)
EV IC 'J UTSIDE FE
SANITARY Y N
nwner r D RECEIPT#
• c DRAINS-FLOOR,ROOF,ARE
WORKMAN COMPENSATION DECLARATION SCHOOL TAX Y N
❑ Irs'Co afflrNNaRhnance ca.Gerd r copythromf(Snsure,0r Lab C.)which FIXTURES-PER TRAP RECEIPT
Workcrs'Compensmion Insurance oracertiFied copy thereof(Sec.3800,Lab CJ which PARK PEE Y N
overs all em to ee's under this pemtiL RECEIPT'N
P Y GAS-EA.SYSTEM-1 INC.40UTLETS '
Policy# BUILDING DIVISION FEES
Company GAS-EA.SYSTEM-OVER4(EA) PLANCHECK FEE '
El Certified copy is hereby famished.
rm
❑ Certified copy is filed with the city inspection division. GREASEANDUSTRL WASTE INTERCEPTOR GRADING FEE
CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE TRAP SOILS FEE
COMPENSATION INSURANCE
(This section need not be completed Hine permit is Income hundred dollars($100) SEWER-SANITARY-STORM EA.200FT. ENERGY FEE
or less.)
I emify that in the performance of the wnrk for which this permit is issued,I shall WATER HEATER W/VENT/ELECTR
Art employ any Person in any manner so as to become subject to the Workers PAID
Compensution Lawsof Califomia. Date WATER SYSTEM/TREATING Date Receipt#
Q 7-+ Applicant -
Z 2 NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should NEW RESIDENTIAL PLMB. SQ,FT. i TOTAL:
rA become subjectto the Worker's Compensation provisions of the Labor Code,you must
forthwith comply with such provisions or this permit shell be deemed revoked. - - BUILDING FEE
W z CONSTRUCTION LENDING AGENCY t SEISMIC FEE -
^a (hereby from that there is a construction lending agency for the performance of
V O the work for which this Permit is issued(See.3097,Civ.C.) TOTAL: ELECTRIC FEE
�n Lenders Name
O !� Lenders Address QTY, MECHANICAL PERMIT 0 FEE PLUMBING FEE
LU$I1 certify that 1 have read this application and state that the above information is MECHANICAL FEE
act.l agree to comply with all city and county ordinances and state laws relating to PERMIT ISSUANCE
�-' In building construction,andhereby authorize representatives ofthis city to enter upon the - CONSTRUCTION TAX
U y above-mentioned property for inspection purposes. ALTER OR ADD TO MECH.
F7 (We)agree to save,indemnify and keep harmless the City of Cupertino against
liabllitia,judgmente,cases andexpe eas which may in any way accrueagainst said Cly AIR HANDLING UNIT(TO 10.000 CFM
nsequence f the granting o/f t�hio'P]ermit AIR HANDLING UNIT(OVER 10,000 CFM)
�o��/{�C — tO�Q� .
Signature of ApplicanUContacmEXIfAUST HOOD(W/DUCT)r Date PAID
HAZARDOUS MATERIALS DISCLOSURE HEATING UNIT(TO 100,000 BTU) Date Receipt#
Will the applicant or future building occupaatstme or handle hazardous material HEATING UNIT(OVER 100,000 BTU) - L:
me defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Code,Section 25532(a)P
0Yee El N0 VENTILATION RAN(SINGLE RESID)
ISSUANCEDATEUP
Will theapplicantorfuture bmildingaccupabtuse equipmenmrdeviceswhichetnit BOILER-COMP(3HP OR 100,000 BTU) i
. hazardous air rnntaminants as defneJ by the Buy Arm Air Quality Management BOILER 100,000 BTU)
Dia°�°°'
❑Yes 11 No NEW RESIDENTIAL MECH. SQ.PT. DEC 10 1992
1 have read the hazardous materials requirements under Chapter 6.95 of the CI I I OF Curt:5
California Health&Safety Code,Sections 25505,25533 and 25534. 1 understand that
if the building does not currently have a tenant,that it is my responsibility to notify the
occupant of the re paimanctus which must be met prior to issuance of a Certificate of
Occupancy.
Owneroramhorized ngent Date TOTAL: ISSUCD BY:71J."
OFFICE
CITY OF CUP>✓.0 INV PERMIT NO.
BUILDING DIVISION - BUILDING PROJECT IDENTIFICATION 4
BUILDING ADDRESS: r SANITARY NO. APPLICATION SUBMITTAL DATE
VNERS NAM PIIONE: CONTRACI'ORBNAME: LIC NO: I
• 1 _ _"_ __ NIC CONTROLa
ARCHITEC IENGINEEFL N :y� r LIC N(r:\4 i ADDRESS: ❑
INSPECTIONS -� �` DATES INSPEC. INSPECTION RECORD BUILDING PERMIT INFO
";;:% BLDG ELECT PLUMB MECH
FOUNDATION/PIERS/H.D.S. /,45 NOTE: ALL GRADING AND DRAINAGE ❑ ❑ ❑ ❑
UFER GROUND
SHALL BE INSTALLED TO COMPLY WITH JOB DESCRIPTION
-
PAD/SET BACK-CERT THE APPROVED PLANS AND CITY OF i n 0 �
CUPERTINO STANDARDS. t�/-�--}�'O�r
GARAGE SLABS/PREGUNITE
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED INSPECTION SPLCIAL INSPECTION DATE INSP.
UNDERGROUND/SLAB REr1UIPED
PLUMBING
ELECTRICAL
DO NOT POUR FLOOR UNTIL ABOVE HAS BEIN SIGNED
PLUMBING
MECHANICAL
ELECTRICAL
I
FRAMING VENTS
INSULATION
PLACE NO SUBFLOOR UNTIL ABOVE HLLAS BEEN SIGNED
ROOF SHEATH/DLAPHRAM
PLUMBING ro _
TUBS&SHOWER PAN n _ ® �
-�
ECHANICAL i r\
ECTRICAL/POOL BOND
FRAMING/STAIRS/E.EGRESS - z-q DA 1 n j
INSULATIONNENTILATION `
COVER NO WORK UNTIIABOVKHAS BEBN SIGNED;;
EXTERIOR SHEAR/HOLD DOWN
INTERIOR SHEAR/HOLD DOWN
SHEETROCK/SHEETROCK SHEAR
EXTERIOR LATH/W-SCREEN
SHOWER LATH
NO TAPE OR PIASTER UNTIL ABOVE HAS BEEN SIGNED
SCRATCH COAT
SEWER/WATER '
TEMPORARY APPROVALS -
BUILDING
ELECTRICAL
GAS
FINALS
GAS TEST
GRADE PROVED FOR OCCUPANCY ❑
FIRE
HANDICAP
TO ARRANGE INSPECTION ISSUANC&DATE .y '` a•
CA1.1, UFTFRNOONS 113:30 PNL .4:00 PNII ..
LECTRICAL/ENERGY 252-4505 MONDAY TO FRIDAY 24 HOURS
-UMBING/ENERGY BEFORE REQUIRED INSPECTION. JOB AD-
DRESS AND PERMIT#ARE NEEDED WHEN
MECHAN[CAL/ENERGY PHONING.
BUILDING/ENERGY �z-y .CI"I EN'!Il):N CONI RAI:f0kJ:
ELECTRICAL FINAL TEST NO PERSON(S)SHALL PERFORM WORK ON
THIS JOB SITE WITHOUT WORKER'S
OCCUPANCY OF BUILDING IS NOT PERMITTED COMPENSATION INSURANCE.
UNTIL BUILDING FINAL IS SIGNED BY BUILDING IM11OR FANI
INSPECTOR. PLEASE READ REVERSE SIDE BEFORE -`l"
CALLING FOR FINAL INSPECTION!! ISSUED BY:
APPLIOANT'S_POSTING COPY_
0--l— citv
10300 Torre Avenue
Cupertino, CA 95014
of
Cupertino Building Division
(408)7 -
(408)777-3333 (fax)
March 29, 1995
Owner
7732 Carriage Circle
Cupertino, CA 95014
REFERENCE: Building Permit 924583, Carport
Dear Owner:
• Our records indicate that the above referenced building permit for a carport, has not been
finaled in our computer. Our records indicate that the last inspection made was January
29, 1993, by inspector Jerry Brager, and this was for a final on the project. According to
our records, this failed to pass inspection.
If your inspection card shows that your project has been inspected and finaled by the City
of Cupertino, we would like to show this as a part of our permanent inspection record.
Please contact this office within thirty (30) days of this letter. If we do not hear from you
within this time, we will expire the permit and dispose of the file.
Thank you for your assistance.
CITY OF CUPERTINO
04
Christ?Akatiff, Administrative lerk
(408) 777-3203
CA/cda
cc: file
P,ntec.:n Fecvded P,.iOe,