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19313 POST THIS CARD NEAR FRONT OF BUILDING rERnuT No. CITY OF CUPERTINO 19313 INSPECTION DIVISION- JOB INSPECTION RECORD1 3 •. JOB ADDRESS 1 U LJ S C,a C T UNIT# `' LOT# CATEGORY CONTROL c OWNER V V2_ e_ 'S6�� CONTRACTOR BUILDING PERMIT INFO INSPECTION DATE INSPECTOR INSPECTION RECORD - BL1:1 _1_1FOUNDATION/PIERS NOTE E ALL GRADING AND DRAINAGEIs UFERGROUND SHALL BE INSTALLED TO COMPLY WITH JOB DESCRIPTION PAD SETBACK-CERT THE APPROVED PIANS AND CITY OP CUPERnNOSTANDARDS' GARAGE SLABS PREGUNITE - - - C 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 EN75 CLEARINSULATION - 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/SHEETROCK SHEAR - . EXTERIOR LATIN/W-SCREEN -•,: ' SHOWER LATH - SCRATCH COAT - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED - NOTE:NO FINAL INSPECTION SHALL BE MADE BEFORE - _THE CONSTRUCTION TAX IS PAID FINALS DATE INSPECTOR SAN.#' ELECT.ENERGY PLUMBING ENERGY - MECH.ENERGY. ' - • ' - - f - - BUILDING ENERGY - - ELECT.FINALTEST ` - PLUMBING GAS TEST MECHANICAL - HEATING - - ELECTRICAL RELEASE• - FIREDEPT. 'GRADE OCCUPANCY. 'TEMPORARY APPROVALS - .ELECTRIC - - - • 'GAS - .. BUILDING OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL ISSUH�G:DATE `�• BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR CC'' AAdd ARRANGE FOR INSPECTION BY PHONING 252-4505 BETWEEN NOV N 11983 12:30 PM AND 4:30 PM MONDAY THROUGH FRIDAY,24 HOURS BEFORE REQUIRED INSPECTION. JOB ADDRESS AND C{tr rl ^u^ rf a6 PERMIT#ARE NEEDED WHEN PHONING. ' IMPORTANT! yy PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION if:l DBY. OFFICE COPY' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES USE BALL POINT PEN ONLY Building Project Identification - PERMIT NO. Baud mas:ILAdd . . ': � ' 19:313 ner1//�ante: - Phone: YL ti( 2uo/l '/][���^[J'�OFCUPERTINO-BUILDING DIVISION Contractor's Name: • Lle.No: ,•, /" a APPLICATION /PERMIT: ArcfiBect/Engineer. BUILDING-ELECTRICALPLUMBING-MECHANICAL CATEGORY CONTROL If _ LIc No: QTY ELECTRIC PERMIT' FEE BUILDING PERMIT INFO Address: 101 y� C�SS P1, CUPF duo e,4 PERhf1TISSUANCE I� ❑.' ❑ LICENSED CONTRACTOR'S DECLARATION I-II I hereby affirrathat l am licensed under pmvederesof Chapter 9(examclicar- APPLIANCES-RESIDENTIAL JOB DESCRI'C[ON « ingwith Se on7000)of Dlvisim3ofthe Busimmand ProfesdonsCode,and my - - itcense Ia In full force and affect. _ PANELS , Dale - Contracto( w ARCHITECTS DECLARATION 2014000 AMP"' q�+oZ I understand my plana shall be used as Public mounts. OVERI000"I'S - - SQ.FT.FLOOR AREA sm.IT. K Lirensed Professional - SIGNS ELECTRICAL �¢6 OWNER-BUILDER DECLARATION SI'ECIALCIiCUIT/MLSC f I •Ihereby affirmmntract that I aexempt fromthe Coors License Law for the Z,.,QQ p�p following means.(Section 7031.5,Business and Professions Code:My city or - '�z W enuntywhich requires a pertNt tomrutruR,alter,Improve,demolish,orrepalr '141P.METIR ORPOLE[NST. anystmeture priorto its essuance,ae. ,, orequireatheapplicant forsuch permit to POWER DEVICES O 'fil...igned statement that he is licensed punt rsuato the provie cut,of the , w Contractor's License Law 3 (Chapter 9(rommeneing with Section 7000)of Divl-p SWIMMING POOL ELECTRIC � Joe Business Profeeelons Code)artist Kee.exempt therefromend VALUATION , the basis for the alleged exemption. Any violation of Section 7MIS by any 4q OUTLE7SSWITCHESFIXCURES Z a d p� aPpIlcm,for a Permit subjects the applicant to a civil penalty of net more than flue h ed dollats($500). NEW RESIDENTIAL ELECTR- .. is owner of the properly,or my employees with wages all their sale - SFT' STORIES TYPE CONSTRUCTION compensation,, will do the work and the structure is son:intended or offered for O sale(Sec.7044,Business and Pmtessiona Code:The Contractors License law . $ does net apply to an owner of property who builds or improves thereoM and OCC.GROUP FRES.UNITSwho does such work himself or through his own employees,provided that each �3 Improvements are not Intended oroffered forsale.If,however,lhebulldlegor ' TOTAL: Improvementheoldwithinoneyearofcomple loMtheowner-buBderwBlhave ' tllRkurden of proving that he did not build or improve for purpose of sale.). QTY, PLUMBING PERMFF FEE FLOOD ZONE ApN „ LJ L all owner of the property,am exclusively contracting with licensed PERMIT ISSUANCE - .atnctaretoconstruct the project(Sec.7044,Bush.and Professions Code: - - The Contractor's License Law don net apply to an owner of property,who Wilda or Improves thereon, and who contracts for such projects with a ALTER-DRAIN&VENT-WATER(EA) _ �gR(factor(sl lkensedpunuaatrothe Cmtmdor'sLt nse Law. FEE SUMMARY LJI am e;e t under Sec B &P C f r this enon` BACK FLOWPROTECT.DEVICE OUTSIDE FEES DRAINS FLOOR ROOF,AREA,COND. SANITARY Y_ N_ - Owner s 'Date RECF3PCX h COMPENSATION DECLARA ON FIBMIF SPER TRAP SCHOOL TAX Y_ N_ ❑I he affirm that I have o certificateno of consent m op thereof ora RECEIPT X 3certificate 800,Lbo(Workers'Comperuailonlriaurance oracertifled ropythereof(Sec. GAS EA SYSTEM[INCA OUTLET � PARKFEE Y_ N_ 3X00,Lab CJ Poll X GAS BA.SYSTEM-OVER 4(EA) .. RECEI'f X 4' • Cogs - BUILDING DIVISION FEES _ MCertlfied copy b herebyfurnished.the city GREASE/INDUSTRL WASTE INTERCEPTOR PLANCHECKFEE MCertlficd copy e.(fled with the city Impaction division. CERTIFICATE OF O(EMFTION FROM WORKERS' GREASETRAP „ " PAID INSURANCE COMPENSATION (Chis ecctlon readout be comp[ COMPENSATION te.(orone hre undd dollars SEWEILSANITARY-STORM EA,2[017. Date Recei t# ($10()orlcss.)' WArERHFATERW;/VENT/ELECCR ENERGYFEE Y N I certify that in the perfarmanceaf the week(orwhich this permit is heated; I shall not employ any pence In any manner so all to became subject to the WATER SYSTEM/TREATING Workers'CompensaRan Laws of California.Data - PAID C✓ ZAppllaant - NEW RFSIDFNTTAL FILMS. SQ}T.` Date Recei t# Z O NOTICE TO APPLICANT:K,after making this Certificate of Exemption,you _ Hshould become subject to the Workers'Compensation provisions of the Labor TOTAL:' N Code,youmuetforthwilh complywithauch provifterea rthe.permRshall W BUILDING W deemed revoked. ' CONSTRUCTION LENDING AGENCY SEISMIC FEE FEE tl . 'Iherebyaffirmthat there be construction leading agency forthe perform - ELECTRIC FEE , 0 Z ante o(thework for which this permit e.issued(Sec.3097,CIV.G.) - �'" � ,•70TAL: 0 O Lender's Name - PLUMBING FEE ,LLf Lender's Addreas QTY. MECHANICAL PERMIT FEE MECHANICAL FEE „O W ImrHfy that have mad this applicatbnand&ami that the above Information - S Lsmmed.I agree to complywlth all city and county ordinances and state laws PERMIT ISSUANCE FEE$ } Wrelating to building walrusHon,and hereby authorize representative of this (— Z city to enter upon the abovimenUoncd property for Inspection purposes. ALTER OR ADDTO MECH. Date 'R0Ce1Pt# r V (We)agree to save,Indemnify an d keep harmless the City of Cu partlno agabut liabi ties,judgments,rosmand expenses which may In any vay.crnre AIR HANDLING UNIT(TO 10,000 CFM) SUBTOTAL: agai+et sal�C;fty in causeter kie granting of the.permit. /� � AIR HANDLING UNIT(OVER 10,000 CFM) CONSTRUCTION TAX .. SIgnatureoffAApap86cant/Contractor Date IXHAUST HOOD(W/DUCT) CONSTRUCTION TAX PAID: HAZARDOUS MATERIALS DISCLOSURE ' Will the applicant or future building occupant store or handle hazardous HEATING UNIT(TO 100,000 BTU) material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Date Recei t# Health and Safety Code Section 25531(a)l HEATING UNIT(OVER 100,000 BTU) TOTAL: e0 F1Yes _ ' Tr,�,.J,No Willtheappiicant or fu tum building occupant use equipment or devices VFNIIIAT16N FAN(SINGLE RESID) ISO]A(x]'C�DATE which emit hazardous air contaminants as defined by the Bay Area Air �iA D (L+ Iity Management D❑lstrict7 BOILER-COMP DII'OR 100,000 BTU) yes ]have read the baza Nornaterials requirements under Chapter 6.95 of BOILER-COMP(OVER 100,000 BTU) ' {I{(11( 1- �(]O(1, the California Health&Safety Code,Sections 25505,75533 and 75534.1 understand that if the building does not currently have a tenant,that it as my NEW RESIDENTIAL MECH. 9Q.FT. responsibility to notify the occupant of the requirements which moat be met p p .{, prior to Issuance of a Certificate of Occupancy. City of cupm>RQ Owner or authorized agent Data ' ' s1,, L . TOTAL: ,.•' ISSUED BY: J.�� Iyh`UC L./ OFFICE COPY