19376 POST THIS CARD NEAR FRONT OF BUILDING 14RMITNO.
CITY OF CUPERTINO193 r 6
INSPECTION DIVISION- JOB INSPECTION RECORD i
JOB ADDRESS 7 d 0 Z 1 l Vd. (. UNIT N LOT # CA BY CONTROL,I_• 7,C
Lf � CC'
sr.� �1A.•P I�«
BUILDING PERMIT INFO
OWNER V CONTRACTOR Lfl
INSPECTION DATE P CFO INSPECTION RECORD =� u
FOUNDATIO PIERS NOTE ALL GRADING AND DRAINAGE
UFER GROUN - SHALL BE INSTALLED TO COMPLY WITH _Oe F WPDON
PAD/SETBACK-CERT CE�INOSfANNDD RRDSNS M'DCITY OF �
GARAGE SLABS PREGUNITE PA T U.
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 SCIBFLOOR UNTIL ABOVE HAS BEEN SIGNED
ROUGH
PLUMBING
TUBS&SHOWERPAN
MECHANICAL
i.
ELECTRICAL/JACUZZI BOND
FRAMING STAIRS ,
INSULATION/VENTILATION
EM ERG.EGRESS
OSEWER WATER -
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
EXTERIOR SHEAR HOLD DOWN
INTERIOR SHEAR/HOLD DOWN
SHEETROCK/SHEETROCKSHEAR
EXTERIOR LATH/W-SCREEN
-W•R 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 ANSPECTOR
SAN.#
ELECT.ENERGY .
PLUMBING ENERGY
MECH.ENERGY _
BUILDING ENERGY
ELECT.FINAL TEST -
PLUMBING
GAS TEST
MECHANICAL
HEATING '
ELECTRICAL RELEASE
TIREDEPT.-
GRADE - ..
OCCUPANCY
TEMPORARY APPROVALS
ELECTRIC
GAS
BUILDING
OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL - ISSUANCE DATE
BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR _ PAID
ARRANGE FOR INSPECTION BY PHONING 252-4505 BETWEEN JAN -1219911
12:30 PM AND 4:30 PM MONDAY THROUGH FRIDAY,24 HOURS
BEFORE REQUIRED.INSPECTION. JOB ADDRESS AND City
BF(inn Rp
PERMIT# ARE NEEDED WHEN PHONING.
IMPORTANT!
PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION IeauEDBY: "'T
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY
Eulldin Project Identification 7 PEtMIT NO.,
Building Aadrtv: {93I^/�1�
APPUCA DON SIJBIMUTI�.L DAM
— A k"a,,, 7' ] one. CITY OF CUPERTINO-BUILDING DIVISION
Contnaor'e Name: T ur.Na. APPLICATION ( PERMIT —O
32 INGELECTR)CALPLU MNC.MFZHAMCAL CATEGORY C L/u`e—/)
• ArehNed/Fsglnmr. Iir.N.
J Ot
BU TNG PE IT INFO
Q ELECTRIC PERMIT FEE
Aaa.1 w- n Bi" PERMITISSUANCE Ilam
LICENSED CONTRACTORS DECLARATION
I harebyafflrmthat l am lNnm l urderprwW¢u of Chapter9(nmmm APPLIANCESRESMEZ47TAL JOB D RB'[[ON
Ing Mth Setbn7000)of Divldan3oftheBvlmsaand PmfeWo e,and
Bee b b full f and offed. PANELS k o f'e
LI¢ve Chw_Q[�iJS LIC( /�/'� ) 1/I
Date��=j c. czar f ytA� 1 Q� (/ C d PrP
ARCHITECIPSDECLARATION MM"AMM
MOZ, Iumde•t rryplamahaUb usedupubhcre�da OVER1000AMPS SQ.FT.FLOOR AREA 5/SQ.FT.
O
Lkensed Professional SICNS ELECTRICAL
OWNER-BUILDER DECLARATION
7�F" 7 m
lherebyafBrtbatl ante.emrom
ptfthe CoMradori Ll .nee f«the ST'CCIAL CIRCUIT/MISC
p following reasun.LSedlon 70315,Business and Profmbv Cade My dry or
TRIP:MECL4OR IDLE(NSE.
Fmunrywhlch requirvapemd[tomalad,altm,imprwe,demoWh,or repair
anydrvdum prbrto ibbsuave,aho requlreethe.ppBthe f«su.ni;of the POWER DEVICES
elle a algned statement that he b 11¢ved pursuant b the prudnlov of the
�Qu� Contractor,, keveLaw(Chapter9(mmnendb
ngwithSean70UpCT
ofDivi. SATMWNGPOOL ELERIC
O sbn3ofthe BuMev dProfessbv CMe)ortbalhebeumpttherefromaany nd VALUATION
S the base,for the alleged exemption. My vlolatlon of Se tion 70315 by
OQp app0ont(ora permit acts
subjtheappikanttoadvll pevhy of not moreHun OITILE]SSWITCHFSFIXTURFE SJ�?O
live�undred dallan(Lri0Q. I �•/
u I,u m
owner of the Property,or y employee,with wages as their pule NEW RESIDENTIAL ELIiCIR �.FT. .STOW ES TYPE CONSTRUCTION
C7¢ eompensatlon,wllldothe wvkaedtbe.tsudurebrcorma d?.Limnered w
5 O No(Sec 7014,to an. and f prop by Code:The Contndoh IJ¢rne Law
j$ dm notapplyto•nowvrorthrouh who buimplaymprovidedthatand OCC.GROUP R6 UNITS
who dine Mu tare k hlmhnu«through hbownle.If howe prwded that such
Impavementlarenot Intended earofcofmsale.If, owner-r, elder ilt hsor TOTAL
Improvement bwlo wlthinorcyearofeompldbn,theownm-bullderwlll love "
t)�¢.,rden of proving that he did not build or improve f«purpose of sale.). QTY. PLUMBING PERMIT FEE
LJ I,as owner of the property,am a.hadvely contracting with 14xn,ed FLOOD ZONE 'VRJ
mntracmn to mMlad the pmFd(See 7004,Business ant Professbv Code: PERMIT ISSUANCE
The Comndor.Lice.Law dm not apply to an owner d property who ALTER DRAW 4 VENT WATER(EM
or Improve tbereon,and who o mnm f¢each prokds with
ogplraetm-WB¢ved punuant to the Contndor•.LI¢nss Law. BACK FfAWI'ROITICT.DEVICE FEE SUMMARY
LJ I am exempt under Sec B 4 P C for thio naaon
DRAINS FLOOR ROOF,AREA,CONT). SANITARY Y_ N_
Owner DNe R_ N
WO .N
WORKMAN COMPENSATION DECLARATION FI% RF_S PER TRAP SCIi00L TAX Y_ N_
❑1 hereby affNm that 1 have•xrtl(I¢te of concent to self-impure,or a RECEIP17 P
¢rtN¢te o(Workere CmnpevaHonlruuru¢«a¢ndled oopythereof f5«.
3800,LAb C) _ /� GAS EA.SYSIFAf-1WUOITILE'IS PARK FEE Y_ N_
I'd kyl V� �� '� GAS EA.SYSTEM-OVFR 4 BA) RCLmTe
CF— C6 _ BUILDING DIVISION FEES
ified ropy it hereby fornIsheg
enified ropy Is filed with the dty unpin odivWon. GREASE/WDUSIRI.WASTE INTERCEPTOR PLANCHECKPE•E .
CERTIFICATE OF ESENPTION FROM WORKERS CREASE TRAP PAID 3l �`
COMPENSATION NCE FWER.SpMIARYSTORM EA MOP Date Recd t#
Rble sscUon need ata Mcompleted Bthe permit bf«one hundrM doOan
(SIW)«lese) WATER HEATER W/VFM/E.ECTR ENERGYFEE Y N
I oerWy that b the pedu ¢ hich
omnof the wok for wthis permit b issued,
I shall not employ any person b any manner•o a to hemme subjed to the WATEt SYSTF1r1/TREATING
W«kern Compensation Laws of Calfomb.Dane PAID
PP NEWRESTDFNfIALPLMB. SQFT.
Applicant
Z Dole Remi t#
Z O sWTICETOAsub)CAM:IL ftereWorls making ComperCenBkate of Exemption,you
should become subject to the Wm4ern Compeartbn prvvbba of the Labor TOTAL:
~
W fA Code,you rruatforthwbh—Ply with suchprovbloa«thl,permit"Ibe BUILDINGOU
> domed revoked.
W
o CONSTRUMONLENDENGAGMCY SEISMIC FTE
S'O
I ofthe af,kfmha. were amvtsu sawed bet, D97,C f.C.) perform TOTAL. ELECTRIC FEE
7 Z an¢of the work lorwbkh h fer�tbLsued(See 3D97,CN.C.) _
0O I<rder',Name t LL- PLUMBING FEE
LL F lender.Aaaax Z° T QTY. MECHANICAL PERMIT E
O w l mkifythat l have read thbapp8otion and statethatthabovebfomutl
e m MECHANICAL FEE
LU bmnedLSS
.I.greemmmplywW aBdtyaM county ordlanmand,ratelaw. PFRMITUANCE FEES PAID:
reW Ing to bulldln6 mnsrudim,and hereby authoiru representatives,of this
in city to enter upon the above-merwoed pmpenyforlapect,m purpo�s ALTERORADDTOMFGH.
Z (We)agree to save,i demnlfy an d keep harmlensthe City of Cupenlno Date. RCCelpl#
aga LutllabWtles,ydgme ,m aMexpe whkhm.ylnanywayamue AIR HANDLING UNIT(TO 10 SUBTOTAL:
ag;�y.eGd City In co^•e9uenre oft h t this errs".
�� Lr/�'A1e_/ AIR HANDLING UMI(DVFR IO,WOCFM) CONSI'RUCIION TAX
Signature of Appll«nt/Contndm Date I EXHAUST HOOD M/DECD CONSTRUCTION TAX PAID:
HAZARDOUS MATERIALS DISCLOSURE
Will the a ppBvnt orfuture building acwpant Ane or hard lo haurdous HEATING UNIT(TO tW,WO BID) Date Rmci t#
material as deBred by the Cupertino Municipal Cade,Chapter 9.1 Z and the
He.kh i rd Safety Code SSedan 25537(,)7 HEATING UNIT(OVER 1 W,000 BI'U) TOTAL: 1132,sit
W Yn fu on '1Q��A�,,
Blthe appllantm tore building occupant use equipment or devim VENTILATION FAN RESTD) ISSyr>raJDATE
whkheMthanrdov airwa.deBrud bythe Bay Arca Alr
• W Illy Managementgement Dltrkt?rkt7 BORF.R{OMP OTB'DR1W,000 BTU)
n❑No
4h;vcread the ha mousmMeriabrequirementsunderChapterfi95Of BOILER-COMP(OVER IW,0W BTU) JAN 12 1990
the Gldomia fifth bSafety Code,Sedbv25505,75SI3and25531.I
usp.ro Mtha.notif bth000edmrotmrrtntlyh otswhwhmustittarry NEW RESIDENTIALMECH SQFT
rxpovibBNy to nduy thcomrpaM of the ire rde whkh mrsthamet City Pf CUn9rtjp0
priorto nm ofaCertlflatc of Oc
Owner or authorized agent Date Lg'UED BY:�/' �t�"`� CL V{/
TOTAL:
OFFICE COPY