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13708r• POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD JOBADDRESS 20590 HOMESTEAD ROAD UNIT# LOT# OWNER CUPERTINO CONTRACTOR MYONG K PAK PERMIT NUMBER 137ER 08 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU-- ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION LIFER PREGUNITE PERMIT VALIDATION n ' 44 ISSUANCE DATE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING p Il" j ELECTRICAL MECHANICAL BLDG, ELECT.11 PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDsuI�DING Clty PERMIT `I CEIN FO RMATION WOOD FLOOR PLUMBING � VALUATION v.r $/FT. MECHANICAL ELECTRICAL PERMIT TO r FRAMING INSULATION , STORIES TYPE CONSTR. OCC. GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO. FT, FLOOR AREA TOTAL ACREAGE DIAPHRAGM. ' BUILDING USE RES IND CON PB Onrr ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH ASSESSOHS PARCEL NO. PLUMBING GAS TEST - TRACT NO, PARCEL NO. MECHANICAL ELECTRICALFINALS — /- DATE INSP. ACC. DATE aCC. FILE NO. FRAMING SAN # INSULATION PLUMBING ZONING ENG. SITE NO, GAS MECHANICAL FIRE SPRINK Y ❑ N❑ ENERGY T 2 Y ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH—INTERIOR ELECTRICAL _2 _ _ FLOOD ZONE E:]N❑ A.L. U: C. Y 0 N LATH—EXTERIOR FIRE DEPT..Y SHEETROCK GRADE _ -- -- SUMMARY SHEARINTERIORFEE BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC - - PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JUCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, F ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. =SEE PERMIT FOR EXPIRATION DATE — ELECTRIC PLUMBING MECHANICAL IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. CONST. TAX TOTAL Orrout wry APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 13708 BUILDING D �� Nv 2 OWNER'5 NAME ( 909 QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION aPHONE 12-64 DATE OF APPLICATION NAME AcroRs 1'� y p 0 Pqk UC.No. LI 3,5 UTLETS-SWITCHES-RECEP 10.00/1.00 AS LIGHTING FIXTURES 10.00/1.00 CONTRADDRESS roR' A✓ IVs��lUo6 AODRE55 / oS6 J*rbes PHO PPLIANCES-RESIDENTIAL 4.00 PANELS 10.00 OR OR ENGINEER uc. No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. - SIGNS TRANS. 3.00 ADDRESS ARCH OR ENG, SPECIAL CIRCUIT 5.00 PERMIT VALIDATION EMP. METER OR POLE INS. 20.00 ZIP ` yf APPLICANT'S ADDRESS 3oS6 �Drb.._6ALI MOTORS SEE FEE SCH. C - v SERVICE CHANGE )410 20.00 /�, LICENSED CONTRACTORS DECLARATION _- q//d /C 7 �, t,- J % 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full forcgand efferls� License Class L' / a Lic. Number 9 7 J' Dale J e•� Contmctorlyye y� ISSUA CE DATE BLDG. ELECT PLG. MECH. ♦ p city Ot VuC k PERMIT INFORMATION OWNER -BUILDER License 1 hereby affirm Thal I so exempt from the 7031.5, mess and Professions Law Code: Any city Code: Any city or county which requirese permit to construct. alter, countng whicheauircia permit to E711BUILDING MISC.- REFER TO ORD PERMIT ISSUANCE 10.00 vALUAnON $/FT. ELEC. CONTR. LIC. NO. ELEC. TOTAL 3O ,� improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 703 LS by any applicant fora permit subjects theapplicant toacivil penalty of not more than five hundred dollars ($500).): PERMIT TO � TT/ QTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. ALTER -DRAIN VENT -WATER (EA.) 5.00 ❑ 1, as owner the property, or my employees with wages my em their sole compensation, ion, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of . BACK FLOW PROTECTDEVICE 4.00 OCG GROUP RES. UNITS DRAINS -FLOOR, ROOF, AR EA, COND. 5.00 FIXTURES - PER TRAP 5.00 property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- ments are not intended or offered for sale. If, however, the building SD. FT. FLOOR AREA TOTAL ACREAGE GAS - EA. SYSTEM - I INC.4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or im prove for purpose ofsale.). ❑ I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, BusinessLAWN and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractogs) licensed pursuant to the Contractor's License Law. ❑ I am exempt under Sec. ,B.&P.C. for this reason GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB Other INDUSTRIAL WASTE INTER. 30.00 SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. LAWN SPRINKLERS - OVER 5 (EA.) 1.00 SEWER -SANITARY -STORM EA. 200ft/10.00TRACTNO. WATER HEATER W/VENT 6.00 PARCEL NO. Owner Date WATER SYSTEM 5.00 WORK ERS'COMPENSATION DECLARATION ACC. DATE ACG FILE NO. WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a certificate of consent to self -insure, or a Certificate of Workers' Compensation Insurance, or a certified copy thereof ( ec. 3g 0, Lab.C.).SL 20NI NG ENG. SITE NO. Policy No. .ompany r ❑ Certified copy s hereby furmshe f FIRE SPRINK y� N� ENERGY T 24 v� N� ❑ CertifiedCoy filfd with Ih rCit� inspectrio}'n� division. Applicant MISC.- REFER TO ORD, rI CERTIFICAT1.OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars IS 100) or less.) PERMIT ISSUANCE 10.00 FLOODZONE Y N A.L. U. C. Y ❑ N PLG. CONTR. LIC. NO. PLG. TOTAL OTY MECHANICAL PERMIT FEE FEE SUMMARY 1 certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. BUILDING Date Applicant NOTICE TO APPLICANT: If, alter making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 emplion, you should become subject to the Workers' Compensation provisions of the Labor Code, you nmst forthwith Comply with such provisions or this permit shall be deemed revoked. APPLIANCE 5.00 AIR HANDLING UNIT (TO 10MCF.M.) 4.00 PLAN CHECK FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, CN.C.). t Lender's Name AIR HANDLING UNIT (OVER 1ODMC.F.M.) 6.00 SEISMIC FEE EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 6.00 HEAT[ NG UN IT (OV ER 100,000 B.T.U.) 9.50 ELECTRIC 30 Lender's Address 1 certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby hereby authorize representatives of this city to enter upon the abovomentiorud property for inspection purposes. (We) agree to save, indemnify and keep harmless theCity of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting Of this permit. 1 / p a• VENTILATION FAN (SINGLE) 4.00 BOILER-COMP(3H.P.or10O,000B.T.U.) 6.00 PLUMBING 1B 100,000 BTU) SEE FEE SCH. MECHANICAL MISC.- REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT. LIC. NO. MECH. TOTAL TOTAL Si ala f licant/Contractor Date FFICE COPY