3266 CITY OG CL'PEPTLNO INSPECTIM' RECORD (Office .Copy)
3266__ _ _ _ _19990 Olivewood-,,_Unit_ C__,__
ei'EP11IT N0. SANITARY DIST. NO. LOT NO. ADURP:SS
Re-Model Property Services
PROJECT OWNER- JOB SITE PIIO14E NO.
PERMIT ISSUED Date ELECTRICAL
BuLldinc — 5/25/83 Date l.nsp .
Iae_ctrical 5/25/83 Power Pole_
I'lumhina, Underround —
Nechnni.cal Rough Wiring
'Temp. Gas/Elect. fla I]s _
Solar Cci1Ln9-
Fire Sprinkler Fixtures Int/Ext
Sign Motors
Grounding
Hisc. Temp. Power _
FINAL INSPECTIONS NoC A proved _
Date Insp.
r"s PLUMBING
FIectri.c Date Insp.
Plumb in , Backflow
ilechanical Under round
Solar Underfloor _
Pool Partial. Rough
. Gradin , RoughComplete
I' --
.lnnni.n Solar
P.ouPh
Fire Dept. Water & Insulation
Health Dept. 'Main Drain
Building R/of/S Drain
Other Gas
Other
BUILDING Not Approved
Date Insp.
Pad Certification ilECHANICAL
Foundation Date Insp.
Pre-Gunite Underfloor S.M.
Slab-Ilembrane Ducts & Insulation
Bond Beam Fire Dampers
Underfloor Girders Fireplace
Floor Steel Grease Duct & hood
Ti.edowns One (tour Shaft
D.iaphrams Condensate Drain
Seismic Bracing EquipmenC Anchorage _
Ilal..ls-Panels Flues & Comb. Air
Frame Other
Lath Not Approved
Wallboards Int/Fxt.
Firewalls
Other
Mot Approved
s
BUILDING
•
ELECTRICAL
PLUMBING
MECHANICAL
MISCELLANEOUS
APPLICANT.TO FILL IN INFORMATION WITHIN RED LINES - USE BALI- POINT PEN ONLY
BUILDING PROJECT I DENTIFICATI ON PERMIT NUMBER
euILDINc I O�Y APPLICATION & PERMIT .
ADDRESS 'UN tTL
4 OL BUILDING-ELECTRICAL-PLUMBING -MECHANIC
OWNER'S _ PLAN CHECK VALIDATION
NAME _ OTY. -ELECTRIC PERMIT FEE
DrvE S
CONTRACORs OUTLETS-SWITCHES-RECEP 5.00/1.00
NAME pglD
uc NO S ILIGHTING FIXTURES -5.00/1.00
CONTRACTOR'S -RESIDENTIAL 4.00
APPLIANCES r� oQ
ADDRESS
• PRONE" PANELS p, - 5.00 T\IEo a}'IP L19I CATI0N
ARCHITECT SIGNS' 6,00 PLAN CHECK FEE P.C.NO.
OR p
GINEER - of Cupe mo
EN
' uc.NO. SIGNS TRANS. 3.00 y)f y
ARC H.OR ENG. - SPECIAL CIRCUIT 5.00 PERMIT VALIDATION
ADDRESS V -
ZIP EMP.METER OR POLE INS. 15.00
Avvu EArvrs MOTORS SEE FEE SCH. *�2sr
AooREss �SERVICE CHANGE 10.00oo LICENSED CONTRACTORS DECLARAHON,
U U 1 hereby affirm that 1 an licensed under provisions of Chapter 9 ANCE DATE
H G w (commencing with Section'7000)of Division 3'of the Business and - BLDG. EI-ECT. PLG. MECH.
H m z, Professions Code,and my license is in full force and effect. ❑ ❑ ❑ ❑
z o m - License Class Lia Number
Q y4 �0 Date Contractor ,
Ii w a OWNER-BUILDER DECLARATION - - BUILDING PERMIT
O REFER TO ORD INFORMATION
X
3 a- N 1 hereby affirm that I am exempt from the Contractor's License . MISC._ VALUATION S/FT.
F .. o J Law for the following reason.(Sec.7031.5.Nosiness and Professions PERMIT ISSUANCE 6.00 OD
Code Any city oraunty which reyuiresa perm cotr
it to nsuct,alter,
2 Q ' improve,demolish,or repair any structure,prior to its i%Tmnce,also ELEC.CONTR. - .LIC.NO. ELEC. t) D f
w- O u requires the applicant for such permit to IHe a signed statement OUR TOTAL r PERMIT T0.,.�y/�//
m he is licensed pursuant to the provisions of the Conlmetor's License �4Of✓C/t-�
F z r Low(Chapter 9(commencing with Section 7000)of Division 3o fthe
- a Business and Professions CoJC)or that he is exempt therul'rom cord QTY. PLUMBING PERMIT FEE
r p the basis for lite alleged exemption.Any violation of-Section 7031L5 STORIES TYPE CONSTR.
by any applicant fora permit subjects the applicant In a civil penalty ALTER-DRAIN&VENT-WATER.IEA.) 4.00
of mot more than five hundred dollars(S500)J:
❑ I,as owner of the property,or rey eturdoyces w;t11 wages as BACK FLOW PROTECT. DEVICE.' 2.00 OCC.GROUP RES.UNITS
their Sole cam pensatbn,will do the work,and the structure is not _
intended or offered for sale (Sec. 7044, Business mail Professions DRAINS-FLOOR,ROOF,AREA;CONO. '4.00
Code: The Contractor's License Law does not:ylply to an owner ot'.
property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 4.00 SO,FT FLOOR AREA TOTAL ACREAGE
hinvsell or thmugh bis own employ ccs.Provided that such improve-
ments are not intended or ofteredfor sale.Il,however.the bwWing GAS-EA.SYSTEM-I INC.40UTLETS 4.00
or improvement is suld within one year of completion', the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 1.00 BUILDING USE
builder will have the burden oft,roving that he did rat build or fill- RES IND CON Pe Om.,
for purpose of sale). INDUSTRIAL WASTE INTER.. 20.00 El El 11 C] El
I,as owner of the proPertR am exelus;vely cmnrue Ung with
licensed contractors to construct file project IS,,7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 5.00 - ASSESSORS PARCEL NO.
_ and Professions Code:The Contractor's License Law dues not apply
to an owner of property who builds or improve,thcrcno.and who LAWN SPRINKLERS-OVER 5d EA.) 1.00
contracts for such projects with a contmetod s)licensed pu scant to
the Contractor's l.iccnmLaw. SEWER-SANITARY-STORM EA.200ft/8.00 TRACT NO. Pa CELNO.
❑ lam exempt colder Sec. ,B.&I'.C.I'nr oli> WATER HEATER ANENT 4.00
retain
Daw _ Owner- G- WATER SYSTEM - - 4:00 ACC.DATE ACC.FILE NO,
W MPG All
Of CL
"RATiON WATER TREATING EQUIP. 4.00
I hereby affirm that I have a certificate of consent to self-insure,'. - ZONING ENG.SITE NO.
or a certificate of Workers'Compalsalion Insurance,or,a certified _
copy therenf(Sec.3800.L.b.C.).
Policy No. Company
Q ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24
Z Z ❑ Certified copy is fled with the city inspection division. MISC- REFER TO ORD.
0 Applicant Y❑ N❑ Y ❑ N❑
a PERMIT ISSUANCE - 6.00 FLOOD ZONE - A.L.U.L.
CERTIFICATE OIs EXli\IPTION FROM W'ORKIi RS" _
lL >_ CO S11-NSWION INSURANCE PLG.CONTR. UC NO. PLG.
a'a (T'his section need mol be completed if the permit is far orf TOTAL Y❑ NO ❑ N❑
Z hundred dollars(SI00)Or less.f
U O 1 certify that in the performance of the work far which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL P mit is issued,I shall not employ any person in any manner so as to
U become subject to the Workers'Compensation Laws of California. - BUILDING' DO
U w Date Applicant ALTER OR ADD TO MECH. 4.00
} y NOTICE.TO APPLICANT: IL after making this Certificate of I.x- � -
♦- ? emption,you should become subject to the W'orkco;Compensation APPLIANCE 4.00 PLAN CHECK
Provisions of the Labor Code, you most forthwith comply with FEE
U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 3.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 5.00 SEISMIC FEE 56
1 hereby affirm that there is a construction lending agency for - EXHAUST HOOD(WITH DUCT) 2.00
the performance of life work for which this permit is issued(Sec. MICROFILM
3097,Cie.C.). HEATING UNIT(TO 100,000 B.T.U.) 4.00
Lender's Name
Lenders Address - HEATING UNIT(OVER 100,000 B.T.U.)7.50 ELECTRIC VO
1 certify that I have read this application and swle that life an... VENTILATION FAN (SINGLE) 3.00
inI'onnation incorrect. I agree to comply with all city and county BOILER-COMM H.P,or 100,000 B:T.U.) 4.00 PLUMBING
ordinances and state laws relating to building construction, unit
Hereby outhori a representatives,of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
above-mentioned property for Inspection purposes.
(We) .gree to save, indoRAfy and keep hunnless the City of MISC.- _ REFER TO ORD. .
Cupertino against liabilities,judgulen Ls, casts and expenses which CONST.TAX
may in any way accre,-.g.;nst said tty in consequcn c of the PERMIT ISSUANCE � 3.00
granting of this pen it. MECH.CONT. ' LIC.NO. MECH,
Z �
OTA TOTAL S(/
Signa re of Applicant CI con Uu �'L
OFFICE COPY '