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19586/ POST THIS CARD NEAR FRONT OF BUILDING ` ' PERMITNO. CITY OF CUPERTINO a 1 AL AM 19586 INSPECTION DIVISION- JOB INSPECTION RECORD _ U 'JOB ADDRESS Z2..Z D {�d�u� t.�UNIT# LOT # ca RY CONTROLi,L. OWNER _ s CONTRACTOR S 1.�f BUILDING PERMIT INFO INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION/PIERS NOTE ALL GRADING AND DRAINAGE UFERGROUND SHALL BE INSTALLED TO COMPLY WITHTHE Otl DESCWI'IiON PLA NS AND PAD/SETBACK-CERT CUPERTINO SA DARDS. CITY OF GARAGE SLABS/PREGUNITE I 120ow, 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 SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROUGH PLUMBING TU13S&SHOWER PAN MECHANICAL ELECTRICAL ACUZZI 13OND FRAMING/STAIRS INSULATION/VENTILATION EM ERG.EGRESS • SEWER WATER COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED EXTERIOR SHEAR HOLD DOWN INTERIOR SHEAR/HOLD DOWN SHEETROCK/SHEETROCK SHEAR EXTERIOR LATH/W-SCREEN SI IOW ER LATH SCRATCI I 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 MCCH.ENERGY 13UILDING ENERGY ELECT.FINAL TEST PLUMBING GAS TEST MECHANICAL HEATING ELECTRICAL RELEASE FIRE DEPT. GRADE OCCUPANCY TEMPORARY APPROVALS ELECTRIC GAS BUILDING ISSUANCE-DATE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL PAID . BUILDING FINAL 15 SIGNED BY BUILDING INSPECTOR ARRANGE FOR INSPECTION BY PHONING 252-4505 BETWEEN rE13 02 1990 12:30 PM AND 4:30 PM MONDAY THROUGH FRIDAY,24 HOURS BEFORE REQUIRED INSPECTION. JOB ADDRESS AND Cjtl P�Cq ortiRp PERMIT# ARE NEEDED WHEN PHONING. IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION ssuEDeY: �1�� / 3n�l =" e ' OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY / Building RoMrt Identification ' - • • PERMIT NO. Address...Building AddBu 22z7© PN-M flee CuPE2f10o C&L. . 95014 19 586 Phone: p Jct N a ���es 1415 45171 CITY OFCUPERTINO-BUILDING DIVISION CoXen" sNam� Lie.No: APPLICATION / PERMIT • • vQ BUILDING-ELECTRICALPLUMBINGMECHAMCAL CATEGORY CO . Architect/Engineer. Lie.No: QTY ELECTRICPERMIT FEE BUILDING PERMIT INFO Address: 1425 VIL1-A D(L• Los Awns PERMIT ISSUANCE ��-PO F-1 ❑ LICENSED CONTRACTOR'S DECLARATION I herebyaffirm that lam licensed under p.Wonsaf Chapter 9(comment APPIJANCESRESIDENTIAL JOB DESCRIPTION tngwith Section7000)of Dlvtston3 ofthe Bustnessand Protested...Code,ancimy license is in full force and effect. PANELS Llrense Class Lie.It ' s.11 Dale Contractor \- C 0 •ash �+ 0 L� ARCHITECT'S DECLARATION 201-1000AMPS q�q�uv tx 2 I understand my plans shall be used as public records. OVER 1 ODO AMPS SQ.FT.FLOOR AREA $/SQ.FT. Fi o Licensed Professional SIGNS ELECTRICAL 6 .� G��Ed OWNER-BUILDER DECLARATION SPECIAL CIRCUIT/MISC p„ Ihereby affi.that l am exempt from the Cont ractore License law for the following reason.(Section 7031.5,Business and Professions Code:Any city or TEMP.MECFROR POLE INST. countywhich requiters a permit tocorstmct,alter,improve,dernolbh,orrepair asystruclum pricrta its Lvuance,aLso requtmothe applicant for such permit o POWER DEVICES yP file a signed statement that he la licensed pursuant to the providom of the On Contractor's License Law(Chapter 9(commencing with Seaton 70M)of Divi- SWIMMING POOL ELECTRIC '0�' slon3 oflhe Business and Pro .. fevioCode)orthat he b exempt therefroand VALUATlO Sn 5 the basisfor the alleged exemption. Any violation of Section 70715m by anyd OUILETSSWITCHFS-FIXfURES z, O I c1 S' « ppli..tfo,a permitsubjn theapplinuotoadvil pe..11yerfnotmore(han I_ 1. a�undned dellars(SSOO. NEW RESIDENTIAL ELECTR SQ.FT, STORIES TYPECONSTRUCTION I,as owner of the property,or my employees with wages as their sole compensation,wll clothe work and(hestroctum In net intended or offered for OIn(Sec.7014,Business and Professions Code:The Contractors License Law $g does not apply to an owner of property who builds or Improves thereon,and OCC CROUP RES.UNITS who does such work himself orthrough hisown employees,provided thatsuch D Improvements are not intended oroffered forsale.If,howeveq thebuiiding or TOTAL: •V e(lJ../ Improvement bald within one yearof completion,the owner-Wilderwlll have tl(9�urdeo of proving that he did na build or Improve for purpose of vleJ. QTY. PLUMBING PERMIT FEE FLOOD TONE APN LJ L as owner of the property,am exclusively contracting with licensed PpRMR ISSUANCE contractors to construct the project(Sec.7014 Business and Professions Code: The Contractor's Licc..e Law does not apply to an owner of property who Wilds or Improve thereon, and who comnns for such ptojeats with a ALTER-DRAIN&VENT-WATER(EM actorta)Ilcensedp t to the Contractor's License Law. BACK FLOW PROTECT.DEVICE FEE SUMMARY lir Sec B &P C for lab masonOUTSIDE FLES nen Date DRAINS FLOOR ROOF,AREA,COND. SANITARY RFFCE N O (MOAN COMPENSATION DELLA TI �.U�PER.�P SCHOOL TA% Y N ❑1 by f �l have a certi0cate of con t m el(-Inwre,ora RECEIPT N cateofN r 'Com lj r tionlmuranmorace Ifiedmpythemof(Sec. GAS EA.SYSTEM-1 INC OUTLETS PARK rM Y N 3800,lab CJ I'ollry p P GAS EA.SYSTEM-0VER 4(EA) RECEIPT N PT Com any BUILDINGPT VISION FE CS any copybhcrcby turn ed. GREASE/INDUSTRL WASTE INTERCEPTOR PLANCHECKFEE fled copy V filed with(he iv n division. CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE TRAP PAID_t��� COMPENSATION INSURANCE SEW ER SANITARY STORM EA 200FT Date Retei t# 32a14'O (This section need not be completed if the permit la for one hundred dollars (S1W)orless) WATER HEATER W/VENT/ELFFCTR ENERGY FEE Y_ N_ I certifythat N the performance of the work forwhich this permit b issued, 1 shall not employ any person In any manner a as to become subject to the WATIR SYSTEM/TREATING PAID Workeri Compensation Lawsof California.Date Onppu ant Date Recei t# Z Z NOTICE TO APPLICANT:I,after making this Certificate of Exemption,you NEW RE9DFiVRAL PLMB. SQFT. 0should be..subject to the Workers'Compensation provetione of the Labor TOTAL: CC N Code,you mu at forthwith comply with such provisions or this permit shall be BUILDING FEE co W > deemed revoked. CONSTRUCTION LENDING AGENCY SEISMIC FEE 4 a Iherebyaffirmthatthem baconstruction lendingagencyfortheperform ELECTRIC FEE It,op 7 Z arce of the work for which this permit is Issued(Sec.3097,C1v,C.) TOTAL: U O lander.N.me PLUMBING FEE LL I— Lenders Address QTY. MECHANICAL PERMIT FEE MECHANICAL FEE OW 1cerifythat l have mad this applicetion and statethatthe above Information G Is correct.I agree to comply with all city and county ordinances and state laws PERMIT ISSUANCE FEES PAID: >. 0. to building construction,and hereby authorize representatives of this F Z city to enter upon the above-mentioned property for inspection purposes. ALTORADDTOMECH. Date RCCCIPt# L) (We)agrce to vrive ik-mm�ityandkrepbarred.es whip the City many Cu pert... AIR HANDLING UNIT(TO]O,DOO CPM) against iia les,' n(s,meta and expenses which may many wayaceme SUBTOTAL: st said consequence of Ne in ofthispe it. _ AIR HANDLING UNIT(OVER 10,"C IM) CONSTRUCTION TAX Sigww o rant/Contncior Dae IXHAUST HOOD(W/DLK:T) CONSTRUCTION TAX PAID: HAZARDOUSMATERIALS DISC SU Willt p ca r future building occupant at or ndlehsardcus HEATING UNIT(TO Iffl,"BTU) Date Rete) t# .in rich byt uperino Mu Idpal Code,Chapter 9.12,and the QZ Heal dSaf Code Se ? HEATING UNIT(OVER IW,0X1 BTU) TOTAL: OE (/ ❑ cs [ No Wathea plica or or futum building occupant use equipment or devices VFMILATION PAN(SINGLE RISID) ISEPoATI�'DATE whicheM avWous air corstaml..nts as defined by the Bay Arca Air Q.alit ...gement District? BOILER-COMP QHP OR 100,0(10 BTU) Yrs (nn No pp 4have read the h.zar�Oae ma(erlals requirements underChapier 6.95 of BOILER-COMP(OVER1D0,0088TU) 1- GU U( I�S7 � the Celifomla Health&Safety Code,Sections 25505,75533 and 25534.] understand that if the building does not currently have a tenant,(hat it kmy NEW RESIDENTIAL MECH. SQI`T. responsibility to notify the occupant of the requirements which most be met Clh/ of rfingrti6I/ prior to issuance of a Certificate of Occo pa ney. Owner or authorized agent Date TOTAL: A ISSUED BY_11 OFFICE COPY