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19621 POST THIS CARD NEAR FRONT OF BUILDING PERMITNO. 19621. CITY OF. CUPERTINO A A DALE INSPECTIONDIVISION-•JOB.INSPECTION I;ECQ D JOB ADDRESS . �•-� LIE' �y,��1tir. Rr IT p_ .t� � - CATEGORY CONTROL N,' a� BUILDING PERMIT INFO, OWNER_ CONTRACTOR �-(.' INSPECTION % FOUNDATION/PIERS 'DATE- INSPECTOR NOTE:ALL GRADING AND DRAINAGE,ECORD 0 E UFERGROUND. v SHALL BE INSTALLED TO COMPLY WITH .�'1 TOB DES CRI191ON PAD SETBACK-CERT - THE APPROVED PLANS'ANDCITYOF.� ' - I CUPEMNO STANDARDS. GARAGE SLABS PREGUNITE -POUR,NO CONCRETE UNTIL ABOVE HAS.DEEN SIGNED' UNDERGROUND/SLAB` INSPECTION,, ' DATE INSPECTOR ' PLUMBING - - - ELECTRICAL " MECHANICAL - - DO NOT POUR FLOOR UNTIL ABOVE.HAS BEEN SIGNED, WOOD FLOOR ' 'PLUMBING MECHANICAL Al r - - ELECTRICAL _ FRAMING VENTS CLEAR. - INSULATION' PLACE NO SIIBFLOOR UNTIL ABOVE HAS BEEN SIGNED I - ROUGH. ' PLUMBING. .'- . . TUBS&SHOWERPAN - MECHANICAL - _ ELECTRICAL ACUZZI BOND - FRAMING STAIRS - _ - INSULATION/VENTILATION EME RG.EGRESS ( , SEWER WATER '- COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED'. EXTERIOR SHEAR HOLD DOWN INTERIOR SHEAR/FIOLD DOWN SI-IEETROCK/S 12ETROCK SHEAR , - 'EXTERIOR LATH/W-SCREEN ' SHOWER LATH - SCRATCH COAT NO TAPE OR PLASTF,R'UNTIL ABO VF. HAS BEEN SIGNED - NOTE:NO FINAL INSPECTION SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS,PAID, ' FINALS • . DATE INSPECTOR SAN.N ELECT.ENERGY' -• .t - - _ PLUMBING ENERGY - MEChI.ENERGY. BUILDING ENERGY. - ELECT.FINAL TEST , .PLUMBING - - GAS TEST MECHANICAL - HEATING ELECTRICAL RELEASE - - ,•� I .'. FIRE DEPT. GRADE. - - OCCUPANCY TEMPORARY APPROVALS - - ELECTRIC ' GAS BUILDING - •• . ..165 ANTE DATE . OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL � � 9".!•11t.,d BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR .. , "` - - ARRANGE FOR INSPECTION.BY PHONING 252-4505.BETWEEN- FE Q O J 1990 12:30 PM AND 4:30 PM MONDAY THROUGH FRIDAY 24 HOURS BEFORE REQUIRED INSPECTION..JOB ADDRESS ANDroghltl0 ".PERMIT # ARE NEEDED WHEN PHONING. IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING 'FOR FINAL INSPECTION ssueD°Y' OFFICE COPY APPLICANT TO FILL IN INFORMATION WiltlU LINES — USE BALL POINT PEN ONLY Building Projekt Identification PERMIT NO. Bulletin Address: �.`-�Y�. _ 19621 a wnerI. ante ,Phone: - CITYOFCUPERTINO,BUILDING DIVISION APPLICATION I PERMIT ` BUILDINGm, TRICALML BING-Mp.CI-IAMCAL CATEGORY CONTROL If r tc /'nglneer. o; E i BUILDING PERMIT IN FO, - (r� QTY ''"ELECTRIC PERMIT -',FGEI - ' Add.2 I �(„L,t PER)ATISSUANCE I�.D DIS ❑ LICENSED CONTRACTOR'S DECLARATION Ilk ,Ihereby affirmthat lam licensed under provisions of Chapter 9(commmc- APPLIANCESRE4DEM10kl JOB DtiSCRE'DON Ingwith Sccttun7000)of Dlvlslon3 ofthe Buslmssand ProfessionsCods,and my - ��� � s licenm b in tali(rce d d(ect. PANELS - . License Claw _ LICM y� Data Conlndor //IL ARCHITECT ECGRATION 201-1000 AMPS qw�O Zp ]understand my plan shall be used as public records OVER 1000 AMPS SQ.RC.FLOOR ARG S/SQ.FT.. k� Licensed Professional SIGNS ELECTRICAL GGGG 6 OWNER-BUILDER DECLARATION I'n SPECIAL CIRCUIT/MLSC ZFp, a Ihercbyaffirothatlam exempt from the Contractor's License Law for the OFF.pOj following mature.(Section 7031.5,Business and Professions Code:Any city or coaq�p,MEfER OR POLE]NST. - ntywhlchmquimsaperrmtwmnstnct,alter,impmve,dermllsh,orrepalr , q �F anystructure priorto its issuance,alsorequiresthe applicant for uch permit to FEWER DEVICES tlWJ5 rY1 B�1 S file a signed statement that he b licensed pursuant to the provisions of the 3m� Contractor's License Law(Chapter 9(commencing with Section 7000)of Divi- SWIMNUNG IDOL �Og ELECTRIC VALUATION 0 5 the basis for the alleged exemption. Any violation of Section 7MI-5 by any OUTLETSSWETCHESFIXTURFS _ (� applicant fora permit subjects the applicant to a dull pemlty of no ..than re than five hundred dollars($500, - NEW RESIDENTIAL ELFCTR FS ❑I;as owner of the property,or my employees with wages as their sale SQ'Fr' 57'OItITYPE CONSTRUCTION C7a compensatlon,willdo the work andthestomure isna intended or offered for ' '$ ,❑ sale(See 70K Busbuss and Professions Code:The Contractors License Law - j$$ does set apply to an owner of property who W ildsor improve-themem,and OCC.GROUP RES.19NC1'S 0. who doro•uch work hlmselt orthrough his own employees,provided that such improvements are notlntended oroffered forsale.Ithowever,thebulldingor TOTAL; S";pD improvement esold with In oneyearofcompletion,the owear-budderwlll have th,L�+rdeo of proving that he did not build or improve for purpose of ode.). QTY; PLUMBING PERMIT',' " ' FEE' FLOODZONE APN LJ L as owner of the property,am exclusively contracting with licensed contract..to construct the project(Sec.7044,Business and Profetai.ns Code: PERMIT ISSUANCE The C.ntnctore License Law does one apply to an..at of property who ALTER-DRAIN&VENT-WATER(G) Wilda or Improves thereon, and who contracts for such projects with a mact.r(s)Ikensed pursuant to the Contractor's License taw. ''.i t�', FEEAUMMARY -LI I am exempt under Sec. B&P C for this reason BACK FLOW PROTECT.DEVICE OUTSIDE FEES Owner DRAINS FLOOR,ROOF,AREA,COND. SANITARY Y_ N WORKINAN COMPENSATION DECLARATION RECEIPT NARATION FIXTURES.PER TRAP SCHOOL TAX Y N Of hereby affirm that I have a rlrtum to of c.nxnt to spythmre,or a 3800,Ltb of Workers'Compensatlon lnsuranceora ttkitled ropythere.f(Sec. RECFRY N 3800,Lab C.) GAS EA.SYSTEM-1 INCA OUTLETS PARK IFP. V_ N policyN GAS G.SYSTDA-GVER4(FA) _ RECEIPT Cram any _ - BUILDING DIVISION FEES CertlOed ropy b hereby furnished. GRGSE/INDUSTRL WASTE 94TERCEPTOR PLANCHECK FEE lBed ropy Is(fled with the city inspection division.ty CERTIFICATE OF EXEMPTION FROM WORKERS' GREASE TRAP PAID COMPENSATION INSURANCE o " SEWER-SANITARY-STORM G.20OFT. Date Reeel t# . (Thlasectl.nneed not be completed if the permit r'9 for one hundred dollars ($10)).rinsd certify WATER HEATER r'4/NEM/ELECTR ENERGY FEE Y Id I rtify that in the performance of the work f.rwhlch this permit is Issued, I shall not employ any person in any manner so as to become subject to the WATCR SYSTEM/TRGTING Worker'Compensatl.n Lawsof Glitorect.Date - PAID ' licant I Z Q NOTICE TO APPLICANT.If,a flat ma king this CcAUF-te of Exemption,you NEW RESIDENTIAL PLMIL SQ.ET - Date Reel t# Hshould bcmmesubject to the Workers'Compensation proetiom ofth,Labor TOTAL: N Code,you must forthwith comply with such provisions or this permit shall be BUILDING ' deemed rev.knd. W S CONSTRUCTION LENDING AGENCY SEISMIC FEE tl Z . Ihereby affirm that there is a rorstructlon lending agency for the perform- _� TOTAL: ELECTRIC FEE arca of the work for which this permit is issued(See.3097,Civ.C.) Q_ U O Lender's Name PLUMBING FEE LL 1= Lender's Address QTY. MECHANICAL PERMIT —FEE , MECHANICAL FEE O W ce l rtitythat l have mad thisappliave ti.rand statethat theaboinformation - 4 um,.d.lag.e tacomplywithalldtyandrountyordi...ces and state law• PERMIT ISSUANCE FEES PAID: } relating to building construction,and hereby authorize representatives of this - Zcity to enter upon the above-mentioned pmperty for inspection purposes. ALTER OR ADD TO MECH. ' V _ (We)agree to save,Indemnify an d keep harmless the City of Cupertino Date 'Receipt# age net llablities,judgments,costs a rad expenses which may In any way accrue AIR HANDLING UNIT UO 10,000 CFM) SUBTOTAL: ago Wt City Inco sequence of the this Permit. Of AIR HANDLING UNIT(OVER l(LaoocFM)' CONSTRUCTION TAX Signatumot Appliant/ContracolrData EXHAUSTHOOD(W/DUCD ' CONSTRUCTION TAX PAID: HAZARDOUS MATERIALS DISCLOSURE' Will the applicant orfutuce building occupant store or handle hazardous HEATING UNIT(TO 100,000 BTU) nuterulasdefn.dbytMCupnino Munidpal C.de,Chapter9.12,andths _ Date Receipt# Heaith and Saf&y Codd,SPction 2S532(.)I HEATING UNIT(OVER 100,000 BTU) TOTAL: ❑Yes Will the applicant , uturc building occupant tomequlpment.,devices VENTIGTIONFAN((SINGLE RESID) ItjSU DATE which emitN hazardous air comanants as defined by the Bay Area Air j[" " Quality Management Dist 7 BOILER-COMPpFB'OR10(iDWBTU) 4M1Yea road the ��j}� o FEB 0 Z) 1990 avccath&SafetyCoeriabrcgW25505, under 5533anhapier6.95of BO LHR-CONP(OVR700,000BTU) the otod Californiais Health&Safety Code,Soolons curre25505,21533 and 25534. I understand that tithe building does not currently have atenanp that itEmy NEW RESIDENTIAL MECFL pr,ort ibllltr-cdlfytM1e meant ofthemqulremenbwhich must be'met C'TMI PI :xel^9(tIB(� priors arum o(a Certlfla of0 pa Owner or out odzed agent Date ISSUED BY.. .�- �_ V C 1 TOTALf— OFFICE COPY