00080122 CITY or CUPERTINO
DIVISION
BUILDING CONTRACTOR INFORMATION:
nun.nDvntvtstorJ PERMIT' .
BUILDING ADDRESS -
ITRM1f iT NO. -
OwNE:R'SNA QO040 RO _ — - pv`t 't, NS II DATE
L,
ONS: I_AN.E BILTMOR
, SANITARY NO. 017147ft
1.O ZC ARCHLIFCTIENGINF.IiH: - ' 3 — BUILDING PERMIT INFO
K , BLDG , - ELECT '
PLUMB NIECE'
..
fn
o_z z LICENSI1DCOM NACI'OH'S DECLARATION "
OL=1 In�rony:n,m,m that :tecta p rch pm r9 t. n 'ns Job Description -
'F'3C w'Ih Se a (1.7110f11d'D '. 3ollolm cadlrolLsh C...E. Joyl' '
• 9 .
¢y^j se
is in Gil fonemd effect ..
m z a 6 License Claws Lic.
0`U °'°` c11110LAI RMDL INT. � .NEW, KITCFIEN� BATHS, I.-WASHER/
3 u t- ARCHITECT'$uIicLAR^'TION
I J :I Jmy PI h llw sed pbl'cnmNs
etin
- � R%C NEW FLOORCOVERINGS, 'Lpl'I'. DOORS F'AII
yCO IJeco,edP t:. or I
Ny OWNLR]I )ER"DECLARA'I]ON ,{
1 h by ufian that I am ease opt from the Compactors Liceria,Laaw Bribe -
'' reason.(Section 7031 5,Business and Pr t nw Cade Any c ty or tali uy
FC wlnh q ' p 1t t m h J I'1 p' yl curt - r „ . , t'• -
i 3C3 P peon t u aL y e.0 ppllr t .-ch p u u g
so
awanumna ` •. - " '.
mon 1 IP ant R p fll C , t L W ICh purr9 _
(c9n g 'mv t 7000) rD' i ash ❑: ,eP 1 no, Sq. FL Floor Area., - Valuation
oelh tl Illhe 10 his -II Ily 1 ,PI A,y '9hti„ „
ors r Toil ter 'r pvl If- x t nr am ppl tt < Ipc,mly ._ ', .
ern t , Iw a nn dmaa n -(scan - • APN Number Occupan�y.T
ype
- p1 III Pnptynr ,ye,Ploy sxhw:gexnel Ie„penwl _ . '$3�I71i5 '
wbe In kaJ t mm . m tea pdI .-I Is .7(aa,
ptkPly t m' ,R Dined Ins en' Ir02eqqn3603 .{caredo AL.. E.
®•,
offer J I If hox Ili b ild'ng ,p n e t is I lh 'yea f
omplt the ecr-'a Id ll have theh ofn Ip -ing ti t1eJJ sbuld
r pan.•or-I .I 1.01' — FOUNDATION NOV U_3 a. Q�
I.is owner o(mhe propenY.dm exciusismly contracting with licensed com ucturrss to: 2
swct Re proiec,Isec. ( .Raslnas!amt Preft"i,mw Cal The Contractor's. m' . . ]0e. — PIERS .
- .
Cee cl -I aawn't' l,en,rl p y hubuile nn-suwlheno 1.03 UFE'R BII�L�fIJG`
and h t I h p J t. with a c t Ian),tic J pursuant or a e BUILDING
��VV '
conm n dee 104 — REBAR
❑l a ill See - Barter a'.red '
105.' — 'ANCHOR BOLTS
WO HE OM ENSNUON DECLARATION 1,Or—, ;— SEWER R. WATER
nd•�¢ny mhrm,ann¢rp¢nally nr PeBary„rte dobe ronLwiog de�l;,:am,nw: P02' —' UNDERFLOOR PLUMBING ' '
wvnand .'m maintains CerRp�mte of Counsel, m,clt.inare '2te3 — UNDERFLOOR MECHANICAL
for Workers 1
C'omlwn,aamm us nrovided for ny'Smtiun 3700 of Ice LNwr Cnd , mall(:, '
Perrorman=eofnteworkforwhich lot,pemalidiskaed, 204,'- .UNDERFLOOR FRAME
❑Ihave J willmainta Worker's Compensation Insurance,as miquiroodbySection ,205• — UNDERFLOOR INSULATION
17M I'tile Labor Code.I (he P I:rm:: 1 tl- k fn 1 I'J h Pcrni t ix '.
issued.Myworke,wa,mpd,,.ahm,b,mraaceconieraadPo6gnamber,u., 301. - ROUGH PLUMBING
cam¢( PoliicyNo,t .302 e— TUB 8 OR SHOWER
♦CI?RI'I1ICcoMPFNs^TioNI�NSuenlNcrOltic°RS' _ 303''— ROUGH
C mssection need nor be¢rmtpmo ijirwe�emritisfut oefannreJdhuaa ..31214 — 'ROUGH ELECTRICAL
IS 100)nr mwa.) -
•,nau IIoomy,that
ypri Performance e fth kr whrnthi w m : J1 � •306 .- HOLDOWNS annual -
w to h,aomn w ljeu to me Work",
Co. "a"nion Lnws of Calinonfl ,Dam
Applicant 307 - INSULATION
f NOTICETOAPPUCANT:It,aGcrmaking@inCcnlfcumufCxemption,youshnulJ 308 SHEETROCK' _
O•pbecome wubjwt to the Worker's Co:nloc'waum:,ro,i,, ns of the 1,clas Gale you inusl
ronhMEroam, ithmcbprovt ,aa-rRis .it fall . . jtD9 — EXTERIOR LATH
CONSrRUCTIONLENDING AGE
Ncv 310 — INTERIOR LRTH
C > nc<nya0irmmnnm. is,tact. re ar,nlewingagencyrothepemmnapca 31.] — SCRATCH COAT
ofthc lookf r 'h l th' p ed](S 3097 C C) '..
] q Lanae . N ,31.3 — ROOF NAIL
� Lan b A d .-
�'O co I nry,brlh ppr a tm IntR N r f ,w 501 — FINAL ELECTRICAL' ENERGY`_'
Erect,I g m pin R II city d ty rd' - I m o n I m ng
O v tobudd g wwcro,,: Ihaabyt,derxe l ee,ofo ,nlym�.lernp„ 502 — FTNRL F'I_UMBThIG ENERGY
�. W he an...r- cnuoaed property for Impeefion puri nses. •'
'r. Os - (N'c)agnam'arc,indemnify and keep hwale,s the Cit of C.,somno al503 — 'FINAL MECHANICAL ENERGY
V G li bilis ( b ems,cost .-J penses whichlos
ay may in any y.acial against said '
t •ofa,eb t g ,nh"Pe 504 — FTNRL. BUILDING ENERGY
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NONPOINT
SOURCE REGULATIONS, Issued by: 505 — FINRL ELECTRICa to
bignamie al AephcanuLona°cmr - 4, Octal Re-roofs ' �. - '
HAZARDOUS MATERIALS DISCLOSURE s 507 — FINAL PLUMBING _
Will the applicant or Rome wilding occupant.mm or harelc wzrpui contend Type Of Roof
asdeaaaby heCnperanoMaob.ipdCode,Cw,bor';12,aadtile iic:amland samty 508 - FINAL. MECHAN.T.'CAL.
Code,S"II 25532(). TN1s�AQ' '
0v. 0n - FOI"[UY [ L.,
All roofs shall be`i pacted,�r m[xx;;,, material being installed.
Will lq ppr t r i n 'Ire p t ' pI:e t . . .n' If a r•ooF is installcYA tPithitutFfildt16141alhi�rb :
caul hart sJreonemim ns as JJoed by l It Bay Anna Aireaily Manno,ement• SJCtion;I itgree to remove
I mora all new tnaterialsff''44ns efFoTiNW IPAADLnUEstldfd.RKyf9 will comply.with
. ave. ❑N„ . '. � Pe bP
- r all non-point source regulations. '_ . .
1 nave read nc hvnrious mammals rtquimmems under Chapter fi.95 of the
Clifford.H h 4fetyCde S t n 25505 2t5iJ nd 255,J d t dthm
TIh ho ?�gd [ Ily h' n t mhit I' ,'b'Il mob f ib , .
zvp' I 1 I 'µme��t11`yy Fault no .i he'act tYlswnne Cen tcam,t
Oce real
//y//y`//���I/ p
Wi d—ZZ Signature'of Applicant Date
nwn¢r nr dad,°('red ag=not - Dam ." _-� All roof coverings [ii be Class "B" or better
OFFICE
CITY OF CUPERTINOz• ss`xsw .,mac x.,+` s x •. - --
BUILDING D"''.'D" PERP ! :,CONTRACTOR INFORMA'T'ION
BUILDING AF)DRER.S- ��• PLRhIDNO,
OWNER S NAn14;t Ij( �,l•'I t'-.i701' l l l-SLi`� 1 1 —i'7 6•IFoI_I)1''.f ll�l (. 191-I` `f V%LII I l; i g1'1'Y''..r1'1�1{ �V�I�A�t141C:Ylt�l t i.`e:'
ONE,' "+T1..'('1°tf,!Ifl': f:li•AR I h1F�hiTE .'a 1•II-.1'1}IE:P l I _til iE; snNlTaxv ND , It;c. � .ylol
' AHCtII'IGCTI(iN<'dNIiFRPHot1 1 ONBN Y �/--tl - BUILDING PF.RAII'r INFO
Itiii MA) ruin PLUMB NiECrl
t a1 TO ARRANGE INSPECTION OB DESCRIP"ETON
(- INSPCCTIONS }f - s 4D 1TG INSPEC.l
CALL 777-3228 MONDAY-FRIDAY 24 HOURS gF.SID&NTIAL:
¢ BEFORE REQUIRED INSPECTION.JOB ADDRESS Cl SPDWL KITCHEN REMOIIEL
i z FOUNDATION/PIERS/H.D.S L7AND PERMIT BARE NEEDED WHEN PHONING.
z
UFER GROUND ❑ ADDITION 17PLUMBINGPITH
❑ MLlla'I-UNIT El STRUCTURAL ALL
xx¢ PAD/SGT BACK-CIiRI' RESIDENTIAL_COMMERCIAL_OTHER_ MODIFICATION
3 r
GARAGE SLABS/I RFCUNITE OUS FIRE 1RN;.1 [IINTERIOR ❑CHIMNEY REPAIR
H,\7,ARD
u o -,06URNO'CONCRGTE'UNTICrAPOVFiiAS BEEN SIGNED> 'nx'' IMPROVEMENT' Ll SWIMMING POOLS
❑ BATH REMODEL/REPAIR 11 DEMOLITION UNDERGROUNDSIAB LI if ten Iotd...t,W,hm, Clx A,o.,f em y'� .I.'...d. ❑ OTHER
PLUMBING
❑ NO Initial I.C.B.O.B
ELHCfRICAL
tCOMM ERCIAL`
*DO NOT POUR FLOOR.UNTIC'ABOVE HAS BEEN SIGNED; H',j STI 'G RODF C -)—,FRINC
❑ NEW BLDG/ADDITION ❑ DEMOLITION ,
PLUMBING El TENANT 71FOODSERVICE
MFCIIANICAL Nunthcl'of csisting coverings IMPROVEMENT _
ELECTRICAL - TU be removed T.be reminal ❑ OTHER
FRAMING VENTS - —
INSULATTON
-' TYPE OF ROOF COVERING `
PLACE NO SUBFCOOR. ,ABOVE HAS.BEEN SIGNEDs*"'xlh
ROOF SHEATHJDIAPHRA _' EXISTING' PROPOSED•
PLUMBING _ -- LZZ'
❑ Built-UP R.f ❑ Bail-Up Ronf
TUBS&SHOWER N +' ❑ A,phall Shingles ❑ AaphW(Shingles
MECHANICAL ❑ Wood Slmkes - ❑ Wnod Shakes
ELKTRICAL/POOLB lj^' - El Wood Shingles ❑ Wnod Shingles
s ❑ 01her(Specil'y) ❑ Otha(Specify)
FRe\MING/STAIRS/E.PAS'ESSj- � Provide I.GB,O.Report Na.SOLATION/VENTILA'1'I0tt'„j,'"' -
VER'NO;WORK`UNTI+ Q - AS BEEN.SIGNE t x.+,., 'S Provide Mfgr.In.mll cion Specs.
EXTERIAL SHEAR/HOLD DOWN'.
INTERIOR SHEAR/HOLD DOWN,Y"
SHEET'ROCK/SHEETROCK SHEAR. INSPECTION SPECIAL INSPECTION REQUIRED ❑ DNI F. INSP
.F, TERIORLAIH/W$CREED .:
VT
t%M. ,I S NTIL'AB VE HAS BEENSICNED,:,-,4, .'
SCRATCH COAT
SEWER/WATER
TEMPORARYPPROV LS
OCCUPANCY
Y _
+rFINALS t, -
z PLANNING 777-3308f,
zQ GAS TEST
F, 4 GRADE(RW.777-1354] _
x _5 FIRE
6r HANDICAP
C) ELECTRICAL
O F
PLUMBING IL
W MECHANICAL
r
� ENERGY
U r2. VISUAL FINAL ONLY
BUILDING --0(5
,OCCUPANCY P:BUILDING ISNOT PERMI'IT,EDa L a EVIm '3'
y C �d %J1 1 'Nl I +•N k,
UNTIL BUILDING FINAL IS SIGNED BY BUILDING
iivsrL.ctoRl, ?lig ' �:X38, "' ,r+1 , "� CERTIFICATE OF OCCUPANCY❑
RE-INSPECTION: PLYWOOD: IN-PROGRESS
INSP DATE INSP. DATE. INSP. DATE
TEAR OFF INSPECTION: BxITENS: FINAL:
INSP DATE. INSP. DATE INSP DATE
NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION
APPLICANT'S POSTING COPY