00080117 is,
CITY OF CUPERTINO' �, A -
BUILDING DivISION a PERMIT CONTRACTOR INEORMATIONi
HUILUING AUUIUiSS pd ITRMII NO, 1 1,'+
- STRI_ICT I O CDMPAIQY@ID0f312 1 i 7 ,
OWNER'S NAME: - f - f - �.. ." APPLICA'I'IONSUITDATE, f
T LANE 08/16/2000.
ONE: _ r - - yANUARY NO. CONTROLNO.
p'a Z 'ARCHITECT/ENGINEER. r' BUILDING PERMIT INFO"1 .
- 'd - BLDG a- ELECT - PLUMB MECH
F, ..
LICENSED CONTRACTORS DECLARAi6i-
Ilserel,affiraillnol an,liarn,ed abaternwo,.l Chr,Nr9aa earn, "F +. • Job Description - .'•�...
,hof I 9000) fD ,3 Vfihe liu 1f fe.' Cd er�yrc - '�����1�D
in nor
k1e, " , h1
ARCHITECTS DECLARATION ' I IVT REMODEL• OCT, O
I nden,unJ ny Plni Snell be u.ed lubl'erw,Ms •
Qi Y • iI'd.
Licarsed Professional
OWNER BUILDER DECLARATION' { .�������� _ { 1
Ih nI Ir- 1h II' B PE[ C C o- N C I f dhe
H Z C foll ,oras n Neati ,'1031 5 Bus m e I f:' C d A,ally ly _ e {y� '
wh 1 y
lie
Inflate,
L ,I PPn If hP nfl . , 111 1 x - _ .
" n d, : II m P- nn c ,', 1 L' 'rcn.P,, 9 -•Sq. Ft FlocrArea x 1: VHluation
Ro n6 'dS I pIX1U) [D i TIF B .', JI r." Cd) a ,. 4 e •• 4,t`
rt Ih I I pI 1 n 73
nfS I p0315 hY Y pPl ,CP „ubjedn,hc nit Pl ivl, 'IIy -
1' ifs , na,to
wren emWr6 f5sOm. ' APN,-Number e Occupancy Type '
N
❑L's rof,hu Prnper,y.or nyenpl�y Yx'1h xn,�s uF,h -ile conp,.nsroaai 'tc
will fh k -
Bn 1 Fine
fly I') •,- q'. Required Inspections
ow fP In+p Wnkit nwll R' '
'n ,n n': nor . p den , n' I ' 1 ,' , emir ;1 - 101"—' FOUNDATION: '
offeree fertile,if,h, a er it,,boldo,, earn ie ole within one
ycnr el -
pit, m n n 111 how,the lonleanot,dt,,or ill.,I fdend hoold or 102 '.:PIERS -
Pforl,f l p. fall ) 4
103 LIFER
rfarelarE,fh ,rd,saaS rrwa B. P 1. c )Tl c , , 104 - RE'BAR,,.'. - .
re 1 1 1 ,ply, . fF P Iy n n le ; a .
„a b I 1:_r nen Probed,within ,rfracm(,) ed p-r, ,n, I,ne - ': .f 1 05 — ?ANCHOR BOLTS
- .1 LL - , n't ,
or I,peSI' B&PCr..ror ],06"$- SEWER "R, I,IATER tir.
Duid ' ^�1i7`+.t'- "UNDERFLOOR
" PLUMBING• -
WO KERS MPENSA'I'ION UECLARA'I'ION
203`= UNDERFLOOR .MECHANICi
I -nr qu l P o> ,r�T ) nn rllbl II'I ' + .
204 — UNDERFLOOR FRAME
I h e1 'Il I' n
C 'f aI rC enl to If' 1 N k a 4
Cr„le, n
,, ,';i, ew for,by Seed 3700 of mi m
Labor coda, for e .20`-i — '`UNDERFLOLOR INSULATION
Perrnrrennce nnhe work on h' nthis u 'I' 1„ndd. "�01 -`ROUGH PLUMBING
FJ I hirseand Worked” I ' IFrSection
1i
p-alnr it,,wbrr code r Proboo e, wok for in d,m, m1 302OR' SHOWER - -e
- - `
listed My waaer'iCl;inpen.nrnn ln.nrnnce anter and wucy ngnlner are: 303, — ROUGH MECHANICAL
Cnrrien - ' Polli y Ni.: < "
CERTIFICATION OF EXEMPTION FROM WORKERS'
- - 304' —'. R�UGH ..ELECTRICAL ,
COMPENSATION INSURANCE 305;"<— FRAME
t is rn,.as,norther!dolla - ,y0p - .HQI_DOp;I�IS ,
rsmol loss.)
1 certify that 11 pr fn kr -nom� 1 d1 307 '—' ItJSULRTION •n �.
d :hill"n , PI Y y P y r' ax In hision .nnie'1 to the We k r 308 — SHEETROCK
Co p ista Lu _ f Calf Dale
r , ..
rviNlce TO APPLICANT, n 'k y11 calf I rE Ff >" n Id 309 EXTERIOR -LATH
I z ne w k c p 1 nit Ln e, 1 "r N' 310 — INTERIOR
.. 311 '— 'SCRATCH;CORTp _ATF' " (
_ . .
r'P4
CONSTRUCT]ON I1 NDNCAGENCYF
-- ROOF hereby Intl that e f lending agency tle pertorn 31 ,
f,
a p olla,work , nm . C.
Eidn, NP e
8 501 FINAL, ELECTRICAL- ENERGY,
� z
50
Lend Abd 4 ;FI
— NIAL 'PLUMB ING "'ENERGY
UO eoi 1 knfr,nlln In'-lyl I a:I' lnld n f ', e 503 — FINRL. MECHAN'ICAL' ENERGY,. .
Vmb IJ ,c 'I dl ny ,h , 1"i Pith,eoy li ane p • "•a +{F
y.W Ind.n(We)tidrd, pnynr l.P�nnpnrpn,,, 04 FINAL BUII_DPpIG ENERGY'
We a ee m,acc in rd o"p se,wh harness mi Cd nit ,r,,e a w n ollw 'S
GLI ( ) 2r Y P Y. P 6 le
� m City nea:lld.meceorth lndr,ofthiwn1=hn,n mop way pieriii iln,I,iie 505 = FINAL ELECTRICAL
l .1 s p v r v s _ -
�l, ' U7 ,any',cin,ulnenee onhe,einn„ir n,. pato, '- —
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT
SOURCE REGULATIONS. a 11 y'.; Issued b SiD6 „, TEST �' D&6
_ illllT % ,
sis;inrem nppl einvcinlrielir •�a - -'
Data . Re-roofs '.508 -.''FINAL MECHANICAL. . � '
H\ZARDOUS MATERIALS DISCLOSURE u
won Ilr 1I , n II nun Type of Roof 509 — FINRL' GRRDE
isdf defined Crp I Municipal ce Cnpl 9.12 111 H Ilhu IS fly - -
ClO set 255320)It - 510 = "F1.NAL -PLAN NING -
❑v ' +± CN s• All roofs shall j7t,7y$pecte "p/.L' o �,py [p 5,* din installed.
Will Ih f" , f1b IT I , I .wn'IC(1 W— I -NI ICeII”: -� F
nE a l a�p If a roof is' Instal i ho t Ir, bta n'ing an inspection agree to remove
ooh d c n 1v def ul
by the Roy AmnA Q IIy M'n'n,e oenl
., 1 - all new inkerials•for inspection. Appllciint understands and will comply4wlth-
-oY,.� ❑n,n', all non-pointsource regulations.l'
1n-.i re ne Illel "'ad-o'
-mI ofi,,.ruk yr",. o,u nndcr Cnnmer dvs„one
nC.l f '' H hl SnT y C d "S I cc 255115 25fl3' 425534.l 1 '1 d,hm . I
if,hc bit ild d nm nni rtly hrvealem if the , emy fespo u'b llj m000fy the
oe-pmu f n "'old enl.wit' n inns,h=noel primo iq.unncc if o Ccrtifimc of
°� p' r Signature of Applicant •• Date
-ow nn loa<w n,=nit., Dile All roof.co,verings to be Class "B" or better
- ,: - OFFICE..
CITY OF CUPER'fINO -
BUILDING DIVISION PERP NTRACTOR INFORMAT:ZONt'
BUILDING ADDRESS: / PFRanT NO, .
.'•CON" I. ).
ARCf11TEQ/Ii6G1,VECR: I'HGNEw •1 �. ..�. - I - -
' OIIILUIN'0 PF-N,xlli'INFO
BI.UG fil.[C'IPLUNIB %1ECH
I _.I
auG JNSPFCT10NSe:;T , `sT -1', q "DAFEt aINSPFCI,� TO ARRANGE INSPECTION JOB DESCRII'PION
a_ X-- ''`= _ CALL 771-3228 MONDAY-FRIDAY 24 HOURS
BEFORE REQUIRED INSPECTION,JOB ADDRESS NF.SI11FV1-Ipls; -
��z FOUND\TION/PIERS/H DS AND PERMITq ARE NEEDED WHEN PHONING. -1 SFDWI- L-1 KITCllFN REMODEI
UFER GROUND r
J ADDITION ❑pLL1MflINC RE-PIPE
s s 7 PAD/SET BACK-CERT ❑ MULTIUNIT' ❑STRU
CTTIR:\L
tRESIDENTIAL_CONINIERCIAL OOTHERhMODIFICATIONi
n GARAGE SL\BS/PRIiGUNI'ffi —
c p .- ❑ IN'I'F:RIOR
". __ HAZARDOUS FIRE r1BEA ❑CII immI REPAIR
S`POUR NO CONCRL 7EUNTIL ABOVE'HAS BEEN SIGNCIJ'-- ='..�-. IhIPRO\'IibIEN'1' ❑ SKIM.\ZING POOLS
Wry
s=s UND[?RGR0UND/SLAB ❑ YES 11)cxdOm.,s]liana Cl.-A rnm u...n,hly I.lcyuiad- ❑ 13ATI I RENIO CL/REPAIR❑ DF,MOLIT'ION
f-I�7DPLUNAOIflTI•NPGO . ' OlIIER
eof-H-6-/1
_Ia ELECTRICAL I.C. O.q - -(O -( I ;—UR'FLOOR UNTILABOVE:HAS BEENSIGNED'"1`pt. O(iIEXIS7TNC RO F VFRIN' �FR
\L:
PLUMBING ❑ NEW BIAIG/ADDITION ❑ DEMOLITION
MECHANICAL Number ofexisling coverings ❑ I'P.NANT ❑ FOODSHRVICH
IMPROVEMEN"F
ELECTRICAL Tho rclnoccd 'IL he rclainal ❑ O'1'f1ER
FRAMING VENT —
INSULATION
wPL`ACE'NO SUBFCOOR UNTII:'ABOVGHAS BEEN SIGNEU }:f,.F'
'TYPE OF ROOF COVERING
ROOF SHEATIVDIAPI IRAh1 EXISTING; '),80POSEIL
PLUMBING ❑DO Boill-Il Roof P ❑ Bnilt-Up Rnol'
TUBS d SHOWER PAN ❑ Asphalt Shingles ❑ Asphah Shingle..
MECHANICAL - -40 ❑ Wood Shake, ❑ Wood Shake,,
ELECTRICAVPOOL BONI) 8- -0 ❑ Wind Shingle. ❑ W.enl Shingle,
RAMING/STAIRS/E.EGRESS01_ ❑ Olhor(Spccify) ❑ Olhor(SN,,ify)
SULATION/VENTILATIGN Prnvidc LC.B.O.Rcpm No.
•COVER NO,WORK UNTIL']1BOVEi HAS BEEN,SProvide Mfg,,ImB1llation Specs.
EXTERIALSHEAR/HOLU OON'N
INTERIOR SIIEAR/HOLD DOWN
SHEETROCK/SHEETROCK SHEAR INSPECTION SPECIAL INSPECTION REQUIRED ❑ DATE INSP
EXTERIOR LATil/W-SCREED
SHO\VER LATH
,.NONAPE'OR`PL'ASTEk-UNTIh,', OBo HAS BF.EN'SIGNCI)`-ti's ,rr
SCRATCH COAT
SEWER/WAI'ER
TEMPORARY APPROVALS
:
OCCUPANCY -
1
z PLANNING 777-3303
zQ GAS TEST
F GRADF(P.W.777-3394)
1=4 FIRE
j z HANDICAP �.
V O ELECTRICAI.
0 PLUMBING
y W MECHANICAL
F" h ENERGY
U Z VISUAL FINAL ONLY
BUILDING
OCCUPAA,CYIOFF BUILDING IS'NOT 9ERMITFED-
(UNTIL BI ILDINGFINAI IS SIGNED B\ OUILDINC F
.3 1
'`NSPECTOR( n-_+*� s "s t 1 "' '': CERTIFICATE OF OCCUPANCY❑
RE-INSPECTION: PLYWOOD:
IN-PROGRESS
INSP. _ DAFI! INSP. DATE. INSP, Il:\TE
'I'F-AR OFF INSPECTION: BNTI'HNS: --- FINAL: —
INSP. DATE___ INSP,_ DATE INSP. DATE
NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION
APPLICANTS POSTING COPY