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19506 POST THIS CARD NEAR FRONT OF BUILDING rrxM T No. c . 19506 i9506 CITY OF MtRTINO A INSPECTION DIVISION- JOB INSPECTION RECORDAs J06 ADDRESS /�©� �.�i/L9-�1��� U`NIITT# LOT# CATEGORY CIONTROL# K�^ L OWNER - ' CONTRACTOR BUILDING PERMIT INFO , FOUNDATION/PIERSINSPECTION DATE INSPECTORINSPECTION NOTE ALL GRADI LAND DRAINAGE UFERGROUND Sl IALL BE INSTALLED T O 'LY WITH IOB DESCRII"DON, THF-APPROVEDrMu,ANS A D OF PAD/SETBACK-CERT CUPERTINOSTAX - { GARAGE SLABS PREGUNITE ! ' POLIR'NO CONCRETE,uNriTTABOVEWAS BEEN SIGNED Al -. 1 UNDERGROUND SLAB INSPECTION DATE INSPECTOR PLUMBING ELECTRICAL - MECHANICAL - DOi NOT POUR FLOOR UNTILAIIOVE HAS BEEN SIGNED WOOD FLOOR - PLUMBING MECHANICAL ELECTRICAL PRAMINC VENTS CLEAR - INSULATION " PLACE NO SUBFLOOR UNTIL ABOVEHAS+BEEN SIGNED ROUGH p q PLUMBING F TUBS&SIiOWGR PAN � +I \ P P.-,. l,.✓ it e7 MECHANICAL ' ' l f\/I, ELECTRICAL ACUZZI BOND / L J FRAMING STAIRS "IG INSULATION/VENTILATION EMERG.EGRESS SEWER WATER _ COVER'NO'MORK UNTIL ABOVE HAS BEF•N•SICNE6, EXTERIOR SHEAR HOLD DOWN - INTERIORSHEAR/HOLD DOWN SHEETROCK/SHEETROCK SHEAR - EXTERIOR LATFI/W-SCREEN SHOWER LATH - SCRATCH COAT - - NO TAPE.ORI PLASTER UNTIL A BO VEW HAS'•BEEN SIGNED NOTE:NO FINAL INSPECTION SHALL BE MADE BEFORE -THE CONSTRUCTION TAX IS PAID FINALS DATE INSPECTOR - SAN.# ELECT.ENERGY " PLUMBING ENERGY - MECH.ENERGY BUILDING ENERGY ELECT.FINAL TEST PLUMBING GAS TEST MECHANICAL HEATING ELECTRICAL RELEASE . Il RE DEPT, GRADE OCCUPANCY ' TEMPORARY APPROVALS , ELECTRIC GAS 13UILDING - - - - - OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL ISSUANCE DATE BUILDING FINAL IS SICNED BY BUILDING INSPECTOR - PARD • ARRANGE FOR INSPECTION BY PHONING 252-4505 BETWEEN e,,_ 12:30 PM AND 4:30 PM MONDAY THROUGH FRIDAY,24 HOURS BEFORE REQUIRED INSPECTION. JOB ADDRESS AND PERMIT# ARE NEEDED WHEN PHONING. CiN of PlinortiOQ IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING 'FOR FINAL INSPECTION ISSOf'DBY'� -4/ -' OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY ' Building Prn'ert Identification - PERMIT NO, BaBdiiso w_. ) TpdA sua1y�IhUE 19506 111111Qs UIW I5dfP p —91P' CITY OF CUPERTINO-BUILDING DIVISION Contractors Name: L1c.No: APPLICATION I PERMIT L -1 BUILDING -MECHANICAL CATEGORY CONTROLM Archi /En neer: L� QTY ELECTRIC PERMIT FEE BUILDING PERMIT INFO Address: L� LL�l FLUME MUCHi PERMITISSUANCE El 1:1 ❑ LICENSEDCONTRACTOR'S :CLARATION I hereby.flren that lam licensed under provisions of Chapter 9(menmenc APPLIANCES-RESIDENTIAL JOS DFSCRR'ITON ingweh in forceofdafeon3o(the BusinessandlrmfemionsCode,and my Limes b in full force and died. PANELS Data hm Lk.M Dale Contractor ARCHITECTS DECLARATION 201-IMOAMPS 0 20 I understand my plane shall be used as public remrtls. OVER IOW AMPS SQ.FT.FLOOR AREA $/SQ.FT. EU Limnsed Professional SIGNS ELECTRICAL 6 OWNER-BUILDER DECLARATION SI'F.CIALCIiCUIT/MISC IherebyafOrm that lam exempt from the Contractors License Law fee the qq following reason.Section 7811.5,Business and Pretensions Code:Any city or county which requbesa Fermat tomrutruct,alter,impreve,demoleh,orrepalr TEMP.METER OR POLE INST. UP7t"'q 7 anystme mpdortoibl ancgalsonquirestheapplimntforsuchpert tto 4 file o signed statement that he is licensed pursuant to the provisions of the POWER DEVICES 301- Contractors License Law(Chapler9(mmmencingwHIt Section 7000)of Divi- SWIMMING POOI.ELECTRIC �� J7 s,on3olthe Business and Prolemiom Code)or<hat hebeaemptthere(mmaMSWIMMINGVALU ON the basis for the alleged exemption, Any violation or Section 7001.5 by any OOTLEi'SSWITCFIFSFI%TURES applicant for a permit subjects the applicant to a civil penalty of not more than E o five hundred dollar($.500), NEW RESIDFNTIALELECTR ❑I,as owner of the property,or my employees with wages as their sole FT' —STORIES T TE CONSTRUCTION 7a compensation,will clothe work and thestructum is not Intended or alferedfor O sale(Sec.7614,Business and Professions Code:The Cor tmetoes Llcemo Law $ does nm apply to an owner of property who Wilds or Improves therem,and OCC.GROUP ft15.UNITS who does such work himselforthrough his own employees,provided that such lmprovementa are not intended or offered for sale.If,however,the build Ing or TOTAL: Improvement is sold within one yearofcumpletlon,the owner-bullderwlll have to rden of proving that he did not build or Improve for purpose of sale.). QTY, PLUMBING PERMIT ,FEE FLOOD ZONE APN 1,as owner of the properly,am exclusively mmrading with licensed PERMITLSNANCE - t clan la mestruct the project(Sec.7064,Business and Prefembm Cade: The Contractor',License taw don A) not apply to an owner of property who ALTER-DRAIN k VENT-WATER(E Wild. or Improves thereon, and who contracts for such pWjeds with a mypetor(s)Bren d pursuant to the Contractor's License Law. FEE SUMMARY IJ 1 am a empt under S B 4 P C for this reason BACK FLOW PROTECT.DEVICE DRAINS.FLOG ROOF, SANITARY V N . Owner ate Ar- DRAINS. R ARBA,GOND. RECEIPT M 1 COMP TIO URA N pD(NppS,ITER TRM SCI-[CGL TAX Y N ❑I herby af(irmahat I have a rtlflcats o onsent to sets-insure,ora RFGEE'7.M certificate of WorkeraCompevatlan Insurance ora certified mpythereof(sec. GAS EA.SYSTEN-1 INCAOUTLETS PARK FFE Y N 3800,Lab C.) Policy p GAS EA.SYSIGM-OVER 4(FA) RECEIPT p Com any BUILDING DIVISION FEES [ ccrit dropye Hereby rumehed. GREASE/INDUSTRL WASTE INTERCEPTOR PLANCHECK FEE F-1 Certified ropy is riled with the city inspection FROM division. __- _ 1 CERTIFICATEMPE EXEMPTION FROM WORKERS' GREASE TRAP pplp -�✓„ a/L}II'lll'_(1,Je1 11"1� COMPENSATION INSURANCE SEWER-SANITARY-STORM EA.200FT. ate RCCCI III J Rhb,ectlon need not he completed If the permit a for one hundred dollars (8100)oify that N WATER HEATER W/VENT/ELECTR ENERGY FEE Y N I certify that the performance of thework farwhkh this peris Issued, WATER shall not employ any person in any manner so as to become subject to the WATER SYSTEM/TREATING a Workers'Compensation Laws of California.Date ]pip O Z Applicant NEW NEW RESIDENTIAL PCMB. SQ1•T. Date Remi tN Z O NOTICETOAPPLICANT:If,aBermnkingthe Cedifiateof ExemptWn,ymu Fshould became subject to the Workers'Compensation provlaloruof the Labor TOTAL: N Code,you moat fon hwith comply with such provebw ore his permit shall be, j deemed revoked. -BUILDING FEE 252�cc CL G CONSTRUCTION LENDING AGENCY SEISMIC FEE is N I hereby afflrm b 3 that there is a mntructlon lending agency forthe perform ELECTRIC FEE 7 Z anceoftheworkforwhlch the permit Luued(Sec. 097C.),CIv. TOTAL: O Lender+Nance PLUMBING FEE U. Lenders Address QTY. MECHANICAL PERMIT ,FEE . MECHANICAL FEE O W Icenifythailhavereaathisappliati...ndatatethattheabvc olnfomutlon - a boomed.I agree to complywlth all cityand county ordinances and state laws PERMITISSUANCE FEES PAID: } relalingtobuildingcomtrudloryand leebyauthoroempresentativesofthis f-. Z city to enter upon the ebovcmentloned propertylorimpecion purposes. ALTERORADDTOMECH. DatC Recei tN — (We)agree to save,indemnify and keep harmless the City of Cupenlno P against liabilities,judgments,costa and expenses which mayinanywayaame AIRHANDUNG UNIT UO I0,000CFM) SUBTOTAL: age Cut aid City in consequenceof the gmeting of this permit. AIR HANDLING UNIT(OVER loco6CFM)- CONSTRUCTION TAX Signatureof Applicant/Contractor Data EXIAUS I HOOD(W/DUCT) CONSTRUCTION TAX PAID: HAZARDOUS MATERIALS DISCLOSURE Will the applicant or lutum building occupant store or handle haeardous HEATING UNIT(DO 100,000 BM Date Recei til material as defined by the Cupertino Municipal Code,Chapter 9.12,and the �j Health and Safety Code Sedlon 2"' (a)? HEATING UNIT(OVER 100,000 BTU) TOTAL: Rill No Ill the splitless tuebuilding..past useequipment or devices VENTILATION FAN(SINGLE RESID) ISSUANCE DATE which emit havardous air contaminants as defined by the Bay Area Air q� Quality Management District? BORER-COMP OHPOR 100,IX0 Bile 4Yes •-�•p /yrLl have read the hax ous materials requirements under Chapter 6.95 of BOI.ER-C'OMP(OVER 100,000 BTU) JOV AwTaL,[i CCa the Ca liforne Health k Safety Code,Sed ions 25505,25533 and 25534.1 understand that lithe building does not mmently have.tenant,that it b my NEW RESIDENTIAL MECIL SQFT. AI` 11 <3 LJ Ili responsibility to notify the occupant of the requirement,which at be met prior to uanmofa teo cctrpancy. 1 ( 90 Cjt;r of rltpprt / p iso Owneroa o agent - Data TOTAL: ISSUED BY: OFFICE COPY