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19445POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION - JOB INSPECTION RECORD JOB ADDRESS �1 -1 85 Sri:OO"s' L¢, 13w0 UNIT # LOT # OWNER CONTRA. -�R Nj6.a,� e,!: PERMIT NO. •19445 APPLICA IION SUSMrrrAl_D=. _ 7— k 4 CA _ CONTROL# " BUILDING PERMIT INFO INSPECTION DATE INSPECTOR INSPECTION RECORD 'NOTE ALL GRADING AND DRAINAGE SIIALL 9E INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. ❑ FOUNDATION/PIERS - UFERGROUND ' 309 DFSCRIPII N " / PAD/SETBACK-CERT GARAGE SLABS PREGUNITE 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 TUBS & SHOWER PAN MECHANICAL ELECTRICAL/JACUZZI BOND ' FRAMING STAIRS INSULATION/ VENTILATION EM ERG. EGRESS SEWER WATER COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED . EXTERIOR SHEAR FIOLD DOWN , INTERIOR SHEAR/1-IOLD DOWN SHEETROCK/SHEETROCK SHEAR EXTERIOR LATH/ W -SCREEN SHOWER LATH SCRATCH COAT " NO'.TAPEow,�PLA STER'•UNTIL ABDVE'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' " FIRE DEPT. GRADE ' OCCUPANCY TEMPORARYAPPROVALS ELECTRIC GAS - c/ BUILDING OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL yI.SSpUA�NCE DATE TI BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR ARRANGE FOR INSPECTION BY PHONING 252.4505 BETWEEN 12:30 PM AND 4:30 PM MONDAY THROUGH FRIDAY 24 HOURS BEFORE REQUIRED INSPECTION. JOB ADDRESS AND of I tlnartinn PERMIT # ARE NEEDED WHEN PHONING. Ci17 IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION 'S'uco9Y: OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES —USE BALL POINT PEN ONLY Bulldin Pro'est Identification B°"d'egi ' ylo'sW PERMITNO. 19445 wners ane... - '•- Phone: ., d p sv - - oS v •xa CITY OF CUPERTINO-BUILDING DIVISION APPLICATION / PERMIT Contractors Name: Lie. Na: g 7' BUILDING -ELECTRICAL r'LUMBING-MECHANICAL CA RY COOL # Architect/Engineer. Lic. N. aLl QTY .4 ELECTRIC PERMFC FEE BUILDING PERMIT INFO Address: El F-1 El PERMIT ISSUANCE CONTRACTOR'S DECLARATION I hereby inn thatlamlicensedunder C9(commmc- IngwhSedion7000)of on3oftheBusinemand Pro(esssionsCade,end my licensee 1.In fu and of(ect. n Lte# B 1 Date, �C"tractor ARCHITECT'S ION Iundentand my plans shall be a daspubll records. APPLIANCFIDENIL JOB DESCRIPTION C� GM' PANELSLlcenseC 2014000AMPS OVER1000AMPS SQ. Fr. FLOOR AREA s/SQ.Fr. SIGNS ELECTRICAL Licensed Prufess onsi SPECIAL CIl2CUIT/M15C OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the TEMP. METER OR POLE INST. POWER DEVICES following reason.(Semon 70115, Business and Pro(eabne Code: Any city or county which requires a permit tonne ract, alter, Improve, demolish, ormpair anystructure prlortolts Issuance, also requlresthe applicant forsuch permit to file a signed statement that he is Bernard pursuant to the provisions of the Commerce. License Lw(Chapter9(commendng with Section 7000) of Divi. sion3 ofthe Businesaend Pmi.t mCade)orthat he Is exempltherefromand s SWIMMING IDOL ELECTRIC VALUATION the besets for the alleged exemption. Any violation of Section 70315 by any applicant for a permit subjectapplicant to a civil penalty of not room than OUTLETSSWITCFICSFIXTURFSsthe a NEW RESIDENTIAL ELECTR SQpT, /Ivc hundred1, as dolner of thepe. I, as owner of the property, or my employees with wages a their sok STORIES TYPECONSTRUCTRON compensation, will do the and the structure not intended or for :offered Business and .Is (Sec.7064, Buelnessand Professloru Code:TM Contractors License law Code:The �� ^ does not apply loan owner of prepertywho Wilds or improves thereon,and whodoessuchwork himself orthrough hisownemployees, provided that such OCC. GROUP RES. UNITS Improvements are not Intended oroffered forsale. IL however, thebuilding or Improvement l.sold withinoncycarofcompletim,the owner-bullderw111 have TOTAL: t4jl,Lmrdeo of proving that he did not bund or Improve for Purpose ofsale.). Lj L as owner of the property, am exclusively contracting with licensed contractors to comm ud the project (See. 7044, Business and Professions Code: QTY. PLUMBING PERMIT FEE PERMITISSUANCE FLOOD TONE APN The Contractor. License Lw does not apply to an owner of property who builds or Improves thereon, and who contnds for such pw)ods with a cgRtl7actor(s)licensed pursuant to the Contractors License Law. LJ I am exempt under Sec. B 4 P C for this mason ALTER -DRAIN & VENT -WATER ff.N FEE SUMMARY HACK FLOW PROTECT. DEVICE DRAINS. FLOOR ROOF, AREA, COND. FLCTUggq, PER Tgpp SANITARY Y_ N_ RECEIPT If Owner - Date may" WORKMAN COMPENSATION DECLARATION LEU hereby affirm that I have a certificate of consent to self4ttges, ora m l(laof Worken'Compewatlonlreurance SCHOOL TAX Y_ N_ RECEIPT # GAEA. SYSTEM -]INCA OUTLETS S PARK FEE Y N oracerti(led copy thereo((5m. 3800, labb C0 FC REPr # Poimrya# Y GAS EA. SYSTEMAVER 4 (EA) BUILDING DI VISION FEES Certified copy hercbyafurnished. OI CedlRed copy Ls filed withhthe1M dty inspection division. �A 6 GREASE./INDUSTRL WASTE INTERCEPTOR PLANCHECK FEE GREASETRM ' CERTIFICATE OF EsTMPr10N FROM WORKERS' COMPENSATIONmbecINSURANCE (rhos sedton need nest h omplded :(the permit V (Drone hundred dollars PAID Date Remi t# SEWER-SANITARYSTORM PA 100FT (fl00)rtifyt.) Imnot that In the persmanany m neerworan as t cern pesubjec ho the I shall not employ any person In any manner n u to bmonre subject to the Compcntlon L W a ove of California. Date WATER HEATER W/VENT/ELECTR ENERGY FEE Y N PAID WATER SYSTEM/TREATENG Applicant NOTICE should shwld become eubjad to the Workers' Comperaatlon prov0lov of the Labor be O ..bis AM:IL.her making thin Certificate Pro of Exempt a Labor Code, you =at forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Date Reml t# NEW RESIDENTIAL PLMB. :OFT. TOTAL: B DING FEE ' 2400 SEISMIC FEE I hembyaffirrotlat there is a constroctoon lendlogagency forth perform- anmaftheworklo�syhichthbpermitV Wued(Sec. 3097, CIv. C.) Lenders Name [510.160 Iendee.Addre.a - I mrtl(ythatl hvereadthosappliation and smtethatthe above Information Is carred. I agree to comply with all city and county ordinances and state laws relating to building mnstrudton, and hereby authorize representatives of this TOTAL: �1 I�aW ELECTRIC FEE PLUMBING FEE QTY. MECHANICAL PERMIT FEE PERMITISSUANCE MECHANICAL FEE FEES PAID: city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify an d keep harmless the City of Cupertino ALTER OR ADD TO MECH. Date RCCCI t# P SUBTOTAL: against llablllti% judgment.,matsand expenses which may in anywayaccrue against f,f In conseque a of the granting of this permit �� •, /�7 AIR HANDLING UNITED 10,000 CFM) AIR HANDLING UNET(OVER 10,000 CIM) CONSTRUCTION TAX PnanVC tractor Date SI m(defted IXHAUS'r HOOD(W/Dum) CONSTRUCTION TAX PAID: HA7A OUS MATERIALS DISCLOSURE HEATING UNIT (TO 100,000 BTU) Willlicant/ .tum building..pantstore or handle hazardoua materialb h CupertinoMunicipal Code, Chapter 9.1Z and the aend, a Section 25531(a)7 ❑ Yes aO No Date RCCci t#��Health HEATING UNIT (OVER 100,000 BTU) 7,n%TOTAL• VENHLATION FAN (SINGLE RESID) ISSUANCE DATE I-•; .,'! '' '�(1!T� r Will the applicant or future building occupant use equipment ordevices which emit hazardous air contamme est, as defined by the Bay Area Air Qu hty Management 13*JH07 No 6)1LER-COMP OHP OR 100,000 BTU) 4Yea havereadtheth nus minerlalsrequlmmenlsund.lid Mer8.95 of the erst.rrnta Health building Safety Code, Sect1orently have that i I u thatif not currently ve. meant, that R k my pp Lyl�'/, of �nnnefirvn BOILER-COMP(OVE[{100,000 BTU) NEW RESIDENTIAL h(ECH. SQ.FT. sponsi it to rnporolbllil to otilythe occupant of ally tht occupant a requirementswhich ircmente which must be met prior to is s� of a Certi(Icate olOcmpanry. , p.rcy. (I ISSUED BY G 4\ a' �• e Owner or authoa Da B TOTAL: OFFICE COPY