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19444 POST THIS CARD NEAR FRONT OF BUILDING PFRMIT NO.19444 CITY OF CUPERTINO ' INSPECTION DIVISION- JOB INSPECTION RECORD • //• r JOB ADDRGSS ;t—e) � w-I L t/�"DNIT# —LOT# CATFLORY CONTROL -2 - OWNER 'OWNER r CONTRACTOR oe BUILDING PERMIT INFO INSPECTION DATE INSPECTORI INSPECTION RECORD FOUNDATION/PIERS' NOW ALL GRADING AND DRAI NAGE OB DE9CRIEl UFER GROUND - SIiAl, SINSfALLEDJOB THE APPROVED PLANS AND CITY OF PAD/SETBACK-CERT CUPER'nNO STANDARDS. CARAGESLABS PREGUNITE- POUR NO CONCRETE IUNTIL 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 SIIBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROUGH PLUMBING TUBS&SHOWER PAN MECHANICAL ELECTRICAL/JACUZZI 13OND FRAMING STAIRS INSULATION/VENTILATION EMERG.EGRESS - • - 10 SEWER WATER COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED EXTERIOR SHEAR 1-IOLD DOWN INTERIOR SHEAR/HOLD DOWN - SHEETROCK/SHEETROCK SHEAR ` EXTERIOR LATH/W-SCREEN, SHOWER LATH - SCRATCH COAT - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED NOTE:NO FINAL INSPECTION SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PATD - FINALS DATE INSPECTOR SAN.# - - ELECT.ENERGY PLUMBING ENERGY - MECH.ENERGY. BUILDING ENERGY ELECT.FINAL TEST PLUMBING GAS TEST MECHANICAL - HEATING ' ELECTRICAL RELEASE FIREDEPT. - GRADE OCCUPANCY TEMPORARY APPROVALS ELECTRIC GAS BUILDING OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL ISSUANCE DATE BIIILDING FINAL IS SIGNED BY BUILDING INSPECTOR - ARRANGE FOR INSPECTION Ill PKONING 252.4505 BETWEEN 12:30 PM AND 4:30 PM MONDAY THROUGH FRIDAY,24 HOURS ' ` I ` / U BEFORE REQUIRED INSPECTION. JOB ADDRESS AND PERMIT# ARE NEEDED WHEN PHONING. IMPORTANT! 7 PLEASE. READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION ISSURDRY / � c^ OFFICE COPY f APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY Building Pro act Identification - - PERMITNO. Hulldug Acidmas: 1 9 4 4 4 e i a= oto 1 caner. assn: yd> Phone: 499 CITY OF CUPERTINO-BUILDING DIVISION . contr nr.wme: LI_.No: APPLICATION I PERMIT 6 BUILDING-ELECTRICAL-PLUMBINGMECIIANICAL CATEGORY CONTROL ^_- Archil Engineer. Lic.No: �r QTY ELECTRIC PERMIT FEE BUILDING PERMIT INFO ' Add. 0 t PERFRTISSUANCE LICENSED CONTRACTOR'S DECLARAT1914 I hereby affbm that l am licensed under provisions of Chapterg(common, APPLIANCES RESIDENML JOB DESCRIPTION ingwlthSection 7000)of Divlslon3ofthe Susineuand ProfeaalonsC-ode,and my license ie in soca force endic.# PANELS Date iar X5 9 Contraaor �vfclDEC TRATION f —UP TO 200ANIPS ARCHITECTS DECLARATION OVER AMPS ��O ZIundenland my plans shall be used as public records OVER IO30AMI5 - SQ.FT.FLOOR AREA 5/SQ.FI. x 0 Licensed Professional SICNSELECTRICAL / S y1f 6 OWNER-BUILDER DECLARATION SPECIALCIRCUIT/MISC zL, owing af0mthat lam exempt lmms a d Professions tsionsCnx Law fort he O q county gresson.iresa per0lt.ountruct and,Improve, Code:Any tltyor ty coon whlchre requires rmlttoronstw p P TEMP.MEfIR OR POLE INSC, F,4 3 county qu pe requires the applicant wvgdemolbh,arre air any structure tatemeprior to itshat he Is also rcqu pursuant to the provisionch of permit POWER DEVICES to '�� Elle a dgned statement that he ts licensed pursuant m the provisions of the �3wIContractors License Law(Chapter9(rommencingwllhSetlbn7000)olDivl- n SWIMMING POOL ELECTRIC s1on3oflhe Buelneseand l'roteulowCade)orthathebevemptthercfromand ��Ca, VALUATION I5pi O•.1 the bash for the alleged exemption. Any violation of Section 7071.5 by any OUTLETSSWITCHESF7)(7URFS /4"� applicant fora permit subjects the applicant to a civil penalty of not more than W1 9 CP P, flue1,as demodollarhepr. SQFII STORIES TYPE CONSTRUCTION 9.7 ❑hundred as owner of the property,or my employees with wages as their Bole NEW RESIDENTIAL ELECTR compensation,will do the work and the structure is not intended or offered for / qas In(Sc.7044,Business and Pmfessiow Code:The Contractors License Law $ docs not apply to an owner of property who Wild,or Improves thereon,and OCC,GROUP RIS.UNITS does such work himself or through his own employees,provided that such Improvements am not Intended motioned for sale.If,however,the building or TOTAL: Improvement lasold withlnoneyearofcompimioNtheowner-W liderwlll have • t rden of provingthat he did not build or Improve forpurposeofsale.). QTY, PLUMBING PERMIT FEE FLOOD LANE APN �1,as owner of the property,em exclusively contracting with licensed PERMIT ISSUANCE contractors to rons"d the project(Sm 7044,Business and Professions Code: no Contractor's Licen.e Iaw doe.net apply to an owner of property who Wilda or improves thereon,and who contracts for such p(ojeM with a ALTER-DRAIN&VENT-WATER(EA) co�{a,mr(s)licensed pu muant to the Contractor's License Law. BACK FLOW PROTECT.DEVICE FEE SUMMARY u I am exempt under Sec. B &P C for this reason _ • DRAINS FLOOR,ROOF,AREA,COND. SANITARY Y N Owner Daae RECFTPTN herWORKMAN COMPENSATION DECLARATION eby affirm that I have a cereRXTURFSPERTRAP SCHOOL TAX Y_ N_r<IRrate o!consent to self-Inw ,or RECEIPT Y certificate o(Workars'Compensatlonlwurance ore rcrtifled ropy Nemof(Tec. GAS EA.SYSTEM-1 INCA OUTLETS PARK FIT Y N 3800 Lab Ci N— Policy Y - RECEIPT`/7Y CCAS EA.SYSTEM-OVER 4(FA) BUILDING DIV] ISeIONFEESm Ned copy Tha;! duct. PLANCHECK FEEit artlfcd copy tsfiled with the dry inspection division. GREASE/INDUSIRL WASTE INTERCEPTOR O /3 CERTIFICATE OF EXEMPTION FROM WORKERS' CREASE TRAP PAID COMPENSATION INSURANCE SEWERSANITARYSTORM FA 2DOFI Date RI [# (hIssectiun need not be completed lithe permit is for one hundred dollars CCCP (51 artily that WATER HEATER W/VENT/ELECTR ENERGY FEE Y N Ill not employ an performance any manner work as to this pewbJecnnit is Issued, I shall not employ any petso In any manner at u to bemma mbject to the WATER SYSTEM/TREATING Workers Compensatlonl o(Calllomh. Date PAID Z Z Applicant NEW RFSIDENDAL PLMH. Date Recei t# Z NOTICE TO N'PLIC :If,after maldng this Certificate of Exemption,you Hshould becomes to the Workeri Compensation provisions olthe Labor TOTAL: N Code,you moat arthwlth comply with each provisions or this pNt W ertshall 7 deemed revoYcd. BUILDING W C CONSTRUCTION LENDING AGENCY V SEISMIC FEE I hereby affirm that there ts s ronstroction lending agency for the perform. ELECTRIC FEE Z ance of the workforwhlchth crMtVbaued(See 3097,CIv.CJ OO Lenders Name PLUMBING FEE LL H lender.Addm.� QTY. MECHANICAL PERMIT MECHANICAL FEE OW Icertifythatlh readthisapplicatlonand state that theabove informerton C Is m.tect.lagree o c' ply with all city and county ordinances and state laws PERMIT ISSUANCE FEES PAID: '} N relating to building construction,and hereby authotlze mpresent vnsof this F Z city to enter upon the above-mentioned pertyfor inspectlo rpoxs. ALTERORADDTOMECH. Date RCCCI 4# — (We)agree to save,Indemnify a P harMeu tis of Npertino against liabilities,jidgmente,c and penin Ic nanywayacerue AIR HANDLING UNIT 10,00OCFM) SUBTOTAL: against of gr n'S ermlt. AIR HANDLING UNIT(OVER I0,000C17M) CONSTRUCTION TAX nature of -pp cant/Contra rDat EXHAUSTHOOD(W/DUCT) CONSTRUCTION TAX PAID: HAZARDOUS MATERIALS DISCLOS RE - Wllltheappllcantorfulurebulldingoavpanlatoworhandlehazardous HEATING UNIT(TO 100,ODD BTU) Date RCCCI f# material as defined by the Cupertino Municipal Code,Chapter 9.12,and the - Health Yes SafetyCodeSSe_NIl n 2S532(a)7 HEATING UNIT(OVER 100,000 BTU) TOTAL- Wlllthe applicant on future building occupant use equipment or devices VENTILATION FAN(SINGLE RESID) ISSUANCE DATE which endt hazardous air cenUMoants as defined by the Bay Area Air • Quality Management Dbtrl BOILER-COMP PIE'OR 100,000 BTU) 4hYee o /y ave read the hazer ousmderlals mqulremcnts underChipter 6.95 of BOILER-COMP(OVER 100,000 BTU) the Callfomla Ile.Ith&Safety Code,SMi.m25505,25533and2S534, I / understand that if the building docs nm mmently hrvcatenanL that itbmy NEW RESIDENTIAL MECH.. SQ.FT. responsibuitytonoll the rat of the requ lnement which mu at he met Priam a colOccv cy. C--c---u adredagent ISSUED IOTA I.: OFFICE COPY