0825 (2) CITY OG CUI'ERT'1N0 INSI'I:CTIOf! RECORD (Office Copy) r ��
0825 _ 604 Elderwood Ct
PI:PJIIT NO. SANITARY DIST. 110. LOT N0. )[11 `.55
Electrical & Mechanical Dr. Du Ha 446-4489
PROJECT OWNER JOB SITE P11014E NO.
PERMIT ISSUED Date ELECTRICAL
flu 'Jdine _ Date Insp.
EJectrical 8-6-81 Power Pole
I'Iumhing Underground —_
llechanical - - P.ough Hiring
'Temp. Gas/lilcct. Iia17.s
Solar Ceiling
Fire S rinkler Fixtures Int/Ext
Si n llotors
Grounding
Hisc. Temp. Power _
Other
FINAL, INSPECTIONS Not Approved
Date Insp.
r,"s PLUMBING
Electric Date Insp.
Plu ,mb in Backflow Insp_
Mechanical Underground
Solar Underfloor
Pool Partial Rough
Grading Rough Complete
FirDe Solar Rough
—
Pire a Dept . Water & Insulation
Health Dept. 'lain Drain
Duildin R/of/S Drain
Other Gas
Other
BUILDING Not Approved
Date Insp.
Pad Certification MECIIAN[CAL
Foundation Date Insp.
Pre-Gunite Underfloor S.H.
Slab-Hembrane Ducts & Insulation
Bond Beam Fire Dampers
Underfloor Girders Fireplace
Floor Steel Grease Duct & Ilood
Tiedowns One [lour Shaft
Diaphrams Condensate Drain
Seismic Bracing Equipment Anchorage
Iialls-Panels
Flues & Comb. Air
Frame Other
Lath Not Approved
Ilallboards Int/Ext.
Firewalls
Other
Not Approved
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINTM ONLY
BUILDING PROJECT IDENTIFICATION
PERMIT NUMBER
Sun
LDIN5G�,�' APPLICATION & PERMIT 0825
AD sW'7 E Q� BUILDING - ELECTRICAL-PLUMBING -MECHANICAL
EER'S � PLAN CHECK VALIDATION
LJ
'1Nq`\ME (� QTY. ELECTRIC PERMIT FEE
R.DV Wrt PRONE
CONTNACTORS
CONTR TORS OUTLETS-SWITCHES-RECEP 5.00/1.00
URu_F_7 HeATlnLT uC.No LIGHTING FIXTURES 5.00/1.00
coNTRAcroR'5 30 n . i3l-hsr' APPLIANCES'RESIDENTIAL 4.00
ADDRESS v O J�1 '
' PHON PANELS 5.00 DATE OF APPLICATION
ARCHITECT SIGNS 6.QQ PLAN CHECK FEE P.C.NO.
ENGINEER
uC.NO, SIGNS TRANS. 3.00
AARCHDDREOR SS ENG SPECIAL CIRCUIT S.QQ PERMIT VALIDATION
zip frEMP. METER OR POLE INS. 15.00
ADDRESS MOTORS SEE FEE SCH.
SERVICE CHANGfE 10.00
' 02 LICENSED CONTRACTORS DECLARATION CI11�tI�OF y W.
a i w 1 hereby affirm that I am licensed under provisions of Chapter 9 I55U CE DATE
w a (commencing with Section 7000)of Division 3 of the Business and AUGBLDG. ELECT. PLG. MECH.
H y i 1'rol'essmin,Co p,a�4.at wrote is in lull fur NU
z o m - Licen .las Lic.\umber
w _w Date Contractor
1 El D
� - H
st y E BUILDING PERMIT
¢ a OWNER-BUILDER UIiCLARA ON
o a - INFORMATION
w3 LL H 1 hereby affirm that 1 am exempt from the Contractor's Licen MISC.- REFER TO ORD
LL D j Law for the following reason.(Sec.7031.5,Business and Professions VALUATION $/FT.
H - PERMIT ISSUANCE 6.00
Code:Any city or county which requims a permit to constrocl,alter,
Q ¢ G 0 improve,demolish,or repair any structure,prior to its issuance,also E EC.CONTF. LIC.NO. ELEC. ���E/'�)
0 ¢ requires the applicant for such permit to Glc a signed statement that �T/n1r TOTAL 5 PERMIT TO
E
mhe is licensed pursuant to the provisions of the Can tractor,License �• FF�� I
aiQ Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe
i D Nosiness and Professions Code)or that he is exempt therefrom andQTY. PLUMBING PERMIT FEE
¢ H o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR.
n by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 4.00
of not more than five hundred dollars 1 S500).)'
❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 2.00
their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS
intended or offered for sale (Sec. 7044. Business and professions DRAINS-FLOOR,ROOF,AREA,COND. 4.00
Code: The Contractor's License Law docs not apply to an owner of
property who builds or improves thereon,and who does such work F IXTURES-PER TRAP 4.00 5D.FT.PLooR AREA rorAL ACREAGE
himself m through his own employees,provided that such improve- GAS-EA.SYSTEM-1 INC.4 OUTLETS 4.00
meats are mens is sold or offered yearsale.o If,however.the building
or builder
will have
is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 1.00 BUILDING USE
builder will have the burden of proving that he did not build or im-
RES IND CON PB Omer
prove for purpose a sale.). INDUSTRIAL WASTE INTER. 2000
❑ L as owner of the properly,and exclusively contracting with . ❑
licensed contractors to construct the project(Sec.7044, apLAWN SPRINKLERS-1 INC 5 V.B. 5.00 ASSESSORS PARCEL NO.
and Professions Coop:The Contractor's License Law docs notof applyply
to anowner of property who builds r improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00
contracts for such projects with a contractions)licensed punuant to
the Contractor's License law. SEWER-SANITARY-STORM EA.200ft/8.00 TRACT No. PARCEL NO.
real Clson I mn cun
xcmpt der Sec.-.B.&P.C.for this WATER HEATER W/VENT 4.00
Date Owner WATER SYSTEM - 4.00 ACC.DATE ACC,FILE NO.
\VORKERS'COAIPISNSATION DIiCLARATION WATER TREATING EQUIP. 4.00
1 hereby affirm that I have a certil'icale otconsent to sel&insure.
or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO.
copy tile f( e- 1 0,Liih.C.)
I'a11Cy 1Nl alllpany l,l_)insn l ti/�Q.5
Q ❑ Certiflv'd cop}'is hccehJ'fumishcJ. FIRE SPRINK ENERGY T 24
Z Z C"TIF en i Ill- with ci in ection Aivision.
H O pp ican IMISC.- REFER TO ORD. Y ❑ N❑ Y ❑ No
� N CER'I'IP} A'I'Ii UI'IiX1iN TION PROAL )RKIiRS' PERMIT ISSUANCE 6.00 PLOOD ZONE A.L.u.C.
LU > CO.MPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.
CL O (This section need not be completed if the permit is for one TOTAL Y❑ N Y E] N�
::) Z hundred dollars IS 100)or less.)
U O 1 certify that in the performance of the work for which 01Is per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY
LL H mit is issued, I shall not employ any person in any manner ssl as to
O W become subject to the Workeri Compensation Laws of California.
D. Date Applicant ALTER OR ADD TO MECH. 4.00 BUILDING
} w NOTIC17 'rO APPLICANT: 11,alter making this Certificate of[-.a-
eruption,you should become object to the Workers'Compensation APPLIANCE 4.00 PLAN CHECK
Uc1pion isof the or Code, you mist forthwith comply with
p this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10)000C.F.M.) 3.00 FEE
CONST'RUCT'ION LENDING AGENCY AIR HANDLING UNIT(OVER I0OOOC.F.M.) 5.00 SEISMIC FEE
I hereby affirm that there is a construction lending agencv for EXHAUST HOOD (WITH DUCT) 2.00
the performance of the work for which this permit is isocd(SCC. MICROFILM
3097,Civ C)
Lender's Name HEATING UNIT LTO 100,000 B.T.U.) 4.00
HEATING UNIT(OVER 100,000 B.T.U.17.50 r S�
Lender's Address ELECTRIC
Iel ly that l haveread thisappheiihon andstate that the above VENTILATION FAN (SINGLE) 3.00
in
formation n is Street. I agree coply with all city and cowltY PLUMBING
infomat
rscioto m
and state laws relating to building construction. and BOILER-COMPI3 H.P.or 100,000 B.T.U.) 4.00
hereby authorise representatives of this oily to enter upon the BOILER-COMP (Over 100,000 BTU(SEE FEE SCH.
above ntc Bonet property for uupection pu.posYs. MECHANICAL -7
(We) agree to save, indemnify and keep hurmlcss the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 3.00 CONST.TAX
may in any way accrue against said City in consequence of the
gra Of is per il. MECH.CONT. - LIC.NO.. MECH.
U I /
TOTAL j)DO TOTAL So
Ig at f pplicantlCo cmr Uale r
OFFICE COPY