3546 (2) CIT}' of CUPERI'INO INSPECTIOI' RECORD (Office Copy)
• 3566 _ 10395 Glenview Avenue'
Pl:PJIIT N0. SANITARY DIST. 140. LOT 110. ADDRESS
Solar R. Bunce
PROJECT OWNER JOB SITE P11014E 140.
PERMIT ISSUED Date ELECTRICAL
Buildin 6/2/83
s Date Insp.
Electrical
Power Pole
Plumhinq 6/2/83 Underground
1lcc11nnicaI Rou th Wiring _
'Temp. Cas/]ilec t. ITaI s
Solar Ceiling
Fire S rinkler Fixtures Int/Ext
Si .,n Notors
Grounding
Misc. Tem2. Power
Other
FINAL INSPECTIONS Not Approved
Date Insp. .
Ge.s
PLUMBING
Electric Date Insp.
Plumbin , Backflow
Mechanical Underground
Solar Underfloor
Pool Partial Rough
Gradin Rough Complete
I'lannin Solar Rough
Fire De t. Water & Insulation
Health Dept. 'lain Drain
Building R/of/S Drain
Other Gas
Other
BUILDING Not Approved
Date Insp.
Pad Certification MECHANICAL
Foundation Date Insp.
Pre-Gunite Underfloor S.M.
Slab-Membrane Ducts & Insulation
Bond Beam Fire Dampers
Underfloor Girders Fireplace
Floor Steel Grease Duct & Hood
Tiedovms One Hour Shaft
Dinphrams Condensate Drain
Seismic Bracing Equipment Anchorage
Ualls-Panels Flues & Comb. Air
Frame other
Lath Not Approved
Uallboards Int/Ext.
Firewalls
Other
r Not Approved
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -,USE-BALL POINT PEN ONLY
BUI LOI NG PROJECT I DE TI FIC PERMIT NUMBER
BUILDING APPLICATION & PE1W 3 5 4 6
DDREss
o39S G Nw VlG /�/" � BUILDING - ELECTRICAL-PLUMBING-MECHANICAL
OWNER'Sn /`� - PLAN CHECK VALIDATION
Wi}d� OTY. ELECTRIC PERMIT FEE
CO iE ��� PHane
CTOR'9
NAIVE
NnME �Q UTLETS-SWITCHES-RECEP 5.00/1.00
CRv4MaT►� �ODrLTc N 0«IS, LIGHTING FIXTURES 5.00/1.00
DDRESSTOR's y APPLIANCES-RESIDENTIAL • 4.00
72, �O N� � PHON,2E2-/JJe1 PANELS 5.00 DATE OF APPLICATION
ARCHITECT PLAN CHECK FEE P.C.NO.
on SIGNS 6.00
ENGINEER t*M,`p
` ua NO SIGNS TRANS. 3.00
ARCH Bis ENG' - SPECIAL CIRCUIT 5,00 PERMIT VALIDATION
d C 'ZIP EMP:METER OR POLE INS. 15.00
APPLICANTS ' MOTORS SEE FEE SCH:
ADDR'c59 �I w 1 O✓
CA, �� /7SCSERVICE CHANGE
o re i
r o o LICENSED CON'1'RACTUR$DECLARATION
a z w I hereby'affirm that 1 am licensed under pros'isirns of Chapler 9 ISSUANCE DATE
a (commencing with Section 7000)of Division 3.f the Business and LD ELECT. PLG. MECH.
r m i Professions Co n c is in full fo c and feej,,
Z, Z y o Llcensc Cjuss 3�ltl� i.Nmnbcr y0 �j _ - x ❑ ❑ ❑
Date VZO/p.�_Conlmcmr{��_ F. Q
w ~ G� 5
F
y.� Ot BUILDING PERMIT
In OWN ER-It UI LDF-R DECLARATIONS
c- 1
r� INFORMATION
wI hereby affirm that I am exempt from the Contractor's Licari, MISC.- REFER O CHD
r u o a Law for the following reason.(Sec.7031.5,Businrssand professiuns PERMIT ISSUANCE - VALUATION 5/FT.
Code:Any city or county which requires a permit m construct,alter, 6.00
Q40 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0. y SO
r O , requires the applicant for such ELEO.
9 PP permit to file u signed statement Li nse TOTAL PERMIT TO
a w m he is(Chapter
pursuanten the provisions of the )ofDivmr's License L
F z Q
Law lChapter9(commencingwith Section is rsomf Dthereno theand Q O2 Sys T�
i G Business and he alleged
a amp or that he is tion of therefrom and DTV. PLUMBING PERMIT FEE
c, I- the basis for the all r a Cxrm ptirn.Any violation of Section malty STORIES TYPE CONSTR.
s3 � of by
applicant fora permit dint...the applicanuoacivil penalty ALTER-DRAIN -WATER (EA.) 4,00
oC not more than five hundred dollop 155001.1: - - '
❑ I,as owner Of the property,or my rmployne'with wages as BACK FLOW PROTECT. DEVICE 2.00 OCC.GROUP RES.UNITS
their sole compensation,will do the work,and the structure is not
intended or offered'for sale (Sec. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 4.00
Code:'rhe Contractor's License Law does not apply to an owner of -
property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 4.00 SOL FT FLOOR AREA TOTAL ACREAGE
himself re through his own ffered for s Provided thus such improve-
meetsareIthrounot rndedor adCm oyrrs,a le.If.however.such
rbuilding GAS-EA.SYSTEM-1INC.4OUTLETS 4.00
or Improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 1.00 BUILDING USE
builder will have the burden rf proving thm he did not build or inr RES- IND CNG PB Omor
Prove for purposC ufsele.). INDUSTRIAL WASTE INTER. 20.00
❑ 1,as owner of the property,an exclusively contracting with ❑ ❑ ❑ ❑ ❑
licensed contractors to construct the project(Sec. 7044,Buslmoss LAWN SPRINKLERS-1 INC 5 V.B. 5.00 ASSESSORS PARCEL NO.
and Professions Code:The Comracmrs License Law dews not apply
to an owner of property who builds or improves tlarcon,and who LAWN SPRINKLERS-OVER 5(EA.) 1,00 - -
contracts for such Projects with a cuntractorts)licensed pursuant to
the Contractors License Law. SEWER-SANITARY-STORM EA.200ft/8.00 TRACT NO. PARCEL NO.
❑ l am cs<mpl under Sec. .B.&P.C. wthis. WATER HEATER W/VENT q,p0
reason
Date owner WATER SYSTEM 4.00 ACC.DATE ACC.FILE No.
WORK ERS'COMPENSAt']ON DECLARATION WATER TREATING EQUIP. 4-00
1 hereby affirm that I hove a certificate W consent In selGi ours. ZONING
racer fjpte nf4 rs'Compensation Insurance,or a certified ENG.SITE NO.
9 G��JTTy�t part' l �
oP e,lir. r mpunY�aAa
O ❑ Certified ml y hereby tarnished
• Z Z dFertificd tory is�ffie h the I in}pyli�n J"ir lyre. FIRE SPRINK ENERGY T 24
O Apphcant.S$ .KIn 1� �9_�l-L�c.�- MISC.- - REFER TO ORD. [:] N❑ Y ❑ NN[:]= N CFRTIFICA'TI'01'FXFMPI[ON FROM WORKERS' PERMIT ISSUANCE 6.00 W FYLOOD ZONE A.L.U.c.
W > COMPENSATION INSURANCE PLG.CONTR, -- LIC.NO. PLG.
CL _O (This section need not be completed if the permit is for one TOTAL Q Y E] N❑ Y❑ N❑
Z) Z hundred dollars($100)Or Tess.)
L) O 1 certily that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY
LL F mit is issued,I shall not employ any prrson in anymanner so as to
O w become subject to the Workers'CompewtiunLaws ofCalifornia.
a Daft ApplicantALTER OR ADD TO MECH. 4.00 , BUILDING A_
} o NOTICE '10 APPLICANT: It,alter making this Certificate of Ex-
♦- ? rmption,you should become subject to the Workers'Compensation APPLIANCE 4.D0 PLAN CHECK
provisions of the tabor Code, you most forthwith comply with FEE
U such proviiions Or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10)0000F.M) 3.00
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER10=C-F.M.) 5.00 SEISMIC FEE S7L)
I hereby affirm that there is a construction lending agenev for EXHAUST HOOD(WITH DUCT) 2.00 . .
the performance if the work for which this permit is issued IScc. MICROFILM-
3097.Civ.C.l, HEATING UNIT (TO 100,000 B.T.U.) 4.00
Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)7.50
Lender's Add, ELECTRIC
I certily that I have read this application and state that the alwve VENTILATION FAN (SINGLE) 3.00 /
nl'ormalion is correct. I agree to comply with all city and compy PLUMBING
ordinances and stale laws relating to building conM ruction, anJ BOILER-COMP(3 H.P.or100,000B.T.U.) 4.00
( abrebyove- entharicc representatives lorries ec this city to borer urn Ihu BOI LER-COMP IOvur 100,000 BTU)SEE FEE SCH.
herebymcntinned Property efnr inspection purposes I). - MECHANICAL
(We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD.
Cupertino against liabilities,judgments, costs and expcnus which CONST.TAX
may i any way accrue against said City in CUrsCgnellce of the PERMIT ISSUANCE 3.00
grammg of thh perinll' H.
MECH.CONT. - LIC.NO. MEC
L!J TOTAL TOTAL 6 / OZ
/<
Signature ul Applicant/Cool rador Date
OFFICE COPY