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19578 (2) POST THIS CARD NEAR FRONT OF BUILDING rrxM TNo. 19578 CITY OF CUPERTINO AMUCATIONSUBMIIIALDAM, INSPECTION DIVISION-;JOB INSP �1� D JOB, ADDRESS' z,Z 3 4 �,C!/ry�,�� q(_ LOT# �CA'I10DRY - CONTROL x IBUILDING PERMIT INFO, OWNER L "°cL�� CONTRACTOR �—CT�TI �'E�C � I ,� INSPECTION 3INSPECTION EORD FOUNDATION/PIERS DATE', INSPECTOR • NOTE ALLCRADINC ANO DRAINACE ❑ - UFERGROUND• _ - SHALL BE INSTALLED TO COMPLY VATH JOB DESCRIPTION THE APPROVED PLANS AND CITY OF - - .,,� j • PAD/SETBACK-CERT- - . ,''CUPERTINO STANDARDS. �--� j6'� � . GARAGE SLABS PREGUNITE .r . 11- POUR-NO CONCRETE UNTIL.ABOVE.HAS BEEN SIGNED UNDERGROUND/SLAB INSPECTION- DATE INSPECTOR PLUM13ING ELECTRICAL - -- - MECHANICAL. DO NOT POUR FLOOR UNTIL ABOVE HAS 13EEN SIGNED• - WOOD FLOOR 'PLUMBING - - ., MECHANICAL ELECTRICAL FRAMING/VENTS/CLEAR - INSULATION PLACE 7NO'SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROUGH PLUMBING- - TUBS&SHOWER PAN - MECHANICAL ELECTRICAL/JACUZZI BOND'- ` FRAMING STAIRS - '" " INSULATION/VENT]LATION ` EMERG.EGRESS - .. r• SEWER WATER - - COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED,e EXTERIOR SHEAR 1-IOLD DOWN I I - - INTERIOR SHEAR/HOLD DOWN SHEETROCK/SHEETROCK SHEAR - - EXTERIORLATH/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 PAID - FINALS " .DATE INSPECTOR SAN.# - - ELECT.ENERGY PLUM BING ENERGY ' MECH.ENERGY - - - 13UILDING ENERGY ' ELECT..FINAL TEST PLUMBING - GAS TEST MECHANICAL HEATING • ELECTRICAL RELEASE TIREDEPT. GRADE - OCCUI'ANCY TEMPORARY APPROVALS • - " ELECTRIC - - GAS ., BUILDING ' Y " 1S�[1J,ILJ ' OCCUPANCY OF BUILDING IS NOT PERA7ITTED UNTIL � CE DATE BUILDING FINAL"IS SIGNED BY BUILDING INSPECTOR - ARRANGE FOR INSPECTION BY PHONING 252-4505 BETWEEN I FIE Q 0 j 195 12:30 PM AND 4:30 PM MONDAY THROUGHTRIDAY,24,HOURS . BEFOREREQUIREDINSPECTION. JOB"ADDRESS AND �lrl flE f, lr�TFinQ PERMIT# ARE NPF,DED WHEN PHONING. IMPORTANT!' PLEASP READ REVERSE SIDE BEFORE. CALLTNG FOR'FTNAL INSPECTTON:. : fimDBY : -il. h r OFFICE COPY . APPLICANT TO FILL IN INFORMATIO IN RED LINES — USE BALL POINT PEN ONLY ' Bui],Aing Probe Identification Building Apdna.: n 234$ aATLT �, `J 578 me: Phone: - ^ ^�C,� l(� L.(_• CITY OF CUPERTINO-BUILDING DIVISION. o.I C �1 c°ntraa°isName: Lie.No: APPLICATION / PERMIT ( (J T_ C I'26BUfLDINGELECTRICALMUMBINGMECHANICAL CATEGORY - CONTROL N ArcIteet/Englneer. Lie.N. 5YM4 caww0FSA M QiY�'-•;�,'-ELECTRICPER,INIT � 'FEE� BUILDING PER -�ITINFO Addrc.s:7_66S t!. M�Ay�� .rj• a• PcahnTlssuANCc LICENSED CONTRACTORS DEion, fC ON .pi - ]hereby affirm that lam licensed under prwisionao(Chaptcr9(carnmenc, APPLIANCFSRESIDEMTAL . 19U JOBD RB'HON . Ingwith Sactlon 7000)of Dlvision3oflhe Bu.inmandPmfmionsCode,andmy _ Beer.is In full force and effect. PANELS eJ O, l •'1` Llrenae Class C I O Lic.N ZIO 1 SIS - Date�r'.4!�_Q_ContraRar_ '( (L{(� ARCHITECTS CLARATION 201-1000 AMPS ! ✓/ 4- �7. I understand my plans shall Musedas publlerecords. OVER]ODO AMPS SQ.FT.FA RAREA $/SQ.FT. O ra Llcnsed Professional - SIGNS ELECTRICAL �<6 OWNER-BUILDER DECLARATION SPECIALCIRCUIT/MISC OD IM1ercbyalfirtntMllam exempt(romlhe Contractor's License Law for the pp following reason.(Section 70315,Businessand Professions Code:Any city or TEMP.METER OR POLE]NST. - countywhich requiresa permktocoratroct,alteq improve,demollah,or repair _ - anystrumn,prior to itsissuance,also requlrestheapplicxnt forsuch permit to POWER O DEVICES,file a signed statement that he is licensed pursuant to the provisions of the 3u, Contractor's License Law(Chapter 9(commencing with Section 7000)of Dlvl SWIMMING IDOL ELECTRIC H OJ sien3of the Bueincaa and Professl°raCodc)arthal hale aemptthercfromand - VALUATION Yi•7 the basis for the alleged exemption. Any violation of Section 7WIS by any ' 6X applicant fara pereraft subjects the applicant to a civil penalty of ot mare than OUTLETSSWITCHPSEIXTURES I� oD ' n. fivehundreddollarshepr. NEW RESIDENTIALELFGTR SQ,F7', I STORIES TYPECONSFR=ON I,as owner ll the property,or my employees with wages r there sok �q7q.Q compensation,willdothe cas and uk,and Proftethest ode:Thure net Intended oroff Law , 5pd for 0 due(notappy B.iffiin.--w of Professlom Code: or Improves themor,Law does not apply to enownero(property who builds orimprovee thereon,and S� who doessuchwork himself orthmugh hisown employees,provided that such OCC.GROUP RCS.UNITS improvements are not intended muttered forsale.IL however,thebullding or TOTAL: 3 S 6 D - Improvement(+sold within oneyearofcompletlon,tM owner-bullderwlll have th,£.4urden of proving that he did not bund or improve for purpose of sale.). QTY, '. PLUMBINGPERMIT ° FEE'" HADD ZONE APN L)L as owner of the property,am exclusively mntnRing with licensed contractors to mnaWd the project(Sec.70K Business and Professions Code: PERMIT ISSUANCE The Contractors Llcenae Law does not apply to an owner of property who ALTER-DRAIN VENT-WATER Wilds or improve. thereon,sand who contracts for such ptvjacte with a (EA) _ co ador(s)licensed pursuant to the Contractor's License Law. FEE SUMMARY I am exempt,under Sec. B&P Cfar this reason BACK FLAW PROTECT.DEVICE • .riffs— DRAINS FLOOR,ROOF,AREA,COND. SANITARY Y N� Owner Date ,RECEIPTtl WORKMAN COMPENSATION DECLARATION FIXTURES PER TRAP SCHOOL TAX Y N ❑L hereby affirm that I have o certificate of consent to.py tnmre,ora RECEIPT N certificate olWorkeri Compecaatlonlmurance orarertifled copy thereo((Eec. GAS F.A.SYSTEM-1 INCA OUTLETS PARKFTEE Y N poli Lab C.) , Po11ry N GAS FA.BYSTEMAVER 4(EA) RECEIPT p Com any - BUILDING DI VISION PEES Certified copy 6 hereby filed the cid. GREASE/INDUSTRL WASTE INTERCEPTOR PLANCHEC -EE �Certl(ied ropy la filed with the city inspection division. KWWWWWlIIIII CERTIFICATE OF EXEM PITON FROM WOR KER S' GREASE TRAP PAID .. COMPENSATION INSURANCE SEWER-SANITARY-STORM.EA 20OFF Date Recel t# Rb os section need n°tM<omplcted if the permit bforonc hundred dollars ($100)otifyth WATER HEATER W/VENT/ELECTR ENER YFEE Y N Icertifythat in the per(ormanreofthe work for which thlsperinitlaissued, — I.hall not employ any person In any manner so u to bemuse mbject to tM WATER SYSTEM/TREATING Worken'Compensatloh laws of California.Date PAID O Z Applicant NEWRMDENTLALPLMB. SQ.IT. Date Recei t# Z O NOTICE TO ICANT:IL after mating lhfs Certillate of Exemption,you should Wrome s abyd to the Workers'Compersation prov Woru of the Labor TOTAL: N Code,you mostforthwith complywtthauchprovlsioraorthls N dtshaIIW K j deemed revoked, -BUILDING FEE W p' CONSTRUGP10N LENDING AGENCY.' SEISMIC FEE f _ d Z IherebyafflrmtMt there is a corawctlon lendingagency forthe perform- TOTAL: ELECTRIC FEE .VA- ance of the work for which this permit is Issued(Sec.3097,Civ.Q V 4 Lender's Name r PLUMBING FEE LL Lender.Addre.s QTY. MECHANICAL'PERMIT FEE MECHANICAL FEE O W Icertify that l have read thi.appliallonand mate that the above information IsmrrecLlagree tocomply with all city and muntyordinances and statelaws PERMIT ISSUANCE FEESPAID: r V) relating to building construction,and hereby authorize representatives of this • ~ N cuytoenterupontW.Wve-mentionodpropertyforlrapectlonpurposes. ALTER OR ADD TO MECH. ? Me)agree to save,indemnify an d keep h.,odc"the City of Cupertino Date Receipt# O .gal the ties,fadgments,mstsand expenses which may In anyway.ecrue AIR HANDLING UNIT(TO 10,000 CIM) SUBTOTAL: .gal Id It uence of the grant ing of this'permit _5_q� MR FIA NDLING UNIT(OVER i BODO CF.M) CONSTRUCTION TAX rat/Contractor Date IXtfAWT HOOD(W/DUCT) CONSTRUCTION TAX PAID: HAZARDOUS MATERIALS DISCLOSURE - Willtheapplimotorfuture building occapant store or handle hazardous I BATING UNIT(TO I M,ODO BTU) Date Recei t# _ material as deft ned by the Cupertino Mu nidpal Code,Chapter 9.12,and the - Ikalth a rad Safety Codr�,`ction 25532(.)7 HEATING UNIT(OVER 100,000 BTU) _ -TOTAL: Yes Q No - - Willtheapplica., Pleture building oemp.rt.xe equipment ordevices VENTILATION FAN(SINGLE RESID) ISSUANCE DATE which emit hazardous air cntaminants as defined by the Bay Arca Air /k • Quality Mavgement DuI'ct7 BOILER-C0MP(3HPOR IW,IXDBTU) PAQdD 4haveYes No (� read the lama smaterials requirements under Chapter 6.95 of BOILER-COMP(OVIA 100,000 RU) FEIi y(� +I the CIfernla Ilealth&Safety Code,Sectlom 2550.5,25533 and 25534.I U D. I J�LI understand that if the building does not currently have a tenant,that it is my NEW RESIDFN77AI.MECH. 'Q.1'1'. , r P. tyi notify theompant of requirements which most met ' P to CeelficateofOccupanry. L`'}II faf VIIPOrtIrIQ neroraut or agent 'D t� I TOTAL: ISSUEDBYJ V _ OFFICE COPY