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B-2016-1849
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1849 10760 JOHNSON AVE CUPERTINO, CA 95014-3818 (375 31 005) PAB CONSTRUCTION INC CUPERTINO, CA 95014 OWNER'S NAME: YU HENRY DATE ISSUED: 08/26/2016 OWNER'S PHONE: 408-966-9899 PRONE NO: (408) 499-6595 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #980537 Contractor PAB CONSTRUCTION INC Date 01/31/2017 X BLDG —ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under,the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: CONSTRUCT (I) 2 STORY SFD (2,184 S.F.) WITH ATTACHED (427 I hereby affirm under penalty of perjury one of the following two declarations: S.F.); (N) BASEMENT LEVEL (1,130 SF); (N) COVERED 1. I have and will maintain a certificate of consent to self-insure for Worker's PORCH/BALCONIES (386 S.F.) Compensation, as provided for by Section 3700 of the Labor Code, for the DEF #1 - TRUSS CALCS - ISSUED 7/31/2017 1,00ferformance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: 3741 Valuation: $450000.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 375 31 005 Deferred Submittal (R-3),R-3 (Custom) representatives'of this city to enter upon the above mentioned property for inspection purposes. (We) agree tol save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. Additionally, the applic t un erstands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per e C e ino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Si , tAe Date 7/31/2017 Issued by: ABBY AYENDE 0 -B�ILDERDL[LARATIQN Date: 08/26/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any, roofing material being installed. If a roof is t.. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) z. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 7/31/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER t: I have and will maintain a Certificate of Consent to self-insure for Worker's Compensation, as provided for by Section 370Q of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the s. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous. shall not employ any person,in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous Worker's Compensation laws of California. If, after making this certificate of air contaminants as defined by the B y Ar a Air Quality Management District I will maintain compliance with theunicipal Code, Chapter 9..12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, ctio s 5 5, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. A011 Wwner or authorized agent: APPLICANT CERTIFICATION Date: 7/31/2017 I certify that] have read this application and state that the above information is TR LE A Y correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a consIrtiction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Signature Date 7/31/2017 Licensed Professional '1 (408) 777-3228 • FAX (408) 777-3333 • buildingaC�cupertino.org CUPERTIN ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI P REVISION DEFE ORIGINAL PERMIT # PROJECT ADDRESS 9 - ��"Nyt APN # f OWNER NAME 1A PHONE 4in-(t1L��/�_..sq-MAIL _� STREET ADDRESS `A CITY,'STATE,ZIP�J® /' FAX 4� l CONTACT NAME Ij� /�•' Y , PHONE�E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑'ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME %b � .A I LICENSE NUMBER �p �� LICENSE TYPE J BUS. LIC # COMPANY NAME �p r `�/�• E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP F3- PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK _W EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES I USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA , PORCR_7 DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RE - IVSD BY a !G T. TOTAL VALUATION: PLANTNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of following: I am the property owner or authorized agent tollact on th property owner's behalf. I have read this application and the information I have prov d d is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to�buildi construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL 1N ATION REQUIRED <-. ,ROUTING SI 7P , � [ Om E, TxE cbUIviER � ❑ IiiiII DINGPLAI REVIEIv _ New SFD or Multifamily dwellin Apply for demolition permit for existing building(s). Demolition permit is required prior to Issuance of building lliq F permit for new building.ExPEss� PLA.NNINGPLANREVIEw _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ,144 @�❑ ❑ S AN ppRn ©PTJBLIcwoI�s form if any Hazardous Materials are being used as part of this project. t LARGE I ❑ FTRE DEPTER Copy of Planning Approval Letter or Meeting with Planning prior to z i _ submittal of BuildingPermit application. PP I�tAroR' ❑ SA1`?rTa[YS> wER DtsTRIC� a EST �,§ r , � w 'E'NVTRbA'14I'ENTALHEALTki4�?K.;l.:•_. �......�° BldgApp_201 Ldoe revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1849 10760 JOHNSON AVE CUPERTINO, CA 95014-3818 (375 31 005) PAB CONSTRUCTION INC CUPERTINO, CA 95014 OWNER'S NAME: YU HENRY DATE ISSUED: 08/26/2016 OWNER'S PHONE: 408-406-0956 PHONE NO: (408) 499-6595 LICENSED CONTRACTOR'S DECLARATION ATION BUILDING PERMIT INFO: License Class B Lic. #980537 Contractor PAB CONSTRUCTION INC Date 01/31/2017 X BLDG ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing _ MECH X RESIDENTIAL _ COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: CONSTRUCT (N) 2 STORY SFD (2,184 S.F.) WITH ATTACHED (427 I hereby affirm under penalty of perjury one of the following two declarations: ST.); (N) BASEMENT LEVEL (1,130 SF); (I) COVERED t. I have and will maintain a certificate of consent to self -insure for Worker's PORCH/BALCONIES (386 S.F.) Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: 3741 Valuation: $450000.00 permit is issued. APPLICANT CERTIFICATION 1 certify that I have read this application and tate that the above - information is correct. I agree to comply with jail city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 375 31 005 Deferred Submittal (R -3),R-3 (Custom) representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non -point source regulation per the Cupertino Municipal Code, Section 9.18. ' 180 DAYS FROM LAST CALLED INSPECTION. Signature— `. ' Date 1 9 Issued b : Kim Dunbar y 'Ili,v Date: 08/26/2016 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFSROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is i. 1, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (See.7044, Business & Professions Code). Dater 08/26/2016 1 hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the C ertino Mu icipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, cti i 25 O5, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. .Owner or authorized agent: APPLICANT CERTIFICATION Date: 08/26/2016 I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws C STRITCTiokLENDMG AGENCY I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 08/26/2016 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildin-g a�.cupertino orq +i.IPIEwR."d`IN� T3 r' Z,0 t �'• NEW CONSTRICTION ❑ ADDITION ❑ AL'T'ERA'T'ION/ TI ❑ RENTISION 1 DEFERPED ORIGINAL RM1T 4 PROJECT ADDRESS U T G7 Ca C �� - M1'1 A VeAPN #-7 / �J f + ` r f e- 07 7 OWNERNAiv1E 'HONE {-•� { &MAIL o Q6_cgel 1�Lc;nS STREETADDRESS + CITY, STATE, ZIP �i }�7 l FAX CONTACT NAME j l � PHONE L4� .�JY- 1A `i -1- 6 rPCI� B-MA]L � C STREET ADDRESS 7 + (,J Y _! CITY, STAd, ZIP (} FAX ba U 11 OWNER ❑ OWNER -BUILDER ❑ Ole'NERAGENT 0 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME n J\ � 5 LICENSE NUMBER q j�.� � � LICENSE TYPE BUS. LTC tl R/}v ti tS �j �} COMPANY NAME ti i r{U' C \ 1Ct n y>^ C F MAIL 1� C C' YI 4 Y� 1y1C f FAX z r+ STREfiT ADDRESSrC'06'CJ ` CITY STATE, ZIP UPe PHONE aYI'It'S�t°L,c� �IT�iI�C� 4 NS ARCHITECTIENOINEERNAME�, y LICENSE NUMBER BUS.LIC#i COMPANYNAME STREET ADDRESS &MAIL I FAX CITY,STATIi,Z1P I PHONE R DN'ELUNG UNITS; IS A SECOND UNIT ] YES I SF.COND STORY ❑ YF9 6EINGADDED? NO AMMON' NO PRE -APPLICATION YES IFYES,PR0-V1DECOPYOF PLANNER'S NAME; O PLANNINGAPPLil ❑ NO PLANNING APPROVAL LETTER �! By my signature below, I certify to each of t Ie to o iug: I am the property owner or an application and the ir�ibintation I have prov' ed ' or ec I have read the Description of ordinances and state laws relating to buiidu con ru ti authorize representatives of Signature of Applicant/Agent: AA Now SFD or Multifamily dwellinYs: Apply for demolition permit for existingbuilding(s). Demolition petmtit is required prior to issuance of building permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure foam if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. off—to e property owner's bebarf—1-h ee read this Xmffyit is accurate. I agree to comply with all applicable local to enter the above -identified property for inspection purposes. _ Datc: %—I -A` ,81dg'App2011:doc revised 03116111 `?v 00-4 GreenBluEarth, Iric. 117 Bernal Rd. #70-336, San Jose, CA 95119 Ph.: 108.772.4381 Email: osunaenginee►ing@gmail.com Building Department City of Cupertino 10300 Torre Avenue C Ino, 95014 Avenue, To Whdm It May Concern: This is to certify that the according to the approved l3 - CA — New House � 6 --,. �� 0 December 6, 2016 Job No. 1206 ;,t8 RZ Ate_':. ,ment foundation for thepro erty mentioned above, was staked and that the setbacks are per he approved Plans. Oscar RCE PLS M.S., P.E., P.L.S. 117 Bernal Rd. #70-336, San JIse, CA 95119 . 408.772.4381 • Email: osunaengineering@gmail.com MS Engin CONSULTING CIVIL ENGIN 5149 Moorpark Ave. Suite 1 (408) 377-6504 (408) 377-6511 DATE: SUBJECT: PROJECT ADDRESS: As requested by the contx above property on Decen At the time of our inspect in place and the basement installed. i Bering & Ass ERING SERVICES 8-B, San Jose, CA 95129 December 7, 2016 Basement slab inspection 10760 Johnson Ave Cupertino, CA ,r, our office performed site 4 and 7, 2016 the basement rebars had been Zor bolts and holdowns, inclu( We understand that the soill engineer and the waterproofing , waterproof membrane prior lo the rebar/hardware placement. All work appears to comply with the approved plans and r At the time of our inspectio; we noticed the shoring piers excavation. Please contact our office ifl u have anv question. Mahmoud Sanatkhani, PE MS Engineering & Associ. L7jr:�>.. .o. A95A5 . `e;Sq Exp. t� ..,;,,..%rl;i 12/0712016 Inc. iates, Inc. ions for the basement slab at the wall reinforcing dowels were (6) hardy panel rods where had inspected the details. been in place, prior to the start of roe. GeoEngineering Consultant 4125 Blackford Avenue, #1° San Jose, CA 95117 800 -GEC -3752 Mr. Moe Jalili PAB Construction, hie. 21060 Homestead Road Cupertino, CA 95 Subject: roposed 10760 Jo A Dear Mr. Jalili At your request, GeoEngin and drainage backfill on N, backfill drains were proper the retaining wall. Should you have any quest additional information, ple GEC ,GEC) ential Improvement Ave. OBSERVATION ring Consultants (GEC) has obs ember 2"d , 2016. The basement installed and placed. GEC show s relating to the contents of this do not hesitate to contact our o C� Project No. P15.0179 December 5, 2016 ied basement wall waterproofing all waterproofing and drainage observe the native backfill behind rt or should you require at your convenience. yours, No. C6&379' 0 No. G 79 -Exp. 6130!201$m IL ` OF GA1 iF nran Ghiassi, Ph.D., icipal Geotechnical Engineer Page i I r o. 09/06/16 MY. I II I euomn BASEMNET SHORING NOTES, I I I- 'PROJECT CIVIL ENGINEER` TO CERTIFY PAD ELEVATIONS AND BUILDING SETBACKS PER APPROVED .PLAN I T- SEE' ARCHITECTURAL PLANS FOR DIMENSIONS, R I O O a 3 -SOILS ENGINEER SHALL 05SREVE THE LOCATIONS AND DRILLING OF SHORING PIERS AND DETRMINE FINAL PIER DEPTH, SHORING STICH PIERS SHALL NOT I BLOCK OR INTERRIIP THE l T' I -- I I, v u ~ = ' y BASEMENT DRAINAGE PIPE AND DRAINAGE MATERIAL. 4- PRIOR TO FINAL INSPECTION FOR ANY BUILDING OR STRUCTURE, THE GEOTECHNICAL I ENGINEER OR CIVIL ENGINEER O O I h WHO PREPARED THE SOIL INVESTIGATION SHALL ISSUE A FINAL 5 h P REPORT STATING THE COMPLETED PAD, FOUNDATION, FINISH GRADING, AND' ASSOCIATED SITE WORK. SUBSTANTIALLY CONFORM TO THE APPROVED PLANS, 6PEC5 ANS SOILS REPOR' O. I L______________________________.__—__--_--- I O 6-601L$ ANDIN ENGINEER SHALL SE PRESENT DURING FOUNDATION EXCAVATION I' AND INSTALLATION Or BASEMENT SLAB AND RETAINING WALL SUB -DRAIN SYSTEM. T -SOILS ENGINEER SHALL REVIEW 1 APPROVE FOUNDATION AND BASEMENT PLANS N RELATED DETAILS PRIOR TO CONSTRUCTION. I I O �___—_ i I OI 6l 3 0. B 8 -FRO IDE SHORING PIERS FOR ANY VERTICAL CATS DEEPER I THAN 4'-0" PER DETAIL I/5-0 I I I O i OI � N c iSHORTING; � I M BASEENT STITCH PIER DETAIL NT9 � OI L I OI i I — PIERS II w�o(wwU� I ° w AT TR'O OLu Z Q I S O LL J i— Lu O r - O B i z z or- ----- w O O TWR P)5 T4 VERT. BARS J ETIESO 07, BASEMENT SH0f21NC3 PLAN B )LD I �In[ B �uI o.,e�ls L-- oB.5 ---------------- ------- --- -----------� 0 CAPEX ENGINEERING INC. PO BOX 14198, FREMONT, CA 94539 Tel: (510) 668-1815 Fax: (510)490-8690 Building Department ,City of Cupertino 10300 Torre Ave, Cupertino, CA 95014 P r6aakR'17 May 05.2017 Subject: Henry & Michelle Yu Residence at 10760 Johnson Avenue, Cupertino. CA (Permit No. B 2016-1849) SPECIAL INSPECTION SERVICES FINAL AFFIDAVIT FOR STEEL WELDING Dear Sir: CAPEX ENGINEERING INC., has provided testing and special inspection services at the subject'site in. accordance with section 1704A of the California Building Code (2013 Edition) as listed below: (1). Review mill certification (test reports) & Check welder's certification. (2) 'Inspcction of welding procedure (FLAW process) specifications qualification and equipment. (3) Check structural'mcmbers for thickness adjacent to welds. (4) Inspect joints for proper preparation. - (5) Check the type.and size of electrodes (NR 232) to be. used for the various joints and positions. (6) Observe ,the technique of .each welder periodically with the use of a welding inspection shield. (7) Observe fillet welds on WF (WIOx22) and (W100)9) beams to clip plates. Between WF'(W I UY30)beam to stiff, clip and buckets plates. Personnel's"under, the general supervision of a registered Civil Engineer performed these inspections. Based on the inspections performed and upon our substantiating reports that the inspected work was performed; to the best of our knowledge. in conformance with the approved,"plans ,and specifications and the applicable .vorkn ship- v.,isions of the California Building Code. 4 �% ' +1 Sincerely,,' a� C PEX ENGINEERING INC. .4__ 3` G I- s Principal A Z � MS Engineering & Associates, Inc Consulting Structural Engineering Services 5140 Moorpark Ave Suite 108-B (408) 377-6504 mahmoud a,msengineering. net San Jose CA 95,123 (408) 377-6518 (Fax) Frambw & shr. Wall nailing walk throggh Observation DATE: PROJECT ADDRESS: August 21, 2017 10760 Johnson Ave Cupertino, CA As requested by the contractor, our office inspected the proposed framing, and shear walls -on June 28, August 16, and August 18, 2017. Our observation was based on a walk through the readily accessible areas and it did not include the ,concealed areas nor any actual measurements. The framing and shear nailing in general appears to be consistent to our approved plans. Please contact our office if you have any question. M$ Sanatkhani; MS PE tering,& Associates, Inc. NOTE: The above inspection was based on a visual walk through framing observation as defined in C13Q6Apter h ;Concealed or covered areas were not inspected. Structural observation does not waive, he', responsibility of the contractor for full compliance with approved plans, with the exceptions of, approved changes specifically addressed Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone 408-777-3228 CUPERTINO Fax. 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS \OFa 0 cl.‘•Yr in Ave. PERMIT# 5 - 001 6 - 524 q OWNER'S NAME. `k.) e PHONE# i-to8-J4q4 -6ct4 GENERAL CONTRACTOR. IV)0 E (P A g) BUSINESS LICENSE# ADDRESS 10-60 rd ge-2 6 CITY/ZIPCODE C&AQ1vw *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors. Signature Date Please check applicable subcontractors and complete the following information. V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing c,\D eg-4e6r1 Electrical E3's E ri -62-672:7"&c--A/a9re-/ Excavation cl`L)) 0C.A - • -745/7 Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Nark 3a,\ gO/ 6,9 Insulation 3/3/ Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing A 6 Car s'i,( Cji6 nn -1-6;"144 `C&P.0 7 Roofing 7414 Septic Tank Sheet Metal Sheet Rock Tile pp stf be..1.3,7„ q /:52)(po A1 jh Ow e /C ntractor Signature \e-6_NT Date