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19507 POST THIS CARD NEAR FRONT OF BUILDING r Rw no. CITY OF CUPERTINO 19507 DAIE INSPECTION DIVISION- JOB INSPECTION RECORD � C I . JOB ADDRESS I O�-/ S �' lir fkf-ti CATEGORY coNTxolr. UNIT# .LOT# C' OWNER Ct fO CONTRACTOR BUILDING PERMIT INFO INSPECTION DATE 1INSPECTORI INSPECTION RECORD © ❑ M FOUNDATION/PIERS NOTE ALL GRADING AND DRAINAGE El LIFER GROUND MALL BEIWrALLED TO COMPLY WITH JOBMON PAD/SETBACK-CERT THE APPROVED PLANS AND CITY OF CUPERTINOS ANDARDS" I, GARAGE SLABS PREGUNITE " - !�,a' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND SLAB INSPECTION DATE INSPECTOR PLUMBING 179M.e •rC!/ fH. �� ELECTRICAL MECHANICAL 7 . DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED WOOD FLOOR PLUMBING MECHANICAL ELECTRICAL. FRAMING VENTS CLEAR INSULATION A.+ojg1 !AA A'A9"1"VI :i I/` Q AI PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ( l ROUGH PLUMBING TUBS k SHOWER PAN ^_ C MECHANICAL ELECTRICAL ACUZZIBOND FRAMING STAIRS - •. INSULATION/VENTILATION . EM ERG.EGRESS SEWER WATER COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED EXTERIOR SHEAR HOLD DOWN INTERIOR SHEAR/HOLD DOWN SHI=OCK/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 PAID FINALS DATE IINSPECTOR SAN.# ELECT.ENERGY PLUMBING ENERGY MECH.E•NERGY BUILDING ENERGY ELECT.FINAL TEST PLUMBING GAS TEST MECHANICAL HEATING ' ELECTRICAL RELEASE FIRE DEPT. -GRADE - OCCUPANCY TEMPORARY APPROVALS ELECTRIC GAS BUILDING - NCE DATE em OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL r ISSUANCE , BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR °' �- ARRANGE FOR INSPECTION BY PHONING 252-4505 BETWEEN 12:30 PM AND 4:30 PM MONDAY THROUGH FRIDAY,24 HOURS BEFORE REQUIRED INSPECTION. JOB ADDRESS AND ppp$jn0 H PERMIT# ARE NEEDED WHEN PHONING. IMPORTANT! /qlt:/ /% . /J PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION DBY: OFFICE COPY e° ~ APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALLPOINT PEN ONLY Buildln Poen lden011c.d. S; jj� *�{ PFXWT NO. + Ruading Addreae: IW TANDtm n�mP�nh z�,�;.pzQo &Mf-119b cAAve 19507 r. ams Phme ( � - 61io o CITY OF CUPERTINO-BUILDING DIVISION Uc.No, APPLICATION / PERMIT rpm CMA ,�i,(rnt� BUILDING-ELECIRICALPLUMBINGMECHANICAL CATEGORY CONTROL 0,5--r A �/ F`�.j` �•nr„IA� " L nNa QTY ELECCRICPERMIT FEE BUILDING PERMIT INFO Aad— Kim l/�1- q4 LZ PFR)ATISSUANCE ❑ ❑ ❑ LICENSED CONTRACTORS DECLARATION Thereby art dutlamlfce wdunderpr Wv of C)upler9(amnrttmc APPLIANCESRESEDEMIAL JOB UhIiL LION ingwith Section 7DO0)d M,olcm3cfthe Budnessand Pro/eatlovCade,and Itanx la In fullforce and a fecL PANELS / Leanne Clam Lee9e.���f — �Q Yr.Q Date ContractorrContractor UP TO 2DOAHM ARCHITECTS DECLARATION 201-IODD AMT'S mOVER 1WO AMPS SQ.FT.FLOOR AREA f/SQ.FT. I understand my plans shoe k used u public road• k C Licensed Professional SIGNS ELECTRICAL G LLRuIu OWNER-BNLDER DECLARATION SPDCIALCDICUfT/MI9C F, 3 Iheabyafflnnthatlame.empt f.the Comoscu,e Lk,.Laawforthe F6 9 following reason.((Section 7M15,Buainem and Profmlov Cody.My cityor L F. TEMP.METER OR POLE 7NST. 4 muntywhlch requlroapermkromvtruct,alter,Impmve,demolUh,orrtpalr q any at statement Ucarme pursuant hetforwchpeWte 01e a signed aatement the k b Iken.ed puauant to the provisions of the Nw'FR DEVICE' Ow{� Contractors Leve law(C)upler9(mmerencingwith Section 7W0)ofOwl-3O;} alon3 ofthe lkdnessand ProfembvCode)ort at he be theaarid SwpAflNGP�' ELECTRICVALUATION F' San.•]] the basins for the ilkged eaanptlon. My Wdatbn of$ecmnb� abm700IS by any OZITLEISSWrfCHES FIXTURES D D l O e 0� appBant for a pemdisublect"the a ppllcant to a civil penalty of not room than () "N-Lndredddhnhe M.pro - NEW RESIDENTIAL ELECIR I,uowrcro/the property,or my empbyee with w.geutheir sub 1 R21T' STORIES TYPECONSI}tIKTION compcvadan,wflldo thework,andthe structure Hotel IHIerecd or offered for psale(Sec.70K Busines and Profnalov Code:The Contractor'.(lame Lw docs one apply to an owner of property who builds or Improve thereon,and FS^ who doe such work hlmaelfmthrwgh his own employee,provided that such OCC.GROUP RES.UMTS improverrena am nor Intended oroffered forale.If,however,the W ilding a TOTAL: unpmvemery bold within orcyearofcompletmntheowner-bullderw have e.of proving the be dm not WRd or Improve for pa..arpof wa.>. QTY. PLUMBING PERMIT FEE L as owner of the Property,am eachraively contractlog with Licensed FLOODZONE AIW cias to construct the project(Se,7036,Buainem and Profembv Code: PIXMIT L4UANCE so The Contractor'.Lioeve Lw doe not apply to an owner of property who ALTER-DRAW 6 VENT-WATER(FA) W Ildr or improve themon, rad wk comnc4 fo such p,jem with a ryL1�. Cris llanaed pumun .the Con tnear'.Llce.Law. BAIX Flow PROTECT.DEVICE FEE SUMMARY b order Se B 6 P C (o tIW mucin Owner aaww Dae _60151 DE_HES VM Ah DRAINS-FLOOR ROOF,AREA,COND. SANITARY Y_ N_ • WOR IIT- izo PjiSATION ECLARATI RECFRTR ❑1 hereby affirm the I h cralRote of roe:Bt to self-Inane,a a FDC[URES MR TRAP SCHOOLTA% Y N artl9am o/Workeri Corepensation Insuranm or a certified copy thereof(Sec. RECEIPT 3800,IAB C.) GAS-EA.SYSTM-1 INCA OUTLETS PARK FEE Y_ N_ Policy RLCRECEIPT It Com ♦ GAS EA.SYSIT7t1-OA)VER4(Eray BUILDING DI VISION FEES CertNed ropy is hereby fuml.hed. GRFASEAINDUSIRL WASTE INIFRCEPTOR LANCHECK FEE ❑Certified copy b filed with the city Inspection division. > CERTIFICATE OF F3(EM M PTION FROM. WORKERS GREASE TRAP I�`r 1 0 COMPENSATION INSURANCE PAID �16 s3 Crhi.sectlanneed notbecanpleled Bthe perrdt bfoorchundred dollars SEWE-SANITARY-STORM EA.LOOFT. Date Reoef t# 451 W)car I..) WATER}IFATQt W/VENT/fl.FCl'R ENERGY FEE Y N I artByttum t M the perfounce of the work f.r-hich thl.permot is•a,ed, I.hall not empby,any pen®b any manner w u to broom object to the WATER SYSI.EAt/.IREA.DNG Workers Compensation Lw.of Caifomea.Dee PAID PP SQ Date Recei t# Z O AIlam NOTICE TO APPLICAM:R,after maklry thio Certifiate of Exemption,you NEIV RF9DFNTIAL PIMB. FT. ahold Beco..ubpo an the Workui Cornpevelon provbbv e f the LaW r TOTAL: 52.6 N Cade,you rtud forthwith comply with such provisions orthb Fermat cull be DING FEE DD W ] deemed revoked. BUT CONSTRUCTION LENDING AGENCY EISMIC FEE S- Il O I hemby amrm that them b a construction lending agency for the peeom� ELECTRIC FEE Z armof the work for which this permH b bwed(Se,3D97,Clv.C.) IOTA . U,O Lerler:N.�rc PLUMBING FEE LL ~ L rler.Addrtaa QTY. MECHANICAL PERMIT E MECHANICAL FEE O W Iartifytlutlhawmadthb.pp0 tbnaMd tatbatheabovelnfom im 4 bcoroct,lagreetocomplywithaBdtyand muntyordlnanmand.tamlaw. PERMIT ISSUANCE FEES RAIDt } relatingto Wllding corstruMm,and hereby.uthodumpessentatiwolthia H = dtyt.c.mrupontheabove-mentlord propertyforbupectbn purpose. ALTERORADDIOMECH. Date Recel t# (We)agree to we,bdernmlfy an d MrtNea the City of Cupertlnm V ago OabBltbs,ydgnrms,cminaiM pens which may lnanyway.. AIR HANDLING UNIT OU 10,000 CFM) SUBTOTAL: .gal d City in c ...quena of the rat Ing of this Ferrell. AIR HnNDUNc uNTr(OVER io,ImcE�I) CONSTRUCHON TAX Sign PPR rat on Date E%ITAUSI'HOOD(W/DLCO CO HAlARIXIUSMA RIALSDISCI.OSURE wwthc.ppOnntrefitumbuudln pantstoreorhardeehaurdw. HFATWG UNIT(TO IW,WO BTI) Date R material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code Section 25532(a)7 HEAT WG UNIT(OVER 100,ODD BTI) TOTAL: ❑Ye,, M No WBltheappliamwfwmWOdingci pantuaeequlpmM ordevkxs VENTILATION FAN(SINGLE RESID) ISSUANCE DATE which emit lueardous ee conumlvnts a.de0red by the Bay Area Air Ilty Mawgement Doitci? - BOILER-COMP DID OR 100,000 RTI) PAID Ye No shave mad the h isi,ardonts rvterlab requirements u nder Cha pter 6.95 of BOILER-COMP(OVER100,00)BTU) S the Uldoroa Health k Safety Code,Sectbv 25505,25533 and 25534. 1 JAN' I 'e IC.J o urdennard that if the Wilding does rad currently have a tenant the it is my NEW RESIDENTIAL.MECIL SQ.FT mspov Bitytonallfythe oavpam the require— is which nest k met prior to arcs da C<rti0am of Wncy. ,,L .y inV Owner a a / ' TOTAL: ISSUED BY: OFFICE COPY