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L � .5,� � �I I �LrL- ������ �vi���-� . �X STKHHT ADDRGSS CITY, STATG ZIP FAX �� �� L � � �, C ._�i � CONTRACTOR NAME PHON E-MAfL � . �,., C�iUS�TRv� ��ryti� Z��� �Z� 1-1 S ��LL STREET ADDRESS CIT , STAT�.ZIP FAX � �V � 1'� � �o' b(-014r G( � �S � �J MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery): WNTACTNAME ���� P[-ION�� • � �� E-�1�IL STREETADDRESS CITY, STATE.ZIP �� - ;/) /� FAX �, �a ll r i3IV� � E-,Z C;,= .;��t � � � ���I �� LIST ALL BUILDING PERMITS ISSUED FOR PROJECT: PERMIT StiBNi[T ISSUE DATE INSPECTOR SCOPE NUMBER DATE DATE ['1NALED 1 - Ol - r' ���5'(� ^6 'Ll/I 2 3 OCCUPANCY DATA: USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD 1 ��5 lt,`},�N'7 �`� a z 3 4 BUILDING DATA: #STORIES #STORIES OVERALL MA%OCCUPANT FIRE SPR[NKLERS FIRE SPRIVKLERS BELO��'GRADE ABOVE GRADE FLOOR AREA LOAD REQUIRED 'ES OR NO PROVIDED ES OR NO #PARKING #STANDARD/CODiPACT #ACCESSIBLE REQUIRED PARKING PROVIDED YARKING PROVIDED NOTE: ATTACH A COPY OF THE SIGNED INSPECTION CARD TO THIS APPLICATION. - OFFICE USE ONLY- SPECIAL STIPULATIONS OR CONDITIONS: CHECKLIST: Copy of Job Card Attachcd(both sidcs)? Permit Signed off in sys[em? No other pennits open or expired in system? Location of Approved Office SeY? CorO Application.doc rei�rsed OS/17/!6 CPI1'OF CUPfit17N0 BLJILIIING YII2A�IlT INSPE("ITON CARD —i �UILDA:GADDRFSS I 1�VAL:_C,O PKWY COn IRACTOR PIl2I1qT NO ��CUPk.�tTINO,CA 95014 PI'�TA'iJM��ERALCONSTRUCITON INC B-201fr2039 O) \WNIIt'S NAI�I� 19620 S'CEVINS CRffiC BL#2(Kl STE 120 C[JPIItTINO,CA 95014 P��TISSUID: �CUPF1tTLN0 PROPIItTYDEVEI_I LL.0 04/OS/2017 0�3";FY2'S FHOI�'E � PHONENO: i � JOB DESCRIPTTON: I SUITE 120;1ST FT_OOR;T.I.-RFSTF,(JRANT RFIvfODE1.(2,697 S.F.)-BOII.ING POINT' I— Tl'PE INSPECTOR DATE �.., - �*, � ��� � PLU\7HLVG �3�e�..�j�'C' � �-g;� v� � J'+�vV�d.'t^�T ��v.[ ,�`�S �"'` ��L'"�y�=�Jt_ '� UNDEIiGROLIND l'v1S PIPING �C IIU^IlJHRGROUt�'D WATER I � �<�l�L_� ' � �i.�����-� L.J I UNDERQtOUIv'D SEWER � UI�IDL•RFC.00Kt � kOIJGH PLUMI3,T'G I SHOR77iPAN � WATER HLP.TER ! '�"— - — � hVATEft SQL�qCE �- " - � '�YRESSURE TFST C� ...- ��-��� ���� i + CAS TvfE.TER RELEASE � �-�.. _�"....._`• �'--- — IPROPERTY L7NE CLEANOCT IIYLUMBING FTAL �r � ELECIRICAL I;`� TO ARRAIVGEINSPflCTION �i,����,J.�� Ca11777-3228 behreen 7:30 am aud 3:30 pm Monday th:ough Frid3y,at least 24 how-s 6efore rec�irr_d �__--�� — inspection.Johadchess andPermitNumbers are neededw#�en requesting an inspecfion. I�LR'��ERf'L��R tL--- I I CUPII2T�0 SANIT.4RYDISTRICT r.CUc;H c�CTe.Ic.;: Closed circuit�ideo inspection of groF;rrty tine cleanout,point of conneclion �i��c;x.vtv P�v,�Et;POLti and street lateral required prior to}racsing FY1\'.AL CTI'YPLL1lIBING ��---- INSPFS'ITON.Call the District(41i8-253-7071)for an appointment �i^rxvicr t,mcannE (r-------f�--�--/�— FiECTi:IC;'.fETF.;iRELliLSc �\ ' �r-- � - NOBUB.DINGI�7IVAISll�$PECTl�\SLJ�rCII..f1LLREQU:RF� �---- --- --- ' �J(' �'-''„U' BLCSINESS LICE�SFS AREOBTAII�`}5? � ., �'��Ecrwc F�.�. Ir ns�cxailcaL PFRM[TNN�II2F�IFWORI�IS NOTSTART�D WfITIQV 180 DAYS OFPIILVi1T �i�,����t � ISSUANf.EOR 180 DAYS FI20MLAST CALLID INSPECTIt�N. I i +iRouc;r3 t�&�Ha`nca'- ti1�PORTANI'Whzn a perirtit has e�ired,a charge toialing one-tcaif the tees to d�ain a newpermit ( ---- � II P r must be paid in order to reacti�ate fhe permit If x peraut has beeu ex�red for nwre � �n,Trrnt�rCr than one year,a charge totaling the full fees to oUtain a newpermit must be paid iF-� �IAIR cor�ITtO?�7:R to reacd�ate the permit ���-ICODS � �'r�r,TCAL F�N,a�� NOTF�: ��— •r-e.ua --- -T �Li;hff3NG I i -'�— 1 (IE]_L'CI'ICAL. � I ��F�C'HA.*IICAL . �'--- ---- — HUIL.DWG � I�-- ; I'iRE �---- I���.. 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DO(1J.�tEM'ATION , — ---,.__;---...._____1 �---------- , U.^U>ER}�'LIXiC.FW�FdL*ii; � .j._B� i - PAD!SEI'BACKCERTIF1CATiON i-- - - ��' -;---I------{ I�i.vDFR�LOCiF PvSLTA'(ION � PLUMBING vt i� 'kUSS' ES _- I52A:1{[f:G - - --� �r'� --- � --- E.LECTICAL - �. SPECiAI.ASPLt�I'iONR��PORTS �i�'LC�Ut N.�;iJ:;I-IP.AT`ii\G � ( � SMOKE/CART3(�I MONOXIDE CFR'I OF -�1�-IFA.�f1AhZCAL �ROliCiItYLU}.1Fili�'G ��J..�-�c1,�/ _J`+j`�f; ..ii COMPLIANCE __V I ��-..-_-�.-.---�p�--� -��IRt� � . 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