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14254I� POST T*ARD NEAR FRONT OF BUILDING• CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD JOBADDRESS 20590 HOMESTEAD UNIT# LOT# • OWNER MOSKATELS - CONTRACTOR MYONG K PAK PF Rn+liNUMBER 14254 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION LIFER PREGUNITE PAID ' PERMIT VALIDATION artinD ISSUANCE DATE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING 01 CUP ELECTRICAL MECHANICAL SLUG. ❑ ELECT, El . PLG.ECH. 11M ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING VALUATION SIFT. MECHANICAL ' ELECTRICAL PERMIT TO L •n,' FRAMING INSULATION STORIES TYPE CONSTR. OCL GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOSBEEN ROOF SO. FT FLOOfl AREA TOTALACREAGE DIAPHRAGM - BUILDING USE HES IND CON PB Oth,, ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH ASSESSORS PARCEL NO, PLUMBING GAS TEST TRACT NO, PARCEL NO. MECHANICAL ELECTRICAL FINALS DATE INSP. ncc'DnrE .. Acc. FILE No. FRAMING SAN # INSULATION PLUMBING ZONING ENG. SITE NO, GAS MECHANICAL FIRE SPRINK ° ❑ IN[] ENERGY T.YG Y ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - LATH—INTERIOR ELECTRICAL _ Y .� FLooD zarvE Y❑ 'N❑ aL.0 c. Y❑ NEI LATH—EXTERIOR FIRE DEPT. SHEETROCK GRADE FEE - - --- -- FEE SUMMARY .I SHEAR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, LEI ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — ELECTRIC PLUMBING MECHANICAL IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. CONST. TAX TOTAL vrrFec wr r ,10 0 . i Foo QUU N2w ¢ c � y.z ow oZX NHj �-f a 0 ¢ U w�A< H u O< S,w sc 3 x¢00 la 6 LL ,a o E. sio ¢ a 3 E FAS, O POA LU _ tl 0 Z) z UO_ LL Ow } SO SO f.. z A •V APPLICANT TO FILL IN IN`GtMATION WITHIN RED LINES-,USF,.8ALL POINT PEN ONLY - BUI4_DI NG PROJECT I DENTI FION APPLICATION & MIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 14 254 9UILOINc y. o7Yle.s%t=�: ADDRESS zoy q qC OWNERS AAO C/��, NAV(, N Lh 112,C PHONE Q( C7-- )2 TV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION rvONI RACTOR5 L°- A Uc, No.*t7q.3 5,75LIGHTING OUTLETS -SWITCHES -RECEP 10.00/1.00 d� FIXTURES 10.00/1.00 GONTR cTOR AD�Ess, }"vrb�s AV y65 =9�'6 O _ I NE PPLIANCES- RESIDENTIAL 4.00 PANELS 1D.DO RCHITECT OR ENGINEER LIC. No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH, ESS ENO' ZIP SPECIAL CIRCUIT 5.00 PERMIT VALIDATION /� l�/ 61.(i-Rr/`: �J ///�3/0p / ISSUANCE DATE BLDG. ELECT. PLG. MECH. TEMP. METER OR POLE INS. 20.00 APPLICANT A APPLICA ADDRESS SQ771f? Ca.L x.601/ -e- MOTORS S FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,�ynd1ny license is in full force n of c License Class I, Lic. Number Date1,11�_L R,2 Contractor OWNHR-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Businessand Professions Code: Any city or county which requirese permit to construct. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9(commencing with Section 7000) of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects SSOO).ire licam toacivil penalty of not more than five hundred Dollars (5500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for Sale (Sec. 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own eanployces, provided that such improve- ments are not intended or offend for sale. If, however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or Do prove for purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a conlractogs) licensed pursuant to theContractor'sLicenseLaw. reason❑ l am exempt under Sec..,B.&BC. for this ' O BUILDING PERMIT INFORMATION MISC.- REFER TO ORD PERMIT ISSUANCEo.00 V0, VALUATION g/FT. ELEC. CONTR. LIC. NO. ELEC. TOTAL 67 PERMIT TO �/ i�T e-ec DTV. PLUMBING PERMIT FEE STORIES TYPE CONSTR. ALTER-DRAIN-WATER(EA.) 5.00 BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 FIXTURES - PER TRAP 5.00 GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00. SO. FT. FLOOR AREA TOTAL ACREAGE GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB Omer 0 0 0 0 0 INDUSTRIAL WASTE INTER3000 . . LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. LAWN SPRINKLERS - OVER 5 IEA.) 1.00 - SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 Owner Dale WATER SYSTEM 5.00 WORK F.RS'COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified copy there f (Sec. 80 , Lab .C.) - policy No. mpany-C./j�G- ❑ Ce itis copy hereby furred -- O Certified coli is 'led ith the ty inspecon d inion. Applicant CERTIFICATE F 4 (EMPTIO PROM W RKL'RS' COMPENSATION INSURA NCE ('fres dollars need not be completed if ilio permit is for one hundred dollars ($ 1 the pe tens.) of the work for which this per- 1 isissued, certify that h the to employ mit is issued, I shall not employ any person in any manner so is to become subject to the Workers' Compensation Laws of California. Date Applicant ACC. GATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 ZONING ENG. SITE NO. MISC. - REFER TO ORD. FIRE SPRINK Y C] N� ENERGY T-24 Y ❑ N� PERMIT ISSUANCE 10.00 FLOOD ZONE V N A.LLLC. V ED ry PLG. CONTE. LIC. NO. PLO. TOTAL QTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING ALTER OR ADD TO MECH. . 5.00 NOTICE TO APPLICANT: If, after making this Certificate of lex- emplion, you should become subject to the Workers Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097, CH.C.). Lender's Name Lender's Address I certify that 1 have read this application and slate Ilial Ore above information is correct 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 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 May in any way acentric against said City in consequence of the granting of the; permit Q 0 v APPLIANCE 5,00 PLAN CHECK FEE AIR HANDLING UNIT (TO 10,000C.F.M.) 4.00 AIR HANDLING UNIT(OVER 10=C.EM.)6.00 SEISMIC FEE EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM ELECTRIC HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT(OVER 100,000 B.T.U.)9.50 VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILER- COMP(3 H.P. or 100,000B.T.U.) 6.00 BOILER-COMP (over 100,000 BTU) SEE F E E SCH. MECHANICAL MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT. LIC. NO, MECH. TOTAL TOTAL Si na a Applica /Co tractor ate