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16829 POST THIS CARD NEAR FRONT OF-BUILDING . � PERMIT NUMBER CITY OF CUPERTINO 16829 INSPECTION DIVISION ' , JOB INSPECTION RECORD, f '(�(�J PERMIT EXPIRATION JOB ADDRESS•_./D1.�;{�ST�L —/v C-� /\0 UNIT# LLOT# _ - PERMIT EXPIRES IF WORK OWNER .. T ,: �o-,e,7�h/d co"rRncroR �- - ISNOT STARTED WITHIN': INSPECTI N DATE INSPECTOR INSPECTION RECOAD AN DAYS OF PERMIT FROM FOUNDATION LAST AL 180 DAYS FROM I _ NOTE: LAST CALLED INSPECTION. t UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED ' TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION r PR EGUNITE CUPERTINO STANDARDS. ' GARAGE SLABS i POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB - PLUMBING � - ! ' ELECTRICAL ISSUANCE LATE ME GHANIGAL - - - BLDG. ELECT PLG. El 4 MECq. ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT WOOD FLOOR. - INFORMATION PLUMBING - VALUATION SIFT. MECHANICAL ELECTRICAL PERMIT 1O. ' FRAMING9/y' "".z'.'/'2'/CJ INSULATION - _. STOFI11ES TVPECONSTR OCC.GROUP - RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' • ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE so IT,ELooB nREA TOTAL AcgcncB DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IND CON PB Om.. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS 'DATE INSP. 1:1El110 11ASSESSORSPARCEL NO ROUGH SAN.N PLUMBING ELECT.ENERGY - - TUBS BSHOWER PAN - PLUMBING ENERGY TRACT NO. PARCEL No MECHANICAL - MECH.ENERGY - ELECTRICAL - BUILDING ENERGY ACC.DATE ACC.FILE NO .FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION � PLUMBING " � - GAS TEST. GAS FIRE SPRINK, ENERGY i.29 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v ❑ N❑ v ❑ N❑ EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE AL U C. INTERIOR SHEAR FIRE DEPT,. "❑ r ❑ "❑' SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY - SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING.FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ' ARRANGE'F.OR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE- MECHANICAL i IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY . APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT-PEN ONLY ' UAPPLICATION & PERMIT ' ILDING PROJECT IDENTI FICATION `PERMIT NUMBER 1 6829 a nmrvc CJ aJ ADDRESS BUILDING -ELECTRICAL-PLUMBING-MECHANICAL 10185 Stelling Road OWNER'a � PLAN CHECK VALIDATION NAME . - QTY. ELECTRIC PERMIT FEE City of Cupertino PHONF252-4505 NAMERAcroRs OUTLETS-SWITCHES-RECEP 10.00/1.00 E.A. Hathaway & CO.LIC.No. 99257 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S ADDRESS Santa Clara APPLIANCES-RESIDENTIAL 4.00 565 Laurelwood Rd. PHONE 988-4200 PANELS 10.00 DATE OF APPLICATION ARCHITECTOR PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. Tfl'AEEtteinberg Group uc No, C13447 SIGNS TRANS. 3.00 ARCH.Ofl ENG.60 Pierce Ave. SPECIAL CIRCUIT S.00 PERMIT VALIDATION ADDRESS San JOSe, CA zip 9511C-T- EMP.METER OR POLE INS. 20.00 APPLICANT s MOTORS SEE FEE SCH. ADDRESS 565 Laurelwood Road Santa Clara, CA 95050 SERVICE CHANGE 20.00 ��//�� -00 LICENSED CONTRACTORS DECLARATION <Li w 1 hereby affirm that I um licensed under provisions of Chapter 9 ISSUANCE DATE H G w (commencing with Section 7000)of Division 3 of the Busar ss and BLDG. ELECT. PLG. MECH. E M z Ins monsioCode,and my license Is In full force and effect Q z m o License CWss_A_& B__Lie.Numher-9.925-7 I rvf El F-1 2 m H j Date Contractor Q y ¢ a OWNER-BUILDER DECLARATIONBUILDING PERMIT g o a U INFORMATION X ; N I hereby affirm that I am ex enhpt from the Contractor's License MISC.- REFER TO ORD F u O j Law for the following reason(Sec.7031.5,Businessnod Professions PERMIT ISSUANCE VALUATION' $/FT. Code:Any city or county which requires a permit to construct,alter, 10.00 ¢ Q 2 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0. ELEC. Ew OD¢ requires the applicant for such permit to file a signed statement that TOTAL n w 1 he is licensed purimant to the provisions of the Contractor's License PERMIT TO .F z a Law(Chapter 9(commencingwith Section 7000)o f Division 3ofthe 4 o Business and Professions Code)or that he is exempt therefrom and L ¢ H a the basis for Ole alleged exemption.Any violation ol'Section 7031DTV. PLUMBING PERMIT FEE .5 STORIES TYPE CONSTR. i ; m by any applicant for a permit subjects the applicant to a Civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not mom than five hundred dollars(S500).): ❑ I.as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 DCC,GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such Improve- meats are not intended or offered for sale.IL however,the building GAS-EA.SVSTEM-111NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will[have the burden of proving that he did not build or im- GAS-EA.SYSTEM•OVER 4(EA.) 2.00 BUILDING USE prove purposeRES IND CON PB 011o , 1,asowner of sale.). ar ❑ 1,as oof the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 El 0 11 K1 licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. RI and Professions Code:The Contractor's License Law does not apply U to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractors)licenser)pursuant ro SEWER-SAN V-STORM EA.200ft/10.00 till Contractor's License Law. TRACT NO. PARCEL NO. ❑ 1 am exempt under Sec. ,R&P.C.for this CIN reason WATER HEATER W/VENT 6.00 W Owner Date ACC.DATE ACC.FILE NO. O WATER SYSTEM 5.00 0 WORK ERS'COMPENSAIION DECLARATION WATER TREATING EQUIP. .5.00 '4 1 hereby affirm two 1 have a certificate ofennsent to sell'-insurei U or a certificate of Workers'Compensation Insumnec,I,,a cert 1imZONING ENG.SITE NO. om copythere f(Sec.3800,LAC.). p Polley Crnnpeny-AETNA O crtifiud copy is herchy furnished. ' FIRE SPRINK ENERGY T-24 Z Z Certified copy is fled with ilia city inspection division. MISC- REFER TO ORD. Y N Y Cr OApplicant - N CI:RTIFICA'I'E OF EXEMPT ION FROM WORK CRS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > COMPtiNSATION INSURANCE. PLG.CONTR. LIC.NO. PLG. Z (This section need not be completed if the permit is for one TOTAL Y❑ N Y N C3 hundred dollars IS 100)or less.) - U Q 1 certily that in the performance of the work for which this per, OTV MECHANICAL PERMIT FEE FEE SUMMARY IL U mit is issued.I shall not employ any person in any manner so as to beeonhe subject to the Workers'Conhpensatlon laws of California. ED Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING >_ m NOTICE TO APPLICANT: If,offer making this Certificate(it Ex- ? caption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with - FEE U such provisions or this permit Shall he deemed revoked. AIR HANDLING UNIT(TO 10)000C.F.M.) 4.00 CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000C.F.M.) 6.00 SEISMIC FEE 1 hereby uffirnh tml there is o construction]seining agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work I'or which this permit is issued(Sec. MICROFILM 3097,Ck,C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I cert ify that l have read this applicat ion and state l hat the above VENTILATION FAN (SINGLE) 4.00 Information is correct. I agree to comply with all city and county BOILER-COMP(3 H.P.OF 100,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and hereby enthorire.representatives ativas ec thin city S, enter upon the BO LER-COMP (Ovar 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property 1'orjnsp of this purposes. (We) agree to.save, indemnify and.keep [harmless the City of MISC.- REFER TO ORD. upertin0 at lno..ties,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may . an ay accrue s' s id City in consequence of the r l this p i1. - MECH.CONT. LIC:NO. MECH. TOTAL ' TOTAL .ignnture of Applicant/Contractcri Date' OFFICE COPY G _ . . EDWARD J. HAHAMIAN • CIVIL ENGINEER • 1211 PARK AVENUE-SUITE 212 SAN JOSE.CALIFORNIA 95126 (408)2792954 Nov, 17, 1933 Building Official City IIall Cupertino, Ca, Subject : 21321 Dolores Ave , , Parcel One, Lands of Craig Clark 1?e : Pad & Setback Certi£ic,..tion Gentlemen: On'-this date I made the necessary meaeurements and certify• that: 1 ) The pad has been correctly graded per approved build— ing plans, 2) The foundation forms have been correctly set in accor— dance with the setbs.cks shown on the approved plans as per City Ordinance. Submitted b � LIZ C) � 1� ca "' No.Ct3328 ' zo Exp: 3-51- 7 OF CkL`ftLt. ONI183d00 30 AM 1NMIM30 N01103dSNI T019 98fi1 s t AON ,r