21805 Y//'40
n
4
'g
3-A-
WNW, aY' M-ew"-11 !'
OR-`M
t i No. 845 f tr ]a f it a Mr
Tity of Tuvrrtinw
This certificate issued pursuant to the requirements of Section 307 of the
Uniform Building Code certifying that at the time of issuance this structure wu
in compliance with the various ordinances of the city regulating building Arlt N
construction or use. For the following:
Use Classification Strings RPq+'rauan+-
Bldg. Permit No. 218 Q 9
Group R-2Yy
-Type Construction 17—N _ Use Zone-P-lant2erl ppyt- kpmpnf
Ownerof Building T. I . Iqf-rinq Address2_0235 'qt-(1vr1nS Creek R1v(j
BuildingAddress 20735 Stevens Creek Boulevard
Locality _Cuperf-j no
_ajjfr)rniA 95014
By: SOP Ani-anur'j
uilding Official
..........
T POST IN A CONSPICUOUS PLACE
.. f�'`.a C,:f., .tr+.� F.c..e��. .,t.c.r, C, i•'ac. ..r rlxnuTNO.
_ POST THIS CARD AR FRONT OF BUILDING 21805 ;.
CITY OF CUPERTINO
INSPECTION DIVISION- JOB INSPECTION RECORD `Z
-7 C �^ CATEGORY TROLM
�2
JOB ADDRESS . C>-7 1y `"1, � UNIT H LOT N
•fi(}�t,�fiBUILDING PERM1TiBVFOLi,,,I,„ •�
OWNER_ ti CONTRACTOR
INSPECTION ' '.SI” '• "DATE ' INSPECTOR INSPECTION RECORD
FOUNDATION PIERS NOTE.-•ALL GRADING AND DRAINAGE ppE5C4tfpON
FOU GROUND SIiALLBE INSTALLED TOCOMPLY MITI
THEAI'11ROVFDPLANSANDUIY017 T,
PAD SET BACK-CERT CUPER'HNOSTANDARDS. ` I .
GAIZAGESLABS PREGUNITE
POUR NO CONCRETE UNTIL A13OVE HAS BEEN SIGNED INSPECTION DATE INSPECTOR
UNDERGROUND/SLAB y
PLUMBING -p-9
ELECTRICAL - +• % -
♦ '�liY li
MECHANICAL
W .
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
, ,}_I
WOOD FLOOR 'I,'
PLUMBING ��
MECHANICAL 4
ELECTRICAL - !
FRAMING/VENTS CLEAR
INSULATION
PLA CF, NO SlHIFLOOR UNTIL"ABOVE HAS BEEN-SIGNED
ROUGI I
PLUMBING
TUBS&SI-IOWER PAN
MECHANICAL -
ELECTRICAL ACUZ411SUNIJ
FRAMING/STAIRS
INSULATION/VENTILATION -
EMERG.EGRESS -
SEWER WATER
t\ COVERWO WORK UNTILIABOVE'HAS BEEN SIGNED"`"t1+� OI/�L-Y
EXTERIOR SI]EAR MOLD DOWN
INTERIOR SMEAR/HOLD DOWN
SIIEETROCK/SIIEETROCK SHEAR
EXTERIOR LATIN/W-SCREEN
51 IOW ER LATH
SCRATCI-I COAT
:NO:TAPE+ORrPLASTERWNTIL"ABOVEWAS-BEE :SIC,NED
NOTE:NO FINAL INSPECTION SHALL BE MADE BEFORE
THE CONS RUCTION TAX IS PAID
FINALS DATE INSPECTOR
SAN.B
ELECT.ENERGY
PLUMBING ENERGY
MECI-I.ENERGY
BUILDING ENERGY
ELECT.FINAL TEST
PLUMBING
CAS TEST
MECHANICAL ^`
HEATING
ELECTRICAL RELEASE
FIRE DEPT.
GRADE
OCCUPANCY
TEMPORARY APPROVALS
ELECTRIC
GAS
BUILDING ISSUANCE DATE
OCCUPANCY OF BUILDING IS NOT 'ERAII E TIL;
BUILDING FINAL IS SIGNED BY BUILDING INS CTOR PAID
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
l'IRMIT # ARE NEED 'D
WHEN PHONING. Il,p
IMPORTANT! ssn;noY:�� 1
PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION
APPLICANT'S POSTING COPY
APPLICANT TO FILL IN INFORMATION %ItTH1,N RED LINES — USE BALL POINT PEN ONLY
greBuildingProject Identification PERMITNo.
Building As: l /A //
'20 7 �S 21805 8O5
nere arae: n�1 - one: - -
E(��L'tlbT�Z CITY OF CUPERTINO-BUILDING DIVISIO -2—
N<
_ -
ra1msName: - 1 . APPLICATION /PERMIT
N ►v BMDINGELECTRICAL PLUMBING-MECHANICAL CATEGORY CONTROL*63 6 3 .
Architect/En neer. Lk. o: U
5b 6.iLfntb(2r�•d QTY ` ELECTRIC PERIv11T ,FfiE • BUILDING PERMILIVID FO ,
Addre t 1
�'"F:1 PERhBTISSUANCE 1.L.C$� ISI, ❑
LICENSIs CONTRACTOR'S DECLARATION ''IJ 1�7
I hereby ffirm n7")that lamBcensefthi under B.pro...d'o(Chapter9(e,and m- APl'S.IANCESRESIDENTiAl ]OB DESCRR'770N
it me 1,
]0meandeffeon3ofthe Buelneaeand Profeealon'Code,and my
licence is in m me and effect. PANES.
Licence CWss f]�1 Contract. .1
I ,
Date Contracto '
RCHITECTSDEC RATIO WI-1000 AMPS
qrem Ztfoflow� .
ex. be used m pu lic record. OVER 1000 AMPS SQ.FT.FLOOR AREA b/SQ.FT.
O /
onal SIGNS ELECTRICAL 3l
<6OWNER-BNL II DECLARATION SI'ECIALCIRCU[T/MLSC /
g � thatIam exemptfrom the Contractor's License Law for the
O (Section 7001.5,Busmea.and Prefeanions Code:Any ctty orOzTEMP.MEIT:R OR POLE INST.
ires a on
tocom uct,alter,improve,demollsh,orrepair
a anystructure priorm its issuance,alsorequirestha appllontfor such permitto POWER DEVICES
r�E file a signed statement that he is licensed pursuant to the pmvisiora of the
Sa: Contrectorb License Law(Chapter 9(commencing with Section 7000)of Divi- SWIMMING POOL ELECTRIC
OS A..3 ofthe Business and Profmah,.Code)orthat he l'exempttheref.nn..d VALUATIOl
Ny •-t the bash for the a1legN exemption. Any violation of Section 7031.5 by any U
p05 applicant for a permit subjects the applicant to a civil penalty of out more than OUILETSSWIICI-IESEXTURES
a� five hundred doll..($500). NEW RESIDENTIAL ELECTR SQ.[•T,
j. F1 r,as owner of the property,or my employees with wages as their sole TORIES TYPE CONSTRUCTION
compensation,will do the work and the structure le,not intended or offered for
O In(Sec.7044,Business and Professions Code:The Contractors License Law
�,I $ does not apply to an owner of property who Wilds or Improve thereon,and ^OC
who does such work himself or through hisown employees,provided that such C.GROUP RFS.UNITS
7 Improvements are not intended oroffered fm5xIv.If,however,thebuilding or - TOTAL: ` a
improvement lssoldwithinoneyearofcompletiorythe owner-bullderwiilhave
t rden of proving he did not build orlmprove for purpose ofsak3. QTY; ';'PtiUM$ING PERMIT t +' " FEE';.,. FLOODZANE APN
jI,as owner of the property,am exclusively contracting with licensed PERMIT ISSUANCE 'ZW,
contractors to contract the project(Sec.7044,Business and Profeeshms Code:
The Contractor's Licence Law does not apply to an owner of property who ALTERDRAIN&VENTf;"Q
lds or improve.thereon, and who contracts for such pwiects with a - -WATER Zs
cq➢_t(actor(s)Imensed pursuant to the Contractor'.License Law. - ,FEE.SUMMARY-t
i�l I am exempt under Sec. B k P C for thinmason BACK FLOW PROTECT.DEVICE
DRAINS FLOOR,ROOF,AREA,COND. SANITARY Y NGUISID�
Owner FEES
Date REC N=
r WORKMAN COMPENSATION DEC FIX'IVRES PER TRAP I (�'� SCI100L TAX Y N
�I hereby a((Irm that 1 have a artiflote of consent ro self-Insure,ora x RECEIPT N
certHlnateofWorkers'Compessatlonlruurance or a certl(led copythereof(See. GAS FA.SYSTEM-1 INCA OUTLETS .-1 PARK FFE Y N
3800,Lab C.) qAI��JJ//�� Q { yQj
Policy N a"!'IP` i 1 - - RECEIPT q
Com any GAS EA.SYSTEM-OVER 4(EA) BUILDING DIVISION FEES
MCertifled copy is heed with the
cityed. GREASE/INDUSTRL WASTE INTERCEPTOR PLANCHECICPEE
�Certl(led copy V filed with the city Inspection division.
v6.68
CERTIFICATE EXEMPTION FROM WORKERS' GREASE TRAP - PAID
COMPENSATION INSURANCE SEWERSANITARYSTORM EA 20OFT. 'Date Recei t#
l .r lcction need not be completed i(the pertN[R(scone hundred dollars
($100)^rfess.) WATER HEATER W/VENT/ELECTR ENERGY FEE Y N
I cent emplohat in y
an person in an oftheworkso as to b cornhis permit is issued,
I shall list employ ariy person In any manner so as to become subject to the WATER SYSTEM/TREATING ,
Workea'Compensation Laws of California.Date ppjp
O Z Applicant NEW RESIDENTIAL PLMB. SQ.FI'. Date Recei t#
ZO NOTICEco esubjettothe orkerfter aComprking this Ctics,procate o(ons of the
y
.H Code,you
to co ply with
or
pormuhe Lab be - TOTAL: •66
� N Code,you mv't(orthwith comply with each provisions or this permit shall be
> deemedmvoked. - DIN •E rS�O
LU
CONSTRUCTIONLENDINGAGENCY SEISMIC FEE /{, 0
I hereby affirm that there is a construction lending agency for the perform- SEISMIC
ELECTRIC FEE
Z sendersnm.fthework for which this permit is issued(Sec.309],Civ.CJ TOTAL. "Lr 1 L-YI
!) O Ic^ser.Name - - PLUMBING FEE —W-`.'
IL Lender's Address QTY: '; , MECHgNICAL'PERMIT FEE`. MECHANICAL FEE
OO 1mAifythatl havereadthis applicetlonand statethattheabove information
LU Is correct l agree to comply with all cttyand county.mi..ec¢sand state laws TMMIT ISSUANCE �y�f/ FEES PAID:
)• IL relating to building construction,and hereby authorize representatives ofth -
1— N city to enter upon the above-mentioned propertyfor Inspection a ALTER OR ADD TO MFCH.
Z pP1t purposes,
Date Recei t#
— (We)agree to save,Indemnify an d keep harmlev the City of Cupertino - P '
mst
a,alnstii t ' dgem , s and expenses which may In anywayaccrue AIR HANDLING UNIT(TO10,000 GEM) SUBTOTAL'
insba City'I room
ntse ofthe granting ofthls permit. p
4- 7—cT AIRHANDLING UNIT(OVER 10,000CFM) CONSTRUCTION TAX
Signature )pucam/Contractor J Dat EXHAUST HOOD(W/DUCD- CONSTRUCTION TAX PAID:
HAZARDOUS MATERIALS DISCLOSURE
Willi eappl ant or metre building occupant atom or handle hazardous HEATING UNIT(TO 100,000 BN) Dale Recei t#
_ material delicts by the Cupertino Municipal Code,Chapter 9.12,and the _
Healthan et ode Section25532(a)7 HEATING UNIT(OVER IM OW BTU) - TOTAL: �J
(]Yee No
Will the applicant or uture building ompant use equipment or devices VFNIILATION PAN(SINGLE MID) ISSUANCE rBaTOM
which emit hazardous air contaminants as defined by the Bay Area Air •-BT9}Ri
Quality Management Distrct7 BOILER-COMP DEE'OR 100,000 RTU,
4 Yes n No I ��1
havereadtheth&Sr f,iy C.e, ls&digW25505, under Chapter 6.95 of BOILE&COMP(OVER 1W,OfA BTU) t'!i�(t
the
understand
t Health building
and26534. I -
understantlthatllthe building dcesnot currently haveatenanL that It 1.9 my NEW RESIDENTIAL MECH. JZ.FT. alp
Impmuibllity to notify the occupant of the requirements which must be met _ MOM
i1Y � �,;•M
prior to Issuance of a Certificate of Occupancy. IRgVt—�,,
Owner or authorized agent - Date
TOTAL: ISSUED BJ� I/ ;-
OFFICE COPY