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17427POST THIS CARD NEAR FRONT OF BUILDING • CITY,,_0F CUPERTIN0. INSPECTIONDIVISION JOB INSPECTION RECORD O y�3 6 A�� , C Y. `n .,•-. JOB'ADDRESS Y Com' (�/�[JNIT# •_LOT# OWNER CONTRACTOR - PERMIT NUMBER 17427 PERMIT EXPIRATION r " PERMIT, EXPIRES IF'WORK IS NOT STARTED WITHIN 'iBO DAYS OF PERMIT ISSU- ANCE OR IUU DAYS FROM LASTCALLED INSPECTION. INSPECTION - DATE INSPECTOR INSPECTION RECORD FOUNDATION - NOTE: - ALL GRADING AND DRAINAGE SHALL BE INSTALLED COMPLY WITH THE APPROVED PLANS AND CITY OF; CUPERTINO STANDARDS. - - - UFER PREGUNITETO " -,PERMIT VALIDATION - Ji!:Jli s'I r • ISSUANCE DATE . GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED . UNDERGROUND/SLAB PLUMBING '� •' MAR I joib'I ELECTRICAL MECHANICAL. t* Ot (CDJKIeti BLIxi. ELECT. ❑ . " PLG. . MecR. .❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED. - BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING--' ,� � - VALUAT N �� $/FT. MECHANICAL - - ELECTRICAL, ', _ vp AM ' SiW�Gti %R PiIN L [ PER^^'T To FI '-_ FRAMING INSULATION sroRles T PE CONSTR. OCC GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' ROOFso. NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID - -- FT PLOORAPEA TOTAL ACREAGE - •. DIAPHRAGM ROOF SHEATHING BUILDING USE ncS IND CON PR Dn„•, ❑ ID ❑ Ell, ❑• APPLY NO ROOFING UNTIL ABOVE HAS-BEEN SIGNED FINALS' DATE INSP.'- ' - ROUGH SAN.p � ASSESSORS PAR � CE L N0. - PLUMBING ELECT. ENERGY - TUBS & SHOWER PAN PLUMBING ENERGY'TRACT No PARCEL rvo. MECHANICAL MECH. ENERGY - ELECTRICAL' BUILDING ENERGY ACC. DATE ACC FILE No FRAMING' ELECT, FINAL TEST INSULATION PLUMBING ZONING ENG. SITE. NO. GAS TEST GAS i ' MECHANICAL E�'jy- FIRE SPRINK . Y ❑ "❑ ENERGY'T. 24 ` ❑ ' "❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR.” ELECTRICAL RELEASE �• ^ri�%i'O / FLOOD ZONE Y ❑ "❑ Ay C, Y ❑ No INTERIOR INTERIOR SHEAR FIRE DEPT• SHEETROCK '- GRADE FEE SUMMARY' EXTERIOR LATH BUILDING, - BUILDING INTERIOR LATH TEMPORARY APPROVALS _ SCRATCH COAT ELECTRIC PLAN CHECK FEE' GAS .. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE' OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM uJ . ARRANGE FOR INSPECTION BY PHONING,252-4505„ o� :ONE WORKING DAY BEF..ORE REQUIRED'INSPECTION; z PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC {" PLUMBING MECHANICAL CONST. TAX v. IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION.. TOTAL 1 OFFICE COPY • A APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY BUILDING PROJECT I DENT(FICATI ONPERMIT APPLICATION.& „ PERMIT I BUILDING -ELECTRICAL-'PLUMBING -MECHANICAL NUMBER '�` 17427 BUILDING ADDRESS Ll I PAPJ If OWrvER's NAE M I I DTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION - A PHONE ' NoMERADTORs .. , _ LETS-SWITCHES-,RECEP 10.00/1.00 - UC. Nof Z LIGHTING FIXTURES 10.00/1.00 DATE APPLICATION' NO. GOGEa$ ons AOOREss %� -3q OSS I S PHOrvE ��Id _ APPLIANCES - RESIDENTIAL '- 4.00 ' PANELS 10.00 ZI �V onCHrlicI - ENGINEER/ ' LIC, NO, PANELS (OVER 200 AMP) 20.00 JV. 06 K PLAN CHECK FEE P.C. NO. " SIGNS TRANS. 3.00 r ARCH.ORENG_ SOS }P I1 `��. ��'�" ' ADDRESS // r.YNlr r��YCIf('O VY Fn 0,uk'/ nv fVI SPECIAL CIRCUIT 5.00 PERMIT VALIDATION 7I'IMVLI'AI //// 3I I (p I .. TEMP. METER OR POLE INS. 20.00 APPLICANTS ' AODRFES _ d S _ MOTORS - SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION - 1 hereby affirm that I am licensed under provisions o'Chapter 9 (co rameneing with Section 7000) of Division 3 of the Business and Professions Code and my license is in full forceJyld effec License Class Ga -R Lia Tactor F1( -4.L/_( Date V Contractor ♦!/' V. ISSUANCE DATE HL G. ELECT PLG. MECH. layer ❑ ❑ C1u IYY,iI - BUILDING PERMIT INFORMATION OWNER -BUILDER DECLARAI ION I hereby affirm that 1 am exempt from the Contmmor s License Law for the following reason, (Sec. 7031.5, Busineaamm Professions Code. Any city or county which requires a pernin to tr consuct..Iter, MISC.- REFER TO OR pERM1T ISSUANCE .. 'i9'.90 VALUATION $/FT. ELEC. CONTR. LIC. NO. ELEC. I G� TOTAL `hJ improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that Ile is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the PERMIT F TO E ' Business and Professions Code) or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE L ' the basis for the alleged exemption. Any violation of Section7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500).)'. STORIES T PE CONSTR. ALTEfl-DRAIN-WATER(EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 oce. GROUP RES, UNITS DRAINS -FLOOR, ROOF, AREA,COND. 5.00 - intended or offered for sale (Sec, .7044, Business and Professions Code: The Contractor's Licence Law does not apply to an owner of - FIXTURES, PER TRAP 5,00 GAS - EA. SYSTEM -11 NC.4 OUTLETS 6.00 property who builds or improves thereon, and who doessuch work himself or through his own employees, provided that such improve- ments are not intended oroffered for sale. if, however, the building 50. FT, FLOOR AREA ' TOTAL ACREAGE or improvement is sold within one year of comph cion, the owner- builder will have the burden of proving that he did not build or im- prove for purpose of sale.).. ❑ I, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB Omer E:]❑ E] E] ❑ INDUSTRIAL WASTE INTER. - 30100 licensed contractors to Construct [be project (Sec. 7044, Business and Professions Code', The Contractors License Low does not apply to an owner of property who builds or improves thereon. mW who LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. LAWN SPRINKLERS - OVER 5 (EA.) 1.00 contracts forsuch projects with a co oracloos) licensed pursuant to the Contractors License Law. ❑ tum exempt under Sec._, B.iP.0 1'nr this reason SEWER -SANITARY -STORM EA. 200h/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT - .6.00 Owner Dare WATER SYSTEM 5.00 ACC. DATE ACC: FILE NO. . WORKI:RS'COMPI;NSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that'[ have a certificate of consent to selpinsure, _ ZONING _ ENG. SITE NO, or a certificate of Workeca' Compmuati n Igsurunce, or. certified copy thereof(Sce. 380QLab.CJ.n!, /._ r Policy No. ' Com pant a'Z ' ' ❑ Certified copy is hereby furnished �[ l.'llrllfle ��,yy�.la�dcdl wtL& n CItY Illep •' I1 IIIvisioll; Ap-plfcanw- MISC.- REFER TO ORD. FIRE SPRINK v❑ No ENERGY T 2 1 1! N[:] CERTIPIICC`ATH OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE IT his sectionne.d not be completed if the permit Is for,one PERMIT ISSUANCE 10.00 FLOOD ZONE Y [:]N❑, A.L.u.C. Y [:]N[]hundred PLG. CONTR. LID. NO. PLG, TOTAL Collars IS100) or less.) - I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so as to DTV. MECHANICAL PERMIT FEE FEE SUMMARY . becomo subject to the Workers' Compensation Laws of California. OR ADD TO MECH. 5.00 Date ApplicantALTER BUILDING NOTICE TO APPLICANT: If, after making rill, Certificate of Ex- APPLIANCE 5,00 - AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 PLAN CHECK FEE emption, 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. AIR HANDLING UNIT (OVER IQOOOQF.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby, affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this pannit is issued (Sec. 3097, Civ.CJ. MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name LendIINSdress HEATING UN IT ER 100,000 B.T.U.) 9.50 ELECTRIC IFF - ✓t! VENTILATIONFAN (SINGLE) 4.00 I certify that I have iead this application and state that the above information is correct: I -agree to comply with 111 city and county ordimnces'and state laws relating to building construction, and PLUMBING BOILER -COMP (3 H.P. or 100,000 S.T.U.) 6.00 hereby authorize representatives of this city to anter Inion the abovrmeationed properly fm inspection purposes; BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL (We) agree io''save, indemnify and keep harmless the City of MISC. - REFER TO ORD. uperlino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the ra ti lis cr it. i reo(APPlican /Contracmr Uam PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT, LIC. NO.MECH. TOTAL TOTAL IG�� OFFICE COPY