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17262POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO.. INSPECTION DIVISION JOB INSPECTION RECORD �_y Z S-. �L 4, / JOB ADDRESS / "f V _ UNIT# _LOT# I GuS ��n/CONTRACTOR OWNER CONTRACTOR V �'✓��tG� PERMIT NUMBER 17262 l PERMIT EXPIRATION �G` ��''''^^ `dy�14,1TILPAA IF WORK, IS NOT STARTED WITHIN 150 DAYS OF PERMIT ISSU. ANCE•OR 180 DAYS'FROM LAST CALLED INSPECTION. INSPECTION DATEC INSPECTOR INSPECTION RECORD FOUNDATION - [ �'� :r NOTE: ALL'GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER e PREGUNITE PERMIT VALIDATION 4-4, �IW�2�k�W1 , C� ISSUANCE uATe _ � � GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ;:�,I, _ 1. .. ELECTRICAL MECHANICAL. _ _ _ B(L(u�c ELECT, �Y �l 1 PLG. MECR El_ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING VALUATION �-1 $IFT. MECHANICAL ELECTRICALJF ,PERMIT - TO , '1 I F 1 ' FRAMING - INSULATION - STORIES TvPE CON STE, PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -- OCC.GROUP RES UNITS ROOF THE CONSTRUCTION TAX IS AIDMADE BEFORE So FT FLOG EA .3 b G TOTAL ACR EASE t ' DIAPHRAGM ' ROOF SHEATHING5 BUILDING USE RES IND CON Pa Omn ❑ ❑ ❑ ❑. ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.H ASSESSORS PARCEL NO ' PLUMBING - ELECT. ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT No, • PARCEL No ' MECHANICAL MECR. ENERGY ELECTRICAL BUILDING ENERGY, ACC DATE ACC. FILE NO FRAMING - - ELECT. FINAL TEST INSULATION PLUMBING ZONING ENG. SITE .NO. GAS TEST • GAS - MECHANICAL FIRE SPHINK Y ❑ N❑ EN ERCY 'T 2a [:]"❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR Z ELECTRICAL' RELEASE aooD zorvE Y❑ "❑ ALu.c. '°.❑, N❑ INTERIOR SHEAR FIRE DEPT.,% SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS 'SCRATCH COAT I r6.q VW5 ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IUUCUPANCY SEISMIC FEE D OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILBUILDING FINALISSIGNEDBV BUILDING INSPECTOR. ARRANGE FOR INSPECTION BY PHONING 252-4505, F� ONE WORKING DAY BEFORE REQUIRED INSPECTION. z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MICROFILM'. ' a 1 ELECTRIC Q PLUMBING —^^ MECHANICAL CONST. TAX ' IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL (j 39 OFFICE COPY O ZZ N CC ; W_ a 0 M Z 0 LL U Ow } a � z A APP! ICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION &PERMIT BUILDING - ELECTRICAL -'PLUMBING - MECHANICAL .PERMIT NUMBER .7 1 262 a I I autLotNG APS L OWN ER's NAME GUS (/f � PHONE l DTV• ELECTRIC PERMIT FEE PLAN CHECK VALIDATION a/ 9 DATE OF APPLICATION. CONTRACTOR'S NAME =_ACjjJ&S LIC.No.38 13 JOUTLETS -SWITCHES - RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 x DU CONTRACTOR'S A DRESS OF, 9pa ILS IRON, 395rIV, PPLIANCES- RESIDENTIAL 4.00 I PANELS 10.00 ARCHITECT - OR ExGyytrcc ��11 C.PTC) Vh IT..N.. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. - e` SIGNS TRANS. 3.00 ARCH. OR ENG. DRESS /' S p AD977 IN ZIP SPECIALCIRCUIT '5.00 PERMIT VALIDATION / p J. VU TEMP. METER OR POLE INS. 20.00 APPLICANT'S ADORE 5 rjQ" MOTORS SEE FEE SCH. _ SERVICE CHANGE 20.00 - LICENSED CONTRACTORSDECLARATION I " " I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cod and my license is in full for.can ect. _ Licenss Class Lic. Number - 1) 1) e_b »S"a ` r- Contractor rJ{ce '�INHI ISSUANCE DATE - BLDG. ELECT. ,ti( �( PLG. - MECH. ❑ /�, city ot ypllftn0 OWNBRBUILDkiR DECLARATION 1 hereby collo that I urn exempt from the Contractor's P Licence Law for the followingreason.(See .uiresa,emBusiness ond Professions Coda Any mulish coo my whiny structure, r prior to consuance, also improve, demolish, or repair any structure, prior to its issuance, that requires n e applicant for such revisit to file a signed statement that he is licensed pursuant to the provisions of the Cobtractor s License Busi (Chapterand cing Code) or Section is exemp( theref om theand Professions Business and Professions Cale) or that he is exempt therefrom and BUILDING PERMIT INFORMATION MISC.- REFERTOORD PERMIT ISSUANCE 10.00IV VALUATION v\ A 0� D!/ $/FT. ELEC. CONTR. - LIC. NO. ELEC. �'''/1 TOTAL rqa -1 // PERMIT TO ' %j I e 1 mg DTV. PLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty Of not more than' five hundred dollars ($500).): ALTER -DRAIN -WATER IEA.) 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 F LOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- Dents are not intended or offered l'ar sole. If, however, the building FIXTURES - PER TRAP 5.00 GAS-EA.SYSTEM-11NC.40UTLETS 6.00 SO. FT. FLOGsgR��gggEA O (�( -I TOTAL ACREAGE 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- prove for purpose ofsale.). ❑ I, as owner of the properly, am exclusively Contracting with, GAS - EA. SYSTEM -OVER 4 IEA.) 2.00 BUILDING USE RES IND CON PB Om., El El. ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 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 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with a commelons) licensed pursuant ,o the Contmelor s License Law. SEWER -SANITARY -STORM EA. 2001t110.00 TRACT NO. PARCEL NO. ❑ l am exempt under Sec. ,B.&P.C. I'.. this WATER'HEATER ANENT 6.00 reason Owner Dale WATER SYSTEM 5.00 ACC. DATE ACC. FILE N0. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self -more, or a certificate of Workers' Compensation Insurance, or a Certified ZONING ENG. SITE NO. copy thereof (Sec. 3800, Lab.C.). �,. Policy No. Company. Z41 a r0N4 FIRE SPRINK Y ❑ N❑ ENERGY T-24 Y ❑ N❑ ❑ Certified copy is hereby furnished. gQ[ Certified copy is filed with the city inspection division. AISpRcant 'TPt,K,/�Jt/a.dL(, MISC. - REFER TO ORD. C17 RTI FICATE OF EXEMPTION FROM WORK ERS' - PERMIT ISSUANCE 10,00 FL00D20rvE A.L.O C. COMPENSATION INSURANCE This section need not he completediIfthe per..hit is for one Y ❑ N ❑ V ❑ N ❑ PLG. CONTR. LIC. NO. PLG. " TOTAL hundred dollars IS 100) or It,,.) I certify that in the performance of the work for which this per. mit is issued, I shall not employ any person in any marcher so as to QTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING 2505 420 become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, alter making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 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 (TO 10MC.F.M.) 4.00 AIR HANDLING UNIT (OVER 10,000C.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction Icnding agency for EXHAUST HOOD (WITH DUCTL 5.00 the performance of the work lou which this permit is issued (Sec. 3097, Cie.C.). MICROFILM ..-x I HEATING UN IT (TO 100,0008 Lender's Name Lender's Address H EATI NG U N IT ER 100,0 B.T.U.)9.50 ELECTRIC �'I I certify that 1 have rend this application andstale that the above VENTILATION FAN (SINGLE) 4.00 information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING BOILER-COW(3 H.P. or 100,000 B.T.U.) 6.00 BOILER COMP love, 100,000 BTU) SEE FEE SCH. MECHANICAL r oU 1" authorize herebhereby authorize representatives of this city to enter upon the y property forinsp of ction purposes. ` (We) agree to Save, indemnify and keep harmless the City of MISC. - REFER TO ORD. upertino against liabilities, judgments, costs and expenses which y in a way accrue against said City in consequence of the ling this - ♦y ` y lr�atGD !J CONST. TAX PERMIT ISSUANCE 10.00 s op MECH. CONT. LIC. NO. MECH. TOTAL �7 I, D O. TOTAL d7 a i atur fAp ' ant/Contractor Dale \jl OFFICE COPY