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15901 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 15901 INSPECTION DIVISION JOB INSPECTION RECORD II,� PERMIT EXPIRATION JOB.ADDRESS 4o4'�Co 13 2-12 '`i UNIT# LOT# I 1 __ - PERMIT EXPIRES IF WORK - OWNER 1- I..II Fy0 U .:'2. CONTRACTOR lucle—a �% [--[t CrjC� IS NOT STARTED WITHIN INSP TION DATE I INSPECTOR INSPECTION R ORD 180 DAYS OF PERMIT ISSU- FOUNDATION _ 2 NOTE: 'ANCE OR 180 DAYS FROM LIFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND.CITY OF PER VALIDATION CUPERTINO STANDARDS. GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB 'T- PLUMBING '/1 If" X01 ` �! •'! !! ` � a ELECTRICAL ISSUANCE DATE " MECHANICALlh _ ,y PLUG. ELECT PLG. - MECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED �. -�� f_/�/�[j^'4- �K BUIL NG PERMIT INFORMATION WOOD FLOOR vAwanoN SIFT. PLUMBING MECHANICAL - 7G�CT W i�-aLG ELECTRICAL / l/ dy,, r RMIT ro E FRAMING - INSULATIONsTDRIEs_ TYPE CONSTR. . OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED $O.FT FLOOR AREA TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE F DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING - RES 'IND CON PB OSI,„, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS , DATE' - INSP. 1--] ❑ Q L ASSESSORS PARCEL NO ROUGH SAN* PLUMBING - ELECT,ENERGY TRACT NO PARCEL NO TUBS8 SHOWER PAN PLUMBING ENERGY ' MECHANICAL - - - MECH.ENERGY ELECTRICAL BUILDING ENERGY Acc.OATS ACC PILE No FRAMING ELECT.FINAL TEST ZONING ENO,SITE NO. INSULATION - PLUMBING GAS TEST GAS MECHANICAL • EIRE SPOINK .ENERGT'T.24 COVER•NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING `”❑ NE-] N[:] EXTERIOR SHEAR ELECTRICAL RELEASE �'`��Y FLOOD ZONE• AL.U.C. INTERIOR SHEAR FIRE DEPT, v "❑• Y --I NL 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_SI,G_NED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUIL DING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED.BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, `j ELECTRIC 3 • �� ONE WORKING DAY.BEFORE REQUIRED INSPECTION. �\ PLUMBING o PLEASE GIVE JOB ADDRESS WHEN PHONING. \ Z MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - IMPORTANT! CONST.'TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ' dUILDING PROJECT IDENTIFICATION .PERMITNUMBER - BUILDING APPLICATION & PERMIT 15901(�01 ADDRESS I 5 J 1 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL N; OWNER'S - PLAN CHECK VALIDATION NAME OTY. ELECTRIC PERMIT FEE P _ co EFACTORs s UTLETS-SWITCHES-AECEP 10.00/1.00 LQ S IGHTING FIXTURES - 10.00/1.00 7 -a rorvraacroRs PPLIANCES-RESIDENTIAL 4.00 AODR f Q/J[ PHONE PANELS 10.00 - DATE OF APPLICATION OR1"0C ARCHITECT PANELS (OVER 200 AMP) 0 PLAN CHECK FEE I'.Cf NO. ENGINEER LIC,NO SIGNS TRANS. 3.00 ' ARCH.OR ENG. SPECIALCIRCUIT 5.00 PERMIT VALIDATION ZIP-- EMP.METER OR POLE INS. '' 20.00 ADDRD [C.APPLICANrsMOTORS �O f SEE FEE SCH. O SERVICE CHANGE 20.00 �'ESS � l/�r-'a'o"'- - �f woo LICENSED CONTRACTORS DECLARATION //Is7�6 ¢ U U 1 herthy off rm that I am licenud under provisions of Chapter 9 ISSUANCE DATE a ^ w G n (commencing with Section 7000)of Division 3 of the Business and !1L BLDG. ELECT. PLG. MECH. H vii Professions Code d license is in full to a f(' ❑ ❑ ❑ o i m o License Chs Lic.Number; F m r j Dale Contractor a m s BUILDING PERMIT OWNCR-BUILDER DECLARATION ¢ w u INFORMATION X ;LL N I hereby affirm that 1 um exempt from the Contractor's License MISC.- REFER T VALUATION $/FT. F .. C Q Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE Code:Any city or county which requires a permit to construct,alter, a ¢ improve,demolish,or repair any structure,prior to its issuance.also ELEC.CONTR. LIC.N0. ELE )q�i-tl! E 0, - requires the applicant for such permit to file a signed statement that TOTA +C� PERMIT TO w m he is licensed pursuant to the provisions of the Contractor's License Hzi Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ =$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a by any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($5001.): - - ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 - OCC.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 sa.FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such improve- merits are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4(EA) 200 BUILDING USE builder will have the burden of proving that Ise did not build or im- . . . RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RE IN 11❑ 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. 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-OVER 5(EA.) 1.00 contracts for such projects with a contractions)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.'200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Dam WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING'EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure. ZONING ENG.SITE NO. or a certificwaflf W rq kcrsfyglyugyntion Insurance,ora certified copy then a E/hf/([� �Qr••.iyu-,ri Policy No. n pony (, Q ❑� ['crti0ed opy is her by furnished. FIRE SPRINK ENERGY T 2 Z Z ❑XCertifie -con✓k I d w'th a city inspection division. MISC.- REFER TO ORD. O Applicant !/RR11�� Y[] N� V F] N[3 ~ m PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. � > CERTIFICATEPE I ATI PTINS FROM WORKERS' W _ COMPGNSATION INSURANCE PLG.CONTR. - LIC.NO. PLG. d 0 (This section need not be completed if the permit is for one TOTAL Y I] NY ❑ N❑ 0 Z hundred dollars 1S 100)or less.) U 0 1 certify that in the performance of the work for which this per, QTY. MECHANICAL PERMIT FEE FEE SUMMARY U. )- mit is issued,I shall not employ any person inury,manner so as to U become subject to the Workers'Compensation Laws of California. y. Date Applicant ALTER OR ADD TO MECH. - 5.00 PSEISMICFEE } N NOTICE TO APPLICANT. If,after making this Certificate of lix- F. Z emplion,you should become subject to the Workers'Compensation APPLIANCE 5.00 provisions of the labor Code, you must forthwith comply with U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 h9perrformance of the work for which this permit is issued(Sec. 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 9S S� 1eertily that l have read this application andsime that l he above VENT I LAT I ON FAN ISI NGLE 1. 4.00 _information is correct.I agree to comply with all city and county - PLUMBING ordinances and state laws relating to building construction, and 130ILER-COMP.(3H.P.or100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,0006TU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which CONST.TAX 4a, a a Ie againt said City in consequence of the PERMIT ISSUANCE 10.00 1 Y. MECH.CONT. LIC.NO. MECH. � l TOTAL TOTAL plicant/Contractor Data OFFICE COPY