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17539- POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD (/"�V ,/' /, JOB ADDRESS�1y-�`L a/lJ �1 a D UNIT4*_ILOT# - OWNER ^T'.\. CONTRACTOR. .ArTA� �6w�_- �` PERMIT NUMBER 17539 PERMIT EXPIRATION •PERMIT EXPIRES IF W ORK' IS NOT STARTED WITHIN - 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION_ NOTE:' ALL GRADING AND DRAINAGE SHALL BE INSTALLED TC.COMPLY WITH THE APPROVED PLANS AND CITY OF 'CUPERTINO STANDARDS. - LIFER P•REGUNITE' '. - PeHMIT VALIDATION ��^ - �• rTA SKJ1 1� 3I1Z 18G •ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING �`► ELECTRICAL MECHANICAL -Arlit—FLOG—FE—LECT-7 ❑ El 1 PLO.MECH 0'•� ❑ . 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED City of.etfperfineBUILDING PERMIT INFORMATION WOOD FLOOR VA�. ILLATION _ SIFT. PLUMBING � � - � i MECHANICAL ELECTRICAL - - - , -• PERMIT TO IT�'• 4, FRAMING - INSULATION 4, STORIES rvPE CONSTR. •r t DCC. GROUP RES, UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 'ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID sU. TT FLOOD AREA TOTAL Aceence DIAPHRAGM - ROOF SHEATHING BUILDING USE RES IND -CON' PB 00,„, ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE - INSP. ROUGH SANA ASSESSORS PAHCEL NO ' PLUMBING - - ELECT. ENERGY • TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT Na FARDEL Na - MECHANICAL' MECH. ENERGY ELECTRICAL - BUILDING ENERGY Acc. DA rE -Ace FILE No, ,FRAMING' - ELECT. FINAL TEST INSULATIONPLUMBING ZONING, , ENG. SITE NO. GAS TEST GAS ' MECHANICAL FIHESPRINK Y ❑" N ENERGY T-24 Y ❑ , N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE Y N❑ A U. C. Y ❑ N❑ INTERIOR SHEAR FIRE DEPT. SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING - BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ° r ELECTRIC PLAN CHECK FEE ' - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY `INSPECTOR, SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, H ONE WORKING DAY BEFORE REQUIRED INSPECTION. O PLEASE GIVE JOB ADDRESS WHEN PHONING. Z — SEE PERMIT FOR EXPIRATION DATE — s ELECTRIC PLUMBING MECHANICAL C�J coNST:TAz .,IMPORTANT!. PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY' ' ten! } • Ar-P(LIC4NT TO FILL IN INFORMATION WITHIN RED LINES'- USE BALL'POINT PEN ONLY BUILDING PROJECT IDENTIFICATION' -. ` '. ,APPLICATION'& PERMIT BUILDING—ELECTRICAL-PLUMBING—MECHANICAL .PERMIT NUMBER „ °p,- 1 7 �j C� y':.. '1 1 539 SoILOIN ADOR$e' D , OWNER NAM i QTY.ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PHONE - CONTRACTOR' - NA j� •; .OUTLETS• -SWITCHES -RECEP 10.00/1,00 - LIGHTING FIXTURES .10,00/1.00 Lul ; - DATE OF'APPLICATION ' CONTRACTORS.. A D Q PHO v/ APPLIANCES -RESIDENTIAL'" 4.00 PANELS • 10.00 ARCHITECTPLAN OR ENGINEER • LIC. No, PANELSJOVER 200 AMP) -- - 20.00 CHECK FEE P.C. O. - , - - - SIGNS TRANS;: 3.00 ANRESSEn SPECIAL CIRCUIT,: - .5.00 PERMIT VALIDATION EMP. METER ORpOLEJNS. 20.00 ZIP • AN�11 �� 1`t Ars ADDRESS ADDRESS MOTORS . , r ISEE FEE SCH. ' SERVICE CHANG W Mi) ', - 20,00 LICENSED CONTRACTORS DECLARATION , 1 hereby.affum that 1 am licensed under provisions of Chapter 9' ISSUANCE DATE' (commencing with Sec ion.70001 of Uivisi0 {,c{and Professions C y license Is in full fr c / License Class Llc Numb Date .1 Contractor 1 „ I BLDG. El'❑. ELECT. PLG MECH. ^�,' y IJ ❑ Iv/Q, pp.,{� L. UryE4n0 BUILDING PERMIT INFORMATION ' r ^ . OWNER -BUILDER DECLARATION '^,', 1 hereby affirm that 1 am exempt from the Contractor's License Law forthe following reason.(Sec. 7031.5, Business and Professions CodeTAny city orcounty which requires a permit to construct, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9(wmmencingwilh Section 70000of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom and . • '" - MISC. — ' . I REFER TO ORD VALUATION /FT. pERMIT ISSUANCE 1000 - - . ELEC. CONTR. LIC. NO. -' •• 'r -' ' -` ELEC. TOTAL _ r PERMIT TO r1mb _ QTY. 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 app licant-loacivilpenalty of not more than five hundred dollars ($500).): - - 'ALTER -DRAIN& VENT.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 intended or offered for sale (Sec. 7044, Business and Professions BACK F,LOW'PROTECT. DEVICE 4.00 - OCC. GROUP RES. UNITS . ' 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 himself or through his own employees, provided that such improve- meats are not intended or offered for sale. If, however, the building F IXTUR ES - PER TRAP 5,00 SO.FT. FLOOR AREA TOTAL ACREAGE GAS-EA.SVSTEM+I INC.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- prove for purpose of sale.). ❑ 1, as owner of the property, am exclusively' contracting with GAS - EA. SYSTEM - OVER 4 IEA.) 2.00 BUILDING USE RES' IND CON PB Orner- ❑ ❑ ❑ -❑ ❑ 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 contractor(s) 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 reason . WATER HEATER'W/VENT 2,X e-00 Owner - Dale WATER SYSTEM I, 5.00 ACC. DATE ACC. FILE NO. WORKERS'COMPEIsSATIONTECLARATION WATER TREATING EQUIP. %5.00. I hereby affirm that I have a certificate of rcrosral to self -insure.' or a cer IC' f Workers' oa certificate 0 1 ur ace, or o cerbf jjA - ZONING ENG. SITE NO. copyt�`5��•�.a C.). �� //�y�d Polic ❑ i Cetlified copy is hereby furnished. - ❑ Cerlifi cop is I ill lh •. cit i c i Applicant 7, .'• r FIRE SPRINK Y❑ N❑ ENERGY T 24 YQ N❑ MISC.- REFER TO ORD. rC - C. IFICATE OF EXEMPTION F, KERS' _ -PERMIT ISSUANCE . 12� .19eB9 FLOOD ZONE A.L.O.C. PLG. CONTR." LIC. NO. PLG. - TOTAL COMPENSATION INS ANCE (Thi section need not be completed if the permit is for one Y,❑ N❑ Y ❑ N❑ OTY MECHANICAL PERMIT FEE FEE SUMMARY hon fled dollars ($100) or less.) 1 certify that in the performance of the work for which this per- ndt is dsaued, I'shall not employ any person in any manner so as to BU I LD I NG become subject to the Workers' Compensation Laws of Culdorma. Date Applicant - - ALTER -OR ADD TO MECH. 5.00 - ' NOTICE TO APPLICANT:. 11, Sher making this Certificate of Ex- APPLIANCE '•"'' 1__5.00 ' PLAN CHECK 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 bu deemed revoked. , FEE AIR HANDLING UNIT (TO 10A00C.F.M.) . 4.00 'AIR HANDLING UNIT (OVER 10=C.EM.) 6.00 SEISMIC FEE. .. CONSTRUCTIONLENDING'. AGENCY i 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 permit is issued (Sec.HEATING 3097, Civ.C.). - UNIT.(TO 100,000 B.T.U.) 8.00 MICROFILM HEATI NG UN IT (OV ER 100,000 B.T.U.) 9.50 ELECTRIC - ' Lender's Name Lender's Address Icertify thatl have read this application and state that the above information is'Correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and VENTILATION FAN (SINGLE) '' 4-00 - PLUMBING /- - BOILER- COMP (3 H.P. Or 100,000 B.T.U.)' 6.00 BOILER -COMP IOvar 100,000 BTU) SEE FEE SCH. MECHANICAL hereby authorize representatives of this city 'toenter upon the above-mentioned property for inspection purposes. MISC. -' REFER TO ORD. ''(We) agree to, save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses -which ma any way,accrue against said City in con uence of the CONST. TAX? ' PERMIT ISSUANCE' 10.00 ra [i g Of lhi p rm' . ECH, CONT. LIC. NO. MECH. TOT - TOTAL ' Si ture Applic nl Contractor [e U, l / OFFICE COPY