The URL can be used to link to this page

9086 POST THIS CARD NEAR FRONT OF, BUILDING PERMIT.NumBEv CITY OF CUPERTINO INSPECTION DIVISION �J�J Vi3 JOB INSPECTION RECORD -� PERMIT EXPIRATION JOB ADDRESS UNIT#p LOT,*f "`� •,PERMIT EXPIRES IF WORK OWNER oNTRAc.oR !`--�I/-., IS NOT STARTED WITHIN INSPE 'I N DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ,11 . Cg♦L. selZZIF �� ANCE OR 180 DAYS FROM LIFER LAST CALLED INSPECTION. . PERMIT VALIDATION PREGUNITE ,)% ' -s-sc �hc. so. Ifer POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 7¢-Y. -1)4-Q ' UNDERGROUND /SLAB - PLUMBING ELECTRICAL ISSUANCE DATE " MECHANICAL _ Bcoa ELECT. PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED I BUILDING PERMIT WOOD FLOOR INFORMATION VALUATION PLUMBING ^ MECHANICAL . ELECTRICAL PERMIT To e FRAMING ' - ' INSULATION sTDRIES TYPE CONSTR. OCC.GROUP• RES.UNITS. PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF - e J .• 50.FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE RES IND CON PB Dmer APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 1:1 ❑ ❑ .❑ ASSESSORS PARCEL NO. ROUGH PLUMBING • ' GAS TESTTRACTNO. PARCEL NO. Y MECHANICAL ACC.DATE ACC.FILE NO. ELECTRICAL FINALS DATE INSP. FRAMING - - SAN a - ZONING ENG.'SITE NO. INSULATION PLUMBING GAS _ FIRE SPRINK ENERGY T.Zn MECHANICAL Y EI N Y ❑ N[] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH—INTERIOR - ELECTRICAL FLOOD ZONE aL.0 c. LATH—EXTERIOR FIRE DEPT. - Y ❑ ,N10 No ' SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR.' MICROFILM y ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ' « F ONE WORKING DAY BEFORE'REQUIRED INSPECTION.. PLUMBING j z PLEASE GIVE JOB ADDRESS WHEN PHONING. ' - SEE PERMIT FOR EXPIRATION'DATE - MECHANICAL 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 _ BUILDING PROJECT IDENTIFICATION - PERMITNUMBER BUILDING APPLICATION & PERMIT a ORE55 `,, i 11��/"��r, 1 . - BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 9086 OWNER S PLAN CHECK VALIDATION ME QTY. ELECTRIC PERMIT FEE CONTRACTORS ME / �jOUTLETS-SWITCHES-RECEP 10.00/1.00 LIC.NO.5 ;Z LIGHTING FIXTURES 10.00/1.00 ftr. NTRACTORS AL2 PPLIANCES-RESIDENTIAL 4.00 A D s 'K�3 PANELS 10.00 DATE OF APPLICATION C IPLAN CHECK FEE TECT PANELS 200 AMP) 20.00 OR ENGINEER LIC.No. ISIGNS TRANS. - 3.00 AN CH.08 ADDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 avaucaers MOTORS SEE FEE SCH. ADDRESS -- SERVICE CHANGE 20.00 - i w 02 LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00 Q�^��}� a I hereby affirm that I am licensed under provisionsof Chapter9 'P" `"P DANCE DATE N z"' (commencing with Section 7000)of Division 3 of the Business and a a g BLDG. ELECT. PLG. MECH. r O a, Professions Co , nd my license is in full force and effect f, o i L'i D License Class Lie.Numb Y a1 It ❑ 2 N F j Date ContracluAxpow a y E BUILDING PERMIT M BE a OWNER-BUILDER DECLARATION Citeljp#AWMATION F ; H 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD u O us Law for the following reason.(Sec.7031.5,Business and Professions VALUATION S/FT. s- - w PERMIT ISSUANCE 10.00 f ,n > 4 Code:Any cityorcounty which requires a permit to construct, 2 a O improve,demolish,or repair any Structure,prior to its issuance,also ELEC.CONTR. LIC.NO. . ELEC. �40/ G Be requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO E: m he is licensed pursuant to the provisions of the Contractor's License Cva/L/ti4 T Cel r i Law(Chapter9(commencing with Section 7000)of Division 3 ofthe i i o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE AUT OdC C- M I-$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500)J: ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS 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 docs such work F IXTUR ES-PER TRAP 5.00 a0.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments 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 IEA) 200 builder will have the burden of proving that h . . . e did not build or im- BUILDING USE RES IND CON PB Other prove for 1,aso nee of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,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!I contractors)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractors License Law. TRACT NO. PARCEL NO. ❑ lam exempt under Sec..,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACO.FILE NO. WORKERS'COMPF.NSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure, t ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Labd{{',',� Policy No. Cnmpany"I_1117+ T�C�Yx)n O Cl Certified copy ishereby furnished. FIRESPRINK ENERGY T-24 ❑ Cerlifiyp�1 m Rhe� wUh he,�cµy tpsy�coon division. Zp ApplkC �3Y "[LT_.�- `pSL3cr MISC- REFER TO ORD. Y❑ N❑ Y ❑ N❑ F' y 1 PERMIT ISSUANCE 10.00 LU - CERTIFICATE COPE 1 ATI PT ION FROM WORKERS' FLOOD ZONE A.L.u.C. W > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. OL 0 This section need not be completed if the permit Is for one TOTAL Y❑ N❑ Y ❑ N❑ hundred dollars IS 100)or las.) U 0 1 certify that in the performance of the work for which this per. DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL U mit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of Californid. O w Date Applicant BUILDING IS. ALTER OR ADD TO MECH. 5.00 of } to NOTICE 1'0 APPLICANT: If,after making this Certificate of Ex- emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10p00CF.M.) '4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IQOOOC.F.M.) 6.00 SEISMIC FEE a 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. MICROFILM 3097,Civ.C.). - HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's AddHEATI NG UN IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC ress I certify Ihxt I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COUP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-men, property for inspection purposes. (We) agr a to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino a ins[ liabilities,judgments, costs and expenses which CONST.TAX m in any ay accrue against said City in consequence of the PERMIT ISSUANCE 10.00 g ants f tis enn' . MECH.CONT. LIC.NO, MECH. TorAL TOTAL Si ure Gf Applicant/Co tractor Data OFFICE COPY