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17556 POST THIS CARD NEAR FRONT OF BUILDING PERM IT NUMBER QITY OF CUPERTINO . Pao � 7556 " INSPECTION DIVISION JOB INSPECTION RECORD �`� i 1989 ! 1 �� CUpertlOp j O�IXII�T E^PIRATION JOB ADDRESS_._.�OJ SO �L (Y YCZ' �( UNIT# _LOT P#BEY !� M 1p'- .. - P RMIT EXPIRES IF WORK OWNER CONTRACTOR - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM' NOTE: LASTCALLED INSPECTION: , UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO.COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION PREGUNITE CUPERTINO STANDARDS. rr I GARAGE SLABS - �y�T'O•}„..Vyl POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - UNDERGROUND /SLAB ' PLUMBING ELECTRICAL' - - ISSUANCE DATE MECHANICAL - ECR ELECT LG. M ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - ' BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING • - VALUATION SIFT. MECHANICALS ! ' RM111T TU ' ELECTRICAL • - _' 11� FRAMING - - - 7wv"` STORIES TYPE CONSTR. INSULATION - OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SG-FT FLOOIIPFFa TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE I DIAPHRAGM THE CONSTRUCTION TAX IS PAID I. BUILDING USE ROOF SHEATHING IIES IND CON PR' OUu•. El APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH SANA PLUMBING ELECT.ENERGY TRACT NO PARCEL NO. ' TUBS BSHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY. - ELECTRICAL ACC DATE ACC.PILE NO BUILDING ENERGY FRAMING• 'S' ELECT,FINAL TEST _ ZONING ENG SITE NO. INSULATION PLUMBING ' A GAS TESTGAS FIRE SPRINK ENERGY TQa MECHANICAL v � NEI .v.❑ 'N� + COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 1: EXTERIOR-SHEAR ELECTRICAL RELEASE FLooD zoNE hAL,u c, INTERIOR SHEAR r FIRE DEPT. Y E:] NY NEI SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - �� ' • - BUILDING - � b INTERIOR LATH - ' TEMPORARY APPROVAL BUILDING 3 SCRATCH COAT - - C. ELECTRIC PLAN CHECK - - GAS. FEE . NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE _ OCCUPANCY OF BUILDING ISNOTPERMITTED UNTILSUILOING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM �- ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ID' ONE WORKING DAY BEFORE REQUIRED INSPECTION. . PLUMBING' o PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - SEE PERMIT FOR EXPIRATION DATE -' MECHANICAL IMPORTANT! CONST.rnx PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY -- -- -- _ 1 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ' BUILDING PROJECT IDENTIFICATION .PERMIT NUMBER BUILDING APPLICATION& PERMIT 7556 AODPE r•'}, 5 � BUILDING-ELECTRICAL-PLUMBING-MECHANICAL- OWNER'S • PLAN CHECK VALIDATION 2 S�' OTY. ELECTRIC PERMIT FEE ' NAE -aNc� 1 r �,• PHONE CONTRACTORS NAME �� II OICS � UTLETS-SWITCHES•RECEP 10.00/1,00 O ,/�S woNc ads (cryo ILIGHTING FIXTURES 10.00/1.00 ' COCONTRACTORS u N' PPLIANCES-RESIDENTIAL 4.00 /O1T ACT/ pp�D d31q].��ALI{�frsr�fl C` PHON PANELS 10.00 DATEOE�ICATION' n ARCHITECT PLAN CHECK FEE; P.C.NO. oP .�^ n_ � �G� /,// • PANELS (OVER 200 AMP' 20.00 ENGINEEP I o SIGNS TRANS. 3.00 ARCH OR ENG. PERMIT VALIDATION ADD Ess _ SPECIALCIRCUIT 5.00 ZIP TEMP.'METER OR POLE INS. 20.00 dL Il.LV MOTORS SEE FEE SCH. Li. SERVICE CHANGE 20.00 w 00 LICENSED CONTRACTORS DECLARATION a z W I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000)of Division 3 of the Business and �n Q A •f Lr , !gas ELECT. PLG. MECH. F 7 i . Professions Code,unduly license is in full force and effect. ❑Q z=In License Class Lic.NumberGw rjDate Contract., p��,a st 2 .+ �� BUILDING PERMIT e,wuOWNER-BUILDER DECLARATION INFORMATION 0A yI hereby affirm that I um exempt from the Contractor's License MISC.- REFER TO ORD LLoa Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 5/FT. - Code:Any city or county whichrequiresapermittoconstructaultef, Cba 2improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. LL reQnRes the applicant for such ponot t0 file a signed statement that TOTAL PERMITTO ' whe is licensed pursuant to the provisions of the Contractor's License H z i Law(Chapter 9(commencing with Section 7000)of Division 3 offle l-�q < Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE i2EMDDEL ec F o the basis for flit,alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a3=' by any upplicum for a permit subjects the applicant to a civil penally ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500).): ❑ 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 Ihereon,and who does such work FIXTURES-PER TRAP 5100 SD.IT,FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- s ments,are not intended or offered for sale.lt;however;the building GAS-EA.SYSTEM-I1NC.40UTLETS 6.00 or improvement is sold within one year of completion,the Owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- RES IND CDN PB Orher prove for purpose of sale.). INDUSTRIAL WASTE INTER. ' 30.00 1:1 ❑ ❑ ❑ 1:1❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(See.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORSPARCEL NO. and Professions Code:The Contractor's License Law dons not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts actor s L erne L with a mmractor(s)licensed purstmnt m SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. the Contractor's License Law. ❑ I am exempt under Sec ,B.&POC.for this WATER'HEATER W/VENT 6.00 reason Owner Dale WATER SYSTEM 5AD ACC:DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have acertificate ofcoment t.self-insure. ZONING ENG.SITE N0. or a Certificate of Workers Compensation lnsumace,or a certified Copy thC,eof(Sec.380CL I.A.C.). . Policy No. Company OB ❑ Certified COPY is hereby furnished. FIRE SPRINK ENERGY T$4 Z_ Z Q!Crrtil'i cokY ti it with the city inspection division, MISC.- REFER TO ORD.E4__❑ ❑ ❑ ❑ O APPbcan Y N .Y N ~ rn PERMIT ISSUANCE 10.00 - CIi R'fI PICAll3'OF•EXF:h1PT4 FROM WORKERS' FLOOD ZONE AL,O.C. W'E COMPENSATION INSURANCE PLG.CONTE, LIC.NO. PLG. CL O ('Phis section need not be completed it' the permit is for one TOTAL .Y❑ N❑ Y❑ No Z) Z hundred do1lars(SI000 or less.) L) O 1 certify that in the performance of the work for which this per- DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL.� mit is issued,I shall not employ any person in any manner so as to O () hecome subject to the Workers'Compensation Laws ol'Cablorma. p Date Applicant BUILDING ? a ALTER OR ADD TO MECH. 5.00 F W NOTICE prion,TO APPLICANT: II',after making this rs'C sane of ISx- F. ? emvision you should become subject to the Workers'Ccomply with APPLIANCE 5,00 PLAN CHECK such sow io the Labor Cit shall you most d forthwith comply with FEE U such provisions or this permit shall be deemed revoked. ' AIR HANDLING UNIT(TO 10,000GF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER IODWC.F.M.) 6.00 SEISMIC FEE 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,Cie.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's NO H EATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I certify that l have read this application and sone that the above VENTILATION FAN (SINGLE)• 4.00 information is correct, I agree to comply with all city and county PLUMBING- ordinances and stale laws relating to building construction, and 'BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hmby,authorize representatives of this city to eater upon Ilse BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL -1J above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. urertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in way accrue against said City in consequence of the mn n• Pcr MECH.CONT. LIC.NO. MECH. I 5/ 4_� TOTAL TOTAL S� Signature of Applicant/Contractor Dale OFFICE COPY