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15729POST THIS CARD NEAR FRONT OF BUILDING 1 CITY OF CUPERTINO INSPECTION DIVISION' JOB INSPECTION RECORD _! /��J ,1�• JOB ADDRESS �Qss U^ S��Lr?Nz.�-'/✓�V� UNIT# LOT# - ^ OWNER 7�Nv CONTRACTOR /i/E 6 PERMIT NUMBER Y 15729-, PERMIT,EXPIRATION PERMIT EXPIRES IF WORK' IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 -DAYS FROM LASTCALLEINSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUND'ATION - NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS, LIFER - PREGUNITE PEHM(T VAI.17TTON ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL " MECHANICAL BLDG -, ELECT. 1. PLO. MECH 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED Q BUILDING PERMIT INFORMATIpN WOOD FLOOR ALUATION VFT, PLUMBING - ` 30- 30 - _.� -✓�Ayf Pct, I To _r l�� '. MECHANICAL ELECTRICAL ELECTRICAL - �E ' Cil`7 - FRAMING INSULATION - STORIES TYPE CONSTH. OCC. 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 " SOFT FLOOR AREA TOTAL ACREAGL . DIAPHRAGM ROOF SHEATHING BUILDING USE HES 'NO CON PB Do" ❑ ❑ ED - ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.# ASSE111115 PARCEL NO PLUMBING - ELECT. ENERGY TUBS 6 SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL NO, MECHANICAL MECH.ENERGY ELECTRICAL, BUILDING ENERGY ACC GATE ALC. FILE NO FRAMING - - ELECT. FINAL,TEST• INSULATION PLUMBING ' ZONING ENG. SITE NO. - GASTEST GAS - FIRE SPRINK Y Q N❑ ENERGY T 2 ❑ NE3 MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING' EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE NEj A.L U C. Y L ry� INTERIOR SHEAR FIRE DEPT, SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING I F BUILDING INTERIOR LATH, TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECKJ'- FEE • - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, o ELI ARRANGE F WORKING DAY BEFORE REQUIRED INSPECTION. O PLEASE GIVE JOB ADDRESS WHEN PHONING. Z. - SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL %^ OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT -PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL - PERMIT NUMBER 1 [�J�(� I J r J BUILDING ADDDssstI, Omo�a� �' PHONE- TY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION > CO3 COR/11160n OUTLETS •SWITCHES - RECEP '10.00/1.00 LIGHTING FIXTURES . 10.00/1.00 " DATE OF APPLICAT ION, PLAN CHECK FEE P.C. NO. ADDo EacTOR's �77 P PPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 PANELS (OVER 200 AMP) 20.00 ARCHITECT oR tj(' ENG/!q'g LIC,rvO. - SIGNS TRANS. Q-�- ARCH O °' A SPECIAL CIRCUIT 5.00 PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 ZIP APPQk^s Ao s MOTORS SEE FEE SCH. SERVICE CHANGE20.00 /• t / iff , LICENSED CONTRACTORS DECLARATION I hereby 'affirm that I am licensed under provisions of Chapter 9 (Commencing wfitel 7000) of Division 3 of the Business and Professions Cod mense is in full f License C ss- _ Lic. Numb yy�-7 'l7 ISSUANCE DATE "LUG. f ELECT. PLG. I MECH. (�U El [J Contractor Date_747I" OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 703 1.5, Buldessand Professions Code: Any city or county which requiresa permit toconstruct, alter, 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(commencing with Section 7000) of Division 3 ofthc Business and Professions Code) or that he is exempt therefrom and PERMIT BUILDINGINFORMATION INFORMATION MISC. - REFER TO ORD VALUATION $/FT. ' PERMIT ISSUANCE - - 4-6;00 y'Z - ELEC. CONTR. LIC. NO. ELEC. q TOTAL 0 L PERMIT TO 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 applicant to a civil penalty of not more than five hundred dollars (4500).): ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sale compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE .4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA,COND. 5,00 intended or offered for sale (See, 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 does such work himself or through his own employees, provided that such improve- ments are not intended or offered for sale. 11; however, the huilding ' FIXTURES - PER TRAP 5.00 GAS - EA.SVSTEM - i INC.40UTLETS 6.00 SO. FT. FLOOR AREA 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 of sale.). I, as owner of the properly, aexclusively contracting with m GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 - BUILDING USE .RES IND CON' PB Omer ❑ El 1:1❑ INDUSTRIALWASTE INTER. 30.00 Mnsed contractors to construct the project (Sec. 7044, Business 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,8. • 6.00 LAWN SPRINKLERS - OVER 5 IEA.) 1.00 ASSESSORS PARCEL NO. contracts for sue rojects with a conlmmor(s) licensed puramnt to the Contractor' cense SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. L- ❑ 1 al pt under See. ,B.&P.C. for this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. GATE ACC. FILE N0. WATER TREATING EQUIP. 5.00 WORKERS'COMPENSATION DECIARA'rION I hereby'affirm that I have a certificate of cons •nI to sell' -insure, a certificat of Workers' Compensation su ce, retl ificd copy there I' icyN ZONINGor ENG. SITE NO. ' ertii My' r yu i m• SR fi co mspaction division. Applicant FIRE SPRINK YE]'N❑ ENERGY T -24 - I Y❑ N❑ MISREFER TO ORD. CER1'IFICA1EOF!XEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.UC. PLG. CONTR. ILIGNO. PLG. TOTAL COMPBM1'SATION INSURANCE. (This section need not be completed if the pe nnit is for one Y ❑ N❑ Y C] N❑' hundred dollars (S I OOl or less.) I certify that i I performance ol'the work lin which this per- mit is issue a 1 not employ any person in any manner so as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING becomes to tie Workers Compensation Laws of California. Old '5 ALTER OR ADD TO MECH. 5.00 NO'rIC' TO APPLICANT: If, after making this Certificate of Fx- 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 APPLIANCE 5.Q0' �` PLAN CHECK FEE tt�� ! 'r AIR HANDLING UNIT (TO 10,000CF.M.) 4.00 AIR HANDLING UNIT (OVER 10=C.FM.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance yf.(I ork for which this permit is issued (Sec. 3097, Civ.CJ. zlI MICROFILM H EATI N G UN IT (TO 100,000 B.T.U.)' 8.00 HEATI NG UNIT (OV ER 100,000 B.T:U.) 9.50 ELECTRIC a nder'S Name ev Lcnder's Addy s Le I cert ify that l have readthis application and state that the above VENTILATION FAN(SINGLE) 14.00 information is correct. I agree to comply with all city and county ordinances and state laws relating l0 building construction, and PLUMBING - BOILER -COMO(3 H.P. or 100,000 B.T.U.)' 6.00 BOILER -COMP IO., 100,0008TUI SEE FEE$CH. MECHANICAL Hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes, MISC. - REFER TO ORD. I, ) agr o save, indemnify and keep harmless the City of Cupertino costs expenses which may in y nstSadCity "' sequenceof the CONST. TAX PERMIT ISSUANCE 10.00 MECH.CONT. LIC. NO. MECH. TOTAL TOTAL f s - �RS1b,,,fi,1w,,,aiu1gmeGts, Signa a ft App scan 'onlractor Date ' OFFICE COPY