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172880 POST THIS CARD NEAR FRONT OF BUILDING :PERMIT NUMBER ��. CITY OF ,CUPERTINO 172$$ ` INSPECTION DIVISION JOB INSPECTION RECORD • PERMIT EXPIRATION �1 _ JOB ADDRESS �a.303 �jR'�.12.i% Gi1�-G UNIT# _LOT# RC PERMIT EXPIRES IF WORK OWNER I��^'� CONTRACTOR 5� IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- OR 180 DAYS FROM INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATIONANCE NOTE:' ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF LASTCALLED INSPECTION. LIFER PREGUNITE PERMIT VALIDATION CUPERTINO, STANDARDS. GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLABTO�� r/ ISSUANCE UA. TE PLUMBING L J- ,2F ELECTRICAL. - MECHANICAL. - BLDG ELECT I. PLG . MecM. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - • BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION siy PLUMBING MECHANICAL ELECTRICAL - �^ PERMIT TO k:�7 iA LAKY)°' ,IL'ii FRAMING INSULATION STORIES TYPE CONSTR. DEC GROUP -• RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAXJS PAID ' - sD.FT. FLOOR AREA TOTAL ,ACREAGE DIAPHRAGM BUILDING USE I. ROOF SHEATHING -. RES IND CON PB, ORI- 1 11 I] ❑ 1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.# AS ESSO R6 PARC E L NO - PLUMBING ELECT_ENERGY ' TUBS&SHOWER PAN PLUMBING ENERGY TNACI NO PARCEL NO: � ' FRENO,- MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC.DATE ACC. FRAMING' ELECT. FINAL TESTi INSULATION PLUMBING ZONING 5 ENG SITE -NO. GAS TEST GAS MECHANICAL EIRE SPRINK - "E3 ENERGY T.24 NF] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR' ELECTRICAL RELEASE FLOOD ZONE Y El .` "El A:L UC. ' Y L,, N❑ INTERIOR'SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING E �/ INTERIOR •LATH G' �'� TEMPORARY APPROVA S SCRATCH COAT ELECTRIC PLAN CHECK FEE - 1�r. - GAS ' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE �6 OCCUPANCYOF BUILDING ISNOTPERMITTEO UNTIL'BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC L71 JQ F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING . z PLEASE GIVE JOB ADDRESS WHEN PHONING.Z:00 MECHANICAL 2 ' = SEE PERMIT FOR EXPIRATION DATE—' CONST. . IMPORTANT!' TOTAL PLEASE READ REVERSE SIDE -BEFORE CALLING FOR FINAL INSPECTION. ,Z OFFICE COPY ' ' o=z. FOO ,tU 2 w Njzo N z ozr°w Q y E J S¢I¢au W ; 0 F r u o a w 2 n 4 0 re u ar N rzQ. E z o ar e- 3 I 10 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY 8 ILDING PROJECT IDENTI FICATION 'APPLICATION&PERMIT BUILDING —ELECTRICAL— PLUMBING —MECHANICAL .vERMITNUMBER � Q 1 U 17288 BVIEDC pOR"`_2 j 3 Dei/ r je O A/ C � N• OWNERS , � NAME G- C.? _NL�`/6roi37 ( OTV. 'ELECTRIC PERMIT FEE PLAN CHECK VALIDATION , DATE OF APPLICATION' CONTRACTORS ONTACTOR - NAME LIC, NO, UTLETS-SWITCHES -AECEP 10.00/1.00' t OX ILIGHTING FIXTURES 10.00/1.00 JLVOO CONTRA ADDRESS Ons '"JBtZ e� PHONE 39S PPLIANCES-RESIDENTIAL 4.00 PANELS - 10.00 ORRCHITECT ENGINEER LIC. NO, PANELS(OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH. OR ENG.PERMIT ADDRESS SPECIAL CIRCUIT 5.00 VALIDATION . EMP. METER OR POLE INS. - 20.00 zip A-� Tey n - APPLICANTS' SdmQ� MOTORS SEE FEE SCH. SERVICE CHANGE ." - 20.00[— ' LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code; and my license isin full force and effect. . ISSUANCE DATE BLDG. ELECT. PLG. MECH, License Class Lie. Number Date Contractor- BUILDING PERMIT INFORMATION OWNER -BUILDER DECLARATION- ' I hereby athe ffirm that I so exempt from the mess Contractor's License Law for nycit llorcoutywh(Sea 70r Lapersi[tocodProfessions perm; loots issuance alter. Code: Anymolish nor ntywhiny structure, improve, demolish, or repair any strunure, prior to its issuance, also MISC.— REFER TO ORD �Z e00 VALUATION �8 L/ L�k/Q�� $/FT. PERMIT ISSUANCE 10.00 ELEC. CONTR. - LIC. NO. ELEC. Bey+ �� (yam) 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 70000of Division 3 of the Business and Professions Code) or that he is exempt therefrom and TOTAL I J l J OTY. PLUMBING PERMIT FEEthe PERMIT TO n �fl Q�{�I�E'•`\b y' STORIES TYPE CONSTR. 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 ($500)J: ALTER -DRAIN -WATER (EA.) 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 BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA,COND. 5.00 intended or offered for sale (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 does such work himself or through his own employees, provided that such improve limits are not intended or offered for sale. If, however, the building FIXTURES - PER TRAP 5.00 SQFT. FLOOR AREA -TOTAL ACREAGE GAS - EA. SYSTEM - i INC. 4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he d Elul not build or am- pros for Purpose of sale.). I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: "file Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who GAS EASYSTEM -OVER 4 IEA) 200 - - . .. BUILDING USE RES IND CON PB Omer , ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. INDUSTRIAL WASTE INTER. .30.00 ' _ LAWN SPRINKLERS- 1 INC 5 V.B. -• 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 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.., BAP.C. for this reason WATER HEATER W/VENT 6.00 Owner - Date WATER SYSTEM 5.00 ACC. GATE ACC. FILE NO. ' WORK ERS'COMPENSATION DECLARATION - WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self -insure. or a certificate of Workers' Compensation Insurance, or a certified FEB ZONING ENG. SITE NO. O IL copy thereof (Sec. 3800, Lab.C.). Policy No. Company FIRESPRINK V N 1:1 Cl ENERGY T-24 V N ❑ ❑ ❑ Certified copy isloactly furnished. ❑ Certified copy is filed with the city inspection division. A IiCanl - MISC. - D. PERMIT ISSUANCE ,OO Cts CERTIFICA'rF, OF EXEMPTION FROM WORKERS' FLOOD ZONE A.L.U.C. PLG, CONTR. LIC. NO. - PLG. ^.� TOTAL 0.y.Da COMPENSATION INSURANC17 e permit is for one (This action need not be completed if tile Y ❑ N ❑ Y ❑ N❑ OTV MECHANICAL PERMIT FEE - FEE SUMMARY Imndredd.dkRx(S100)o}less,) '- I certify that in the performance of the work for which this per. out is issued, I shall not employ any person in any manner so as o become the Workels'C ens. io I'Calil' Date APE can" NOTICE; TO AI LICANT: 11, u} cr making this Ccrli a:ate of lix- BUILDING 111 06 ALTER OR ADD TO MECH. 5.00 j APPLIANCE - 5.00 PLAN CHECK FEE �y trun ion, 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. AIR HANDLING UNIT (TO 10=QF.IW 4.00 AIR HANDLING UNIT (OVER 10=C.P.M.) 6.00 SEISMIC FEE P� CONSTRUCDON LEND) NC AGENCY + I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 .. e work for which this permit is issued (Sec. the performance of tile MICROFILM HEATING UNIT (TO 100;000 B.T.U.) 6.00 ' Lender's Name - Lender's Address H EATING UNIT (OVER 100,000 T.U.)9.50 B. ELECTRIC /+ Sys `7L,7 �+ I certify that 1 have read this application and state that the above information is correct. 1 agree, to comply with all city and county ordinances and stale laws relating to building construction, andBOILER- VENTILATION FAN (SINGLE) 4.00 PLUMBING q 2vLA� DOW (3 H.P. of 100,000 B.T.U.) 6.00 BOI LER-COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the above-nsentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of uperlino against liabilitie judgments, costs and expenses which' may in y way ace e � abot said City in consequence of the i of this per i . 2 G3 MISC. REFER TO ORD. eC70 'CONST. TAX PERMIT ISSUANCE 10:00 Moo MECH. CONT. LIC. NO. - MECH. TOTAL �. i� � � TOTAL ^1 ,u� aLO%Jrl.(D1 ' nature of Applicant/Can actor Uale OFFICE COPY i CITY OF COLKI-1Vt'.j INSPECTION DIVISIG,J JOB INSPECTION RECORD PERMIT EXPIRATION •2P G2tLGl.r UNIT tt _LOT# PERMIT EXPIRES IF WORK �B ADDRESS —1=�—P� Ai'�� IS NOT STARTED WITHIN wNER G . RPI; Utr2 CONTRA CTOR 180 DAYS OF PERMIT ISSU- INSPECTION:' . , DATE INSPECTOR INSPECTION RECORD- ANCE OR 180 DAYS FROM FOUNDATION NOTE: LAST CALLED INSPECTION. LIFER TO GRADING AND DRAINAGE SHALL BE INSTALLED rl unu, vni mn uUN TO COMPLY WITH THE APPROVED PLANS AND CIN OF PREGUNITE C ERTINOSTANDAR S-J.-'rA j GARAGE SLABS L L. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 22 uNInFRGROUND/SLAB ELECTRICAL YJI W MECHANICAL -BUILDING PERMIT ABOtlE HAS BEEN SIGNED INFORMATION . -00 NOT POUR'FLUORUNTIL WOOD FLOOR sfE T. E^VAL.UAnUN PLUMBING�-J- PU+NRt 10 MECHANICAL ELECTRICAL s, auEs ,vrl l:ON5t1+ FRAMING INSULATION ufG GROUT REs UNITS A111 R t.L ACI FACE PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED S„ „ n.a°" NOTE: NO FINAL INSP. SHALL BE MADE BEFORE ROOF THE CONSTRUCTION TAX IS PAID DIAPHRAGM B,,,ENING USE Nts No CON PR Uw.• El 13 ROOF SHEATHING INSP. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE A55ESSOHSPAnCkI NO ROUGH SAN .# Z ELECT. ENERGY m<u NU PARctE No PLUMBING PLUMBING ENERGY TUBS & SHOWER PAN MECH.ENERGY Acc nnTt ncc EnE. No MECHANICAL ELECTRICAL BUILDING ENERGY ELECT.FINALTEST zON�NG EN(: SITE NO FRAMING - -•� PLUMBING INSULATION-- GAS TEST GAS FINE SrHINR ENERGY" E-]< MECHANICAL ❑ N❑ v ❑ N❑ WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ,uxnvuNE A. Uc COVER NO EXTERIOR SHEA JELECIHECAL RELEASE ❑ N❑ . ❑ N❑ INTERIOR SHEAR FIRE DEPT. FEE SUMMARY GRADE SHEETROCK �= EXTERIOR LATH BUILDING INTERIOR LATH 'r Fi- . .TEMPORARY APPROVALS BUILDING PLAN CHECK C ELECTRIC SCRATCH COAT' FEE I l GAS SEISMIC FEE L CJ NO TAPE DR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY 1 OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ELECTRIC ARRANGE FOR INSPECTION BY PHONING 252-4505, PLUMBING 7,00 w ONE WORKING DAY BEFORE REQUIRED INSPECTION. 00 PLEASE GIVE JOB ADDRESS WHEN PHONING. MECHANICAL Z ,o0 z - SEE PERMIT FOR EXPIRATION DATE - CONST.TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL OLfij� CALLING FOR FINAL INSPECTION. APPLICANTS POSTING COPY