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17596 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OFICUPERTINO 17596 INSPECTION DIVISION JOB INSPECTION RECORD 00 (-� PERMIT EXPIRATION ��A C( �� JOB ADDRESS —� d Z/ I IP 8 UNIT_I# LOT# PERM - 'V� �L< P C_� S NORTEDWIT STAIRES IF I HRN OWNER, '�CCt--.C� CONTRACTOR INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALUATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING APR I ! _ . ��L•� �. '�I v. 10 ki ELECTRICAL ISSUANCEDATE MECHANICAL BLDG ELECT I PLG. mecH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATI0 SIFT. . eq MECHANICAL r ! ELECTRICAL. .� //(fPER 1 TO FRAMING t'f' (L �' INSULATION STORIES TYPE CONSTR. OCC:GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - • . ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE. SOIT,'.10OR AREA TOTALACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID _ BUILDING USE ROOF SHEATHING RES IND CON PB "I", APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. L ❑ Cl L L ROUGH SAN.a AS LSSOHS PARCEL NO. - PLUMBING ELECT,ENERGY TUBS BSHOWER PAN PLUMBING ENERGY TRACT NO, PARCEL NO MECHANICAL - - MECH.ENERGY ELECTRICAL ACC DATE ACC.FILE NO. BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG,SITE NO. INSULATION PLUMBING - , GAS TEST GAS MECHANICAL FIRE SPHINK ENERGY 124 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y NL ` L NL EXTERIOR SHEAR ELECTRICAL RELEASE .� FLOODZDNE AL u.C. INTERIOR SHEARFIRE DEPT. Y L NL Y L NL SHEETROCK - GRADE - FEE SUMMARY EXTERIOR LATH BUILDING �� —"`7 BUILDING 3.p� INTERIOR LATH ' TEM ORARY APPROVAL SCRATCH COAT ELECTRIC - PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY' SEISMIC FEE „1 OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, . ELECTRIC I.— ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. F . — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! coNST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY J - ' APPLICANT TO FILL'IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT �f� ADDRE9$-/yD�� I x 17596 �(�) BUILDING - ELECTRICAL-PLUMBING-MECHANICAL OVniER'$ PLAN CHECK VALIDATION NAME 29Z ]��9 DTV. ELECTRIC PERMIT FEE PHONE(..�(. �J 1 CONT © NAME OUTLETS UTLETS-SWITCHES-RECEP 10.00/1.00 1 Ca.. V• 123 LIGHTING FIXTURES 10.00/1.00 co TRACTO 'e APPLIANCES-RESIDENTIAL 4.00 ADDRESS pcnrtecT u PHONE Z PANELS 10.00 9. 5"DDATE OF APPLICATION + ORPANELS (OVER 200 AMP( 20.00 PLAN CHECK.FEE P,C.,NO. ENGINEER Lie.NO SIGNS TRANS. 3.00 ADDRESS ENA. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP EMP. METER OR POLE INS. 20.00 ADDRESS Ar3 MOTORS SEE FEE SCH. 7 d ADDRESS o SERVICE CHANGE 20.00 o D LICENSED CONTRACTORS DECLARATION a v w 1 hereby affirm that 1 um licensed under provisions of Chapter 9 ISSUANCE DATE y (commencing ith Section 7000)of Division 3 of the Business and APR I- 2 a BLDG. ELECT. PLG. MECH. r 0 i Pnrksamns C( rid license is In full Ib -c: t a, 0°9 License Cl s Lie.Nunth El - o z h o UiC Contruclor�� N/�{�.,.a (�pB��gQ yF C* at '-T`-- BUILDING PERMIT OWNER-BUILDER DECLARATION o> INFORMATION X ; I- I hereby a0irm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD .,a Law for the following reason.(Sea 7031.5.Buslneasand Professions VALUATION 4/FT. � - Code:Any city or county which"itiresa permit mconstracUalter, PERMIT ISSUANCE 10.00 J�Op 9v 'tJ) 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.C((O11N�TT'Rp, �'po1 1 LIC, 'J ELEC. �1 D O u requires the applicant for such pemrit to file a signed statement that K(_F _, ,�T_V �oo-7Z3 TOTAL PERM TO a w m he is licensed pursuant to the provisions of the Contractor's License Fii Law(Chapter 9(commencing with Section 7000)of Division 3 of the - < Nusin-ss and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEEfD4eG I ce t S the basis for the alleged exemption.Any victor ion of Section 703 L5 STORIES TYPE CONSTR. c- ; _ by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500f): ALTER-DRAIN& VENT-WATER (EA.) 5.00 ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS Omit sole compensation,will do the work,and the stricture is not intended or offered for sale (Sec. 7044, Buslocss and Ptufesslons DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Commetur's License Law docs not apply to an owner of proNrly who builds Or improves thereon,and who does such work FIXTUR S-PB .TRAP _ 5.00 SD.IT.FLOOR AREA TOTAL ACREAGE mmsfirmed re through his own employees,lot , le,If.sed that such improve- _ mcros°re througot h or offered sale,If. that suhebulWing GAS-E �S`.a..97e -11NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM OVER 4(EA.) 2.00 builder will have the burden of proving that he did not build or im- BUILDING USE Drove for purpose of sale.). INDUSTRIAL WASTE INTER3000 ' RES IND con PB oma. ❑ 1,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 Lav 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 a contruchims)licensed pursuant to the Com meter's License taw. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO: PARCEL NO. ❑ lura exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 ouse w net Dace WATER SYSTEM 5.00 ,ACO DATE ACC.FILE NO. WORK ERS'COMPENSA'nON DECLARATION WATER TREATING EQUIP. 5.00 I hereby alfrm that l have a ccrtilicutc of consent to n-If-insure, ZONING ENG.SITE NO. or u ccrtilicutc of Workcrs Compensation Insurance,or a certified copy thctcof(Sec.3800,Lab.C)L - Policy Nn. Company O ❑ CcrtiNcd copy is hereby fumishcd. FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is filed with the city,inspection division. MISC.- REFER TO ORD. O Applicant V ❑ N E] V IN � N CERTIFICATE OF F.XIiIII PTI ON I:RONt WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.UC. LU > CONIPENSAT[ON INS URANCEi PLG.CONTR. LIC.NO. PLG. v� N� vF] IN El CL Z I'I'his vection need not be completed if the pen n..it for one TOTAL hundred dollars IS 100)or less.) U O I certify that in the perfo rice of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY L.L I- mit is issued,I shall not en toy Try perso n y ma az to O w becolV-1101 sir he Work o n u. M n°a' T� Appl'ca"' ALTER OR ADD TO MECH. 5.00 BUILDING .3• CAD } w NOTICE' 10 APPLICANT, If,after nukil (his Curt aw of Ex- F_ Z enlption,you should hecome suhjen to th Workers'Compensation APPLIANCE 5.00 PLAN CHECK _ provisions of the labor Code, you (mist forthwith comply wit Itch FEE U , h provisions or this permh shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=1C.6NL) 6.00 SEISMIC FEE I hereby affirm that there is u construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the perfunnunce 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 HEATING UNIT(OVER 100,000 B.T.U.) a� Lender's Address ELECTRIC I C I "tiny that 1 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 countyPLUMBING ordinances and state laws relating to building construction, and BOILER-CO P(3 H.P.or 100,000 B.T.U.) 6.00 hereby aurhoroe representative of this city to enter upon the BOILER-COMP (Oser 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purpovs. (We) agree to save, indemnify and keep humaess the City of MISC.- REFER TO ORD. upartino sig st liabilities,judgments, cost, and expenses which PERMITISSUANCE 10.00 CONST.TAX n in ony w y accrue oge' s said City in consequence of the m ing of t is •nn IMECH.CONT. LIC.NO. MECH. -Il TOTAL TOTAL Signo[uro a ppliun[/ nntmdor Date OFFICE COPY