The URL can be used to link to this page

12869I`• 0 i0 POST THIS CARD NEAR FRONT OF BUILDING �• CITY OF CUPERTINO PFHH9, NUMBIiR INSPECTION DIVISION �roa JOB INSPECTION RECORD 2,1,.3 Z3 DEy1%�� Tp R --- 1 -UNIT# PERMIT EXPIRATION JOB ADDRESS LOT# PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION _ _ UFER LASTCAI-LED INSPECTION. PREGUNITE - v MfFVALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB 'no' ti -I PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG_ ELECT. PLG. MECH, I 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT -INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO - t.' FRAMING I 1 - INSULATION STORIES TYPE coesTq. - OCC, GROUP RES, UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO. FT, FLOOR AREA TOTAL ACREAGE DIAPHRAGM OUILDI DSE RES IND CONP9 Otlun APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ • • ROUGH ASSESSORS PARCEL NO. PLUMBING GAS TEST TRACT NO. PARCEL NO. MECHANICAL -. ELECTRICAL FINALS DATE INSP. ACC DATE ACC. FILE NO. FRAMING SAN # INSULATION PLUMBING - ZONING ENG, SITE NO. GAS MECHANICAL —- •• FIRE SPRINK � ❑ No ENERGY T]< ° ❑ NE] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING -y LATH -INTERIOR ELECTRICAL OO FLD ZONE ❑ N❑ A.L.U,C. Y ❑ NO LATH -EXTERIOR FIRE DEPT. SHEETROCK - GRADE FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, 1 ELECTRIC o�ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING MECHANICAL -SEE PERMIT FOR EXPIRATION DATE - CONST. TAX IMPORTANT! TOTAL PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. 14 OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI VDI NG PROJECT I DENTI FICATION- - APPLICATION & PERMIT' BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER g 2 Q 6 n I 0 J RDILDING ADDRESS 21373 Dexter Drive OWNER'S NAME Susan Huang 252-5482 QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION vlsoNE DATE OF APPLICATION Lions NAME A.A.A. Furnace Co. 277145' & "AME LIL.3&6361 OUTLETS -SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 R's CONTRACTORS A 1712 Stone Ave. PNDNr293-4717 APPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 ARCHITECTS s a. ENGINEER LIC. NO PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE .P.C. NO. SIGNS TRANS. 3.00 ADDRESS E"G SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP EMP. METER OR POLE INS. 20.00 ANT'E ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 3�aa) LICENSED CONI'RACfORS DECLARATION rlfll�I I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 1'rofussions Cs"S...0 sc is in full forty and cffeo. Licensgf/a{S_ G Lic. Number_2]_71L5&_ DateG1__y.Q Contractor_371636jIx ISSUANCE DATE ityof BLDG. ELECT. : PLG. MECH. ❑ BUILDING PERMIT INFORMATION OWNER -BUILDER DECLARATION 1 herby alollo that I am exempt from the Contractor's License Law for the followingrcason(Scc.uincia,crintssanstrucessions Code Any city or coo my which requirese permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such rovisit r, file a signed Cont stn is Li that he Is (Chapter 9 (comm en the provision of the ) ofDicmrx License of Division 3 of the LAW (Chapter') (commencing with Suction is exempt and Professions Code) or that he is exempt and MISC.- REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION S/FT. ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO �f L�+�+ US QTV. PLUMBING PERMIT FEE STORIES TYPE CONSTR. the bass ecrefwm the basis for the alleged exemption. Any ptoaclion applicant en lty by any more five Hundred dollar.,lhcapplicatt toacivil penalty nl' noDmoru than five hundmd dollars (5500).)'. ALTER-DRAIN-WATER(EA.) 5.00 ❑ 1, 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 ODD. 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 properly who builds Or improves IIICIcon, and who does such work himself or through his own employees, provided that such improve- Formsarcnotintendedorolferedforsale. If, however. the building F IXTUR ES - PER TRAP 5.00 - SO. FT. FLOOR AREA TOTAL ACREAGE GAS - EA. SYSTEM -1 INC'.4 OUTLETS 6.00 or improvencnt is sold within one year of completion, the owner- builder will have the burden of proving that h e did not build or im- Prove for purpose of sale.)' ❑ I, as owner of the property, acts exclusively contracting with - . -.. GAS EASYSTEM OVER 4 IEA) 200 BUILDING USE RES IND CON PB Other 0 0 0 ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project (Scc. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or improves (hereon, and who LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 IEA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with a contractor(s) licensed puramnt to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ 1 im exempt under Sec. ,B.&P.C. for this reasol WATER HEATER W/VENT 6.00 Owner Dam WATER SYSTEM 5.00 ACC.DATE ACG FILE NO. WATER TREATING EQUIP. 5.00 WORKERS'COMPENSA'1'ION DECLARATION ' I hereby affirm that l have a certificate of,orsent to self.insure or a ccs(' Workcri Compcnsstion Insumnn•, or a certified ZONING ENG. SITE NO. heater -__91 cop ero(IScc. 00, Lob.C.).�.. ,, �.,,� F11nC1strater 1'p cy Np..77aaaa{{-ompany_ Cer1A'1Cll'CUp - hereby fur crlificd c y lite I m city spection ,division. A beat' FIRE SPRINK V F] NEI FLOOD ZONE ENERGY T-24 VE] NF] A. L. u. C. MISC.- REFER TO ORD. CE 'ICATE OP EX Ii MITI 'PROM WORKERS' PERMIT ISSUANCE 10.00 PLG. CONTR. LIC. NO. PLG. TOTAL COMPIiNSAT $URANCE (This scrtlor need Ilpt be completed If life permit IS for one Y E] N V E3 N hundred dollars IS 100) or loss.) 1 certify that in the performance (if the work for which this per, mit is issued, 1 shall not cnsploy any person in any manner so as to DTV. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers' Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICANT: IC after making this Certificate of E.. APPLIANCE 5.00 PLAN CHECK FEE sorption, you should become subject to the Workers' Compensation provisions of the Labor Code, you most forthwith comply with RICH provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (TO 10p00GF.M.) 4.00 AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGI7NCY 1 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. 3097, Civ.C.L MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lenders Name Lender's Address HEATING UN IT (OVER 100,000 B.T.U.)9.50 ,Q ELECTRIC I certify that 1 have read this application and slate that the above V ENTIL'ATION FAN (SINGLE) 4.00 information is correct. 1 agree to comply with sell cily and county ordinances and state laws relating to building cunlruelion, and PLUMBING BOILER-COMP(3 H.P. or 100,0008.T.U.) 6.00 BOILER -COMP over 100.000 BTU) SEE FEE SCH. MECHANICAL 3p�•W hereby authorize representatives forms of this city a era upon the above-mentioned properly forinspofth i purposes. (We) agree to save, indemnify and keep liarmless the City of Cup• ins) liabilities, j rvnts, costs send expenses which y in any ay accrue, said City in consequence of the granting of th'par MISC. - REFER TO ORD. CONST. TAX PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. _ 3/2 9 TOTAL 32.00 TOTAL tea? Signa[ Applin it/Con c[ IJnte /' OFFICE COPY