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15553 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 15553 INSPECTION DIVISION JOB INSPECTION RECORD f //�� PERMIT EXPIRATION JOB ADDR ESS/U I2 �/'47� .//R+ UNIT# _LOT# (� PERMIT EXPIRES IF WORK OWNER SC CONTRACTOR QU / (20n/S7, IS NOT STARTED WITHIN INSPECTION DATE IN ECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM NOTE: , UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PLRA9T VALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB //,�� 7{/ ` PLUMBING - �1D �"'�:' .11. ELECTRICAL �' " ISSUANCE DATE MECHANICAL Dc. eLBCT PLa -MECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR F �� 01 CU INFORMATION VALUATI $TFT, PLUMBING � � �s� MECHANICAL ELECTRICAL PERMIT TO FRAMING INSULATION . L�-�b' STORIES TYPE CONSTR .000.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROOF lC,lT.FLOOR AREA TOTALACREAGE NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAXIS PAID 5 -• ROOF'SH EATHING(�."" - BUILDING USE \IZ C5IVYe �� vus IND CON Pe Ouo•i APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ASSESSORS PARC ' ROUGH SAN.k ELNO PLUMBING / ELECT.ENERGY _ o- J. �� TUBS&SHOWER PAN �' ' PLUMBING ENERGY TRACT DO PARCEL NO MECHANICAL - ;tti MECH.ENERGY ELECTRICALI BUILDING ENERGY Acc Ohre AC-FILE NO FRAMING 1- ELECT.FINAL TEST 6- ,� INSULATION PLUMBING zoNING ENG.SITE No. GAS TEST - GAS .. _ MECHANICAL FIRE SHRINK ENERGY T.]4 P Y ❑ N❑ v.❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATINGOD� EXTERIOR SHEAR - ELECTRICAL RELEASEELaZONE ALuc. INTERIOR SHEAR FIRE DEPT. Y ElN❑ v ❑ NE] SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING . INTERIOR LATH TEMPORARY APPROVALS BUILDING c w&4Z fa SCRATCH COAT - ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUI LDING FINAL IS SIGNED BY BUILDING INSPECTOR. t MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC Ed ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING o PLEASE GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL. C.?, - SEE PERMIT FOR EXPIRATION DATE - / IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL da. CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY CBUILDING PROJECT IDENTIFICATION 'PERMIT NUMBER l NBUILDING APPLICATION & PERMIT 15553 AOOREss JQ/!` E �2 BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S NgmE � PLAN CHECK VAyyyggq ATION SCNHfYF �y�s OTY. ELECTRIC PERMIT FEE veoN /f0(O CONTRgCTOR$ NgmE�•� /' - OUTLETS-SWITCHES-RECEP 10.00/1.00 J(JI"Ml9 (SU 7n LIC NO, (,q-s 4LIGHTING FIXTURES 10.00/1.00 ADDRESS oEs APPLIANCES-RESIDENTIAL 4.00 391 In`54A)CCY LV) C/WPRONE3'J)-S_;JL5PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P_C.NO, OR PANELS (OVER 200 AMP) 20.00 ENGINEER (9 � n Llc rvo SIGNS TRANS. 3.00 ARCH.OR ENG. PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT 5.00 ! d;05o/� �%'�'-02 S zIv .jr EMP.METER OR POLE INS. 20.00 .� ADDRESS r$ MOTORS SEE FEE SCH. ADDRESS yy��-/"' - 391 /E t- &&,JCC-Y C07B" SERVICE CHANGE 20.00 ,1t� oo LICENSED CONTRACTORS DECLARATION �/V r a u z w ISSUANCE DATE u 1 hereby of firm that I am un licensed der provisions of Chapter 9 - (commencmg with Section 7000)of Division 3 of the Business and PLG. M ELECT.G. ECT. Ali r w i Professions C-d�c Idose is in full force ❑ z o w - License Cl... Lic.Numb 7 y_ Data Conlmalor < Y -c N wu 4 OWNER-BUILDER DECLARATION BUILDING PERMIT Foe" . ;A H I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD ORMATION u O j Law for the following reason.(Sec 7031.5.Business and Professions '1'0"00 UATION S/FT. r - PERMIT ISSUANCE Code:Any my or county which requires a.crushes construct.cions 2 as ¢ 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC. ''II pp PERMIT TO o u requires the applicant for such permit to file a signed statement that TOTAL OtJ w m he is licensed pursuant to he provisions of the Contractor's License HZQLaw(Chapter 9(commencingwlth Section 7000)of Division 3 oftlm ��L� ,_ / 4 o Business and Professions Code)or hat he is exempt therefrom and OTY. PLUMBING PERMIT FEE 'k/ I-o the basis for the alleged exemplion.Any violation of Section 7031,5' STORIES TYPE CONSTR, nim by any applicant for a permit subjects the applicant toa civil penalty gLTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars(S500).): ❑ 1,as owner of he property,or my employees with wages as BACK FLOW PROTECTDEVICE 400 their sole compensation,will do the work,and h . . e structure is not OCC.GROUP RES.UNITS intended or Offered for sale (See. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of properly who Wilda or improves hereon,and who due,imal,work FIXTURES-PER TRAP5.00 $0.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenotintendedoroffered for sale.If.however,the building GAS-EA.SYSTEM-I1NC.40UTLETS 6.00 547 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 prove for purpose of saleJ' INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer ❑ I,as owner of the property,am exclusively contracting with 1:1 ❑ El El ❑ Code:licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 6.00 ASSESSORS PARCEL rvo. and Professions CodThe Contractor's License Law does not apply V.B. to an owner of properly who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with it contractors)licensed pursuant to the Contractors License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO, ❑ lam exempt under reason �1 S C ,B,&P.C.I'ur l his WATER HEATER W/VENT 6.00 ' owner _OF I Doe WATER SYSTEM 5.00 ACC.DATE ACG FILE NO. WORKERS'COMPIiNSATION DECLARATION WATER TREATING EQUIP. . 5.00 1 hereby affirm that I have a certificate of consent to self-insure. or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec 3800, �� L,m C.). � - Policy Na Company= 7-Av- Z✓A O ❑ Cyyrtifcd my is hereby fumished. Z Z �Cerf y the,'tl inspection division. FIRE SPRINK ENERGY T-24 FO Applicam�'t.f--- � MISC.- REFER TO ORD. PERMIT ISSUANCE Y ❑ N❑ Y❑ N❑ lr w CGRTI EIGCI'II E SAI I PI'INS FROM WORKERS' 10.00 FLOOD ZONE A.L.u.c. 0. 0 (This section need f not beTc mpluLLd INSURANCE thepermitis for one PLG.CONTE. UC.NO. TOTAL Y❑ N❑ Y❑ N❑ ao :� Z hundred dollars(S 100)or less.) U O 1 certify that in the pertormance of he work for which his per- OTY MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issucA. I shanY person In anY manner mI ax In O w become suhj,ct FIT nsu Ion Laws of C:diliuniu. } y Date ALTER OR ADD TO MECH. 5.00 -� BUILDINGKOTICEr0 AI' ,altar mkin•this C,rt ilica¢•Of lix- emption,you shosubject Io thWorkeqppLIANCE 5.00 PLAN CHECK provisionsofEme, youmustforthwsuch provisions oshall be deemed revoked. AIR HANDLING UNIT TO 10,OWC F.M.) 4.00 FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE P2 I hereby aEirm that here is a commRetion lending agency ID, - EXHAUST HOOD(WITH DUCT) 500 the perfomwnec of tile . e woreI I �'ch this per is issued(Sec. MICROFILM 3097,Civ C.). -. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name )9 Lender's Aedress HEATING UNIT(OVER 100,000B.T.U.0.50 ELECTRIC SCJ 1 certify that I have Den6this.pplicluhm and slat,that the above VENTILATION FAN (SINGLE) 4.00 Information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws relating ID building construction, and BOILER-ODMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby auhorite representatives of this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which -r1 CONST.TAX may in any way accr against Said City in consequence of the PERMIT ISSUANCE .yQ,pp K ramm nn'. MECH.CONT. LIC.NO, MECH. a re of p icant/Contractor EDate TOTAL a TOTAL .L OFFICE COPY