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15069POST THIS CARD NEAR FRONT OF BUILDING '-CITY OF CUKRTINO INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS ZO Z ?/ UNI T# LOT# r OWNER C.cs$/r CONTRACTOR pca JL_ x- PERMIT NUMBER 15069 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION - NOTE: GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY, OF CUPERTINO STANDARDS. LIFERALL PREGUNITE PERMIT VAI.IOATION SSUANCE (TATE' GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING cn0li,M' ELECTRICAL MECHANICAL May T ELECT o ❑ . MECR PLc❑❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 1Nv BUILDING PERMIT ., INFORMATION . WOOD FLOOR PLUMBING � � „ VALUATION SIFT. �'�. MECHANICAL ELECTRICAL PERMIT TO FRAMING INSULATION - STOwES TYPE CONSTR,� - - FOCC.GHOUP ' RES, UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF - NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID - So, FT FLOOR AREA TOTAL ACREAGE DIAPHRAGM ROOF SHEATHING +BUILDING USE RES IND CON PB O'Iv, ' ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ' � - � ROUGH SAN.N ASSESSORS PARCEL NO - ' PLUMBING ELECT. ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO. - PARCEL NO MECHANICAL MECH.EN_ERGY- ELECTRICAL - BUILDING ENERGY e 1. - 2, 8d'.�1 ACC DATE ACC. FILE NO FRAMING ELECT, FINALTEST INSULATION PLUMBING 7 6,y ZoNlNc ENc. sire No. GAS TEST GAS MECHANICAL "• FIRE SPH iNK ' ❑ N❑ [NERDY T2 Y ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE `'❑ N❑, A.L U '❑ NI] INTERIOR. SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING ,gyp S (r'I ool. .jj.8f BUILDING ✓ ;✓ ' INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE" GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE" ) OCCUPANCY OF BUILDING ISNOTP ERMITTED UNTIL BUILDING FINA LI S SIGNED BY BUI LDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, oZ� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. CONST. TAX ,TOTAL i •.." ` OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY - BOIiILDINGPROJECT IOENTIFICATION /aPPLICATIONffiPERMIT BUILDING— ELECTRICAL— PLUMBING — MECHANICAL 15PERMIT NUMBER, lam, BUILDINGADORE OWNER' NAME�/y �jrE�_ .O 1/ " PRONE4y' , TY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION OMTE�RADTOR'S n I L/CO / V I � s Llc.rvo. �i UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S rrj�,r yn 3 45 41 ,ONE q 4c PPLIANCES- RESIDENTIAL 4.00 PANELS 0.00 ARCHITECT �i(�) 01�y ENGINEER LIC. NO. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARC F. OR ADDRESS ENG. ZIP SPECIALCIRCUIT 5,OQ PERMIT VALIDATION � 0 ISSUANCE DATE BLDG. ELECT. PLG. MECH. _11 EMP. METER OR POLE INS. 20.00 A ADDRESS AORE MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 '• LICENSED CON'T'RACTORS DECLARATION 1 hereby mhos Thal I am licensed underprovisions of Chapter9 (commencing with Section 7000) of Division 3 of the Business and IAIy nee is in full force effect Litell ClassSip—`j Lic. Number_ I'n>1'essions CoINFR-BUILDER Cotractor DfiCLA ' I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Business and Professions Code: An cit to its Ssume alter, Any City cot Pull which fracture, improve, demolish, or repair any structure, poor to its issuance, also he isles the applicant for such permit to file a signed statement that he is licensed pursuant m the provisions of the Contractor's License Law (Chapterand t therefromion 3 the Business and Professions Code) or that he is exempt therefrom and I'Toco signs Codeng with Section is 00) exempt the by any applicant lura permit subjects the applicant tea civil penalty nyaporthe slot aJermit faion.A the violation o loacionenalty ol'not more than five hundred Jollars1S500).T: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sal, IS&, 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of properly who builds or improves lhcreon, and who does such work himself or through his own employees, provided that such improve- .Cutsarenotintended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or int- prove for purpose of sale.). ❑ h as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, BusinessLAWN and Professions Code: 'f he Contractor's License Law does not apply to an owner of properly who builds or improves thereon, and who contracts for such projects with u contractorls) licensed pursuant to the Contractor's License Law. ❑ lam exempt under Sec. ', B.&P.C. for thisrelix011 MISC. — REFER TO ORD1F0 BUILDING PERMIT INFORMATION PERMIT ISSUANCE 10.00 ELEC. CONTR. UC. NO. 10 ELEC. N TOTAL QTY. PLUMBING PERMIT co ALTER -DRAIN & VENT -WATER (EA.) 5.00 LUATION - Ip 0® $/FT. PERMIT Tp � Ot ' // -- __ O �+` sZ STORIES- TYPE CONSTR. BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, CON D. 5.00 FIXTURES - PER TRAP 5,00 GAS - EA. SYSTEM -11NC. 4 OUTLETS 6.00 GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 SO. FT. FLOOR AREA TOTAL ACREAGE BUILDING USE RES IND CON PB Other INDUSTRIAL WASTE INTER. 30.00 SPRINKLERS - 1' INC 5 V.B. 6.00 ASSESSORS PARCEL N0. LAWNSPRINKLERS - OVER 5 (EA.) 1.00 SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 WORKERS'COMPENSA NON DECLARATION I hereby affirm that I have a certificate ofconsent to self insure, or a certificate of Workers Compensation Insumnc , or a cc ified copy thereof (Sec. 3800, Lab .C.I 7r- PolicY�b � Qnn ry_ fyCerlificdc y'sh• ryfur 1•d. ❑❑ C rtitic c i I� he speedo, division. 1 Applicant— _ - CER'I'IFI 'fie OF: iSxdbIPT101J 1*ROM WORKERS' COMPENSATION' INSURANC17 s,clio need not be completed if the permit is for ane dollars fS 100) or less.)I certify that in the performance of the work for which this per- not is issued, I shall not employ any person in any mannerso as to become subject to the Workers Compensation Laws of California. Date Applicant A,,Iic' ACC.DATE ACC. FILE NO. WATER TREATING EQUIP, 5.00 ' ZONING ENG. SITE NO. ' FIRE SPRINK Y [] N� ENERGY TY4 Y O N� MISC. - REFER TO ORD. PERMIT ISSUANCE •i6Q9 — IPLG.NTR. FLOOD ZONE N� A.L.U.C. v N�handfed UC. No. PLG.(This TOTAL �Y Y MECHANICAL PERMIT FEE FEE SUMMARY BUILDING (,,� Y -w ALTER OR ADD TO MECH. 5,00 NOTICE 'I'O AI'PI. IL after making this Certificate of fix- emption, you Should become subject to tile Workers' Compensation Provisions of the Labor Code, you must forthwith comply with such provisions or This permit shall be deened revoked CONST' RUC'f1ON L1iNDING AGENCY I hereby affirm that there is a construction lending agency for the P,rfornence nl' the work for which this permit is issued (Sec 3097, Civ.C.L Lender's Name Lender's Address I certify that l have read this epPlicatlon and slut, that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building Construction, and hereby authors a representative of this city to enter upon the above-mentioned property for inspection purposes. (We) agree t0 vv,, soden ify and keep harmless the City of "Perrino agar ]iabilities, �dgments, costs and expenses which ay in an accrue ug: t Said ly m consequence of the Oa o tha ennl��MECH. APPLIANCE - 5.00 PLAN CHECK FEE AIR HANDLING UNIT (TO 10,000C.F.M.) 4.00 AIR HANDLING UNIT(OVER 10=1C.F.M.) 6.00 SEISMIC FEE S0 EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC VENTILATION FAN (SINGLE) 4.00 BOILER- COMP 13 H.P. or 100,000 B.T.U.) 6.00 PLUMBING / BOILER -COMP IOve, 100,000 BTU) SEE FEE SCH. MECHANICAL MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX CONT. LIC. NO. MECH. -CONT. LIC. NO. MECH. . TOTAL TOTAL los -S Siyn' c fApplicam/Conlrador at OFFICE COPY