The URL can be used to link to this page

9108J - POST THIS CARD NEAR FRONT OF BUILDING Y CITY OF CUPERTINO �. INSPECTION DIVISION J/�J JOB I)N%SPP/EjCTT16N RECORD , JOB ADDRESS lO�o 45 - wo , 'vV Te. UNIT# LOT# - OWNER CONTRACTOR PERMIT NUMBER 9108 PERMIT EXPIRATION 'PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 190 DAYS FROM LASTCA AVPV PECTION. INSPECTION DATE INSPECTOR INSP�TION RECORD ��y € ' ff,Z_��i V'H Qy_YCo.+.�iAla.d. FOUNDATION „y UFER PREGUNITE PERMIT VALIDATION JU►N 2 0 165 ' uty,OtcuaB&O - . ISSUANCE GATE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ' UNDERGROUND/SLAB. PLUMBING ' ELECTRICAL MECHANICAL • BLDG. ELEcr. vLG MECR DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED'BUILDING - PPE mIT / INFORMATI N WOOD FLOOR' PLUMBING - VALUATION - S/FT. MECHANICAL - ELECTRICAL - PERMIT TO j t-•] 1 T 1tI. Al FRAMING INSULATION" STORIES TYPE CONSTR. OCC. GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO. FT. FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE RES IND CON PB Ow" (jrj ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH - l ASSESSORSPARCELNO. - - PLUMBING GAS TEST. - TRACT NO, PARCEL NO. MECHANICAL ELECTRICALFINALS 'DATE INSP. ALC. DATE ACG FILE NO. FRAMING SAN # - INSULATION ��/'�: PLUMBING - zoNlNc ENG. SITE NO.. GAS COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED MECHANICALFIRE HEATING / SPRINK Y ❑ N J❑ ENERGY Ljd. Y ❑ N❑ LATH -INTERIOR LATH -EXTERIOR r)_ ,S' ELECTRICAL - FIgE E FLOODZONE v❑ N❑ A.L.U. C. v❑ No SHEETROCK FEE SUMMARY SHEAR INTERIOR BUIL IN L BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS .ELECTRIC PLAN CHECK GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANC" Y OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY'PHONING 252-4505, o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING r MECHANICAL . - IMPOATANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. CONST. TAX TOTAL ��—��• OFFICE COPY 1 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ON_ LY BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICA ERMIT NUMBER 1 08 aUILEING . ADDRESS lel Efl�'TEs'TftTES D,e CANNOT NAME�f AlIKEE/✓DFpS PHONE J�4 O ELECTRIC PERMIT FEE P' HECK VALIDATION DATE OF APPLICATION CONTRACTOR N NAME - wsF 9LC/CrEe LIC. No 3OUTLETS -SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 roNTRacrona SAN vSE • AOOREss . �3 -7i 7S -Z 9'7 DoucLRNF qVdF PHONE APPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 ARCHITECT OR ENGINEER Lm. No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ADDRESS ENa ZIP SPECIALCIRCUIT 5,00 PERMIT VAf1#1EW O 19a� pQ yin p1yx' DI "UQe„ ISSUANCE )DATE rrEMP. METER OR POLE INS. 20.00 APPLICANT'S APPLICA Cd 01)C. AdC VL' U� /I f✓ t�iC MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 Of the Business and Professions CoJ • rid my license is in lull for' • 'c License Class Lic. Number Date + Contractor - OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason, (Sec. 7031.5, Businessand Professions Code: Any city orcounly which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also 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 7000) of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by of artmlic:un for a permit dollars $500r)icant too civil penalty of nm more than five hundred dollars (my employees ❑ I, as owner of the property, or my employees with wages as their sole compensal ion, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: TheContractor'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 improv ments are not intended cur 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 im- Prove for purpose of sale.). ❑ I, as owner of file property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, BusinessEl and Professions Code: The Contractors License Law does riot apply to an owner of property who builds or improves thereon. and who contracts for such projects with a contructons) licensed pursuant to the Contractor's License Law. ❑ lam exempt under Sec. ,B.&V.C. for this reason TEMP. POLE 30.00 BLD E E L MCH BUI DING E MIT INFORMATION MISC. - REFER TO ORD PERMIT ISSUANCEYALUATION 10.00 py,�. J / v V 0 $/FT. ELEC. CONTR_ LIC. NQ ELEC. / TOTAL PERMIT TO , ��-'1 I I/ ' 1 N V D. QTY. PLUMBING PERMIT FEE ALTER -DRAIN & VENT -WATER (EA.) 5.00 STORIES TYPE CONSTR. BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 FIXTURES -PER TRAP S.00 GAS - EA. SYSTEM -1 INCA S GAS - EA. SYSTEM -OVER 4 IEA.1 2.00 SQ FT. FLOOR AREA TOTAL ACREAGE BUILDING USE IND CON PB Other El El 0 ASSESSORS PARCEL NO. INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - 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 W'ORKF;RS'COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self -insure. or a certificate of Wurkers' Compensation Insuran11",ce, or a cal'ier ed copy thereof ISec. 3804 Lab.C.l. �"-j�}_ 6 Policy No. Company ACC. GATE ACG FILE NO. WATER TREATING EQUIP. 5.00 ZONING ENG. SITE NO. ❑ Certified copy is hereby furnished. . Cc tifmd ,espy s fled wity..ey ity ins edion division. Applicant "� '�/ I js FIRE $PRI K Y [3 N ENERGYT24 Y C] IN MISC. - REFER TO ORD. CERTIFICATE OI' EXEMPTION FROM WORKERS' COMPENSATION INSURANC17 (This Section need not be completed if the permit is for one hundred dollars (S 100) or less.) of the work for which this per. 1 certify that h the to employ mit is issued, I shall not employ any person in any manner so i to become subject to the Workers' Compensation Laws of California. Date PERMIT ISSUANCE FLOOD ZONE Y [] N� AL. U.C. Y 0 NE] PLG. CONTR. LIC. NO. PLG. TOTAL Q y MECHANICAL PERMIT FEE FEE SUMMARY BUILDING % I Applicant NOTICE you APPLICANT: If, after making this rs' Compe sa ion em vision you should become subject to the Workers' Compensation Provisions io the Labor Codc, you must forthwith comply with Stich provisions or this permit shall be Acemed revoked. CONSTRUCTIONLENDINGAGENCY I hereby affirm that there is a construction lending agency tier the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). Lender's Name ALTER OR ADD TO MECH. 5.00 � APPLIANCE 5.00 PLAN CHECK FEE /� ) lip / - AIR HANDLING UNIT (TO 10,000GF.M.) 4.00 AIR HANDLING UNIT (OVER 10,000 CEM.) 6.00 SEISMIC FEE EXHAUST HOOD (WITH DUCT) 5,00 MICROFILM HEATING UNIT 170100,000 B.T.U.) 8.00 Lenders Address HEATI NG UNIT (OVER 100, 000 B.T.U.1 B.50 ELECTRIC 2-g I certify that I have read this application and state that the above information is carred. ate lI agree to comply with all city and county ordinances and saws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting rs pumif L SS f]acror VENTILATION FAN (SINGLE) 4.00 BOILER- COMP(3 H.P. Or 100,0008.T.U.) 6.00 ' PLUMBING BOILER -COMP Over loo,000 BTU) SEE FEESCH. MECHANICAL MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT, LIC. NO, MECH. TOTAL/�w'?> (/fes TOTAL li 1. Sign re of Apphcanl/Contractor Ua[e OFFICE COPY