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15342 POST THIS CARD NEARFRONT OF BUILDING - PERMIT NUMBER ; I CITY OF CUPERTINO 15342 . INSPECTION DIVISION JOB INSPECTION RECORD .� ..PERMIT EXPIRATION JOB ADDRESS 10750 :-FARALLONE DRIVE- UNIT.# LOT# PERMIT EXPIRES IF-WORK ' WEIGHT WESTW60D DESIGN OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU. FOUNDATION - ANCE OR 180 DAYS," OM NOTE: LASTCALLED INSPECTION. LIFER ALL GRADING G AND DRAINAGE SHALL BE INSTALLED PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CIN OF PERMn VALID N GARAGE SLABS CUPERTINO STANDARDS: { ! ' - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 3-1(o- hocl� IIc ex cep UNDERGROUND /SLAB QeNdiN YOJct� o� ",A fy + Q �Q;;: � y PLUMBING - ELECTRICAL - City Of PIInort SUANCE DATE MECHANICAL BLDG ELECT PLG. NIECE +' - ❑ ® ® -� DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION -WOOD FLOOR - VALUATION SBFT. PLUMBING., - MECHANICAL - ELECTRICAL II vERrI ro FRAMING. .. LI1 !.I 'I .INSULATION - - SIORI S IYP.ECONSTR. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS-BEEN SIGNED SO FT FLOOII AREA TOTAL ACREAGE - • ROOF' NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING us ROOF SHEATHING - - I+es Irvu cCN PB OILY. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE ' INSP. ❑ ❑ ❑ ❑ ❑ ' ROUGH SAN.k ASSESSORS PARCE L NO _ � '• PLUMBING ELECT. ENERGY _ TUBS&SHOWER PAN , - PLUMBING ENERGY TRACT No, PARCEL No MECHANICAL MECK ENERGY ' • ELECTRICAL BUILDING ENERGY - ' HCC.DATE ACEFILE NO FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION � PLUMBING " GAS TEST - GAS " FIRE SPRINK ENERGY TQG MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - Y - "� ` ❑ "0 EXTERIOR SHEAR ELECTRICAL RELEASE FLooD zarvEA.L u.c. INTERIOR SHEAR FIRE DEPT. Y❑ "❑ ° ❑ "❑ SHEETROCK' - GRADE FEE SUMMARY EXTERIOR LATH BUILDING oc INTERIOR LATH -TEMPORARY APPROVAL BUILDING SCRATCH COATELECTRIC PLAN CHECK GAS FEE NO-TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE OCC UPANCYOF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL IS SIGNEDBY BUILDING INSPECTOR. MICROFILM ELI ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC c5- • ONE WORKING DAY BEFORE REQUIRED INSPECTION. / PLUMBING 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. _ 1 Z - SEE PERMIT MECHANICAL FOR EXPIRATION DATE - IMPORTANT! oNST.TAX PLEASE.READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY ' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LD1 NG PROJECT I DENT[FICATI ON .PERMIT NUMBER BUILDING APPLICATION & PERMIT - ADDRESS ' 15 3 4 2 [6*,s- rA-> �[,(O Al BUILDING - ELECTRICAL-PLUMBING -MECHANICAL OWNERS NAME • , - PLAN CHECK VALIDATION OTV. ELECTRIC PERMIT FEE (,JY.f ONE CONTRACTORS 'S NAME [O UTLETS-SWITCHES-RECEP 10.00/1.00 '19 f - ­ Yliszlli, LIGHTING FIXTURES 10.00/1.00 I. DoRs ADDRESS PPLIANCES-RESIDENTIAL 4.00 ORE55 [(00 Zan PNONE 2 -,$]O PANELS 10.00 DATE OF APPLICATION OORRCNITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE _C.NO. ENGINEER LIC.No. ISIGNS TRANS. 3.00 nooaEss cute. - SPECIAL CIRCUIT' 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 1.AID APPLICANTS MOTORS SEE FEE SCH. Y • CkMh��I DOR E55 116,11) L.CWI �� �[ SERVICE CHANGE 20.00 o a LICENSED CONTRACTORS DECLARATION - Q 5 u 1 hereby a0inn that I am licensed under provisions of Chapter 9 I CunArliMUANCE DATE 2 "' (commencing with Section 7000)of Division 3 of the Business and res< N BLDG. E ECT. PLG. MECH. F 3 z Professions Codyy,a�nd qqry license ism full fort d�fje - ❑ 2 0 2 - License Class Y.GM Lie.Number- JC7 O Z F° Dmc Col..mclor. rIl ¢ y E ¢ ¢ ¢ OWNER-BUILDER DECLARATION BUILDING PERMIT a o a U INFORMATION X 3: LL H 1 hereby affirm that 1 am exempt from (lie Contractor's LicenseMISC.- REFER TO ORD I Loa Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 VALUATIONr S/FT. Code:Any city or county which reyuirna permit toconslnml,alter, a ¢¢ 0 improve,demolish,or repair any structure prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. 0 ¢ requires the applicant fur such permit to file a signed statement That TOTAL 6 w m LL he It 111nzed IIUrNlant to die proiisions Oftlle Contractor's License 'PERMIT TO Law(Chapter 9(commencing with Section 7000)of Division 3 of the 1Ei'� �IC/11 a Business and Professions Code)or that he is exemprtherefrom and QTY. PLUMBING PERMIT FEE II 4-L.� N1�{� ¢ = $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a ; by any applicant far.'unlit subjects the applicwlt wacivil penally ALTER-DRAIN -WATER IEA.) 5.00 of not more than Live hundred dollars(55000.): ❑ I,a.owner of the property,or my employees with wagesas BACK FLOW PROTECT. DEVICE 4.00 OCG GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or uttered for sale(Sec. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code: The Contractors License law don not apply to an owner of . property who builds or improves thereon.and who does such work FIXTURES-PER TRAP 5.00 Ll 5O.FT FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve- memsara not iolcuded or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC,40UTLETS 6.00 •t or improvement d'Vdd 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 purpox,ofsaleJ. INDUSTRIAL WASTE INTER3000 RES IND CON PB Other . . ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ - ❑ licenwd contractors In construct (lie project(Sec.7044,Business LAWN SPRINKLERS-11 INC 5 V.B. 6.00 ASSESSORS PARCEL NO, f and Profecriots Code:The Contractor's License Law 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 contractariso licensed purnenl to A the Cot tractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.&P.Cforthis WATER HEATER W/VENT 6.00 teasers Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO, WORKERS'COMPENSA'I ION DECIARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate ofconsent to self-insure, or a certificate of Workcri Compcnmtion Insurance,or a certified ZONING ENG.SITE NO, copy thereof(Sec.3800,Lah.CJ, Policy No. Company Q ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z ❑ Certified copy is Bled with the city inspection divisimt. MISC.- REFER TO ORD. O Applicant Y❑ N❑ Y ❑ N❑ CC y CERTI FICATE 017 EXENIP PION FROM WORKERS' PERMIT ISSUANCE 10.00 •� FLOOD ZONE A,L.U.C. LL > . ' COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL O (This Kction need nut he conyrleted if the pennh is for un4 TOTAL �L7 V E] NE] V❑ NE] �•Z hundred dollars(SI00)orless.) U O 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY H It is issued, 1 shall not employ any 'arson in any moaner su as to 0U Nconm subject to the Wnrkera'Com,cuidiun LawsotMc 'Carniu. n Date Applicant - ALTER OR ADD TO MECH. 5.00VE } w NOTICE TO APPLICANT: If,eHcr making this Certificate of lix- F = cardion,you should become subject to the Workers'Compensation -0 APPLIANCE 5.00 provisions of IIIc labor Code, you most forthwith comply with U such provisions or this'crmit shall be deemed revoked. AIR HANDLING UNIT(TO 10AOOC.F.NL) 4.00 CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10 OOC.F.M.) 6.00I lenity_affirm that there is a constitution lending agency 1ot EXHAUST HOOD (WITH DUCT) 5.00the performance of the work for which this permit is issued(See.3097,Civ.0 u HEATING UNIT(TO100,000 B.T.U.) 8.00 Lenders Name HEATING UNIT(OVER 100,000 B.T.U.)9.50Lender's AIf �`� ( certify that lhave read this application and state that the above VENTILATION FAN (SINGLE) 4.00 . information n correct, I s rel to comply with all construction, city and county BOILER-CCINW(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances ar and state laws relating to building const r u on and hereby mentioned roperty tar fives of this city es enter upon tire BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL abovo-mentioneJ property for inspection purposes. (We) agree to save, indemnify and keep arless me City of misc.- REFER TO ORD. on y liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 -CONST.TAX nayy in anyy way accrue against said City In consequence of the .ling of this permit MECH.CONT. LIC.NO. MECH. ' Ems.•/a.v1 /7 t> 3-9-8P TOTAL TOTAL Ignature of Applicant/Contractor - Date �� OFFICE COPY