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15669POST THIS CARD'NEAR FRONT OF BUILDING ' CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD '• / ��./( c/ �.,I / S JOB ADDRESS-/Oli/ ./'/ V�-��yGc ✓V ''✓� UNIT# LOT# OWNER yv U 'CONTRACTOR �'-QO ,l/d"T ! PERMIT NUMBER 15669 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: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. ' UFER .. PR EGUNITE - PREGUNIT�E'. PERMIT VALIDATION„ �..' .•L. �= '�'` `'� / f I E," ,', t ISSUANCE DATE GARAGESLABS- POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - - - `-T .,UNDERGROUND/SLAB ; ',,.. PLUMBING ' - ELECTRICAL MECHANICAL , pp1 BLDGELECT. I ❑ ❑ PLO, MECH. ❑ O: DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED N9 IN OIRNG MATIONT .: WOOD FLOOR "1 va}u TION . SIFT. PLUMBING.'t- _ MECHANICAL .. ELECTRICAL • E,"(�.}'�T•T/o%%` FRAMING INSULATION � - � � _ � � STORI 1YPECONSTR. , NEC, GROUP 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 ACE CAGE DIAPHRAGM. ROOF SHEATHING. BUILDING USE , RES IND CON PB, 0,, ❑ ❑ ❑ ❑ ' ❑ " APPLY NO ROOFING-UNTIL ABOVE HAS BEEN SIGNED -FINALS DATE INSP. ROUGH SANA ASSESSURS PARCEL NO, PLUMBING. - ELECT. ENERGY. - TUBS PAN � _ PLUMBING ENERGY TRACT NO, PARCEL NO . MECHANICAL, . MECHANICAL, MECH.ENERGY ELECTRICAL .- BUILDING ENERGY ACC.DATE ' ,ACC. FILE NO - FRAMING ELECT. FINAL TEST .INSULATION-ZONING PLUMBING ENG. SITE NO. ` GAS TEST _ - GAS ' MECHANICAL FIRE SPRINK Y ❑ NEI, ❑ ENERGY T.7B ° ❑ , NL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE. ROODZONE Y❑ NEI A.LUC. `L -❑' INTERIOR,SHEAR FIREDEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH v t BUILDING,.. BUILDING Gf>?----• .INTERIOR 'LATH TEMPORARY APPROVALS SCRATCH COAT, - ELECTRIC .PLAN CHECK FEE OIr ' GAS NO TAPE OR P, LASTER UNTIL ABOVE, HAS BEEN SIGNED OCCUPANCY. SEISMIC FEE ^' Q01 OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED 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 MECHANICAL y CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE - CALLING FOR, FINAL INSPECTION.. TOTAL _S•�- OFFICE COPY, APPLICANT TO FILL IN'INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY .. BUILDING PROJECT IDENTIFICATION APPLICATION &PERMIT • ' - BUILDING - ELECTRICAL- PLUMBING - MECHANICAL ,PERMIT NUMBER p 15669 - •IW%N ADDRESS O 1' , .. OWNER'S NAME 1\4.P, w Ll I CITY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION " PHONE CONTRACTOR'S I NAMF_ UTLETS- SWITCHES -RECEP 10.00/1.00 P'"C'Coti C' _ - r' - -LIGHTING FIXTURES 10.00/1.00 CONTRACTOR CONTRAS*onsOOREss /mow' ^J l'_N " PPLIANCES- RESIDENTIAL 4.00 - py ' 2 PHONE 'Z•8 - DATE OF APPLICATION PANELS- '10.00 ARCHITECTon ENGINEER LIC. No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE .c. No. SIGNS TRANS. 3.00 n..cess ENG' SPECIALCIRCUIT 5.00 PERMIT VALIDATION EMP. METER OR POLE INS. 20.00 - • ZIP APPLICANT ADDRESS MOTORS 'SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION I hemby'aflirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business arld Professions Code d my license u in full fort mT In '4 License Class Lie. Number Num, [)are --(Contractor N W'� OWNER -BUILDER DECLARATION hereby affirm that 1 am exempt from the Contractor's Limens, Ww for the following reusnn. (Sec. 70JL5, Businwand Professions Code: Any city or county which requires a permit to construct, alter, ISSUANCE DATE BLDG. ELECT.- PLG. MECH. CW - BUILDING PERMITOWNER-BUILDER1 INFORMATION elIMMLUATION 'S/FT. ' f7 ` 'I MISS.- REFERTO D PERMIT ISSUANCE 10 0 ELEC. CONTE. LIC. NO. ELEC. TOTAL improve, demolish; or repair any structure, prior to its issuance, also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9(commencing with Section 7100) of Division 3 ofthe / PERM T TO ((--�� V/(, u Business and PH fcoions Code) or that Ile is exempt therefrom and QTY. PLUMBING PERMIT FEE STORIEEf TYPE CONSTR. the basis for the alleged exemption. Any violation of Sectwn 7031.$ by any applicant for a Permit subjects the applicant toa civil penalty of not mom than rive hundred dollars (SSOOL : ALTER -DRAIN -WATER (EA.) 5.00 ❑ I, as owner of the progeny, or my employees with wages as their sole compensation, will do the work, and the structure is not BACKFLOW PROTECT. DEVICE 4.00 O=GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 intended or offered for sale (Sec. 7044, Rusin. and Profession, Code: The Contractor's License Law docs not apply to on owner of ' FIXTURES - PER TRAP 5.00 property who builds or improves thereon, and who docs such work himself or through his own employees. provided that such improve- mems are not intended or offered for Sale. IC lmwevcq the building So. FT. ELOOR AREA TOTAL CREAGE , GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of confpletion, the owner- builder will have the burden of proving that he did not build or in,- prove for purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM - . .00 OVER 4 (EA) 2 BUILDINGUSE RES IND CON PB Other ❑ El ❑ El Q INDUSTRIAL WASTE INTER. 30.00 licensed contractors in construct the project (Sec. 7044, Business and Professions Codd The Contractor's License Luw dues not apply to an owner of property who builds or improves thereon, and who LAWN SPRINKLERS -,1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSE650R5 PARCEL NO. ' contracts for such projects with a contructods) licensed pursuant to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ Iain exempt under See ,B.&P.C. for this m,isOn WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM' - .' 5.00 ACG DATE ACG FILE NO. WATER TREATING EQUIP. 5.00 WORK CRS'CO.VPENSA'I' ION DECLARATION , I hereby atrirm that I have a certificate of corisont to self -imams. cale of Workers' Compensation Insurance, or a certilied certirins ZONING ENG. SITE NO. arpy tbcreof(See. 3800, Luh,C.), Policy No, Company J Y• ' ❑ Certified c h y fu niched. `` Certilied- y ed Ili Tif pity inspection division. A Ehc nt� \\----101 ' FIRE SPR INK YE] N0 ENERGY T40 Y[:] No MISS.- REFER TO ORD. CE RTI FICAI E OI' ii xEN7P-rhmTrnwwm'IiRs, PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.UC.' COMPENSATION INSURANCE (This section reed not be completed if the permit is for one YE]' N0 Y[:] N0 PLG. CONTE. LIC. NO. PLG, TOTAL hundred dollars (S 100) or leu.1 ' I certify ohms in.the performance .1 (lie workTor which this per-' mil is issued, I shall not employ any person in any manner so as to CITY MECHANICAL PERMIT FEE FEE SUMMARY BUILDING �. become subject to the Workeri Con,,mation laws of California. Date Applicant - ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICANT: If, after making this Certificate u( Ex- APPLIANCE5.00 c PLAN CHECK FEE emption, you should become subject to the Workers'Compensation provisions of the Labor Code, you must forthwith comply with such provinces or the permit shall be deemed revoked. AIR HANDLING UNIT (TO 10=C.FJA) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT (OVER 10 C.F.M.)6.00 SEISMIC FEE LSA I hereby affirm that there is a constrnetim, lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the pe,f.nnerce of HE, work for which this permit is issued (Sec. 3097, Civ.C.). MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.D0 Lender's Name \ Lender's Address HEATING UNIT 100,000 B.T.U.) 9.50 ELECTRIC I certify mai I have read this application and state that the above VENTILATION FAN (SINGLE) , 4.00 Inlbnn.1ma is correct. I agree to comply with all city and county ordinances and state laws relating in building construction, and PLUMBING - BOILER-COf•�813 H.P. or 100,000 B.T.U.) 6.00 hereby authorize 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 MISS. - REFER TO ORD. upertino against habllitius, judgments, costs and expenses which may in any w ec eta 'rel said City in Consequence of the ra of th ermi S G a -PERMIT ISSUANCE 10,1)0 CONST. TAX MECH, CONT. LIC. NO. MECH. TOTAL I TOTAL SSS �� Sign ureof - Date OFFICE COPY