The URL can be used to link to this page

12851 POST THIS CARD NEAR FRONT OF BUILDING, . PFRMIT NUMBER CITY OF�CUPERTINO ,. ' 1285 . . INSPECTION DIVISION JOB INSPECTION RECORD, ; ' PERMIT.EXPIRATION JOB AODR ESS It, UNIT4* LO #- PERMIT EXPIRES IF WORK OWNER CENTFACTOR `' IS NOT STARTED,WITHIN . INSPECTION DATE INSPECTOR INSPECTION RE-CORD r 180 DAYS OF PERMIT ISSU- -- ANCE OW,180 DAYS FROM . FOUNDATION - _ LAST CALLED INSPECTION. ,4 UFER PREGUNITE - PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB / PLUMBING ELECTRICAL - _ ISSUANCE DATE MECHANICAL • eLDc. ELEcr,. PLc. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - - - - BUILDING PERMIT INFORMATION WOOD FLOOR .,VALUATION $IFT. PLUMBING ,J MECHANICAL - _ PER IT TO - ELECTRICAL- 2 FRAMING ST T:'t _• - - � Y STORIES TYPE CONSTR. INSULATION • A LL OCC,GROUP. RES.UNITS p PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF SO,FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM Buamnc USE 1 RE IND, , CON PB DII," APPLYAO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH' - • I - , PLUMBING - 7. ' GAS TEST - TRACT NO. PARCEL NO, MECHANICAL - - ELECTRICAL I 14' _ FINALS DATE INSP. ACC.DATE . Acc FILE no; FRAMING SAN E TND INSULATION PLUMBING ZONING ENG.SITE . .. GAS ' - MECHANICAL 'FI RE SPRINK, ENERGY T 14 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING "� ❑ No ' LATH—INTERIOR - ELECTRICAL FLOODZONE A.L.U.C. LATH—EXTERIOR - FIRE DEPT.' i - Y ."EI I v I] "❑ SHEETROCK - GRADEFEESUMMARY SHEAR INTERIOR - BUILDING. -SHEAR EXTERIOR TEMPORARY-APPROVALS +'- BUILDING �� FIREWALLS ELECTRIC PLAN CHECK' GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY ' SEISMIC FEE P'LJ. OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE'FOR INSPECTION BY PHONING 252-4505,, 4,' ELECTRIC' F-0 ONE WORKING DAY BEFORE REQUIRED!INSPECTION. PCUMBwG PLEASE GIVE JOB ADDRESS WHEN PHONING. Z .MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — IMPORTANT.! coNsr.rnz PLEASE READ REVERSE SIDE BEFORE TOTAL ✓ .It{ i CALLING FOR FINAL INSPECTION: - - OFFICE COPY ' ' - APPLICANT TO FILL IN INFORMATION WITHIN REDLINES _ USE BALLPOINT PEN ONLY. @UILDING PROJECT I DENT[FICATI ON PERMIT NUMBER X -HVEN APPLICATION & PERMIT `M1 OWNERS`7g0 JO Id"N (JTZ-. BUILDING-ELECTRICAL-PLUMBING-MECHANICAL _ 12851 WNEPHonE RS -7'/ TY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION 3 7 L g6y0 Q I�- o CONTRACTORS ^�� NAME /1 ,{ p OUTLETS-SWITCHES-RECEP 10.00/1.00 LIC.No,442 Of LIGHTING FIXTURES' 10.00/1.00 CONTRACTORS PPLIANCES-RESIDENTIAL 4.00 ADDRESS OeS '� cam• y piJv FHDNEJO 7O "(6rd PANELS - 10.00 DATE OF APPLICATION RCNrtECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. OR D ENGINEER LIC.No. - SIGNSTRANS. 3.00 noCH.OR END. SPECIAL CIRCUI 5,00 PERMIT VALIDATION ZIP EMP. METER ORP 20.00 _ ) APPLICANTS MOTORS SEE FEE SCH. ADDRESS , " SERVICE CHANGE IDD 20.00 �oo LICENSED CONTRACTORS DECLARATIONI �3/�� U u 1 hereby affirm that I am licensed under provisions of Chapter 9 n<"' (commencing with Section 7000)of Division 9 of the Business and _ E 1--PLG. - MECH. r w Professions Code, d my license is in full fospoj efl'ec1 rJ z O Liwnu Cl u s Lic.Number-��y�9'G ❑ w Uute��j�f Contractor V'81UTLDIh1b3 PERMIT E'p w u 'OWNER-BUILDIiR DECLARATION INFORMATION I hereby affirm that'I am exempt from t he Contractor's License MISC.- REFER TO ORD LLo ¢ Law forthe following reason. 7031.5,Busmessand Professions PERMIT ISSUANCE .10.00 C) VALUATION $/FT. Cotte:Any city or county which requires a permit to constnmt,alter, J p p Y prior t0 its issuance,a15U ELEC.GONTR. '" LIC NO. 2 a ¢ 0 improve,demolish,or repair h structure,p TOTAL /fs / D¢ requires the applicant for such permit to file a signed statement that - TOTAL PERMIT TO u w m r he is licensed pursuant to the provisions of the Contractor's License H 2 Law(Chupler 9(commencing with Section 7000)of Division 3 of the ' r ,��,Q ¢ Business and Professions Code)or that he is exempt therefrom and OTY, PLUMBING PERMIT FEE Q 1-$ the basis for the alleged exemption.Any violation of Section 7031.5 r 9TORIES TYPE CONSTR. by any applicant for a permit Subjects the applicant toa civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more(Iran five hundred dollars(E500L): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEV ICE 4.00 OCC,GROUP RES.UNITS their sole cotnpensmion,will do the work,and the structure is ron intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of • property who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself(ir through his own employees,provided that such improve. meats are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.4OUTLETS 6.00 or improvement is sold within nue year of completion, the owner. GAS-EA.SYSTEM-.OVER 4 (EA.) 2.00 - buBtler will have the burden of proving that he dill not build or iso. _ BUILDING USE prove for purpose of sale.). I INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB- -Omer ❑ I,as owner of the property,um exclusively contracting with ❑ ❑ Cl ❑ ❑ licensed contractors to construct the project(Sec.7044,BUSUICss LAWN SPR INKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions 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 contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEUNO. ❑ I am exempt under Sec.. ,B.&P.C.to,this WATER HEATER W/VENT 6.00 reason Owner _ ,Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have'.certificateof consent to self.iroum, •ZONING ENG.SITE NO. or a certificate of Workers:Compenwtion Insurance,or a certified l� copy Ihereof(Sec.3800,Lab.C.).rTt Z:: Policy N Company _ Q ❑ trifled ' is hereby turn is c FIRE SPRINK ENERGY T 24 Z- .❑ is filed witl in, division. MISC.- REFER TO ORD. O Apphe � V ❑ N❑ Y ❑ N❑ rn PERMIT ISSUANCE 10.00 � - CERTI -CA'I'E OF IiXEMPTION FROM WORKERS' FLOOD20NE LU - OMPENSATION INSURANCE PLG.CONTR. .LIC.NO. I.G. 'CL a (Phis section need not be completed it the permit is for one t I TOTAL Y❑ N❑ Y❑ N❑ hundred dollars'($100)orlessJ' U O I certify that in the performance of the work for which Br's per. OTY MECHANICAL PERMIT FEE FEE SUMMARY LL F Hilt is issued,I shall not employ any persnn irfany planner so as IU O W become subject to the Workers'Compensation Laws of California. rn Date-Applicant BUILDING V } tail NOTICE TO APPLICANT: If,after making this Cerlificam of E.- ALTER OR ADD TO MECH. 5.00 F. Z emlption,you should become subject to the Workery Compensation APPLIANCE _ 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE . U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 CONS'I'RUCI'ION LENDING AGENCY AIR HANDLING UNIT(OVER 10DWC.F.M.) 6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.L HEATING UNIT(TO 100,000 B.T.U.) Boo �/�� Lender's Name HEATI NG UNIT(OV E R 100,000 B.T.U.)9.50 ELECTRIC 44 -•�' Lender's NameAddre - I certify that I have read this application and state 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 to building corls(rumion, and BOILER-OOMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city, to enter upon the BOILER-COMP(Over t0n,0008TU1 SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We).agree to sav indenmify and keep Kann less the City of MISC.- REFER TO ORD. f 0 against Iia li' 'udgnnenls, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX any way u e a, I Said City in consequence of the tin of this per MECH.CONT. LIC.NO. MECH. '14ee7 TOTAL TOTAL S' re of Applicant/Contractor ate , OFFICE COPY