Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
6124
CITY OF CUPERTINO INSPECTION RECORD (OFI;ICE COPY) 61Rgo. 10392 Los Ondos Way P� 4ght Swinter OWNER PERMIT ISSUED DATE "ELECTRICAL DATE INSP. ui ink Electrical Plumbinjz Power Pole mcnanical un Temp as ec u RTW:nil Solar Ivalls Fire Sprinkler Ceiling Sign Fixtures Int/Ext Motors Misc. roun in e ower er FINAL INSPECTIONS DATE INSP, Not .Approved Gas Electric Plumbing "PLUMBING DATE INSP. anica Solar Backflow Awool r un �r in r Fun Planning Partialou ire a t. u ete eat a t. Solar u m in9 Water '4 Insulation er in ain 176-f 7Main Uas Other BUILDING DATE INS,P, Not rove Pad Certification Foundation ELECTRICAL DATE INSP. Pre-Gunite glab-Membrane Underfloor S.M. Bond Beam DYcts nsu ation Undertloor Girders Fire Fors Floor Steel ace ie owns Grease ct & Hood erams - t Esmecbracn Condensate Drain s- ane s — ui ent Anchorage rare RIOr Lath er allboards lnt/Ex-t. Not rove • rew s est er Net Approved APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY • BUILDING PROJECT IDENTIFICATION ' PERMIT NUMBER BUILDING . APPLICATION & PERMIT ADDRESS 103 9Z(� • - L40S ©IJI)CM %A BUILDING-ELECTRICAL-PLUMBING-MECHANICAL 6124 OWNER'S PLAN CHECK VALIDATION NAMEiswlfxrS , ' •�-�9 QTY. ELECTRICPERMIT FEE /3 2 T' • J vRDrvE rQ--e� CONTRACTOR'S (/ NA^ME_'- Q 'r UTLETS-SWITCHES-RECEP 5.00/1.00 GAV7&gUIFJ1_(BL0i1 LIC.Nu. / S'- LIGHTING FIXTURES 5.00/1.00 iADORE CONTRACTOR APPLIANCES-RESIDENTIAL 4.00 ; ,I Shen�SUVNL PHONE 2, 0404frif PANELS 5.00 DATE OF APPLICATION ARCHITECT - - - PLAN CHECK7 P.C.NO. DR - SIGNS 6.00 ENGINEEn LIC.NO. SIGNS TRANS. 3.00 ARCH,OR ENG. PERMIT VALIDATION ADDRESS SPECIALCIRCUIT "5.00 "nP EMP.METER OR,POLE INS. 15.00 (� ADDRESS MOTORS SEE FEE SCH. J + SERVICE CHANGE 10.00 woo LICENSED CONTRACTORS DECLARATION !/ Fi w I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE N (commencing with Section 7000)of Division 3 of the Businessand - BLOG" ELECT. PLG. MECH. r y z Professions Code nd y license is in full fo t o i w License�7,�y Cm Numbo _ ❑' Dale_] Contmcto(-2-g�..�'�-'� ' a m BUILDING PERMIT ao i D OWNER-BUILDER DECLARATION' - INFORMATION w ; r I hereby affirm that 1 am exempt from the Contractor's License MISC. REFER TO ORD Fwov, Law for the following reason. 703 t.5,Business and Professions . PERMIT ISSUANCE 6.00 VAL E/FT. Code:Any city or county which requiresa permit to construct,alter, p Q O improve,demolish,onrepair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. - / O, requires the applicant for such permit to file a signed Statement that - TOTAL UU rQ R Ir -r E $ he is licensed pursuant to the provisions of the Contractor's License U4 /� H2 > Law(Chapter 9(commencing with Section 7000)of Division 3 of the Q Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE M sem- the basis for the alleged exemption.Any violation of Section 703 LS SIPMEI01 VU IUMPIRACONSTR. a ;$. by any applicant for a permit subjects the applicant loacivil penally ALTER-DRAIN -WATER (EA.) 4.00 of not more than five hundred dollars(8500).): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 2.00 'OCC.GROUP RES.UNITS - their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044• Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 4.00 Code:The Contractor's License Law does not apply m an owner of ' property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 4.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improse - • mcnts.,c or intended or offered for sale.If,however,the building GAS-EA.SVSTEM-GAS4.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-'OVER 4'(EA.) 1.00 BUILDING USE builder will ha4e'0e.bunlem of proving Dml he did not build or im- RES IND . . CON PB m Oer prove for purpose of sale.). INDUSTRIAL WASTE'INTER2000 ❑ I,as owner of the properly,am exclusively contracting with 1:1 [31 ❑ ❑ 1:1licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 5.00 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 Cocontracts for such projects with a contramorls)licensed pursuant to the Contractor's License Law. A:SEWER-SANITARY-STORM E200ft/8.00 TRACT NO. PARCEL NO. the Cl I ams exempt under Sec.' 1 B P.C.lot this WATER HEATER-W/VENT 4.00 reason Owner Date WATER SYSTEM 4.00 ACC,DATE ACC.FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 4.00 I hereby affirm that I have a cerliftcale of consent to scibboure, - or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thane fp_(4crt3j{f 1R amy 1.Rw..,�. . Policy ere its'Ldr_f'dmpuny 0 Cl ('yflifYed copy is hereby furnished. FIRESPRINK ENERGY T-24 Z Z C tlifte �I lie inspection division. O Applicant s.�a�/��` MISC.- REFER TO ORD. Y ❑ N❑ Y❑ N❑ inT CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE - 6.00 FLOOD ZONE A"L.DC. Lu > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG.+ Y❑ NE] Y❑ N❑ d O (This mction need not be completed if the permit is fur one _ TOTAL Z hundred dollars IS 100)or less.) s U O I certify that in the performance of lire work for which this per, CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. fa 0 i Date Applicant ALTER OR ADD TO MECH. 4:00 BUILDING } N NOTICE 'rO APPLICANT: if,after making this Certificate of Ex- F- Z emplimt,you should become subject to the Workers'Compensation APPLIANCE 4.00 PLAN CHECK provisions of the Labor Code, you must forthwith Comply with FEE (� such provisions or this peimit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.). 3.00 AIR HANDLING 5.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY LING UNIT(OVER 10CeS I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 2.00 the performance of the work for which this permit is issued(Sec. MICROFILM ;3097•Cv.C.). . .// HEATING UNIT ITO 100,0008.T.U.) 4.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.17.50 ELECTRIC Lender's Address ' I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 3.00 - • information is correct.I agree to comply Willi all city and county' PLUMBING ordinances and slate laws relating to building construction, and ' BOILER-COMP(3 H.P.Dr 100,0008.T.U) 4.00 hereby authorize representatives of this city to en let#upon the 1B IS (Over 100,000 BTU)SEE FEE SCII. MECHANICAL above-nom ioned property for inspection purposes. - (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may in any way accrue against said City in consequence of-the PERMIT ISSUANCE 3.00 granting of this permit. MECH.CONT. - LIC.NO.. MECH. TOTAL TOTAL Signature ul APPlicanl/Contractor Date JI OFFICE COPY - - I -