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14676-'POST THIS CARD NEAR FRONT OF BUILDING ,CITY -OF CUPERTINO_% . INSPECTION DIVISION JOB INSPECTION RECORD, -• - JOB ADDRESS 7ap,�_ Z— C'7 'UNIT LOT# - - OWNER A vi car&,j- CONTRACTOR PERMIT NUMBER 14676 PERMIT EXPIRATION '•- ' PERMIT EXPIRES IF WORK IS. NOT STARTED WITHIN , 180 DAYS OF PERMIT ISSU - ANCE OR 180 DAYS FROM LAST CALLEDTNSPECTION. - INSPECTION— DATE I INSP CTOR INSPECTION RECORD FOUNDATION - _ .. NOTE:' - ALL GRADING AND -DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER- - PREGUNITE ' - - •PERMIT VAODATION '� 1ssuANce.uATe GARAGESLABS'' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING +.. + � � '•'� ELECTRICAL - � MECHANICAL M - BLDG El ELECT, El PLG. MECH.I )CJ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - ' - BUILDING PERMIT INFORMATION - WOOD FLOOR ,. - VALUATION S/FT. PLUMBING MECHANICAL ELECTRICAL - //' PERMIT TO /ld,y/ FRAMING c �FIVE INSULATION - - STORIES TYPE CONSTR. OCC. 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 ACReAGE DIAPHRAGM- - • ROOF SHEATHING BUILDING USE RES' IND CON PB O,o.•, D D D D' D APPLY NO ROOFING'UNYIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. � ROUGH � � � SAN.N ASSESS QRS PARCEL NO - I PLUMBING ELECT. ENERGY - - TUBS &SHOWER PAN PLUMBING ENERGY TRACT NO. PAR , CEL NO MECHANICAL MECH.ENERGY - ELECTRICAL t - %P5 BUILDING ENERGY ACC. DATE ACC. FILE NO ' FRAMING - ELECT. FINAL TEST' y- 'INSULATION. ,f�g PLUMBING - - ' ZONING ENG. SITE No. GAS TEST GAS • MECHANICAL FIRE SPRINK Y LJ "� ENERGY T 34 - Y. D "� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - EXTERIOR SHEAR -, � � � ELECTRICAL RELEASE � FLODD ZONE .. r,❑ N❑ A.L U: C. - � YD A'D INTERIOR SHEAR - FIRE DEPT. SHEETROCK Q.CC '(•V ��_ 8 .GRADE - FEE SUMMARY EXTERIOR LATH coffer, Lo 10-31— BUILDING - BUILDING r- " - INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC - PLAN CHECK .FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - .SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUI LDING FINAL IS SIGNED BY BUILDING INSPECTOR- MICROFILM ARRANGE FOR INSPECTION:BY PHONING 252-4505, .. H ONE WORKING DAY BEFORE REQUIRED INSPECTION. C� PLEASE GIVE JOB ADDRESS WHEN PHONING. Z —SEE PERMIT FOR EXPIRATION DATE = . ` ELECTRIC PLUMBING MECHANICAL coNsr. TAX IMPORTANT! - , PLEASE READ, REVERSE SIDE BEFORE ° CALLING FOR FINAL INSPECTION. TOTAL C� 4' OFFICE COPY. -,APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY t U Y, O Z z H O' cc LU _ G_ =)z UO U. U Ow >_N F - LE -BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 14676 BUILDING ADDRESS 5� LCL CT L OwyN1§E R'S (ffJ - ///,W (r/�j /i%r CWI76S-Z232_ . PHONE 4oqG QTY' ELECTRIC PERMIT FEE - PLAN CHECK VALIDATION NAMEEnGToaa UTLETS-.SWITCHES- RECEP- 10.00/1.00 - LIC. No. LIGHTING FIXTURES 10.00/1.00 6 ` CONTRACTORS ADDRESS' PPLIANCES-RESIDENTIAL 4.00 PANELS 10.00 PHONE DATE OF APPLICATION onCHITECT ENGINEER LIC. No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 nouFEss ENG. SPECIALCIRCUIT 5,00 PERMIT VALIDATION TEMP. METER OR POLE INS, 20.00 z y Iy✓ (,� P. r `/&/4 ADORES / kz . r MOTORS SEE FEE SCH. �,,, SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION .. I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect License Class Lie. Number Date Contractor n tds SY V ISSUANCE DATE - BLDG.- 1.1 �I 'ELECT. PLG. MECH. ' s ;LyJP - - - - OWNER -BUILDER DECLARATION I hereby affirm that I eat exempt from the Contractors License Law for the following reason. (Sec. 7031.5, Business and Professions Code: Any city or county which requiresapermit to construct, after, BUILDING PERMIT INFORMATION ' MISC:- REFER TO ORD VALUATION - $/FT. PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. ELEC. r� TOTAL 3xS^ 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 of the Business and Professions Code) Or that he is exempt therefrom and q ( / PERMIT TO ` �Ey A?T4,y QTY. PLUMBING PERMIT FEE 1 STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (8500):): . ALTER -DRAIN -WATER (EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not ' BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who docs such work himself or through his own employees, provided that such improve- men" are not intended or offered for sale. If, however, the building FIXTURES - PER TRAP 5.00 Q SO. FT. FLOOR AREA TOTAL ACREAGE GAS - EA.SVSTEM - i 1NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner. builder will have the burden of proving that he did not build or int - prove for purpose of sale.).INDUSTRIAL ❑ I, as owner of the properly, am exclusively contract .ng with . -.. GAS - EASYSTEM OVER 4 IEA) 200 BUILDING USE RES 'IND CON PB other ❑ ❑ ❑ ❑ ❑ WASTE INTER. 30.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply to in owner of properly who builds or improves thereon, and who LAWN SPRINKLERS.- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 , ASSESSORS PARCEL NO. contracts for such projects with a contractor(s) licensed pursuant to the Contractors License Law. - SEWER-SANITAR V -STORM EA. 200ft/10.00 TRACT NO, PARCEL NO. O l am exempt under Sec. ,B.&P.C. for this reason WATER HEATER W/VENT 6.00 Owner Dat WATER SYSTEM 5.00 ACC. DATE ACC, FILE NO. WORKERS'COMPI? A"TION DECI.A RATION WATER TREATING EQUIP. .5.00 I hereby affirm that I have a certificate ofconsent LLI self -insure, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copy thereof (Sec. 3800, Lab.C.). Policy No. Company ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city inspection division. Applicant _ FIRE SPRINK Y ❑ N ❑ ENERGY T-24 Y ❑ IN MISC. - REFER TO ORD. CERTIFICATES OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 �" A.L.U.C. PLG. CONTE. - LIC. NO. PLG. TOTAL COSIPIiNSATION INSURANCE (This section need not be completed if the permit is for one =FLOOD Y❑ N❑ Y❑ N❑ QTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars IS 100) or less.) I certify that in the performance of the work for which this per mit is issued, I shall not employ any person in any manner so as to BUILDING become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Ex ALTER OR ADD TO MECH. 5.00 ` , APPLIANCE 5.00 PLAN CHECK emption, you should become subject to the Workers'Compensation provisions of the Labor Code, you most forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY FEE AIR HANDLING UNIT (TO 10=C-F.M.) 4.00 AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 'SEISMIC FEE 3 3 I. 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. 3097, MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC 3L Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinaries and slate laws relating to building construction, and VENTILATION FAN (SINGLE) 4.00 PLUMBING f/L2 d .�- 130ILER-COMP(3H.P.or1OO,000B.T.U.I 6.00 BOILER -COMP (Over 100.000 BTU) SEE FEESCH. MECHANICAL ✓ hereby 'authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC.- REFER TO ORD. (We)t' agree to save, indemnify and keep harmless the City of upertino against liabilities, judgments, costs and expenses which may in any way accme against said City in consequence of the CONST. TAX PERMIT ISSUANCE 10.00 V - MECH. CONT. LIC. NO. MECH. TOTAL �S- TOTAL I, SPI ' StarrIT s r Signature of Applicant ntractor Dae OFFICE COPY