The URL can be used to link to this page

16349W POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD � ' JOB ADDRESS (d 7 Q /-('1��SL�Il� UNIT# _LOT# OWNER ��J/ CO FACTOR PERMIT NUMBER 16349 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER PREGUNITE PIHMIT VALIDATION -- ISSUANCE DATE ' GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL uLDr o ELECT ❑ PLC., MECI E . MECHANICAL Ip Pao DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDe BUILDING PERMIT V INFORMATION ' WOOD FLOOR VnLUATION b w UT/ `� ' SIFT. PLUMBING C MECHANICAL I'EHMII�TU �Sp �/L-lO� •6aC.% ELECTRICAL FRAMING STORIES TYPE CONSTR. INSULATION OCC. GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50 IT FLOOR <HEN TOTAL ACREAGE ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID DIAPHRAGM auaOl ON usE PE om. 0 ❑ IND El EL ROOF SHEATHING APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ' ROUGH SAN.# PLUMBING ELECT, ENERGY IHAPT NO. PARCEL NO TUBS B SHOWER PAN PLUMBING ENERGY MECHANICAL MECH. ENERGY ACC DATE ACC FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT. FINAL TEST ZONING ENG SITE NO. INSULATION PLUMBING GAS TEST GAS FIRE SPRINN Y N❑ ENERGY i,24 ❑ N� MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE Yo ry� ALU c .L, N❑ EXTERIOR SHEAR ELECTRICAL RELEASE - ' INTERIOR SHEAR FIRE DEPT. FEE SUMMARY SHEETROCK GRADE EXTERIOR LATH BUILDING BUILDING d INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS SEISMIC FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING IS NOT PERMITTED UNTI L BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, H ONE WORKING DAY BEFORE REQUIRED INSPECTION. 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z —SEE PERMIT FOR EXPIRATION DATE — ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE ' CALLING FOR FINAL INSPECTION. TOTAL CI OFFICE COPY O Z z F O CC- W CL 0 0 2 U O LL U Ow F ? u 1 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDI NG PROJECT I DENT] FICATI ON APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 16349 /� (] h"' U �F �7 BUILDING AD O x� PMa I , f 1I,('�'' OWNER' N%t \ ... �,�f PHONE OTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION , DATE OF APPLICATION " CONTRACTOR E `a ' LIC. ND. 1 �J UTLETS- SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 . DRESS s ADDRESS nL^ 4`1 1 PHONE �� APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 CHITECT 5A� A / � / /Q (1C' n OR -✓1•' Yl 1, 111 0 ENGINEER Luc. No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. , SIGNS TRANS. 3.00 ARCH. OR ENG, ADDfl EaS SPECIAL CIRCUIT $,DO PERMIT VALIDATION EMP. METER OR POLE INS. 20.00 ZIP APPLICANT S ADDRESS MOTORS SEE FEE SCH. SERVICECHANGE 20.00 / fT (/ �� LICENSED CONTRACTORS DECLARATION _ I hereby affirm that I am licensed under provisions 0f Chapter 9 ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business and Professions : Cod •, and my license•. is in full firg 1, I/� Lie. Numberlll- Ualc YV_._...-Centrotor BLDG. ❑ ELECT. El PLG. MECH. 11License �,1 BUILDING PERMIT OUWONER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec 7031.5. Business annd Professions unty which requires a peon it to consttacL atleq CodAny city .,,(,only Came: Improve, demolish, or repair any structure, prior to Its Issuance, aLW 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 ofthe Business and Professions Code) or that he is exempt therefrom and INFORMATION VALUATION $/FT. 9�rvL.L�1 MISC.- REFER TO ORD PERMIT ISSUANCE 100 . ELEC. CONTR. LIC. NO. ELEC. TOTAL C PERMIT TO J OTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 1 by any applicant for a Permit subjects the applicant Ica civil penalty of not more than five hundred dollars (55000,): gLTER-DRAIN-WATER(EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure Is not BACK F LOW PROTECT. DEV ICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, F, AR EA, COND. 5.00 intended or offered for sale (Sec 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or mproves thereon, and who does such work FIXTURES - PER TRAP 5.00 SO. FL FLOOR AREA TOTAL ACREAGE himself 0r through his own employees, provided that such improve- ments are not intended or offered for sale if, however, the building GAS-EA.SVSTEM-11NC.40UTLET$ 6.00 or improvement is sold within one year of completion, lire owner- builder will have the burden of proving that he did not build or im- prove for purpose of sale). ❑ I, as owner of the properly, am exclusively commcting with GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES mo CON PB Omer ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. licensed contractors to construct the project (Sec 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner o1property who huilds or improves thereon, and who contracts for such projects with a conlractor(O licensed pursuant 10 lire Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO, O I am exempt under. Sec.-, B &RC. for this reason WATER HEATER W/VENT 6.00 Owner Dam WATER SYSTEM 5.00 ACC. -DATE ACC. FILE NO. WORK ERS'COMPFNSA'I' ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby infirm that I have a certificate of consent to self -insure, or a/ce or a certificate of Workers' ComPemcnion Insurance, rtil ied 3800, L.b.C.TJ _ - L�/r" ropy l No. Policy Nrt Company-!Bishc&��L Jf�" ZONING ENG.SITENO. FIRE SPRINK Y ❑ N❑ ENERGY T 24 Y ❑ IN ❑ Certified coT, Is hereby famished Cerci�¢yofr u J vAl 0Vc 1 /Pection division. plicam 1�1 iJ, 4 MISC. - REFER TO ORD. l C F RI' ll' I CA 1117 OP EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. PLG. CONTR. LIC. NO. - PLG. TOTAL COhIPENAATION INSURANCE f-fhis section need not be completed it the permit is for one Y ❑ N❑ Y ❑ N❑ OTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars IS 100) or less) I certify that in the performance of the work for which this per. Or is issued, I shall not employ anY Pcrson in any manner so asto BUILDING O'd ar V 7 become subject to the Workers' Compensation Laws of California. Data Applicant - ALTER OR ADD TO MECH. 5.00 NOTICE "f0 APPLICANT: If, alter making this Certificate of Ex caption, you should become subject to the Workers' Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith coomly with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 FEE AIR HANDLING UNIT(OVER 10MC.RM.) 6.00 SEISMIC FEE 'f'O CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending is agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued (Sea 3097, Civ.C.). MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UN IT (OVER 100,000 B.T.U.) 9.50 ELECTRIC Lender's Name Lender's Address VENTILATION FAN (SINGLE) 4.00 PLUMBING 1 certify that l have read this application and stale that the above information is correct I agree to comply with all city and county ordinances and slate laws relating to building construction, and BOILER - COMP (3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEESCH. MECHANICAL hereby authorlm representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC. - REFER TO ORD. (We) agree m save. Indemnify and keep harmless lire City of Cupertino against liabilities, judgments, costs and expenses which may 'n any, way accrue again said City in con • Ben' of the agg oI (iris Pro, t CONST. TAX / PERMIT ISSUANCE 10.00 MECH.CONT. LID. NO. MECH. / y TOTAL TOTAL of i9 Signature of Applicant/Contractor m OFFICE COPY