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15190.i le POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO � INSPECTION DIVISION JOB INSPECTION RECORD I�E��E M �+� JOB AD K109a1 tESS ' `o— UNIT# / _LOT# OWNER , I'd (� corvTRAcioR /i �\� (,j 1 PFHMIT NUMBER 15190 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 1B0 DAYS OF PERMIT ISSU. ANCE OR 100 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION =b • NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER - PREGUNITE PEEWIT VALIDATION ' - - _ LiIQ,JS ISSUANCE UALE GARAGE SLABS- POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED O UNDERGROUND/SLAB PLUMBING rj Sj «fie wPti�.- ELECTRIC - MECHANICAL tlLUG ELECL YLG. MECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED 1"' t`.,�PYInD BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION - $IFT. PLUMBING MECHANICAL 6, ELECTRICAL FERWIT To RI G (---- - w� FRAMING /� ,/ INSULATION $IOWES TVI'F CONSTH. J - (JCC OHOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE CONSTRUCTION TAX IS PAID SO FT ILOOH AREA - LOT4L nCH EafE DIAPHRAGMTHE ROOF SHEATHING I--� BUILDING ISE HES IND CON PB om., ❑ O 11 0 - APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH NCNAT PLUMBING .NR ELEC TUBS & SoOWER P S PLUMBING ENERGY TRACT NO V / PARCEL NO MECHANICAL 6— —qsty MECH. ENERGY ELECTRICAL BUILDING ENERGY ACC.DATE AcG FILL NO FRAMING ELECT, FINAL TEST INSULATION PLUMBING ZONING ENG SITE NO, GAS TEST GAS FIRE SPR INK V N� ENERGY TQC v LL N� MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE N❑ A u.c . L7 N❑ EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING b BUILDING - INTERIOR LATH - TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLANTCHECK FEE GAS SEISMIC FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM Uj ARRANGE FOR INSPECTION BY PHONING 252-X1505,. ONE WORKING DAY BEFORE REQUIRED INSPECTION. 00� PLEASE GIVE JOB ADDRESS WHEN PHONING. —SEE PERMIT'FOR EXPIRATION DATE — ELECTRIC PLUMBING t — MECHANICAL _ CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY r Dai Foo QVU N2w Q y o0NO N � Q y E J 6 0 w O w ; 0 H Favsc E .40 4p0 yE se 0 se n E. ¢ r o n 3 m 0 O Z Z F O LU _ 0- 0 :DZ 00 LL U Ow } rn I"' Z 7 APPJ;ANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN ONLY UILDING PROJECT IDENTIFICATION B -L APPLICATION & PERMIT BUILDING - ELECT R ICA L -PLUMBING -MECHANICAL PERMIT NUMBER 1 (� -' I 9! 0 RDllr c ADDRESS �" Q ka rf ' lD OPFI ME Ea _SWI Ca PRONkME - QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION CONTbuy: caoRs N IaAME UTLETS-SWITCHES-PIECED 10.00/1.00 . LIGHTING FIXTURES 10.00/1.00 LIC. NO. CONTRACTORS ADDRESS APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 PHONE DATE OF APPLICATION. ARCHFTECT OR ENGINEER ' ILIC. O Igmt PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH.OR ENG. I AtliSPECIAL ADDRESS z, 1 M 0 CIRCUIT 5,00 PERMIT VALIDATION Ga `(/ ' EMP. METER OR POLE INS. 20.00 APPUCA TSMOTORS ADORE55 � F C4 44 4fl SEE FEE SCH. SERVICE CHANGE 20.0 LICENSED CONI'IIACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with $cel ion 7000) of Division 3 0l the Business and Professions Code, V4 my licensee is in full force and elect. License 1 {{{s Lie. Number- t Dale Conlmclor - y 1�vl ELECT. PLG. NI BUILDING PERMIT OWNER -BUILDER DECLARATION 1 hereby affirm that I s. exempt from the Contractor's License Law fa nthe idi llowingremon.ch(See. Professions ren031.S,emit to Codeimprove, dem y virsh Cor my whiny str a tusre p prior t o is i suance, alsofter, recuncdemolish, or repair any structure, prior to its issuance, also mquims the applicant for such permit in filo n signed stutcmenl that he is licensed pursuant to the provisions of the Contractor's Licenser Law (Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 INFORMATION MISC. - REFER TO ORD VALUATION �9}(�/� - $/FT. - PERMIT ISSUANCE i9'66- ELEC. CONTR.- LIC. NO. TELECOT,. TOTAL PERMIT TO ' -.F4 (i{J� N] QTYPLUMBING PERMIT FEE QTY.F_ STORIES TYPE CONSTR. ALTER-DRAIN&VENT -WATER 5.00 by any applicant for a permit subjects the applicant Ina civil penalty of not more than five hundred dollars (45001.1: O I, as owner of life property, or nsy employees with wages as their sole compensation, will do the work, and the structure is nut intended or uttered for sale (Scc. 7044. Business and Professions SACK FLOW PROTECT. DEVICE 4.00 oee. GROUP R- 3 RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 Code The Contractor's License Law does not apply to an owner all properly who builds or improves thereon, and who Joos such work FIXTURES -PER TRAP 5.00 so. PT. FLOOR AREA TOTAL ACREAGE himself or through his on employees, provided that such improve mems are not intended or offered for sole. 11, however, life building -1 Q GAS-EA.SVSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- build,, will have the burden of placing that he did not build or i+nRES - powefp(purposeofsalc.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE ther I❑ ❑N ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code: *The Contractor's License Law docs not apply to an owner of property who builds or improves thereon, and who LAWN SPRINKLERS - OV ER 5 (EA.) 1.00 contracts for such projects with a contractors) licensed Personal to the Contractor's License Law. r Sec F_ .B.&I'.C. for l+ia ❑ la�WORVJ,kq, SEWER -SAN V -STORM EA. 200ft/10.00 TRACT dNO. 8��d PARCEL NO. WATER HEATER W/VENT 6.00reason owner Dam WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. OMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm thut 1 have a certificate ofcoma+t to self -insure, or a certificate of Workers' Compensalion Insurance, or a CCHiI'icd copy thereof (Sec. 3800, Lah.CJ ,,11N rsj ZONING ENG. SITE NO. I'olicyNo, Company a fo `6, Ift ❑ I2irlifmd npy is hereby fun ishcd AF - FIRE $PRINK ENERGY T 44 Certifie N le the i cyan division. Applicant_ 1 ISL -/L V ❑ N ❑ Y ❑ N❑ MISC. - REFER TO ORD. CERTIFICA'I'17 OF IiXRMPTION FROM WORKERS' PERMIT ISSUANCE •19:69 FLOOD ZONE A.L.U.C. PLG.CONTR. LIC. NO. PLG. S TOTAL COMPENSATION INSURANCE This section need not be completed it the permit is for one Y❑ N❑ v❑ N❑ QTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars IS 100) or lessJ I Certify that in the performance of the work for which this per- ntit Is issued, I shall not employ any person in any m:mner so as to become subject to the Workers'Compensation Laws of California. Dale Applicant BUILDING fD ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICANT: If, after making this Certificate of Ex.. emption, you should become subject to the workers' Compematloo provisions ul' the Labor CodC, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LI! LADING AGENCY APPLIANCE 5.00 PLAN CHECK FEE AIR HANDLING UNIT (TO 10=CF.M.) 4.00 AIR HANDLING UNIT (OVER 10fWC.F.M.) 6.00 SEISMIC FEE 61� EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM I hereby affirm that there is a construction lending agency for DLB performance of the work for which this permit is issued (Sec. 3097, Civ C.). Lender's Num, HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OVER 100,000 S.T.U.)9,50 ELECTRIC ss Lender , Address I certify that I have read this application and state that the above inli+rnmtien is correct, I agree to comply with all city and county ordinances and state blas relating to building construction, and hereby authorire representatives of this city to enter upon the above-mentioned property for inspection purposes. (we) agree to save, indemnity and keep harmless the City of upertino against liabilities, judgments, costs and expenses which ay in any way accrue agai st said City in consequence of the VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILER-COMPQ H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP love, 100,000 BTU) SEE FEE SCH. MECHANICAL MISC. - REFER TO ORD. _^ CONST. TAX Q3 9 PERMIT ISSUANCE 14 a MECH. CONT. LIC. NO. MECH. TOTAL �iZ - TOTAL rm g of dRt pc,n'L Ta b -u K1- Signature of ApplicarOCont actor Ute OFFICE COPY