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15595�' �- - POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS dZQLja�/Vl9-461A/kVC UNIT# LOT# n_ _ OWNER LJ CONTRA[TOR l_I8-d'E 6 PERMIT NUMBER 15595 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR .180 DAYS FROM LASTCALLED INSPECTION. INSPE T N TE INSPECTOR INSCTION RECORD PE FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. LIFER PR EGUNITE PERMIT VALIDATION / -- ' ISw ce DATE ' GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL MECHANICAL PAI ULU(i ❑ IiLF:CP ❑ PLG. MIi CH ❑ ❑ . 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED N 1 BUILDING PERMIT INFORMATION WOOD FLOOR LUAnON I'riRO SIFT. PLUMBING City Of C MECHANICAL ELECTRICAL PERMn To FRAMING INSULATION - STORI(S TYPE CONSTH. - OCC CROUP 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 BUILD use HEs IND cONory PB OtI," ❑ ❑ El ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT. ENERGY TUBS B SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC. DATE ACC, FILE NO FRAMING ELECT, FINAL TEST ZONING ENG. SLE NO. INSULATION PLUMBING GAS TEST GAS FIRE SVRINK Y E N❑ ENERGY L29 v ❑ N❑ MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE vREDY PLu.c ❑ NEI EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS SEISMIC FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY I- OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. LU ARRANGE FOR INSPECTION BY PHONING 252-4505, I- ONE WORKING DAY BEFORE REQUIRED INSPECTION. z0 � PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE - MICROFILM ELECTRIC 3 e2o - PLUMBING' MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. ' TOTAL OFFICE COPY AP,RLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI LDI NG PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING -ELECTRICAL- PLUMBING -MECHANICAL „PERMIT NUMBER. 15595AES BUILDING 0 .NO. I PLAN CHECK VALIDATION NAM DTV. ELECTRIC PERMIT FEE ONE co THACTORs N E UTLETS-SWITCHES -RECEP 10.00/1.00 Ic. NO LIGHTING FIXTURES 10.00/1.00 f.DNTRAc7OWs Ica APPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 ONPA E DATE OF APPLICATION OR CH ECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P. C..NO. SIGNS TRANS. 3.00 ENGINEER LIC. No. AARCH. OR DDRESS ENG cap SPECIAL CIRCUIT 5.00 PERMIT VALIDATION / EMP. METER OR POLE INS. 20.00 APPUCANTS ADDRESS MOTORS - SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONT RACTORS DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business and Professions Corly�,md my liccnLi in' in full k !'� Liana Class Number _ J BLDG. ❑ ELECT. PLG. MECH. ❑ ❑ lV Cen Uute6Conlracto _ _ _,- BUIL NG PERMIT TOWNI?R-BUILDER DECLARATION I herebyMISC. alfirm thin ten cxac. 703 fmm tic Cont and rO License Low: A nycity owtngreywhich requiresa permit Business Professions Code: Any c olish coon pair any Structure permit to construct, alter, pa Si n statement that requires the applicant for such permit to file a signed statement that na,fires demolish, Or repair any Structure,it tofile lie is lrt iixcd parstant 10 the provisions Of the COI1tractOr$ License Law (Chapter 9 ( commencing with Section 7000) of Division 3 of the Business and Professions Code) or (hot be is exanpt therefrom and INFORMATION VALUATION $/FT. 90p UU - REFER TO ORD PERMIT ISSUANCE ELEC. CONTE. LIQ NO. ELTA TOTAL PERMIT TO WD90 ^ OTY. PLUMBING PERMIT Cita STORIES TYPE CONSTR. the basis for the alleged exemption. Any' violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of no[ mom than five hundred dollar, (S5001): ALTER -DRAIN -WATER (EA.) 5.00 ❑ 1, as owner of ❑Ic property, or my employees wiW wages as their sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. CROUP RES. UNITS DRAIN$ -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 does such work FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTAL ACREAGE himself or through his own employees. provided that such improve - melts are not intended orolfieredl'or sale. If, however, lift building GAS-EA.SYSTEM-11NC.40UTLETS 6,00 Or improvement is sold within one year of completion, the owner- builder will have the burden of proving (hat Ile did not build or im- Prove for purpose ofsAaJ. Et 1, os owner Of the property, am exclusively contnmling with licensed contractors m construct the project (Ste. 7044, Business and Professions Code: The Contractor's License Law docs pot apply to an owner of property who builds or improves thereon, and who GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB One, 1:1 ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 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 10 tit Contrunpr's Liccnsc Law. SEWER-SANITARY-STORMEA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under see. .B.&I'.C. for this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO, WORKERS'COmpBNSA'I'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copy thersof(Sve. 3800, Lab -C. Policy No. Cnmpan>t,y�a-♦x/�j�ls FIRE SPRINK ENERGY T-24 ❑ CertiHidcopyishereby l mon,jed. ❑ Certi�fit/��cpjp�y is it i e the city inspection division. Applicant . Y ❑ N❑ Y ❑ No MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. CB R1 I FWATE OF EXEMPTION FROM WORK 17 RS' PLG. CONTE. LIC, NO. PLG. TOTAL COMPENSATION INSURANCE section need' not be completed if the permit is I'or one v ❑ N ❑ v [:] N E](This DTV. MECHANICAL PERMIT FEE FEE SUMMARY hundred &.11m,(SI00)or less) I certify that in the performance of the work for which this per- alit is issued, 1 shall not employ any person in any planner so as to BUILDING become subject to the Workers' Compensation Laws of Califisraio. Date Applicant NOTICE l'O APPLICANT: If, after slaking this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK emption, you should become subject to the Workers' Compels a tion provisions of the Labor Code, you must forthwith comply with such provisions Or Ihl, permit shall be deemed revoked. FEE AIR HANDLING UNIT (TO 10MC.F.M.) 4,00 AIR HANDLING UNIT (OVER 10MC.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. Ltmad Civ.C.). Lender's Name Lender's Address HEATING HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC �� VENTILATION FAN (SINGLE) 4.00 PLUMBING I certify that 1 have read this application and stats: that the above information is correct. I agree to comply with all city unit county ordinances and state laws relating to building construction, and BOILER -COMP (3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTUI SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC. - REFER TO ORD. CONST. TAX (We) agree t save, indemnify and keep harmless the City of Cupertino again. liabilities, mdgmenu, coats unit expenses which m� n ny wa accrue ' gains[ Said City in consequence oUtbe PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. TOTAL TOTAL ane S' lure of pylic t/COnimctor Untc `--- OFFICE COPY