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15721POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD ,,� JOB ADDRESS � 4NY 4ye: UNIT# LOT# OWNER D 4 M U CONTRACTOR LT PERMIT NUMBER 15721 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU. OR 180 DAYS FROM LAST CALLED INSPECTION. INSIPPOTION DATE INSPECTOR INSPECTION RECORD FOUNDATIONANCE NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER PREGUNITE PERMIT VALIDATION , ' DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED see•- p UNDERGROUND/SLABY�'T'Sl� PLUMBING ELECTRICALISSUANCE MECHANICAL LUG ELECT El PLG MECR O DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILM PERMIT INFOORRMATION WOOD FLOOR Lw noNsTFT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO FRAMING 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. IT. FLOOR AREA TOIALACREAGE DIAPHRAGM -BUILDING USE REs IND CON Pe 00— ElEl❑ ❑ ❑ ROOF SHEATHING APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT. ENERGY THACI NO PARCEL NO TUBS &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 SPR INK v [:]N❑ ENERGY i@d v ❑ N[] MECHANICAL- COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FL000 raNE Y E) NEI n-1 Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. FEE SUMMARY SHEETROCK GRADE 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 OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, IL ONE WORKING DAY BEFORE REQUIRED INSPECTION. O� PLEASE GIVE, JOB ADDRESS WHEN PHONING. Z -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING d, MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL f dD, OFFICE COPY dle Z I 0 X Z . ,00 M a �, z ai 0 - tr at X 0 0 < ar 4 0 0. 2, du > CL a D z 00 LL k- 00 A APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY DI ING PROJECT I DENTI FICATION BU I LDI ING FROM APPLICATION & PERMIT BU I LDING - ELECTR ]CAL- PLUMBI NG - MECHAN ICAL PERMIT NUMBER 15721 ING BU��' NO ULO * RE S F SS v R us RS AM, A-E ION OTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION 0 T ACTOR'S * T To. C. E J_OUTLETS - SWITCHES - RECEP 10,00/1.00 -LIGHTING FIXTURES 10.00/1.00 LiC. N AC OHS ... E S T SC6T APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 ME DATE OF APPLICATION 09 ENGINEER LIC. NO. PANELS (OVER 200 AMPl 20.00 PLAN CHECK FEE I PX, NO. - SIGNS TRANS. 3.00 ARCH. OR ENG. ADD RESS ZIP SPECIAL CIRCUIT 5.00 PERMIT VALIDATION 4o TEMP. METER OR POLE INS. 20.00 APPLICANT S ADO. Ess MOTORS SEE FEE SCH. SERVICIECHANGE 20.00 LICENSED CON FRACTORS DECLARATION I hereby alfirin that I am licensed under provisions ol'Chapter 9 ISSUANCE DATE (,.uninercim, will, S,Cti(... 7000) of Division 3 of the Business and r essm my license is in full to cerise Class Lic. Nmrnbc,,��. TIET E -C -T T_ PLG. MECH. 1`71 Date- BUILDING PERMIT OWNER -BUILDER DECLARi TION I hereby affiTin that I am exempt from III, Contractor's L Law for the following reason. (Sec. 7031.5. [hisicessaudProlessmes Code: Ally city or county which requires 3 pCHrit to construct, alter, improve, demolish, or repair any structure. prior to its issuance, also INFORMATION A ISC. REFER TO ORCk %Vd LUATION $jFT. PERMIT ISSUANCE ELEC. CONTR. 0 ELEC. requires the applicant for such permit to file a signed statement that he is licensed for,mint to the provisions of file Cmuta,mu's License Law. (Chapter 1) (commenchig with Section 7000) ofDivision 3 ofthe Bas ress and Professions Code) or that lie is exempt therefrom and TOTAL 'tin 0 PERMITTO QTY PLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation CH'Section'7031.5 by any applicant For a permit subjeds the applicant to a Civil penalty .f,,.t omne limit Use hundred dollars ($500l): ALTER -DRAIN & VENT -WATER (EA.).&. -00 v� 0 1. as owner of (lie properly. or iny employees with wages as their Sale 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 a, offered for sale (Sec. 7044. Business and Professions Code- The Contractor's License Law does lot apply to an owner of property who builds or iniprove,; thercon,aril who does such work F IXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTAL ACREAGE himself or through his own employees, provided that such improve- clients a. .01 intended or offered for sale. It, however. the building - GAS - EA. SYSTEM - I INC. 4 OUTLETS 6.00 or Improverneo t is sold within one year of completion, the owner- bu der 11 have the burdeti of proving that lie did not tolild or in, wl prove for purpose of Sale.). 0 1, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON pe Our, El 1:1 El 0 0 - INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS -I INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. licensed contractors to Construct file project IS". 7044. business and I'Todle,Oions Code The Contractor's License Law does not aprly to an owner (it property who builds or iniliroves thereon. and who contracts for such projects with a contractoms) licensed pursount to the C..tr.cl.,'s License Law. SEWER -SAN ITARY-STORM EA. 200ft/l 0.00 TRACT NO, PARCEL NO. 0 reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5-89 C2_ ACC. DATE ACC. FILE NO. WORK ERS'COMPENSA riON DECLARA1 ION WATER TREATING EQUIP. 5.00 I ben,by atrium that I have a ccrtihcalc of consent In seit�lrscfc. or a certificate of Workers' Compensation Insurance, or a certil , led ZONING ENG. SITE NO. copy thereo f (Sec. 3 800. Lab.0 policy No. Comp. FIRE SPRINK ENERGY T 24 0 Certir, it , y is filo 1, 0 city inspection division, Applicant- 0 Y E) N Y N[] - M I SC. REFER TO ORD. CFR IIFICAI 1: 017 EXEMPfION FROM WORKERS' PERMIT ISSUANCE FLOOD ZONE A.L.U.C. PI_G.CONTR. LIC. NO. P LG TOTAL CO�iPENSA�ION INSURANCE This section necil let be Completed if the permit is 11), One Y [] NE] I Y F] N C] OTY. MECHANICAL PERMIT FEE FEE SUMMARY I tend led dolla ry ($ 100) (it less I I certify that in the perfmTriance of (lie work for which thk per� mit is issued. I dealt not ..play any person in any nummer va as to BUILDING become subject to the Worken'Compensation Laws OfCaldforri�.. [)are- Applicant NOI ICE 10 APPLICAN 1. It, Site, locking Iles C,rtil,,atC of Ex-_ ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 r PLAN CHECK FEE emption, you should become subject to the Workers'Compersatkon provisions of (he Labor Code, you must forthwith comply with Such provisions or this perillit shall be deemed revoked, AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 AIR HANDLING UNIT (OVER 10PMC.F.M.) 6.00 SEISMIC FEE VELECTRIC CONSTRUCI ION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of tire work lot which this permit is issued (Sec.. 3097, Civ.C.) EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM 1, HEATING UNIT (TO 100,000 B.T.U.) 8.00 H EATI NG UNIT (OVER 100,000 B.T.U.)9.50 L CTR I C /Q Lender's Na Leader', I certify that I have read this application and state that the above information is correct. I agree to coicaly wijjngrl�ln)'�Isy "dm";�Llary ordinal and state laws relating to b 1, "a d VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILER - OOMP (3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Ove, 100,00OBTU)SEE FEE $CH. MECHANICAL hereby I ize representatives of this city to enter upon [lie above -me ion property for inspection purpose, misc. - REFER TO ORD. CONST. TAX tig, - to ve, aide ..... ity and keep harioless tile City of Ctipei-fin. t bilities, judgments, costs and expenses which May in any a -me against said City in consequence of the PERMIT ISSUANCE 10.00 MECH. CONT. TOTAL gat in SigmamPe Detractor Jz- (loe. I OFFICE COPY