No preview available
12476POST THIS CARD NEAR FRONT OF BUILDING Fa CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD C /' •,�('o JOB ADDRESS UNIT# LOT# OWNER -n/� A/G CONTRACTOR IQUi.y G-K�'-'e PFHM1IIT NUMBER .12476 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 I LIFER PREGUNITE P D PERMIT VALIDATION f Cupertino ISSUANCE DATE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED MAY UNDERGROUND/SLAB PLUMBING p1 ELECTRICAL MECHANICAL HL L_ ELECT. I PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL ,f T �y R77mi��� z To� �D / N 71CSr ELECTRICAL e FRAMING /!/-- �,p.� >z d ?,AR fffrL- INSULATION STORIES TYPE CONSTR. -UNITS OCC. GROUP ___RES PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO. FT, FLOOR AREA TOTAL ACREAGE ROOF DIAPHRAGM USE D CDN PB Oi1i RES INr [:] E]ASSESSORS QBUILDING JT�cL 0.1/ F�ifQPL� G / APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED PAR CEL NO ROUGH PLUMBING low TRACT NO. PARCEL NO. GAS TEST MECHANICAL ACC. GATE ACC. FILE N0. ELECTRICAL FINALS DATE INSP. FRAMING 0 SAN # ZONING ENG, SITE NO. INSULATION - p- PLUMBING _ GAS FIRE SPRINK Y[] No ENERGY T'44 v [DNE]COVER MECHANICAL�1 NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD zoNE YE] No A.L.u.c. ❑ NF]SHEETROCK LATH -INTERIOR ELECTRICAL - y LATH -EXTERIOR _ �(� FIRE DEPT. FEE SUMMARY _ GRADE SHEAR INTERIOR _ BUILDING - Z BUILDING ;. .� SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE GAS SEISMIC FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OEEUPANCY OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. 1 MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, I -ONE WORKING DAY BEFORE REQUIRED INSPECTION. O�' 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 / OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDI NG PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING -MECHANICAL PERMIT NUMBER 12476 BUILDING ADDREss .!/ % O M4QR/TT (7Q Z y• OWNER'S �%/hHI�NJ NAME aro AV -.VC 4;1 6 -6z z ELECTRIC PERMIT FEE A d PLAN CHECK VALIDATION 9 /s Z S-� '33 -,a -� / �. w its - DATE OF APPLICATION PLAN CHE FEE P.C. NO, CONTRACTORS NAME J ovIS LEI eke UC.N.141'97 4o:�LO UTLETS- SWITCHES -RECEP 10.00/1.00 77 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS 5�q.�y �F ADORE 5 �s �/ 1 U&CAIVE F PHONEY T�- �s ARCHITECT OR ENGINEER LIC, NO. APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 PANELS (OVER 200 AMP) 20.00 SIGNS TRANS. 3.00 ARCH. OR ENG'SPECIAL ADDRESS ZIP CIRCUIT 5.00 PE ©ATION L NS EMP. METER OR PO. 20.00 AfPLICANT's ADDRESS MOTORS rS E SCH. SERVICE CHAN 20.00 LICENSED CONTRACTORS DECLARATION Aj C.dneltinn oft I hereby affirm that I am licensed under provisions of Chapter 9 (commenemg with Section 7000) of Division 3 of the Business and ISSUANCE DATE BLDG. ELECT. PLG. MECH. Professions Code td my license is in full for c h it f' -c License Class . Lie. Number MA I DateContmcmr BUILDING PERMIT OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law forthe following reason. (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for Such permit to file a signed statement that INFORMATION MISC. - REFER TO ORD VALUATION z4-" $/FT. PERMIT ISSUANCE 10.00 -- ELEC. CONTE. LIC. NO. ELEC. �. TOTAL PERMIT TO he is licensed pursuant to the provisions of the Coatrnclor's License La. (Chapter 9(commencing with Section 7000) of Divlsion3ofthe Business and Professions Code) or Ilett he isexempI tberefnnn and the basis for the alleged exemption. Any violation OfS- lion 7031.$ by any applicant for a permit subjects the applicant to a Civil penalty of not more than five hundred dollars ($500).): /� QTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. ALTER -DRAIN & VENT -WATER (EA.) 5.00 BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sea 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- meals are not intended or offered for sale. IL however, the building DRAINS -FLOOR, ROOF, AREA, COND. 5.00 6" FIXTURES - PER TRAP 5.003 _sGL FT. FLOOR AREA TOTAL ACREAGE I GAS-EA.SYSTEM-l1NC.4OUTLETS 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 im- ro • forpurpow ofsale.). 1, as owner of the property, am exclusively contracting with h hsed contractors to construct the project (Sec. 7044, Business GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB OIL., INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS- 1 I 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 contracts Ibr such projects with a contructoEs) licensed pursuant to the Contractor's License Law. ❑ l am exempt under See. ,B.&P.C.f ruts LAWN SPRINKLERS - OV .) 1.00 SEWER-SANITARY-STOR A,2 .00 TRACT NO. PARCEL NO. WATER HEATER W/ 6.00 Teas net Dale WATER SYSTEM 0 Ace. DATE ACC. FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING E 5.00 I hereby affirm that I have a certificate of consent to self -insure. or a certificate of Workers' Compensation Insura9{'c, or a cert ificA ZONING ENG. SITE NO. ' thereof Copy thereof (Sec. 3800, Lab. �'T /LTJ--y_`njF,V Policy No. COmpaoy `❑ Certified' py is hereby furnishcJ. MD pt. Certifie c y is Filed with 14e�ity insetio�division. dpllCeDt Qfic c�/ 'J fIRE BPRINK Y N� ENERGY T -Z4 Y N� MISC.- REFER TO ORD. CERTINCATEOFEXEM PTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one PERMIT ISSUANCE 1LIM FLOOD ZONE v N A.L.U.C. Y N PLG. CONTE. LIC. NO. PLG. / .- TOTAL !� 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 nhanneruh as to become subject to the Workers' Compensation Laws of California Date Applicant NOTICE 'f0 APPLICANT If, after making this Certificate of Ex emplion, you should become subject to the Workers' Compensation Provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY BUILDING 3a i 00 �C ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK FEE AIR HANDLING U 10,000C.F.M.) 4.00 AIR HANDLINGUNITIOV C.F.M.) 6.00 SEISMIC FEE EXHAUST H (W DUCT) 5.00 MICROFILM I hereby affirm that there is a construction lending agency for the pciformmLee of the work for which this permit is issued (Sec. 3097, Civ.C.). Lender's Name HEATING UNIT 1T0 (pU.) 8.00 / I HEATING UNI ,000 B.T.U.)9.50 ELECTRIC Lender's Address VENTILATION FAN (SINGLE) 4.00 PLUMBING ib I certify that I have read this application and state that the above 1 information is correct. I agree to comply with all city and coushty ordinances and state laws relating to building construction, and BOILER -COMP 13 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL CZ6 hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the MISC. - REFER TO ORD. CONST. TAX PERMIT ISSUANCE 10.00 Q MECH. CONT. LIC. NO. ECH. MTOTAL a6 - TOTAL granting of this permit. z / Signature Of Applicant/Contractor Da e Up."GE GUYY