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14651 ' POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO4651 1 • INSPECTION DIVISION JOB INSPECTION RECORD - S✓.'fG PERmrrlxPI RATION JOB ADDRESS � OUS'S /moi �� UNIT# �U _LOT# e / - - PERMIT EXPIRES,IF WORK OWNER �� CONTRACTOR �D/7 14^Q G t�j IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS of PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. - UFER ALL GRADING AND DRAINAGE-SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VA TION ' PREGUNITE CUPERTINO STANDARDS. GARAGE SLABS " - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 2x77- z•. a H� '', •-� UNDERGROUND /SLAB �_' �* PLUMBING •2^2_ ,.r ,•s„�,t.�p, � 'y L ELECTRICAL � ,( � � ✓xX � f•-� /vim � �ssuArucc DATE MECHANICAL - dLD ELECT, PLC, MECH.-- 19 ❑ ❑ ❑. . . 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDuILDING PERMIT I' t1f+n� WOOD FLOOR P: Of CINFORMATION' vALUA,ION SIFT. PLUMBING ry _*J MECHANICAL - - ELECTRICAL "' - - PERMIT TO: T FRAMING _ - III-V�l 'I 1 1'' 11 I ,- INSULATION �• ' STORIES TYPE CONSTH. - - OCC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS,BEEN SIGNED " ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE ' SO.Fr FLOOR ARTA TOTAL ACREAGT S DIAPHRAGM, THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES. IND CON PB Om.. " APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ El ❑ ❑ ❑ ASSESSORSPARCEL NO ROUGH SAN.# - PLUMBING - ELECT.ENERGY ' TRAC1 N0. TUBS BSHOWER PAN PLUMBING ENERGY � � . .. PARCEL NO MECHANICAL MECH.ENERGY. 'ACC DATE ACC.FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT,FINAL TEST ' INSULATIONPLUMBING . `ZONING ENG.SITE NO. GAS,TEST GAS FIRE$PRINK ENERGY T 24 MECHANICAL v FF Y 0 No COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED ' HEATING FLOOD ZONE A L u.C. .. EXTERIOR SHEAR � - � "RELEASEELEASE INTERIOR SHEAR 2 2 C Y❑ "❑ ❑ "❑ SHEETROCK. FEE SUMMARY EXTERIOR LATH INTERIOfi LATH - ORARY APPROVALS BUILDINGSCRATCH COAT . PLAN CHECK FEE NO TAPE OR PLASTER UNTIL ABOVEHAS BEEN�SIGNED SEISMIC FEE OCCUPANCY OF BUILDING ISNOT.PERMITTEDUNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE'FOR INSPECTION BY PHONING 252-4505, ELECTRIC F� ONE WORKING DAY BEFORE REQUIRED INSPECTION: PwMewc - O PLEASE GIVE JOB ADDRESS WHEN PHONING. —� Z _. 'MECHANICAL �- — SEE,PERMITFOR EXPIRATION DATE — IMPORTANT! '- coNsr.dAx PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL n a OFFICE COPY' APPLICANT TO FILL IN-INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY - BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT 1 4651 � - AD�uSS t. Nr�'��ev• BUILDING-ELECTRICAL-PLUMBING-MECHANICAL , Yr OWNER'S I PLAN CHECK VALIDATION DTV. a ELECTRIC PERMIT FEE �' PMONE eL. NpMrRAcrons UTLETS-SWITCHES-RECEP 10.00/1.00 elbie ki Llc.rvo. C eV LIGHTING FIXTURES 10.00/1.00 ADDRESS Rs PPLIANCES-RESIDENTIAL 4.00 65S LII VY 4 e PHDNE U116 OPANELS 10.00 DATE OF APPLICATION A CHITECT PLAN CHECK FEE" P.C.NO. . OR - ��P /` ' PANELS (OVER AMP) 20.00 ENGINEElie t n Cl{U' I�f6 4 uC. o. SIGNS TRANS. - 3.00 ARCH.OR ADDRESS44ENG. ' ^�'�XP^ SPECIAL CIRCUIT 5.00 PERMIT VALIDATION 0 QlW e- [C) LP EMP.METER OR POLE INS. 20.00 APvucarvrs - MOTORS SEE FEE SCH. ADDRE ,sr✓.--_ SERVICE CHANGE 20.00 D ¢z p r/ /,p, i o o LICENSED CON'rRAC1'ORS DECLARATION n L, �,ry{ q (U 0 c i U• 1 hereby affirm that I am'licensed under provisions of Chapter 9 L7. J ISSUANCE DATE (commencing with Section 7000)of Division 3 of the Business and a w - - BLDG. PLG. MECH. r G Z Professions Cole,and my license is in full force and effect.: ` ueapitl El 1:1o z=O _ License Class Lin.Number 1 WL•'Jl Date Contractor Q y f J s IS a OWNER-BUILDER DECLARATION RATION BUILDING PERMIT n INFORMATION w o a U; w I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD VALUATION S/FT. H u m J Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 ,A> Code:Any city or county which requiresa permit lu constn¢t,alter, �(� "-ej 2 a p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTH. LIC.NO. ELEC. w0 LL requires the applicant fur such permit to file a signed statement that - TOTAL PERMIT TO $ he is licensed pursuant to the provisions of the Contractor's License Fz > Law(Chapter 9(commencing with Section 7000)of Division 3 of the i c Business and Professions Code)or that he is exempt therefrom andDTV. PLUMBING PERMIT FEE I V• H$ the basis for the alleged exemption.Any violation.of Section 7031.$ STORIES TYPE CONSTR. by of more fora permit subjects lheapplican[toa civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not marc than five hundred dollars(my em): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole cooperation,will the work,and the structure is not intended o (Sr offered for sale(Sec. 7004, nota and Profession DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not applpl y loan owner of • property r through builds or improves thereon,provided who does such work FIXTURES,PER TRAP . 5,0) SQ FT.FLOOR AREA TOTAL ACREAGE himself re through his own employees, le.I ,ho that such improvr or improvemenotnt herded or within ronefor year I Lhowetion the building GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 or improvement will is sob within one year of completion,Ne owner. GAS-EA.SYSTEM-OVER 4(EA.) 2.00 builder will hove the lh r.) n of proving that he did not build or int- _. BUILDING USE prove fors owner of sale.). REB ,IND CON PB Other ❑ d as owner of the properly,am exclusively contracting with INDUSTRIAL-WASTE INTER. 30.00 0 0 � 11 E] licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contructorts)licensed pursuant to the Con{mctor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. am exemnu her Sec. ,B.&P.C.for this reason WATER HEATER W/VENT 6.00 V4Zfe 4q OwnerDart - WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO, RK - S'COMPENSATION DI:CLARATION WATER TREATING EOUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure, or a certificate of Workers'Compensation Insurance,ora certified ZONING ENG,SITE NO. copy thereof(Sec.3800,Leb.C.). - Policy No. Company O ❑ ertifled copy lslereby furnished. FIRE SPRINK ENERGYT-24, Z 2 erlified copy -ed wi h it- city inspection division. 01x Applicant - - yp1,. MISC- REFER TO ORD. Y [:] Put[]'I Y ❑ NE] ~ PERMIT ISSUANCE - 10.00 Lu - CERTIFICATE iiPE EXEMPTION FROM WORKERS' FLOODZONE A.L.u.c. W 7 COMPENSATION INSURANCE URANCE PLG.CONTR, LIC.NO. PLG. Q. Z (This Section need not be completed if the permit is for one TOTAL Y ElNo V 1:1 NO hundred dollars(S 100)or less.) Ed U O I certify that in the performance of the work for which this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY W H mi(is issued,I shall not employ any person in any manner so as to U become subject to the Workers Compensation Laws of California, y Dalc - Applicant ALTER OR ADD TO MECH. " _500 " BUILDING } W NOTICE TO APPLICANT: If,after making this Certificate of Ex- . ? ensption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith Comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE b .I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.), HEATING UNIT(TO 100,000 B.T.U.) 8.00 _ Lender's Name HEAT[NG U N IT ER 100,000 B.T.U.)9.50 Lender's Address - ELECTRIC I certify that I have read this applieoior and state that(he shove VENTILATION FAN (SINGLE) 4,00 information is correct. 1 agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3H.P.or 100,000B.T.U.) '6.00 hereby authorize representatives ins of this city es enter upon the BOILER-COMP love,100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property forinsp of (h i purposes. (We) agree t save, indemnify and keep harmless the City of MISC.- ' REFER TO ORD. upertina again liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in anyy true against said City in consequence of the ranting of Is nil. i/J��'� - MECH.CONT, LIC.NO. MECH. , P t/KTL// TOTAL // ]] C� Si chorea Applicant/Contractor Date TOTAL �! aC OFFICE COPY