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14691 POST THIS CARD NEAR FRONT OF BUILDING PERMIT N,umseR CITY OF CUPERTINO 14691 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION' JOB ADDRESS 10055 MILLER AVE. UNIT# _LOT# _ - - PERMIT EXPIRES IF WORK OWNER Kontrabecki Group CONTRACTOR Kam Electric IS NOT STARTED WITHIN I INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- . FOUNDATION ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. LIFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED • PREGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PLHMFT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ve CQI 1 PLUMBING - (C P �' `'! 7 ELECTRICAL `. EDATE MECHANICAL - / ElPLGmE l 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR - INFORMATION • PLUMBING VALUA f4ft ��1,T,. MECHANICAL II ELECTRICAL PERMIT TO 14 FRAMING ' -INSULATION - STORIES. TYPE CONSTR - - ()Cc GROUP. RFS,UNITS PLACE NO SUBFLOOR UNTIL ABOVFHAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sO.Fa.11.00.ARTA rorAL ACRenee DIAPHRAGM THE CONSTRUCTION TAX IS PAID _ ROOF SHEATHING a - - HES IND N Onm, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.N ASSE55UH5 PARCEL NO PLUMBING ELECT.ENERGY , ' TRACT NPA- ^ y"PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL, MECH.•ENERGY ACC DATE ACC FIL 'NO' ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ENG.SITE.NO. INSULATION PLUMBING ZONING 'NO. GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T?a - v � N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Nv Z . - EXTERIOR SHEAR � ELECTRICAL RELEASE FLOOD ONE AL.0 C INTERIOR'SHEAR• FIRE DEPT. Y❑ N❑ Y L] N❑ SHEETROCK GRADE FEE SUMMARY . ., EXTERIOR LATH BUILDING„ i. INTERIOR LATH TEMPORARY APPROVALS;.'_ BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS - - FEE NO TAPE OR PLASTER UNTIL ABOVE,.HAS'BEEN SIGNED OCCUPANCY SEISMIC FEE' i OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING.FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, PLUMBING ELECTRIC' I" ' ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z� PLEASE GIVE JOB ADDRESS WHEN PHONING. —,SEE PERMIT FOR EXPIRATION DATE — MECHANICAL I IMPORTANT! . CONST.TAX 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 rn BUILDING PROJECT ID NTI FICATION PERMIT NUMBER - BUILDINGgomusee"1 APPLICATION & PERMIT 1 �L+�1 ADDRESS I C7 I too!Ss I�lltltYZ _ 6nnµh UILDING ELECTRICAL-PLUMBING,-MECHANICAL '. oA - PLAN CHECK VALIDATION • 'NAME mE /, ��p OT ELECTRIC PERMIT FEE AVMA PHONE CONTRACTOR'S � � NAME Z UTLETS-SWITCHES-RECEP 10.00/1.00 metria P1" LIC.No. L) LIGHTING FIXTURES 10,00/1.00 CONTRACTORS ADDRESSuv1 PPLIANCES-RESIDENTIAL 4.00 'I;{o ELL paE- CPAW&Rilyp}/ ' PANELS 10.00 DATE OF APPLICATION ARRCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE:' P.C.NO. ENGINEER UC.No. ISiGNS TRANS. 3.00 ARCH OR ADDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION' ZIP TEmP.mETEROR POLE INS. 20.00 . ' APPLICANT'S MOTORS - SEE FEE SCH. ADDRESSDRESa ' SERVICE CHANGE � 20.00 ^s,/1/-'(^W-d'•-,�`� ' w D o LICENSED CONTRACTORS DECLARATION <u aOU I hereby affirm that I am licensed under provisions of Chapter 9. - 1/SSUANICE DATE (commencing with Section 7000)of Division 3 of the Business and a �t�G. ELECT. PLG. MECH. H H i Professions Cade,end nty-license is in full fort _f rs 3 r z i m 0 License Class E V Lic..Number 9 ,A H w Dale 2,_lef Contractor er m f + .a BUILDING PERMIT ¢ ¢ a OWNEB-BUILDER DECLARATION ,tine o t o - MISC.- REFER TOO INFORMATION X ; 1- 1 hereby affirm that I am exempt from the Contractor's License w w a-w VALUATION F _0a Law for the following reason.(Sec.703 1.5,Businessand Professions PERMIT ISSUANCE 10.00 CJ -� La Code:Any city or county whichmquiresa permit toconstruct,alter, a ¢ ¢ ei 0 improve,demolish,or repair any structure,prior to its issuance,also ELED.ODNTR. - LIC.NO. ELEC. / - iL 0 w requires the applicant for such permit to file a signed statement that TOTAL r'a e w $ he is licensed pursuant to the provisions of the Contractors License PERMIT TO Z a Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthc 4 0 Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE ¢ H$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(8500).): ❑ I,as owner of the property,or my employees with wages as t BACK FLOW PROTECT.DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of • property who builds or improves thereon,and who docs such work F IXTUR ES-PER TRAP, 5.00 so.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments amnot intended oroffered for sale,IL however,the building GAS-EA.SYSTEM-l'INC.40UTLETS 6.00 or improvement is sold within one year of completion,rhe owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 builder will have the burden of proving that he did not buildorim- BUILDING USE RES IND CON PB Otha, prove 1,aso nee of sale.). INDUSTRIAL WASTE INTER. 30.00 - - ❑ d as owner of the property,he exclusively contracting with13 EI El 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 anowner of property who builds or improvesand who LAWN SPRINKLERS-OVER 5(EA.) 1:00 contracts for such projects with a contractor(s)licensedensed puu rsuant to SEWER-SANITARY-STORM EA.2001t/10.00 the m License Law. - TRACT N0. PARCEL N0, laexe ❑ lam exempt under Sec..,B.&P.C.for this reason WATER HEATER W/VENT 6.00 Owner Data WATER SYSTEM 5.00 ACC.DATE ACL.FILE NO. WORKERSCOMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a Certificate of consent to self-insure. ZONING or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO. copy thereof(Sec.3800,Lab.C.1. Policy No. Company FA-Ln�,Aa-17 1•ISs.IAALC Q ❑ Certified copy is hereby furnished. IYCertifeCC NpK is city inspection division. FIRE SPRINK ENERGY T-24Z6Applicant MISC- REFER TO ORD. NO No Y [:] No D: T . CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLO. Z (This section need not be completed if the permit is for one TOTAL - Y❑ NO Y ❑ O N hundred dollars IS 100)or less.) U Q 1 certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL U mit is issued.I shall not-employ any person in any manner so as to 0, become subject to the Workers Compensation Laws of California.y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } N NOTICE TO APPLICANT: If,after making this Certificate of Ex- Z emption,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 he deemed revoked, AIR HANDLING UNIT(TO 10A00OF.M.) 4.00 CONSTRUCIION LENDING AGENCY AIR HANDLING UNIT(OVER IOAOOC.F.M.) 6.00 SEISMICFEE _ I hereby affirm that there is a construction lending Agency for EXHAUST HOOD,(W ITH DUCT) 5.00 the performance of the work for which this permit is issued ISec. MICROFILM 3097,CiYC.L HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name H EATI NG U N IT IOV ER 100,000 B.T.U.)9.50 6 Lender's Address - ELECTRIC I certify that I have read this application and smtn that the above VENTILATION FAN (SINGLE) 4,00 .� information is correct.1 agree to comply with all city and countyPLUMBING ordinances and state laws relating to building construction, and BOILER-0011 I3 H.P.or 100,000 B.T.U.) 6.00 hereby entioed repertyforins inspection this citydo enter upon the 801 LER-COMP (Ove,100.000 STU)SEE FEE SCH. MECHANICAL above-mentioned properly forinsp of parlous. (W"i.21 Inde ify anJ keep harmless the City of MISC.- REFER TO ORD. upEhies, agree costs and expenses which PERMIT ISSUANCE 10.00CONST.TAX e age i st s d icy in consequence of the MECH.CONT. LIC.NO. MECH. . j Z-(x_bb TOTAL TOTAL ,\ ^ Si ure of Applicamij6haActor Date - OFFICE COPY -