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15179POST THIS CARD NEAR FRONT OF BUILDING ;-ERMITNUMBER CITY OF CUPERTINO 15179 INSPECTION DIVISION JOB INSPECTION RECORD 'JOB 1Q.2:T /7i n��C..,./8G, PERMIT EXPIRATION 1 . UNIT ADDRESS. # LOT# ' �S " PERMIT EXPIRES IF WORK qq OWNERrt L-L..R)-/�,. �n/Z.�vi2G- coNTRAcroR, — '[�; /A - � -IS NOT STARTED WITHIN - 18a'DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM ' INSPECTION DATE INSPECTOR .1INSPECTION RECORD FOUNDATION - NOTE: ' ALL GRADING.AND DRAINAGE SHALL REINSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF LAST64LLED INSPECTION. ' LIFER � - •� PREGUNITE• PERMIT VALIDATION CUPERTINO STANDARDS. - •. ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEENSIGNED UNDERGROUND/SLAB," PLUMBING - ELECTRICAL T' MECHANICAL• - - BLDG ELECT E] ❑' PLG. MECH. •❑ ❑' DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDBUILDING POP PERMIT INFORMATION WOOD FLOOR VALUATION .• SIFT. • PLUMBING. 17 MECHANICAL ELECTRICAL" Alin PERMIT TO T FRAMING INSULATION h STORIES TYPECONSTR. - „ M -/ •��,� 'CC. 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, FT FLoon AREA TOT AcneAce DIAPHRAGM ROOF SHEATHING BUILDING USE Res IND CON PB GO - ❑ ❑ 0 0 0 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. „ ROUGH SANS ASSESSORS PARCEL NO, PLUMBING ELECT. ENERGY TUBS 8 SHOWER PAN - PLUMBING ENERGY TRACT NO, PARCEL NO - MECHANICAL MECH, ENERGY ELECTRICAL - BUILDING ENERGY ACC DATE ACC FILE N0. FRAMING ELECT. FINAL T ST INSULATION PLUMBING ZONING ENG. SITE NO. GAS TEST '• GAS ' MECHANICAL' - FIRE SHRINK'• Q ENERGY T-24 r 'NLj COVER NO WORK'UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIORSHEAR � ELECTRICAL RELEASE - " ❑ A,L U.9 ° ❑ NO INTERIOR SHEAR FIRE DEPT, - SHEETROCK GRADE - UMMARYr- RPLALNCHECK EXTERIOR LATH BUILDING BUILDING �"'--" INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT - ELECTRIC - GAS NO TAPE OR PLASTER UNTIL ABOVEMAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FIN ALISSIGNEDBYBUILDING INSPECTOR: MICROFILM ARRANGE FOR INSPECTION BY PHONING 252;4505, ELECTRIC REQUIRED dNSPECTION. PLUMBING ONE WORKING DAY BEFORE z PLEASE GIVE JOB ADDRESS WHEN PHONING. MECHANICAL — SEE PERMIT FOR EXPIRATION DATE'— CONST. TAX IMPORTANT! TOTAL �[ "! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. _ ;, OFFICE COPY ; APPj.ICANT TO FILL IN INFORMATION WITHIN REDLINES - USE BALL POINT PEN ONLY BUILDING PROJECT I DENTIFICATI ON APPLICATION & PERMIT BUILDING -ELECTRICAL -PLUMBING -MECHANICAL - PERMITNUMBER 1.[ 79 I JJ BUILDING pOORESS q OWNERS Np E QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION '. GCJ G- ,/ PHONE v CONTRACTOR rvpme B - SWITCHES -RECEP � 10.00/1.00 LIGHTING FIXTURES 10.0011.00 ��11-OUTLETS LTC.NOt7 L� GATE OF APPLICATION' CONTRACTORS HOA�� PPLIANCES- RESIDENTIAL 4.00M/� PANELS10.00 ARCHITECT OR �v C n�� $Ya�°JVS PANELS (OVER 200 AMP) 20.00 F.C.+ PLAN CHECK FEE NO. - SIGNS'TRANS. 3.00 ENGINEER (✓ ' LIC. NO. ADDRESS ENG SPECIAL CIRCUIT 5,00 PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00APPLICANTS zlv { \/ - ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 V ,7 /�� LICENSED CONTRACTORS DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Sneti ri OOpof DivlslOn 3 of the Busi ss and' ProfessionsC •' 00 is f fol Lforeenl4}ffec� License CIS Lic.Number ....JJ �/OO ISSUANCE DATE _ - BLDG. � ELECT. PLG. MECH. -E - Dete Contractor - OWNER.BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec 7031.5, Businessand Professions Code: Any city orcounty which requires a permit to construct, alter, improve, demolish, or repair any structure, prior W its issuance, also requires the applicant for such permit to file a signeti statement that he Is licensed pursuant to the provisions Ol'the Contractor's License Law (Chapter 9(commencing with Section.7000) of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom and BUILDING PERMIT INFORMATION MISC. - REFER TO 116,*LUATION )) `,V ,x C CI $/FT. PERMIT ISSUANCE ' 10 ELEC. CONTR. LIC. NO. ELEC. C,'JI - TOTAL PERMIT TO ��T✓�Q ��Q,� OTV. PLUMBING PERMIT FEE STORIES TYPE ONSTR. the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant toa civil penalty of not more than five hundred dollars (SS00)J: ALTER -DRAIN -WATER (EAL) 5.00 ❑ I, as owner of the property, or my employees with wages as their sole 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 or offered for sale (Sec' 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of FIXTURES - PER TRAP 5.00 GAS-EA.SYSTEM-11NC.40UTLETS 6.00 SO. FT. FLOOR AREA , TOTAL ACREAGE property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- mentsarenotintendedorofferedforsale. If, however, the building 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. prove for purpose ofsthpe ❑ 1, as owner of the properly, am exclusively contracting with , GAS - EA. SYSTEM - OVER 4'(EA.) 2.00 BUILDING USE RES IND CON PB Omer E] El El ❑ INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project (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 LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5.IEA.) 1.00 - ASSESSORS PARCEL NO. , , contracts for such projects with a contractor(sl licensed pursuant to the Contractor'sLicense Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C. for this, reason WATER HEATER W/VENT - 6.00 Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 WORKERS'COMPENSATION DECLARATION I hereby affirm chat I have a certificate ofconsent to self -insure, or a certificate of Workers' Compensation I/n�aNamc r a certifi copy Cher ( 00, Lab.C,). n Gu Sv PolicyN�Cmrpa y / - ZONING ENG. SITE NO. - FIRE SPRINK. Y NE] ENERGY T-24 Y❑ N❑ ❑ Certified py is hereby furnished: ❑ Ce I; d C Py s fled with the city Inspeclio division. Applicanl� g rL�l�l-,/rr , MISC.- .- REFER TO ORD. - CERTII'ICA'I'IiOF EXEMPTION FROMMORKF-RS' PERMIT ISSUANCE - 10,00 FLOOD ZONE A.LU.C. ' COMPENSATION INSURANCE This section need not be completed if the permit is for one YE] NE] Y� N❑ PLO. CONTR. .LIC. NO. - PLG. TOTAL hundred dollars (5100) 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 manner so as to DTV. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers' Compensa c ion Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICANT: If, after making this Certificate of Ex- APPLIANCE5.00 AIR HANDLING UNIT (TO 10,000C.F.M.) 4.00 PLAN CHECK ' FEE emption; you should become subject 10 the Workers' Compensation provisions of the Labor Code, you must forthwilh comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNITIOVER 10=C.RM.) 6.00 SEISMIC FEE STS CONST'RUCT'ION LENDING AGENCY 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. 3097, Civ.C.), MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATI NG UNIT (OV ER 100,000 B.T.U.) 9.50 ELECTRIC VENTILATION FAN (SINGLE) 4.00 I certify that I have read this application and stale that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building 'construction, anJ PLUMBING - BOILER -Cm"(a H.P. Dr 100,OOD 8.T.U.1 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC. - REFER TO ORD. (We) agree to save, indemnify and keep harmless the City of upertino against liabilities, judgments, costs and expenses which Byin any way accrue against said City in consequence of the ra ing lhle permit. rS ��j / I a�aqica PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT. LIC. NO. MECH. TOTAL TOTAL L f SignaNre of pln actor Date OFFICE COPY