The URL can be used to link to this page

09810 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO �y//n 0981 0 INSPECTION DIVISION JOB INSPE TION RECORD • - - PERMIT EXPIRATION JOB ADDRESS O UNIT ILOT# - ' [ PERMIT EXPIRES IF WORK OWNER CONTRACTOR ( IS NOT STARTED WITHIN INIPECTION1 DATE INSPECTOR INS ECTION ECO D 180 DAYS OF PERMIT,ISSU- FOUNDATI N '3�� .� NCE OR 180 DAYS FROM, LIFER 3-46 ' L AST CALLED INSPECTION. PREGUNITE*' PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING - ELECTRICAL ISSUANCE unrE MECHANICAL , BLDG._ -CC . PLG. MECH. 1 ✓ ~❑ ❑ , I DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION PLUMBING WOOD FLOOR ALUATION 190 $/FT. 9 MECHANICAL ELECTRICAL / IT TO FRAMING -I/I ua INSULATION STORIE' F + T PE CONST _ OCG.GHOUP HES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO.FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM ✓ '� r BUILDING USE RESCON PB OIPe, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ROUGH ASSESSORS PARCEL NO. - PLUMBING GAS TEST - TRACT NO.• PARCEL No. „ MECHANICAL - - ELECTRICAL FINALS DATE INSP. ACC.DATE ACC.FILE NO, FRAMING - SAN if ZONING ENG.SITE NO. INSULATION PLUMBING GAS FIRESPRINK ENERGY T 2 MECHANICAL v N� v Q . N[ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ? LATH—INTERIOR ELECTRICAL FLOOD ZONE A.L.U.C. LATH—EXTERIOR FIRE DEPT. 7 Y❑" N❑ Y ❑°. NE]SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING ' SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL.BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC Iw ONE WORKING DAY BEFORE REQUIRED INSPECTION.' PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. ' — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT!. CONST.TAX PLEASE READ REVERSE SIDE; BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY , APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT I IDENTIFICATION , PERMITNUMMBEgR BUILDING APPLICATION & PERMIT O98 I O ADDRESS I O P_ I '� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL DW NLA'$ PLAN CHECK VALIDATION NAME yy�ll DTV. ELECTRIC PERMIT FEE r PHONE yLN OpJ ONTRACTOR3 V ME LS¢-S u UTLETS-SWITCHES-RECEP 10.00/1.00 p Epu`C.rvoLIGHTING FIXTURES 10.00/1.00 I � 1f�xP Q ADDDDRESSRESS PPLIANCES-RESIDENTIAL 4.00 A PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. O ENGINEER LIC.NO, SIGNS TRANS. 3.00 ADDH.REOR SS ENG. SPECIAL CIRCUIT PERMIT VALIDATION Zip EMP.METER OR POLE INS. ADDRESSTs MOTORS SEE SERVICE CHANGE 'o o LICENSED CONTRACTORS DECLARATION TEMP.POLE '- 30.to a� < U I hereby affirm that I am licensed under Provisions of Chapter 9 ISS D E y 's' (commencing with Section 7000)of Division 3 of the Business and Q> BLDG. EL P MECH. 0 2 i License Professions Code,and my license is in full force and effect. E ❑ oi W License Class I.ic.Number ,A F DateContractor 3 m rt ¢ OWNER-BUILDER DECLARATION BUIL ce U INFORMATION w;a N I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD LLOve Law for the following«ason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 fo VALUATION,,..��ss SIFT. F W 0 Code:Any city orcounty which requires a permit to construct.alter. Q �/"1/ a ce ¢ FO improve,demolish,or repair any structure,prior to its issuance,aim ELEC.CONTR. LIC.NO. JE EC. 1(� t/(/ O u requires the applicant for such permit to file a signed statement that TOTAL �V PERMI TO n x$ he is licensed pursuant to the provisions of the Contractor's License r z a La.(Chapter 9(commencing with Section 7000)of Division 3 ofthe I E D Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ¢ S the basis far the alleged exemption.Any violation of Section 7031.5 STORIElf TYPE CONSTR. n ; _ by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.0011 of not more than five hundred dollars(5500).): ❑ 1,as owner of the property,or my employees with wages asBACK FLOW PROTECTDEVICE 4.00 OC OUP RE�.UNITS their sole eolnpunsal ion,will do the work,and the structure is not . intended or offered for sale (See. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code;'file Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 s0. T AR T EAGE himself re of rote his own employers,provided that such improve. ' mems are through ugh des or offered employees, sale.lf,ed that such building GAS-EA.SVSTEM-11 6.00 or improvement is sold within one year of completion, the owner- GAS.-EA.SYSTEM-OVER 4(EA.) 2.00 builder will have the burden of proving that he did not build or im- IL I prove for purpose of sale.). E I CON PB Other ❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 Cl 11 licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-I 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 cOmractons)licensed pursuant to SEWER-SAN V-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C.for tills WATER HEATER W/VENT 6.00 reason Owner . e Q- .L Date� WATER SYSTEM 5.00 ACC.GATE ACC.FILE NO. WORK Ii RS'COMP:NSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate ofconsent to self-insure. ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sce,3800,Lab.C.L Policy No. Company 0 ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. O Applicant Y ❑, N❑ I Y ❑ N[] va PERMIT ISSUANCE 10,00 LU - CG R'I'I PICCOI OP EXEMPTION IONS FROM WORKERS' FLOOD ZONE A.L.U.C. W > C'OMI'IiNSAT'ION INSURANCE PLG.CONTR. LIC.NO. PLG. CL Z( P ' his section lived not be completed if the permit is for are TOTAL Y❑ N� Y [] NE] hundred dollars IS 100)or less.) U O 1 certify that in the performance of the work for which this per. OTY. MECHANICAL PERMIT FEE FEE SUMMARY UL I- mit is issued,1 shall not employ any person in any manner so as to 0 U become subject to the Workera Compensation Laws of California. y Datc ApplicantALTER OR ADD TO MECH. 5.00 BUILDING } In NOTICE TO APPLICANT: If,after making this Certificate of Ex F Z emptlon,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 10,000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 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 HEATING UNIT(OVER 100,000 B.T.U.)9.50 011 Lender's Address ELECTRIC 1 certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with oil city anJ countyPLUMBING ordinances and atate laws relating to building ronstmelion, and BOILER.OOMP(3H.P.or100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP IOver t00,0008TU15EE FEE BCH. MECHANICAL J above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against Save, judgments, Costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way nccnm agams s'id City in consequence.of Iha grunli go this pen it MECH.CONT. LIC.NO. MECH. C TOTAL TOTAL G U . %lbutire ol'Applic t/ Ontrac Date OFFICE COPY