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16551!0 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD '^ JOB ADDRESS 1�✓��'�-�-E`� UNIT# _LOT# 11��/ OWNER coNTRAcroR I2L FEROITNUMBER 16551 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 RE ORD FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER PR EGUNITE PERMIT VALIDATION _ 4_1 / `•'fib l=!C ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL MECHANICAL - BLDG ELECT PLG MLCH El DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIISIFT.. INFORMATION WOOD FLOOR VALUATION PLUMBINGMECHANICALPERnuT ELECTRICAL rO FRAMINGSTORIES INSULATION YPE C OCC 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 F \' C\ Qk SO, IT FLOORAREA O UQO TOTAL ncveAr,e DIAPHRAGM ] auILO usE RES ]NO CON PB omr, ❑ ❑ ❑ ❑ ❑ ROOF SHEATHING APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE NSP. ASSESSORS PARCEL NO ROUGH SAN,# PLUMBING ELECT. ENERGY TRACT NO PARCEL NO TUBS & SHOWER PAN .PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC DATE: ACC `ILI: NO FRAMING ELECT. FINAL TEST zorvlNc NO SITE No. INSULATION PLUMBING — GASTEST GAS FIRE SPRINK Y ❑ N� ENERGY T 2 Y ❑ NE] MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE v N� A.L U C ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT.: SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE - GAS - SEISMIC FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, H_ ONE WORKING DAY BEFORE REQUIRED INSPECTION. z PLEASE GIVE JOB ADDRESS WHEN PHONING. -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL IMPORTANT! PLEASE READ. REVERSE SIDE BEFORE • CALLING FOR FINAL INSPECTION. Ez /-� pd OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LDI NG PROJECT I DENTI FICATI ON APPLICATION & PERMIT BUILDING -ELECTRICAL- PLUMBING -MECHANICAL -PERMIT NUMBER 1 `+[C1 i, I U J 5 I ' BUILDING ADDREs �r OWNERS PLAN CHECK VALIDATION NAM 71 PHONE b OTV. ELECTRIC PERMIT FEE DATE OF APPLICATION CONTRACTORS NA E ^n� �JLI/ LIc. No IJ[I UTLETS -SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S ADDRESS`/ `.�/T �//y-��j p J Shc `Ja gHONIi.(,/ rOIO PPLIANCES- RESIDENTIAL 4.00 PANELS 10,00 Aq HITECT OR ENGINEER LIC. No. PANELS (OVER 200 AMP) - 20.00 PLAN CHECK FEE P.0 NO. SIGNS TRANS. 3.00 ADDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION EMP. METER OR POLE INS. 20.00 zIP 9P A ADDDRDREESSSS . MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 - Vr�/, ///I At. / { -v CON' I' RACI'ORS DECLARATION I I hereby aftirn that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 01lire Business and Professions Co a y license is in full for"/ License Class-_ Lic. Number ISSUANCE DATE BLDG. ❑ ELECT. ❑ LG MECH. ❑ DJte GDmraclOr_ BUILDIN PERMIT /F OWN 1: R-BUILDH R DECLA RA'I'I ON License 1 hereby affirm that I am exempt from the Contrametra and Low for the owingreason. (Sec.703sapeonineo,oIr Professlnns ecoi suance, alser,o Code: Any mulish county whiny structure. p prior its issuance, that improve, demolish, or repair structure, prior INFOR ATION MISC. - REFER TO ORD VALUATION S/FT. PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. ELEC requires the applicant for such permit to file a signed statement that h p n he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9(commencing with Section I,7000) Division3 of the and Professions Code) or Oath is Cxomll therefrom and exempt TOTAL PERMIT TO p QTY. PLUMBING PERMIT , FEE ST RIES VPE CONSTR. theBusinesss i Lire basis for tam alleged exemption. Any violation of Section 703L5 by of ormilicanl for dupe ir,subjects th5000.) ant lea civil penalty subjects of not mare then frvc hundreJ Antlers lS5001.1'. ALTER-DRAIN-WATER(EA.) 5.00 1 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the Structure is not '.(ended or offered for vale (Sec 7044, Business and Professions Code: 'file Contractor's License Law does not apply t0 an owner of property who builds or improves Omreon, and who docs such work BACK FLOW PROTECT. DEVICE • 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 FIXTURES - PER TRAP SO, FT, F4008 AREA TOTAL ACREAGE himself or through his own employees, provided that such improve- mentsare no' intended oroffered l'or sale. IL however, Lite building GAS-EA.SVSTEM-1INC .4 OUTLET 6.00 or improvemctn 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 of saleJ. ❑ I, as owner of the property, am exclusively contracting with GAS- EA. SYSTEM -OVER 4 (EA.) 2.00 BUILDING USE Res IND CON PB Other ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of property who builds or improves thereon, and who contacts for such projects with a colaraclotls) licensed purzuant to the Contractors License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ Ian exenhpt under Sze. ,B.&P.C. for this reason WATER HEATER W/VENT FiOB 2*-) Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP, 5.00 WORKERS'COMPFNSA1 ION DECLARATION I hereby attlrm that I have a curtifieate (if consent to Sclfolnsure, or a eetlificate of W •rs' Compuns.µ on Insurance, or a certified poly Lh- 00, Lab.C.)/1// r✓_��a�_G%y ZONING ENG. SITE NO. Policy Con any �(Q ❑ C�'opy is he by furnished. eI- co led will, the city inspection division. A plicae m s FwESPRwK y ❑ NEI, ENERGY T-24 Y ❑ IN C] MISC. - REFER TO ORD. CER' 1' CATE OF EXEMPT ION PROM WORKERS, PERMIT ISSUANCE O fva FLOOD ZONE A.L.U.C. PLG. CONTR. LIC. NO.PLG. TOTAL ,QD COMPENSATION INSURANCE I[ his section need not be completed if the permit is for one V ❑ N❑ Y ❑ N❑ QTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollar,(S100)or, less) 1 certify 111111 in the performance of the work I'or which this per- mit is slued, 1 shall not employ any person in any none( so as to BUILDING becmne subject to the Workers' Compensation Laws of California. Dat Applicant NONCE TO APPLICAN'1: If, alter making this Certificate of Es- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK emption, you should hecume subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. FEE AIR HANDLING UNIT (TO 10MC.F.M.) 4.00 AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE CONSFRUCEION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.C.L EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OV ER 100,000 B.T.U.) 9.50 - ELECTRIC LendrN. Address Lender's Addr ss 1 certify that 1 have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and stale laws relating to building construction, and VENTILATION FAN (SINGLE) 4.00 PLUMBING 017 BOILER-COMP13 H.P. or 100,000 B.T.U.) 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 leve, indemnify and keep harmless the City of upe'dit. agui st bahilitics, judgments, costs and expenses which may in any wk accrue against said City in consequence of the CONST. TAX PERMIT ISSUANCE 10.00 MECH.CONT. LIC. NO. MECH. OTAL TOTAL Sob r' tgo this •rmit. Sig eof Applicant/Contractor Date V OFFICE COPY