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16586POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD �• / (' JOB ADDRESS �I`� 7A/�-�! vL9N� iGY UNIT# _LOT# OWNER U CONTRACTOR E' -Z EC7.QcC PERMIT NUMBER 15586 PERMIT EXPIRATION ' PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM . INSPECTION.FER - - I INSPECTIO ATE INSPECTOR INSPECTION RECORD FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. LIFERLASTCALLED PREGUNITE PERMIT VALIDATION r J r/f A ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ' UNDERGROUND/SLAB PLUMBING I I e / ELECTRICAL - MECHANICAL i_ BLDG ELECT ❑ PLG, MECH ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED pINFORMATION � BUILDING PERMIT III ' WOOD FLOOR vn wnnON 4 $/FT. PLUMBING RR MECHANICAL ELECTRICALp PERMIT TO FRAMING INSULATION BTO IES TYPE CONSTR 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 - - � SO FT FLDGR AREA TOTAL ACREAGE DIAPHRAGM ROOF SHEATHING � � � OUILD USE Hes IND CONON PB om, ❑ 1:1 ❑ 0 0 ' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SANA 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 No FRAMING ELECT. FINAL TEST INSULATION PLUMBING - .ZONING ENC SITE No, GAS TEST GAS' MECHANICAL FIRE SPRINK "� ENERGY T 24 IN "� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE EL zoNE. Y E] ❑ N❑ -ALu,c. v �] N❑ INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH • BUILDING INTERIOR `LATH TEMPORARY APPROVALS SCRATCH-COAT ELECTRIC GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY PELECTRIC OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. 'A'�M uJ ARRANGE FOR INSPECTION BY. PHONING 252-4505,/ F ONE WORKING DAY BEFORE REQUIRED INSPECTION. i`° o� PLEASE GIVE JOB' ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE —.' r^' PLumewc MECHANICAL CONST. NST. TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY O Z z P: o Cc T W_ CL Uo LL U Ow } ti ,Id APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU LD1 NG PROJECT I DENTI FICATI ONPERMIT UILDING - APPLICATION& PERMIT PLUMBING -MECHANICAL NUMBER . C p J U BUILDING AD q�5 YS r,• / OWNER'S NAME //�/� NE=] %J��r® QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION - CONTRACTOR'S - NAME '� OUTLETS -SWITCHES - RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1,00 CONTRACIOR's .,a / ADDRESSsd/�j9// %�/! L APPLIANCES-RESID ENTIAL 4.00 PANELS 10.00 oNE _ DATE OF APPLICATION - ARCHITECT OR ENGINEER LIC. No. PANELS (OVER 200 AMP) -20.00 PLAN CHECK FEE-P.C:NO. , SIGNS TRANS. 3.00 ADD Ess ENG' SPECIAL CIRCUIT 5.0Q PERMIT VALIDATION TEMP. METER POLE I 20.00 ZIP / p�(s-.r •`-' APPucnrars ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 • p /f �/. (�//�/�ry ( ' LICENSED CONTRACTORS DECLARATION xv�ISSUANCE 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business land Professions Cod an ply license is in full fort n License .loss. V Lia Date Contractor DATE C. ELECT. PLG. MECH. ❑ ❑ '111P BUILDING PERMIT INFORMATION OWNER -BUILDER DECLA RATION`a I herchy atfinn that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5. Business and Professions Coele: Any city or county which requires permit toconslrucq alter, Improve, denl0hsh. or repair any Structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9(commencing with Section 7000)o(Division 3 ofthe MISC.- REFER TOO VALUATION PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. ELEC. DY TOTAL PERM IT TO Business and Profesel6ns Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 CITY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant toss civil penalty of not more than five hundred dollars ($500).): ALTER -DRAIN -WATER IEA.) 5.00 , ❑ L as owner'of the property, or myemployees 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, BusinessandProfessions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- ments are not intended or offered for sale. If, however, the building FIXTURES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTAL ACREAGE GAS - EA. SYSTEM - I INC.4 OUTLETS 6.00 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- thep prove for purpose ofs ❑ I, as owner of the properly, am exclusively contracting with GAS - EA. SYSTEM -'OVER 4 IEA.) 2.00 BUILDING USE RES IND CON PB OsM1ee 0 ❑ 0 ❑ INDUSTRIAL WASTE INTER. 30,00 licensedd-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 (EA.) 1.00 ASSESSORS PARCEL No. contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. SEWER -SAN V -STORM EA. 200ft/10:00 TRACT NO. PARCEL NO. ❑-lamcxemp imait'Sec. ';R.&P.C. for this reason WATER HEATER W/VENT 6.00 Owner Date WATER,SYSTEM 5.00 ACC. DATE ACC. FILE N0. WORKS RS'COMPENSATION DI[CLARA'IION WATER TREATING EQUIP. 5.00 1 herchy affirm that I have A certificate ofconsent to self -insure, ZONING ENG. SITE NO. or a certificate at Workers' Compensation Insurance, or a certified copy thereof ( Sec . 3800, Lab.C Policy No. Comp.- ❑ Cerli lied cot, is he yto mshed. 'TJ }( Certifiyydd. p 11 .1 ith" thy yily',m e' on division. Apphcantl4� it tri/ FIRE SPRINK YD NE) ENERGY T 14 Y❑ N❑ MISC.- REFER TO ORD. CERTIFICATROF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10,00 FLOOD ZONE A.L.U. C. COI IPENSATION INSURANCE (This section need not be completed if the permit is for one Y ❑ N Y [:] N PLG. CONTR. LIC. NO.PLG. TOTAL hundred dollar, IS 100) or less) I"certify that in the performance of the work for which this per- mit is issued, I shell. not employ any person in any manner so as to QTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, alter making this Certificate of lix- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK FEE emption,. you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT ITO 10, 00C.F.M.) 4.00 AIR HANDLING UNIT(OVER I0,000C.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGIiNCY I hereby affirm that there is is construction ]ending agency for the performance of.lhe work for which this Permit is issued (Sec. 3097, Civ.C.). EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC Cy �� VENTILATION FAN (SINGLE) 4,00 BOILER •OO P(3 H.P. or 100,000 B.T.U.) 6.00 I certify that I have read this application and state that the above information is correct. I agree to LORIPly with all city and em,my ordinances and State laws relating to building construction, and PLUMBING BOILER•COMP (DVBf 100,000 BTU) SEE FEE SCH. MECHANICAL hereby eulhorio, representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC. - REFER TO ORD. CONST. TAX (We) agree to Sr , Indemnify and keep harmless the City of Cupertino agmnst labilittes, judgments, costs and expenses which toy in any way accrue sigulnstamd C' y In consequence of the ranting fill 0hit 4' PERMIT ISSUANCE 10,00 MECH. CONT. LIC. NO. MECH. TOTAL TOTAL Signa re o Applicant/Contractor Datif OFFICE COPY'