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17706POST THIS CARD NEAR FRONT OF, BUILDING CITY OF, CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD C/� �p p JOB ADDRESS 11 �'LO l�LAL�GL SQK��✓G� CP UNIT# -_LOT# `�`3 _ ow ER CONTRACTOR PERM IT NUMBER 17706 PERMIT EXPIRATION 1 PERMIT EXPIRES IF WORK , IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- OR 180 DAYS FROM LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION5i� 15ANCE ML NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. pAw. UFER W5 PREGUNITE PERMIT VALIDATION J ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED HAY 2 31989 UNDERGROUND/SLAB PLUMBING crw Of CUP -440 ELECTRICAL MECHANICAL BLrnrnOc EEEcr PLG. MECR DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDQJ BUILDING PERMIT INFORMATION WOOD FLOOR VALUAI ION GIFT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO FRAMING INSULATION. STORIES a Tvve coNSTR. rim OCC CROUP 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 'T FI.00RANIiA, I 2A7 TOTALACREAGE T DIAPHRAGM ROOF SHEATHING 2 BUILDING USE RES IND CON PB CIII ❑ ❑ El APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH '' 2A/S'S�E'S�SORS PARCEL N. 3"^" 5J. 04) PLUMBING ELECT. ENERGY .TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NO me PARCELNO MECHANICAL Q MECH.ENERGY ELECTRICAL � O � BUILDING ENERGY ACC DATE ACC: FILE NO FRAMING \ - ELECT. FINAL TEST - INSULATION PLUMBING TONING. ENG. SITE NO. ,GAS TEST GAS MECHANICAL FRREsPRINK " ENERGY 1.24 "� COVER NO WORK UNTIL ABOVE HAS BEEN IGNED HEATING EXTERIOR SHEAR - 'Z ELECTRICAL RELEASE FLOOD]ONE Y ❑ N❑ ALUC. ° ❑ N❑ INTERIOR SHEAR FIRE DEPT. - SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS -' SCRATCH COAT ELECTRIC PLAf,IrGLiGGK FEE �c''E�u lIYY GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE ' OCCUPANCY OF 8 UI LOING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNE D BYBUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ~�. ONE WORKING DAY BEFORE REQUIRED INSPECTION: z PLEASE GIVE JOB ADDRESS WHEN PHONING. 1. — SEE PERMIT FOR EXPIRATION DATE— ELECTRIC 70.36 PLUMBING 70'M MECHANICAL CONST. TAX IMPORTANT[ PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION.' TOTAL 1�S44.Q9 OFFICE COPY D 0 i oD 400 a 1. I-�z o_- ZOyr� Q Q K a W V w0Am LL04 E i 8 a � 0 0 a w �y � � a sit US a O ZZ =Q W j _ CL D Z UO LL U 0W } N Ab APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION -APPLICATION &PERMIT BUILDING - ELECTRICAL- PLUMBING -MECHANICAL PERMIT NUMBER 1 ?706 ADDRESS n9 aooREss OWN`nME J r, 1'S �/ (� } NA ' PHONE415/595-2100 DTY ELECTRIC PERMIT FEE PLAN CHECK VALIDATION CONTRACTOR AM QRACTOR's p n0 OUTLETS -SWITCHES• RECEP 10.00/1.00 LIC. No.B-4397 DATE OF APPLICATION LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S W1n in 1V2 ADDRESS ' CA 94065 PHONE RryM.IlJ1 415/595-2100 PPLIANCES-RESIDENTIAL 4.00 ' PANELS 10.00 ARCHITECT ECT S`Senian (gyri 11:2CYS O OR ENGINEER 0-8395 LIC. NO, PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE SIGNS TRANS. 3.00 ADDRESS ARCH. ORENG.2W1 iVe Santa Ana Heights, CA zip 92707 SPECIALCIRCUIT 5,00 PERMIT VALIDATION � r1 - TEMP. METER OR POLE INS. 20,00 APPLICANT Sr ADDRESS W)R 0olphin Of1Ve M, CA 94065 MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION 1 - AI PFAY I hereby affirm oval I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, my my license is in full loser t. License Class 6 o Number `F ISSUANCE PATE BLDG, ELECT. PLG. MECH. -Im Date' Cnntraemr 1 p ' VIy of OWNER -BUILDER DECLARATIONMISC I hereby affirm that I am exempt from the Contractor's License itocodProfessions Law for nyfollowing ntywhch c. 703 requires Code: Any city or county it any structur e Permit riooo tsissuance, also improve, demolish, or repair any structure, f, prior to its issuance, also for such revisit Is file a signed Smtemmn that orates the licensed hl' IS pursuant to the provisions of NIL' License BUILDINGPERMIT INFORMATION - REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION 185 865 , $/FT. ELEC. CONTE. LIC. NO. ELEC. TOTAL PERMIT TO (Chapter Luid (Chapter 9 f commencing with Section is exe of Division 3 of the 9ficor with )o t'DivisioS Business Professions or thus he is exempt therefrom and DTV. PLUMBING PERMIT FEE SFW for empt the basis for the a ora ermits exemption. Any applicant of a ciao malty by any applicant fora permit subjects the 500).)icum macivil penally : of not more than flue hundred dollars fray STORIES 2 TYPE CONSTR. ^1� 51Y1R ALTER -DRAIN VENT -WATER IEA.) 5.00 em s with wages as ❑ I, as owner of the will dol t or my, and the their sole compensation, will do the work, and the slruc[ure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AR EA, COND. 5,00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Low does not apply to an owner of r� R-3 FIXTURES - PER TRAP 5.00 GAS - EA. SYSTEM -11NC. 4OUTLETS 6.002917 SO. FT. FLOOR AREA - TOTAL ACREAGE UV property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve- mentserenotintendedorofferedforsale.lf, 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 of sale.), ❑ I, as owner of the properly, am exclusively coptmaing with GAS - EA. SYSTEM -OVER 4 IEA.) 2.00 BUILDING USE \ RES 1 IND CON PB Omer LM ❑ 0 0 1]\ . . INDUSTRIAL WASTE INTER3000 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law sloes 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 PARCE L NO. contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law. ❑ I am exempt under Sec.-, HL&P.C. for this reason -�� r SEWER -SANITARY -STORM EA. 200ft/10,00 TRACT NO. 8098 PARCEL NO. WATER HEATER W/VENT 6.00 Owner Data - WATER SYSTEM 5.00 ACC. DATE ACC: FILE NO. WATER TREATING EQUIP. 5.00 WORK ERS'COMPr.NSATION DECLARATION I hereby affirm that I have a certificate of consent to schimsu}e' or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. ropy thereof (See. 3800, Lob.C.). W1ted Pacific Policy No. Company 1.EU Certified copy is hereby furnished. XFIRE Certifi• py is fled with tl - city ili,speclion Aivision. Appli, c BPRINK V N ENERGY TY4 V N MISC. - REFER TO ORD. 'I I P"fl N FROM WORKERS' ' CIi RTH I'A'IEXEM PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. COMPENSATION INSURANCE (This section need not be completed iLlhi permit is for one y ❑ N ❑ y ❑ N ❑ PLG. CONTR. LIC. NO. PLG. TOTAL hundred dollars IS 100) or less.) I certify that in the performance of the work far which this per mil is issued, I shall riot employ any person in any runner so as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING J W.50 became subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, alter making HH, Certificate of Ex- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN,�jJ;QK FEE /C71CI T�r '15j:� 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 doomed revoked. AIR HANDLING UNIT (TO 10=C.F.M,) 4.00 AIR HANDLING UNIT (OVER IQOOOGF.M.) 6.00 SEISMIC FEE 13.02 CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 tire performance of the work for which this permit is issued (Sec. 3097,Civ,CJ. , HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name Lender's Address I certii'y that l have read thisapplieution and sane that the above HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC 70.35 VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply Witt, all city and county m ordinances and state laws relating building construction, and PLUMBING 70.35 BOILER •CUMP(3 H.P. or 100,000 B.T.U.) 6.00 hereby authorize representatives Of this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP IOver 100,000 B7u1 SEE FEE SCH. MECHANICAL 70.35 (Wo) agree to save, indemnify and keep harmless the City of MISC. - REFER TO ORD. Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against mid City in consequence of the unljn f 111unut- PERMIT ISSUANCE 10.00 'CONST. TAX 302.02 MECH. CONT. LIC. NO, MECH. TOTAL TOTAL 1,544.09 Signature of Applicant/Contractor Data OFFICE COPY