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13919POST THIS CARD NEAR FRONT OF BUILDING -CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS 10055 N. Portal. Ave UNIT# 110 LOT# OWNER CONTRACTOR Bay Area Mech PFRM1IIT NUMBER 13919 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU ANCE OR 180 DAYS FROND LASTCALLED INSPE#ION: INSPECTION DATE INSPECTOR INSPECT ION RECORD FOUNDATION UFER PREGUNITE PERMIT VALIDATION n r 00c �,PLUMBING ISSUANCE DATE POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED , 1 1`� Lh'4. tr'(,��, 111 ,. r' •, I/ UNDERGROUND/SLAB ELECTRICAL MECHANICAL y JL,I IA •• BLDG,tE LEC T. PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ��1i`, I10SF Ot: C�S?ERI BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION $/FT. PLUMBING U MECHANICAL ELECTRICAL PERMIT To (/J; .FRAMING INSULATION STORIES TYPE CONSTR. OCC. GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO. FT. FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE IVES INP CON- PB Ober ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH ASSESSORS PARCEL NO, PLUMBING GAS TEST TRACT NO, PARCEL NO. MECHANICAL _ -V ELECTRICAL FINALS DATE INSP. ACC.OATE ACC. FILE NO, FRAMING SAN u INSULATION - PLUMBING ZONING ENG. SITE NO. GAS . MECHANICAL FIRE SPRINK ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH -INTERIOR ELECTRICAL FLOOD ZONE Y N❑ A.L.U.C. Yo N❑ LATH -EXTERIOR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR' BUILDING ,BUILDING SHEAR EXTERIOR' TEMPORARY APPROVALS FIREWALLS - ELECTRIC .PLAN CHECK FEE I' GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY . SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, F ONE WORKING DAY BEFORE REQUIRED INSPECTION. z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL / CONST. ONST. TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL / OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ._ BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMITNUMBER 13919 BUILDING ADD Es t O N 's NAME f/ c� /15 QTY. ELECTRIC PERMIT E PLAN CHECK VALIDATION PHONE CONTRACTORS OUTLETS - SWITCHES -RECEP 10,00/1. LIGHTING FIXTURES 10.00 .00 . rvo. .o TR croRs �..-PPLIANCES ADDRESS -RESIDENTIAL 4.00 PANELS 10.00 Ada DATE OF APPLICATION ITECT OR ENGINEER LIC. NO. PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C. NO. SIGNS TRANS., 3.00 ARCH. OR ENG.SPECIAL ADOREss zIP aPPucarvr's aooREss CIRCUIT 5.00 1 -r � 1 � EMP. METER OR P E INS. 20:00 ,J �(' MOTORS SEE FEE SCF]. PERMIT VALIDATION � rL� '.' 8 SERVICE CH GE 20A0'� LICENSED CONTRACTORS I .CLARATION CI 111' It,nn. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cad icense is in full fort fey. License lu Lic. Numher.r�-�'Is-/--- ISSUANCE DATE •vs ; 4pi(, BLOGI '•❑ �ECEMT� ),ELECT P.LG. MECH. �j�I �' ❑ Date Contract yL `�x s BUILDING PERMIT NI>R-BUILDNR DE I hereby affirm that I am exempt from the i GmNctor's Licens Law for the following mason. (Ser 7031.5, Business and Pro fess] s Code: Any city or county which requircsa permit to construct ler, improve, demolish, or repair any structure, prior to its issua e, also requires the applicant for such permit to fill` a signed stat ent that he Is licensed pursuant to the provisions Of the ContraC is License,/ Law (Chapter 9(commencing with Section 7000) of ision3 ofthe Business and Professions Code) or that Ise is exe therefrom and the basis for the alleged exemption. Any violati of Sect ion 7031.5 INFORMATION MISC. - REFER TO ORD VALUATION $/FT. PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. - ELEC. TOTAL PERMIT TO OTY. PLUMBING PERMIT FEE 1 STORIES TYPE CONSTR. ALTER -DRAIN -WATER IEA.) 5.00 by any applicant for a permit subjects the app' ant to a civil penalty of not mare than five hundred dollars ($50 .): ❑ I, as owner of the property, or in employees with wages as their sole compemcnion, will do the w k, and the structure is not intended or offered for sale (Sec. 7 44, Business and ProfessionsDRAINS-FLOOR, BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS ROOF, AREA,COND. 5.0 Code: The Contractor's License L docs not apply to an owner of property who builds or improve hereon, and who does such work himself or through his own a oyces, provided that such improve- ments are not intended or o red for sale. If, however, the building FIXTURES - PER TRAP .00 SD. FT, FLOOR AREA TOTAL ACREAGE GAS-EA.SYSTEM-11NC.40UTL S 6.00 .r improvement is sold w' ]n one year of completion, the owner- builder will have the bu en of proving that he did not build or im. prove for purpose of s e.). 0 L as owner o the property. am exclusively contracting with GAS - EA. SYSTEM - OVER 4 ( .) 2.00 BUILDING USE RES IND CON PB Omer ❑ ❑ ❑ 0.0 INDUSTRIAL WASTE IN 30.00 licensed contract s to construct the project (Sec. 7044, Business and Professions .ode: The Contractor's License Law does not apply to an owner property who builds or improves thereon, and who LAWN SPRINKLERS- 1 C 5 V.B. 6,00 LAWN SPRINKLERS VER 5 IEA.1 1.00 ASSESSORS PARCEL NO. contracts f such projects with a cnntmetor(s) licensed pursuant to The Coat Clors License Law. - SEWER-SANITA -STORM EA. 200tt/10.00 TRACT NO. PARCEL NO. ❑ am exempt under Sec. , BAP.C. lilt this rea WATER HEAT W/VENT 6.00 O er Date WATER SYSTEM 5.00 ALL. DATE ACC. FILE NO. -WATERYAEATING EQUIP. 5.00 WORKERS'COAIPENSATION DECLARATION I hereby affirm that I have a certificate of consent to sCIFinsum, or a certificate o Workers' Cotnpen ]on Insurance, or a cunified ZONING ENG. SITE NO. Copy therygf C.). [j/t/ I'oli�cy yy � FIRE SPRINK Y ❑ rv❑ ENERGY T 24 Y ❑ N❑ ,til ied copy is hereby furnishc it ❑ CertiO it copy ]s filed with the city inspection division. Applicant MISC. - REFER TO ORD. :RTIF C E OF Ex MPI 10 FRO n 1 KERS' PERMIT ISSUANCE 10.00 FLOOD20NE A.L.U.L. PLG.CONTR. LIC. NO. PLG. ITOTAL OMPENSATION INSURANCE (This section need not be completed if the perm' or one Y ❑ N ❑ Y ❑ N❑ hundred dollars IS I GO) .,less) I certify that in tlm perf."mm"e of thefor which this per mil is issued, I that not employ any anin any manner so as to bec esut ws of Ca if t'. - TI A I emption, you thou ecome subject to the Workers' Compersal ion provisions of Labor Code, you must forthwith comply with such prov' s or this'perm]I shall be deemed revoked OTY. MECHANICAL PERMIT FEE FEE SUMMARY NG BUILDING ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK FEE AIR HANDLING UNIT (TO 10=C.F.M-) 4.00 AIR HANDLING UNIT(OVER 10000C.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agent EXHAUST HOOD (WITH DUCT) 5.00 the performance at'the work for which (],Is ol ISec. 3097. Civ.C.). MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATING UNIT (OVER l00,000B.T.U.)9.50 ELECTRIC Lender'I Name Iss VENTILATION FAN (SINGLE) 4.00 I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating m building construction, and PLUMBING BOILER - COMP 13 H.P. Dr 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000STU1SEE FEESCH. MECHANICAL00 hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in w accrue against said City in conseque a oft gran fit' erunit MECH. CONT. - LIC. NO. MECH. TOTAL ZLITOTAL �v ig reof App' ant/Co ractor to OFFICE Cr NJ