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15963 POST THIS CARD NEAR FRONT OF BUILDING ERMITNLMBEa' CITY OF CUPERTINO 1596 INSPECTION DIVISION JOB INSPECTION RECORD ' 1 i J I L PERM T�EXPIRATION� JOB ADDR ESS / y (. ./u1-� f UNIT# _LOT# - - - PfRMIT•E PIRIS I WORK OWNER e`PJJ P CONTRACTOR S 7� 93 NOT �fARTE�WITHIN I SPECTION DATE INSPECTOR INSPECTION RECORD - 1BODAYSOFPERMITISSU- FOUNDATION ANCE OR 180 DAYS FROM ; NOTE: LIFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION C.UPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE LATE MECHANICAL BLDG. TEyECT9 LG. M CH XIP DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION GALUAt.ION $IFT. PLUMBING MECHANICAL �'��© ELECTRICAL PERMm To FRAMINGPAID el� INSULATION sroRlEs TYPE coNs 1-1 •q VI• . TI OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so FT aooa AREA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING HIS IND CON Pe and APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. L 0 .El L 11 ASSESSORS PARCEL NO. ROUGH - SAN.#' PLUMBING ELECT,ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY Q TRACT NO PARCEL NO MECHANICAL _ 2 MECH.ENERGY ACC DATE ACC.FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION PLUMBING _ q 41.0(� ' GAS TEST _ L GAS •' MECHANICAL FIRE SPRINK '.ENERGY T 74 , COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING yo NO yo NL A FLOOD ZONE ALUC• ' EXTERIOR`SHEAR - ELECTRICAL RELEASE rL NO rL N[]INTERIOR SHEAR FIRE DEPT. - SHEETROCK ` -e GRADE - FEE SUMMARY EXTERIOR LATH BUILDING ` BUILDING ,INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK GAS - FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED occuagNlcv SEISMIC FEE /I OCCUPANCY OF BUILDING IS NOT PERMITTE D UNTI L BUILDING FINAL IS SIGNED By BUILDING INSPECTOR. MICROFILM LU ' ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC IF Q I ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL �p IMPORTANT! CONST.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 PERMIT NUMBER BUILDIN APPLICATION & PERMIT 15963 ADDflESS I J J J - AVE BUILDING-ELECTRICAL-PLUMBING -MECHANICAL Cf]�rJ ER's PLAN CHECK VALIDATION NAME -Z 3r QTY. ELECTRIC PERMIT FEE 14 • PHONE �9.7J- iS NAME CONTRACTOR UTLETS-SWITCHES-RECEP 10.00/1.00 .9P CONTRACTOR'S LIC.NO. LIGHTING FIXTURES 10.00/1.00 ADDRESS ,r 11 APPLIANCES .4.00 ness PHONEPANELS 10.00 �, DATE OF APPLICATION onARCHITECT- PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.N0. ENGINEER - . uc.No. SIGNS TRANS. 3.00 ARCH.OR ENG. PERMIT VALIDATION ADDRESS SPECIALCIRCUIT 5.00 ZIP TEMP.METER OR POLE INS. 20.00 ADDRESS ' MOTORS SEE FEE SCH. r'D SERVICE CHANGE PAMW w 00 LICENSED CONTRACTORS UECLARATION ' S,U V I hereby affirm that 1 am licensed under pwviSionr of Chapter 9 ,ISSUANCE DATE ' H 4 y (Commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. I-w z Professions Code,and my license is in full force and effed. Z,o m - License ClassLic.Number (K„I o m w Date ac Contrtor City of Dimino a F y f - BUILDING PERMIT Im ¢ OWNER-RUILDER DECLARATION a d u INFORMATION w 3 u t hereby Rolan that I um exempt from the inessacd Pr License MISC.- REFER TO ORD VALUATION $/FT. FuoJ Law for nycity orcoung nlson.(Srequirsir permit tocodProfessions PERMIT ISSUANCE 10.00 Z,pD Code!Anymolish cuuNyir any structurep prior illoconstrucLaaeq /� ^^/ Q¢ improve,demolish,or repair any ntrudur0.prior m its issuance,also ELEC.CONTE. LIC.N0. ELEC. IX�� d o u requires the applicant for such permit to file a signed Statement MIDI TOTAL / i PERMIT TO w m he is licensed pursuant to the provisions of the Contractor's License F z i Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe •17 a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE IF- ¢ Is-°$ the basis for the alleged exemption.Any violation ofSection 7031.5 gTORES TYPE CONSTR. d3 - by any applicant for a permit subjects the applicant to a civil Penalty gLTER-DRAIN -WATER (EA.) 5.00 of nor more that five hundred dollars(15001.1: {¢i 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS tlmlr sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business anti Professions DRAINS-FLOOR,ROOF,AREA,CONE). 5.00 Code:The Contractors License Law does not apply Io an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5,OD x O D 56 FT.FLOOR AREA TOTAL ACREAGE 4 himself re of intended his own employees.provided that such im Prove I mems are throng nhis or Offered employees. or provided that sthebuildiug GAS-EA.SYSTEM-1INC.4OUTLETS 8.00 of Impravemem is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4 (EA.) 200 builds,will have the burden of proving that h • . . . e did not build or im- BUILDING USE RES IND CON PS other prove for Purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 0 � ❑ El ❑ ❑ L as owner of the property,be exclusively contracting with licensed colons od to construct the project La 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The who o License Law neon not aptly ho to tr owner of property who builds or improvesthereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts far such cense L with a contuaon sl licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200tt/10.00 TRACT No. PARCEL No. ❑ I am exempt under See..,BAP.C,for this WATER HEATER W/VENT 6.00 reason Owner Dam -IH- WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS OMPENSA'rION D17CLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have acerli5eate ofconsent toself-inshre, ZONING ENG.SITE NO. or o certificate of Workers'Compensation Insurance,or a certified copy thereof(Secv3800,Lab.C.). Policy No. Company 0 ❑ Certified Copy is hereby furnished FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is riled with the city inspection division. O_ Applicant MISC.- REFER TO ORD. y ❑ III[] Y ❑ N[D T CERTIFICATIi OF EXEMPTION I7ROM WORKERS' PERMIT ISSUANCE 10.00 (.Z•/1!J FLOOD ZONE A.L.U.C. - LU > COMPHNSATION INSURANCE PLG.CONTE. LIC.NO. PLG, nn'''' Z ' I' 1'his section need nut he connpltlel if Ills permU it is for one TOTAL U.00 Y� N Y 1:1N hundred dollars(5100)or less.) 0 O I certify that in the performance of the work for which this per- OTV MECHANICAL PERMIT FEE FEE SUMMARY - LL F mit is issued,I shall not employ any person in it nuuuscr so us to U become subject to the Workers'Compensation Laws of California. y Date Applicant ALTER OR ADD TO MECH. 5,00 BUILDING Z0 oD >_ So NOTICE 1'0 APPLICANf: If,utter nuking this Cerlil kale of Ex' F 2 ensption,you should become subject to Dm 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 10O00C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE D I hereby affirm thatthere is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 r the performance of the work for which this permit is issued(Sec. MICROFILM 3097, .C.). HEATING UNIT(Tq 100,000 B.T.U.) 8.00 , 0 D Lender's Name HEATING UNIT 100,000 B.T.U.)9.50 r D Lender's Address ELECTRIC L I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and county PLUMBING Oa p U ordinances and state laws relating t0 building conStruelion, and BOILER-CONT(3H.P.or100,000B.T.U.) 6.00 hereby tf h i Purposes.oritt representatives oThis city to enter upon the above-mentioned property forinspBOILER-COMP (Over 100,000 BTU)SEE FEE SCH, MECHANICAL I n0 x L(We) to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. nst liabilities,judgments, costs and expenses which CONST.TAXay accrue against said City in ennserumtce of fhc PERMIT ISSUANCE 10.00 E)0 permiC� MECH.CONT. LID,NO. MECH. JTOTAL TOTAL/Contractor OFFICE COPY