The URL can be used to link to this page

17157 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 17157 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS UNIT# _LOT#* PERMIT EXPIRES IF WORK OWNER ✓ CONTRACTOR e. �- V IS NOT STARTED WITHIN INSPECTION DATE F INSPECTOR INSPECTION RECORD IV 180 DAYS OF PERMIT ISSU. FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASE CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL-BE INSTALLED PR EGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMrt vn uOA nDN OUPERTINO STANDARDS. GARAGE SLABS POUR NO NCRETE UNTIL ABOVE HAS BEEN SIGNED FED v UNDERGROUND /SLAB O /� PLUMBING !7 V H Oct-/ ELECTRICAL - - ISSUANCE LATE MECHANICAL - - m.Dc ELECr. PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION s/ET. PLUMBING MECHANICAL ' ELECTRICAL PERM1+IT To FRAMING `e-r—st STORIES TYPE CONSTR. INSULATION OCC GROUP r RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so Er FiooR AREA TOTAL AcnEACE -� DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RCS IND CON PB Om., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP ' ❑ ED ❑ ❑ ❑ ROUGH SAN.q ASSESSOR5 PARCEL No. � PLUMBING ELECT,ENERGY. TRACT NO PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL - MECH.ENERGY ELECTRICAL A c DATE ACC PILE No BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG SITE NO, ' INSULATION PLUMBING GAS TEST GAS - MECHANICAL FIRESPRINA ENE[] LSE COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Q NE] N� . EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONEA L U C. Y❑ N❑ YL N❑ INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE 'FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE " NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. MICROFILM w ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z�-H- PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL 2J'V CALLING FOR FINAL INSPECTION. OFFICE'COPY , 'APP4.ICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER DO APPLICATION & PERMIT AII�� [� ADDRESS p �J Z1O i/ aeafA-rr' /eO�D BUILDING-ELECTRICAL-PLUMBING-MECHANICAL I OWNER'5 PLAN CHECK VALIDATION ' &DOXV �D 1!f{r� OTY. ELECTRIC PERMIT FEE G gr 2/oD CONTRACTORS/ UTLETS-SWITCHES-RECEP 10.0011.00 V*W LIC. LIGHTING FIXTURES 10.00/1.00 COrvrHacroRs C PPLIANCES-RESIDENTIAL 4.00 r ' O ' PANELS 10.00 j'sio DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C. 0. oR Z PANELS (OVER 200 AMP) 20.00 ENG uc.e SIGNS TRANS. 3.00 AARCH OR DDRESS ENG. / T SPECIAL CIRCUIT 5,00 PERMIT VALIDATION -5 4CA_fM Al zIP f� EMP.METER OR POLE INS. 20.00 �C APPLICANT'S ) - 2- - MOTORS SEE FEE SCH. A�74�AO ss V SERVICE CHANGE 20.00 11 G o o LICENSED CON'T'RACTORS DECLARATIONLa k.fJCG( < u W I hereby affirm for I an, licensed under provisions of Chapter 9 a i ISSUANCE DATE I-z (commencing with action 7000)of Divisor of the Business and y ¢ BLDG. ELECT. PLG. MECH. �w i Professions Cade, d my license is in full fo effec o L w License a>.� Lie.Numbe f� City of Cupertino m� Date_ Contractor a y s azl BUILDING PERMIT ¢ ¢ a OWN[ BUILDER DECLARATIO p d u INFORMATION F ; a-n I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD u O¢ Law for the following reason.(Sec.7031.5,Business and Professions VALUATION S/FT. _ PERMIT ISSUANCE 10.00 Q Iv'0 Code:Any city or county whichrequiresa permit to construct.alter, , ac ¢ ¢ O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIG NO. ELEC. , O LL requires the applicant for such permit to Ole a signed Statement drat TOTAL a.. 1/ PERMIT TO E se he is licensed pursuant to Ore provisions of the Contractor's License HiQ Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe' eL Se 4 O Business and Professions Code)or that he is exempt therefrom and' DTV. _ PLUMBING PERMIT FEE ¢ F$ the basis for the alleged exemption.Any violation of5ection 7031.5; STORIES TYPE CONSTR. n3- by any applicant l'nr a permit subjects the applicant too civil penally gLTER-DRAIN&VENT-WATER IEA.) 5.00 of not more than five hundred dollars($5000.): 0 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SD.FT.FLOOR AREA TOTAL ACREAGE himself re through his own employees,provided that such improve mems are throuhh isot or Employees,ffered for rovideoweveglhomp... e. GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 builder will have the burden of proving that he did not build or im. BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Other ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. 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-OVER 5(EA.) 1.00 contracts for such projects with a contractoAs)licensed pursuant to SEWER-SANITARY-STORM EA.200ft 10,00 the Contractors License Law. / TRACT NO. PARCEL NO. ❑ lam exempt under Sec. .BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Z /� II me WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO, WORKIiR C MPEN5ATIOI U`ARATION WATER TREATING EQUIP. 5.00 1 reby atfrm Hrat l have acertiflcate ofecosent toself-insure, ZONING ENG.SITE NO. or a c ificate of Workers'Comp�ntion Insurance or a certified copy the •o' Sec.3800,Lab.C.l ^J /7a Policy N _Company .�J�-r- O ❑ Cert died copy is hereby furnished FIRE SPRINK ENERGY T24 Z 2 ❑ Certifie copy is filed with the city inspe ion division. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ O Applicunl- Y N Y N ~ rn CCCIiR"f 119CA'I'Ii OP EXI"M PTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. I LU D COMPENSATION INSURANCE PLO,CONTR. LIC.NO. PLG. 0. 0 ('Phis sectidn need not be completed if the permit is I'nr ane TOTAL Y❑ N❑ v ❑ N❑ hrmdled dollars I$100)or less.)O I certify flint in tiro performance of the work for which this per' OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL U mit is Issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. 0 i Dale ApplicantALTER OR ADD TO MECH. 5.00 BUILDING } W NOTICE TO APPLICANT: If,after making this Certificate of Ex- ? emplion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10ACC.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the peocirrearce.AL the work for which this rm it is issued(Sec. MICROFILM 3097, .C.). •Cy--i5� ��j e HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name rFJ ��= HEATI NG UN IT E R 100,000 B.T.U.)9.50 Lrnders Addre � � ELECTRIC e I certify that I have radoAAM ap� V/ate that Ilse above VENTILATION FAN (SINGLE) 4.00 information is correct I agree to comply sal h all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.Dr 100,000 B.T.U.1 6.00 hereby authorirc representatives of this city to enter upon lire BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection put pows. tnuy We) xgr.1 to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. o against liabilities,judgments, costs and expenses which CONST.TAX in y wa accrue against said City in consequence of flue PERMIT ISSUANCE 10.00 ting hi or,tit. - MECH.CONT. LIC.NO. MECH. F� Z TOTAL TOTAL n ro of Applicmr t/Contractor ate - OFFICE COPY _ Lr h