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14182
POST THIS CARD NEAR FRONT OF BUILDING I`FRM iNUMtlER CITY OF CUPERTINO 14182 . INSPECTION DIVISION JOB INSPECTION RECORD I�x ' PERMIT EXPIRATION . JOB ADDRESS d /O91 /'�:�J I,(/ SUNIT# LOT# PERMIT EXPIRES IF WORK OWNER LuemAjCONTRACTORCc/ IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR ;;?w'INSPEC ON RECORD 180 DAYS OF PERMIT ISSU- ANCEFOUNDATION c5- - �` -'p"-}Z• -=Np'I KIf '�;,r,�,pl µ0 fG OR 180 DAYS FROM LASTCALLED INSPECTION. LIFER O PREGUNITE 9/�&/-s -u'��- PERMIT vALlonrloN POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I UNDERGROUND /SLAB �9 PLUMBING Q A ELECTRICAL (NVQ ISSUANCE DATE MECHANICAL C��y BLoc. ELEcr. PLc. mECR. � N DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED � :' aIT'`ssq"` t4sFN WOOD FLOOR r,NOMb i PLUMBING vALUATIDN -�lPFQT,'k i-i - O oZ L9 ab a ^' MECHANICAL ELECTRICAL �p��To -� FRAMING - -pY`�q+ �'�- - INSULATION /I— —00 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 RES IND CON PB me,' ;`APPLY NO ROOFING UNTIL-ABOVE HAS BEEN'SIGNED." ONO. El ASSESSORS PARCEL C; ROUGHa3 �S-o� PLUMBING T I - A 1152, GAS TEST TRACT NO. PARCEL NO. MECHANICAL 2Z ELECTRICAL G,.`�l., - n a( �-DATE°, ''ANSIR.v; ACC.DATE ACC.PILE No. F'S FINALS a;% Is`:; �+;.1° Ii;:f= a.�, FRAMING - SAN # ( (pia ZONING ENG.SITE NO. INSULATION � PLUMBING GAS -s- �'j,�_ L y FIRE SPRINK ENERGY TZ< MECHANICAL t - - Y E3 No Y Q N[3 tCOVER NO WORK UNTIL-ABOVE HAS BEEN SIGNED,@ HEATING _ $ FLOOD ZONE A.L.U.C. LATH-INTERIOR ELECTRICAL — - L,G v� N� Y ❑ N❑ LATH-EXTERIOR _ _j FIRE DEPT, �� SHEETROCK GRADE - 'a '"'d�K ] - ?'a."FEE SUMMARY, jIa SHEAR INTERIOR BUILDING —2- C SHEAR EXTERIOR ' Z TEMPORARY APPROVALS BUILDING 730V" FIREWALLS ELECTRIC 73_/;X-64F PLAN CHECK j� S/in r'I 2 GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS OPEN SIGNED JOCCUPANCY I SEISMIC FEE IS-3i OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 011 • o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 4.0 Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANTI CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL �6 CALLING FOR FINAL INSPECTION ` OFFICE COPY APPLICAN-I TO FILL_ IN INfORmA fIOIV VVI-I Hi V RLD LINES - 0:11'E BALL POINT P'icl'J ONLV y BUILDING PROJECT IDENTI FICATION � PERMIT NUMBER aoILDING APPLICATION & PERMIT - o7 ADORE as 141 n 2 BUILDING - ELECTRICAL-PLUMBING-MECHANICAL ownEHs -�C NAME QTY PLAN CHECK VALIDAT)ON ,4R� A`/Jt / n (J s J� ELECTRIC PERMIT FEE /7 G� PHONE /6 (d 3«/ !O ' NAMECONTcrony OUTLETS-SWITCHES-RECEP 10.00/1.00 jINAME p LIGHTING FIXTURES 10.00/1.00 rONTRACTOR'S ADDRESS _ (Jn/ PPLIANCES-RESIDENTIAL 4.00 PANELS 10.00 DATE OF APPLICATION Afl CHITECT PANELS (OVER 200 AMP) 20.00 OR PLAN CHK^ F P.C.NO ENGINEER (i 4• Lo.No. SIGNS TRANS, 3.00 ARCH.OR ENG. aoOHEss SPECIALCIRCUIT 5.00 PE'R,MIITE A ID nP EMP.METER OR POLE INS. 20.00 AOD APPuRE55 canrMOTORS s SEE FEE SCH. s'( SERVICE CHANGE 20,00 D _ .02 LICENSED CONTRACTORS DECLARATION rt u I hereby t,..II flat I am 000) of under l 3 of[he of Chess and ISSUANCE DATE _ a"' (cmnmencing with Section 7000)of Division 3 of the Business and F„Z Professions Cole,m nsy hCeltie is in lull Ibree red a 1. BLDG. ELECT., PLG. MEC Z v,w License Clug_- Lic.Number._,L.Y/ 2 ,a F� Date - = C'avracor- .. ¢ ¢ w OWNER-BUILDER DECLARATION BUILDING PERMIT w0 u w I hereby affirm than I am exempt from Ile Conlopa is ns Licee MISC.- REFER TO ORD • 'INFORMATION i Foo 'a Law forthe followingreason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE VALUATION $/FT. Fwj Corte:Any city ar county which re9uiresu permit loconslruct,16, x'98 au ? ¢0 improve,demolish,or repair ally structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC. AA "' / y a IS fell ulres lite applicant for such permit to tele a signed statement that TOTAL 9 VV J w m he is licensed Pursuant to the provisions of IIle Contractor's License / PERMIT TO F. z i Law(Chapter 9(commencusg will,Seelmn 7000)of Division 3 of the W ^ wr/- ¢ Business and Professmns Code)or than Ilis exempt therefrom and CITY. -PLUMBING PERMIT- FEE' the V L a H m the basis lar fisc alleged exemption Any violation of Section 7031.5 I t , 1' STORIES TYPE CONSTR i ; � brant orePlilicarlora Permit dollars lheapplicam noucivilpewlly ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not mare Ilan five hmsdrop dollars 1Y5 employees � „Z-•� ,i' ❑ Las owner at tileon,properly,or my employees with wages as BACK FLOW PROTECT. DEVICE l.1 /\T~ their sole compensu[ion,Will do the work,and the structure now 4.00 OCC.CROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The CONIIRC(O!s License Law does amt aPPiy to an owner.I' - 3 'I Property who builds or improves thereon,and who dues such work FIXTURES-PER TRAP 5.00 himself or through his own employees,provided that such improve- SQ.FT.FLOOR AREA TOTAL ACREAGE ments are not intended oroifc,,d for sale.If,however,the boldingGAS-EA.SYSTEM-I INC.40UTLETS 6.00 . 3 O to or improvement is sold within one year of completion,the ownco builder will have the burden of Proving Hurt he did not build or ins GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 USE -" prove for purpose al'saleJ. BUILDINGINDUSTRIAL WASTE INTER. 30.00 RES IND CON PR Omni ❑ d as ownsr of the property,am excessively. 7044.(ing with ❑ ❑ ❑ ❑ licensed croons od :Tile truct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 and Professions GOJC The Contruclor's License Law does not apply ASSESSORS PARCEL NO. to an owner of property who builds or improves thereon,laid who LAWN SPRINKLERS-OVER 5(EA.) 1.00 36,2 " 3 -©V contruCIS for such Projects wills a contractor(s)licensed pursuant to the Contractor's License Law, SEWER-SANITARY-STORM EA.2001t/10.00 TRACT NO. PARCEL NO. ❑ I um exempt under Sec. B.&P.C,liar this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC.DATE ACC,FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm Ilial 1 have r,Crtil'ica,CufcON.aI luself-insure, or a certificate of Worker:Compensation Insure nee,, a certa..-J ZONING ENG.SITE NO. copy thercol'ISec.3800,Lab.CJ. L Policy No. Clmnpany O O Certified copy is hereby furnished. Z gJApplik Cerured copy is filed w'(lt the city inspection division. FIRE SPRINK ENERGY T 24 cao ��re�_g1/ILtilL.ej7T�� r_ MISC.- REFER TO ORD. - Y N Y N[ lir w CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 1 IYV W > COMPENSATION INSURANCI! FLOOD ZONE A.L.U.C. CL O PLG.CONTE. LIC.NO, PLG. (L,� Z (This xClars need Hol be completed If the Permit is for Otic TOTAL �Iv, Y N� Y 0 N� UO hundred Dollarslnl 00)pe less) 1 certify that In the to employ n of the work lot which this Per- QTY• FEE SUMMARY I�L0 F- mit is issued, I shall net roll s' an, "'MECHANICAL PERMIT P Y' Y Person in any Hunner so ax to FEE . wbecome subject to the Workers'Conspensution Laws of California. d Uate Applicant ALTER OR ADD TO MECH. BUILDING } w NOTICE TO APPLICANT: If,after making this Certificate of Ex- 5.00 )- Z solation,you should become subject to Ne Workers'Compensation APPLIANCE 5.00 PLAN CHECK Provisions Of the Labor Code, you must forthwith comply with -• C.1 such provisions or(his permit shall be deenmd revuked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 FEE CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.RM.) 6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 [Ile performance of the whrk for which this flbrihll is issued(Sec. 3097,Ch,C.), HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Leaders Name Lender's Address HEATINGUNIT(OVER100,000B.T.U.)9.50 ELECTRIC CQ77 I certify that I have read this application and stale that(he above VENTILATION FAN (SINGLE) 4.00 information is correct 1 agree to comply with all city and county Ordinances and state laws relating to building Construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING « ,.J hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL 1794�51 (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments', costs and expenses which ~ CONST.TAX may in any way accrue agains c quence of We PERMIT ISSUANCE «-i&BO -� n3 glan(ia I)is rr IL i Mf:CH.CONT. LIC NO. MECH, p OTAL / 9 J� TOTAL 33 9 SI Haran•ul r\Pplicanl/L'unlraclor Il.