The URL can be used to link to this page

12384 POST THIS CARD NEAR FRONT OF.BUILDING CITY OF CUPERTINO lFRi INSPECTION DIVISION ^ �� JOB INSPECTION RECORD PERMIT-UPI RATI ON JOB ADDRESS 9101ti/Ad./ UNIT# _LOT# 160.00 Q111'd PERMIT EXPIRES IF WORK OWNER 5 CONTRACTOR IS NOT STARTED WITHIN INSPECT N DATE INSPECTOR INSPECTI NRECO 180 DAYS OF PERMIT ISSU- FOUNDATION S^ ANCE OR 180 DAYS FROM LIFER _ �� LASTCALLED INSPECTION. PREGUNITE PERMR VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED i UNDERGROUND /SLAB 7 PLUMBING 1 ELECTRICAL ISSUANCE DATE MECHANICAL BLDG. ELECT I PDG. MECH/ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION PLUMBING WOOD FLOOR vALunnoN SIFT. MECHANICAL 143 000 ELECTRICAL • PERMIl TO FRAMING 8111 10 F ily Dwell STORIES TYPE CONSTR. INSULATION 1 rJ N. 6L. OCC GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED R-3 1 .� ROOF SO,FT.FLOOR AREA TOTAL ACREAGE DIAPHRAGM 2227 BULLU use ' ries IND CON PB - DO- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ® El 1:1 0 0 ROUGH - O K#� W,.y{` ASSESSOR=P±HCFC NO. PLUMBING4,70? or -a0-d / - p•7?w TRACI'NO. PARCEL NO.. GAS TEST 0_ -7 -L../. III-0 MECHANICAL ! " 7"" 7907 ACC.DATE ACC PILE NO. ELECTRICAL ,�J FINALS DATE INSP. FRAMING 6 SAN # / Q(o ZUNING ENG.SITE NO, INSULATION - PLUMBING 2- jGAS StutiI 71).,Z4�2 MECHANICAL N �1-2� FIRE SPRINK ENERGY P24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y "� � LATH-INTERIOR - ELECTRICAL FLOOD ZONE A,L.Uc. LATH-EXTERIOR 9 $. p"f FIRE DEPT. Y❑ NEj Yo No SHEETROCK 3. GRADE FEE SUMMARY SHEAR INTERIOR 9.7%3-ABUILDING -22 SHEAR EXTERIOR -%3 TEMPORARY APPROVALS BUILDING 540.50 FIREWALLS ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE 10.01 OCCUPANCY OF BUILDING ISNOT.PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM i ARRANGE FOR. INSPECTION BY PHONING 252-4505, ELECTRIC � Lu ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING . z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX 273.90 . PLEASE READ REVERSE SIDE,BEFORE TOTAL 824.41 CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUI LDI NO PROJECT I DENTI FICATID PERMIT NUMBER -• nml.mrvc APPLICATION & PERMIT ADDRESS21170Rainbow Dr. '/ BUILDING -ELECTRICAL-PLUMBING -MECHANICAL 12384 NOWNERAMh1� ,�-J y PLAN CHECK VALIDATION I� GREGORY GROUPS PHON. QTY. ELECTRIC PERMIT FEE 351.33 Nome A°TORS -•� OUTLETS-SWITCHES-RECEP 10.00/1.00 i y13��9� LIGHTING FIXTURES 10.00/1.00 160.00 paid LIC. noo ess Tona � d1''II C-d✓�/ �(1 ` ' .` APPLIANCES-RESIDENTIAL 4.00 C, �W FHONEJ ]S uDU PANELS 0.00 DATE OF APPLICATION OR J PLAN CHECK FEE P.C.NO. SECT PANELS )OVER 200 AMP) 20.00 ENGIN, � mC�u .rv0. SIGNS TRANS. 3.00 ARCH.OR Ery SPECIAL CIRCUIT 5.00 PERMIT VALIDATION DOREss ��9/� �� • �� 0� zIP9LlEMP. METER OR POLE INS. 20.00 PAID •J APPucANrs -�J r� MOTORS SEE FEE SCH. AODR A Q C �5 [IJCi C2's SERVICE CHANGE 20.00 IV 1 ,, :� o D o LICENSED CONTRACTORS DECLARATION {�I�/ t/1 �1N/ <u I hereby affirm that I am licensed under provisions of Chapter 9 `l Of YIIGIA DATE ' (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. r wi Professions Code,an y license is in full for�-kj y4pd e f�p1 J ® ❑ ❑ ❑ 2 o w - License Class_1_l Lic.Number c �V 7 O m r Dale Contrnctar , mf - BUILDING PERMIT rc a OWNER-BUILDIiR DGCLARA'fION a a u,u INFORMATION aa ;'r I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD w VALUATION $/FT. HLo J Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requires a permit to construct,alter, 2 ¢ ¢ p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. 143 e D )0 - O LL requires the applicant for such permit to file a signed statement that TOTAL n w he is licensed pursuant to the provisions of the Contractor's License PERMIT TO i Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE Single Family Dwell. r$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 1 5 N. Hr. of not more than five hundred dollars(8500).1: ❑ I,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 R-3 1 • property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SD,FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve GAS-EA.SYSTEM 1 INC.40UTLETS 6.00 ments are not intended or offered for sale.If,however,the building 2227 or improvement is sold within one year of completion, the owner. GAS EASYSTEM OVER 4 (EA.) 200 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 Omer ❑ 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 properly who builds or improves.1 hereon.and who LAWN SPRINKLERS-OVER 5 (EA,) 1.00 [ a 3 contracts for such projects with a contraclor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sea ,B.&P.C.for this WATERHEATER W/VENT 6.00 reason 7907 - Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPF.NSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to set GinsUm, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insura ora certified .opyulereGnsee.3800 Lab Cp.ny 06 7 A112 policy er - Company_ 0 {7/Cerifled is hereby fur015I d. FIRESPRINK ENERGY T-24 Z 2 .8{1 Certified cCO,',' is filed with �th� ny�inspection division. O App cant ' 'Y°j'C'�' --4,`�1112L ' MISC.- REFER TO ORD. v❑ N❑ v ❑ N❑ OC N CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU COMPENSATION INSURANCE PLG.CONTR, LIC.NO. PLG. Z ('Phis section need not be completed if the permit is for one TOTAL Y E] N El Y❑ N❑ hundred dollars IS 100)or less.) U O I cenify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL, F- mil is issued,1 shall not employ any person in any manner so as to O W become subject to the Workeri Compensation Laws of California. a Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 540.50 } rn NOTICE TO APPLICANT: If,alter making this Certificate of Ex. F 2 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 U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10)DOOQF.NL) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000QEM.) 6.00 SEISMIC FEE 10.01 I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.L t HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATINGUNIT(OVER 100,000 B.T.U.) Lender's Address ELECTRIC . 1 certify that 1 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 ordinances and state laws relating to building construction, and BOILER-COMP(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 )Over 100.000 BTU)SEE FEE$CH. MECHANICAL (We),agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX 273.90 may accrue against sa' City in consequence of the Ming Of[his rmiL MECH.CONT. LIC.NO. MECH. �3 TOTAL . TOTAL 824.41 Signatu of Applicant/Contac r Date - ' OFFICE COPY