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16386POSTTHISCARD NEAR FRONTOF BUILDING ' CITY OF CUPERTINO��$� INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS _LOT# OWNER. e-1 !1✓t1„ V CONTRACTOR SGOT(Q ' PERMIT NUMBER ` PERMIT EXPIRATION PERMIT EXPIRES IF WORK I IS NOT .STARTED WITHIN,t 180.DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE. INSPECTOR INSPECTION RECORD NOTE:' ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUBERTINO STANDARDS. - O LIFER � � PREGUNITE - Pili MIT VALIDATION I r !'x rd Tr issuANCE un Ir: BLOCELecT PEs.. MEr,R .x 06 GARAGE SLABS' - �. POUR NO CONCRETE UNTIL ABOVE. HAS BEEN SIGNED 1d UNDERGROUND/SLAB- PLUMBING Qlp ELECTRICAL -'Got MECHANICAL DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATIONS WOOD FLOOR - PLUMBING - VA UA7ION �il" PC$ �I. $IFT. MECHANICAL ELECTRICAL _ q PERMIT TO FRAMING(TCFIS INSULATION sTORle R Tvve corvsr. -PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ,nCC CROUP RES UNITS • ROOF. NOTE:.NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID SO FT. FLOCK AREA TOTAL ACREAGE DIAPHRAGM ROOF SHEATHING BUILDING USE RES IND CON PB 00 - ❑ ❑ ❑ ❑ ❑ "APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS'' DATE ' INSP., ROUGH SAN.a ASSESSORS PARCEL NO PLUMBING ELECT. ENERGY TUBS &SHOWER PAN - PLUMBING ENERGY - IRACT NO PARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC. DATE ACC FILE NO FRAMING K' cke a ELECT. FINAL TEST - INSULATION K�i'�N I_$�bC PLUMBING-�.- zoNlNc .ENc. SITE No. GAS TEST - GAS' MECHANICAL FIRE SPAINK Y ❑ N❑ ENERGY T.IA Y ❑ No COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR,L ELECTRICAL RELEASE — �j � FLOOD&INE - Y ❑ N A.L U.0 Y ❑ NEI INTERIOR SHEAR - FIRE DEPT.• SHEETROCK GRADE' FEE SUMMARY EXTERIOR LATH BUILDING % BUILDING pQ INTERIOR LATH _ TEMPORARY APPROVA SCRATCH COAT ELECTRIC. - PLAN CHECK FEE , - �+. 2 'S -,-- GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUI LDI NO IS NOT PERMITTED UNTI L BU I LDING F I NA L IS SIGNED BY BUILDING INSPECTOR. MICROFILM' ul ARRANGE FOR INSPECTION BY PHONING 252-4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. z PLEASE GIVE JOB ADDRESS WHEN PHONING.. -SEE PERMIT FOR EXPIRATION DATE — ELECTRIC 1 V PLUMBING,up MECHANICAL — coNsr: rax IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL. 127 OFFICE COPY m APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -USE BALL POINT PEN. ONLY I I '81.JILDING PROJECT IDENTI IDENTIFICATION.- - APPLICATION$! PERMIT.- ' BUILDING - ELECTRICAL- PLUMBING. -MECHANICAL PERMIT NUMBER ,.. 16386 ADDRESS . ADDRESS �� C .�„ OWNERS ANE - 'T" I We-El He .Zw41 yob PHONE QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION ' DATE OF APPLICATION I DO AMERACTORs .. ',. :5 GS a7h C r1c. No UTLETS-SWITCHES-RECEP '10.00}7-00 LIGHTING FIXTURES 19:00/1.00S"D no�o']eess�T/ORS 1`I $�'/:� OI {7/ PLt PHONE LQ Y PPLIANCES- RESIDENTIAL X4M &-O PANELS 10.00 ARCHITECT on ENGINEER AAA LIC. No. PANELS (OVER 200 AMP) ' 20.00 PLAN CHECK FEE - .C,,NO. SIGNS TRANS. 3.00 - AARCH . OR DDRESS ENG. $PECIALCIRCUIT 5,00 PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 ZIP' APPLICANT'S - ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION PAID - 151988 I hereby affirm that 1 um licensed under provisions of Clmptel' 9 (commencing with Section 7000) of Division 3 of the Business and Professions Co e, nd y license is in full fn{C�P ffec4. 3 License ss Lie. Number" J ISSUANCE DATE BLDG. ELECT. PLG. -' MECH. -� Uale_ /S� Contrucmr,57s _n_C7_, OWNER-BUILDFR DECLARATION" I hereby nffiun that I am exempt from the Contractor's License Law for the following reason.(Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit toconstruct,alter, BUILDING PERMIT INFORMATION MISC. - O ORt PERMIT ISSUANCE, h0�d'^ LUATION rt �/aO0' $/FT. ELEC. CONTR. LIC. NO. ELEC. j TOTAL - QTY. PLUMBING PERMIT FEE Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed Statement that he is licensed personal to time provisions of the Contractor's License Law (Chapter 9(commencing with Section 7000) of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom and PERMIT TO ,,\\ ''`` / 4b 1%!d the basis for tire alleged exemption. Any ululation of Suction 7031.5 by any applicant for a permit subjects the applicant toa civil penalty than of not more than five hundred dollars ($500)J: STORIES - TYPE CONSTR. ALTER -DRAIN & VENT -WATER (EA.) .5.00 ❑ 1, as of the property, ,r my employees with wages as their sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE ` 4:00 OCC. GROUP AES. UNITS DRAINS -FLOOR, ROOF, AREA,COND. 5.00 - intended or offered for sale )Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds'or improves thereon, and who does such work himself or through his own employees, provided that such improve - Glenns are ao( intended or offered for sale. If, however, the building •' �. FIXTURES - PER TRAP 5.00 ;L So. FT, FLOOR AREA TOTAL ACREAGE GAS - EA. SYSTEM -11 NC.4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have tire e burden of proving that he did not build or int- prove for purpose of sale.). ❑ 1, as owner of the property, am exclusively contmeting with - . - 'GAS EASYSTEM OVER 4 IEA.) 2.00 BUILDING USE RES' IND CON PS 'Other 1:1 ❑ ❑ INDUSTRIAL WASTE INTER.- 30.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or inproves thereon, and who LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ' LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with a contmclonsl Incensed pursuant to the Contractor's License Law. SEWER -SAN V -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under See. ;IL&P.C. for this reason WATER HEATER W/VENT - 6.00 Owner Dam' WATER SYSTEM 5.00 ACC.DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 WORKERS'COMPENSA'1' ION DECLARATION I hereby affirm that I have a certificate ofemnsenl to sell -insure. ,r a certificate of Workers' Compensation Insurance, ,r a certified ZONING ENG. SITE NO. copy thereol'(See. 3800, Lab.C.)r.. Polic 'Company / rpM _lune Certified copy is hereby furnished. M d �Cerlified copy is fled with time city inspection division. Applicant��-h-�` - FIRESPRINK Y [:] N0 ENERGY T-24 Y [] NC] ,. MISC. - ' REFER TO ORD. PERMIT ISSUANCE 40:00 '" CER'fIFICATF: 01' EXEMPTION FROM WORKERS' FLOOD ZONE I A.L.u.C. C'OMPRNSATION INSURANCE (This section need not be imo, lead if the permit is for one PLG. CONTR. LIC. NO. PLO, ,y -p TOTAL 'C_. Y [] NE] V [] N F] hundred dollars($100) ,(less.) 1 certify that in the performance of the work for which this per- mit is issued, 1 shall ml employ any person in any nmannerso as to QTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING 7 d - become subject to the Workers' Compensation Laws of Culitornia. Dane Applicant NOTICE TO APPLICANT: If, after making this Certificate of Ex- . . ALTER OR ADD TO MECH. 500 APPLIANCE 5.00 AIR HANDLING UNIT (TO 10,000 C.F.M.) 4.00 PLAN CHECK FEE em vision you should became subject to the Workers' Compensation provisions of for Labor Code, you most forthwith comply with such provisions or this permit shall he donned revoked. AIRHANDLING UNIT (OVER 40000C.F.M.) 6.00 SEISMIC FEE C V CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency lot EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). - - W Al e J^ MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC VENTILATION FAN ISINGLE) 4.00 Icertify that l have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING BOILER- COMP (3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL thereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. - (WC) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against mid City in conserLuence of the minting, f this p il. y ,- y �N a MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT. LIC. NO. MECH. TOTAL - - TOTAL /4�3 - 3s L� Signature of Applicant/Cont clot Date "' OFFICE COPY