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18094Is 1 4**. POST THIS CARD NEAR FRONT OF BUILDING - CITY OF "CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD T ��-JAR JOB ADDRESS_Iq_Ir����VA_I� `4=j/ I!1_iIvUN I # _LOT#. �I. (�•�(,r .1 OWNER Ul.. V (. ` L� IS ONTRACTOR sp I'[RMLT NUMBER 1$094 PE TE+{ -4 TION EXPIR�rI$ F;WORK IS INDSTAR ED V�ITHIN PERMIkS 188 DOF PERMIT ISSU. ANCE OR 180 DAYS FROM LASTCALLED INSPECTION, INSPECTION DATE INSPEC OR INSPECTION RECORD FOUNDATION ' NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER PRRGUNITE PERMIT VAUDAT1ON t ',, -I •a 1� V1 � a. r - 'ISSUANCE DATE GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED V�'S%WS 1-3-goGlC� . UNDERGROUND/SLAB PLUMBING - ELECTRICAL MECHANICAL pLDr, ELCCT. PLC. MLCI DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT •INFORMATION WOOD FLOOR VALUATION SIFT. •_ / I' ryir ! PLUMBING MECHANICAL- �G`0 7w r— z /' ELECTRICAL PC i HMII TC (`C'F'•b' •fir FRAMING INSULATION O STORIES TYPE. CONSTR OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF - NOTE: NO FINAL INSP. SHALL BE MADEBEFORE THE CONSTRUCTION TAX IS PAID - Stl. E O R' HEA 111Y'i" f TO TA I: CR EA(iP (tre DIAPHRAGM - ROOF SHEATHING ! BUILDING USE HES IND CON.. PB oe„•. 0 L L L ❑ - APPLY NO ROOFING UNTIL ABOVE HAS'BEEff SIGNED - FINALS DATE INSP. ASSESSORS PARCEL NO. ROUGH SAN.# W (a U E PLUMBINGELECT. ENERGY _ TUBS B SHOWER PAN `D2 -h PLUMBING ENERGY rRncr NO. PARCEL No MECHANICAL 'Z ELECTRICAL- 24to8 MECH. BUILDI Y Acc. unrE ACC, FILE No FRAMING u(l 4 INSULATION ELECT. PLUMB ZONING ENG. SITE NO, GAS TEST Q GAS MECH ANI L EIRE SPR INK v NL R ENER`v r14 v 1 N D COVER NO WORK UNTIL ABOVE HAS BEEN S GNE HEATING FLOODIGNE Y NL ALUc. v L N❑ EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. SHEETROCKI) GRADE FEE SUMMARY EXTERIOR LATH - BUILDING - BUILDING INTERIOR LATH ' TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAFEE CHECK ..„._,,,• GAS - FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY LSEISMIC OCCUPANCY OF BUILDING IS NOTPERMITTEO UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM '^•- ARRANGE.,FOR INSPECTION BY PHONING -252-4505, , F ONE WORKING DAY BEFORE REQUIRED INSPECTION. o� PLEASE GIVE JOB ADDRESS WHEN PHONING. z - SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL - Z CONST. TAX �'p7 IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINALINSPECTION. TOTAL / , .. OFFICE COPY O X z Foo QUV y�i a o?=w F Q0WU B., IS Hu IS BEw > E QQ00 Aw LL a iii sza r o a 3 m 0 Z y L _ CL C) Vo LL h- 0 F Z A APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICA IQN - APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL ,PERMIT NUMBER O ADOREa � BUILDINGP114� - 13 D ER'S ,t "NAME ._. OTY. ELECTRIC PERMIT FEE P CON KfDIDATI , CCO•NNTTRACTOR'S NAME UTLETS- SWITCHES -RECEP 10.00/1.00 2/ - LIC. No. ✓fp s II LIGHTING FIXTURES 10,00/1.00 CONTRACTOR'S ADDRESS ��'L- 5£_ y96-3669 S APPLIANCES -RESIDENTIAL 4.00 ( C DATE OF APPLICATION PANELS 10.00 ARCHITECT OR ENGINEER c. rvo,Z�6 '0 PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE P.C. NO. .._ SIGNS TRANS. 3.00 AR, ENG. ��tl,,,/// ADDRESS ss a�.� �iA-c.crry 21P SPECIAL CIRCUIT 5.00 PERMIT VALIDATION b (/ TEMP. METER OR POLE INS. 20.00(1001,, AAooREPPLICANT'" ss MOTORS SEE FEE SCH: Si £, - /t ` J • /L'L�rl� t-\ SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION ,1. I hereby affunt that 1 am licensed under provisions of Chapter 9 Icommencing with Section 70001 of Division 3 of the Business and Professions Code,.Vd my license is in full forc�aryl f eel. License, Class_Aj Lic. Number_Or? DIIte Contract., OWNER-BUII.DI:R DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the following onxr.(Sec. 703 1.5, Ifusinessand Professions Code: Any city or county which rcquiresa permit to construct, biter, ISSUANCE DATE BLDG. E ECT. LO. EC . - B LDING ERMIT INFORMATION MISC. REFER TO ORD -' - PERMIT ISSUANCE 10.00 (=Z6 VALUATION --yy $/FT. �]/411 ELEC. CONTR. LIC. NO. ELEC. TOTAL $ • �' 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 pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and I_I I�1 PERMIT TO QTY. PLUMBING PERMIT FEE the basis for the alleged exemption. Any violation of Section 7031.5 byanyappllcantforapermit subjects the applicant to a civil penalty of not more than five handfed dollars ($500f): STORIES TYPE CONSTR. - ALTER -DRAIN -WATER (EA.) 5.00 ❑ I, as owner of the property, or 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 RES. UNITS ROOF, AREA, CON D. 5.00 intended or offered for sale (Sec. 7044, Business and ProfessionsDRAINS-FLOOR, Code: The Contractor's Licanse Law don not apply to an owner of ' FIXTURES - PER TRAP 5.00 GAS-EA.SYSTEM-I1NC.4OUTLETS 6.00 property who builds or improves thereon, and who docs such work himself or through his own employees, provided that such improve-- mentsare notimor endedofferedfarsale. ILhowevecthe building SO. FT. FLOO EA IDS TOTALPP PAGE r 00 or improvement is sold within one year of completion, the owner-AALI builder will have the burden of proving that he did not build or im- prove for purpose of sale.). ❑ I, as owner of the property, am exclusively contracling with GAS-'EA..SYSTEM -OVER 4 (EA.) .2.00 BUILDING USE RES IND CON PB Othe, ❑ ' ❑ El El ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.1 1.00 licensed contractors m Cot the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who ASSESSORS PARCEL NO. contracts for such projects with a contracbms) licensed pursuant to line Contract.,', License Law. SEWER -SAN V -STORM EA. 200ft/10,00 TRACT NO. PARCEL NO. 0 taco exempt lender Sec. ,E.&P.C. Oa Ibis reason WATER HEATER W/VENT 6.00 Owner Date WATERSYSTEM5.00 ACC. DATE ACC, FILE NO, WATER TREATING EQUIP. 5.00 WORKBRS'COMPENSATION DECLARATION I hereby affirm shut I have a certificate of consent to yell -insure. or a ceniflcate 01' Workers' Compenaa�li n I�nsu,rance, or u cerliffed copy thereof (Sec , Lab,C I'nlicy �mpany ❑ CertiSed Copy i. hertby furnished xL. CertTified col�t' is filed with tspectinn Division. Applicant /" Q, _y 6Z� ZONING ENG. SITE NO. . FIRESPRINK V ❑ N ❑ FLOOD ZONE Y ❑ N❑ ENERGY T-24 Y ❑ N ❑ A.L.U.C. Y ❑ N❑ MISC. - REFER TO ORD. "•f CL'R1'IPICA'1E OF EXEMPT ION FROM WORKERS' COAIPENSA'ITON INSURANCE (This section need not be Completed if the pennit'i_s for one PERMIT ISSUANCE 10.00 (Z•OD PLG, CONTR. LIC. NO. PLG. TOTAL iZ hundred dollars IS 100) or less.) I certify that In the performmnce of the work for which this per- hill is issued, I ,shall not employ any person in any Conner so as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING �^ '�11 become subject to the Workers' Compensalion Laws of California. Date Applicant NO'T'ICE TO APPLICANT: II', after making this Certificate of E ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00. AIR HANDLING UNIT (TO lo=C-F.M:) 4,00 PLAN CHECK FEE' _ emption, you should become subject to the Workers' Compensation provisions of the Labor Code, you most forthwith comply with such provisions or this permit shall be deemed revoked AIRHANDLING UNIT(OVER 10PMC.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance d' tl work lot w ich ilii p,. rmit s Issued ISea 3097,Civ.C.). % 'ate MICROFILM '+-- HEATING UNIT (TO 100,000 B.T.U.6 8.00 Lender's Nam Lender's Adji,ress' �• HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC $y'•L7 Icertif •�fl-MJvetupplicalion and state that tile, above VENTILATION FAN(SINGLE) 4.00 information is correct. I agree ,, comply with all city and county ordinances and state laws relating to building construction, and. PLUMBING _L - BOILER-COMPOH.P.or100,0008.T.U.' 6.00 BOILER -COMP (Over 1DG,OGO BTUI SEE FEE SCI. MECHANICAL 7 �L� hereby authoritt representatives of this city to enter upon tin° above-mentioned property for inspection purposes. (We,) agree to save, indemnify and keep harmless the City of - MISC. - REFER TO ORD. 2.Z7 Cupertino against liabilities, judgments, costs ;cod expen which may in any way accrue against said ,Ci in Came on • of tl e moil ren CONST. TAX PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. TOTAL 7/1,�7 1 TOTAL ���,6 Signature of ppllcaul/Cunemctor Date OFFICE COPY .