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16322'! POST THIS CARD NEAR FRONT OF BUILDING - ... CITY OF CUPERTINO - •INSPECTION DIVISION - JOB INSPECTION RECORD /� �� JOB ADDRESS ap 7 ✓LK�L • rL 'p, UNIT# LOT# OWNER CONTRACTOR' PERMIT NUMBER 16322 'PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN .180DAYSOPPERMITISSU- ANCE OR 180 DAYS FROM 'LASTCALLEDINSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION - NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER - PREGUNITE - PERMIT VALIHATION i. -- r k< < �? _ • ISSUANCE DATE GARAGE SLABS � � POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -UNDERGROUND/SLAB PLUMBING - ELECTRICAL•� MECHANICAL - p oG ELECT. p PLG, .MECO. ❑ El 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDcZ S�(� LDI NU PERMIT INFORMATION WOOD FLOOR PLUMBING - VA ASTON - �Ilper�o SIFT. MECHANICAL ELECTRICAL PERMR TO _ ^ Db1i• FRAMING INSULATION STORIES { TYPE CONSTR, - PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED OCC GROUP Res UN]TV Q ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID - SO. FT, I LOOM AREA IOTAI. ACREAGE. DIAPHRAGM - ROOF SHEATHING BUILDING USE REs IND 'CON PR Do...,, .• ❑ ' ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.q % H' AESSOS PAHCBL NO PLUMBING- ELECT. ENERGY TUBS &SHOWER PAN ' PLUMBING ENERGY TRACT NO. PARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC. DATE ACC FILE NO FRAMING - ELECT. FINAL TEST INSULATION -- PLUMBING ZONING ENG, SITE NO.. GAS TEST- GAS - - MECHANICAL FIRE SPRINK Y ❑ 'N❑ ENERGY T 2 Y ❑ N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING A EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE Y ❑ "❑' A,CU C. Y L,, N❑ INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPR VALS SCRATCH COAT ELECTRIC - - PLAN CHECK FEE GAS, NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINALJSSIGNED BY BUILDING.INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY.PHONING 252-4505, H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. O PLEASE GIVE JOB ADDRESS WHEN PHONING.,, Z • —SEE PERMIT FOR, EXPIRATION DATE — ELECTRIC PLUMBING �. . MECHANICAL coNsr. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE 'CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY O¢i Foo QUU H G y ONS �yHW Qy� E 0 w u co a. F 00 J t 6 Sp0 A. W m N or CE E o CE a 3 04 0 Z z F 0 Cr T W > (L Cl z U0 LL I- 0 OU F— z Z APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY "' BUILDING PROJECT IDENTIFICATION ---�% APPLICATION & PERMIT BUILDING — ELECTRICAL— PLUMBING—MECHANICAL PERMIT NUMBER 16322 BUILDING DDDRESS I -1 R'V rD�—-�-��.p —t OWNER'B JZ QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION CONTRACTOR S NAME �, 3 UTLETS- SWITCHES -RECEP -10.00/1,00 LIGHTING FIXTURES 10.0011.00 LIC. NO. corarnncTORs ADDRESS - APPLIANCES -RESIDENTIAL 4.00. PANELS - 10.00 PHONE DATE OF APPLICATION ARCHITECT ENGINEER uc. No. PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C:NO. ' - SIGNS TRANS. 3.00 AR. ENG. ADODDRE SS SS SPECIAL CIRCUIT —5.90 7 J-- PERMIT VALIDATION EMP. METER OR POLE INS..' 20.00 cap . n� ADDRESS rS MOTORS SEE FEE BCH. SERVICE CHANGE 20.00 G' LICENSED CONTRACTORS DECLARATION 111!—, I hereby affinl that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business Brd License Cha f,'Odl`, a11J my hel'n Li IS in IIJI force and effect. License Class Li,. Number 'ISSUANCE GATE BLDG. ELECT. PLO. 'MECH. ❑ ❑ _ Date Contractor p�0 OWNER-BUD.Df:RDECI.ARA'IION I hereby cthe ollo that I am exempt from the u Contractor's License Law forAny countywhihng reason. requiresc. a perminess t tocnd Professions Cope: Any city or county which requirese permit inconstant,,alter, also improve, Ianpplic or repair any structure, prior n 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 n License Law (Chapter Pr.conlmenCnd)or Section 7000) Business and Professions Code) or that he is exempt and exempt BUILDING PERMIT . INFORMATION %sas%LUATION $/FT. 1pD PERMIT TO %ice z�8o / MISC. — REFER TO ORD PERMIT ISSUANCE ELEG. CONTFl. - LIG. NO. TOTAL `` TOTAL 1 1 QTY. PLUMBING PERMIT FEE Ccti.nv0 fI1C basis for the alleged exemption. Any viololinn of Section 703 LS by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (5500)J: STORIES TYPE CONSTR. ALTER -DRAIN -WATER (EA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sola compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 - OCC. GROUP RES. 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 FIXTURES - PER TRAP 5.00 SD. FT. FLOOR AREA TOTAL ACREAGE property who builds or improves thereon, and who does such work hrough ownor offered lot Sfe. If, Howevered that , improve- meats are not meats are sat in sold offered lot Safe. If, the ith building GAS - EA. SYSTEM -1 INC.4 OUTLETS 6.00 is within mpleveq or improvement is sold within one year of completion, the owner- builder will have the burden of proving that h e did not build or am- GAS - EASYSTEM - OVER 4 (EA) ' 200 . .. BUILDING USE p ofor purpose of sale J. I, as owner of the properly, am exclusively contracting with RES IND CON PB Amer ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 lice sed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Luw Joys sol apply to an owner of property who builds or improves 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 contractors) liunwd pursuant to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10,00 TRACT NO, PARCEL NO. 01 a xemv under Sea ,B.&P.C. br his reason ' IS 1 WATER HEATER W/VENT 6.00 Owner �� - �� r f-� WATER SYSTEM 5.00 ACC. DATE ACO FILE NO. WATER TREATING EQUIP. 5.00 WORK Ii RS'COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of Consent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copy thereol'(So,. 3800, Lah.C.). Policy No. Company ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city inspection division Applicant FIRE BPRINK V N F]❑ ENERGY T 24 Y N F]❑ MISC.- REFER TO ORD. CI?RTIFICA'I' F: OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. ' COMPENSATION INSURANCE This sectlon used not be completed if the permit Is for one PLG. CONTR. LIC. NO. PLG. TOTAL Y ❑ N ❑ Y ❑ N hundred dollars IS 100) ar less.) I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner sn as to OTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING Q-0 became subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Ex- ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 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. AIR HANDLING UNIT (TO 10=CF.M.) 4.00 AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE �T 0-0 r - CONS' I' RUCTION LENDING AGENCY I affirm that there is a construction Imit is agency for EXHAUST HOOD (WITH DUCT) 5.00 performance f the performance of the work for which this permit is isauud (See. 3097, I. MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender,'a s NaNo me Lcnper's AAdress HEATING UNIT (OVER 100,000 B.T.U.) ELECTRIC fe VENTILATION FAN (SINGLE) 4.00 . I certify that I 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 relining to building construction, and PLUMBING BOILER -COMP ($ H.P. Or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city togenter upon the above-mentioned property for inspection purposes. BOILER -COMP IDVBr 100,000 BTU) SEE FEE BCH. MECHANICAL (WC) agree to save, indemnify and keep harmless the City of MISC. - REFER TO ORD. upertin. against liabilities, judgments, costs told expenses which a in any way accrue against sad City in consequ ce f the PERMIT ISSUANCE 10.00 CONST. TAX nr of th put I T si MECH. CONT. LIC. NO. MECH, TOTAL TOTAL 76Z Signature of Applicant/Contractor Dat OFFICE COPY