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16199 POSTTHIS CARD NEAR-FRONT OF BUILDING PERMIT NUMBER CITY OF 'CUPERTINO 16199 INSPECTION DIVISION JOB INSPECTION RECORD •' G� I _ `PERMIT-EXPIRATION JOB ADDRESS /940 C/ UNIT# - _LOT# PERMIT EXPIRES IF WORK ! OWNEd "-(„_ �1 ULCl CONTRACTOR - '• IS NOT STARTED WITHIN INSPECTION DATE jjNSPECTOR INSPECTION RECORD 180 DAYS OF'PERMIT ISSU. FOUNDATION _ ANCE OR 180 DAYS FROM NOTE: LAST CALL EDINSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT vn LIDATTON CUPERTINO STANDARDS. ' GARAGE SLABS FAID POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB W.E',)A PLUMBING , �- ELECTRICAL - ISSUANCE DATE �V MECHANICAL - - oc.`L �LF.Ci .� ,Ea+.I DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - - BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING VALUATION gTf r. MECHANICAL ELECTRICAL f�,I- /ppPEIIRMIT TO , 1I FRAMING INSULATION - STORIES TYPE CONSTR OCC,GROUP RES UNITS PLACE NO. UBFLOOR UNTIL ABOVE HAS BEEN SIGNED S. FT,1=1.01111 A1ILn TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL 9E MADE BEFORE II - THE CONSTRUCTION TAX IS PAID 50 R \ DIAPHRAGM •� ouu.D uSE ROOF SHEATHING. - ❑ ED ❑ON ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE 'INSP. nssessO11s PARCEL NO ROUGH SAN.k 86q in�,_ b l PLUMBING ELECT.ENERGY I lJ TRACT NO. PARCEL NO. TUBS 8 SHOWER PAN \— PLUMBING ENERGY MECHANICAL MECH.ENERGY - ' ELECTRICAL .BUILDING ENERGY ACC.DATE ACC.PILE NO FRAMING ELECT,FINAL TEST INSULATION ZONING ENG SITE NO. PLUMBING �. r GAS TEST _ GAS FIRE SPRINK ENERGY T 24 .- • MECHANICAL p' i COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y E] N'❑ Y E] N _ EXTERIORSHEAR ELECTRICAL RELEASE �j � YLOCH ZONE A L U.C. E] N❑ Y ❑ NEI SHEAR FIRE DEPT. ' SHEETROCK •6.21'4°1 GRADE _ FEE SUMMARY EXTERIOR LATH BUILDING /-� .P•' BUILDING .INTERIOR.LATH - - TEMPORARY APPROVALS .E SCRATCH COAT — . ELECTRIC 'PLAN CHECK GAS FEE FTAPER PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY. SEISMIC FEE .6 Y OF BUILDING ISNOTPERMITTED-UNTILBUILDING FINAL ISSIGNED13Y BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRICONE WORKING DAY BEFORE REQUIRED INSPECTION. =` PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION.DATE — MECHANICAL IMPORTANT! coNsr.TAX PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE, BALL POINT PEN ONLY 41 BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER aUILDING APPLICATION &-PERMIT 16199 ADDRESS //�� �f� y � I� S/1C,'-E Cil ' BUILDING -ELECTRICAL-PLUMBING• -MECHANICAL '� OWNER'S p(:. INAME QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION 01tcktR4 s� w a s 7 s43� ''j s PHONE oC�/ - NAMERAcrDRs UTLETS-SWITCHES-RECEP 10,00/1.00 LIC.NO. LIGHTING FIXTURES' 10,00/1,00 ADDRESS OR's PPLIANCES-RESIDENTIAL 4.00 - 0 PHONE PANELS 10.00 2, rb DATE OF APPLICATION ARCHITECT PLAN CHECK FEE 11C.NO. OR PANELS (OVER 200 AMP) 20.00 MA PilSSOC-IH- ES LIC.NO. C- 1-541 ISIGNS TRANS. 3.00 ARC..OR ENG' SPECIALCIRCUIT 5,00 PERMIT VALIDATION SS w0 FL CRIY I,x,o SAW Ct-LN0 x,P 40b EMP.METER OR POLE INS. 20.00 AS - MOTORS SEE FEE SCH. l ADDREDDRESSS , I;L Sir , - c�r SERVICE CHANGE 20.00 w o o LICENSED CONTRACTORS DHCLARATION CU v u 1 hereby arOrm that 1 am licensed under provisions of Chapter? z w ISSUANCE DATE vHi¢ H (commencing with Section 7000)of Division 3 of the Business anti BLDG. ELECT. PLG. MECH. H w z Professions Code,and my license is In full force and effect, o z x D License Class Lic.Number H [)ate Contractor a " F ; Ci of Cupertino X ¢ w ¢ OWNFR-BUILDER DECLARATION - BUILDING PERMIT °AU MISC.- REFER TO ORD INFORMATION E: ; I- I hereby affirm that I am exempt from the Commetor's License' I w O 0' Law for lire following reason.(Sec.7031.5,Ifusinessand Professions VALUATION $/FT. L - PERMIT ISSUANCE 10.00 �. or 7 Code:Any city or county which requires permit to construct,alter, 111 R 6 ¢ 0 improve,demolish,or repair any structure,prior to its issuance,alio ELEC.CONTR. LIC.NO. ELEC. �i� �If 0 LL requires the applicant for such permit to file a signed statement that TOTAL s i 1/ PERMIT TO e- w m he is licensed pursuant to the provisions of the Contractor's License Hzi Law(Chapter 9(commencing with Section 7000)o'Division 3 critic7f-1/uJTL!/V a: o Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢H o the basis for lire alleged exemption.Any violation ofSection 7031.5 STORIES TYPE CONSTR. n; m by any applieanl for a permit subjects the applicant loa civil penalty gLTER-DRAIN&VENT-WATER IEA.) 5.00 U of nut more than fivehundied dollm,(S50().)t 1 ❑ .I,as owner of the property,or my Ent ployees with wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered tar sale (Sec. 7044, Business and Professions DRAINS.FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to anw owner or a.� property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 I ( r IQ+Oo SO.FT.FLOOR AREA TOTAL ACREAGE himself through his own employees,provided that such improve- -` ..r menus arere not intended or offered for Bale.It,however,the building GAS-EA.SVSTEM-l1NC.40UTLETS 6.00 I� I or improvement is sold within one year.of completion,the owmer- builder will have the burden of proving that he did not build or in- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE prove for purpose ofsnlc.). . INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer I,as owner of Ore property,an exclusively contumling with El El E El El lice ed coors construct tee project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V-B. 6.00 ASSESSORS PARCEL NO. and Professionslons Cade::The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPR IN KLERS-OVER 5(EA.) 1.00 ZL^l? r/' - ©I Contracts for such projects with a contractors)licensed pursuant to ✓.TI 1 the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lamex• sp un , ,ILAPSC.for this ' reason ` l' WATER HEATER W/VENT 6:00 ' Owner [)ate WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a ceriDeate of wmsent to sell'-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy Ihereof(Sec.3800,Lab.C.). Policy No. Company - 0 ❑ Certified copy is hereby furnished. FIRE SPRINK -ENERGY T24 Z Z 0 Certified copy is fled with the city inspection division. F O Applicant MISC.- REFER TO ORD. y E] N❑ Y ❑ AIC] cc: LO CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 �U' FLOOD ZONE A.LU.C. W COMPENSATION INSURANCE - PLG.CONTR. LIC.NO. PLG. Q' 01 (This Section need not be completed if tee permit is for one TOTAL a (D Y❑ N V,E] NC] Z hundred dollars(SI00)or less.) U O 'I certify that in the performance of the work for which this per QTY MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner so os to U become subject to the Workers'Compensation Laws of California. Q. Datc Appl'cam ALTER OR ADD TO MECH. 5.00 D BUILDING 33 d >_ In NOTICE TO APPLICANT: II',after making this Certificate of fix- , F. ? eruption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK CJ provisions of the Labor Code, you must forthwith comply with FEE Such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONST RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE I hereby alfirm that there is a construction lending aguncy for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name es3�g _ L,Tder's Add,", HEATING UNIT(OVER 100,000 B.T.U.) ELECTRIC I certify that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 ,y A mfonnation is correct.I agree to comply with all city and.county PLUMBING Q� ' unaoces and state laws relmm, m building BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 6 6 Construction,upon and Eby aulhoriee representatives Of this city to corer upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL ZSi ul.ove+ncntioned property for inspection purposes, "-� (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. ertinu against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 Z p p CONST.TAX I,, in any s rue against said City in conset uence Of fire , Ping of If rmi. MECH.CONT. LIC.NO. MECH. TOTAL TOTAL yZFt+ �b Stgnam hATipf¢anl GwNPasiae Vale OFFICE COPY /I