The URL can be used to link to this page

12412 POST THIS CARD NEAR FRONT OF BUILDIfLIG,,WW PERMIT NUMBER CITY OF CUPERTINO 12412 INSPECTION DIVISION JOB INSPECTION RECORD" _ lr PERMIT EXPIRATION •JOBADDRESS 10135 Scenic Blvd UNIT# _LOT,# PERMIT EXPIRES IF WORK OWNER CONTRACTOR Teru Brown IS NOT STARTED WITHIN 180 Dnvs of PERMIT Issu- INSPEC ION DATE I INSPECTOR INSPECTION RECORD FOUNDATION - 7-(4--k-7ee a{y, wrcLk xreotr 16PNICE OR 180 DAYS FROM - LASTCALLED INSPECTION. UFER L PREGUNITE 0%, PERMIT VALIDATION POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ^1 lr*[< '� 1 ' UNDERGROUND /SLAB �/� �•C./ PLUMBING `• p ELECTRICAL DIOISSUANCE DATE MECHANICAL •,. BLDG. ELECT, PLL. MECH. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT ` INFORMATION WOOD FLOOR vALunnoN slRr. PLUMBING ?rf MECHANICAL „8•51 216" PERMIT t0 ELECTRICAL FRAMING -Z STO R IES TYPE CONSTR. INSULATION l J OCC.GROUP RES.UNITS IRLTACEIN aSU,BFLOOR UNTIL AB VE HAS B N SIG ED SO,FT,FLOOR AREA TOTAL ACREACli ROOF i D'IAP'HRAGM _ BUILDING USE ! I RES' IND CON PR OtLrr f?APPL'°V NO ROOFING UNTIL ABOVE HAS BEEN SIGNEEl ❑ El El ElD ASSESSORS PARCEL NO. ROUGH — PLUMBING GAS TEST TRACT NO. PARCEL NO, MECHANICAL ACC-DATE ACC.FILE NO, ELECTRICAL FINALS DATE INSP. FRAMING - I SAN n ZONING ENG.SITE NO. INSULATION, PLUMBING GAS FIRE SPRINK ENERGY T24 MECHANICAL �❑ N❑ r ❑ NE] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH-INTERIOR - -Ill- ELECTRICAL FLOOD ZONE A.L.u,C. LATH-EXTERIOR _ .� FIRE DEPT. •v❑ No 10 No SHEETROCK GRADE FEESUMMARY SHEAR INTERIOR J•• _ BUILDING - BUILDING r• � SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS 0 ELECTRIC PLAN CHECK GAS - i- FEE - [NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY , I I SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM .-u ARRANGE FOR INSPECTION BY PHONING 252.4505, ELECTRIC / k� * ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING / : r jPLEASE GIVE JOB ADDRESS WHEN PHONING. ' ? * — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT!' CONST.TAX G /J . PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. ` OFFICE COPY I r FINAL Q GRADE - ,�/ ROUTE SLIP _ li File No. ate l0 �O .3 Lo ation Su t i V , y Approve ----------------- 4 - �., .. L ICANT TO FILL IN INFORMATION WITHIN RED LINES - USE3AL11POINT PEN ONLY BUI LDING PROJECT IDENTIFICATION PERMIT NUMBER DILDINc APPLICATION & PERMIT ADDRESS 1. sLENtC R, �� 12412 /3S BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME CiTY. ELECTRIC PERMIT FEE rCZ / cDNTPac oP's- OUTLETS-SWITCHES-RECEP 10.00/1.00 � /! d t'/V aME tC Efzn eirto(A/rJ LIC.No.g'352f, LIGHTING FIXTURES 10.00/1.00 nooeass Dni121 GRANM1OA {}VQ 3 PPLIANCES-RESIDENTIAL 4.00 &. PHONE-SVksvy` - I PANELS 10.00 DATE OF APPLICATION nctorecT IPANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. on O ENGINEEP {� LIC.No. $jD 1.27C SIGNS TRANS. 3.00 ADDRESS ENG. SPECIALCIRCUIT 5.00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.00 APPLICANTS MOTORS SEE FEE SCH. aooPEss S RVICE CHANGE 20.00 G 0 o LICENSED CONTRACTORS DECLARATIONic c,w I hereby affirm that 1 am licensed under provisions of Chapter 9 I I I NI n n.�.. ISS CE DATE Q (commencing with Section 7000)of Division 3 of the Business and v v u /� rd IJI.;r BLDG. EL GT_ ' s F o z Professions Cod§and my license is in full for,gtt l effec},Z L r�p 'r Z o G- License lass Lic.Number '2 6 7� 9 z R D Dilc �-'�Contractor City of Cupertino r.= -, Q se -+ BUILDING PERMIT X a wu& OWNGBUILDER DECLARATION E: o INFORMATION n t- I hereby arm that I am exempt from the Contractor's License MISC.- REFER TO ORD ; 0 affirm Law fertile following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 0 VALUATION g/FT. - Code:Anycily orcounty which requires a permit to construct,alter, / fi/ ELEC.CONTR. LIC.NO. � EE 66 Q i Q Q improve,demolish,Of repair any structure,prior to its issuance,x150 ELEC. / ! 0 o.LL requires the applicant for such permit to file a signed statement that TOTAL / PERMIT TO se$ he is licensed pursuant to the provisions of the Contractor's License - FiQLaw(Chapter 9(commencing with Section 700()ol'Division3ofthe 3'� W Business and Profeuions Code)or that he is exempt therefrom and DTV. k PLUMBING PERMIT FEE r the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. P. by any applicant for a permit subjects the applicant to a civil penalty DRAIN&VENT-WATER IEA.) 5.00s � of not more than five hundred dollars($5001.): ALTER- ❑ 1,as owner of the property,or my employees with wages asBACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for Sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 _ 3 / Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who docs such work ( F IXTURES-PER TRAP 5.00 50.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve menta are not intended or offered for sale.If,however,the building GAS-EA.SV$TEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS EASYSTEM-OVER 4(EA,) 2.00 builder will have the burden of proving that he did not build or i - .m- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 3000 RES IND CON Pa Oram 111,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 Comracim's License Law does not apply t3 oases to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 oo - 9 -75 contracts for such projects with a contractors)licensed pursuant to I the Contractor's License Law. I SEWER-SANITARY-STO RM EA.200ft/10.00 Q TRACT NO. PARCEL NO. Cl I am exempt under Sea ,B.&P.C.for this ' 1 WATER HEATERIWIVEN.t 6.00 6 reason Owner Date WATER SYSTEM 5.00 S ACC.DATE ACC.FILE NO. WORKF.RS'COMPENSATION DECLARATION WATER TREATING:EOUIP,/ 5.00 1 hereby affirm that I have a certificate of consent to self-insure, ZONING or a certificate of Workers Compens ti nsumnce,or a certified ENG.SITE NO. copy thereof(Sec.3800,Lab.CJ.A en, uIty ot Uuportino 11 Policy No. - CompanyOG-1000'1 1901 CPA O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z O Certlfiedsp is filed w I the ity inspection division. REFER TO ORD. O Applicant 1 En.12J' S /LbWYI/ MISC.- y ❑ ry❑ y ❑ ry❑ PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. LU CERTIFICATEOFEXEMPTION PROM WORKERS' v W COMPENSATION INSURANCE PW.CONTR. LIC.NO. PLG. a dollars a YE] N❑ Y N .I (This section need not he completed if the permit is for one TOTAL � 2 hundred dollars(S 1001 or less.) U O 1 certify that in the performance of the work for which this per, DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,'I dtall not employ any person in any manner so as to O become subject to the Workem'Compensation Laws of California. W Date Applicant ALTER OR ADD TO MgC.y"n 5.00 BUILDING � B' } to NOTICE TO APPLICANT'. If,after making this Certificate of Ex- F2 emption,you should become subject to Ole Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with - FEE V such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10,000 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT IOVERIO,000D.EM, 6.00 SEISMIC FEE �3 01- I hereby affirm that there is u construction lending agency for EXHAUST HOOD( „ITH,DUCT), 5.00 the performance of the work for which this permit is issued(See MICROFILM 3097,Civ.C.). + HEATING UNIT (T 6100,000 B.T.U.) 8.00 Lender's Name Lenders Address HEATI NG UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read this application and state that the above 4 VENTILATION FAN (SINGLE) 4,00 146 - information is correct. I agree to comply with all city and county PLUMBING ordinances and slate laws relating to buildingconstruction, and BOILER-COMP(3 H.P.Or 100,000 B.T.U.) 6.00 Q hereby authorize representatives of this city to enter upon the BOILER-COMP(Overt0O,000BTU)SEE FEE SCH. MECHANICAL 3 above-mentioned property for inspection purposes. (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 3 9J may in any way acerae against said Ci in consequence of the granting of this permit. MECH.CONT. LIC.NO. MECH. p �F_arfti/3 oauAl R 3-6- TOTAL 3� TOTAL ` Signati�ppticant/Contra am / �// OFFICE COPY