The URL can be used to link to this page

17704POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD U 7 v JOB ADDRESSNIT# LOT# OWNER CONTRACTOR PERMIT NUMBER 17?04 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU. ANCE OR 180 DAYS FROM LASTCALLED INSPECTION: INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION 'z NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. - P - UFER (e PREGUNITE PERMIT VALIDATION I• v ISSUANCE DATE GARAGE SLABS r- POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ! - of 0"Ano ELECTRICAL MECHANICAL B,.uc ® ELccr ® PLc MECR AJ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING ' VALUATION SIFT. 185oft MECHANICAL ELECTRICAL nN' /1 PLOW (�SIIANITU FRAMING INSULATION STORIES 2 TYPE CONSTR 9" pt-2SEt��rcC-i 4-�4Cil(1' OCC GROUP R-3 RES UNITS 1 PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID $O. FT FLOOR AREA M7 TOTAL 'I ACREAC.E DIAPHRAGM ^1/_0(1 ROOF SHEATHING A.�.1 1l BUILDING USE Res' IND cNN Pa ou„•, IN ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE ' INSP. ROUGH PLUMBING / - SAN.k _I ELECT. ENERGY ASSESSORS PARCEL NO TUBS& SHOWER PAN _ PLUMBING ENERGY T"A I No PARCEL NO MECHANICAL �_1 _ y� MECH.ENERGY ELECTRICAL 2.�jCI BUILDING ENERGY ACC DATE ACC FILE NO FRAMING z,?j ELECT. FINAL TEST INSULATION 2a, O PLUMBING ZONING ENG. SITE NO. GAS TEST GAS MECHANICAL FI RE scRlNrc ` ❑ N❑ ENERGY r as V ❑ N❑ COVER NO WORK UNTIL AB VE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLaou zorvE ❑ "❑ A.,.Uc v ❑ N❑ INTERIOR SHEAR FIRE DEPT.`' SHEETROCK p I GRADE - FEE SUMMARY EXTERIOR LATH BUILDING BUILDING 90.50 INTERIOR LATHTEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED (OCCUPANCY SEISMIC FEE 13.02 OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED By BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, o�ONE WORKING DAY BEFORE REQUIRED INSPECTION. Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - ELECTRIC 70•%, PLUMBING 70.38 MECHANICAL 70•% IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. CONST. TAX 302•(2 TOTAL 19544.M OFFICE COPY A APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PPERMIT NUMBER 17704 AoAr oEss OWNER'S (3 m Trr. ' 1 NAME �JJ W wY P„ONE415/595-2100 QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION NAME ACTORGroup, Inc LIC. No. B-430097 UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 DDRRAcroR's wlrj In C1Ve CONTRACTORS (�� 1 RWC, lA94065 PHONE 415/595-21 APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 ARCHITECT OR sseman Lagoni Architects ENGINEER LIC. No. 08395 PANELS(OVER 200 AMP) 20,00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ARCH OR ENG. 2031 0irrhard Drive 100 AGGRESS LVJ lIl Li I4t lJ Drive % tLN Santa Ana Heights, CA zip 92707 SPECIALCIRCUIT 5.00 PERMIT VALIDATION / / 1 _ J i �MCA MCA I ISSUANCE DATE BLDG. ELECT. PLG. MECH. rrEMP. METER OR POLE INS. 20.00 APPLICANTS 220-0 Twin Dolphin Drive AooREss Redl+ood City,94065 MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing will, Section 7000) of Division 3 of the Business and Professions Code, bpd my license is in full fore LHAY Liccroc Class D Lir.Numhcr_ . Dom Contractor 2 p�� IC1`O^RI�11 wV_ of W Q owthat IBUILDER DECLntile C that I am exempt Gam theC c,,and u License I hereby following Low Iia the following reason. (Sec. ]031.5, Business and PRN'ellum, Code: An t Any city Or county which sequiture permit toconstructalter, improve, demolish, or feralr any structure, tore, prior to its issuance, also requires ne applicant for such permit to fele a signed statement Li that he is licensed pursuant er the provisions of the ) o(Division License n( Division 3 of the Law (Chapter 9 (co Professions Business and Professions Code) or tlmt he is exempt therefrom and Cod with Thin Section is exempt the basis for the alleged exemption. Any violation of Section malty by any ore the fora permit subjects the applicant toacivil penalty of not more than five hundred dollars 15$0empl ❑ Las owner of the property, or my employees with re is as (heir wlc compensation, will do the work, and the structure rs not intended or offered for at, (Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of property who builds or improves thereon, and who does such work himself' or through his own employees, provided that such improve- meats are not intended or offered for sale. If, however. the building or improvement is sold within One year of completion, the owner- builder will have the burden of proving That he did not hoild of ins prove lbrp.....eofs'ale.)' CI 1. as owner of the property, um exclusively contracting with licensed contractors to construct the project ISce. 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of property who builds or improves fiction. and who a contracts for such pmjeets will, contraelmrs) licensed pursuant to the Contractor's License Law. ❑ l am exempt under Sec. ,BAP.C. for this rcasou BUILDING PERMIT INFORMATION MISC. - REFER TO ORD PERMIT ISSUANCE - 10.00 VALUATION p� p� 185,865 $/FT. ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO SFW SFW QTY. PLUMBING PERMIT FEE ALTER-DRAIN&VENT-WATER(EA.) 5,00 STORIES 2 TYPE CONSTR. BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP R-3 RES. UNITS . 1 DRAINS -FLOOR, ROOF, AR EA, COND. 5.00 FIXTURES - PER TRAP 5.00 so. FT FLOOR AREA 2917 orgt ACREAGE L 24�,;,)A U VI GAS-EA.SYSTEM-111NC.40UTLETS 6.00 GAS - EA. SYSTEM -OVER 4 IEA.) 2.00 BUILDING USE RBS IND CON PB Omer EX El El El E-1 INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. Y/„/'� �� ^A 64(y :i C-%2 ( LAWN SPRINKLERS - OVER 5 (EA.) 1.00 SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. p�a(�r, wA PARCEL NO. WATER HEATER W/VENT 6.00 Owner Dale WATER SYSTEM 5.00 WORA ERs confPENSnnoN DECLARATION 1 hereby affirm that 1 have a Certificate ofennsent to Self-IRSUI, or a certificate if Workers' Compensation Insurance, ora cetliGcd copy lhercof(Sec. 3800, Lab.CJ. Ik» ted Pacific Policy No. Company ACC. DATE ACC. FILE NO. WATER TREATING EQUIP, 5.00 ZONING ENG. SITE NO X❑ Certified copy is hereby famished. Cerfific co y is Bled with the y inspglion division. Applicant_ - _ - MISC. - REFER TO ORD. FIRE $PRINK - Y ❑ NEI ENERGY T44 Y ❑ N� Cil H'ICATE OF EXIT MPI ION FROM WORKERS' COMPENSATION INSURANC17 ('Phis "no,, need nut be completed if the re rn if is for one hundred dollars (S 100) or less.) I certify that in the performance of the work for which this per- Hit is issued, I shall not employ any person in any Rlanner so as to become subject to the Workers Compensation laws of California. Dat` Applicant - N01'ICIi se APPLICANT: If, alter making this Certificate of F.x50 empfio t, you should become subject to the Workeri Compensation provisions of the Labor Code, you must forthwith comply with such provisiansor this permil shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the perforomnce of the work for which this permit is issued (See. 3097, Civ.C.). Lenders N:onc Lender's Add.... that l have read this application and state that the above information is correct 1 agree to comply with all city and county ordinances and state lows relining To building costruction, and authorize representatives of this city To enter upon the above-mentioned property for inspection purposs. agree to saveindemnify and keep harmless the City of against liabilities, judgments, costs and expenses which in any way accrue against said City in consequence of therant ofill permit PERMIT ISSUANCE 10.00 FLOOD ZONE Y El NEI A.L.U.C. Y E] N D PLG. CONTR. LIC. NO. PLG. TOTAL DTV MECHANICAL PERMIT FEE FEE SUMMARY BUILDING 94n. ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK FEE �r� 15.50 62 AIR HANDLING UNIT (TO IOMCF.M.) 4.00 AIR HANDLING UNIT (OVER IOAOOC-EM.) 6.00 SEISMIC FEE 13.02 EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATI NG UNIT (OVER 100,000 B.T.U.) 9.50 VENTILATION FAN(SINGLE) 4.00 BOILER-COMP(3 H.Ror 100,000B.T.U.) 6.0035hereby BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. 4ELECTRIC70.3535Icertily 35(We) MISC. - REFER TO ORD.Cupertino PERMIT ISSUANCE 10,0 02ay MECH. CONT, LIC. NO. MECH. TOTALySignature .09 ofApplicant/Contractor Datc OFFICE COPY