Loading...
9031 POST THIS CARD NEAR FRONT OF BUILDING '. t ✓' L PERMIT NUMBEi1 CITY OF CUPERTINO I . •� . � 901 • INSPECTION DIVISION ' JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS —UNIT#_.L OT# ' ' PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN' INSP C ION I DATE I INSPECTOR - INSPECTION RECORD 180 DAYS OF PERMIT ISSU, 'FOUNDATION o: 'ANC. OR 180 DAYS FROM ' UFER LASTCALLED INSPECTION: PREGUNITE PERMIT VAUDATTON POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ,(�o PLUMBING 667 ' ELECTRICAL ' ISSUANCE DATE MECHANICAL BLDG. ELEC . PLC,' MECH. '. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - B' ILDwG ERMIT �. WOOD FLOOR - /INFORMATION 'PLUMBING _ •VALUATION $/FT. _ MECHANICAL ELECTRICAL. - PERMn;T FRAMING INSULATION STORIES TYPE CONSTR, - OCC,GROUP HES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF "' •, SO.FT.FLOOR AREA TOTAL ACREAGE - DIAPHRAGM Z ' BUILDING USE RES IND CON PB Co'.., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ ❑ ❑ ❑ ❑ ROUGH ASSESSORS PARC E L NO. PLUMBING I GAS TEST TRACT NO. PARCEL NO, MECHANICAL ELECTRICAL . FINALS DATE INSP. . ` ACC.DATE ACC.FILENO. ' FRAMING SAN # INSULATION PLUMBING ZONING ENG.SITE NO., GAS -24 MECHANICAL FIRESPRINK ENERGYT COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 4❑ "❑ ❑ N❑ LATH-INTERIOR - ELECTRICAL - FLOOD ZONE A.L.U.C. '. LATH-EXTERIOR FIRE DEPT. Y❑ NO YO N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING . FIREWALLS ELECTRIC - PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM _._.. 'ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATIONDATE'- MECHANICAL.- IMPORTANT! covsT.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. ' - OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY - BUI LD1 NO PROJECT I DENTI FICATI N - PERMIT NUMBER H ROING APPLICATION & PERMIT 9031 A IL N BUILDING - ELECTRICAL-PLUMBING-MECHANICAL Y11YOWNER'S N ME PLAN CHECK VALIDATION �Y e� Asa 836 OTV• ELECTRIC PERMIT FEE 'ANIF "cro s UTLETS-SWITCHES-RECEP 10.00/1.00 /0 uc.NO, LIGHTING FIXTURES 10.00/1.00 p - ADDRESsroea PPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION ARCHITECT - PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP) 20.00 ENGINEER Lac.NO, SIGNS TRANS. 3.00 ARCHADDDRESS ENG' SPECIAL CIRCUIT 5,00 PERMIT VALIDATION nP EMP.METER OR POLE INS. 20,00 APPLICANTS ADDRESS MOTORS SEE FEE SCH. (Y/f/Mw,��J SERVICE CHANGE 6,� P 0 M Z F O O LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00 S a' a 0 w I hereby affirm that I am licensed under provisions of Chapter 9 (;(({J �� V A V .. ¢ y (Commencing with Section 7000)of Division 3 of the Business and _ I C 7 ISSU CE DA •• - 0 D- Professions s and my license is in full toles and el feet. n^ BLDG. ELECT. PLG. , MECH" 0 0)�- License Class Lic,Number City of Cupe)lino ®-' 1 '© o A w Date Contractor ry 1 p , a Y f J ¢ ¢ w a OWNER-BUILDER DECLARATION BUILDING PERMIT • O o o INFORMATION aa: 0 u N I hereby affirm that 1 am exempt from the Contractor'sLicense MISC.- REFER TO ORD LL O ¢ Law for the following reason.(Sec.7031.5,Businessund Professions VALUATION $/FT. Code:Any city or county which ruquiresapernlit toeonstruct,alter, PERMIT ISSUANCE 10.00 U-' ¢ a o improve,demolish,or rePairuny structure,prior to its issuance,also ELEC.CONTE. LIC.N0. ELEC. T A o u requires the applicant for such permit to file a signed statement that TOTAL u w m be is licensed pursuant to the provisions of the Contractor's License PERMIT TO H i Law(Chapter 9(commencing with Section 7000)of Division 3 oftbe io Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE Cl 7e CN ¢ F $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant too civil penalty ALTER-DRAIN IEA.) 5.00 of not more than five hundred dollars(S5001.): , ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 Oce.GROUP RES.UNITS their sole compensation,will do tire ctur e work,and the strue is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Comorctor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- me.ats mprove-menis are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6,00 or' mvnment is sold within one year of completion,the owner- GAS-EA,SYSTEM-OVER'4 (EA.) 2.00 IT l •r will have the burden of proving that he did not build or im- BUILDING USE pr for Purpose of salcJ' INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer 1,as owner o1 the properly,um exclusively contracting with ❑ ❑ ❑ ❑ ❑ It ns d commeto-s to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. a d Professions Code:The Contractor's License Law does not apply t an owner of property who builds or improves Ihereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 ontracts for such projects with u contractor(s)licensed pursuant to the Contractor's L' se Law. SEWER-SANITARY-STORM OOf[/10.00 TRACT NO. PARCEL NO. ❑ tum exe oder Sec. B,&P. .f rihi' WATER HEATER W/VENT - 6.00 Owner WATER SYSTEM5' MENSAPLA. V 5.00 ACC.DATE ACC.FILE NO. O KERP1 ION DECLARA'fl0 WATER TREATING EQUIP, 5.00 I here y affirm that I have a certificate of Consent to self-insure, or a certificate of Workers'Compensation Insurance,or a certified Of C�lparfino ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.C.). Policy No. Company - O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 Z Z ❑ Certified! copy is filed with the city inspection division. Y � N� V F] N� Applicant MISC.- REFER TO ORD. ~ O PERMIT ISSUANCE 10,00 LU N CERTIFICATE EXEMPTION TINS FROM WORKERS' FLoo02oNE A.L.U.C. _ W � COMPF,NSATION INSURANCE PLC,CONTE. LIC.NO. PLG. / CL O (This seelton need not be completed if the permit is for one TOTAL /p V 0 NV❑ NE] 7) Z hundred dollars IS 100)or less.) U O I eertily that in the perforin ince of lire work for which this per- OTV. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any manner. as[o - W become subject to the Workers'Compensation Laws of California. Q. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } N NOTICE TO APPLICANT: If,after making this Cerl ificate of Ex- ♦- Z emptio n you the L become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions io the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,0000 F.M.) 4.00 CONSTRUCTION.LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is u construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Leader's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC I certify that l have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 information I correct. I agree to comply with all city and county PLUMBING �U information and start laws relating m comply with construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby entiorim representatives of this city es enter upon the BOILER-COMP IOver 100,000 BTU)SEE FEESCH, MECHANICAL hereby above-mentioned property forinsp ofth i 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 CONST.TAX / may in a way accrue against said City in c •quence of the 10.00 granHn lis permit, MECH.CONT. LIC.NO. MECH. TOTAL TOTAL /0� Si t ol'Appl' ant/ onimclor Ic OFFICE COPY