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16330D POST THIS CARD NEAR FRONT OF. BUILDING PERMIT NUMBER CITY OF - CUPERTINO 16330. INSPECTION DIVISION' JOB INSPECTION RECORD 1 a — �{ - X`%eon PERMIT EXPIRATION JOB ADDRESS Cor 'J1"�I T# _LOT# w'e Zi pERM1T EXPIRES IF WORK OWNER NTRACTOR $ Ci' Cr iILtwe,41� �` IS N T-S,TpFtTED WITHIN ' P 160 AVS (5 PERMIT ISSU- ANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION NOTE: - ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF LIFER PREGUNITE - .PI.HMIT VALIOATION CUPERTINO STANDARDS. GARAGE SLABS, POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED' UNDERGROUND/SLAB ISSUANCE�UATr PLUMBING- - - - I ELECTRICAL MECHANICAL " - BLDG ELECT PLG. MECH. ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SiFT. PLUMBING MECHANICAL ELECTRICAL .. pain) .. PeHnur rO FRAMING - - INSULATION - 1400 7 1988 J'I tJ •I IJV�1 STORIES TY PC CONSTR. . OCC GROUP RES UNITS City. of Cupertino PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP, SHALL BE MADE.BEFORE _ THE CONSTRUCTION TAX IS PAID sa. rr FLOOR AREA TOTAL ACREAGE DIAPHRAGM - ROOF SHEATHING �� tlU ILDING USE HIS IND CON PB o"", El 0 13 ❑ El APPLY NO ROOFING UNTIL ABOVE•HAS BEEN SIGNED FINALS DATE . INSP. ROUGH SAN.# ASSESSORS PARCEL NO PLUMBING ELECT. ENERGY TUBSBSHOWER PAN PLUMBING ENERGY I HACT -'NO PARCELNO, MECHANICAL MECH. ENERGY ELECTRICAL - BUILDING ENERGY ;cc GATE ' ACC GLENO FRAMING ELECT, FINAL TEST - INSULATION - - PLUMBING ZONING ' ENC. SITE.NO. GAS TEST - GAS • MECHANICAL- FIRE SPRINK Y ❑ N[]- ENERGY T 2 Y ❑ AT COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE T ED OR ZONE Y ❑ N A.L UC. Y ❑ No INTERIOR SHEAR - FIRE DEPT. SHEETROCK 1 GRADE - FEE SUMMARY EXTERIOR LATH 1,5BUILDING BUILDING INTERIOR LATH TEMPORARY APPR SCRATCH COAT ELE TRIC - PLAN CHECK FEE GAS ' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGN EO OCCUPANCY SEISMIC FEE 1,2,uG OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUI LOING FINAL IS SIGNED BY BUILDING INSPECT OR. MICROFILM — ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC -- LU H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. O PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING�-- iZ - -SEE PERMIT FOR EXPIRATION DATE - MECHANICAL .- CONST. TAX �-- IMPORTANT! TOTAL PLEASE READ REVERSE SIDE BEFORE CALLING FOR.FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY e BUILDINGPROJECT IDENTIFICATION . ' APPLICATION & PERMIT BUILDING - ELECTRICAL -PLUMBING - MECHANICAL PERMIT NUMBER ^! 16330 aUILDING , 1�- A/FN7-7 s-revENS cr, 3UP ) NWI,q(N/ER-'S ` {- cJ 'Jkh1,j� 'IaI((t1WMQibHON I �J QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION 1 DATE OF APPLICATION CONTRACTOR'ST�1 NAME. Q p 1 No'(.,� OUTLETS -SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS SyM) ADDRESS /f� `5Q '� S \ �pRON-E`er S APPLIANCES -RESIDENTIAL 4.00 PANELS 10.00 ogcHlrecT ENGINEER ^II Srpw E C PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. - ISIGNSTRANS. 3.00 ADDRESS ENc. SPECIAL CIRCUIT ' 5.00 PERMIT VALIDATION 70b 5 La'sj% T sn# fi& "P y EMP. METER OR POLE INS. 20.00 A DRESS E55 ADOR MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 C�f�WLO �'�'LLL.Li LICENSED CONTRACTORS DECLARATION PAID I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions C -, and my license ism full for e� t c( Lia-.nsc las' Lir. Numbclkj � Date �. - - Contractor ISSUANCE DATE BLDG. ELECT. ❑ PLG. MECH. ❑ ❑ UILDING PERMIT - OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason:(Sec. 7031.5, Bushessand Professions Code: Any city or county which requires a permit to constia ct, alter, MISC.- REFE TOORDINFORMATION thUATION PERMIT ISSUANCE 10.00 $/FT. ELEC. DONOR, LIC. NO. ELEC.Ut! TOTAL improve, demolish, or repair any structure, prior to 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's License PERMIT TO Law (Chapter 9(commencing with Section 7000) ofl)ivision 3 oftho n �r �/V'r�. (lr�'�/-'l�Ied✓�Z Business and Professions Code) or that he is exempt therefrom and - QTY. PLUMBING PERMIT FEE ( the basis forthcalleged exemption. Any violation of5eation7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500).): - STORIES TYPE CONSTR. ALTER -DRAIN & VENT -WATER (EA.) 5.00 ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not BACK F LOW PROTECT. DEVICE 4.00 OCC. GROUP BEs. UNITS ROOF, AREA, COND. 5.00 intended or offered for sale (Sec. 7044, Business and ProfessionsDRAINS-FLOOR, Code: The Contractor's License Law does not apply loan owner of FIXTURES- PER TRAP 5.00 GAS- EA. SYSTEM - I INC. 4 OUTLETS 6.00 property who builds or improves thereon, and who does Such work himself or through his own employees, provided that slab improve' Cents are not intended or offered for sale. ll; however, the building s0. Pr. FLOOR AREA TOTAL ACREAGE or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or iso. prove for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA.1 2.00 BUILDING USE RES IND CON PB Other ❑ ❑ ❑ - ❑ ❑ INDUSTRIAL WASTE INTER. 30,00 licensed contractors to construct the project (Sea. 7044, Business and Professions Code: The Contractor's License Law does not 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 contraclons) licensed pursuant to III, Contractors License Law. 0 I am exempt under See. ,B.&P.C. rr this reason SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT '6.00 Owner - Date WATER SYSTEM 5.00 ACC.OATE ACC. FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 hereby affirm that I have a certilicate of consent to sell' -insure, - ZONING ENG. SITE NO. or a certificate � �o�f Workers' Compensation In urance, or a certified copy there .0 ./ S` Policy No n pany p h��Q m'- >A, Certified Copy is thereby furnished. ❑ Certified copy is filed with the clly inspection division. Applicant MISC.- REFER TO ORD. , FIRE SPRINK Y ❑ "N❑ ENERGY T-24 Y ❑ N❑ C1: R' I'1 F ICA'f 1301 r EX 1: M PTI ON 17 ROM WOR K Ii RS' COMPENSWION INSURANCE (This section need' Imm o be copleted if the permit is lin one PERMIT ISSUANCE 10.00 FLOOD ZONE Y ❑ N ❑ A.L.U.C. Y ❑ N ❑ PLG. CONTR. LIC. NO, PLC: TOTAL hundred dollars IS 100) or less.) - I certify that in the performance ol'the work for which this per (nit is issued, I shall not employ any person in any manner so as to QTY .MECHANICAL PERMIT FEE FEE SUMMARY become subject to the Workers' Com pe nsal ion Laws of California. DateApplicant NOTICE: TO APPLICANT: IL after making this Certificate of Ex: BUILDING ALTER OR ADD TO MECH. - 5.00 APPLIANCE 5.00 PLAN CHECK FEE ' eruption, 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 10,000C.F.M.) 4.00 AIRHANDLING UNIT(OVER 10=C.EM.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 ' the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Under's Address HEATING UNIT (OVER 100,000 B.T.U.) ELECTRIC �- VENTILATION FAN (SINGLE) 4.00 I certify that I have read this application and state Ih:d the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING BOILER- COMP(3 H.P. or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the om aboventionrd property for inspection purposes. BOILER -COMP (Over 100,000BTU)SEE FEESCH. MECHANICAL - (We) agree to save,- indemnify and keep harnfess the. City of Cupertino against 'lines, judgments, costs and expenses which TRY in y way cc a against said City in consequence of the r ting this perit - - MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 CONST. TAX ' NO. MECH. CONT. LIC. . MECH TOTAL - " TOTAL dW _ Igo mor Applicant/Contr tar Date OFFICE COPY