The URL can be used to link to this page

17172Iw W \ POST THIS CARD NEAR,FRONT OF BUILDING. " V. \\,�CITY sOFTCUPERTINO DIVISION JOB INSPECTION RECORD `r `QQ . / I.� I ��yy JOB ADDRESS I�7C,� L'V'�W--L C`�-iT. "R 1�17N1T# _LOT# ' 1 K' OwrvER \ rN p-pS coNrRAcroR SCI- 1 L I% �'a- CC) V,4 PERMIT NUMBER - pp PERMIT_ EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT I -- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATIE I INSPECTOR INSPECTION RECORD, FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF GUPERTINO STANDARDS. LIFER - PREGUNITE PERMIT VALIDATION � �j Joe !'/V. 14i 1/I v�<—I ISSUANCE UA 1 F. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED MAR 2 4 IVO.; MAR UNDERGROUND /SLAB PLUMBING cityOf CUparttuo ELECTRICAL MECHANICAL BLDG ELECL PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ��./ - '1`703t L'/L,. BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING VALUATION 7r�� SIFT. MECHANICAL ELECTRICAL .. Pelp+n+IT ro(j '_'"T�V� zM'�1t4�• FRAMING - INSULATION � � � "- STORIES TYPE CONSTR. • OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID $O, I'LALODHAREA TOIALACRE.AGE DIAPHRAGM ROOF SHEATHING- RES IND Lo`ON uSE SEPB Om., El 11 0 ❑ 1:1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.N ASSESSORS PARCEL NO PLUMBING i. ELECT. ENERGY TUBS 8 SHOW R PAN PLUMBING ENERGY TRACT NO. ' 'PARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC DATE ACC FILE NO. FRAMING ELECT. FINAL TEST INSULATION � � PLUMBING ZONING ENG. SITE NO. v GAS TEST - GAS ' MECHANICAL FIRE SPHINK v [:] N[2 ENERGY T,24 y v ❑ N[] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ' EXTERIOR SHEAR ELECTRICAL RELEASE GOOD LONE v "� A .L U C. ° ❑ "� INTERIOR SHEAR FIRE DEPT. 7 SHEETROCK- GRADE FEE SUMMARY EXTERIOR LATH- BUILDING BUILDING .A •�" INTERIOR LATH - TEMPORARY P OVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE -- GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE _ OCCUPANCY OF BUILDING IS NOT PERMITTED UN TIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING.252-4505, ONE WORKING DAY BEFORE REQUIRED INSPECTION. o� z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL CONST. TAX 'IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION, TOTAL . . OFFICE COPY 0 O Z Z F-0 cc T LU _ C 0 � 2 Uo_ LL E- 0 L) H � 'a AiLly'ANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING-MECHANICAL ,PERMIT NUMBER .. I r P., 71 7 BUILDING ADDRESS OWNER'S1.� NAME r- bes(7vt - OTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PRONE nf� r11 La�iLao) CONTRACTOR uc. NO. UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS AD w RE55 4.00 PANELS. 10.00 9PPLIANCES-RESIDENTIAL PHONE DATE OF APPLICATION " ARCHITECT oR ENGINEER i. a. C • 9' - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. - SIGNS TRANS. 3.00 ARCH.EN M/vI ADDRESS SPECIAL CIRCUIT 5.00 ' PERMIT VALIDATION Mkof TEMP. METER OR POLE INS. 20.00 3 '( A ADDDRESSDRESS MOTORS SEE FEE SCH. SERVICE CHANGE - 20.00 " E / 1 Joe' ✓C�` LICENSED CONTRACTORS DECLARATION - I hereby afftrn, that 1 an, licensed under provismasof Chapter 9 (commencing with section 7000) of Division 3 of the Rosiness andMAR Professions Code, and my license is in full force and effect License Class Lie, Number ISSUANCE DATE BLDG. ELECT. PLG. MECH. IWYII Date Contractor City of Cupertino V V 1 V Y" OWNER -BUILDER DECLARATION that 1 inn exempt from the Contractor's Pr License I herebyaffirmfollowing Law forthcity owingreason. Code: Any ywhichrequires a permit Business andtrct,alons county wharty structure permit issuance, BUILDING PERMIT INFORMATION MISC.- REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION r $/FT. ELEC. CONTE. LIC. NO. ELEC. TOTAL mulish IIS issuance, x150 also improve, ricIapplic or repair arty structure,it.fie it Or signed mquire9 the applicant for such permit to file a signed xthtcment that he is hetrAed pnrstlant t0 the pPcoki nna of the Contractor's License Law(Chapter 9(commencing with Section 7000) of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom and �i PERMIT TO I�"1'E19 IF.A` 2G` OTY. PLUMBING PERMIT FEE the basis fm the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant ton civil penalty of not more than five hundred dollars (S500).): STORIES TYPE CONSTR, ALTER -DRAIN -WATER IEA.) 5.00 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do file work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP REB. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of FIXTURES - PER TRAP 5.00 GAS-EA.SYSTEM-l1NC.40UTLETS 6.00 50. FT. FLOOR AREA TOTAL ACREAGE property who builds or improves timmon, and who does such work himself Or through his Own couneyecs, provided that such improve- Funisarenotintendedorofferedforsale. 11, however, Ovl building or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or iF- GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 BUILDING USE prove for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with RES IND CON PB 'Omer ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contmeor, Licenso Law does not apply toanownerof property who builds or improves thereon, and who LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. - LAWN SPR I N KLERS - OV ER 5(EA.) 1.00 contracts for such projects with a contmctorfs) licensed purstmnt to the Contractors License Law. SEWER -SANITARY -STORM EA, 200ft/10.00 TRACT NO. PARCEL NO. ❑ I at,, exempt under Sec.-. B.&P.C. tier this reason WATER HEATER W/VENT 6.00 Owner Dam WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WORK1iRS'COMPENSA'I ION DECLARAI ION WATER TREATING EQUIP, 5.00 - 1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copy thereof (Sec. 3800, Leh.CJ. Policy No. Company ❑ Certified copy is hereby furnished ❑ Certified ally, 1S filed with tire elly Inspeetiou distal 0,Appliamt MISC.- -REFER TO ORD. . FIRE SPRINK Y❑ N ENERGY T -Z4 Y❑ N❑ C17R'I'lFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. COMPENSATION INSURANCE ' It section need not he completed if the permit is for one Y ❑ NEI Y ❑ N❑ PLG. CONTE. LIC. NO. PLG. TOTAL hundred dollars IS 100) or less.) 1 certify that in tiro performmnce of the work for which this per- ,,Fit Is issued, 1 shall not enlp o any person in a, Inunner sn allo be cy��Ie Workers' ' s ii C i e 1)6"-7Applicam _� NO CIS API .ICANT: II', .Oct mak b oils. Certificate ol'Aix- emption, you should In onicsuInner to the Workers'Compensation provisions of the Labor Code, you must forthwitli comply with such provisions or this permit shall be deemed revoked. DTV. MECHANICAL PERMIT FEE ALTER OR ADD TO MECH. 5.00 FEE SUMMARY BUILDING �� r /0 - APPLIANCE 5.00 AIR HANDLING UNIT (TO 10=CF.M.) 4.00 PLAN CHECK FEE AIR HANDLING UNIT (OVER IOPWC.F.M.) 6.00 - SEISMIC FEE CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction lending agency for the performmme of the work for which this permit is issued (Sec. 3097, Cis.C.). EXHAUST HOOD (WITH DUCT) 5.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATI NG UNIT 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby enthorim representatives of this city es enter upon the herebymentioned property forinsp ofth i purposes. PLUMBING BOILER- COMP(3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL (We)•agree �, save, indemnify and keep harmless the City of MISC. - REFER TO ORD. upertino agl liabilities, judgments, costs and expenses which may in anaccrue y y against,shid City in consequcnec of the PERMIT ISSUANCE 10.00 CONST. TAX - ran'ng of ypIt,jt. I 11 (Aa• II�n• +y'M{ T/gyp MECH. CONT. LIQ NO. .. MECH. 'OTAL TOTAL 3��• Signature O1'A plica t/Contractor '-Date OFFICE COPY