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7275 CITY OF CUPERTINO INSPECTION RECORD (OFFICE COPY) AIJI!?R0JhL:1 � I PERMIT ISSUED DATE ELECTRICAL DATE INSP.' ui in ctric PiumbinIZ Power Pole mechanical er un Teas ec u irin e Z Solar Na.Us ire tin er ei in Sign vctures Int/Ext otors Misc. roE�in e ower UtheT FINAL INSPECTIONS / DATE INSP. Not ApproveT Gas Electric _30_F s Ll Plumbinz PLUMING DATE TSP. -mecnan3.cal Solar Backflow •Poolr un ra in oor ,Fiann3.ng Partialou Fire Dept u i o ete heaith Dept. Solar Kougn u in ater ' Insulation er in . azn o alm as —7-77-7 Other BUILDING DATE INSP. of rove Pad Certification oun ation ELECTRICAL DATE INSP. re- unite a - rane Underfloor S.M. bond eam cts , nsu ation Undertioor Girders . Fire Danpers Floor Steel ire ace ie owns brease ouct Diaphrams One Hour Shaft eismecracin on nsate a3.n WUls ane sui ment Anchorage Frame �, Flues67 omTi fir Lath tei�Fr— Wallboards Int/Ex—t. of prove � ewa—I� er Net rove 1 JT TO FILL IN INFORMATION WITHIN RED LINES- USE BALL POINT PEN ONLY CI NG PROJECT I DENTI FICATION ":,PER NumeEE APPCI,CATION & PERMIT n/ O o6Q '57'g- -C,C�e BUILDING—ELECTRICAL—PLUMBING—MECHANICAL : 7275 PLAN CHEC�VALIDATION CITY.; ELECTRIC PERMIT =FEE pAiU J PMO CONTRACTORS NA e— ZJ uJC UTLETS-SWITCHES-RECEP 5.00/1.00 �e A 1 N'. LIGHTING FIXTURES 5.00/1.00 "� 'Y ' TRACTOR, Z1 APPLIANCES 4.00 Of CUpe�ln� 17� VOD Ess - - {\�]� ' U'Ia GGr 'T 4115s�.l�� '30 �a PANELS 5.00 DATE OF APPLICATION ARCHITECT.- SIGNS B.00' PLAN CHECK FEE P.C.NO, OR ENGINEER LIC.NO. - SIGNS TRANS. 3.00 'ADDRESS era r• - SPECIAL CIRCUIT 5.00 PERMIT VALIDATION - LIP EMP.METER OR POLE INS. 15.00 ADDRESS PPLICANrs — ' MOTORS' - - SEE FEE SCH. / 1'J{Ip/{.'1(- - �•, ADDRESS ' SERVICE CHANGE 10.00 ' ,- 00 LICI?NSIiDCONTRACTORS�IIECLARATION - a o G- 4t hhereby al firm they timer licansed miller provisioilsol'Chapter9 - - IS$U tTE ' ,(commencing with'Sectiori 7000)of Division 3 of the Ihismess and rn G ,wa„ , RLO ELE MECH. H w z Professions la Code,and my license is in full force and effect. ' ❑ ❑ o z m o Date se Class _ Loc.Number . r w � Uulc% Contractor• , - a m BUILDING PERMIT Emw •OwNIiR-BUILDER DECLARATION "!INFORMATION Do - ! misc.— - REFER TO ORD E s, r I hereby affirm that I am exempt from the Contractor's License LLo¢. Law firthe followingreason.(Sec. uires a,ermit tocodProfessions PERMIT ISSUANCE VALUATION $/FT. r — 2 .Code:Anycolshcor m paircch structurepermitoits issuance, 6.00. asa: 0_ improve;demolish,or rcpai,any slmchlr'ri,prior to its issu:mce,alto ELEC.CONIII. LIC.NO. ELECthal . p/ _ DLL requires the applicant for such permit to file a signed ntor's License - - TOTAL I E w $ he is licensed pecan[en the provisions of the Contracldon License xx ' TO Law(ess and 9(cosions Codeng )or Senior is exempt there om red IIUI — a he Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE r m the basis for the alleged exemption.Any violation of BCetion 7031,$ + - STORIES TYPE CONSTR: as by any'uppli6mt lbr.a permit subjects the applicant toe civil penally ALTER-DRAIN -WATER (EA.) 4.00 ' of not more than five hundred dollars IS 500).): O I,'as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 2.00 . 00C.GROUP RES.UNITS their sole campenution,will do the work,and the structure is not , _ intended or offered for sale (Sec: 7044, BllslnesS-and Professions C J The Contractor's License Law d DRAINS-FLOOR,ROOF,AR EA,CON D. 4.00 s not apply to n owner of '1 Irl sly who hold. 'nip rvusN I,and who does such work FIXTURES-PER TRAP ' ,' 4.00 FT.FLOORAREA 'TOTALACREAGE hinslf Ori thiel his own lmpl0ytts,pr, ividled that rich'improve- GAS-EA.SVSTEM-11NC.40UTLET54.00 mems are hot intended o offered for sale,LI.however,the building 'or improvement Is sold within one year of completion the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 1.00 BUILDING USE b alder will have the burden of proving that he did not build or tin RES IND C PB- Omer pr. .for purpose of sale.).' -: y f- : ! INDUSTRIAL WASTE INTER. ' ,20.00 _ .yA I,as ower,of the property.am'P.iIaiivcly contuwliny with ❑ ❑ ❑ ❑ licensed comramors to construct the project(See 7044,Business LAWN'SPRINKLERS-1 INC 5 V.B.- „5.00 gsSEsso RCEL NO. and Professions Code:- Contractor's License Law dues not apply }.. . In an owner of prop I who Iilds or improves thereon,and who " LAWN SPRINKLERS-OVER 5 (EA.) 1,00 contracts for such j cis a contractors)licensed pursuant to - ,'''„ the Commctu, I nsrrl ., ?. SEWER-SANITARY-STORM EA..200ft/8.00 . TRACT NO. PARCEL NO. ❑ lam cxcn and ,6.&P.C.for th is. WATER HEATER W/VENT' • 4.00 >( rearm — — Owner Un WATER SYSTEM '4.00 ACC.DATE ACC.FILE NO. - ' 0RK r�1At/. ION DECLARATION WATER TREATING EQUIP:, 4.00 ' r l Jicteby affrm that I have if certificate of consent to wI(insure, ZONING ENG.SITE NO. or L certificate of Workers'Compensation Insurance,or a certified C thereof(Sec.3800,LvA C..). ' I alley No.—Company — El Cl Certified olY k hereby1cmished + - FIRES RINK 'ENERGY T-24 Z fled py is filed with•Ihulinty inspection division. MISC:- - ` REFER TO flD. APpluant • Y ❑ N❑ Y ❑ NPERMITASSUANCE 00 TIPICATli061:XIiMPTIONPROMWORKERS' FL000 ZONE J.C. LU > ,`,, COMPENSATr10N'INSURANCE - PLG.CONTE. sec.No. s PLG. d O (this WCR611 nee l n L he omplCted it III& pCnnit is,for ane ' TOTAL Y❑ N❑ Y❑, N❑ Z Minded dollars(8100)or U O 1 certify that in the,performa eciof the work-for which this per CITY- MECHANICAL PERMIT FEE FEE SUMMARY Il P mil is issued.I shall not employ any prison in any manner so as Io U become subject l0 the.Workers'Compensation Laws of California.' J _ O w Dolt Applicant BUILDING a . . ALTER OR ADD TO MECH. 4.00 } m NOTICE TO!APPLICAN'I': II',ager nicking this'Cerlil'ic:to of fix- Z 'tmption,you should become subject to the Worker'Compensation APPLIANCE 4.00 PLAN CHECK provisions of the Labor Code, you'must forthwith comply,wilh FEE `r- - U such provlsionsor.thfs permit shall be dmevok deemed red ' > AIR HANDLING UNIT TO 10=C.F.M.) 3.00 .,t, AIR HANDLING UNIT(OVER 10X0C.EM.) 5.00 'SEISMIC FEE, ✓ CONS]RUCTION Lf NDINC AGENCY N her by'tllino that there ra"a Cons[ru lion lending agency for ,EXHAUST HOOD (WITH DUCT) 2.00 filep fo nmice o6tlie work for w1fich this permit is Issued(Sec. ' ' 'MICROFILM 3097,Cry C.)..;•-' HEATING UNIT(TO 100,000 B.T.U.) 4.00 I-endcr's NamAddress H EATI NG UN IT(OVER 100,000 B.T.U.P.50 Lcndcrs Address - ''ELECTRIC l certify that Phave read this application and state that lite above VENTILATION FAN (SINGLE) 300 Information is Correct I agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.cr100,000B.T.U.) 4.00 hereby-authonze representatives of this city to enter upon the J BOILER-COMP (Over 100,000 BTU)SEE FEE SCH: MECHANICAL above-mentioned property for inspection purposes. - ` (We) a , �eve'inde y I'd"kecp'harmlcss the City of ;1, MISC.-` - REFER TO ORD. ' +; Qiperlino,a est/loaboloti jdJ ancosts and exPenue which .PERMIT ISSUANCE 3.00 CONST.TAX ' may m an wace - ugai t said City in consequence of the 6mnbngo t penin CH CONT LIC.NO. 7, MOECA . - 'r TOTAL l_Q %Sig r of Iwnl/Con ctor ;v - Date /(rJ OFFICECOPY