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15236I0 POST THIS CARD NEAR FRONT OF BUILDING CITY OF- CUPERTINO `INSPECTION DIVISION JOB INSPECTION RECORD • i. - - - JOB ADDRESS 20371 'Stevens Creek Blvd. UNIT# _LOT# " owNER 'De Anza Properties CONTRACTOR ' PERMIT NUMBER 1 �� PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- OR 180 DAYS FROM LAST CALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATIONANCE NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERT. NO STANDARDS. I LIFER PREGUNITE PERMIT VAI.mATION � _ ' 4�/ y - ISSUANCE DATE GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED _ d' I%'d. 1d UNDERGROUND /SLAB PLUMBING ELECTRICAL MECHANICAL .. BLDG i❑ ELECT I ❑❑ PLG. MEC.. ' ❑. DO NOT POUR FLOOR UNTIL, ABOVE HAS BEEN SIGNED �O BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING MECHANICAL ELECTRICAL' I � O PERMIT TO �! 'S FRAMING .. - INSULATION sronus rNvPe comsrR - - 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 511, FT RLOOH AREA TOTAI. ACREAGE DIAPHRAGM ROOF SHEATHING BUILDING USE Res IND CON PB om., ❑ I] .❑ ❑ 0 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH' - SANA ASSESSORS PARCEL NO. PLUMBING ELECT. ENERGY TUBS 8 SHOWER PA PLUMBING ENERGY TRACT NO PARCEL NO MECHANICAL' - io. MECH.ENERGY ELECTRICAL- BUILDING ENERGY ACC DATE ACC. FILE NO, FRAMING ELECT. FINAL TEST INSULATION " PLUMBING. ZONING ENG. SITE NO. GASTEST GAS MECHANICAL i FIRE SPRINK Y ❑ N ENERGY T -]L ` ❑ NO' COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED_ HEATING 7. IS -,?t EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZONE `' ❑ N❑ A.L.UL- ° ❑ N❑ INTERIOR SHEAR - FIRE DEPT, SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING -'S INTERIOR CATH- TEMPORA YAPPROVALS SCRATCH COAT ELECTRIC FSEEI GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCYOF BOILDING'ISNOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR. ARRANGE FOR INSPECTION BY PHONING 252-4505, �� ONE WORKING DAY BEFORE REQUIRED,INSPECTION. z PLEASE GIVE JOB ADDRESS WHEN PHONING. '- -SEE PERMIT FOR EXPIRATION DATE — PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL � r. OFFICE COPY ., 71 i.5 O¢i Foo aZu y% z ¢ n - y - OZywZr EDQ 2 4 9: ow U X �6� Fu0< 3 D > 0 6 W m N Fzs fxo K I-$ • M () Z z F, O M W - d O Z) z V o LL U w } n `. APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT'PEN ONLY , 141t BUILDING PROJECT IDENTIFICATION - APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL .PERMITNUMBER .. 15286 BUILDING ADDRESS -zo 71 5reVL Ca'ee I_ gIJ NOINNERS AMEL' N/Vy Cf2P4( �G(��* / L DTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION PHONE- - '- NAMERAcrDRs OUTLETS - SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 LIC. No. CCNTRACTOR'5 ADDRESS _ APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 PHONE DATE OF APPLICATION ARCHITECT - AN ENGINEER LIc. NO. PANELS (OVER 200 AMP) 20.00 C PLAN CHECK FEE P. C. NO. SIGNS TRANS. 3.00 ADDRRESSS ENN' SPECIALCIRCUIT. 5.00 /PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 ZIP APPLI ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 A - ai// (/ a LIC13N$EDCONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of lite Business and Professions Code, and my license it in full fort and effect License Chxs Lic. Number ISSUANCE DATE BLDG. ELECT. PLG. MECH. Q 14 DateContractor 19 OWNER -BUILDER DECLARATION I hereby affirm ing I oT exempt from the Contractor's fessions Low for the following reason. (Sec. 7031.5. Businessand Professions Code Any city or county which requires a permit to construct, eller, BUILDING PERMIT INFORMATION MISC.- REFER TO ORD- PERMIT ISSUANCE 10.00 VALUATION �j v0 SIFT. ELEG-GONTR. - LIC. NO. TOI TOTAL A' DTV. PLUMBING PERMITrt% prior n Its Issuance, also reprove, heapplic or repair h P g Proud to file he is licensed 9(comn f0 the provisions of the Contractor's License he isles file applicant for such revisit ns file a signed statement Lthaticense Law (Chanif ,.lotions Coli with Section 7s c Scof I I lie re Ruon 3 n the Business and Code) or that he is exempt therefrom and and 0 / V PERMIT TO , n lic alleged the basnyapor the allegedermit ORIE6 TYPE CONSTR.by . tsthAny ea applicant Inaction malty subjects afros applicant fore permittdollirv(SSOpplicem tooCivil penalty of not more Oen five hundred dollars (5500)): ALTER-DRAIN&VENT-WATER(EA.) ❑ I, as owner o1the property, or my employees with wages as their sole cont pensution, will do the work• end the structure is not BACK FLOW PROTECT. DEVICE 4. .GROUP RES, UNITS DRAINS -FLOOR, ROOF, AR EA,CON D. 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 property Who builds or improves thereon, and Milo EOCS SrIC1, Work himself or through his own employees, provided that such improve - Tents are not intended or offered for sale. If, however, the building IXTURES - PER TRAP - 5.00 S. - O GAS - EA. SYSTEM -11NC. 4 OUTLETS 6.00 - SO. FT. FLOOR AREA TOTALACREAGE or improvement is sold within one year of completion, the owner- builder Will have the burden Of proving that he did not build or im- prove for purpose or sale.).INDUSTRIAL'WASTE ❑ 1, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB Orher ❑ ❑ ❑ ❑ ❑ INTER. 30.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: 1he Contractor's License Law does not apply to an owner of property who hudds or improves thereon. and who LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 IEA.) 1.00 ASSESSORS PARCEL NO. contracts forsucheets withacontracmr(s)licensed Pursuant to the Contractor's License cenL se La w. SEWER -SANITARY -STORM EA. 200/t/10.00 TRACT NO. PARCEL NO. Cl I am exempt under Sea , BAP.C. I'or this rcasen WATER HEATER W/VENT 6.00 ' Owner o Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 WORKERS'COMPENSATION DECLARATION hereby affirm that I have o tt Compensation of consent or scl cruised or a certificate of Workers' Compensation Insurance, or a certified - ZONING ENG. SITE NO. cop, (hereof (Sec. 3800, Lab. Policy No. Company - ❑ Certified copy ishereby furnished. • Certified copy is filed with the city inspection divisi Applicant on. FIRE SPRINK Y ❑ N❑ ENERGY T-24 v ❑ N❑ MISC. - REFER TO ORD. 5 -C)L) CERT IFICAT Ii 01' EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 /00 0 1 FLOOD ZONE AL.U.C. COMPENSATION INSURANCE (This Section need not he wmrlmerl if file permit is for one PLG. COPOR. LIC. NO. TOTAL Y N ❑ ❑ V N ❑ ❑ hundred dollars ($ 100) or less,) - I certify that in the performance of the work for which this per- mil is issued, I shall not employ any person in any manner so as to OTV. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers Compensation Laws of,California. Date Applicant ALTER OR ADD TO MECH. 5.00 NOTICE '1`0 APPLICANT: If, after making this Certificate of Ex- APPLIANCE 5.00 AIR HANDLING UNIT (TO 10OOB11F.M.) 4.00 PLAN CHECK FEE emption, you should become subject in the Workers' Compensation Provisions of the Labor Code, you must forthwith comply with "tell provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(OVER 10=1 F.M.)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, CiP.C.).HEATING MICROFILM UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name_fL. Lender's Address H EATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC VENTILATION FAN (SINGLE) 4.00 I certify that l have read this Application and stale that the above information n correct 1 agree ID comply with all city and county ordinances and stale laws In building construction, And PLUMBING 5700 BOILER-COMP(3 H.P. Dr 100,000 B.T.U.) 6.00 uic,,,ng hereby authorise roperty tat sins of til is city to enter upon the Above-mentioned property for inspection purposes. BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL CW (We) agree to save, indemnify and keep harmless the City of MISC. - REFER TO ORD. upertino against liabilities, judgments, costs and expenses which again t Bald Cily in consequenw of Omo PERMIT ISSUANCE 10.00 �(, (J CONST. TAX 21Y.n1wccrue '� `p MECH. CONT. LIC. NO.am/Go TOTPL Off• TOTAL �, 4163 racer- e OFFICE COPY