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155250 -.POST THIS CARD NEAR FRONT OF BUILDING , ' CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD 'I - ' - • JOB ADDRESS �3 7/ e-yo"/J ST yV lt�'CK �L VA IT - _LOT# OWNER 6- CONTRACTOR IS�C+� �""J-V PERMIT NUMBER i 5525 PERMIT EXPIRATION ,5 PERMIT EXPIRES IF WORK IS. NOT STARTED WITHIN 188 DAYS OF PERMIT ISSU-., ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. .+ INSPECTION DATE INSPECTOR INSPECTION RECORD • FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED COMPLY WITH THE APP,ROVEDYLANS AND CITY OF -CUPERTINO STANDARDS. UFER PREGUNITETO PFTm91T VALIDATION {„ (r• I " - ^' ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE, UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL MECHANICAL BLDG ❑ ELECT, '❑ PLG. MecR ❑ ❑ I 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED'• - BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION A STET. PLUMBING � �� MECHANICAL ELECTRICAL pt�ICVQ y.W P naT ro S! N FRAMING. INSULATION STOHIES TYPE CONSTR. OCC, CROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID • - so PT FLooR AREA TOTAL ACREAGE DIAPHRAGM • ROOF SHEATHING BUILDING USE RES IND CON PB 0",. ❑ ❑ .Cl ❑ El APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.# ASSESSORS PARCEL NO PLUMBING ELECT. ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY THACT NO, PARCEL -NC MECHANICAL MECH.ENERGY ELECTRICALBUILDING ENERGY ACC . .DATE .ACC. PILE No FRAMING - ELECT. FINAL TEST INSULATION - PLUMBING ZONING ENG, SITE NO. GAS TEST GAS MECHANICAL FIRE SPRINK Y " ENERGY T24 Y ❑«0. COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOOZONE NEl ALUC., rL N❑ INTERIOR SHEAR FIRE DEPT.." SHEETROCK GRADE- •• FEE SUMMARY EXTERIOR LATH BUILDING 1y ' BUILDING INTERIOR LATH TEM ORAPPROVALS SCRATCH COAT - ELECTRIC PLAN CHECK F EE �3S oZ GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE' OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, o�ONE WORKING DAY BEFORE REQUIRED INSPECTION. 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 `a, APPLICANT TO FILL IN INFORMATION WITHIN RED(,LINES -USE BALL POINT PEN ONLY -. -BUILDING PROJECT IDENTIFICATION APPLICATION '& PERMIT UILDING-ELECTRICAL-PLUMBING-MECHANICAL PERMIT NUMBER ' 15525 sUILDIrvc ADD s�LIJ �k7� LN OWNER'S NAME T�-vN CtA-1 PHONE QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION '.. CONTRACTOR5 NAM I OUTLETS - SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRACTORW 'E • I OV -9f. -M, ADOPE. /•, W PHo - Z� APPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 agcHlrsc ENGINEER, LIC. NO. PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C. NO. , SIGNS TRANS. - •3:00 Q non Ess Ervc. ZIP SPECIAL CIRCUIT y 5.00 PERMIT VALIDATION p EMP. METER OR POLE INS. 20.00 ASrvrs ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 a'• Ar LICENSED CONTRACTORS DECLARATION -/�� - hereby affrm that I am licensed under provisions al Chapters) (commencing with Section 7000) of Division 3 of the Business and ProfesAzLictnnSmn9 Cud? license is in full fore (�f([;hhf1/Y� LicunsC Close_ Liu Number_ vAr/Vv - Contractor- _ Qy_ V - ISSUANCE DATE t BLDG. ELECT. PLG. MECH. ❑ ❑ ❑ ❑ „ - - BUILDINGPERMITOWNER-BUILDER INFORMATION I hereby cthat 1 am exempt from the Contractor's License that IBUILDER t from the ont Law Code: Any City nty hichequiresa permit tocontruct,s cions Code: Any city or county which requirese permit to construct, after, MISC. - REFER TO OR " PERMIT ISSUANCE - ,re.� / VA RATION $/FT. improve, demolish, or repair any Unittofi prior m its issuance, also he is les the dapplicant for such permit to ft x signed stammem that he is licensed pursuant to the provisions of the Contractor's LicenseFERMI Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Codcl or that he is exempt�� therefrom and ELEC. CONTE. LIC. NO. ELECT TOTIEj '� �y OTY. PLUMBING PERMIT C `XEE / / •] TO x1 the basis for the alleged exemption. Any violation of5ection 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ofnot more than five hundred dollar, ($50H.) TYPE CONSTR. ALTER -DRAIN IEA.) 5.00 - ❑ I, as owner of the property, or my employees with wages as their sole Compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 EFLOIORUAREA RES, UNITS _ DRAINS -FLOOR, ROOF, AREA,COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Coder The Contractor's License Law does riot apply to an owner of FIXTURES - PER TRAP 5,00 GAS-EA.SYSTEM-I INC.40UTLETS 6.00 Property who brlllds or Improves thereon, and who does such work himself or through his own employees, provided that such improve- mums are not intended or offered for sale. If, however, the building 50. FT. TOTAL ACREAGE , or improvement is sold within one year of completion, the owner- builder will have the burden of proving than h e did not build or im- prove for purpose of te.[. ❑ Lh as owner of Um property, um exclusively convecting With - GAS EASYSTEM :OVER 4IEA:) 2.00 • . BUILDING USE 1:1 -RES I❑ ❑N PEI 1:1 C] INDUSTRIAL WASTE INTER. 30.00 licensed contractors to Construct the project ISec. 7044, Business and Professions Code: 'I'he Contractor's License Law does not apply to an owner of properly who builds or improves thereon, zinc[ 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 contractor(s) license) Pursuant to the Contractor's License Law. ❑ I am exempt under Sec._, BAP C, for 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. DATE ACC. FILE NO. WORK I:RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I hoot, a totiti.tc of consent to 'elf-a"Re, ZONING ENG. SITE NO. or a certificate of Workers' Compensation Insurance, or a certified copy Nperpr�j5/C /j)DOO, Lab.C.1Q�- POIICy ❑ Certiri copy Is hereby furnished. copyis hereby Certifi c Py Is d with tl city inspection division. App icant_C f/ - MISC.- REFER TO ORD. FIRE SPRINK Y ❑ N ❑ ENERGY T"24 Y ❑ N❑ PERMIT ISSUANCE 10.00 CIiRTTI_F[[C_ATFF: OOFF�•E'lXJ1PTION F M WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one FLOOD ZONE Y ❑ N ❑ A.L.U.C. Y ❑ N❑ PLG. CONT R. LIC. NO. FILE, hundred dollars 1$1001 or less.) - I certify that in the performance of the work for which this per- mit is issued, 1 shall not employ any person in any mannerso as to OTV. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workers' Compersution Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 NO'T'ICE TO APPLICANT: If, after making this Certificate of Ex- APPLIANCE' 5.00 AIR HANDLING UNIT (TO 10,000CF.M.) 4.00 PLAN CHECK FEE �S^ �0 emption, you should hecomesubject to the Workers'Contpensaf ion provisions of ore Labor COLIC, you must forthwith comply with such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(OVER 10PMCF.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction Inuring agency for EXHAUST HOOD (WITH'DUCT) 5.00 ' the performance of Ute work for which this permit is issued (Sec. 3097, Civ.CJ, MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Address Lender's Address HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC •� VENTILATION FAN (SINGLE) 4.00 ICertify that l I...0 read this application and state than the above information is correct. I agree to comply with all city and county onfinances and state laws relating to building construction, and PLUMBING BOILER-OOMP(3H.P.or100,000B.T.U.) 6.00 hereby authorise representatives of"this city to enter upon the above-mentioned property for inspection purposes. BOILER -COMP (Over to0,0008TUl SEE FEE SCH: MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC. - REFER TO ORD. Cupertino against liabilities, judgt tents, co s and expenses which' ay ny way ccrue a ns said Cit in consequence of the r. any w it. tilf'60 nature of Applica /Con tar Date PERMIT ISSUANCE 10.00 CONST. TAX MECH. CONT. LIC. NO. MECH. TOTAL s TOTAL //3 LfS' OFFICE COPY