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15599m POST THIS CARD NEAR FRONT OF BUILDING " CITY' OF CUPERTINO INSPECTION DIVISION' JOB INSPECTION RECORD . JOB ADDRESS 20371 Stevens -Creek UNIT# _LOT# - _ OWNER De Anza.Blvd. CONTRACTOR - PERMIT NUMBER 15599 ' PERMIT EXPIRATION V PERMIT EXPIRES IF WORK . IS NOT STARTED WITHIN.r 180 DAYS OF 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 CUPERTINO STANDARDS. I . - PAID•7• UFER PREGUNITE - PERMIT VALIDATION �,• + I I I� � ``��-r-�� yy• -'� !ily l'�-?lLi..�.•�.S uarE - ' GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED747- Ake L,uN 19 408 UNDERGROUND/SLAB PLUMBING. _ city Of cupffInoISSUANCE .ELECTRICAL ' � � � MECHANICAL - BLUG. E] ELECT. p PLG. ,MEER-: El ' ❑ .' DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT INFId,RMATION WOOD FLOOR. VALUAT�ON $SFT. .y�' . 'PLUMBING • - MECHANICAL ELECTRICAL, PERMIT TO 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 - so. FT rLoaN AREA TOTAL ACREAGE - 9 DIAPHRAGM - - ROOF SHEATHING BUILDING USE NES IND CDN PB O'.F, Q ❑ ❑ ❑ E ' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.q-� - nSSESSONSPA RCEL NO • PLUMBING ELECT. ENERGY TUBS 8 SHOWER PAN - PLUMBING ENERGY iRACT.NO. PARCEL NO - MECHANICAL MECH:ENERGY ELECTRICAL � BUILDING ENERGY - ACC DATE . ACC FILE NO FRAMING - ELECT. FINAL TEST INSULATION PLUMBING 20NING ' ENG. SITE NO GAS TEST GAS - ' MECHANICALFIRE. SPRINK Y N0 ENERGY T 2u Y � NEI COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING, ' - - EXTERIOR SHEAR - - '- ELECTRICAL RELEASE ! 1 nDDmNE Y❑ N❑. ALUC. Y NEI, INTERIOR SHEAR .. - .'FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH - - 'TEMPORARY APPROVALS SCRATCH COAT.. - ELECTRIC PLAN CHECK FEE ' GAS � - - NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED 10CCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDINd FINAL ISSIGNED BY BUILDING INSPECTOR. U-1 ARRANGE FOR INSPECTION BY PHONING 252-4505, I.—� ONE WORKING DAY BEFORE REQUIRED INSPECTION. 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. Z SEE PERMIT'FOR EXPIRATION DATE = MICROFILM , ELECTRIC PLUMBING ' MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE -BEFORE' CALLING FOR FINAL INSPECTION., TOTAL �k! OFFICE COPY o¢i � W O F Zz Q Hh2_ o?�D r ¢¢wu W LLaF r-04 N f a,`0 to awm F Z to ¢ F $ n 3 O Z � o D j LU _ D. o Z) z 00 LL U 0 w } u°i Z L) APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ' BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING -ELECTRICAL- PLUMBING -MECHANICAL -PERMIT NUMBER . + 15599 BNILDING 'OORESS 1 U Gi O.N Los NAME Qy� do r1.( PHONE QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION d5NTRACTORs 767OUTLETS -SWITCHES - RECEP '10.00/1.00 , W� DATE OF APPLICATION' LIGHTING FIXTURES 10.00/1.00 17. 50 , COgRACTOR's ESS AO �-'�.j� py Q // PRONE '•(F) JJ APPLIANCES - RESIDENTIAL :4.00 PANELS + ARRCHITECT - ENGINEER LIC. NO. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. No. - SIGNS TRANS. 3.00 ADDRESS ENG. - ZIP SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ) ! , I I -T ) IRS C. �J EMP. METER OR POLE INS. , 20.00 APPLICANTS aoOREss MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 - - I LICENSED CONTRACTORS DECLARAT10N�•PAID I hereby affirm that I am,licensed under Prue Bions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profession, Cotte ad my license is in full for ' ffeg - LicenseClas Lic. Number O I ISbUAN CE DATE BLDG. ELECT. PLG. MECH. El 56 1 D E' Da[c '1� Contracmr - BUILDING PERMIT INFORMATION OWNERBWCDIfRDIiCLARATION - Ihereb y affirm that I nm exempt front Ota Contractors Lionise Law for the following reason. (Set. 7031.5, Business and ProfessionspERMIT Code: Any city or county which requiresa permit to construct, alter, MISC.- REFER • O D • .•. ISSUANCE 191 419-N / 'VALUATION, $/FT. ELEC. CONTR. LIC. N0. ELEC. TOTAL improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed Statement lila( he is licensed pursuant to the provisions of Be Contractor's License PERMIT TO - - Law (Chapter 9 (commencing with Section 7000) of Division 3 of l be Business and Professions Code) or that he is exempt therefrom and OTY- PLUMBING PERMIT FEE _ the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant lot a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)J: - ' STORIES u ILYPE CONSTR. ALTER -DRAIN -WATER (EA.) 5,00 ❑ 1, as owner of the property, or nay employees with wages as their sole compensation, will do the work, and The structure is no( BACK F LOW PROTECT. DEVICE .4.00 DEC. GROUP , RES. 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 - I INC.4 OUTLETS 6.00 Sp. FT. FLOOR AREA TOTAL ACREAGE property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improve meats are not intended or offered for sale. If, however, the building or improvecment is sold within one year of anpletimm the owner- builder will have the.burden of proving that he did not build or an. prove for purpose ofsale.).INDUSTRIAL ❑ I, as owner of the property, am exclusivgly contracting with GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PS Orn., ❑ ❑ El 0 , ❑ WASTE INTER. 30.00 licensed contractors to construct the project (Sec. 7044, Business and Pro Cessions 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 contractor(s) licensed pursuam to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. O l am exempt under Sec.-, B.&P.C. for this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM5.00 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 WORKERS'COMPENSATION DECLARATION I 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, Lab.C.). Policy No. Company - ❑ Certified copy is here by f mist it ARte rlifi op '. Ole it tl ci(Y inspection division. e - FIRE SPRINK v . N ENERGY T-24 v N MISC. - - REFER TO ORD. CERTIFICATEOF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. COMPENSATION INSURANCE 0Ili, section need not be completed if (he per mi(.is for one Y [] N� Y NE] PLO. CONTR. LIC. NO. PLG. TOTAL - hundred dollars IS 100) or less.) - I certify that in the performance of the work for which this per, mi( is issued, I shall not employ any person in any roomer so as to QTY. MECHANICAL PERMIT FEE FEE SUMMARY become subject to the Workers' Compensation Laws of California. OR ADD TO MECH. 5.00 Dam ApplicantALTER BUILDING - N01'ICE 'l0 APPEICAN'I': If, after making Ihis Certificate Uf 1: x - APPLIANCE 5.00 AIR HANDLING UNIT (TO 10=CF.M.) 4.00 PLAN CHECK , FEE you should become subject to the Worker,' Compensation Provisions of the Labor Code, you must lixthwilh comply with such provisions or this permit shall be deemed revoked. - AIR HANDLING UNIT (OVER 10=C.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that (here is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the'work or which this permit is issued (Sec. 3097, Civ.C.). MICROFILM - HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender' Lender's, AAddrddress HEATING UNIT (OVER 100,000 B.T.U.)9.50 ' ELECTRIC VENTILATION FAN (SINGLE) 4.00 1 certify (hat I have read this application and state (flat 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 BOILER -COMP (Over 10(1,000 BTU) SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the above-mentioned properly for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC. - REFER TO ORD. upertino against liabilities, judgments, costs and expenses which ay in an way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 CONST. TAX - rami Ills eon t - MECH. CONT. LIC. NO. MECH. - _ eI,•��,0 I TOTAL TOTAL 41 _ ' n lure of Applicant/Contractor Date OFFICE COPY