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14735• POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 14735 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS .10150 Torre Avenue - UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER • Chateau Cupertino CONTRACTOR , IS NOT STARTED WITHIN ' 180 DAYS OF PERMIT ISSU- OR 180 DAYS FROM INSPECTION DATE INSPECTOR INSPECTION RECORD - FOUNDATIONANCE NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF LASTCALLED INSPECTION: UFER PR EGUNITE PERMIT VALIDATION. CUPERTINO STANDARDS. I - - !^•_ ,, GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING - 4°G •m .. ` ISSUANCE DATE ELECTRICAL ' MECHANICAL �n „ BLDG ELECT PLG. MLCH!- • DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ', C1hi 01 - BUILDING PERMIT INFORMATION WOOD -FLOOR VALUATION BIFT. PLUMBING MECHANICAL"_�-- ELECTRICAL PERMIT TO s!c�N 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 FLOOR ARE TOTAL ACREAGE DIAPHRAGM - - BUILDING USE ROOF SHEATHING RES IND CON PB Om., El 1:1 ❑ El 11 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO - ROUGH SAN.# - PLUMBING ELECT. ENERGY TUBS 8 SHOWER 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. ' GAS TEST GAS - FIRE SPRINK ENERGY T -2a _ � MECHANICAL v� N� v❑ N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE Y E "0 ALUC v 0 INTERIOR SHEAR - FIRE DEPT. SHEETROCK GRADE - FEE SUMMARY EXTERIOR CATH BUILDING BUILDING"� '.••j INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT' ELECTRIC PLAN CHCCC FEE - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNEDBY BUILDING INSPECTOR, MICROFILM ELECTRIC I J' ARRANGE FOR INSPECTION BY PHONING 252-4505, LU F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0.� PLEASE GIVE JOB ADDRESS WHEN PHONING. Z - —SEE PERMIT FOR EXPIRATION DATE — MECHANICAL CONST. TAX' IMPORTANT!- TOTAL PLEASE READ, REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. OFFICE COPY • 1• 0 • Z_2 0 CC LO W_ (L0 Z)2 UO LL U 0w Ya I- ? A APPLICANT TO FILL IN INFORMATION WITHIN RED LINES- USE BALL POINT PEN ONLY v BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING — ELECTRICAL— PLUMBING — MECHANICAL PERMITNUMBER � I 14735 RUNOm . - ADDRESS —0 �� (l OWNER'S NAME au /A PHDNEI $, yYH QTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION DATE OF APPLICATION CONTRACTOR'S ' NAME { C,ilu_ d� LIC. NO OUTLETS -SWITCHES -RECEP 10.00/1.00 LIGHTING LIGHTING FIXTURES 10.00/1.00 NTRDDREACTOR's A Cnn^,� j'n g'rl GtJ QbPHONE PPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 ARCHITECT OR ENGINEER uc. No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. , SIGNS TRANS. 3.00 moo 'Ess ENG' ZIP SPECIAL CIRCUIT ' 5.00 PERMIT VALIDATION - - �py]�J L—sI�-�'� '•Le -ISSUANCE DATE TEMP. METER OR POLE INS. 20.00 AR Ess ADDOORESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICENSED CONTRACTORS DECLARATION - I hereby affirm that I am licensed under provisunD of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codc, a I ny Iicenxc is in full for ) n •flee / Class Lic. Number DateContractor v ' BLDG. ELECT, ��' L f j U PLG. MECH, EJ El - OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5, Business and Professions Cade: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing wilh Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged excnnption. Any violation of Section 703 t.5 by any applicant for a pemritsubjects the applicant to a civil penally of not more than five hundred dollars (5500).): O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec 7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of property Who builds of improves thereon, and who does such work himself or through his own employees, provided that such improve- ments are not intended or offered for sale. If, however, the 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 no. prove for purpose of sale.). O 1, as owner of the property, tun exclusively contracting with licensed contractors to construct the project (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 who confronts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. ❑ tutu exempt under Sec. ,B.&PLC. lar this reason BUILDING,PERMIT :Gr n4 (INFORMATION MISC.— REFER TO ORD VALUATION �O $/FT. PERMIT ISSUANCE 10.00 10 ELEC. CONTR. LIC. NO. ELEC. 1Z TOTAL 1 ✓PERMIT TO 5 I �� QTV. PLUMBING PERMIT FEE STORIES TYPE CONSTR. ALTER -DRAIN -WATER IEA.) 5.00 BACK F LOW PROTECT. DEVICE 4,00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 FIXTURES - PER TRAP' 5.00 SO. FT. FLOOR AREA TOTAL ACREAGE GAS - EA. SYSTEM -1 INC. 4 OUTLETS 6.00 GAS - EA. SYSTEM - OVER 4 (EA.) 2,00 BUILDING USE RES IND CON PB Omar ❑ ❑ ❑ ❑ ❑ INDUSTRIALWASTE INTER. 30,00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. SEWER -SANITARY -STORM EA. 200tt/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 Owner Dute WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WORKERS'COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance, or certified copy thereof (Sec. 3800, LehCJ. Policy NCompany w- //.-- WATER TREATING EQUIP. 5.00 ZONING ENG. SITE NO. ❑ Certified copy is hereby furnished. Certified cog is Jed lir t ity r pection division. Applicant— oe(/ti C1: RTI FICA 'IF OI: EX E M KNO N 17 ROM WO R K E RS COMPENSATION INSURANCE (This section need not he completed if the permit is for one hundred dollars ($ 100) or less.I 1 certify that in the performance of the work for which this per, mit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Applicant FIRE SPRINK Y ❑ No, ENERGY T 24 Y ❑ N❑ MISC. - REFER TO ORD. PERMIT ISSUANCE 10.00 FLOOD ZONE Y❑ N❑ A.L.UC. Y❑ N❑ PLG. CONTR. LIC. NO. PLG. TOTAL QTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING ALTER OR ADD TO MECH. 5.00 NOTICE: TO APPL1CAN'r: If, after making this Certificate of F,x- emption, you should became subject to ore Workers' Compensation provisions of the [,shot Code, you must forthwith comply with such provisions or this permit shall he deemed revoked. - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.CJ. Lender's Name APPLIANCE 5.00 PLAN C FEE �, 92 AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 AIR HANDLING UNIT (OVER 10=C.RM.) 6.00 SEISMIC FEESID EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00 MICROFILM HEATI NG UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC 13� Lender's Address I certify that 1 have read this application and state that lire above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, anti hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of upertino against liabilities, judgments, costs and expenses which may in any way accrue agar sst aid City in consequence of the ranting of th t mit. -/_00 VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILER -COMP (3 H.P. or 100,000 B.T.U.) 6.00 - BOILER -COMP love, 100,000 BTU) SEE FEE SCH. MECHANICAL MISC. - REFER TO ORD. TAX PERMIT ISSUANCE 10.001CONST. MECH. CONT. TGTAL TOTAL Signature of Applicant/Contractor Date OFFICE COPY