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10897 i CITY OFTHIS CARD ECUPERTINO '" -;. QQ 1 •'� j�WG PERMIT NUMBER INSPECTION DIVISION OVV� JOB INSPECTION RECORD PERMIT EXPIRATION JOBADDRESS lv�l.l "" , `�" v� UNIT# LOT# PERMIT EXPIRES IF WORK OWNER r CONTRACTOR IS NOT STARTED WITHIN INSPECTIIDN DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION _ 7 ANCE 180 DAYS FROM � LASTCALLED INSPECTION. UFEfl V V 7 'tlom P[RMI g�ON PREGUNITE � �'►1Y./ T POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED !JUN 4 ' 1986 UNDERGROUND /SLAB PLUMBING " City Of CUpBrI100 ELECTRICAL - ISSUANCE DATE MECHANICAL - BLDG, ELECT. PLc. MECH. D OT P R FLOOR UNTIL ABOVE HASB BEEN SIGNED euaOwO PERMIT INFORMATION WOOD FLOOR VALUATION s/FT. " PLUMBING ' ✓" MECHANICAL o (' I o PERMIT TO ELECTRICAL r l' FRAMING B— INSULATION - STOPTYPEC NSTR. 0 a—?7 ,.J OCC GROUP RES UNITE /Xj -� I I PLACE NO SUBFLOOR UNTIL ABOVE HA BEEN SIGNED ROOF SO.FT.tFLOO AREA TOTALACREAGE � • DIAPHRAGM f � BUILDING USE HF. IND CON PB OrM1er APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ • ASSESSORS PARCEL NO. ROUGH PLUMBING GAS TEST T9ACT NO.. PARCEL NO. MECHANICAL � .�/ • ACC.DAT ACC,FILE NO. ELECTRICAL FINALS DATE INSP. FRAMING SAN # INSULATION PLUMBING zoNlNc ENG.SITE NO, 7 v� GAS l ,� FIRE SPRINK ENERGY T2 MECHANICAL , Tor COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED IHEATING LATH—INTERIOR ELECTRICAL FLOOD ZONE AL.U,C. LATH—EXTERIOR FIRE DEPT. Y❑ "❑ Y ❑ "❑ SHEETROCK GRADE - FEE SUMMARY SHEAR INTERIOR BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS 'euILOwG FIREWALLS ELECTRIC _ . PLAN CHECK GAS a SW FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE '�• OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM, f l ARRANGE FOR-I NSPECTION BY PHONING 252.4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING O PLEASE GIVE JOB ADDRESS WHEN PHONING. ' Z MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - IMPORTANTI a t CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY I FINAL GRADE ROUTE SLIP 1 y File No. ate 6 Locatio Subject Notes APProve ,� ° Dati tIns ctor APPLjjICANT TO FI N INFORMATION WITHIN RED LINC" - USE BALL POINT PEN ONLY • I LDING PROJEC NTI FICATION PERMIT NUMBER B'U BUILDING _ APPLICA N & PERMIT - ADDRESS O' BUILDING - ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION r�� "AME QTY. ELECTRIC PERMIT FEE PNDry sa-ioz JUN 4 - 1986 CONTRACTOR'S NAME q //IR'f/Oqq/ tb'Sf- UTLETS-SWITCHES-RECEP 10.0011.00 'IL LIC.No. LIGHTING FIXTURES 10.00/1.00 City Of Cupertin6 CONTRACTOR S 1;?2,eO ADDRESS IAC/ /Q ,�-SfK-t/C APPLIANCES-RESIDENTIAL 4.00 /Q/ PHOrvE 2'-i0 PANELS 10.00 DATE OF APPLICATION ARCHITECTPLAN CHECK FEE P.O.NO. OR f'y/(iY/C4,h Ve-4 i" V1 t,*ALJ- PANELS (OVER 200 AMP) 20.00 ENGINEER SIGNS TRANS. 3.00 ADDRESS RCH,OR ENG. /Z2$O �C/G� ✓qQ SPECIALCIRCUIT 5,00 PERMIT VALIDATION ��t/ zIP 9�� EMP.METER OR POLE INS. 20.00 Ars ADDDRESSDRESS - MOTORS SEE FEE SCH. ✓'IS` ���� Q Q - f Qy�-jn SERVICE CHANGE 20.00 0 0 o LICENSED CONTRACTORS DECLARATION < u - I hereby affirm that I am licensed under provisions of Chapter') ISSUANCE OATS (commencing with Section 7000)of Division 3 of the Business and BLO ELECT. PLG. MECH. i Professions Conse is in full force an f .�„{J ❑ ❑ ❑ z o= License C se Number 9 m r w Dulc Contractor ¢ x s a ��-CT BUILDING PERMIT ¢ Q w OWNER-BUILDER DECLARATION INFORMATION w;u at I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD VALUATION SIFT. 1-w o¢ Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 `�l Ew E Code:Any city orcounty which requires a permit to construct, U ¢ Q O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTIT LIC.NO. ELEC. LL tell W res the applicant for such permit to till'a signed statement that TOTAL RM TTG I w2 he is licensed pursuant to the provisions of the Contractor's License L z i Law(Chapter 9(commencing with Section 7000)of Division 3 of the F 4 o 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 STOg1E5 TYPE O�NgTH. a , by anyopplicant l'orapermit subjects the applicant loo civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 � �'n 1'C of not more than five hundred dollars(8500).): I 1 ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 .GR UP RTI their sole compensation,will do the work,and the structure is not occJ�� f intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Cade:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 5.00 50.FT.FLOOR AREA TOTAL ACREAGE l \ 1 im5elf-,p0.l4rnuph his own employees,provided that such improve- I are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00fil or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 B LDING USE builder will have the burden of proving that he did not build or im. IND CON PB Other ( prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contacting with ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of properly who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with aCORImCLOIfS)IIGCn Setl pursuant IO SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. T A T N PARCEL NO. ❑ lam exempt under See,-.BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner � gN[.1_21��_�+yyt/e� WATER SYSTEM 5.00 c .D ACC.FILE NO. W RKFRS'COMPSN ATION DECLARp'I'10 WATER TREATING EQUIP. 5.00 I heo. afflrmlhall have ucertifiwle nfconsenl to selGinsure' ZONING ora Certi 'em of Workers'Compe sa Jfjr�I �us�C qr a certil icd ENG.SITE NO. copy there ec.3800,Lab.C.). /Y! fj/v/✓ Policy No. Company O ❑ Certified copy is Ilerchy furnrs le �� FIRE SPRINK ENERGY T-14 Z 2 ❑ Certified copy'is fled with the city inspection division. MISC.- REFER TO ORD. O Applicant Y El NF Y E] N[:]Hy PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.c. CC CFRTIFICA E -E) �MPTION PCOM WORKERS' LOU > COMPENSATION INSURANCE PLG.CONTR. LIC.No. PLG. tL 0 (This section need'not be completed if the permit is for one TOTAL Y❑ N[] Y ❑ NE]N hundred dollars(S I O0)or less.) U O 1 certify that in the performance of the work for which this per' QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- mit is issued,1 shall not employ any person in any manner SO as to U become subject to the Workers'Compensation Laws of California. CL ED Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } W NOTICE.TO APPLICANT: If,after making this Certificate of Ex- _ F ? emotion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the labor Code, you must forthwith comply with FEE U Such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10X0C.F.M.) 4.00 CONST RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000C.F.M.) 6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 7097 Ci�C,nce of the work for which this permit is issue)(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM Lender's Name HEATING UN IT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC I certify Ihal I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is Correct. 1 agree to comply with all city and county PLUMBING ordinances and state laws relating to building construction, and BOILER-COMP(3H.P.Or100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILEfl-COMP(Over 100,000 BTU)SEE FEE BCH. MECHANICAL above-memkprD, r inspectionpurposes.(We) agrnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino aju s and expenses whichpEflMIT ISSUANCE 10.00 CONST.TAX may in anyinst id C' in consequence of t e agranting Of lCH.CONT. LIC.NO. MECH. 1 /!� TOTAL TOTAL Signal are o pp Ican on rudor OFFICE COPY ' PAFTHI CA 4D NEAR FRONT OF BUIIp�jVG PERMIT NUMBER ( T , OF CUPERTINO` 10897 INSPECTION DIVISION JOB INSPECTION RECORD x PERMIT EXPIRATION �' JOB ADDRESS �e -PSL, �U IT# L T# ' I / PERMIT EXPIRES IF WORK OWNER CONTRACTORI, IS NOT STARTED WITHIN INS ECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATIO ANCE OR 180 DAYS FROM LIFER 0 rj p LAST CALLED INSPECTION. d PREGUNITE O.. rl/.. , PERMI )N Aima III dl-l.� OUR N CONCRETE UNTIL AB E AS BE N SIGNED �E ..�C -$ �Qooy� t .7-a). k�I JUN 4 - 1986 UNDERGROUND /SLAB N PLUMBING ✓ City of Cupertino ELECTRICAL ISSUANCE DATF. MECHANICAL BLDG. I ELECT. I PLG. MECH. DO NOT POUR FLO R 1UN7IL ABOVE HAS BEEN SIGNEDd M Y/ti f v L BUILDINGRMPERMIT WOOD FLOOR INFO ATION PLUMBING 6VALUATION $/FT, _ MECHANICAL ELECTRICAL P gMIT TO FRAMING INSULATION - STORIE TYPE CONSTR. d^ OCC.GROUP RES.UNITS I ! PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO.FT.FLOOR AREA TOTAL ACREAGE I DIAPHRAGM ' ROOF - BUILDING USE HES IND CON PB Om., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑X ❑ ❑ ❑ ❑ ROUGH ASSESSORS PARCEL NO. Ny G G o I PLUMBING _ f GAS TESTTRACT NO. PARCEL NO, MECHANICAL Pr l� Si ' ELECTRICAL ACC.OATE ACC.FILE NO. FINALS DATE INSP. FRAMING SAN * INSULATION PLUMBINGZONING ENG.SITE NO. -121As 'i7 _ GAS FIRE SPflINK ENERGY TQC 2o1Zf J.S MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIG ED HEATING '� N v ❑ N❑ LATH-INTERIOR ELECTRICAL FLOOD ZONE A.U.C. . LATH-EXTERIOR FIRE DEPT. Y❑ N❑ Y ❑ N❑ SHEETROCK - GRADE EESUMMARY SHEAR INTERIOR �BUILDING- qd ., SHEAR EXTERIOR TEMPORARY APPROVALS BUILDING ' FIREWALLS ELE PLAN CHECK G CD 8 GAS FEE' NO TAPE OR PLASTER UNTIL ABOVE HAS BEE SIGNED OCCUPANCY SEISMIC FEE UCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM ARRANGE FOR INSPECTION BY PHONING 252.4505, 1 ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. II } PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — lly MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE t ' t' 1 TOTAL CALLING FOR FINAL INSPECTION. gal'?LICANTP,POSTING COPY