The URL can be used to link to this page

16417r +� 0; 10 POSTTHIS CARD NEAR FRONT OF BUILDING CITY OF WPERTINO INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS,/00fV N, I�L%O L,f-E �� UNIT# LOT# OWNER •1,6�X-� L „u64NTRACTOR 1EX_4 L .C•/�/ PERMIT NUMBER 16417 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION - b NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER PREGUNITE PEHAVT VALIDATION -. ( `7 ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL MECHANICAL B,,LLD�DGp tl.Ecr C}�� ❑ PLG. Mk CR ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION PLUMBING MECHANICAL~` ELECTRICAL P[HMII TU �V FRAMING INSULATION STORIES TYPE CONSTH. 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 50 11 FLOOR AHLA .IOiAL ACH IPGk DIAPHRAGM ROOF SHEATHING F'BUILDING USE +Es O CON Pd Do— ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH SAN.# - - PLUMBING ELECT. ENERGY TUBS & SHOWER PAN PLUMBING ENERGY TRACT NO PARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC DATE ACC, FILE NO FRAMING ELECT. FINAL TEST ZONING ENG SITE No.; INSULATION PLUMBING GAS TEST GAS FIRE 51'RINK Y ❑ N❑ ENERGY L2< ❑ No MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING kFL000 zo Y � N A.Luc L7 '[3 EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC PLAN CHECK FEE L 7v GAS SEISMIC FEE r 1 UJ, NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, H 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 U ..�.. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT I DENTI FICATI ON APPLICATION & PERMIT BUILDING=ELECTRICAL-PLUMBING-MECHANICAL PERMIT NUMBER k' 1641'l 8ILDING ADDRESS 1006-0_ LN -)10 L^` OWNER '$ EI CAL ' I0J yf2s.9 9 :5E_ E O7V. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION ATE OF APPLICATION l� CONTRACTORS N L UTLETS-SWITCHES-RECEP 10.00/1.00 12 -- LIGHTING FIXTURES ' 10.00/1.00 CONTRACTOR'S Yl� A CRESS i C HONEPANELS PPLIANCES- RESIDENTIAL 4.00 10.00 ARL ECT Du'V" OR �/' ENGINEER ' sec. rvo. PANELS(OVER 200 AMP) 20.00 LAN CHECK FEE P.O.tiO. �0 (�� SIGNS TRANS. 3.0 ARCH. OR ENG'SPECIAL ADDRESS ZIP CIRCUIT S,QQ O PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 APPucANr$ AOyRE�� 119 MOTORS SEE FEE SCH. SERVICE CHANGE LIC17NSED CONTRACTORS DECLARATION 1 Z -"----- - -%�PrrLECT. 1 hereby affirm that I am I ecoxod under provision, of Chapter 9 Iconunrnemg with Section 70001 of Division 3 of the Ilusiness and Professions CDJe,al �uv i«•nu Is in full lure ansa f'c Liccnu C'ss l' Lic. Number i Dutc- Contractor SUANCE DATE I PLC. t MECH. ❑ -i---- .._. OWNER -BUILDER DECL ATION I hereby anion that 1 am exempt 31.5 the Contractors License law for the following ntywh(Sec.onics a,tlmit to con Professions Code: Any city or county which requirese permit to construct. tree. improve, demolish, m repair any structure, prior to its issuance, also r<quires Lie applicant for such permit In file u signed statement that he is licensed pursuant to the provisions of the Contractor's License _ _-„17 Qt ILDING PERMIT INFORMATION MISC.- REFER TO ORD VALUATION $/FT. Ip2'i PERMIT ISSUANCE a- ELEC. CONTR. LIC. NO. ELEC. 10TAL PERMIT TO QTY. PLUMBING PERMIT FEE Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation o(Secfion 7031.5 6"V STORIES TYPE CONSTR. ALTER -DRAIN -WATER (EA.) 5.00 by any applicant for a permit Sul jcco, the applicant to a civil penalty of not more than five hundral dollars ($5001): ❑ 1, 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 BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES, UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 Code: The Contractor's License Law does not apply to an owner of property who builds or inlpruves thereon, anJ who docs such work FIXTURES -PER TRAP 5.00 SQ FT. FLOOR AREA TOTAL ACREAGE himself or through Itis own employees, provided that such improve ments are not intended or offered for sale. Il', however, the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 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 of sale.). O I, as owner of the properly. am y cWumvv conlmcting wilh licensed contractors to construct the project (Sec. 7044, Business and Professions Code The Contractor's License Law Jou not apply to an owner of property who builds or improves thereon, and who GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB Omer ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 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 contmetur(s) licensed pursuant 10 Om Cnntmctor's LicenseLaw. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO, PARCEL NO. WATER HEATER W/VENT, 6.00 ❑ lam e.nIpt under Sec. , It.&P,C. for this reason Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. .WORK ERS'COMPEN5AT10N DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have u certificate of consent to .self-insUe' or a certificate DI' Workers' Compensation Insurance. or a certil'icA ZONING ENG. SITE NO. co Yid o 80 Lab.C l' I Party 14as1?(H'V Ff'e6_ ❑ CetliliCd copy is hereby (umishcJ. pprY Cerlific1 IICJ rlhe cit ins noun division. Kpplicanl FIRE SPRINK v ❑ N❑ ENERGY T-24 v ❑ N❑ MISC. - REFER TO ORD, PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. CI: TIFIQ\'I'EOI' 'XE l'ION 17ROM WORKERS' PLG. CONTH. LIC. NO. PLG. TOTAL COMPENSATION INSURANCE section need not be completed if the permit is for one V❑ NEI V❑ NE]1'I'his QTY. MECHANICAL PERMIT FEE FEE SUMMARY htmdmd dollars IS 100) or las.) I cerlity that in the performance of the work for which this per- mit is issued, 1 shall not employ any person in any manner so as to BUILDING o 6� become subject to the Workers' Compensation Laws of California. Rule Applicant ALTER OR ADD TO MECH. 5.00 NOTICE '1'O APPLICANT: 11, after making this Certificate of fix enl Plum, you should become subject to the Workers'Com pensalioll provisions of the Labor Code. You must I'orthwilb comply with such provisions or this permit shall be deemed revoked. APPLIANCE 5.00 PLAN CHECK FEE +� _ AIR HANDLING UNIT (TO 10=CF.M.) 4.00 AIR HANDLING UNIT(OVER 10=C.F.M.)6.00 SEISMIC FEE / OS' CONSTRUCTION LENDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT ITC 100,000 B.T.U.) 8.00 MICROFILM I hereby afl'ino that there is a construction lending agency fur Eu, perfonnancC of the work I'or which this permit is issued (Sec. 3097, Civ.C. ). Lender's Name HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC p2 Under', Address I certify mut l havereud thlsapplicalion ace state amt the above information is correct. I agree to comply with all city and county ordinances and slate laws relating to building construction, and VENTILATION FAN (SINGLE) 4.00 PLUMBING BOILER-COMP(3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL hereby autlmriie representatives of this City to enter upon the above-mentioned properly for inspection purposes. MISC. - REFER TO ORD. CONST. TAX (We) agree to save, indemnify and keep harmless the City of Cupertino a •. liabilit , 'udgmen[s, costs and expenses which may i y ace e a inst 'said City in consequence of the PERMIT ISSUANCE 10.00 MECH.CONT. LIC. NO. MECH. TOTAL TOTAL (( S /V remm spermit. _ ew Sign 1 Applicant/Contract., fare OFFICE COPY