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14415 POST THIS CARD NEAR FRONT OF BUILDING rERniI�N�RER 415 " CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD • 10123 N WOLFE ROAD PERMIT"EXPIRATION ' ' JOB'ADDRESS UNIT# LOT# BUSTERS BAR AND GRID ICOM MECHANICAL PERMIT EXPIRED IF WORK I OWNER TRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE, - TO COMPLY WITH THE APPROVED PLANS AND CITY OF rERM1T VALIDATION CUPERTINO STANDARDS. GARAGE SLABS n POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED C•o's "L'" UNDERGROUND /SLAB r� PLUMBING - ��3k 7 ELECTRICAL ISSUANCE DATE MECHANICAL • Loa ELECT -PLG.. MecR� Y 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT „a• NFORMATION WOOD FLOOR •ti+ VALUATION SIFT. PLUMBING � - • MECHANICAL - - PERMIT TO ELECTRICAL -FRAMING INSULATION STORIES. TYPE CONSTR OCC.GNOUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO,FT,FLOOR AREA TOTAL ACREAGE . . DIAPHRAGM THE CONSTRUCTION TAX IS PAID RUILUI USE ROOF SHEATHING - RES IND CON PR GO— APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ Cl • ❑ El ROUGH SAN.q ASSESSORS PARC EL NO PLUMBING ELECT.ENERGY TRACTNO. PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICALBUILDING ENERGY Gx C.DATE -ACC.FILE NO FRAMING ELECT.FINAL TEST ZONING ENG.SITE N0. INSULATION � � PLUMBING . R GAS TEST GAS MECHANICAL .�., FIRE SPRINK ENERGY T}a COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y❑ " v o- IN FLOOD ZONE A.L.0 C • EXTERIOR_ SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. _Y❑- "❑ Y ❑ "❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR-LATH BUILDING INTERIOR LATH - " TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC w ONE WORKING DAY BEFORE REQUIRED INSPECTION. 4 F PLUMBING /,t: -Q O� PLEASE GIVE JOB ADDRESS WHEN PHONING. SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! corysT.TAX PLEASE READ REVERSE SIDE BEFORE t„ ” +: TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION PERMIT NUMBER BUILDING APPLICATION & PERMIT ADDRESS/�/23 �fe - 14415 /V BUILDING-ELECTRICAL-PLUMBING-MECHANICAL • OWNaE�H'9 r/' �� F��{K�1�L(�yN DTV. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION �� PNONE CONTRACTORS/ UTLETS-SWITCHES-RECEP 10.00/1.00 fGaM �" Llc.rvo.��Zz LIGHTING FIXTURES 10.00/1.00 goNrREJ$As 1O.�rs�7� yM /��(,(r�J"J/� APPLIANCES-RESIDENTIAL 4.00 PHDNE� 10 f/r'-1 PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. on PANELS (OVER 200 AMP) 20.00 ENGINEER / ' LIC.No. SIGNS TRANS. 3.00 ARCH.OR ENG. PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT '5.00 ZIP TEMP. METER OR POLE INS. 20.00 APPLICAN ADDRESS TS MOTORS SEE FEE SCH. ° ¢i SERVICE CHANGE 20.00 r o o LICENSED CONTRACTORS DECLARATION <u U I hereby affirm that I am licensed under provisions of Chapter 9 a t (Commencing with Section 7000)of Division 3 of the Business and - BLD 1 MECH. LE PLG. ' r w z Professions Codg, y license is in full for �� El 1:1 El iw p icense Class U' Lie.Number Q y 2 j Date _contractor M /u/ Inm w 4 OWNER-BUILDER DECLARATION BUILDING PERMIT w ° ° U MISC.- REFER TO ORD INFORMATION 3: u y I hereby affirm that 1 am exempt from the Contractor's License LL O 4 Law for the following reason.(Sec.7031,5,Business and Professions VALUATION S/FT. - PERMIT ISSUANCE 10.00 Code:Any cityorcounty which requires permit to construct,alter, 2 Q improve,Demolish,or repair any sVucturc;prior 10 its issuance,also ELEC.CONTR. LIC.NO. ' iL °M requires the applicant for such permit to file a signed statement that TOTAL a w$„r he is licensed pursuant to the provisions of the Contractor's License PERT IO 1-i> Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe L g q° Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE M f$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. nim by any applicant fill a Permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER IEA'.) 5.00 of not more than five hundred donors(5500).): ❑ Las owner s a the property,or my employees with wages their sole compensation, BACK FLOW PROTECT.DEVICE 4.00 Dec.GROUP RES.UNITSion,will the work,and the structure is s as intended or offered for sale (Sec. 7044, Business' and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law dues not apply to an owner of • property who builds or improves thereon,and who does such work FIXTURES,PER TRAP 5.00 SQ FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- ments arc not intended or offered for sale.If,however,the building GAS-EA.SVSTEM-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- GAS,EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE prove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omar ' ❑ I,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Sec. 7044,BusinessLAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:1'he Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(E ) .00 contracts for such projects with a contractoos)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA O.00 TRACT NO. PARCEL NO. ❑ I ant exempt under Sec. ,BAP.C.tor this reason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM (/ `5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP• �1I - 1 hereby affirm that I have a certificate ofconsent to self-insure. C, ZONING ENG.517E NO. or a certificate of Workers'Compensation Insurance,or a certified copy thefygf }10,j.aEC.1. ti0 rIu/I,..0 Policy NNN n pony /� /r7/`�4� O ❑ Certified copy Is I reby furnished. FIRE SPRINK ENERGY T-24 Z Z ¢ Cert opy rs d with the city inspection division. F O- pplic.F( cup MISC.- REFER TO ORD. Y[] NE] YE) NQ It Q: N CIiR"I PIGn'I'Ii OF E) 'M PTION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU COMPENSATION INSURANCE: PLG.CONTR. LIC.NO. � CL O (This section need not be completed if the peon it is for one TOTAL /I(/� Y❑ NC] Y ❑ N[] D Z hundred doll...S 100)or less,) V O 1 certify that in the performance of the work for which this per: CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL U mit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Wompensation Laws of California. y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING >- to NOTICE TO APPLICANT: If,alter making this Certificate of Ex- ? eruption,you should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with U FEE such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10X0C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000 C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of to work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 1 certify that 1 have read this application and state That the above VENTILATION FAN (SINGLE) 4,01) 0-0. information is cornet. I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and hereby authorize representatives of this city-to enter upon the above-memioned property for inspection purposes. BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which CONST.TAX may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 maTOTAL I, of llhla n l ��1t' MECH,CONT. LIC.NO. TOTAL Sign tore 01 A plica Contractor Daft OFFICE COPY