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15376 POST THIS CARD NEAR FRONT OF BUILDING. '• _ - PERMIT NUMBER CITY OF CUPERTINO 15376` INSPECTION DIVISION JOB INSPECTION RECORD 10123 'North Wolfe Road ' gp. r PERMIT EXPIRATION •may JOB ADDRESS UNIT# _LOT# •� . PERMIT EXPIRES IF WORK OWNER NATURALIZER , ,' CONTRACTOR IS NOT STARTED WITHIN , INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- . FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. . LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EGUNITE - TO COMPLY WITH THE APPROVED PLANS AND CITY OF vERnuT v L Anow CUPERTINO STANDARDS. - GARAGE SLABS - MA!t POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED i UNDERGROUND /SLAB l ItG pr'p-rp4�I(Eta PLUMBING ELECTRICAL ISSUANCE DATE RL MECHANICAL' EG, ELeycr PLG. MECHI,. ❑ . I Rl 1 ❑ ❑ i DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT • INFORMATION WOOD FLOOR ' VALUATION SIFT. PLUMBING - MECHANICAL, ' ELECTRICAL PERMIT TO - - ' FRAMING' - .!� STORIES TYPE CONSTR. INSULATION OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED sa Fr,aooR AREA TOTAL ACR gACL ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE - r THE CONSTRUCTION TAX IS PAID DIAPHRAGM = ' BUI=D N0 USE " ROOF SHEATHING HES IND CON PE Omr, : APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH SANJH PLUMBING ELECT.ENERGY - . TRACT NO. PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY ' MECHANICAL' • � MECH.ENERGY ELECTRICAL - BUILDING ENERGY Acc.onrE ACC FILE No. FRAMING . - ELECT.FINAL TEST INSU LATI ON _ I PLUMBINGZONING ENG.SITE NO. ' .GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY LZ4-- COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED 1HEATING Y ❑ ❑ "❑ EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONE nLuc. INTERIOR SHEAR FIRE DEPT. Y❑ N.❑ Y❑ N❑' 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 JOCCUPANCY SEISMIC FEE OCCUPANCY O F BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM •� ARRANGE FOR ELECTRIC INSPECTION BY PHONING 252-4505, � L H ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING o . ' RLEASE GIVE JOB ADDRESS WHEN PHONING'.. X1,1 Z MECHANICAL f , — SEE PERMIT FOR EXPIRATION DATE - - CONST.TAX ' IMPORTANT! PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT IDENTIFICATION PERMIT NUMBER AODRE55 APPLICATION & PERMIT 15376 z2aUI LD ING - ELECTRICAL-PLUMBING-MECHANICAL OWNER'S J PLAN CHECK VALIDATION "AME DTV. ELECTRIC PERMIT FEE CO"rRACToes $ O UTLETS-SWITCHES-RECEP 10.00/1.00 13 NAME LyI�CA-t-' e1PC RIC LIC.No. '3 1 a LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S 4//S PPLIANCES-RESIDENTIAL 4.00 %aooREss l p C�U4F iejj, PHONE '/'1-10-� PANELS - 10.00 DATE OF APPLICATION' . A CHITELT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. OR. ENGINEER ' LIC,No. SIGNS TRANS. 3.00 ARCH,OR ENG. SPECIAL CIRCUIT . - 5.00 PERMIT VALIDATION ADDRESS VIA TEMP.METER OR POLE INS. 20.00 �� APPLICANTS MOTORS SEE FEE SCH. ADDRESStf SERVICE CHANGE 20.00 - OaiI p .FOO LICENSED CON'T'RACTORS DECLARATION IDICOT� /s t1f nt lilt tiR� . a u I hereby affirm that I am licensed under provisions of Chapter 9 Asl.ISSUAr`fCPDATE y<u (commencing with Section 7000)of Division 3 of the Business anJ - BLDG. ELE�CT1. PLG. - MECH. F O i Professions Co use is in full font )d,•fe LZ Z � lyl/ El 1 Z, z=O License CClIass it Lic.Number K=� F m H J Date L Contractor a w ¢ OWNF-R-BUILDER DECLARATION BUILDING PERMIT ac U REFER TO ORD INFORMATION w;LL I- I hereby affirm that I am exempt from the Contractor's License MISC.- u 04 Law for the following reason.(Sea 7031.5,Business and Professions PERMIT ISSUANCE 10.00 VALUATION 5/FT. � - Code:Any city or county which requires a permit to construct,alter, ` � QQp improve,demolish.or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. O u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO se$ he Is licensed pursuant to the provisions of the Contractor's Licenses HiQ Law(Chapter 9(commencing with Section 7000)of Division 3 of the V' E 4 O Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE fe H the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(5500).: O I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 Oce.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of - Code:property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 so.Fr,FLOOR AREA TOTALACREAGE • himself or through his own employees,provided that such improve. forms a re not intended or offered forsake.If,however,the budding GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,lire owner- GAS-EASYSTEM-OVER 4(EA.) 200 BUILDING USE builder will have the harder,of proving that he did not build or int- . . . RES IND CON Pe Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting 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 property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a conlraetons)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCELNO. - ❑ Tum exempt under Sea ,B.&P.C.fur this WATER HEATER W/VENT 6:00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACO.FILE NO. ' WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a certificate ofconsent to self-insure, ZONING ENG.SITE N0, or a certificate of Workers'Compensation Insurance,or a certified copy there f IS c. ,. ab.C) Policy o any_ �+3 Q �ert:tied copy is hcrehyfu ished - FIRE SPRINK ENERGY T-24 Z Z ❑ Certified copy is filed I the inspection division. MISC.- REFER TO ORD. O Applicant _ Y ❑ N❑ Y❑ N❑ CC T CERTIFICATE 017 EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W COMPENSATION INSURANCE PLG.CONTE. LIC.NO. PLG. C 0 (This section need not be completed if the permit is for one TOTAL Y❑ N Y❑ N❑ 0 Z hundred dollars($100)or less.) - U O 1 certify that in the performance of the work for which this per. OTY. MECHANICAL PERMIT FEE FEE SUMMARY [L H mit is issued,1 shall not employ any person in any manner so as to O W become subject to lire Workers'Compensation laws of California. BUILDING Date Applicant - ALTER OR ADD TO MECH. 5.00 } N NOTICE:TO APPLICANT': If,after making this Certificate of Ex. F Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the.Labor Code, you must forthwith comply with FEE C.1 such provisions or this permit shall be deemed revokedAIR HANDLING UNIT(TO 10. AODC.F.M.) 4.00 f CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER I0)OODC.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is n construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B00.T.U.) 8. MICROFILM 3097,Civ.C.. Lender's Name Lender's Address HEAT[NG U N IT(OV ER 100,000 B.T.U.)9.50 ELECTRIC I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information curate. 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 reWt to building construction, and my hereby authorize representatives of this city to enter upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH, MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep,harnless the City of MISC.- REFER TO ORD. upertino amst liabilities,judgments, costs and expenses which' COETAXaysaaycrueagain Id City in conseyuenee ofthe PERMIT ISSUANCE 10.00 It. MECH.CONT. - LIC.NO. MECH. li T°.A` In d Signatu c of App can[ act Uale W OFFICE COPY