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15379 • I POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 15379 INSPECTION DIVISION JOB-INSPECTION RECORD � / PERMIT EXPIRATION JOB ADDRESS /V �a-3 'Y •UNIT# /oi?LOT# PERMIT EXPIRES IF WORK _ OWNER Things Remembered CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180DAYS OF PERMIT ISSU- I FOUNDATION - ANCE OR 180 DAYS FROM - NOTE: - LAST CALLED INSPECTION. + UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED i•• PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PBRMIT.VauunnuN CUPERTINO STANDARDS'. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -li UNDERGROUND /SLAB ® f PLUMBING ` ELECTRICAL - v ISSUANCE LATE MECHANICAL - ^xv, BLDG ELECT PLG. MECH Y ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING IN ORMATIONT WOOD FLOOR - VALUATION, SIP T. PLUMBING - MECHANICAL - I PERMIT 10' ELECTRICAL _ f -� „ N .• +/_. FRAMING STORIES TYPE CONSTR. INSULATION OCC GROUP RES UNITS --� PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED so.FT rLOORAREA TOTALACREACE r .\ ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE II J DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IND CON PB ombrn APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ 11 ❑ ' D ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO. PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL' ACC GATE Acc,TILE No. .Z/, BUILDING ENERGY FRAMING ELECT.FINAL TEST �u ZONING -< *ENGi SITE NO INSULATION ' PLUMBING .s 1146 GAS TEST GAS FIRE.SPRINK ENERGY ]u MECHANICAL v ❑ NF v ❑ NE COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING NJ _ FLOOU LONEA.L.0 C ' EXTERIOR SHEAR ELECTRICAL RELEASE _ INTERIOR SHEAR FIRE DEPT. b- v N� v I] . N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH - BUILDING INTERIOR LATH TEMPORARYAPPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK F GAS EE 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 LI ONE WORKING DAY BEFORE REQUIRED INSPECTION. 0 PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING, Z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! CONST.TnX PLEASE READ REVERSE SIDE BEFORE TOTALs3 CALLING FOR FINAL INSPECTION. ter. OFFICE COPY . . . A'11 ICQtNT TO FILL IN INFORMATION ,WITHIN RED LINES = USE BALL POINT PEN ONLY - INGP-A�ECTIDENTIFICATION - - PERMIT NUMBER ADDRESS 'f71,f7 S LION APPLICATION & PERMIT 15379 BUILDI /0IZ�fsl,/,i(i//aiire, P4, {cy*h#g7NOO-sqgO/L�- BUILDING -ELECTRICAL-PLUMBING-MECHANICAL awnEa';Pr1�INl7� Ip Tt4b44 AV2C-/ NAME In't"� f 'C.' PLAN CHECK VALIDATION - W11-7-K I� SCWNw` l '`26S$ CITY ELECTRIC PERMIT FEE . CONTRACTORS NAME �/ /� ��//''QQ OUTLETS-SWITCHES-RECEP 10,00/1.00 'f1�lv�F� LOTy!.!/W�T/ilnhl.NC. LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S '��O%//��Le nJ�' S APPLIANCES-RESIDENTIAL 4.00 ADDRESS >s 6v siS ae, PHONE 616200-ay PANELS 10,00 DATE OF APPLICATION ARC}IT j �j�/r\ PLAN CHECK FEE P.C.NO. oNGMrN2T� i/A`F'T PANELS (OVER 200 AMP) 20.00 LIC.NO SIGNS TRANS. 3.00 ARCH.OR ENG. PERMIT VALIDATION ADDRESS ((�� SPECIAL CIRCUIT 5.00 11- IND &(Mar 1��7�° nv12✓19' EMP.METER OR POLE INS: 20.00 f'I�, nppGlcANrs ��' 17�.Z MOTORS SEE FEE SCH. "-� 1'' �' .,57�J� _ SERVICE CHANGE 20.00 o o LICENSED CONTRACTORS DECLARATION a i w I hereby affirm that 1 am licensed under provisions of Chapter 9 O ISSUANCE DATE (commencing with Section 7000)of Division 3 of the Business and ¢c BLDG. ALECT. PLG. MECH. N Professions Code, my license is in full force appd effect. - p❑ ❑ ❑ zom tee, Class Lis.Number ,57.55'/9 V O m-o Dale Contractor a x Jv 611WpING PERMIT ¢ ap IS st OWNE-R;BUILDFR DECLARATION ORMATION E: 3 G I hereby affirm that I am exempt from lite Contractor's License MISC.- REFER TO ORD It WN u O j Law for the,following reason.(Sec.7031.5,Business and Professions VALUATION $/FT. PERMIT ISSUANCE 10.00 Z w> Code, e,de City demolish, county whiny structur a permit to is iSSmanee,also 7 ¢ a ¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC. / / requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO K--m°' he is licensed pursuant to the provisions of the Contractor's License F:i io Law(Chapter 9(commenciagwith Section 7000)of Division 3 ofthe 1Al7ZF)Qi 04. Ai/JR 01/E- �;i o Business and Professions Cade)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE Ie H m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. Li by,any applicant for a permit subjects the applicant toa civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(S500).): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP .RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for Sale(Sec. 7044, Busincss.and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner Of ' property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO,FT.FLOOR AREA TOTAL ACREAGE himself or' . through,his own employees,provided that such improve- mdnts are not intended or offered for sale.If,However,the building GAS-EA.SYSTEM-l1NC.4OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 (EA.) 200 BUILDING builder will have the burden of proving that h . . . NG USE e did not build or im- RES prove for purpose of aide.). IND CNG PB Omer . INDUSTRIAL WASTE INTER. 30.00 ` ❑ 1,as owner of the property,am exclusively contracting with ❑ C1 ❑ Q ❑ licensed contractors to construct the project(Sec.'7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 ASSESSORS PARCEL NO. ^�i,and,Professions Code:The Contractor's License Law does not apply to a`nlowner of property who builds or,improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 coli f cis for such projects with o contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 , the Contractor's License Law. TRACT NO. PARCEL NO. . 'k, ❑ lam exempt under Sec,-,eBAP.C.lot this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACG DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 - 1 hereby affirm that I have a certificate of a Saul to self-insure, ZONING ENG.SITE NO. ora certificate of Workerstified 'Compensation Ins meq or a c ry1 copy them (Sec.3 00,Lab.C- Policy Na ompany L` ❑,Celts" c0 'reby famished. FIRE SPRINK ENERGY T-24 O ❑' Cm in opY Iled with t .inspection division. MISC.- REFER TO ORD. Applican V N Y N . ~ rn PERMIT ISSUANCE 10.00 m > CE IFI EXEMPTION FROM WORKERS' FLOOD ZONE A1.U.C. _ MPE.NSATION INSURANCE. PLG.CONTE. LIC.NO., PLG. O (This clio need not be completed if the permit is for one _ TOTAL YE] N❑. Y E] N❑ Z handl dollms IS 100)or less.) U O 1 In ify that in the performance of tire work for wh¢h this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY IL U mil is issued,1 Shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. BUILDING y Date Applicant 'ALTER OR ADD TO MECH. 5.00 } N NOTICE TO APPLICANT: If,after making this Certificate of Ex- emption,you should become subject to the Workers'Compnsation APPLIANCE 5.00 PLAN CHECK e provisions of the Labor Code, you must forthwith comply with FEE V such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE . st3 I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT). 5.00 the performance of the work for which this permit is issued(Sec. 'MICROFILM 3097,Cis,C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address' ELECTRIC I certify that l have read this application and slate that the aboveVENTILATION FAN (SINGLE), 4.00 information is correct. I agree to comply with all city and county -C o trances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,0008.T.U.) 6.00 ler y authorize representatives of this city to enter upon tee BOILER-COMP (Over 100,000BTIASEE FEESCH. MECHANICAL abov -m lin d properly for inspection purposes. ( e) re to so , indemnify and keep harmless the City of MISC.- REFER TO ORD. ' Cope i o ag inst bilines, figments,costa and expenses which PERMIT ISSUANCE 10.00 'CONST.TAX aya y way come us aid City in consequence of the t c a t isp t MECH.CONT. LIC.NO. MECH. Oyu /r /LIJ TOTAL TOTAL 37rSQ Signa eof Appicant/Contractor ate` L/- �GI `�)792. 5733 OFFICE COPY