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15440 ---mss. POST THIS CARD,NEAR, FRONT OF BUILDING. ,J RMiTNDmEER CITY OF CUPERTINO ' 15440 INSPECTION DIVISION, JOB INSPECTION RECORD. ; 'r.�. • PERMIT EXPIRATION JOB ADDRESS 10123 :North Wolfe SP 2106 UNIT# � -LOT# PERMIT EXPIRES IF WORK 'OWNER V3llCO .:Pdrk/,Daug AllOt.O coNTRacToa .IS lNOT STARTED WITHIN INSPECTION DATEINSPECTOR INSPECTION RECORD ISO DAYS OF PERMIT ISSU- . FOUNDATION - - ANCE OR.180 DAYS FROM NOTE: - LAST CALLED INSPECTION. . UFER F ALL•GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF �:PERMIT VAi IDATION PR EGUNITE o CUPERTINO STANDARDS. - .GARAGE SLABS I - ` - • POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED . ,UNDERGROUND /SLAB PLUMBING L": .i ,,,:" ';• ELECTRICAL _ - ISSUANCE I tE MECHANICAL - FIN.. f J BLDG. .ELECT PLc MECL. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR . - - a ' INFORMATION PLUMBING - - _ } VALUATION SBFT. !'�"5 I ✓I ' ,.• MECHANICAL; ' ELECTRICAL - PER^^IT To FRAMING - . . z.0 l.C. INSULATION STORIES TYPE CONSTR. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -\:, '• . - • - : . - 50 IT,FLOOR AREA TOTAL.ACREAGE . 'ROOF 'NOTE:NO FINALINSpSHALL BE MADE BEFORE DIAPHRAGM ,• , THE CONSTRUCTION TAX IS PAID BUILDING USE RODFSHEATHING - FRES IND CON_ •PR ,0,11" APPLY NO ROOFING.UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INS P,.-* -0 ASSESSORSPARCEL NO. ❑- 1:1 ❑' El. ROUGH � ' � - SAN.N � • - PLUMBING . - - ELECT.ENERGY - TRACIPU5 "PARCEL NO. TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ELECTRICAL -ACC DATE ACC,FILE'NO BUILDING ENERGY . FRAMING ' - ELECT.FINAL TEST - INSULATION - - ^ PLUMBING - ZONING ENG SITE NO. i. GAS TEST GAS " - . FIRE SPRINK" ENERGY T,Z4 ' MECHANICAL' ' No [] NF] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED .HEATING:.' Y .EXTERIOR SHEAR ELECTRICAL RELEASE - FL000 zoNE A.L u.c. INTERIOR SHEAR FIRE DEPT. .. Y'❑ "❑ v L. "❑ r. SHEETROCK • •• GRADE - . - - FEESUMMARY " EXTERIOR'LATH BUILDING INTERIOR LATH TEMPORARY APPROVAL .BUILDING a� 1 SCRATCH COAT ' - ELECTRIC' PLAN CHECK ' GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY. SEISMIC FEE OCCUPANCY OF.BUILDING ISN OT PERMITTE D UNTI L BUI LDING F INA LIS SIGN ED BY BUI LDING I NSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F� ' ONE WORKING DAY BEFORE REQUIRED,INSPECTION. .PLUMBING`. .; z PLEASE GIVE JOB ADDRESS WHEN,PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL." IMPORTANT! CONST. PLEASE READ REVERSE SIDE BEFORE- CALLING FOR FINAL INSPECTION. - TOTAL OFFICE COPY - — APPLICANT TO FILL IN INFORMATION WITHIN REDLINES -LSE BALL POINT PEN ONLY 'PERMIT NUMBER .BUILDING PRO E T ID NZI FIcAtlo - APPLICATION & PERMIT BDII.DIN _ 15.4,40, aDDRES BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNS PLAN CHECK VALIDATION • NamDTV. ELECTRIC PERMIT FEE bb O PHONE ,( rvame ACTOR OUTLETS-SWITCHES-RECEP -10.00/1.00 ^ LIC.NO LIGHTING FIXTURES '10.00/1.00 . . - ADDRESS oRs APPLIANCES-RESIDENTIAL' '4.00 - PHONE PANELS 10.00 DATE OF APPLICATION" - ARCHrtE PLAN CHECK FEE P.C_N0. OR C. PANELS (OVER 200 AMP)" '20.. ENGINEE LIC.NO. SIGNS TRANS.' 3,00 ARCH:O E G. - PERMIT VALIDATION Ajq�G (��nj- " SPECIAL CIRCUIT - 5.00 ZIP 1((���bEMP..METER OR POLE INS.' 20.00 . APL ANTS - MOTORS '` ' SEE FEE SCH. aD . SERVICE CHANGE - 20.00 o 2 LICENSED CONTRACTORS DECLARATION' /�? a z w 1 herehy affirm that I am licensed under provisions of Chapter 9 SSUANCE DATE _ G Pe (commencing with Section 7000)of Division 3 of the Business and , 'BLDG. ELECT. PLG.., MECH. E] H w i Professions Code,and my license is in full force and effect. - _ ...�� El ' 0 O z O m - License Class Lic.Number _ p- I 9 z r'w Date Contractor P m f - - - BUILDING PERMIT ic e .OWNER-BUILDER DECLARATION - A h 1, m r, MISC.- REFER TO ORD "^-If` INFORMATION E, LL N I hereby affirm that 1 am exempt from the Contractor's License - VALUATION ,-S/FT. . r u O J Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE "' 10.00 �, , ave Code;Any city or county which reyuiresa permit to construct,alter, � - ImPI, improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. % LIC.NO, ELEC. WI-3 (4r i D OM requires the applicant for such permit to file a signed statement that - -• TOTAL PERMIT TO K m u he is licensed pursuant to the provisions of the Contractor's License ' r z r Law(Chapter 9(commencingwilh Section 7000)of Division 3 ofthe a Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE $ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES' t TYPE CONSTR. s- by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN, -WATER (EA) 500 - of not more than five hundred dollars($500).): . . - ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECTDEVICE 400 - their sole compensation,will do the work,and the structure is not . . ,OCC.GROUP- 'RES.UNITS 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 - - property who buildsorimproves thereon,and who does such work "F IXTUR ES-PER TRAP 5.00 - SO.FT,FLOOR AREA, TOTAL ACREAGE himself or through his own employees,provided that such improve- mems are not intended or offered for sale.If,however;the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS EASYSTEM OVER 4(EA) 200 builder will have the burden of proving that lie - . - . . . _e did not build or im- BUILDING USE firfor purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB .' Other V1,as owner of the property,am exclusively contracting with _ ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the projecl'(Sea 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 s chpmjec s with a contractorTRACT NO. s)licensed pursuant to SEWER-SAN ITAR V-STORM EA.200ft/10.00 „PARCELNO. the Contract Lice aW. • ❑ Ia mptu Sec. .B.&P.C.for this WATER HEATER W/VENT 6.00 19 son Owner Dat WATER SYSTEM' - 5.00 ACC.OATE ACC.FILE NO. WO 'RS' MPENSATION DECLARATION WATER TREATING EQUIP. 5.00 ,1 hereby affirm that 1 have a certificate of consent to self-insure, - ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified ,VX copy thereof(Sec.3800,Lah.C). Policy No. I Company- 0 ❑ Certified Copy is hereby furnished. FIRE SPRINK ENERGY T-24 - z Z ❑ Certified copy is filed with the city inspection division. " H O 4.s Applicant MISC.- REFER TO ORD. Y❑ N❑ Y ❑ N❑ T PERMIT ISSUANCE - - 10.00 CC CERTIFICATEONSATIOTINS FROM WORKERS' FLOOD ZONE a.L.0 C. W � COMPENSATION INSURANCE PLG.CONTR. - u0.NO. 'PLG. 0. Z I (Th his'section need not be completed if the permit is I'or one _ TOTAL - Y❑ N❑ Y❑ N❑ handred dollars IS 100)or less,) U O I certify that in the performance of the work for which this per- DTV. MECHANICAL PERMIT FEE FEE SUMMARY W F mit is issued',I'shall not employ any person in any manner so as to Q w . become subject to The Workers'Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING as� } r�li• NOTICE TO APPLICANT'. If,after making this Certificate of Ex-- 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 0D AIR HANDLING UNIT(TO 1Q0C.F.M.) 4.00 . CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER IO,WDC.F.M.) 6.00 SEISMIC FEE 1 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,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.)' 8:00 t Lender's Name Lender's Address HEATI NG UNIT(OVER 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 is correct. I agree To comply with all cityand county - -PLUMBING ` ordinances and state laws relating to building construction, and BOER-COMP(3H.P.Or100,000B.T,U.) 6.00 hereby authorize representatives of this city to enter upon the BOI LILEO-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-menti ed property f spection purposes. (We) a to save, i e fy and keep harmless the City of MISC.- REFER TO ORD. - upe n ainst'liddli es dgments, costs and expenses which - CONST.TAX ay In way,sec. last said City in consequence of the PERMIT ISSUANCE 10.00 ra it f i permit. n MECH.CONT. LIC.NO. 'MECH. t Ay 123-0 - TOTAL aS V s+ V TOTAL „ at a p to Co oto Date i OFFICE COPY