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15508 7' POSTTHIS.CARD•NEAR FRONT OF BUILDING PERMIT NUMBER CITY. OF CUPERTINO 5508 INSPECTION DIVISION JOB INSPECTION RECORD } �7 ,. / 103�� _ .PERM IT JOB ADDRESS 10 /,23 /l/ LUeLf-cs �.d' UNIT# `LOT# - /^" /7 PERMIT EXPIRES IF WORK OWNER VtJ S�� 6::o J ,t�,�,/ CONTRACTOR 'rp CJ 'IS NOT STARTED WITHIN , INSPECTION DATE I INSPECTOR NSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. ' UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CIN OF PblMIT VAI.NATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB .e- PLUMBING ELECTRICAL ISSUANCE OATS MECHANICAL BLLG ELECT PLG. MBCR E] ES ❑ ' .DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION VALUATION $IFT. PLUMBING A ^7 �-- MECHANICAL PP►�� l vA �- PERMIT TO ELECTRICAL - i FRAMING - �� '" �zV/G�"\` �N ROU, INSULATIONsroHlEs rvP comsrH - C1q � CuDB OCC.GHOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so Fr aoOR AREA TOTAL ACBcncE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING - - RES IND CON PB Opo•. APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ " ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.a PLUMBING - ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY TRACT NO. PARCEL NO, MECHANICAL 7rZye MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC.OATE ACC FILE NO FRAMING ELECT.FINAL TEST INSULATION PLUMBING ZONING ENG.SITE NO. GAS TEST GAS ' MECHANICAL FIRE SPRINK ENERGY T.24 COVER NO'WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v ❑ "❑ ° ❑ "❑ EXTERIOR SHEAR ELECTRICAL RELEASE F LOOD ZONE ALUC' INTERIOR SHEAR - FIRE DEPT. , Y❑ N❑ v ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING '1 BUILDING y E INTERIOR LATH - TEMPORARY APPROVALS / "E SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE . NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE e2, • OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM W ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC '7,0, ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING.. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL . IMPORTANT! 'CONST.TAX PLEASE READ REVERSE SIDE BEFORE ° TOTAL C� CALLING FOR FINAL INSPECTION. .r OFFICE COPY •APPJJCANT TO FILL IN INFORMATION WITHIN RED LINES -,USE BALL POINT PEN ONLY IAUILDING PROJECT IDENTIF ATI ON .PEHMITNUMBER apILDING O 3 q-' -, ' APPLICATION& PERMIT q [Co 0 ADILDIN I J J 0 )6 /1�•/wa, AR Ai BUILDING,- ELECTRICAL-PLUMBING-MECHkE ; NAMOWNE M-� - * PLAN CHECK VALIDATION � - "AME _ QTY. ELECTRIC PERMIT r �W6:0401/nAAS PRONE CONTRACTOR'S OUTLETS-SWITCHES-RECEP ,10.00/1.00 NAME [ JCoNS�/I✓CgUII LIC.rvo. LIGHTING FIXTURES 10.00/1.00 roti PACT.Rs ADDRESS APPLIANCES.-RESIDENTIAL 4.0013 ' •S �') p,�)Ip Ave ,I - rya rivee APRO E7/`I S'j'-f 7 PANELS ; - 10.00 DATE OF APPLICATION ARCmTECT - PANELS IOV ER 200 AMP) � 20.00 PLAN CHECK FEE .c:rvo. OR e ENGINEER ` $ f uc.rvo. 9. tl SIGNS TRANS. 3.00 ARCH.OR ENG, SPECIAL CIRCUIT - 'rn ' 5.00 PERMIT VALIDATION ADpRE55 p � - _ �! jqeeC4 sl. SAl D;e , �EEMP.METER OR POLE INS.. 20.00 APPLICANTS _ MOTORS SEE FEE SCH. ADDRESS q I, - �,{ • 13QSvvAINPK IA✓C us�� CA SERVICE CHANGE 20.00 J� ��y )c �oo LICENSED CONTRACTORS DECLARATION (/ 0 <U U I hereby affirm that I am licensed under provisions ol'Chapter 9 ISSUANCE DATE y a w (commencing with Section 7000)of Division 3 of the Business and - G. ELECT. PLG. MECH. �Z Professions Code,a my license Is In full for rg a d effect - z 0 w - License C. Lic.Number - - o L r Dote Contractor, - ¢ a a ¢ OWNER-BUILDER DECLARATION BUILDING PERMIT - ¢w REFER ORD ORMATION X 3 A I hereby affirm that I hm exempt from the Contractor's License MISC.'- UU ION $/FT. H u an J Law far the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE "TQ:00 -17 mCode:Any city or rounty which requires permit to construe[,alter, / 'Q R G"0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. �''(f.7 Q le 0¢ requires the applicant for sudl permit to file a signed statement that TOTAL ' O -� PERMIT TO A w m he is licensed pursuant to the provisions of the Contractor's License - - r z i Law(Chapter 9(commencing with Section 7000)o'Division 3 othedry 0.d 1 E. tile Business and Professions Code)or that he is exempt therefrom and OTV. PLUMBING PERMIT 'FEE Mie ¢ he basis for the alleged exemption.Any violation al'Sec[ion 7031.5 STORIES TYPED NSTR. d3$ by any applicant for a permit subjects the applicant to a civil penalty gLTER-DRAIN&VENT-WATER (EA.) 5.00 of not morn than five hundmd dollars($500).): . ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sale compensation,will do the work,and the simmure 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 ' property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SD.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsare not intended or offered for sale.If,however,the building GAS-EA.SVSTEM-1 6.00 or improvement is sold within one.year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or an- RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ' ❑ I,as owner of the property,am exclusively contracting with ❑ 0 ❑ - licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 - ASSESSORS PAHCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who hands or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 . reason Owner Dale' WATER SYSTEM - 5.00 ACC.DATE ACG FILE NO, WORKFRS'COMPENSATION DECLARATION WATER TREATING EQUIP:. 5.00 I hereby aRmm that I have a certificate of consent tows Finsure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified _ copy theWJ(•�c pb.C.L Policny NA� Ilivir;d ZiVS O ❑ Certified copy is hereby faro eryCd. FIRE SPRINK ENERGY T 24 Z Z II�Certified�y�¢y is�Gled .iviN1 tlu!oily in,pection division. MISC.- REFER TO ORD. y N� y � N[ Applicant- cc LL41ffb(/� '(J4..'Ibt3- cc to CERTIFICATE OI°EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.0 C. LU > COMPENSATION INSURANCE PLG.CONTR, LIC,N0. PLG. V NO v N❑ 1 (This section need not be completed if the permit I% for one TOTAL Z hundred dollars(S 100)or I.S.) - L) O 1 certify that in the performance of the work for.which this per. CITY. MECHANICAL PERMIT FEE FEE SUMMARY U_ V- mit is issued,I shall not employ any person in any nIDnner so as In q OO become subject to the Workers'Compensation Laws of California. BUILDING SeC Dale Applicant ALTER OR ADD TO MECH. 5.00191- >.. rail NOTICE TO APPLICANT: If,after making this Certificate of Ex- F ? enlption,you should become subject to the Workers'Compensation APPLIANCE - 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with - FEE V such provisions or this permit shall he deemed revoked AIR HANDLING UNIT(TO 10,000 C.F.M.) 4.00 CONSTRUCTION LANDING AGENCY AIR HANDLING UNIT(OVER 10p00C:EM.).6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency Icor EXHAUST HOOD,(W ITHDUCT) 5.00 - the performance of the work for which this permit is Maid(Sec. MICROFILM 3097,Civ.C.), HEATING UNIT(TO 100,000 B.T.U.) 8.00 y Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9,50 ELECTRIC 7L) SU Lender's Address _ I certify that l have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 ' infornmtion is correct. I agree to comply with all city and cormty BOILER-COMPQ H.P.oe100:000 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 BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL a( •� above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- _ REFER TO ORD. upertino against liabilities,judg nts, costs and expenses which PERMIT ISSUANCE CONST.TAX may in any way accrue egalns a id City in consequence of the ranlin is per MECH.CONT. r LIC.NO. MECH. 2„L TOTAL L TOTAL 41`7 �s Signature f ApplicantiCpfftract.9 DAC OFFICE COPY