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15578 POST TH4RD NEAR FRONT OFFBUILDIN,GaMIT NDMSPCIOF CUPERTINO1 INSPECTION DIVISION � '. JOB INSPECTION RECORD ,,//'' ! ,logo PERMIT EXPIRATION JOB ADDRESS /0��3 WdD UNIT# LOT# PERMIT EXPIRES IF WORK OWNER C4 QT4-1—s CONTRACTOR '� CZdL7.C.-<,.� IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR I INSPECTION RECORD 18DDAYS OFPERMIT,ISSU- FOUNDATION T 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; - 'ERMIT.vALIDATION- rt CUPERTINO STANDARDS. , GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED y.Ci • at UNDERGROUND /SLAB' - PLUMBING . - - ELECTRICAL .. ISSUANCE DATE MECHANICAL' .BLc [:LEr,r. PLG . ME:CH . ❑, El'a DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT WOOD FLOOR PooINFORMATION PLUMBING • - LUATIO N. SIFT. N 198 ' MECHANICAL - � ELECTRICAL - .: - jjnQ veRmmro FRAMING INSULATION STORIES TYPE CONSTH, DEC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED .ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE so.IT FLOORAREA TOTAL AeR EAee DIAPHRAGM THE CONSTRUCTION TAXIS PAID.I f BUILDING USE ROOF SHEATHING HES IND CON PB , OM , APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑' ❑ ❑ ❑ ❑ ROUGH SANA ASSESSORS PARCEL No. PLUMBING ELECT.ENERGY . - TRACT NO PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY - MECHANICAL MECR ENERGY ELECTRICAL BUILDING ENERGY •Acc DATE ACC.PILE No FRAMING ELECT.FINAL-TEST ' ,INSULATION PLUMBING' ZONING .ENG.SITE NO GAS TEST - GAS MECHANICAL ' EIRE SPRINK ENERGY T2 I` COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ ° ❑ N❑ • EXTERIOR SHEAR ELECTRICAL RELEASE FLOODCONE ALU C. . INTERIOR SHEAR FIRE DEPT. °❑ NEIY ❑ IN SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING_ INTERIOR LATH TEMPORARY APPROVALS - BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNEO BY BUILDING INSPECTOR: MICROFILM ARRANGE FOR INSPECTION.BY PHONING 252-4505, ,ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 'PLEASE GIVE JOB ADDRESS WHEN PHONING. z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE IMPORTANT! CONST.rnx PLEASE READ REVERSE SIDE BEFORETOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY +►' •-'•BUILDING PROJECT,I DENT]FIC - - -PERMIT NUMBER 1 ao'gAessn � APPLICATION & PE T 15578 .��. BUILDING - ELECTRICAL-PLUMBING-MECHANICAL ' OWrvER's PLAN CHECK VALIDATION Nage_� # - / CI ELECTRIC PERMIT FEE) O PHONE •'.•. CONTRACTOR 0,0 NAML - UTLETS-SWITCHES-RECEP 10.00/1.00 ��CONTRACTOR'SLIGHTING,FIXTURES 10.00/1.00 , • - aooREss - I' •I(( p PPLIANCES-RESIDENTIAL 4.00/16 0 �AJ Lf.Q)� PRONE y PANELS. '/00 4'YY1 10.00 a DATE OF APPLICATION !_, PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C(NO.' R uc.NO SIGNS TRANS. 3.00 ADDRESS ENG. - ' SPECIAL CIRCUIT 5.00 PERMIT VALIDATION , ZIP TEMP. METER OR POLE INS. 20.00 APPLICANT MOTORS 'SEE FEE SCH. �0 SERVICE CHANGE 20.00 ! o z W LICENSED CONTRACTORS DECLARATION I- V � aG 1 hereby affirm that I am licensed under provisions of Chapter 9 AN 2 w ISSUANCE DATE - y a y (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. H y z Professions Cod nd license is Numbin full fort n f cjL Qi ua o License Class Lia e H w r J DateContractor�[C� _ �,` _ ❑ ❑ ❑ w ¢ OWNER-BUILDER DECLARATION V BUILDING PERMIT wD AU INFORMATION 3 w I hereby affirm that I am exempt from the Contractor's License ' MISC.- REFER TO - HLLOJ Law for the following reason.(See:7031,5,Businessand Professions • PERMIT ISSUANCE _ 'VALUATION $/FT, Code:Any city or county which requires a permit to construct,aIle, at p improve,demolish,or repair any structure,prior W its issuance,also ELEC.CONTR. LIC.NO. E L_ LEC. K G¢ requires the applicant for such permit to file a signed statement that TOTAL ��- w m he is licensed pursuant to the provisions of the Contract,,',License PERMIT TO rzQLaw(Chapter 9(commencing with Section 7000)of Division 3 oftle -- Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE Ei m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR, by any applicant for.'pennitsubjects the aPplimma toacivilpenalty gLTER-DRAIN -WATER IEA.1 5.00 of not more than five hundred dollars($500).): - ❑ I,as owner of the property,or my emPloyces with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS v 'I 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,C_ OND. 5.00 ,a - 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 50.FT.FLOOfl AREA TOTAL ACREAGE himself or through his own employees.Provided that such improve- mentsarenotintended'or offered for sate'If,howeve,the building - G4S-EA.SYSTEM-11NC.4OUTLETS 6.00 or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not hadd or im- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER - ' 30.00 .� RES IND CON Pa Omar ❑ 1,as owner of the property,am exclusively contracting with - Q Q Q Q O license . d contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORSPARCELNO. 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 eontractogs)licensed pursuant to. the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. 1 PARCEL NO. ❑ lam exempt under Sec. reason ,B.&P.C�krr this „ WATER HEATER W/VENT < 6.00 ' ' Owner Date WATER SYSTEM • 5.00 ACC.DATE ACC.FILE Na WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP: 5,00 hereby affirm that I have a certificate of consent to aelf-insure, or a certificate of Workers'Compensation immornc a certified ZONING ENG.SITE NO. copy there a 3_&OIX1 b.C.). - _ Policy No,W_AiPJ b.y "•ur - ❑ Certified op�is hereby Curn to FIRESPRINK ' ENERGYT-24 Z Z � Certified o .is-Rletl wit t e fly insPec w division. - - A6pliLTific n /"7 MISC.-r REFER TO ORD. v0 NQ Y NQ ~ w PERMIT ISSUANCE. 10.00 - L.- CERTIFICATE C0O1r EXC ION RANGE ' - FLooD ZONE A.L.UA. ' W COMPENSATION INSURANCE' - PLG.CONTR. LICCL a .NO. PLG. ❑ ❑ O ❑ r l (This section need not be completed if,the permit is for one _ _ TOTAL v N v N hundred dollar,($100)dr less.) U O I certify that in the Performance of the work for which this per-'. CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL 1-. mit is issued,I shall not employ any person in any manner so as Or U become subject to the Workers'Compensation Laws of California w ail Date Applicant ALTER OR ADD TO MECH. BUILDING •} rNOTICE.T'O APPLICANT: lf,after..king this Certificate of Ex- .5.00 ♦- 2 emption,you Should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK - Proro visiohs of the Labor Code, you must forthwith comply with FEE - V such pvisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 - CONSTRUCTIONLENDINGAGENCY AIR HANDLING UNIT(OVER 10=C.RM.) 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 Lender's Name HEATING UNIT 100,000 B.T.U.)9.50 . Lender's Address ELECTRIC I certify that l have read this application and state that theabove VENTILATION FAN (SINGLE) 4.00 •- • information is correct.I agree to comply with all city and county PLUMBING ordinances and state.laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 above- authorize reot presentatives f this city to enter upon the above-mentioned Property for inspection purposes. BOILER-COMP (Over 160,000 BTU)SEE FEE SCH. MECHANICAL (We) to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. uperti o ag inst liabilities judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX may i any aaccresl said City in consequence of ler ti i, MECH.CONT. -LIC.NO. MECH. TOTAL TOTALSign ureo Apor - Date . 11 r OFFICE COPY' .