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15752 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 15752 INSPECTION DIVISION JOB INSPECTION-RECORD `/ .a. PERMIT EXPIRATION ,v r�o '•�- JOB ADDRESS_�d�_ UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER Sc-/ U/J'V CONTRACTOR +Qf IS NOT STARTED WITHIN INSPECTION DAtE__j 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 CIT/OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGESLABS _ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB f , PLUMBING ELECTRICAL IssUANCE DATE MECHANICAL BLDG ELECr PLMECH. A © G.❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR RN7AT1 N PLUMBING _ L ON STET. MECHANICAL T Cit. Of CUP9611110 ELECTRICAL PERMITTO FRAMING - ELrz7• STOH $ TYPE CONSTR. , INSULATION /2 L�( /f'e�r.1 . (� Q(/ l DCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED sn.TT.rLa o +AI+eA TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING Hes IND + CON PB o+o, , -APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ E ❑ El ❑ ASSESS ORS PARCEL NO 7j ROUGH SAN.H ' PLUMBING ELECT.ENERGY TUBS 8 SHOWER PAN . PLUMBING ENERGY T"ACT No. PARCEL No MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY Acc.DATE ACC.FILE NO FRAMING ELECT.FINAL TEST ` INSULATION PLUMBING ZONING ENG.SITE NO. ' GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY Toa Y r ❑ N� COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING - - NE EXTERIOR SHEAR ELECTRICAL RELEASE FLDDD zorve ,a[u.c: INTERIOR SHEAR FIRE DEPT. Y❑ N� ❑ No SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY.APPROVALS ' BUILDING SCRATCH COAT JEL.ECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL A80VE HAS BEEN SIGNED JOCCUPANCY SEISMIC-FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o F' ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING . o� PLEASE'GIVE JOB ADDRESS WHEN PHONING. Z MECHANICAL — SEE PERMIT FOR EXPIRATION DATE IMPORTANT! CONST.rnx PLEASE READ REVERSESIDE.BEFORE . TOTAL GALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION .PERMIT NUMBER BUILDINGAPPLICATION & PERMIT 1 [r] 101ZlSpa N. Wolfe Rd. H28B BUILDING - ELECTRICAL-PLUMBING-MECHANICAL I J I J OwrvER'a - PLAN CHECK VALIDATION r%y. r, NAme V311CO ,F3ShiOn .Center QTY. ELECTRIC PERMIT FEE SX•',� JjOA HONE �4yd,,1/ rvo TeFUC Rs 56 OUTLETS-SWITCHES-RECEP 10.00/1.00 .20,80 , 11..%%"" Sprig Electric LIc.NG296728C10 LIGHTING FIXTURES 10.00/1.00 22.60 ADDRESS ORs APPLIANCES-RESIDENTIAL 4.00 CUNTR4 1303 Lick AvenuePHDrvE 298-3134 PANELS 100A 10.00 ? DATE OF APPLICATION OR PANELS PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE !.0 NO, ENGINEER Llc.No. ISIGNS TRANS. 3.00 aooeess cmc. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION zlv 1 TEMR,METER OR POLE INS. 20.00 LO.OO APPLICANTS s ApOREaMOTORS SEE FEE SCH. 1303 Lick Avenue SJ CA 95110 SERVICE CHANGE 20.00 p w 00 LICENSED CONTRACTORS DECLARATION ��� �O - <z w I hereby a(finn that I am licensed under provisions of ChapLL•r'I SUANCE DATE (commencing with Section 7000)of Division 3 of the Rosiness and G ¢A ( il4dG. LECT. PLG. MECH. D i Professions Code,mQ t1i01iceiae is in full force2d)(gryupl8 ❑ ❑ z o w License CIBss Lia.Numbs y I- w Date-(='L0 -Contactor a m E ¢ ¢s v a OWNER-BUILDER DECLARATION UVB 19IL ING PERMIT A o INFORMATION I hereby affirm that I am exempt Iron the Contractor's License MISC.- REFER TO ORD u O j Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.0012.00 VALUATION t - Code:Any city or county which mquireso permit to construct,alter, 12•00 ELEC.CONTR. .LIC.NO. IS ca improve,demolish,or repair any structure,prior l u its issuance,also ELEC. QQ i o ¢ requires the applicant for such permit la file a signed statement that rl Electric 296728010 TOTAL - /� PERMIT TO w$ he is licensed pursuant to the provisions of the Contractor's License F Z r Law(Chapter 9(commencing with Section 7006)of Division 3 oftIm a Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE It r 0 the basis for the alleged exemption.An g p Any violation ofSection 7031.$ STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant loo civil penally ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars(S500)J: ❑ 1,as owner of the property,or niy 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, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law docs not apply to as owner of property who builds it improves thereon,and who does such work FIXTURES-PER TRAP 6.00 50.FT.FLOOR AREA TOTALACREAGE • himself or through his own employees,provided that such improve- GAS-EA.SYSTEM-1 1NC.4 OUTLETS 6.00 menta are not intended or offered formic.If,however,the building or improvement is sold within one your of connpletio i.the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE i builder will have the-burden of proving that he did not build or un- RES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ ❑ ❑ ❑ 1,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Sec. 7044,Business ILAWN SPRINKLERS-1 INC 5 V.B. ' 6.00 ASSESSORS PARCEL NO. and Professions Code:'I'he Contractor's License Law does not apply to an owner of properly who builds or improves tlmreon,and who LAWN SPRINKLERS-OV ER 5(EA.) 1.00 contracts for such palest,with a conlractmos)licenud Poauanl to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor%License Law. TRACT NO. PARCEL NO. ❑ tum exempt under Sec. ,D.&P.C.far Ibis WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.­DATE ACC.FILE N0. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm (hut I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Worker,Compensation Insurance,or a certified - copy lher �,S }FjpprsLab.C. PolicyN 7�OCY( parry keoublic Indemnit I Q ❑ Certified c yrs hereby furnishe{I. FIRE SPRINK ENERGY T$4 Z Z I Cert i y Is filed wit 'Al i insp 1'on division. MISC.- REFER TO ORD. ❑ " ❑ ❑ ❑ O Ap-Nont V N V N CC CERTIFICATE OF EXEMPTION FROM WORKERS' PERMITISSUANCE 10.00 FLOOD ZONE A.L.U.C. Lu COMPENSATION COMPENSATION INSURANCE PLO.CONTR., LIC.NO. PLG. (L O (This sectidn need not he completed if Ila permit is for one TOTAL Y❑ N❑ Y❑ N❑ Z) Z hundred dollars IS 100)or less.) U O- 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in imy mmmner so as to U become subject to the Workers'Compensation Laws of California. O LU Date Applicantx- ALTER OR ADD TO MECH. 5.00 BUILDING } % NOTICE-TO APPLICANT: If,after making this Certificate o1'E ' F ? emotion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK (� provisions of the labor Cade. you must forthwith comply with FEE U such provisions or this permit slmll be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE 1: I hereby affirm thal 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,Neme S P�rj.Ve-�J-9rJ}.- Lender's Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 4_a I certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 - information is correct. 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 relating to building constructionand , • �' hereby autimrize representatives of this city to cnmr upon the BOILER-COMP (Over 100.000 BTU)SEE FEE SCH. MECHANICAL - I + f above-mentioned properly for inspection save, purpous. -(We) agree to se, indemnify and keep harmless lite City of misc.- REFER TO ORD. upertino against liabilities,judgments, costs.and expenses which CONST.TAX ay in/..y way accrue against mid City in conseque.nee of the PERMIT ISSUANCE 10.00 'ti of this permit. • / _ +\ MECH.CONT. LIC.NO. MECH. / xpVyTOTAL TOTAL Signature of Applicant/Contractort0 to OFFICE COPY