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15952 .POST THISCAR DNEAR FRONTQFBUILDING ' -- 'PERMIT NUMBER CITY -OF . CUPERTINO : Sg 2 INSPECTION DIVISION JOB INSPECTION RECORD IV• �•A1"I D10' PERMIT EXPIRATION JOB ADDRESS }1{ •t1• lD UNIT# ='LOT# - - - PERMIT EXPIRES IF WORK OWNER l IV\ S/- 1 K'I • CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD taoonvsDFPERMIT ISsu FOUNDATION *.' - ANCE OR 180 DAYS FROM NOTE: LAST CALLED'INSPECTION. LIFER "' - ALL GRADING'AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. C GARAGE SLABS - - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED Z, oAQT)I4 { ' UNDERGROUND /SLAB PLUMBING ' ELECTRICAL I I ISSUANCE DATE MECHANICAL - BLDG .ELECT PLG, MecR. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORLIATION ' - WOOD FLOOR - VALUATION• B/FT. PLUMBING - - - MECHANICAL " ' - PERMIT TO ELECTRICAL FRAMING INSULATION STORIES TYPE.CONSTR, � - - - OCC.GROUP RES UNITS, 1 PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE:NO FINAL INSP,SHALL BE MADE BEFORE so,FT FLoon AREA TOTAL ACREAGE • DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING 'BUILDING USE RES IND CON PB Oum, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO' ROUGH SAN.# - PLUMBING 'ELECT.ENERGY ' TUBS IS SHOWER PAN PLUMBING ENERGY - TRACT NO. PARCEL NO MECHANICAL - p MECH.ENERGY ELECTRICAL - BUILDING ENERGY ADD.DATE ACC.FILE NO. FRAMING ELECT,FINAL TEST ' ZONING ENG SITE NO ,INSULATION PLUMBING' � " GAS TEST ` GAS - MECHANICAL ,FIRE SPRINK ENERGY T',2< COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y-❑ N❑ Y El NEI _ L UC.. . EXTERIOR SHEAR - - ELECTRICAL RELEASE FLOOD ZONE !1'� INTERIOR SHEAR EIRE DEPT. Y ❑ N❑ Y ❑� N❑ SHEETROCK - GRADE FEE SUMMARY EXTERIORLATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC y PLAN CHECK ' GAS .FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY . SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. . MICROFILM ai '. ELECTRIC 2, ARRANGE ARRANGE FOR INSPECTION BY PHONING 252-4505, F� ONE.WORKING DAY BEFORE REQUIRED INSPECTION: PLUMBING O PLEASE GIVE JOB ADDRESS WHEN PHONING. Z — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! � � CON TAX PLEASE READ,REVERSE SIDE BEFORE TOTAL ✓ CALLING FOR FINAL INSPECTION. OFFICE COPY OFFICE COPY' ..k; ELECTRIC SERVICE NOTICE �q BUILDING INSPECTOR'S NOTICE t CITY OF CUPERTINO 1 19- To VTo' �gy You are hereby authorized to Connect electrical service for Owner or Tenant 5�' 0 , At 3 I . Size of Wires Size of Switch Noof Wires f Phase--------------- r Motor Load Voltagec R W Voltage Heating Load i ( LigM 11 L0 Service Reconnect 1\ 7pThree Wire More Service_. ' No.'of Meters Move Mater Power Three Phose � No.of Add.Meters /y^ ©w ELECTRICAL INSPECTOR APPLICANT TO FILL IN INFORMATION WITHIN RED LINES -'USE BALL POINT PEN ONLY• .1 i'� BUILDING PROJECT IDENTIFICATION FICATION' - -PERMIT NUMBER I> APPLICATION &.UFMIT r. emLDBU BUILDING - ELECTRICAL-PLUMBING-MECHANICALx 15952 OWNEn' - PLAN CHECK VALIDATION N;�`vG°oTON DrvE QTV. ELECTRIC PERMIT FEE I NON EnncroRs - 4 OUTLETS-SWITCHES-RECEP 10.00/1.00 TA 1. c.NO. LIGHTING FIXTURES 10'.00/1.00 CONTH5ScrOWs ADDRESS DDREPPLIANCES-RESIDENTIAL •4.00 - S4 Sr ONE PANELS 10.00 DAT90F APPLICATION +' ARCHI E T PLAN CHECK FEE P.C:NO. on. PANELS (OVER 200 AMP) 20.00 ENGINEER UC.NO. SIGNSTRANS. - 3.00 AARCH.OR DDRESS ENG SPECIALCIRCUIT 5,00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS.ftm0 p ' APPLICANTS s .• - MOTORS '.SEE FEE SCH. APPLICA SERVICE CHANGE 20.00 w o 21 LICENSED CONTRACTORS DECLARATION 19 rt U v I hereby affirm 66 that I am licensed under provisions of Chapter 9 - - g ISSUANCE DATE 4' H G w (commencing with Section 7000)or Division 3 of the Business and BLD�Gj.� ELECT PLG. MECH. H w z Professions Code,and my license is in full force and effect. Nal uq ❑ ❑ z o w - License Class Lic.Number 4 w Dale Contmctoi FN- Ju. m BUILDING PERMIT Et Q,w - - OWNER-BUILDER DECLARATION INFORMATION Et ;e y I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD u_ OC Law for the followingrcason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE IYL,„4�B /1 VALUATION $/FT. Code:Any city or county which requires a permit to construct,alter, - ..L,��ee�� improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. - L`�co a u G LL requires the applicant for such permit to file a signed statement that - TOTAL L PERMIT TO w m he is licensed pursuant to the provisions of the Contractor's License - ' i Law(Chapter 9(commencing with Section 7000)of Division3ofthe 4' Business and Professions Code)or that he is exempt therefrom and QTV. PLUMBING PERMIT FEE L.LJ 0 the basis for the alleged exemption.Any violation of$ection 7031.5 STORIES TYPE CONSTR. i39 by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars ISSUE).): " ❑ I,as owner of the properly,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC,GHOUP 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 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- mentsare not intended oroffered l'or sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 •I or improvement is sold within one year of completion,the Owner- builder SYSTEM USE will have the burden of proving that he did not build or int- RES IND CON PB Orae. prove for purpose of sale.). INDUSTRIAL WASTE INTER.' 30.00 ❑ 1,as owner of the property,am exclusively contracting with . ❑ ❑ ❑ ❑ ❑ licensed contractors toconstruct the project(Sec.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 such projects with a contractots)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00ACC.DATE ACC.FILE NO. WORKF:RTCOMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I.have a certificate of consent to self-insure, ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified , copy themof(See.3800,Lab.C.). + Policy No. Company 0 ❑ Certified copy is hereby tumished A FIRE SPRINK ENERGY T 24 Z Z ElCen3"�•��o `y hs�f�it with the//y�r mspj�Ion division. O ApplicanC��,�tJS, .6� MISC.- REFER TO ORD. Y❑ , N❑ Y ❑ No )- y PERMIT ISSUANCE 10.00 FLOODZONE - A.L.U.C: LUCERTIFICATE E SATIOTINS FROM WORKERS' W COMPENSATION INSURANCE: PLG.CONTR. LIC.NO. PLG. CL Z( This section need not be completed if the permit is for one TOTAL v❑ N❑ v E] N❑ hundred dollars(S 100)or less.) - U O I certify that in the performance of the work for which this per- QTV. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall"not employ any person in any manner so as to U 0. become subject to the Workers'Compensation Laws of California.i Date Applicant ' ALTER OR ADD TO MECH. 5.00 BUILDING } to NOTICE TO APPLICANT: If,after making this Certificate of F:x- F ? siphon,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labar'Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.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 h Lender's Name 2,[, HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC, I � Lenders Address I certifythat l have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and countyPLUMBING ordinances and state laws relating to building construction, and BOILER-C(Nv1P(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. "itnany 10 Save, indemnify and keep harmless the City of MISC.- REFER TO ORD. st liabilities,judgments, costs and expenses which CONST.TAX-' ay accrue against said City in consequence of the PERMITISSUANCE 10.00 ai MECH.CONT. LIC.NO. ECOTAL TOTAL2p scant/Con raclor Date ^ OFFICE COPY