The URL can be used to link to this page

15971 POST THIS CARD NEAR FRONT OF BUILDING PERMITNUMRER CITY OF CUPERTINO 15971 INSPECTION DIVISION JOB INSPECTION RECORD . I,` PERMIT EXPIRATION JOB ADORE SS /O�z•3 �' yv OLF� , NIT t# LOT# (n1 PERMIT EXPIRES IF WORK OWNER UA�/.V G�� CONTRACTOR VA L, LK UQ IS NOT STARTED WITHIN INSPECTION DATE - NSPECTOR INSPECTION R ORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PEHMIT VALIDATION CUPERTINO GARAGE SLABS STANDARDS. ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE •`'° MECHANICAL BLDG ELECT I PLC, NEC. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING VALUATION $/F T. MECHANICAL ELECTRICAL '. b , F�, TERM TO FRAMING INSULATION STORIES TYPE CONSTR OCC.GROUP RES UNITS ' PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa.PT FLooly ARCA TOTAL ACR CAce DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING use ROOF SHEATHING - ves IND CON PB. oma, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.N PLUMBING ELECT.ENERGY TUBS&SHOWER PAN PLUMBING ENERGY TRACT NO .PARCEL NO MECHANICAL MECH.ENERGY ' ELECTRICAL BUILDING ENERGY ACC DATE ACC FILE NO FRAMING ELECT.FINAL TEST INSULATION PLUMBING' zoNlNc ENG.SITE NO. 2— GAS TEST GAS . MECHANICAL - FIRE SPRINK ENERGY T]< COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE ALU,c INTERIOR SHEAR - FIRE DEPT, Y❑ N❑ Y ❑ N❑' SHEETROCK' GRADE FEE SUMMARY EXTERIOR LATH - BUILDING INTERIOR LATH TEMPORARY APPROVALS - BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252=4505, arv`' ELECTRIC . F ONE'WORKING DAY BEFORE REQUIRED INSPECTION. i'F PLUMBING ' O PLEASE GIVE JOB ADDRESS WHEN PHONING. Z — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT'! CONST.TAX PLEASE-READ REVERSE SIDE BEFORE �' „ = TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES,-.USE BALL POINT PEN ONLY • <�BUILDING PROJECT IDENTIFICATION PERMI?NUMBER .UTLDING APPLICATION & PERMIT 1 [(] �j ADRrlr,Sa I J�7 I 10123 N. .WOLFS .ROAD SPAC BUILDING -ELECTRICAL- 'PLUMBING -MECHANICAL C»a, NAME V`Ms X1'V�� iV T j PLAN CHECK VALIDATION ' • E OTY. .ELECTRIC PERMIT 1 FEE i s ESTFIELD INC. PRONE CONTRACTOR'S NAME OUTLETS-SWITCHES-RECEP 10.00/1.00 W.L. HICKEY .SONS, INC,,,, No. 1f12.Z. LIGHTING FIXTURES, 10.00/1.00 ' ADDRESSTOHs APPLIANCES-RESIDENTIAL 4.00 - - P.O. BOX 61209 - SUNNXVLALE PANELS' 10.00 DATE OF APPLICA TION ARCHITECT PLAN CHECK FEE PC.NO. ORPANELS (OVER 200 AMP) 20.00 ENGINEER - ' UC.No. SIGNS TRANS. 3.00 neo Ess ENa 'SPECIAL CIRCUIT. 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. '20.00 ADDRESSTE MOTORS SEE FEE SCH. P.O. .BOX 61209 - SUNNYVALE SERVICE CHANGE 20.00 Woo LICENSED CONTRACTORS DECLARATION VVV ( .11..AA00 ¢ v I hereby affirm that 1 am licensed under provisions of Cha ter 9 < y p p ISS AN E DATE .1 <"' (commencing with Section 7000)of Division 3 of the Business and U C _ �A <y BLDG. ELECT. PLG. MECH. H N z Professions Code,grW,my license is in full force anl.etf¢cp ❑ ❑ a Z, O w - License Class ll�aJJOO Lie,Number `171GL - E w r° Date 7-25-88 ContiW11 , •I C. .. , < r - BUILDING PE MIT ¢ ¢ w < OWNER-BUILDER DECLARATION o A u - INFORMATION F g ¢y 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD L_O< Law for the following reason,(See.7031.5,Businessand Professions VALUATION $/FT. l- - PERMIT ISSUANCE 10.00 - Code:Any city or county which requires a permit to construct,alter, ¢ IS) improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. - n w m 2 requires the applicant for such permit to file a signed statement that ,• TOTAL PERMIT TO , he is licensed pursuant to the provisions of the Contractor's License F z ¢ Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe �L48 6- i O Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢F m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. i ; � by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN IEA.) 5.00 of not more than five hundred 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 sole compensation,will do the work,and rte structure is not intended or offered for sale (Sec. 7044, Business and Professions ]- DRAINS-FLOOR,ROOF,AREA,COND. 2, Code:The Contractor's License Law does not apply to an owner of - property who builds or improves thereon,and who does such work 2 FIXTURES-PER TRAP SO.FT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve- as ments are not intended or offered for sale:lf,however,the building GAS-EA.SYSTEM-11NC.'4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 builder will have the burden of proving that the did not build or im- BUILDING USE prove for purpose of sale.). RES IND CON PB Other ❑ 1,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30. �(�,❑ E 0 Ellicensed contractors to construct lite 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 I EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to - theContractor'sLicenseLaw. 1 SEWER-SANITARY-STORMEA.,4W#4:0; S. TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Date SYSTEM SYSTEM Z. ACC.DATE ACC.FILE NO. WORK F.RS'COMPENSATION 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 Co11ryhI_. EjSb`� _024 by)NORTHBROOK PROP O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-Z4 Z Z XXCerti' opy h I[ y i on division. O Applicant tN.f. ) �CK1S11V D., �• MISC.- REFER TO ORD. Y� NEI Y ❑ NEI 1 ~ w 'PERMIT ISSUANCE _ ZDNE A.L.u.c. CC CERTIFICATE OF EXEMPTION FROM WORKERS' -__ LU COMPENSATION INSURANCE. PLG.CONTR. uc.NO: PLG. p IL Cl (This section need not be completed if tile Z. FLOODe permit Is for one TOTAL 25.q' 5 V❑ N Y N� Z) Z hundred dollars($100)or less) U O I certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY U. F mit is issued,I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. Date Applicant BUILDING a ALTER OR ADD TO MECH. 5.00 } to NOTICE TO APPLICANT: If,after making this Certificate sa Ex- emption,n you should become subject to the Workers'Ccomply with APPLIANCE 5.00 PLAN CHECK provisions io the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 70,000 C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER I0,000C.FM.) 6.00 SEISMIC FEE I 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(See. MICROFILM 3097,Civ.C.). - HEATING UNIT(TO 100,000 B.T.U:) 8.00 . Lender's Name Isla ONEHEATING UN IT(OVER 100,000 B.T.U.)9.50 Lender's Address - ELECTRIC 1 certify that I have read this application and stale that the above VENTILATION FAN (SINGLE) 4.00 GG . 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 100,000B.T.U.) 6.00 �L7 hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which CONST.TAX ay in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 rantingofthispermlt MECH.CONT. LIC.NO. MECH. W.L. HI2-29-Ra - - TOTAL TOTAL Si ore p m C or Date OFFICE COPY