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15995 POST THIS CARD NEAR FRONT OF BUILDING PPERrvllTFXPI'RATIO NUMBER CITY OF CUPERTINO 5995 INSPECTION DIVISION JOB INSPECTION'RECORD A// N JOB.ADDRESS-�-(a ; 'V ' JbPUN IT#77 LOT# PERMIT EXPIRES IF WORK OWNER cONTRACToa n -L 0 IS NOT STARTED-WITHIN INSPECTION' DATE INSPECTOR INSPECTION RECORD AN DAYS OF PERMIT j CE OR 180 DAYS FROM . FOUNDATI ONNOTE: LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAI.IDAT,DN PREGUNCUPERTINO STANDARDS. GARAGE POUR NS BEEN SIGNEDB,MBIN " ISSUANCE DATE ELECTRIdLDO F:LF.Ci FLGMLCH..MECHAN ❑ � Q DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDINGM PERMIT ATfON WOOD FLOOR - VALDA,ION PLUMBING MECHANICAL - 9�0MPERMIT O ELECTRICAL - U FRAMING sTOR IES TYPE CONSTR. . INSULATION Y— OCC.GHOUP FES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED sl IT ILOLOOFAFEA TOTALACM GF ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID d W LDI uSE HES IND CON . O Pd' 0'1— ROOF SHEATHING El ❑ c0. 11' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE IN P. ASSESSORS PARC EL,NO ROUGH SANA 1 PLUMBING ELECT.ENERGY TRACT NO PARceL No. TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE ACC.FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. INSULATION . PLUMBING GAS TEST GAS FIRE SPRINK —,ENERGY T 2 MECHANICAL —20 Oo9 Y 0 N[ Y ❑ NE] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE A U C, EXTERIOR SHEAR ELECTRICAL RELEASE Y El INTERIOR SHEAR - FIRE DEPT. N� r I] NE] SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING gU1LDING INTERIOR LATH TEMPORARY APPROVALS ELECTRIC PLAN CHECKT SCRATCH COAT FEE' IV GAS 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, ' ELECTRIC 1'JONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING , . o� PLEASE GIVE JOB ADDRESS WHEN PHONING. d z MECHANICAL - SEE PERMIT FO.R EXPIRATION DATE - CONST.TAX , IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY r T APPLICANT TO FILL IN INFORMATION.WITHIN RED LINES — USE BALL POINT PEN ONLY a BUILDING PROJECT IDENTIFICATION YEflMIT NUMBER aG1LG G Se APPLICATION & PERMIT 1 [(] (� ADDRESS I J J J J 323 N . Wc)lfp Rd BUILDING — ELECTRICAL—PLUMBING—MECHANICAL RL OWNER'$ NAMEPLAN CHECK VALIDATION '. QTY, ELECTRIC PERMIT FEE ' Vallco Fashion Ctr. P„ENE CONTRACTOR'S NAME OUTLETS-SWITCHES-RECEP 10,00/1.00 Cal—Air, Inc.ONTRACTOR'S uc.rvo, 137195 LIGHTING FIXTURES 10.00/1.00 C A.CE,. •1 B g. .66APPLIANCES-RESIDENTIAL 4.00 i 1775 S. st St• Sj P„ONE947-0155 PANELS 10,00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. ENGINEER PANELS (OVER 200 AMP) 20.00 ARCH,OR ENG, LIC..NO. SIGNS TRANS, 3.00 ADDRESS SPECIAL CIRCUIT 6.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 APPLICANT'S aooREss MOTORS SEE FEE SCH. 1775 S. 1st St. Bldg. 66 San Jos SERVICE CHANGE 20.00 q / D (e2 / /( Foo LICENSED CONTRACTORS DECLARATION lD w < o I hereby affirm that I am licensed unJer prtwislons of Chapter 1S6 ANCE DATE w er u (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. P, 2 Professions Code,' d � iwre i Is in full force - ❑ ❑ ❑ OZ i w 0 License��jj,,��sj Lia Numbe — {-17 rvi - F N r j Ua[e—lt1/� _Comrector rjari s w OWNER-BUILDER DECLARATION BUILDING PERMIT w ; LL N I hereby allinn that I am exempt from the Contractor's License MISC.— REFER TO ORD INFORMATION r u o.¢i Law for the following reason.(Sec.7031.5.Business and Professions PERMIT ISSUANCVALUATION $/FT. Ey>f Code:Any city or county which rcquiresu permit mconstnmt,alter, E 10.00 Ii ¢o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NU. ELEC. i w es¢ requires the applicant for such permit to file a signed statement that TOTAL he is licensed pursuant to the provisions of the Cnntmctor's ER O License /,(Y(A riQLaw(Chapter 9(commencing with Section 70001of Division 3 ofthe i o Business and Professions Code)or that he is exempt therefrom and QTY, PLUMBING PERMIT FEE in the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any or IITa fora permit subjectsthe$500).licam toacivil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not more thou five'of the Prop dollars(my em): ❑ I,as owner at the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 thin sole compensation,will(S the work,and the structure is not OCC.GROUP FEB.UNITS intended or offered ntract for sale (Sec. doe Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Code:The Contractor's License Law does not apply o an owner of • � himselfy Who buildshhis wn employees, yes, n,andOmand whoat suches improve- work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACREAGE ©himself re through his own employees, le.I provided that such improve- t ntsareme Iisn old or withinron yearlc.If,however,the building GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 or impfovemenotnt Is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or ire- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE prove for purpose of the.l. INDUSTRIAL WASTE INTER. 30.00 RES IND -CDN PB Omer ❑ d as owner of the property,he exclusively contracting with ❑ 0 licensed contractors to construct the project La does Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL'NO. land Professions Cole:The Contractor's License Law does not apply 41 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 contractorto licensed pursuant to the Contractor's License Law. SEWER-SAN ITAR V-STORM EA.200ft/10.00 TRACT NO. PARCEL No. ❑ lure exempt under Sec._,H.&P.C.for this onWATER HEATER W/VENT 6.00 ^Owner Dam WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO. WORKERS'COMPENSA1'ION DECLARATION WATER TREATING EQUIP. .5.00 I hereby affirm that I have acurtiflcme ofconsen l to ell-insure, - • or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy ThereofASec.3800,Lah.C.L \s Policy No: Compo Finished, M[]tUt31— _ �� ❑ Certili S.copy is herel y l'urnlshed FIRE SPOINK ENERGY T 29 Z � CertiI a 0 d wi tl ity inspection division. F O Applicaml/,�-2_ - MISC,- REFER TOO V Q N� Y ❑ N� CC CERTIFICATE OF EXEIPPTION FROM WORKERS' PERMIT ISSUANCE p FLOOD ZONE A.L.U.C. CL COMPENSATION INSURANCE PLG.CONTR, LIC.NO. G. CL CILIC. section need not he completed if the permit is I'or one TOT L % \ Y E] NC] Y [:3NC3 Z) 2 hundred dollars($100)or less.) r(�'( LL O I certify that it, the performance of the work for which this per- QTY. MECHANICAL PERMI'[w� FEE SUMMARY ly U mit is issued.I shall not employ any person in any manner so is to v p become subject to the Workers'Compensmion Laws OfCalifornia, V C. Datc Applicant ALTER OR ADD TO MECH. p BUILDING } to NOTICE 1'0 APPLICANT: If,after making this Certificate of E.- I— Z emptier,you should become subject to rhe Workers'Compensationqpp APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you Most forthwith comply with U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 FEE CONSTRUCT ION LENDING AGENCY AIR HANDLING UNIT(OVER 10=17—EM.) 6.00 SEISMIC FEE I hereby affirm that mere is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,0008.T.U.) 8.00 Lender's Name Lender's Address HEATING UNIT(OVER 100,000 B.T.U.19.50 ELECTRIC ' I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) .4,90 g information is correct I agree to comply with all city and county PLUMBING ordinances and slate laws relating to building construction, and BOILER H.P.or 100,000 B.T.U.) 6.00 ,�Q hereby uthorin joneze representatives ec this City to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL K x$ ub(W rationed property for inspcc[imI pulposus. - (W gree to sav r emnify and keep harmless the City of MISC.- REFER TO ORD. uper against fir ili e ,jud runts, costs and uxpenses which / CONST.TAX Y any wa' er ains said Ci in consequence f th PERMIT ISSUANCE 1.p�C ,eI ' tis rtiL �.CONTLIC.NO. MECH.- MECH. TOTAL Sigmturc GfAppbc n ractnr Da n 137195 f- I•� OFFICE COPY