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16079
POST THIS CARD NEAR FRONT OF BUILDING ' PERMIT NUMBER CITY 01 CUPERTINO 16079 INSPECTION DIVISION JOB INSPECTION RECORD • 1,., ,1033 PERMIT EXPIRATION JOB ADDR ESS 1,},,`P�- UNIT# _LOT# I PERMIT EXPIRES IF WORK , OWNER .�/1/�ry yL l"U�CY� ; CONTRACTOR 11 IS NOT STARTED WITHIN , INSPECTION DATE INSPECTOR INSMICTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - -- ANCE OR 180 DAYS FROM , NOTE: LIFER � - � ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PeHMn ALIDATION CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB Rju r - r• PLUMBING C- � i �• (V ELECTRICAL - - AUG 2 13 19i ISSUANCe DATE MECHANICAL BLDG, ELECT PLG. MECH, . City'bt Cu er©o ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - sul ING PERMIT WOOD FLOOR - INFORMATION VALUATION SIFT, PLUMBING MECHANICAL! PERMIT TO ELECTRICAL _ FRAMING r I��- STORIES TYPE CONSTR INSULATION , OCC.GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _ $D FT FLO(lli ARTA il)iAL ALH[AGL , • ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE , DIAPHRAGM THE CONSTRUCTION-TAX IS PAID BUILDING USE I _ ROOF SHEATHING Res IND CON vB oyer: APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. D 0- ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING - ELECT.ENERGY : TRACT NO. PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY , MECHANICAL MECH.ENERGY ACC DATE ACC.FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT,FINAL TEST ZONING elvc,SITE No. INSULATION PLUMBING GAS TEST GAS _ MECHANICAL FIRE SPRINK ENERGY T 2E ' v 0 N0 r ❑ NF]COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOOZONE ALUC. INTERIOR SHEAR FIRE DEPT. Y(] NM r ❑ NO 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 JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC • o0 ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - 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 PERMIT NUMBER - APPLICATION & PERMIT I' Ap°10123 N. Wolfe Rd. #1033 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL :• 16079 OWNER'S, PLAN CHECK VALIDATION t "AME .Dara Michele OTY. ELECTRIC PERMIT FEE GNE 257-6958 CONTRACTORS NqM OUTLETS-SWITCHES-RECEP 10.0011.00 prig Electric UC.No. 29672801 LIGHTING FIXTURES 10.00/1.00 DDREsS CroR's APPLIANCES-RESIDENTIAL 4.00 ADDRES 1303 Lick Ave. PHONE 298-3134 PANELS 10.00 DATE OF APPLICATION ARCHITECTPLAN CHECK FEE P.C.NO. on PANELS (OVER 200 AMP) 20.00 , ENGINEER LIC.No. ISIGNSTRANS. 3,00 AR.OR ENG. PERMIT VALIDATION ADDOORESSss. �.. _-� SPECIAL CIRCUIT 5.00 ZIP 1 - EMP.METER OR POLE INS. i ,.� 1 APPucAS$N�rs - MOTORS SEE FEE SCH. _ ADD ij E-3D3 Lick Avenue SJ CA 9511 ` SERVICE CHANGE 20.00 oo LICENSED CONTRACTORS DECLARATION vI hereby affirm that I um licensed under provisions of Chapter 9 - ISSUANCE DATE Z u (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. - MECH. Professions Cod�r rrµ�r��my license is in full force29'(312r$ ❑ ❑ z o m- Lieense,('la55X_Lic.Numberlei 4 0 Z H w Date--O-GS- Contactor2jleC.tr C '� t,-:' y BUILDING PERMIT in in in a OWNER-BUILDER DECLARATION R w u INFORMATION E: ;LL N' I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TOO ` -111 gLUATION $/FT. u0 c Law for the following rcasoa(Sec.7031.5,Business and Professions - PERMIT ISSUANCE 48:00 1 - u -I Code:Any city or county which requires permit to construct.after, QI improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC13?. wDLL requires the applicant for such permit to file a signed statement that prig Electric 2967280 TOTAL PERMIT TO $ he is licensed pursuant to the provisions of the Conductor's License " H z a Law(Chapter 9(commencingwith Section 7000)of Division 3 of[hc MH�II Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE in t the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a ;_ by any applicant for a permit subjects the applicant ma civil penalty ALTER-DRAIN&VENTWATER (EA.) 5.00 of not more than five hundred dollars(55000.): '' - . ' ❑ [,as owner of the property,or my employees with wages as BACK FLOW PROTECT.'DEV ICE 4.00 DCC.GROUP RES.UNITS their sole compensation,will do the work,and the A c,UHc is not intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,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 • meats are net hrough ownemployees,for sale. If,ho ever,the improve GAS-EA.SYSTEM-1 6.00 mems are not intended or offered for sale.If,ed that s the building or improvement is sold within one year of completion,the owner GAS-EA.SYSTEM-OVER 4(EA.). 2.00 BUILDING USE builder will have the burden of proving that he did not build or ire- RES IND CON PB Other prove for purpose ofsale.). INDUSTRIAL WASTE INTER. 30.00 ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ '❑ ❑ ❑ licensed contractors to construct the project(See. 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 contractor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO.. PARCEL NO. ❑ I am exempt under Sec. ,B.&P.C.for Ibis WATER HEATER W/VENT 6.00 reasou Owner Date WATER SYSTEM 5.00 ' ACG GATE ' ACC.FILE NO. WORKERS'COMPENSAI'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self-insure, ZONING ora certificate of Workers'Compensalino Insurance,or a certified ENG.SITE NO. copy there b.C.L Policy No.YI..`1 s1.A1C ny1iE!DQhI.i CIRdernnit O ❑ CetliEed copy is hereby furnis eJ. FIRE SPRINK ENERGY T 24 Z Z X Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. 0 Applicant Y❑ N❑ Y ❑ IN FmPERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. � CIiRTIFICA'I'li OF EXEMPTION FROM WORKERS' LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. CL 11 II'his section Med not be completed if the permit is for one TOTAL V❑ N❑ Y E] INE] Z hundred dollars IS 100)or less.) U 0 I certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY IL P mit is issued,I shall not employ any person in any manner so m to U become subject to the Workers'Compensation Laws of California. w Date-Applicant ALTER OR ADD TO MECH. 5.00 - BUILDING N NOTICE TO APPLICANT: If,after making this Certificate of Ex- F ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or[his 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 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(Sec. MICROFILM 3097,0,C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address • I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 inlbnnation is correct. I agree to comply with all city and county PLUMBING ordinances and slate laws relating to building construction, and 601 LER hereby H.P.or 100,000 B.T,U.) 6.00 hereby authorize representatives of this city, to enter upon the BOILER-COMP IOW,100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. - (We) agree to save, Indemnify and keep harmless the'Cily of - MISC.- REFER TO ORD. - . uperti t liabilities, 'udgments, costs mW expenses which pERM1T ISSUANCE 10,00 CONST.TAX ma Ina in consequence of the anti [h' er - MECH.CONT. LIC.NO. MECH. ft pL TOTAL TOTAL tore of App antlContmetor D(/e r/CJ OFFICE COPY (J a