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16159 POST THIS CARD NEAR.FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO 16159 INSPECTION DIVISION -+.� JOB INSPECTION RECORD ..// ^y( \ ! /�OL�? PERMIT EXPIRATION JOBADDRESS �/UTA3 /V1 Wo�� "� U\NfT�LOT# / /I ' PERMIT EXPIRES IF 'WORK OWNER 4 CSO U,CGCr CONTRACTOR /</PO' A�-.17 dC(.fi-j IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR'180 DAYS FROM NOTE: LASTCALLEDINSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY d� PERMIT VALIDATION PREGUNITE CUPERTINO STANDARDS. GARAGE SLABS P POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ' UNDERGROUND /SLAB PLUMBING , ELECTRICAL ISSUANCE DATE MECHANICAL - BLDG ELECT I PLG. MECH, DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED r� BUN INFORMATION WOOD FLOOR 0 I Ire PLUMBING VALUATION -'F SIFT- ' p �no MECHANICAL tg9 ELECTRICAL . PEI+MIT ro FRAMING �G STO IES TYPECONSTR INSULATION DCC GROUP RES UNITS n^`1 w PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED a\� 6(1.FL FLOOR PIiEA TOTAL ACREAGE 'ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID li/i� ROOF SHEATHING RLS IrvBUILDING USE 0 CON PB O,uw APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ - [1 ❑ 13 ROUGH SAN.k As•sEssoRs PARCEL No PLUMBING ELECT.ENERGY TRACT NO, PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL - MECH,ENERGY ELECTRICAL BUILDING ENERGY ACC DATE ACC.FILE No FRAMING ELECT.FINAL TEST INSULATION PLUMBING ZDNING ENG.SITE NO, - , GAS TEST GAS FIRE SPR INK ENERGY T4C MECHANICAL Y ❑ NY ❑ NE] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A U.C. INTERIOR SHEAR FIRE DEPT.' Y ❑ .01 Y ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH I TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC 8 PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNER JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC dVv� H 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' ELECTRIC SERVICE NOTICE OFFICE COPY I� 1 BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO v To Ig yJr� iYou are hereby authorized to Connect electrical ser/vice for zflw0ner or Tenant lz 5, /0/� 3 No.of Wires Size of Wires Size of Switch Motor Load ' Voltage phase Healing Load K W Voltage No.01 Meters ( Llghr� ~'j p 1 Reconnect ll( Heat 120__Th ree Wire More 5ervl ce,� No.of Add.Meters Power. ^� three Phase Move Meter @ ELECTRICAL INSPECTOR I - APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER BIIGAINDAPPLICATION & PERMIT F. �S ADDRESS Sp I O2.✓/� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL . 16159 OWNER'S PLAN CHECK VALIDATION NAME LkyycSa00-x C �OURCI Or- ELECTRIC PERMIT FEE PHONE100* DHFR rolls UTLETS-SWITCHES-RECEP 10.00/1.00 �O =S LIC.No. ILIGHTING FIXTURES 10.00/1.00 - ONTRACTOR'5 ,QIS" APPLIANCES-RESIDENTIAL ., 4.00 OGRESS �♦/•� III Mo5wiftL PHONE ;tA C) PANELS 10.00 DATE OF APPLICATION' ARCHITECT 1501INJ CISPANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.No. SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIALCIRCUIT 5,00 PERMIT VALIDATION SS IIP TEMP.METER OR POLE INS. M.00 IQ /l' ADDRESS APPLICANTS MOTORS SEE FEE SCH, l/�f SERVICE CHANGE 20.00 Foo LICENSED CONI'RACfORS DECLARATION a v Lc I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE a n (commencing with Section 7000)of Division 3 of the Business and - - ELECT. I PLG77 MECH. r D i Professions Code,and my license is in full force and effect. oz'=G License Class -�_Lic.Number Com- �� , ❑ ❑ ❑ L H Date Contractor O'er r - It ,: Ic BUILDING PERMIT w OWNER-BUILDER RBUILDER DIiCLARATION INFORMATION w0 a REFER TO.ORD ;LL I, I hereby affirm that 1 am exempt from the Contractor's License MISC.- ` VALUATION $/FT. F u o¢ Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE '19:D8 �M Code:Any cilyorcounly which requires a permit to construct,alter, aso> nor to its iSsuatlee.also ELEC.CONTR. LIC.NO. 2 0 o improve,demolish,of repair any structure,p ELEC. D, requires the applicant for such permit 1.file a signed statement that TOTAL r.3eC- PERMIT TO ca m m he is licensed pursuant to the provisions of the Contractor's License _ H > Law(Chapter 9(cmnmencingwi'h Section 7000)of0ivision 3 oftle /C�'/ EL�L� a Business and Professions Code)or that Ile is exempt therefrom and OTY. PLUMBING PERMIT FEE ` /I / ¢_ $ t he basis for the alleged exemption.Any violation ofSection 7031.5 STORIES TYPE CONSTR. is. by any applicant for a Permit subjects the applicant to a civil penalty gLTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars(5500).): ❑ 1,as owner of the properly,or my 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 does not ap Ply to an owner of I. property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE U himself or through his own employees,provided that such improve- ments are not intended or offered for sale.If,howevar,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- SYSTEM-OVER 4 IEA) 2 builder will have the burden of proving that he did not build or im GAS-EA. . .00 BUILDING USE RES IND CON PB Other 'V prove for purpose of Sale.). INDUSTRIAL WASTE INTER. 30.00 CI 1,as owner of the property,um exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct 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.aid!who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts For such prolacls with a contractcos)licensed purmmnt to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I am exempt under Sec.-,R&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE N0. WORKERS'COMPENSA"['ION DECLARATION 'S WATER TREATING EQUIP. 5.00 - I hereby affirm 'list I It P1ert ificx to of consent to self-inxure, ZONING or n cerlificste of Worke Cotdpa'salion Insurance, 'I ceUlfed - ENG.SITE N0. Copy thereof(sec.380 Lab. .). Policy No. amp' O ❑ Cefti Icd co is th yturn' FIRE SPRINK ENERGY T-24 ❑ Certil'icd filed ' t cit rI I division. Z p. Applicant MISC.- REFER TO ORD. y❑ N❑ v ❑ N❑ Cr y CERT 'ICA I'E OI'EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU > COMPENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. 1 IT sect -n need not be completed if file permit is I'or one TOTAL Y❑ N❑ Y❑ N❑ Z hundred doll rs(S HKO Sar less.) fJ O I cenil'y that in the perlormunce of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL F• mit is issued,I shut[not employ any person in any mannerso as to U become subject to the Workeri Compensation Laws of California. y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING } W NOTICE TO APPLICANT: IL after making this Certificate of Ex- ? mnp'ion,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you mus' forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000CF.NL) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,000C.F.M.) 6.00 SEISMIC FEE 1 hereby affirm 11131 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,OF CA HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lenders Address HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 1 certify that I have read this application and state that the above VENT LAT ION FAN (SINGLE) 4,00 . information is correct. I agree to comply with all city and county PLUMBING ordinances unit stale laws relating to building construction, and BOILER-COMPI3 H.P.or 100,000 B.T.U.) 6.00 hereby aullora• representatives of this city to enter upon the BOILER-COMP.(Over 100,000BTU1 SEE FEE SCH. MECHANICAL above-mentioned pro erty for inspect ion purposes. (We) agree Sav , mdemnif_and k harmless the City of MISC.- REFER TO ORD. upertino a cost Iia it It.,j mems , cos slid expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in an way cnm ng' st sur City n consequence of the ranling0 [his in MECH.CONT., ,LIC.NO. MECH. TOTAL TOTAL Signalu of Applicant/Contrec or Date OFFICE COPY