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16170 POSTTHISCARD NEAR FRONTOF BUILDING PEFAITNUMBER -CITY OF CUPERTINO INSPECTION DIVISION 16170 JOB INSPECTION RECORD WO SO, 1033 PERMIT EXPIRATION JOB ADDRESS/e'1 14d AZ z"" UNIT# _LOT# • PERMIT EXPIRES WWORK OWNER �� CONTRACTOR CllJ. IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT'ISSU- . FOUNDATION NOTE: ' ANCE OR 180 DAYS FROM UFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED LAST CALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CIN OF - PLRTAIT VALIDATION . GARAGE SLABS CUPERTINO STANDARDS. • POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED "t�4' L. ~'.� •. - UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE MECHANICAL BLDG ELECT I PLG, TAECR. ❑ ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION ' PLUMBING VALUATION S/FT. .. � MECHANICAL ELECTRICAL PERnm TO FRAMING to INSULATION STORIES TYPE CONSJF. OCC.GROUP RES UNITS PLACE NO SUBFLOORUNTIL ABOVE HAS BEEN SIGNED o %:. ` SU.R f nNF< ROOF NOTE: FINAL ION. SHALL BE MADE BEFORE L00F TOTAL ACREAGE DIAPHRAGM THE COINN STRUCTION TAX IS PAID ROOF SHEATHING BUILDING USE RES -IND CON PB D,I,n APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE ` INSP. ❑ El ❑ ❑ ❑ ROUGH SAN.q ssessoRs PARceL ND PLUMBING —( _ ELECT.ENERGY - TUBS 8 SHOWER PANPLUMBING ENERGY TRACT NO, PARCEL NO MECHANICAL MECH.ENERGY I ELECTRICAL BUILDING ENERGY ACC DATE ACL.FILE NO FRAMING ELECT.FINAL TEST INSULATION PLUMBING ZONING ENC, SITE No. GAS TEST GAS MECHANICAL FIRE STRIDE ENERGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ Y ❑ N❑ EXTERIOR SHEAR ELECTRICAL RELEASE a000 zoNE A.L UC. INTERIOR SHEAR - - FIRE DEPT. Y❑ .N❑ v ❑ 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 SIGNEDOCCUPANCY SEISMIC FEE OCCUPANCYDF BUILDING ISNOTPERMITTED UNTILBUILDIN G FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC o� ONE WORKING DAY BEFORE REQUIRED INSPECTION. • PLUMBING' 9Q 07 Z PLEASE GIVE JOB ADDRESS WHEN PHONING. - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! - CONST.TAX PLEASE READ REVERSE SIDE BEFORE 0 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 BUILDING APPLICATION & PERMIT [�q �O DRE55 6 /_' - rD O BUILDING—ELECTRICAL—PLUMBING—MECHANICAL WNE E PLAN CHECK VALIDATION ' QTY. ELECTRICPERMIT '` FEE o orvTRAcrDRs 'OUTLETS-SWITCHES-RECEP 10.00/1.00 E IC,NO. LIGHTINGFIXTUR ES 10.00/1.00 CONTRACTOR'S ADDRESS PPLIANCES-RESIDENTIAL 4,00 - gin 5T PHONE PANELS 10.00 DATE OF APPLICATION ' RCHITEC PANELS (AVER ZOO AMPI 20.00 PLAN CHECK FEE P.C.:NO. OR ENGINEER 'uc.NO, SIGNS TRANS.' 3.00 ARCH.OR ENG. - SPECIALCIRCUIT 5.00 PERMIT VALIDATION ADDRESS ZIP EMP.METER OR POLE INS. 2000. APPLICANTS MOTORS SEE FEE SCH. ADDRESS o o LICENSED SERVICE CHANGE 20.00 ,CONTRACTORS DECLARATION O ¢ u u I hereby affirm prat I am licensed under provisions et Chapter 9 - ISSUANCE DATE >r Lei < w (commencing with Section 7000)of Division 3 of the Business and - BLDG. ELECT. PLG. MECH. r w i Professions Ca a y license is in full f ❑ ❑ z o m— Licens lass Lic.Nunda, o r w Date Contractor. , a Y E - BUILDING PERMIT ¢ rc w ¢ OWNER-BUILDER DE INFORMATION oA ° ' MISC.— REFER TO ORD w LL N I hereby affirm that I am exempt Qom the Conhoctor's License VALUATION u, ac o g Law for the following reason.(Sec.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requires permit to construct,alter, a, Q Q improve,demolish,Or repair any stmclure,prior to its Iss ince,also ELEC.CONTR. LIC.NO.• ELEC. d,g m LL requires the applicant for such permit to file a signed statement that TOTAL n PERMIT TO be is licensed pursuant to the provisions of the Contractor's License D F z a Law,(Chapter 9(commencing with Section 7000)of Division 3 ofthe LO� i 0 Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT 4� FEE ¢ r o the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE Ix1NSTR. i ;m by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA. of not more than five hundred dollars(5500).): - ❑ 1,as owner Of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE .0 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,AR EA,COND. Code:The Contractor's License Law does not apply to an owner of �_ property who builds or improves thereon,and who does such work F IXTUR ES-PER TRAP 0 SG.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- menuare,notintended or offered for sale.If,however,the building GAS-.EA.SVSTEM-11NC.40UTLETS 6,00 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 ma- RES IND CON PB Omar prove for purpose of sale.). IN4 IAL WASTE INTER.' 30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business RINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Lew does not apply to an owner of property who builds or improves thereon,and who RINKLERS-OVER 5 IEA.) 1.00 eo contracts for such projects with o contractous)licensed pursuant to the Contractor's License Law. . ANITARY-STORM EA.200ftI10.00 ' TRACT No. PARCEL No. ❑ I am exempt under Sec. ,B.&P.C.for this HEATER WAIF RIT 5170 — - reason Owner Date SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKIiRS'COMPENSATION DECLARATION TREATING EQUIP. 5.00 I hereby affirm that I have a Certificate ofconsent toself-insum, r ZONING ENG.SITE NO. or certificate of Workers'Compensation Insurance,or a certified r copy Theriot'(Sec.3800,Lab C:). 9y 1�Zl/��1 Policy No. Company—,�/ Q ❑ rti tied copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z ,VCertified copy Is filed with the city.inspection division. REFER TO ORD. Y N y NO Applicant ❑ ❑ ❑ ❑rnCF,RTIFICATII OF F.XEMI'TION FROM WORKCRS, ISSUANCE d&00 „Z FLDGD ZONE A.L.0c. LU > COMPENSATION INSURANCE• PLG.CLIC.N0. PLG. (!L 'CL o (This section need not be completed If the permit is for one TOTAL a.a Y❑ N❑ V❑ N❑ Z) Z hundred dollar9(S100)orless.) L) O 1 certify that in the performance of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY LL 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. BUILDING y Date Applicant ALTER OR ADD TO MECH. 5.00 } W NOTICE 'r0 APPLICANT: If,after making this Certificate of Iix- F Z emotion,you should become subject to the Workeri Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith Comply with FEE V such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY - AIRHANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE 11 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. HEATING UNIT(TO 100,000 B.T.U.) 8.001MICROFILM 3097,Cw.C.): - - Lender',Addr HEATING UNIT(OVER 100;000 B.T.U.)9.50 ELECTRIC' Lender's'Address q I certify that 1 have read this application and state that Thi above VENTILATION FAN (SINGLE) 4.00 - OLQ Vy information is correct. I agree to compty with all city and county, PLUMBING nNirances and state laws relating to building construction, and BOILER-COMPI3 H.P.or 100,000 B.T.U.) 8.00 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. (W agree' fav 'ndemnify and keep,harniless the City of MISC.- REFER TO ORD. , u ease t abili es,judgments, costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX a in 4y Acer against said City in consequence of the ran is permit I ECH.CONT. LIG N0. . MECH. TOTAL TOTAL at eo picant/Contractor- ate OFFICE COPY