16205 POSTTHISCA13D,NEAR FRONT OF'BUILID ING
PERMIT NUMBER
:CITY OF" CUPERTINO 16205
INSPECTION DIVISION
JOB INSPECTION RECORD
. '/ ( / PERMIT EXPIRATION -'
JOB ADDRESS /O� '_3 I WOL{ /UNIT'# _LOT# _
PERMIT EXPIRES IF WORK
OWNER' '7/ CONTRACTOR - IS NOT STARTED'WITHIN• '
INSPECTION DATE INSPECTOR INSPECTION RECORD 180DAYS OFPERMIT ISSU-•
FOUNDATION - .. ANCE OR 180 DAYS,FROM:
NOTE: '` LASTCALLED INSPECTION.
UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED
PREGUNITE' + TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION I
CUPERTINO STANDARDS:''
GARAGE SLABS - '
POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
UNDERGROUND /SLAB �t 'q� ....
PLUMBING
ELECTRICAL' '
. ISSUANCE DATE '
MECHANICAL
BLDCEk&CT I PLG. �MECH
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT
WOOD FLOOR INFORMATION
PLUMBINGVALUATION $JET,
' ' - - � F,
• \~� n - '
MECHANICAL _
ELECTRICAL /PERM T TO
FRAMING
INSULATION - e s DRIES TYPE CONSTR.
.. OCC.GROUP RES.UNIT%
PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED -
SO.FT.FLOOR AREA TOTAL ACREAGE .
ROOF - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE
`-• DIAPHRAGM THE CONSTRUCTION TAX IS PAID
• BUILDING USE
ROOF SHEATHING'. RES IND CDN - PB ' OR—
APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE 'INSP. ❑ ❑ Cl ❑ ❑
ASSESSORS PARCEL NO.
ROUGH SAN.#
'PLUMBING ELECT.-
ENERGY 1"
TRACTNO. PARCELNO
_ TUBS&SHOWER PAN PLUMBING ENERGY
MECHANICAL MECH.ENERGY
ELECTRICAL -
ACC.OATE ACC.FILE N0.
I BUILDING ENERGY - -
FRAMING ! ELECT.FINAL TEST ZONING ENc.SITE No
INSULATION PLUMBING
GAS TEST GAS , '
• - MECHANICAL FINE SPRINK ENERGY iO4'
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING' Y ❑ '' NE] ` ❑ NQ
FLOOD ZONE A.LU C.
EXTERIOR SHEAR ELECTRICAL RELEASE
INTERIOR SHEAR FIRE DEPT, .� •• `°❑ N❑ v ❑ 'N❑'
SHEETROCK GRADE FEE SUMMARY
EXTERIOR LATH BUILDING -
INTERIOR LATH TEMPORARY APPROVALS eulLDwc-
SCRATCHCOAT 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 ISSIGNED BY BUILDING INSPECTOR. MICROFILM
w�
ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION: ” PLUMBING ll
Z o ,PLEASE GIVE JOB ADDRESS WHEN PHONING. .
- SEE PERMIT FOR EXPIRATION DATE - MECHANICAL
IMPORTANT! CONST.TAX '
PLEASE READ REVERSESIDEBEFORE TOTAL
CALLING FOR FINAL INSPECTION.I
OFFICE COPY
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ,
_ BUI LOWR JECT ID NTIFICATION I IPERMITNUMBER
APPLICATION & PERMIT 6200
ADDRESS . a ~ a n " J
3 Al, � �� 9$9 BUILDING—ELECTRICAL—PLUMBING—MECHANICAL t`.� .
NEfl'$
NAME,. PLAN CHECK VALIDATION
\/O'er\1 x �,rj�G• S OTV. ELECTRIC PERMIT FEE
• I S vNONE
CONTRACTOR
NAME � L, OUTLETS-SWITCHES-RECEP 10.00/1.00
1 aLxS LIDO. LIGHTING FIXTURES . 10.00/1.00
CONTRACTORS , -
OGRESS��I1 //�T J PPLIANCES-RESIDENTIAL . 4.00. ,
`Y Anew 61V PHONE 9 8 PANELS . 10.00 DATE OF APPLICATION,
ARCHITECT PLAN CHECK FEE .C.NO.
- ORPANELS (OVER 200 AMP) '20.00
ENGINEER K//n
'/ \G a n LIC.No. SIGNS TRANS. - 3.00
ARCH.ss eea. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION "
ZIP TEMP.METER OR POLE INS. —20.Op Q
APPLICANT s MOTORS SEE FEE SCH.
ADDRESS oDREss
14241 yonFuR ti SERVICE CHANGE •,,'20.00
D 0 2 LI ENSED CONTRACTORS DECLARATIONae
zw 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE -
y <'w (commencing with Section 7000)of Division 3 of the Business and .• . - BLDG. ELECT: PLG. MECH.
H N z Professions Code,and my license is in full force and effect. ❑
xD- icense Class Lic.Number El
w H ate Contractor
¢o w �, DER DECLARATION.. ) f. ILDING PERMIT ,
MISC.— REFER TO ORD; N ` INFORMATION
w 3: w .1 hereby affirm that 1 am exempt from the Contractor's License + V ON $/FT.
I- u o J. Law for the following reason.(Sea 703 1.5,Business and Professions PERMIT ISSUANCE - —}0:00
� aaCode:Any city or county which requiresa permit tocons'truct,alter,
ec K Q 0 improve,demolish,or repair any structure,prior to its Issuance,also ELEC.CONTR. LIC.NO. _ ELEC. '
0LL requires the applicant for such permit to file a signed statement that TOTAL - PERMIT TO '
A w m he is licensed pursuant to the provisions of the Contractor's License _
HiQ
Law(Chapter 9(commencing with Section 7000)"uf Division 3 of the
i c Business and Professions Code)or tire[Ise is exempt therefrom and OTY. PLUMBING PERMIT FEE
wHi� the basis for the alleged exempt ion.Any violet ion of Section 7031.5 STORIES TYPE CONSTR.
A ;_ by any applicant fore permit subjects $500),licam toacivil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 !;
Of net mom than five hundred Dollars(5500)-):' -
❑ I,as owner of the property,or my employees with wagesas BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS
their sole compensation,will Jo 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 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 TOTALACREAGE'
• himself or through his own employees,provided that such improve- . . —
moots are not intended or offered for sale.ll',however,the building GAS-EA.SYSTEM-11NC.4 OUTLETS.43-.A0
. or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4(EA.) 2.00
builder will have the burden of proving trot h .e did not build or int- - BUILDING USE
T
for purpose ofsale.). RES IND CON PB -. Other
as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 El0 ❑ 11license 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,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00
contracts for such projects with a contractors o licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00
the Contractors License Law. - TRACT NO, PARCEL NO.
❑ '9 am exempt under Sec. B,&P.C.for this WATER HEATER W/VENT 6.00 -
Da e, A
reason �n-B./�Tr/A'1 e WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO.
WORKERS'COMPENSATION DECLARATIOM//
WATER TREATING EQUIP. 5.00 '
I hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO.
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec._3800,Lab.C.). I -
Policy No: Company—
0
-
Q ❑ Certified copy is hereby furnished. - FIRE.SPRINK ENERGV.T44
z Z Applicant
copy is tiled with the city inspection division. MISC.- REFER TO ORD. y'El .N❑ - Y.0 NQ
~LuN' CfHTI FICEXEMPTION fR WORKERS' PERMIT ISSUANCE
tFLOOD ZONE A.L.U.C.
W COMPENATiON INSURANCIi
PLG.CONTR. LIC.NO. PLGr--
CL
Z - (This section need no[ be completed if the pernit is for one TOTAL y❑ N❑ y C] NC]
hundred dollar($100)Io less,)
V O I certify that in the performance of the work for which this per- FEE SUMMARY
LL H ...it is issu d, 1 sh II not enmloy eny person in any manner,so as to CITY. MECHANICAL PERMIT FEE
O W become ec t th orkers'CpQh eony�yony,'Lws of 4a mia. -
y Date "I", ALTER OR ADD TO MECH. 5.00 BUILDING _
} ti NOTI TOA I ANT: If,atcr making this Certificulc of
F Z emlunam you sIhocl become subject m the Workers'Compensation APPLIANCE 5.00 PLAN CHECK "
provisions of [he Labor Code, you mull forthwith comply with
U such provisions or this permit shall he dembed revoked AIR HANDLING UNIT(TO 10,000C.F.M.) 4.00 FEE )''
CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.RM.) 6.00 SEISMIC FEE
I hereby affirm that there is construction lending agency rot EXHAUST HOOD(WITH DUCT) 5.00 - - -
the performance of the work ' r which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM
3097,Civ,CJ.
Lender's Name ' 0,4
Lender's Address HEATING UNIT(OVER 100,000 B.T.U.19:50 ELECTRIC
"I certify runt 1 have road this applic,aion and shine that the above VENTILATION FAN (SINGLE) 4.00 / r
information is correct. I agree to comply with all city and county PLUMBING ,
ordinances and state laws relating to building construction, and - BOILER-COW(3 H.P.or 100,000 B.T.U.) 6.00
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. -
(We) agree to save, indemnify and keep harmless the City of MISC.-. 'REFER TO ORD.
upertino a dins( liabilities, gments, costs and expenses which CONST.TAX '
Tray i y a cru st sa' City in consequence of the ` PERMIT ISSUANCE 10.00 M
r mg I L MECH.CDINL . ! ' s .LIC.NO. MECH. —
a[ure of Ic t onlmr ate OTAL TOTAL V-
OFFICE COPY '