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16224
I .. POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBEF CITY OF CUPERTINO -16224 INSPECTION DIVISION JOB INSPECTION RECORD - '� ] .J/{^! PERMIT EXPIRATION JOB ADDRESS lO�a3 �'"-" '1 / UNIT# - LOT ft ` '' i(� .� PERMIT EXPIRES IF,WORK OWNER wCONTRACTOR 'j/VW IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD- 180 DAYS of PERMIT 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 CUPERTINO STANDARDS. GARAGE SLABS. , POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND'/SLAB PLUMBING - ELECTRICAL PAID ISSUANCE LATE MECHANICAL - - _ BLDG ELECT. PLG. MECH. AUG 23 198 ❑ , 0 ❑ , DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT PLUMBING WOOD FLOOR City of CUpBItIR INFORMATION VALUATION slFr. MECHANICAL j7. •y ELECTRICAL PERMIT TD FRAMING { fH . LrL4-sc'T� INSULATION sroRles TYPE corvsrR. OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50 61,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 CON PR oo,,., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. • ❑ ❑ ❑ ❑ ❑ ROUGH SAN.N ASSESSORS PARCEL NO. PLUMBING - ELECT.ENERGY ' TRACT NO. PARCEL NO TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL „ MECH.ENERGY ELECTRICAL - BUILDING ENERGY ACC.DATE - Acc.PILE No FRAMING ELECT.RNACTEST ZONING ENG.SITE N0. , . INSULATION � � PLUMBING � , GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T 24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING' ❑ "❑ r❑ NE] I EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A L LLC INTERIOR SHEAR FIRE-DEPT. ` Y ❑ N❑ Y ❑ rv❑ SHEETROCK _&' - GRADE . FEE SUMMARY EXTERIOR LATH - BUILDING INTERIOR LATH - TEMPORARY APPROVALS 'BUILDING SCRATCH COATELECTRIC - PLAN CHECK GAS ,FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED IOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING-IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM Lu ARRANGE FOR INSPECTION BY PHONING 252-4505, .. ELECTRIC I_ ONE WORKING DAY BEFORE.REQUIRED INSPECTION. `4 OPLUMBINGZ PLEASE GIVE JOB ADDRESS WHEN PHONING.' ' - SEE'PERMIT FOR EXPIRATION DATE - , .:, MECHANICAL IMPORTANTI CONST.TAX D . PLEASE READ REVERSE SIDE BEFORE,. CALLING FOR FINAL INSPECTION.. ,TOTAL L„ OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY UI LDING PROJECT I DENT]FICATI IN - .PERMIT NUMBER ADDL , • .16224 woo EENG APPLICATION & PERMIT ss ;0%23- /Z3 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL ' Owry R'a "PLAN CHECK VALIDATION N TY. ELECTRIC PERMIT FEE �o�l ��d PHGN NTRAcrDRs UTLETS-SWITCHES-RECEP 10.00/1.00 [ADDH �•�uc.NOA,�, ! LIGHTING FIXTURES 1000/1.00 ON RACTOR'5Ess PPLIANCES-RESIDENTIAL 4.00 O© PANEL$ GATE OF APPLICATION RCHITECT PLAN CHECK FEE P.C.NO. OR A/ Is (OVER 200 AMP) 20.00 ENGIN LIC.No. SIGNS TRANS. 3.00 ARCH.OR ENG. PERMIT VALIDATION ADDRESS SPECIALCIRCUIT 5.00 ZIP TEMP.METER OR POLE INS. 48;80 r APL TRMOTORS SEE FEE SCH. J. SERVICE CHANGE 20.00 woo LICENSED CONTRACTORS DECLARATION < oF. Cs ' I hereby affirm that I am licensed under provisions of Chapter 9 ` v~i, ISSUANTE i (commencing with Section 7000)of Division 3 of the Business and PiUG BLDG. ELECT.CE DA LG. MECH. H w i Professions Code,and my license is in full force and effect �❑ E: ❑ Z o,n - License Class Lie Number 7 9 w r w Date _ - Contractor. ' a Q w OWNER-BUILDER DECLARATION BUILDING PERMIT X ;' N I hereby affirm that I am exwnpi from the Contractor's License MISC.- REFER.T - INFORMATION uo J- Law for the following reason.(Sec.7031.5,Businessand ProfessionspERMIT ISSUANCE VALUATION $/FT. w� Code:Any city or county.which requires a permit to construct,alter, - a, 2 ¢ improve,demolish,or,repair any structure,prior to its issuance,also ELEC.LONTR. LIC.N0. ELEC. Ob i w c , requires the applicant for such.permit to file a signed statement that TOTAL PERMIT TO_ he is licensed pursuant to the provisions of the Contractor's License H z¢ Law(Chap ler 9(commencing with Section 7000)of Division 3 of the i D Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE i &Z-av? ¢ F.o the basis for the alleged exemption,Any violation of Section 7031.5 STORIES TYPE CONSTR. i ;.m by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500).): ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ I,as owner the property, employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC GROUP" RES.UNITS their sole compensation:will thea work,and the structure is not - intended or offered for',ale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 1 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 himself or through his own employees,provided that such improve- ments are not intended 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 builder will have the burden of proving that he did no[build or im- BUILDING USE prove of sale.). RES INDUSTRIALWASTE INTER. 30.00 El El ❑N PS El F-1 1,aso ❑ I,as ownerneer purpose of the property,am exclusively contracting with licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-I INC 5 V.B. 6.00 and Professions Code:The Contractor's License Law does not apply ASSESSORS PARCEL NO. 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 contoolool)licensed pursuant to the Contractor's License Law. . SEWER-SAN ITAR V-STO RM EA.200ft/10.00 TRACT NO. PARCEL NO. mason l am exempt under Sec..,B.&p.C.for this WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC.DATE ACO.FILE NO. WORK F-RS'COMPENSATION DFCLA RATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent to self-insure, or a certificate of Workers'Compensation Insurance,or a Certified I ZONING - ENG.SITE NO. copy thereof(Sec.3800,Lob.Cp_. , - Policy No, - Company - 0 o Certified copy is hereby furnished Z Z Certif copy�t�f�led� WIl�h theAty in'Dect ion division. FIRESPRINK ENERGYT24 O plica tr_%a YIi L�. `•YW �.NlMasU MISC.- REFER TO ORD. V No V NEI CC CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.D. LU > COMPF.NSAT'ION INSURANCE PLG.CONTR. LIC.NO. PLG. CL O (This Sentidn need not be completed if the permit is for one TOTAL Y[:] N� V ❑ NO D Z hundred dollars($1001 or less.) - U O 1 Certify that in the performance of the work for which this per- CITY 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. IS. Datc ApplicantALTER OR ADD TO MECH. 5.00 BUILDING } N NOTICE TO APPLICANT' If,after making this Certificate of lix- F Z emption,you should become subject to the Workers Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with U FEE'- such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=CF.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(See. MICROFILM 3097,Co.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address' - HEATING UNIT(OVER 100,000B.T.U.)9.50 ELECTRIC CV 1 Certify that l have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 informations correct. I agree to with alcity and county BOILER-COMP(3H.P.or100,000B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and hereby authorize representatives of ec thispurposes. thcity to enter upon e - BOILER-COMP ins above-mentioned property for (Over 100,000 BTUI SEE FEE SCH. MECHANICAL (We) agree to save, indemnify and keep hanmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which pERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue against said City in consequence of the an • fthispermit tl MECH.CONT. LIC.NO. MECH. O TOTAL I TOTAL o0 ignalure of Applicant/Contrac or Date OFFICE COPY