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16234 POST THISRD NEAR FRONT OF BUILDING . PERMIT NUMBER 4 . COF CUPERTINO INSPECTION DIVISION 16234 JOB INSPECTION RECORD yp . PERMIT EXPIRATION . JOB ADDRESS �0�°t`3 N' WOLFGr , D UNIT#, _LOT# " � '—�ry• 'PERMIT EXPIRES IF WORK, sl OWNER )`0 ,Q 'CONTRACTOR - �y9R,8/:V(' E,=Z_4(7T,C jC IS "NOT"STARTED-WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD •leo DAYS OF PERMIT ISSU- FOUNDATION - ANCE,OR 180 DAYS.FROM NOTE: LAST CALLED 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 '�, L I F- _ • ,. .Mr ` UNDERGROUND /SLAB' • PLUMBING-: !� ELECTRICAL - ISSUANCE DATE •. MECHANICALBLOC. ELEc r. PLG. isr DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED �c ' BUILDING PERMIT+" WOOD FLOOR INFORMATION PLUMB • �C ATION $/FT, ! MECHAINICAL _ "('1ti NG VQe Rmll TO ELECTRICAL, - .�.- FRAMING INSULATION STORIES - •f YPE CONSTR. " " � OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED , • ' • ROOSO;FT FLOOR AREA ro TALA(:REAGE .� F. NOTE:NO FINAL INSP.SHALL BE MADE BEFORE. ' DIAPHRAGM • - THE CONSTRUCTION TAX IS PAID _ BUILDINGUSE ROOF SHEATHING I RES IND Cori PB OIC I APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 0. - ElEl 0 E ASSESSORS PARCEL NO ROUGH SANA PLUMBING -- ELECT.ENERGY I • I TUBS&SHOWER PAN -- PLUMBING ENERGY. TRACT NO, PARCEL NO. MECHANICAL MECH.ENERGY - - ELECTRICAL BUILDING ENERGY ACC.DATE. . Acc,PILE.No. FRAMING - ELECT.FINAL TEST INSULATION PLUMBING' ," ZONING ENG.SITE,NO. GAS TEST r GAS - - - � FIRESPRINK EN ERGY•T•?a MECHANICAL V . COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y N V I] NC] EXTERIOR SHEAR... ELECTRICAL RELEASE tl� _ FLOOD zoNE ALu.a ' INTERIOR.SHEAR FIRE DEPT. Y [:] No. v❑ N❑! SHEETROCK . - _UR gDE - FEE SUMMARY EXTERIOR LATH _ BUILDING INTERIOR LATH TEMPORARY APPROVALS - BUILDING SCRATCH COAT ELECTRIC.. QXF PLAN CHECK .l .. GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY ' SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINALISSIGNED"BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC " �Q ' FW ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING, Z' PLEASE GIVE'JOB ADDRESS WHEN PHONING. � �. — SEE PERMIT FOR•EXPIRATIO_N DATE — MECHANICAL IMPORTANT! CONST.TAX -PLEASE READ REVERSE SIDE BEFORE Izg I` TOTAL CALLING FOR FINAL INSPECTION. ' 1 0FFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES n USE B LL POINT PEN ONLY r %BUI LDI NGPROJECT I DENTI FICAPPLICATION & PEWT_ PERMIT NUMBER 4• aDRDING ' 16234 : ate✓/ ADDRESS / 10 O` 3 BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME OTY. ELECTRIC PERMIT FEE _ p�. ftftA PHONE NAME AcroRs OUTLETS-SWITCHES-RECEP 10.00/1.00 61 it� x ILIc:No, ffloo* ( LIGHTING FIXTURES '10.00/1.00 So / CONTRAACqC TOR'S L / I APPLIANCES-RESIDENTIAL 4.00 ' 041GI VY7 M ONE Z62'S004- PANELS 4fLOB/ S'a DATE OF APPLICATION ARCHITECT - PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP) 20.00 ENGINEER p - -- - LIC.NO. SIGNS TRANS. - 3.00 ARCH OR ADDRESS ENG, SPECIALCIRCUIT 5,00 PERMIT VALIDATION zip EMP.METER OR POLE INS. 20.00 ADD ESsTa MOTORS SEE FEE SCH. SERVICE CHANGE 20,00 Woo -.LICENSED CONTRACTORS DECLARATION Q is U I hereby affirm that 1 am licensed under provisions of Chapter 9 ,. ) ISSUANCE DATE ,HA <.% (commencing with Section 7000)of Division 3 of the Business and ELECT. PLG. MECH. H 0°' Professions Code and my license is in full force aggd of a t. o i m Licens$s,Class 1(L Lic,Number 4etl ❑ ❑ F w J Date _Conlmctor(q AC C BUILDING PERMIT a OWNER-BUILDER DECLARATION a o a U INFORMATION X g I- 1 hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD VALUATION $/FT. u.oj Law for the following reason.(Sec.703 L5,Businessand Professions PERMIT ISSUANCE ABBOv w> Code:Any city or county which requiresa permit to mnshucL:titer' ELEC.LONTR. LIC.N0. a p improve,demolish,or repair any structure,prior to its issuance,also ELEC. /O n wo u requires the applicant for such permit to file a signed statement that TOTAL rP PERMIT TO $ c' he is licensed pursuant to the provisions of the Contractor's License > Law(Chapter 9(commencing with Section 7000).f Division 3 of the ELese-7', F i o Business and Professions Code)or that he isexempt therefrom and OTY. PLUMBING PERMIT FEE r I-$ the basis for the alleged exemption.Any violation of Section 7031.5 t STORIES TYPE CONSTR. by any applicant fora permit subjects thcapplicant toa civilpenalty ALTER-DRAIN -WATER (EA.) $.00 of not more than five hundred dollars($500).): ' ❑ I,as owner of the property,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 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 ACR EAGE • himself or through his own employees,provided that such improve meatsare not intended or offered for sale.IL however,the building GAS-EA.SYSTEM-I1NC.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 lie did not build or im- BUILDING USERES IND CON PB Omer prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 . ❑ 1,as owner of the property,am 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 holds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1,00 contracts for such projects witha contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. 'D I an,ekemptunde,Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent Io self-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. COPY'hereof(� 38 � ab.0.). PolicyN6joy_ )_b-S�NA A- O ❑ Certifiedcopyisherehyfumished. - FIRE SPRINK ENERGY T.24 Z ❑ Ci`D'Ee copy is Oled w' t the city inspretion division. - O Applicam >J'pal,+i1_�l�-Ipa� MISC.- REFERTO ORD. Y❑ IN[3 Y ❑ N❑ CCy PERMIT ISSUANCE 10.00 FLOOD ZONE -A.L.U.L. � 'CI:RTIFlCATE F I ATIO TINS FROM WORKERS' (L �_ COMPENSATION INSURANCE PLG,CONTR. LIC.NO. PLG.. d Y[:] N❑ Y ❑ N[3O section need not be completed if the permit is for one TOTAL Z) Z hundred dollars($100)or less) L) O I certify that in the performance of the work for which this per, CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any manner so as to O W become subject m the Workers'Compensation Laws of California. y Date ApplicantALTER OR ADD T,0 MECH. 5.00 BUILDING } N NOTICE 10 APPLICANT: If,after making this Certificate of Ex - F Z emption,you should become subject to the Workers'Comperoation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE' C.) such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 1Q000C.F.M.) 4.00 ' CONSTRUCTION LENDING AGENCY AIRHANDLING UNIT(OVER 10MC.F.M.) 6.00 SEISMIC FEE I hereby affirm that is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3097,Civ,C,I, ' Lender's Name Lender's AdHEATI NG LIN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC Q .t� dress I certify dust I have read this application and state that the above VENTILATION FAN.(SINGLE). 4.00 • information is correct. I agree to comply with all city and county - - PLUMBING ordinances and state laws relating to building construction, and BOILER-COUP 13 H.P.or 100,000 B.T.U.) 6.00 hereby auomrile representatives of this city to enter upon tllu above-mentioned property for inspection purposes. BOILER-COMP(Over 100,000 BTU)SEE FEE$CH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. ' �`) I uportino against liabilities,judgments, costs :md expenses which PERMIT ISSUANCE' 10.00 CONST.TAX I, ay in any way accrul against said City in consequence of the I 'ting of thir eon. MECH.CONT. LIC.NO. ECH. yf,� TOTAL TOTAL . I Ire of Applicant 'A. {•rG M onl 'tor Dated OFFICE COPY