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16237 (2) n` ,.POST.THIS RD NEAR,FRONT OF BUILDING ' ' . 'PERMIT NUMBER , CI .OF CUPERTINO 6237. s . INSPECTION'DIVISION JOB INSPECTION RECORD e t D 1 S'. PERMIT,EXPIRATION JOB,ADOR ESS 'IO L,Z3 N� ✓D('C� •—UNIT#• SLOT# I _ - PERMIT EXPIRES IF WORK.1 OWNER. F. :' .CONTRACTOR -[— ISNOT STARTED WITHIN.-! INSPECTION DATE INSPECTOR NS ECTION RECORD •1ao Ogvs of dEAMiTlissu FOUNDATION ANCE OR 180 DAYS FROM ' M1, NOTE: . - "J" -LAST CALLED INSPECTION: UFER, - - ALL'GRADING AND DRAINA6E,SHALPA16ALLED PREGUNITE . . _ TO COMPLY WITH THE APPROVED PLANS AND CITY OF vEFmlrt VALIDATION CUPERTINO STANDARDS. GARAGE SLABS 1`919 8 Y 1 iC•U•�� POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB ., •"s City Of CUp@LIDO �,I PLUMBING - ELECTRICAL'- - r •' • ISSUANCE uare ' I• MECHANICAL "' -p- ) �o BLDG. ELECT. . PLG. ECH, 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT : r WOOD FLOOR' - ' .• 1T ' y INFORMATION PLUMBING r +' VALUATION, S/ET: ,- ' � p -JC. E oL ''7 MECHANICAL . ' ELECTRICAL FRAMING - s' e � .hTeh•'',(u1� iT�• INSULATION' N � � STORIES V rvvE coNSTR.. .i. . • - - OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED $O,Fi,FL00N AHfP TOTAL ACFEAGE ROOF NOTE:NO F.INAL•INSP.SHALL BE MADE BEFORE t - DIAPHRAGM THE CONSTRUCTION TAXIS PAID _ BUILDING USE, W' - ROOF SHEATHING •. _ - .I+ts IND CON PB Ow.f APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ROUGH.' LI' SAN.N ' 2'_, ASSESSURS PAH CEL N O, i PLUMBING 4 0, CELECT.ENERGY , TUBS&SHOWERPANPLUMBING ENERGY.' TRACT NO. PARCEL NO MECHANICAL 0_20- MECH.ENERGY i ., _ t. ELECTRICAL ACC.DATE ..Acc,FILE NO.. • ,. Oc BUILDING ENERGY'" t. . FRAMING ELECT.FINAL TEST :A - ' ZONING ENG.SITE NO. INSULATION r. PLUMBING: GAS TEST GAS • "I - ' MEC HAN ICA_L � �' FIRE SPRINK ENERGYL24 COVER NO WORK UNTIL ABOVEHAS BEEN SIGNED HEATING - Y ❑ N❑ v ❑�'. N❑ - EXTERIOR SHEAR ELECTRIC A L,RELEASE FLOOD ZONE A.L U.C: INTERIOR SHEAR - FIRE DEPT.. Y❑ N❑ Y ❑ 'N❑ SHEETROCK . p, GRADE FEE SUMMARY EXTERIOR. LATH - BUILDING ` INTERIOR LATH .. TEMPORARY'APPROVACS. SCRATCH COAT ELECTRIC PLAN CHECK GAS - FEE ' NO TAPE'OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY- ..... SEISMIC FEE TvE� OCCUPANCYOF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL IS SIGNED By BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505+ 4. ELECTRIC o� ONE,WORKING DAY BEFORE.REQUIRED I'',NSPECTION PLUMBING PLEASE GIVE JOB ADDRESS WHEN•PHONING: — SEE PERMIT FOR EXPIRATION DATE — 4., ` '* MECHANICAL IMPORTANT! coNsr.rgxr I` PLEASE READ REVERSE SIDE BEFORE` CALLING,FOR FINALANSPECTION. TOTAL ;. O/ /1'GO OFFICE COPY ELECTRIC SERVICE NOTICE OFFICE COPY . BUILDING INSPECTOR'5 NOTICE CITY OF CUPERTINO t �J To / 7 19 , You are hereby authorized rof Connect electrical service for Owner or Tenant_ �/V'oo� t-�U47A /gx 1,/,411 SS At No.of Wires Size of Wires Size of Switch Motor Load Voltage Phase 1 Hearing Load K.W. Voltage �.f ( L,hr I10_New Service Reconnect No.of Meters 1 �t�tl l(1 Hew-120- Three Wire More Service te ry No.of Add.Mers Power Three Phase Move Meter. ©� ELECTRICAL INSPECTOR _ _ U r -%`APPLICANT,TO`FILL'IN I N FCAMATION WITHIN RED'L1NES —,, 'U,SE,B L POINT,PEN ONLY ' < f,kSUILDING P.ROJ_ CT DENTI FIC } � - ' - a,,t_ PERMIT NUMBER If — ADLLDINGADDR15 CO APPLICATION & PE IT � `+��� � BUILDING ELECTRICAL PLUMBING—:MECHANICAL OWNERS ` NAME �' - I i �Py AN CHECK VALIDAT N, �, I •x �.�y OTY. - ELECTRIC PERMIT FEE ' UTLETS-SWITCHES.-RECEP ',10.00/100 C ME OR5 NAME , .No. LIGHTINGFIXTURES`,., 10'.00/100 _ - rONTRACTOR'S a-' aooREss ( .'•• PPLIANCES RESIDENTIAL z'•r" 4" �. Y ICIrvICJ a%�v"Iv PANELS t 00 P 10 00 r � 'P •�.DATE OF APPLICATION x , ARCHITECT OR' Q YIU PANEL'S (OVER 200 AMP.) 20.00 r.i PLAN CHECK FEE PC'No ' ENGINEER 'T"�'•11'"� ' _ N 4 LIC;ri SIGNS;TRANS 300 g a ARCH.OR ENG - AO.RESa ''441 SPECIAL CIRCUIT 'P SOO E i kPERMIT VALIDATION s d x' 2 -zl EMP:.METER OR POLE INS 20.00 1 A ORES [MOTORS�NT s23'L' MOTORS - SEE FEE SCH SERVICE CHANGE " , 20.00 gam( L - cSV LI ENSEU CONTRACTORS DECLARATION x w O u 1 hereb affirm that 1 a " Y m licensed^under ,.visions of Cha kr 9 ¢ Z w P P x .Yr'' 155 E 1 _ w ¢y (c mmennng with Section]000)of Division 3 of the Business and r, BLD ELECTNCE PLO MECH. H z Pr (esslons Co an license i m full fur 'n (r z 002— L ccn Class - Lic Numbs � - �E e.p [1' (]e ' Q y o.. Vete ! u - i /S Q,ac'ontracto _ - .. ..?'4 r71-.Pa�:17. 170 I ..'� 'EL.-El ',❑ ¢ a w ¢ OWNER-BUILDER DECLARATION ( BUILDING PERMIT _ °'p - - "t MISC. ^ OR h' INFORMATION t ""x ; u y " 1 hereby.affirm that I am exempt the Contractor's License ` u Oy¢,. Law for the following reason.(Sec 7031.5,Business and Professions - (VALUATION SIFT. I- PERMIT ISSUANCE ^'�J ` Code:Any city.,county which requires a permit to construct,alter, sa ¢Q', improve,demolish,or repair any structure,prior to its issuance also ELEC.CONTE. LEC se m u requires the applicant for such permit to file a signed statement that _ `„ TOTAL 'r^-" ,. - be is licensed pursuant to the provisions of file COInTaC or's License 1 PERMIT TO a HiQ . Law(ChapterProfemme ssions Code)ng or Section is 00)of exempt theren3.f the �v�' y z o Business and Professions Code)or that he is exempt therefrom and DTV. PLUMBING PERMIT FEE T.r� AI ¢ E. $'• the basis for the alleged'exemption.Any violation of$ection 7031.5 •r STORIES TVP CONSTR. •^s d3 - by any applicant fora permit subjects the applicant loacivil penalty ALTER -WATER EA:)-5,00 .= ." . -feet more than five hundred dollars(5500).):' ( - 1- ' ❑ I,as owner f'the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 + c their sole compensation,will do the work,and,the'st-e—o is not - 1 OCC.GROUPII RES UNITS' > intended or offered for sale(Svc. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND.- 5.00 1%;+;� Code:The Contractor's License Law does not apply to an owner of. r' - property who builds or improves thereon,and who does such work FIXTURES-PER TRAP himself or through his own employees,provided that such improve- 5 00 50 FT FLOOR AREA TOTAL ACREAGE � -' ments are not intended or offered forsale.If,however,the building GAS-EA.SYSTEM-1 INCA OUTLETS 600 or improvement Is sold'within one year of completion,the owner- V. a builder will have the burden of proving that he did not build or.in, GAS-EA.SYSTEM-OVER 4,(EA.) '2.00 " BUILDING USE prove for purpose or sale.). - INDUSTRIAL WASTE INTER. ,'30.00 RES IND - coNy Pe Othar ❑ .1,as owner of the popou ,am exclusively contracting with - ❑s ❑ ❑ ❑ .❑„ licensed contractors to construct the project(Sec.,7044,-Business; LAWN SPRINKLERS'-1 INC 5 V.B: ,'.6 00 a gSSEsso RS PARCELl a and Professions Code.The Contractor's License Law does not apply - '' , to an owner or property,who buddsio,improves thereon.and who LAWN SPRINKLERS-OVER•5 (EA.) 1.00 L•Y -t• contracts I'or such projects with a contractogs)licensed pursuant to the Contractors License Law.` > ' SEWER-SAN_ ITARY-STORM EA.200ft/1000 TRACT NO. 'PARCEL No. '❑ .I am exempt raider Sec. B.&P.C.for this' G ' reason " - WATER HEATER W/VENT '00 Owner Uu[e - '• £ ♦' '' . - "sWATER SYSTEM't .' 500 ry7^ .ACC.DATE ACC.FILE NO, WORKERS'COMPENSATION DECLARATION 'WATER TR EATING;EQUIP T 500 hemby at that I have a cerlfkatc of consent th self insure 'r ., 1 or a certificate of Workers'Compensation Insurance or certified _ f ZONING ENG SITE NO" - copy thereof(Sec C0 Lab.C� a • a ' j Policy No. Compan7 �—TIL/L/ - r •[ r .0, ❑ Cetllfie opy's lterehyfurm ed i` 1 IIFIRE SPRINK ENERGY T44 .Z Z [if —co l fly�d. inspection divismn - - 1 - r F..O' pplicaf-'J�',.iL./ �-e[/�--. MISC. '+ - 'y REFER-TO ORD 11'Y❑�tN❑. i •y ❑ N❑ N CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE •°. 1000 FLOOD ZDNE -„ a.L.UC W �• COMPENSATION INSURANCE PLG CONTR. 1 LIC NO PLG. ,'N- A ' art CL'Cl (This section need not be completed if the perniil is for one ^ , 'TOTAL !" 'Y❑•,' IN - 'jV ❑ N❑ 2 - .. 1 ' U O hundred dollars(S 100)or less:) - _ _ - I certify that in the performance.f oi•work for which this per-F 'DTV MECHANICAL PERMIT FEE -;FEE SUMMARY LL mit.is.issued,1 shall not employ any,person In anm y anner so as to O become subject to the Workers'Compensation Laws of C il:m ilia - f _ 0 Q. ' Date Applicant '•` ALTER OR ADD TO MECH' 5.00BUILDING'- } w NOTICE TO-APPLICANT. If,after nicking this CeufIfcaIe of Ex ' r r H ? emption',you should'become subject to'the Workers'Compensation APPLIANCE 5 00 -PLAN"CHECK provisions of the Labor Code, you must forthwith comply with - 1 ? ,FEE*C 1 V+ such provisions or this permit be deemed revoked. AIR HANDLING UNIT(T0,.IQ000CKIA),' 4 00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER.10.000C.EM.)'6.00 • "SEISMIC FEE 1.9 'I hereby affirm that there Is aewnstructiculdending-agency for 'EXHAUST HOOD (WITH DUCT)- ,­'.5.00 ev !. 1 the performance of the work for which tlus'permlt is issued(SecMICROFILM - 3097 Civ.C:)r ',r,-1 t HEATING,UNIT 100;000B.T.U.) 5.00 1 Lender's Name ""- a Lender's Address - HEATING UNIT(OVER 100,000 B.T.U.)950 ELECTRIC I certify that I have read this application and state that the above 1't' VENTILATION'.FAN'(SINGLE) . 4.00 n 4 1 information is correct:I agree to comply with allcity and county BOILER COMP(3 H.P.Dr 100 000 ,; . PLUMBING B.T.U.) 6 00 ordinances and slate Wws relating to building construction, and - I. hereby authorize representatives of this city to. r,upon ththe , Var0,000 BTU)SEE FEES CH MEHANICALCr i above-mentioned property for insp ofhipurposes.enteBOILER-COMP (O10 _ a (Wof agree to save,`indemnify and;keep,hannlesa the City of MISC.- ' REFER TO ORD s I. .Per In.against liabilities,judgments,-costs and.expenses'which 'PERMIT ISSUANCE 10.00 'CONST.TAX 'a as. Ta any„way accrue.agar t sai ity in consequ ace b the nti this permit ' , /► MECH.CONT.• LIC NO:' MECH (/Ywlr? TOTAL E ,TOTAL 76� 1 � Sig re of App ream/ronlr toe ate r, I f ! OFFICECOPY iY