The URL can be used to link to this page

16262 POST THIS RD NEAR FRONT OF BUILDING PERMITNUMBER' �. CI-MOF CUPERTINO 1622 INSPECTION DIVISION ' JOB.INSPECTION•RECORD 1,' , PERMIT EXPIRATION JOB�ADORESS ��a-� /V� I' VLF-ir �J UNIT# _LOT# -- ��,, � PERMIT EXPIRES IF.WORK OWNER ''L - CONTRACTOR. FO7•4- t- CV/ IS NOT'STARTED WITHIN • INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU - FOUNDATION ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. + LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED - PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAUDATIUN CUPERTINO STANDARDS.' GARAGESLABS k POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED 'UNDERGROUND /SLAB ^ -1 PLUMBING ! ELECTRICAL .i - ISSUANCE DATE 0_ MECHANICAL - BLDG. ELECT PLG. MECH ❑ 4 ❑ ❑ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED suaDlNc PERMIT ' INFORMATION WOOD�FLOOR. olCu VALUATION SIFT. PLUMBING - MECHANICAL ' . PERMIT TO ELECTRICAL- - FRAMING �Ey INSULATION . . STORIES TYPE CONSTR,. OCC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOFNOTE:NO FINAL INSP,SHALL BE MADE BEFORE $O ET FLOOR AREA TOTAL ACREAGE • DIAPHRAGM - - THE CONSTRUCTION TAX IS PAID - BUILDING USE ROOF SHEATHING HES ' IND LON PB"00- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ '❑ ❑' ❑ ❑ ROUGH SAN.N - ASSESSORS PARCEL NO. PLUMBING - ELECT.ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY• rRacr No. PARCEL No ' MECHANICAL- MECH.ENERGY, ELECTRICALBUILDING ENERGY ACC DATE ACC.FILE NO FRAMING ELECT.FINAL TEST zoNlNc ENG.SITE No. INSULATION IPLUMBING - GAS TEST GAS a - MECHANICAL _ FIRESPRINK 'ENERGY T.pa COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ° ❑ "❑ ❑ "❑' EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A.L U,C. INTERIOR-SHEAR - 'FIRE DEPT. - Y N❑ Y ❑ N❑' SHEET ROCK:, GRADE - FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT - 1 ' ELECTRIC PLAN CHECK - q • GAS FEE 'I NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY sEISMIQFEE ' OCCUPANCYOF BUILDING ISNOTPERMITTED UNTIL�BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM -��;�, a� -• w ARRANGE FOR-INSPECTION BY PHONING 252-4505, ELECTRIC�• ~O� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE w *> �I `, CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY 61 LDI NG PROJECT IDENTI FIC .PERMIT NUMBER- . UILUING APPLICATION & PE T 16262 ADDRESS .#u',O FpsH OI'f BUILDING -ELECTRICAL-PLUMBING-MECHANICAL NANaE/� / PLAN CHECK VALIDATION • " �'/JeeL DTV. ELECTRIC PERMIT FEE V''J vHarvE�-_�C CONTRACTORS NAME / OUTLETS'- SWITCHES-RECEP• 10.00/1.00 _ -// /M 19 ' 'cic.NO LIGHTING LIGHTING.FIXTURES 10.00/1.00 CO NTRACTORs� -ESSiJ EaOWL°q 4.+'/I PPLIANCES-RESIDENTIAL 4.00 S�`�S�PHONE �� PANELS 10.00 _PF;DATE OF APPLICATION r ARCHITECT CHECK FEE. P.C.:NO. OR PANELS (OVER 200 AMN 20.0 .-. , ENGINEER LIC.No. SIGNS TRANS. 3.0 ARCH.OR ADDRESS ENG. SPECIAL CIRCUIT 5.00 MIT VALIDATION ZIP rrEMP.METER OR POLE INS. .a'i6.6f1 Q ASMOTORS SEE FEE SCH. ADDREDDRESSS SERVICE CHANGE 20.0 �.00 LICENSED CONTRACTORS DECLARATION �L < v I hereby affirm that I am licensed under provisions of Chapter 9 - P ISSUANCE DATE y Z w Icontmencm with Section 7000)of Division 3 of the Business and ¢ A g BLDG.- ELECT. PLG. MECH. F. o z Prolessions Code y license is in full lure e( ` ❑ o i=o icense lass Lic.Nwnber 1® ❑ H w ale Comructor - CUD s¢ PERMIT m¢¢ OWNER-BUILDER DECLARATION BUIL IRT c d v MATION w ; w w I hereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD Fw0J Law for the following reason(Sec.7031.5,Businessand Professions PERMIT ISSUANCE lO.OQ a.'� VALUATION SIFT. Cade'.Any city or county which requires a permit to construct,alter, re aa Q 0 Improve,demolish,Or repair any structure,prior to its Issuance,also ELEC.CONTR. LIC.NO. ELEC. wI]o requires the applicant for such permit to file a signed statement that TOTAL d��- PERMIT TO $ he is licensed pursuant to the provisions of the Contractor's License FY¢ Law(Chapter 9(commencing with Section 7000)ofDivision 3 ofthe Business and Professions Code)or that Ile is exempt therefrom and DTV. PLUMBING PERMIT FEE ¢ H$ the basis for the alleged exemption.Any violatimt of Section 7031.5 STORI S TYPE CONSTR. n3 _ by any applicant for a permitsubjects the applicant to a civil penalty ALTER-DRAIN IEA.) 5.00 of not more than five hundred dollars($500).): , ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT.DEV ICE 4.00 OCC.GROUP REB.UNITS their sole compensation,will do the work,and the stmelure 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-OPimProves thereon,and who does such work F IXTUR ES-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.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 200 BUILDING builder will have the burden of proving that he did not build or im- . USE RES IND eNG PB Other prove for purpose of sale.). INDUSTRIALWASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with E] [:] E] ❑, ❑ 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 builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.)_ 1,00 contracts for such projects with a contractor(s)licensed pursuant to SEWER-SAN V-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO, PARCEL NO. Cl I am exempt under Sec. ,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. •WORKF.RS'COMPF.NSA'I'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate ofconsenl to self-insure. ZONING or a certificate of Workers'Compensetio Insurance,or a cUtificd ENG.SITE NO. SYS copy therep(J-y5 cJJb00o 6/lyCj��U Policy NoS/T//d_J�I(C nearly 0 ❑ Cer r rad Copy is hereby fumisbed. FIRE SPRINK ENERGY T24 Z Z ❑ Certified c filed with•the city inspection division. O MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ Applicant V N V N CC CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. LU > COMPENSATION INSURANCE . . PLG.CONTR. LIC.NO. PLG, 0.Z (' This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y[:] N[_] hundred dollars IS 100)or less.) U O I certify that in the performance of the work for which this per. DTV. MECHANICAL PERMIT FEE FEE SUMMARY LL F- mil is issued,I shall not employ any person in any manner so as to Ow become subject to the Workers Compensation Laws of California. BUILDING d Date Applicant ALTER OR ADD TO MECH. 5.00 }` w NOTICE TO APPLICANT: If,after making this Certificate of lix'- Ir Z emption,you should become subject to the Workers'Compensatiors APPLIANCE 5.00 PLAN CHECK Provisions of the Labor Code, you must forthwith comply with FEE .0 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY- AIR HANDLING UNIT(OVER 10PWC.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency I'or EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work 1'or which this permit is issued(See. MICROFILM 3097,Civ.C.).- HEATING UNIT(TO 100,000 B.T.U.) B.00 -1 Lender's Name - HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC ptpZ00 Lender's Address I certify that 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-COMP(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 BTUI 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. Cupertino against liabilities,judgments, casts and expenses which CONST.TAX may in any way acerae against soil City in consequence of the PERMIT ISSUANCE 10.00 ranting Of ermlt. MECH.CONT. LIC.NO, MECH.' TOTAL i TOTAL Signature of Applicant/Contractor ✓ Dale V OFFICE COPY