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16396 'POST THIS CARD'NEAR FRONT OF BUILDING' PER IT NUMBER CITY OF CUPERTINO 16396 INSPECTION_DIVISION JOB INSPECTION RECORD + ' + , ` • rp t¢�J�'7 - � n PERMIT EXPIRATION ,. .` JOB ADDRESS {0I�l A A/ Uw WOL-FC /\A .. _ k 1 NIT# _LOT# .PERMIT EXPIRES IF�WORK ' OWNER ,e�S ,coNrRAcroR IS'' NOT STARTED WITHIN'. I SPECTION DATE I INSPECTOR INSPECTION RECORD 'r leo DAYS OF P_ERMIT;I'SSU- a FOUNDATION . - b - - '•, ,• ANCE,OR 180'DAYS FROM .NOTE: ' LAST CALLED INSPECTION:: UFER - ` '.ALL GRADING AND DRAINAGE SHALL BE INSTALLED k PREGUNITE - - TO COMPLY WITH THE APPROVED PLANS AND CITrOF PERMIT VALIDATION `. CUPERTINO STANDARDS. 'I I, GARAGE SLABS - - ,ter - POUR NO CONCRETE UNTIL ABOVE HAS BEEMSIGNEO . UNDERGROUND /SLAB ` PLUMBING ELECTRICAL - e I i t "" . - ` IISSUANCE DATE f MECHANICAL` ` p SLDa • ,ELECT PLG MECR. 00 NOT POOR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR INFORMATION n PLUMBING. _ A4y D .vnwnnoN. SiFr. MECHANICALA P�@ " "' \n�; - •. ELECTRICAL - � � -- . 0 � g ;PERMIT,ro, FRAMING' INSULATION - STORIES TYPE CONSTR. i - _ - OCC,GHOUP RES.UNITS I - . PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO.FT;'FLOOR DHEA TOTAL ACHEAGE I ROOF , NOTE:NO FINAL INSP.SHALL BE MADE BEFORE - + DIAPHRAGM THE.CONSTRUCTION TAXIS PAID aWILDING USE E _ ' ROOF SHEATHING - - RES IND CON PB - ti APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE, INSP: ❑3 � ❑ El ❑ S .. - '- B.....TB PARCEL NO. ? ROUGH SAN.a`'.. . PLUMBING ELECT.ENERGY - ! TRACT NO PARCEL NO ,. - TUBS&'SHOWER PAN - -.PLUMBING ENERGY,,. , • MECHANICAL - MECH'ENERGY_ ' , ELECTRICAL-., - BUILDING ENERGY : .ACC.DATE • - 'ACE FILE NO. . FRAMING ELECT.FINAL-TEST'; 'ZONING ENG.SITE NO INSULATION' . ,• PLUMBING GAS TEST - GAS - !FIRE SPRINK -, ENERGY T 74 - ' MECHANICAL COVER NO WORK UNTIL-ABOVE HAS BEEN SIGNED HEATING - Y EXTERIOR SHEAR ELECTRICAL RELEASE .} FLOODZONE ,; - A L U,c.. - .INTERIOR SHEAR - FIRE DEPT,' _ ], Y 0 "'N❑ Y.❑ N❑ SHEETROCK, GRADE " FEESUMMARY EXTERIOR LATH' 4`.., - - BUILDING , INTERIOR LATH ,, „ • TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC - • PLAN CHECK .. GAS- NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY.• 'sEISMIc FEES OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDINGFINAL ISSIGNED�BY BUILDING INSPECTOR( :MICROFILM. ARRANGE-FOR INSPECTION BY•'PHON�ING 252-4505, ` 4? ELECTRIC .'•• ~ � ONE WORKING DAY,BEFORE REQUIRED INSPECTION ' 0 PLEASE GIVE'JOB ADDRESS WHEN PH,ONI'NG ` PLUMBING ± OU; • z 'SEE PERMIT FOR EXPIRATION DATE ~" t MECHANICAL' •CONSTJTAX IMPORTANT!�,' '. PLEASE READ:REVERSE SIDE BEFORE A� f, `:TOTAL CALLING FOR FINALINSPECTION. OFFICE COPY' yIF r — APPLICANT TO FALL IN INFORMATION WITHIN RED LINES — USE BALL POINT PEN ONLY UILDINGPRO.IECT IDENTIFICATION -PERMIT NUMBER Sun WIN APPLICATION & PERMIT 1 C - a00RE55 1639 0 UILDING - ELECTRICAL-PLUMBING -MECHANICAL OWN R' PLAN CHECK VALIDATION OTV. ELECTRIC PERMIT FEE C NTRgCTOR'S hi(i1C. l.Gfi - ^ME � OUTLETS-SWITCHES-RECEP 10.00/1.00 ' UC:NO. LIGHTING FIXTURES 10.00/1.00 , CONTRACTOR'S - ADORE � APPLIANCES-RESIDENTIAL 4,00 . } af-Alj� PHONE —ri(�� PANELS 10.00 DATE OF APPLICATION ARCHITECT PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP) 20.00 ENGINEER - „ LIC.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. ADDRESS SPECIAL CIRCUIT 5.00 PERMIT VALIDATION zlv TEMP.METER OR POLE INS. 20.00 i 1/� ' APPLICANT'S i ADDRESS MOTORS SEE FEE SCH. L.itAKJ SERVICE CHANGE 20.00 - O o 1 LICENSED CONTRACTORS D17CLARATION 57 . - a u. 1 hereby affirm that 1 am licensed under provisions of Chapter 9 - w< y ISSUANCE GATE(commencing with Section 7000)of Division 3 of Ilse Business and BLDG. ELECT, PLG. MECH. r w i Professions C c, license is in fu z O m- Licer ass Cm Numb ❑ ❑ w w Dale Contracm w a - OWNER-BUILDER DECLARATION BUILDING PER IT X ;a y I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD INFORMATION or u O as Law for the following reason.(Sec.7031.5,Businessand Professions VALUATION Code:Any city or county which requiresa permit to construct,alter, PERMIT ISSUANCE- 10.00 - I[ a o O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE, LIC.N0. ELEC. M requires the applicant for such permit to file a signet statement that TOTAL PERMIT TO n w he is licensed pursuanten the provisions of the )ofDivmr's License r i the 4 Law(Chapterand Professions nCodecing )or Section is exempt the of o and FEE f 4 C Business and Professions Code)or That he is exempt therefrom and DTV. PLUMBING PERMIT the hosts for the alleged exemption.Any applicant of Section malty S S STORIES TYPE LONSTR.• by any applicant fora permit subjects the applicant to a civil penalty '4 of not more than fivehundreddollars(myem): ALTER-DRAIN& VENT-WATER IEA. ❑ I,as owner of the properly,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.0 their sole compensation,Will do the work,and the structure is onl OCC.GROUP RES.UNITS intended or•offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON 6 (�� 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 1 5.00 S0.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. ments are not intended Or offered forsale.If,however,the building GAS-EA.SVSTEM-11NC.4OUTLETS III or improvement is Said 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 not build or am BUILDING USE prove for purpose of sale). INDUSTRIAL WASTE INTER30.00 RFS IND 'CON P9 01 bar . ❑ 1,as owner of the property,am exclusively contracting with �' licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC 5 6.00 ASSESSORS PARCEL NO. , and Professions Code:The Contractor's License Law does not apply V.S. 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 contractorfs)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.2001t/1 0.00 TRACT NO. PARCEL NO. Cltum exempt under Sec..,B.&P.C.for this WATER HEATER WVENT 6LEer ;Z— Owner Owner Date WATER SYSTEM5.00 ACC.OATE ACG FI LE NO. WORKfiRS'COMPENSATION IJIiCLARATION WATER TREATING EQUIP. 5.00 L ' I hereby affirm that I have a certificate ofconsem to self-insure, or a certificate of Workers Compensation Insurance,or a certified ZONING, ENG.SITE NO. copy Policy er Company-T_I Y`n(D� Z ❑ CetlifjaAa' s t by furnished. FIRESPRINK ENERGY T]4 Z Z pplic. tl f / Is ltd ith the city inspection Division. F p ApplicapY' •�i'�v Misc.- REFER TO ORD. y D N[D r 0 N[] DCN C17RTIFICATE 01'EXEMPTION FROM WORKERS' PERMIT ISSUANCE FLOOD 20NE a.L.u.C. W COMPENSATION INSURANCE G.CONTji. ��j PLG. QQ CL Cl (This Section 5100) r ., completed if the permit is for one - 2� TOTAL (J Y❑ NEI V N� CL Cl hundred dollars(need nrleIbe U O I certify that in the performance of the work for which this per QTY. MECHANICAL PERMIT FEE FEE SUMMARY t Ll 1- 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. y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING . } Z NOTICE TO APPLICANT: If,after making this Certificate of Ew emption,you should become subject to the Workers'Compensation APPLIANCE 5,00 PLAN CHECK provisions of the Labor Code, you must.forthwith'comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT ITO 10=C.F.M.) 4.00 • CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 - (he performance of the work for which this permit is issued(Sec. MICROFILM 3097,Cie.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name Lender's Address - HEATI NG UNIT(OVER 100,000 B.T:U.19.50 ELECTRIC. I certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) 4.00 - • information is correct. 1 agree to comply with all city and county - PLUMBING ordinances and slate laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hcmby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL on herall mentio riteed Property for representative, of ion purposes. '(We) o to e, indemnify and keep harmless the City of MISC.- REFER TO ORD. upcni tial' ties,judgments, costs and expenses which CONST.TAX Y ac a against said City in consequence of the PERMIT ISSUANCE 10.00 ng t Is porn MECH.CONT. LIC.NO. MECH. TOTAL TOTAL s azure Applicant/Contractor Date- , OFFICE COPY