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16587 I i •POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER . CITY OF CUPERTINO 16587 INSPECTION DIVISION JOB INSPECTION RECORD �© S T I PERMIT EXPIRATION JOB ADDRESS t `y t �3 F " W��e /-@I UNIT# - _LOT# 6ERMITIEXP R IF WORK h Y OWNER .Ip— CONTE CTOR CC 4 Cb V.4--t IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PR EG UNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS A. POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE BLDG ELECT PIG. MECH. MECHANICAL DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION SIFT. PLUMBING „ .{. MECHANICALcity 01 cupe0filu ELECTRICAL p —PERMIT ro FRAMING - QGT 1 �, 98 - BTORIE TVPE CONSTR. INSULATION CL Df CU orfiaQ OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED sn.Ft.FI:ooR nREA TaT AL ACBPAc[ ,• ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE \ DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING RES IND \coN PB oll�,� APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO. ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO. PARCEL NO 91 TUBS B SHOWER PAN PLUMBING ENERGY ' MECHANICAL MECH.ENERGY ACC DATE ACC.FILE NO ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST ZONING ENG SITE NO. INSULATION PLUMBING GAS TEST GAS FIRE SPgINK ENERGY T-44 MECHANICAL v ❑ NED r ❑ NC] COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE A.Luc. <TERIOR SHEAR ELECTRICAL RELEASE ITERIOR SHEAR FIRE DEPT. Y❑ Or Y N❑ 1EETROCK GRADE FEE SUMMARY :TERIOR LATH BUILDING BUILDING ",TERIOR LATH TEMPORARY APPROVALS 1RATCH COAT ELECTRIC ,'jam, PLAN CHECK FEE GAS TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE UPANCYOF BUILDING ISNOTPERMITTED UNTILBUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC �+CD ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING • PLEASE GIVE JOB ADDRESS WHEN PHONING. MECHANICAL — SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTALa'�� CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY. Or,• BUI LDI NG PROJECT I DENTI FICATION PE.-IT NUMBER EUILDING APPLICATION & PERMIT 1658.7 ADDRESS /O�,/ DDRESS t/!�a<EP� r BUILDING = ELECTRICAL-PLUMBING-MECHANICAL J OWNER'S /_� FA/7/ NO/S� PLAN CHECK VALIDATION NAME Cs-• N nS3 �/ OTY. ELECTRIC PERMIT FEE . PHOrd DDrvrRAcrons NA �q OUTLETS-SWITCHES-RECEP 10.00/1.00 _ ME /' t lc.No? 9674- LIGHTING FIXTURES 10.00/1.00 /I/ CONTRACTOR'S Tyiu tic APPLIANCES-RESIDENTIAL 4.00 ADDRESS i3ySh�veNfP/)f� NEyr%�s�1 PANELS 16.OD DATE OF APPLICATION' ARCHITECT ' PANELS (OVER 200 AMPI 20.00 PLAN LHECK FEE .C.NO. OR S ' ENGINEER - uc.No. SIGNS TRANS. 3.00 ARENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION AOGRESS ESS ' ZIP f EMP.METER OR POLE INS. 20.00 ADDRESS rs MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 0 0 o LICENSED CONTRACTORS DECLARATION' a 0 w I hereby affirm that I am licensed under provisions of Chupter 9 - ( ISSUANCE DATE " Z: (commencing with Section 7000)of Division 3 of the Business;;,ad BLDG. ELECT. PLG. 'MECH. L i Professions Code,and my license is in full force and effect GGT ! i ❑ �t El ElCn 20 o License ClassoNumber C � Q m F Date Contractor a y rc ¢ w OWNER-BUILDER UILUER DECLARATIONBUILDING PERMIT CityINFORMATION w;u vHi -I hereby affirm that I am exempt from the Contractor's License MISC.- QRD g Business and Professions VALUATION F w o j Law for the following reason. 7031.5, PERMIT ISSUANCE. 10.00 (2,00 Code:Any city Or County which requires a permit to construct,alter, pQ ¢ Improve,demolish,Or repair any structure,prior to Its Issuance,also ELEC.CONTR. LIC.NO. ELE0. - DLL requires the applicant for such permit to file u signed statement that TOTAL 22 a PERMIT TO wm he is licensed pursuant to the provisions of the Contractor's License Hii Law(Chapter 9(commenciagwilh Section 7000)ofDivisior3 ofthr _C_ 4 Business and Professions Code)or that he is exempt therefrom and CITY. PLUMBING PERMIT FEE r o the basis for the alleged exemption.Any violation of Section 7031.5 STORIE TYPE CONSTR. dam by any applicant for a permit subjects the applicant toacivil penally , ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my empluyees with wages as IBACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their role compensation,will do the work,and the structure is not intended or offered for sale(Sea 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 wino builds or int proves lhemon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve- mentsarenotintendedorofferedforsale.If,however,the budding GAS-EA.SYSTEM-l1NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner GAS-EA:SYSTEM-OVER 4 IEA.) 2.00 BUILDING USE builder will have the burden of proving that he did net build or im" RES IND . CON PB Other prove for purpose of sale.). - INDUSTRIAL WASTE INTER. 30.00 El ❑, El 1:3 El I,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 builds or improves thereon,and who LAWN SPRINKLERS-OVER 5 IEA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.2008/10.00 TRACT NO, PARCEL NO. ❑ l am exempt under Sec..,B&P.C.for this WATER HEATER W/VENT 6.00 reason Owner DateWATER Sy! STEMTING EQUIP. 5.00 ACC.DATE ACC.FILENO. WORKERS'COMPENSATION DECLARATION WATER TE 5.00 I hereby affirm that I have a certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.0.). Policy No. Company O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T-24 z Z ❑ Certified ropy is Cited with the city inspection division. - MISC.- REFER.TO ORD. Y ❑ N❑ Y ❑ N❑ FyApplicant PERMIT ISSUANCE 10.00 FLOODZONE A.L.U.C. LU ; CIi R'I'I PICCOI OF EXEMPTION PTINS FROM WORKERS' 11J _ . COMPENSATION INSURANCE the PLC.CONTR. LIC.NO. PLG. Y❑ N❑ Y❑ N❑ 1 a (This soalldn nee.) not be completed if the mumiit Is for nna TOTAL ::) Z hundred dnllmslSl00)or less.) U O I certify that in the performance of the work I'or which this per. OTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I- 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. BUILDING Date Applicant ALTER OR ADD TO MECH: 5,00 } N NOTICE 'f0 APPLICAN'P: If,after making this Certificate of Ex- 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 FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,000GF.M.) 4.00 CONSTRUCTION LENDING ACENCY AIR HANDLING UNIT(OVER 10,000C.EM.) 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(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00' Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC 2 2r 00 Lender's Address I certify that I have read this application and stale 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 I3 H.P.or t00,0008.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned properly tar inspection purposes. , (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. uperti against liabilities,judgmen00ts, costs and expenses which PERMIT ISSUANCE 10. CONST.TAX may i an way ccrue against City in consequence o tit anf his nut. hi CONT.- - LIC.NO. MECH. DD �i - TOTAL TOTAL SignalfAp­p1w.U`t`r a Date OFFICE COPY