The URL can be used to link to this page

16677 POST THIS CARD NEAR,FRONT OF•BLIILDING PERMIT NUMBER CITY OF CUPERTINO 166.77 INSPECTION DIVISION ` JOB INSPECTION RECORD ' } '/ PERMIT EXPIRATION - ' JOB ADDRESS- N ��C-� / hlo L-wf UNIT# '_LOT# PERMIT EXPIRES IF WORK.", OWNER L CONTRACTOR , �/6-1/ lT IS NOT STARTED WITHIN INSPECTION DATE I INSPECTOR INS ECTION RECOREY 180 DAYS OF PERMITISSU ' FOUNDATION - ANCE OR 180 DAYS FROM NOTE: - LASTCALLED INSPECTION. : UFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VAI.IDAI ION F CUPERTINO STANDARDS. :{ GARAGE SLABS POUR NO CONCRETE UNTIL A86VE HAS BEEN SIGNED •...' UNDERGROUND /SLAB " t PLUMBING ELECTRICAL ISSUANCE DATA MECHANICAL _ BLDG ELECT cLc. MEC. ❑ ❑ ❑ ❑ 1 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNEDpBUILDING PERMIT p INFORMATION WOOD FLOOR n VALUATION SIFT. PLUMBING, ; MECHANICAL - - ' ELECTRICALPERMIT To FRAMING INSULATION - STORIES TvPE CONSTR, OCC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED o s ROOF - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa Fr.ELooRnRFA TOTAL ACREAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID ROOF SHEATHING RFS IND ILDCON USEPB, Onr APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ nssessORS PARCE I-NG. ROUGH SAN.# PLUMBING, ELECT.ENERGY TUBS B SHOWER PAN PLUMBING ENERGY r.ncT No. PARCEL No MECHANICAL - MECR ENERGY - ELECTRICAL BUILDING ENERGY ACC.DATE Acc.FILE No FRAMING ELECT.FINAL TEST ZONING ENG.slrE No. INSULATION - PLUMBING GAS TEST'I/ - GAS MECHANICAL FIRESPRINK ENERGYT.24 COVER UNTIL ABOVE HAS BEEN SIGNED HEATING , - y E] IN y ❑ NEI UQ . EXTERIORS EAR I - ELECTRICAL RELEASE - FLOOD]ONE A.L INTERIOR SHEAR FIRE DEPT. .y NO y L7 NE], SHEETROCK GRADE _ FEE SUMMARY • EXTERIOR LATH BUILDING .INTERIOR LATH TEMPORARY APPROVAL BUILDING S SCRATCH COAT _ ELECTRIC - PLAN CHECK - GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE ' ' OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM UJI ARRANGE FOR INSPECTION.BY PHONING 252-4505, ELECTRIC , cps • ' ONE WORKING DAY BEFORE REQUIRED, INSPECTION. Lf' PLUMBING o� PLEASE GIVE JOB ADDRESS WHEN PHONING. z' — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST. rnx PLEASE READ REVERSE SIDE BEFORE TOTAL . CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDING PROJECT IDENTIFICATION � PERMITNUMBER �DiNG APPLICATION & PERMIT 16677,AI7 RESa ,L nn ' /� BUILDING—ELECTRICAL—PLUMBING—MECHANICAL ' s wNER'S PLAN CHECK VALIDATION NA7V6rS f J/ OTY. ELECTRIC PERMIT FEE CONT (JJrr"1.L� PRONE NAME ACTORS NAME � 1 _ UTLETS-SWITCHES-RECEP -10.00/1.00 S N C ��CNo LIGHTING FIXTURES 10.00L1.00 .oerRAcro s AN /g1CHr PPLIANCES-RESIDENTIAL 4.00 ADDRESS rr, 1 •,E' _ S ¢/v WA PHO PANELS 10.00 DATE OF APPLICATION a ogcXT CT PANELS (OVER 200 AMP). 20,00 -PLAN CHECK FEE .C,NO. ENGINEER LIC.No. SIGNS TRANS. - Y.O@ e�-- ARC OR ENG. 500 PERMIT VALIDATION AODREss SPECIAL CIRCUIT zIP EMP.METER OR POLE INS. 20.00 r ' ADDRESS Ts /DZL „Sq m� �`' MOTORS SEE FEE SCH. SERVICE CHANGE - 20.00 p wo o LICENSED CONTRACTORS DECLARATION /O a-([ ¢u U I hereby affirm that I am licensed under provisions of Chapter 9 \ ANCE DATE I' H ¢vdi (commencing with Section 7000)of Division 3 of the Business and LB ELECT. PLG' MECH. r y z Professions Co de nd myrase is in full force and if - `❑ ❑ ❑. z D w— License Class = Lic.Rumber 9 m L w Date Contractor al y 2 BUILDING PERMIT ¢ M wu OWNEWBUILDER DECLARATION INFORMATION woe N I hereby affirm that I am exempt from the Contractors License REFER TO ORD o¢ Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE _ VALUATION $/FT. f > J Code:Any City or county which requires a permit to construct,alter, '4b--� - Sis ¢0 improve,demolish,or repair any structure,prior 10 its issuance,also ELEC.CDNTR, LIC.NO. ELEC. n w0 u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO m w he is licensed pursuant to the provisions of the Contractor's License 9 ri > Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe a ¢ Business and Professions Code)or tl,3l he is exempt therefrom and QTY. PLUMBING PERMIT FEE at=$ the basis for the alleged exemption.An g p Any violation of Seclian 7031.$ STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to a civil penally ALTER-DRAIN IEA) 500 of not mo . . re than five hundred dollars(5500).): - 0 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 SAGE himself or through his own employees,provided that such improve. meats are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or no- RES IND CON' PB Omer P 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 builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractors)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. Cl I am exempt under Sea.—,R&P.C.for this WATER HEATER W/VENT 6.00 '.. Eason Owner Date WATER SYSTEM 5,00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EOUIP. 5.00 I hereby affirm that 1 have a certificate of consent to self-insure, ZONING or a certificate of Workers'Compensation Insurance,or a certified ENG.SITE NO. - copy thereof(Sec.3800,Lab.C.k Policy No. Company - ``Q❑' Cert ified copy i'heroby furnished. FIRE SPRINK ENERGY T-24 Z p App c lif d cop e, wi0 J city i vection division. MISC.- REFER TO ORD. v ❑ N❑ Y ❑ No F y PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.c. UJ CERTIFICATE. EXEMPTION PROM WORKERS'COMPPENSATION INSURANCE PLG.CONTR. LIC.No. PLG. TOTAL I V N V N 1 O (This section need not:be completed if the permit is for otic ❑ ❑ ❑ ❑ 2 hundred dollars IS 100)or less.) U O 1 certify that in the performance Df the work for which this per. OTY MECHANICAL PERMIT FEE FEE SUMMARY LL f mit is issued,1 shall not employ any person in any manner so as to V become subject to the Workers'Compensation Laws of California. w Dam Al+plieentALTER OR ADD TO MECH. 5.00 BUILDING 15 21 } 0 NOTICE TO APPLICANT: If,after making this Certificate of Ex. _ F ? emption,you should become subject to the Workeri Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE (� such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10,OODC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE S t7 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 7097,Ch,C.). \ HEATING UNIT-(70100,000 B.T.U.) 8.00 Lender's Name A 19 0`7� ELECTRIC HEATI NG UNIT(OV ER 100,000 B.T.U.)9.50 Lender's Add re�� I certify that I have read this application and stale 11,31 the above VENTILATION FAN (SINGLE) 4,00 inl'oonation is correct. I agree to comply with all city and county PLUMBING r ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000BTUISEE FEESCH. MECHANICAL above-mentioned property for inspection purposes. - (We) agree 10 save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino aga&Iitieg,,,.dg,..ntS costs and expenses which CONST.TAX may in nst said ity in consequence of the PERMIT ISSUANCE 10.00 roof 'oft ' MECH.CONT. LIC.NO. MECH. TOTAL TOTAL `J 9 S nature of pplica / ontractor Date 1: OFFICE COPY