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16942
POST THIS CARD NEAR FRONT OF BUILDING ' PERMIT NUMBER CITY OF CUPERTINO. 16942 INSPECTION DIVISION JOB INSPECTION RECORD/ 7 L� PERMI T EXPIRATION `,E/' JOB ADDRESS' l /" y' eo 44! I UNIT# - _LOT*f - �{ PERMIT EXPIRES IF WORK OWNER �. �2,♦ " CONTRACTOR 1^ �.•� �l a IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU FOUNDATION - - - ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANSANDCITY OF PERMIT V AI,jDATION++ PR EGUNITE - CUPERTINO STANDAR( AID - t GARAGE SLABS f_ IDI'''F''dd''AAOO ` POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB " CrCT 1$89 PLUMBING ^- ELECTRICAL GIfV of SeII'�$Ciln'� /� r ANCE DATE MECHANICAL' . �Dc ELEC r.I PLG. DECO ;I DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED Rua DING PERMIT INFORMATION WOOD FLOOR VALUATION ' S/ET. PLUMBING MECHANICAL - ELECTRICAL - PERMIT TO FRAMING W c� INSULATION STORIES TYPE CONSTH, OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SU FT-FLOOH AREA TOTALnCHEAGE . • _ ROOF - NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM;, THE CONSTRUCTION TAX IS PAID BUILDING USE ROOF SHEATHING - ' HES IND . 'CON PB am., APPLY NO ROOFING UNTIL ABOVE HAS BEEN,SIGNED FINALS DATE INSP. E3 � nsSEssoHS PARCEL NO ROUGH SAN.# PLUMBING ELECT.ENERGY TRACT NO PARCEL NO TUBS&SHOWER PAN .PLUMBING ENERGY ! MECHANICAL � MECH.ENERGY ELECTRICALACC.DATE -.qcc FILE NO BUILDING ENERGY FRAMING ELECT.FINAL TEST zoNmG ENG,slrE No INSULATION PLUMBING " GAS TEST - GAB ' FIRE SPRINK ENERGY T-40 MECHANICAL Y E] NE] - Y E] ,; NO COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR SHEAR - ELECTRICAL RELEASE FLOOD ZONEA.Luc. INTERIOR.SHEAR FIRE DEPT. Y ❑ N[] V ❑ No SHEETROCK GRADE - FEE SUMMARY EXTERIOR LATH 11JUILUINU .INTERIOR LATH TEMPORARY APPROVALS BUILDING SCRATCH COAT ELECTRIC . PLAN CHECK' I GAS -3 FEE ' '� NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNEO OCCUPANCY SEISMIC FEE ' OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. . MICROFILM ARRANGE FOR-INSPECTION BY PHONING 252-4505, ELECTRIC `I ONE WORKING DAY BEFORE REQUIRED-INSPECTION. PLUMeiNc. O - PLEASE GIVE JOB ADDRESS WHEN PHONING. Z , — SEE PERMIT FOR EXPIRATION DMECHAN ATE —. t, IMPORTANT! CONST.rnx 16AL PLEASE READ REVERSE SIDE BEFORE CALLING.FOR FINAL INSPECTION. TOTAL 6 .toU, OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY !/ PERMIT NUMBER BUILDING PROJECT IDENTIFI ATIQN APPLICATION & PERMIT 9UILDING ��zA ° 16942.. a00RE55 JOIZ N. 011F6 /CC) It BUILDING-ELECTRICAL-PLUMBING-MECHANICAL OWNER'S - PLAN CHECK VALIDATION NAME c �/J•` QTY. ELECTRIC PERMIT FEE . EQ..7 rNONe T(1'l X710 CONTRACTOR'S NaMEY�� M 1$ UTLETS-SWITCHES-RECEP 10.00/1.00 L W/ ��L 2633 LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S - APPLIANCES-RESIDENTIAL 4.00 AOOR //�� N. NE , W PANELS 10.0D DATE OF APPLICATION ORRC ITECT PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P,C.NO. ENGINEER LIC,No. SIGNS TRANS. 3.00 ADDRESS ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION ZIP TEMP.METER OR POLE INS. 20.00 L1 NTDhlUCG� ADDRESS MOTORS SEE FEE SCH. I'�F ADDRESS SERVICE CHANGE PAUn 20.00 rT 19$9 U •,) Ho o LICENSED CONTRACTORS DECLARATION a U U 1 IT affirm tial I am licenser)under provisions of Chapter 9 r.T (ty - ANCE DATE as a d (commencing with Section 7000)of Division 3 of the Business and B ECT. PLG. MECH. I-y i Professions Cod- and m tic;�s a is in full fort a t. z 0 T o Liven e Clas�J _ _L .Nnnlbe` City of C loertinn ❑ ❑ Date Contractor I y f J - /y/ETp BUILDING PERMIT w o OWNER BUILDER DECLARATION INFORMATION Xoe H I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD Y p VALUATION S/FT. FLLo J Law for the following mason.(Sec.703 1.5,Businessand Professions PERMIT ISSUANCE 10.00 Code:Any city or county which requires a permit to constant,alter, ic ¢ improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC. -O u requires the applicant for such permit to file a signed imminent that TOTAL PERMIT TO wm he is licensed pursuant to the provisions of the Contractor's License tzi Law(Chapter 9(commencing with Section 7000)of Division 3 of the /I, 1 Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE N ICA 1/ G 1- � the balls for the alleged exemption.Any viola)ion nl'SOclion 7031.5 STORIES TYPE CONSTR. 03 _ by any applicant for a permit Subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not more tion five hundred dollars(3500).): ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCG 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 ACREAGE • himselfornot hrough ownemployees.For Sale.If,however,the improve GAS-EA.SYSTEM-1 6.00 mems arc not intended or offered for sale.If,ed that s the building 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 im- provefor purpose ofsale.). RES IND CON PB Other ❑ I,as owner of the properly,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 ❑ ❑ ❑ El iJa licensed contractors to construct the project(Sec 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code'.'I'lie Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OV ER 5(EA.) 1,00 contracts for such projects with a comractous)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 - the Commeun s License Law. TRACT NO. PARCEL NO. ❑ I am exempt under See. ,BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.00 ACC.OATE ACC.FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm)hal I have a certificate of amsem to self-insure, - ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy firmi��gG.- 0,Lab.CJ.,4,r Policy N�7L�[11 .nmpony J, aF1C_ 0 0 Cer PiedAA4 e, copy is hereby furnished. FIRE SPRINK ENERGYT24 . Z Z �[ Cer1'fi-d copy i' filed with the cil!- ection division. MISC.- REFER TO ORD. (] Agicant- - V N V N CC LO CL C'1'IFICATE )I'EXEMPI'I N FROM WORKkiRS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. LU >_ COMP(?NSATION INSURANCE PLG.CONTE. LIC.NO. PLG, 1 D fThis section need not be completed if the permit is for one TOTAL Y❑ NY ❑ NC:] Z hundred dollars(510010.less I U 0 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT FEE FEE SUMMARY IL F ndt is issued,I shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. a Date Applicant ALTER OR ADD TO MECH. -6." d0 BUILDING >_ N NOTICE TO APPLICANT: If,after making this Certificate 0f Ex- � ? 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 CJ such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10000 C.F.M.) •4.90 TE40 CON51'RUCI'ION LENDING AGENCY AIR HANDLING UNIT(OVER IO,000CF.M.16.00 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. HEATING UNIT(TO 100,000 B.T.U.) F MICROFILM 3097,Cur CA 66 �- ' Lender's NameHEATING UNIT(OV ER 100,000 B.T.U.)9.50 - ELECTRIC Lender i Address 1 certify that I have read thisapplication and state,that the above VENTILATION FAN (SINGLE) 4180 information n estate). I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING indurates and stale laws relating to building l city and co and I_q hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL WJ� above-mentioned properly for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upenino against liabilities,judgments, costs and expenses which - CONST.TAX nay in any way accrue against said City in consequence of the PERMIT ISSUANCE •4'8:88 mn1AN of this Per t1. MECH.CONT. LIC.NO. MECH. pTAL, 3 1 D TOTAL �e gnature of pplican/ Ontracto ate 7f1�1+ Y//_ �V OFFICE COPY ELECTRIC SERVICE NOTICE OFFICE COPY ! BUILDING INSPECTOR'S NOTICE CITY OF CUPERTINO yJ 19 I To I I You are hereby authorized to Connect electrical service for ' 'Owner or Tenant // �� Y./L :'f1 J At /rte/ �i /� 79 I, No.of Wires Size of Wires Size of Switch Motor Load Voltage Phase Heating Load K.W. Voltage ` ,. No.of Meters Ughi 110New Service X Reconnect Heat 170ihree Wire More Service i' No.of Add.Meters Power ,�/1 Three Phase Move Meter • ©� ELECTRICAL INSPECTOR / /L: