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17858 .POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER :CITY OF.. CUPERTINO INSPECTION DIVISION 1••785"R , "JOB ;INSPECTION RECORD q. , PERMIT EXPIRATION' �• JOBADDRESS _LOT# ` • F , r PERMIT EXPIRES IF WORK OWNER ' _ CONTRACTOR e ft1 - IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD - Teo DAYS OF PERMIT iSSU. FOUNDATIONANCE OR IBO DAYS FROM NOTE:' ') LAST CALLED INSPECTION. UFER - ALL,GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION ' CUPERTINO STANDARDS r [� ' GARAGE SLABS i - - ,� JP46 POUR NO CONCRETE UNTIL ABOVE'HAS BEEN SIGNED � UNDERGROUND /SLAB' L,f�JI �tGL' . PLUMBING !. ELECTRICAL• - •- " IssunrvcE LATE MECHANICAL - BLDG ;ELECT PLG. .MEC. ❑. ,4�J •K ' - DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED • _ BUILDING PERMIT • WOOD FLOOR INFORMATION PLUMBING ' _ _�, EVALUATION SIFT, MECHANICAL ELECTRICAL 81989 yY) Pe MIT TD - STORIES (( INSULATION of �` TYPE CONSTR, , ' .� - ` OCC;GROUP+ RES.UNITS PLACE NO,SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO,PT FLOOARTA TOTAL ACRAGE ROOF ' NOTE:NO FINAL INSP,SHALL BE MADE BEFORE , �' R E DIAPHRAGM THEAONSTRUCTION TAX IS PAID ' ROOF SHEATHING; p. USE L .es IND. CONING PB o,- APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSR- 0 �' �' �• ROUGH SAN.N I ASSESSORSPANCELNO PLUMBING- ELECT.ENERGY ' - TUBS BSHOWER PAN PLUMBING.ENERGY ' ?.ncT,No,:. PARCEL No. MECHANICAL ' MECH.ENERGY ELECTRICAL BUILDING ENERGY.: ! .ACC.DATE ACC.FILE NO FRAMING ELECT.FINAL TEST ' .,. INSULATION PLUMBING - + � � � ,,� • ' ZONING' ENG.SA`E NO. GAS TEST - • - GAS 14 - MECHANIGA FIRE SPRINK♦ ENERGY T 74 ,COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 4 .L Y "�, '`• "�. EXTERIOR SHEAR. ELECTRICAL FLooD zorvE., aL u.c:INTERIOR SHEAR. FIRE DEPT,. - vL N❑ .vL ivl SHEETROCK GRADE FEESUMMARY EXTERIOR LATH BUILDING . INTERIOR LATH TEMPORARY.APPROVALS, BUILDING SCRATCH COAT ELECTRIC - PLAN CHECK . GAS . 'FEE. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY e SEISMIC FEE = OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED'BY BUILDING INSPECTOR( MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING'DAY BEFORE REQUIRED INSPECTION. ''' PLUMBING ' L, 6 �. 0�.. -c.,PLEASE GIVE JOB ADDRESS WHEN PHONING., Z MECHANICAL-.. .SEE PERMIT FOR EXPIRATION DATE — IMPORTANT! 7 CONST.TAX PLEASE READ REVERSE SIDE BEFORE' CALLING,FOR FINAL INSPECTION. I ' 'TOTAL OFFICE COPY APP6ICANS'TO FILL IN`INFORMATION'WITHIN RED LINES USE BALLPOINT PEN ONLY, " �BUI LDING PROJECT 16ENTI FICAT16N I - r PERMIT NUMBER .; BUR-OHNO C ,ppm APPLICATION'& PERMIT' - ' ' '� 1.7858 ADDRESS ,.�.'' ,. BUILDING—ELECTRICAL—'PLUMBING-MECHANICAL . +: ,fi y OWNER'S. , . PLAN CHECK VALIDATION NAME ' QTY. 'aELECTRIC PERMIT FEE - -a r ."PHONE f. . r�' .. ' •� DONTRAcrORs .OUTLETS-SWITCHES=RECEP ,10.00/1.00 NAME (�JQ ., uc.rvo. ,, LIGHTING,FIXTURES ` 10.00/1.00 CONTRACTOR'S APPLIANCES-RESIDENTIAL 4.00 ADDRESS - .PRONE _ PANELS 10.00 ' DATE OF APPLICATION .` ARCHITECT - - PLAN CHECK FEE P.C.NO. OR - .II. !1�1 - - PANELS (OVER 200 AMP) ' 20.00 r ENGINEER eUm 2A432 I SIGNS TRANS. 3.00 No ARCH.OR ENG. • , •. SPECIAL CIRCUIT'-- S.DD PERMIT VALIDATION , ADDRESS .M SIFeAJ ' `zlr+ / TEMP.METER OR POLE INS. 20.00 S (� `a Irl 9 APPLICRORTs 31 1�2A(.J4L '! MOTORS' SEE FEE SCH. ADDRESS, S �.' . ."5. .�. F / °x :4 - SERVICE CHANGE 20.00 F`00 LICENSED CONTRACTORS DECLARATION ' a uI hereby affirm Oaet'I am licensed under provisions of Chapter 9 1 - - ISSUANCE DATE ' .+ <w (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT, PLG. MECH. Professions Code and my license is in full for and effect. '❑ ❑ o,z 'o ' License Cass Cr3P-43-R Lic,-Number Q601$ _ m w Date Contractor Q w¢. OWNER-BUILDER DECLARATION BUILDING PERMIT ac A" MISC.— EFER TO ORD' INFORMATION X g_a y I hereby affirm that 1 am exempt from the Contractor's License - VALUATION $/FT. H LL O J), Law for the following reason.(See_7031.5,Business and Professions - PERMIT ISSUANCE - 10.00' Code:Any city or county which requires permit to construct,alter,2 Q'¢ C improve,demolish,or repair any MRLCURe,prior to its issuance,also ELEC.CONTR. LIC.NO. V ELEC. i n O,I[ requires the applicant for such permit to file a signed statCment that - _ TOTAL-` PE MIT TO wu om. he is licensed pursuant to the provisions of the )ofDiehu's License ' E z i Busi(Chapterand Professions Code)or Section is exempt ion o of the Business for Professions empt or that he is exemptclo therefrom and DTV. PLUMBING PERMIT FEE Q F o the basis for[he alleged exemption.Any violation t to actiUn malty STORIES TYPE CONSTR. n ;m by any applicant fora permit subjects the applicant toacivil penalty ' ALTER-DRAIN -WATER (EA.) 5.00 ' of not more than five hundred dollars($5000: - ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUPRES.UNITS their sole compensation,will do the work',and the stfucuire 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 Ilan owner of property who builds or improvesthereon,and who does such work FIXTURES-PER TRAP 5,00 SD.FT.FLOOR AREA TOTAL ACREAGES himself or through his own employees,provided that such improve- ments are not Intended or offered forsale.11 however:the building GAS-EA,SYSTEM-I INC.4 OUTLETS 6.00 r or improvement is Sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.), 200 BUILDING USE builder will have the burden of proving that he did not build or OR-: . r - prove for purpose ofsaleJ. INDUSTRIAL WASTE INTER. 30.00 REB IND, CON PB omer ❑ 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 PARCELNO., 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 contractod s)licensed pursuant to the Contractor's License Law. SEWER-SAN ITAR V-STORM EA.200ft/10.00 TRACT NO., PARCEL NO. 0'I am exempt under Sec. B.&P.C.for this WATER HEATER W/VENT• 6.00 reason Owner - Date WATER SYSTEM s5,M.21 ACC.OATE ACGFILENO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 . . r I hereby affirm that I have a certificate of consent to self-insure, - - - - ZONING ENG.SITE NO. `x or a certificate of Workers'Compensation Insurance,or a certified copy Noeof(Sec. ,.9M.Y."-asci— nr•1�.«� - , 1 Poo .No. .spy,• S - ❑ 'Cerifi d � he by famished. ' � FIRE SPRINK ENERGY T2d Z ZertifI d p s RI d with city inspection division. MISC.- REFER TO ORD. ' O Alt. - Y ❑ . N❑ .Y ❑ N ~ w v- r PERMIT ISSUANCE I EQ 'I Z. FLOOD ZONE A.L.U.C. cc CER 'C E OF EXF:AIPT N FROM WORK FIRS' W 7OMPFNSATION INSURANCE ' PLG.CONTR. LIC.NO. '_G. ' d o This section need not be completed if the permit is for one N/N-EIYwI ) 27009 - TOTAL' y �J '+l •V❑ N❑ V ❑ NE] � Z hundred dollars IS 100)or less.), ' U O. I certify that in the performance 0f the work for which this per- QTVr MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner SO as to - I U become subject to the Workers Compensation Laws of California.' - BUILDING W Date ' Applicant } N' NOTICE TO APPLICANT:.If,after making this Certificate of Ex- - ALTER NC ADD TO MECH. 5.00 H ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK K' provisions of the Labor Code, you must forthwith comply with FEE U such.provisions or this Remail shall be deemed revoked, AIR HANDLING UNIT(TO 10p000.F.M.) 4800 CONSTRUCTION LENDING.AGENCY AIR HANDLING UNIT(OVER 10=C.EM.) 6.00 .SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) . 5 the'performance of the work for which this permit is issued(Sec. - HEATING UNIT(TO 100,000 B.T.U.)- B.00 MICROFILM .. 3097,Civ.C.). •Lender's Name HEATING UNIT(OVER 100,000B.T.U.19.50 ELECTRIC Lender's Address - .,' I certify that I have read this application and stele that the above VENTILATION FAN (SINGLE) 4.00 information-is correct.I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.)' 6.00 PLUMBING ordinances and state laws relating to building construction, and - - �, hereby authorize representatives:of This-city to enter, upon the BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL 5 above-mentioned property for inspection purposes. I r (We) aree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. kupertino-against liabilities,judgments;costs and expenses which 'CONST.TAX i anywayaccrueagainsLsaid City in conseyuence ofthe PERMIT ISSUANCEi of this ermilMECH.CONTf LIC.NO. MECH, TOTAL, � TOTALature of Applica t Contractor •Date O� r .. OFFICE COPY Covernno -PI ' Damn Coav BUILDING INSPECTOWS.OFFIC,E ' CITY.OF CUPERTINO , `^ Sanitary Permit No. -------- ,I l O Backflow Device . Plumbing Permit No. ------- Ze c7 Sewer Connectwn Lor No. ��!---- • [3--Plumbing Final / I Owner or Tenant I i . Tract I ;SIS -Sr y -' 19 Date Final �_s----- 19- Dote Connected C"` 1 . _f! � • r' PLUMBING INSPECTOR COPY 6 E G. E.ELECTRIC SERVICE NOTICE P. !% •� BUILDING INSPECTOR'S NOTICE 7 CITY OF CUPERTINO 19 <v 7 To - You are hereby authorized to Connect electrical service for Owner or Tenant /fvvZ p Size of W fres —Size of Switch No.of Wires___---- -- a Phase Morar Laod -- voltage age ._A �� —t-- -��� / K.W. A��/�l �,,;?--V"01 ge r Heating Load Reconnect i' ( light 110 New tree 1\ Three W More 5ery cit ' Na.of Meters Heat' IYO Power Three Phase Move Mewr No.of Add. Meters ©� ELECTRICAL INSPECTO I