The URL can be used to link to this page

17993 I f : POST THIS CARD NEA13 FRONT OF BUILDING - PERMIT NUMBER CITY OF CUPERTlNO 17993 INSPECTION DIVISION JOB INSPECTION RECORD IF OI�� IA 'LOT# PERMIT;EXPIRATION ' JOBADD SS - - I f �,, � � _ PERMIT EXPIRES IF WORK OWNER l-X.! rkfCONTRACTOP I IS "NOT STARTED WITHIN INSPECTION DATE INSPECTOR - INSPECTION RECORD " 1Bo'DAYS OF PERMIT ISSU- ; FOUNDATION NOTE: ANCE OR 180 DAYS FROM LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED' LASTCALLED INSPECTION. , PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY,OF'f PERMIT vnuonnoN CUPERTINO STANDARDS. �. GARAGE SLABS . POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL r I ISSUANCE DATE MECHANICAL ' - - eLUc. E c PLL. MECR o. o El DO NOT POUR-FLOOR UNTIL ABOVE HAS BEEN SIGNED - _ euILOINO PERMIT WOOD FLOOR• - - INFORMATION PLUMBING , VALUATION gfFL . UI�RO a ' MECHANICAL ELECTRICAL PERMrt ro - - FRAMING - t INSULATION , STORIES TYPE CONST'R OCC.GROUP RES)UNITS I PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - ROOF .. I .. sa IT rEooR naea Tornl.nce�nce •. NOTE:NO FINAL INSP.SHALL BE MADE_BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID.' < ROOF SHEATHING' Res INOUILDINNG USEco Pe o,n,•, . APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS' DATE INSP. ROUGH SAN.a ; ❑ ❑ ❑ ' '❑ ASSEsso RCELNO ." PLUMBING , ELECT.ENERGY _ - TUBS&SHOWER PAN PLUMBING ENERGY 'TRACT NO. PARCEL NO MECHANICAL.. MECH.ENERGY ELECTRICAL BUILDING ENERGY - Acc unrEncc.FILE No. FRAMING ELECT.FINAL TEST, INSUL'ATION.- PLUMBING ' ZONING ENS SITE No. GAS TEST GAS . MECHANICAL .FIRE SPRINK_ ENERGY T.as - COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 7 Y ❑ "❑ '❑ "❑ EXTERIOR SHEAR ELECTRICAL RELEASE E}000 ZONE A.L.u.c. INTERIOR SHEAR FIRE DEPT. Y❑. %El Y ❑ NO - SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING - : 9 911, INTERIOR LATH 'TEMPORARY APPROVALS - 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_ ARRANGE'FOR INSPECTION BY PHONING 252-4505, ELECTRIC o�ONE WORKING DAY BEFORE R,EQUIRED'INSPECTION. PLUMBING z PLEASE GIVE JOB'AD,DRESS WHEN PHONING. - SEE PERMIVFOR EXPIRATION-DATE - MECHANICAL IMPORTANT! . CONST.TAX -: PLEASE READ REVERSE SIDE BEFORE' ' CALLING FOR FINAL INSPECTION. TOTAL OFFICE COPY APPLICANT'TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY s, BUILDING PROJECT IDENTIFICATION - - PERMIT NUMBER & BUILDING / x030 APPLICATION PERMIT q (](�,3 ODRESSO/23 A' W01-FF A BUILDING -ELECTRICAL-PLUMBING-MECHANICAL yl I .7J OWNER'S PLANCHEC KVALIOATION NAME WeSI'FIEtD ' QbalG y0ft CITY. ELECTRIC PERMIT FEE , .4LLCC) JC4.S J/Civ PHONE ASYS-46D CONTRACTOR'S NAME TLETS-SWITCHES-RECEP 10.00/1.00 S6/MF_ LIC,NO. LIGHTING FIXTURES 10,00/1.00 CONTRACTORSADDRESS, PPLIANCES-RESIDENTIAL - 4.00 .owe PHONE IPANELS 10.00 GATE OF APPLICATION RcnrtscT PANELS 200 AMP) 20,00 PLAN CHECK FEE P.C.NO, O DR ENGINEER LIC.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. 5.DD PERMIT VALIDATION AOOHEss SPECIALCIRCUIT ZIP TEMP. METER OR POLE INS. 20.00 ADDRESS MOTORS SEE FEE SCH. SERVICE CHANG -P'Pda20.00 w o a LICENSED CONTRACTORS DECLARATION `Q ¢u U I hereby infirm that 1 am licensed under provisions of Chapter 9 ISSUANCE DATE w¢n (commencing with Section 7000)of Division 3 of the Business and y BLDG. ELECT. PLG. MECH. y z Professions Code,and my license is in fall force and effect O ❑ El o m- License Class Lic.Number _ L r Dale - ConlmCior - a m s BUILDING PERMIT ¢ tr w OWNER-BUILDER DECLARATION INFORMATION wO a w I hereby attirm that I am exempt from the Contractor's License MISC.- - REFER TO ORD 3 y' P VALUATION §/FT. _ F u o J Law for the following reason.(Sec.7031.5,Business and Professions PERMIT IS T66B WCode:Any city or County WhichrequiresapernittoconstruchaIter, - ¢Q 0 Improve,demolish,nr repair any structure,prior to Its ISsnanCe,also ELEC.CONTR. LIC.NO. ELEC. y w m¢ requires the applicant for such permit to file a signed statement that TOTAL e PERMIT TO he is licensed pursuant to the provisions of the Contractor's License H i ° Law(Chapter 9(commencing with Section 7000)of Division 3 ofilm a Business and Professions Code)or that he is exempt therefrom and M r$ the basis for the alleged exemption.Any violation of Section 7031.5 DTV. PLUMBING PERMIT FEE STORIES TYPE CONSTR. n ; _ by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 .four more than five hundred dollurs(8500).): �1,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS. their sale compensation,will do the work,anti the structure is no[ 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 themon,and who does such work FIXTURES-PER TRAP 5.00 SD.FL FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsarenotintendedoroffere)for sale.If,however,the building GAS-EA.SYSTEM-11 NC.4 OUTLETS 6.00 or improvement'is sold within one year of completion, . .) 2.00 BUILDING USE the owner- GAS-EASYSTEM-OVER 4 IEA builder will have the burden of proving that he did not build or im- RES IND CON PB Omer prove for purpose of sale.). I N D USTR I AL W ASTE INTER. 30.00 Cl 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(See.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 contractorts)licensed pursuant to the Contractor's License Law. �/ SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ tato oxempt under Sec. �u l .BAP.C.for this WATER HEATER W/VENT 6.00 reason Owner w Date - WATER SYSTEM 5.00 'ACC.DATE ACC.FILE NO. WORKERS'COMPENSA'IION DECLARATION WATER TREATING EQUIP. 5.00 - I hereby affirm that 1 have a certificate of consent to self-insure, ZONING ENG.SITE NO. m a certificate of Workers'Compensation Insurance,or a certified copy thercof(Sec.3800,LbC.). Policy No. Company Q ❑ Cetlified copy is llCreby furnlsheJ. FIRE SPRINK ENERGY T 24 Z Z ❑ Certified copy is filed with the city•inspection division. MISC.- REFER TO ORD. O Applicant V ❑ N❑ V ❑ N❑ � N CER'I]FICATEOF EXEMPTION FROM WORKERS, PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U,C. LLI > COMPENSATION INSURANCE PLG.CONTR. - LIC.NO. PLG. 1 0 (This section need not be completed if Ilse permit is I'or one TOTAL - V❑ N❑ V [3 N❑ Z hundred dollars(S100)orle..) U O I certify that in the performance of the work for which this per- CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL P mit is issued,1 shall not employ any person in any manner so as to U become subject to the Workers'Compensation Laws of California. Go Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING NOTICI7 TO APPLICANT: If,after making this Certificate of Ex- FZ emptim,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 10MOC.F.M.) 4.00 CONSTRUCTION L17NDING AGENCY AIRHANDLING UNIT(OVER IO,OWC.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. HEATING UNIT(TO 100,000 B.T.U.1 8.00 MICROFILM 3097,is Nall. Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 ELECTRIC Lenders Address - I certify that I have read this application and statethus the above VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and county PLUMBING ordinances and stale laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP IOver 100,0008TUI SEE FEE SCH. MECHANICAL above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments,costs and expenses which CONST.TAX may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 ranting of this permit. MECH.CONT. LIC.NO. MECH. - e;_949 TOTAL TOTAL I Signature of Applicant/Contractor Date - OFFICE COPY • L7 J gill �j 4" rn u tli G� gg • :� _erg> _ . Y Py 5 �g. 'rr w It a Fig & yIt / •O r • • •/• • It It ItIt ON 16" It It All F� ' p • I Yr• It :yz •AvgIt It It {I \ :4ti I FSP ii I- I s I \ a�v I 't • , � " e• It$ ItIt cn It C ) '�" "iso cn It is o It ItF" It I / 70 Avg It q It It • IIS ` , I / \ m 'T' i .• 63 'F � F • S w F o • 1/ • • 6 u • 1\ Y1 a • FIt I � • • i A: It �pp_ O 1• I It It / .�`�P EIt IOJI It It \ Li It \\ \It It It h p v It \ 3\ Z l • ; It • \ h1 \\\yam _� z z \ \ \kA \ t a y m ti � T ` RI m � tieII TRI F 1�I �� •`\ ti N h � I W rj rj M T ro i i CI � r•