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16134Z POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS, �`�� at UNIT# _LOTTff OWNER CONTRACTOR L� F'-IS PERMIT NUMBER 16134 r I ! PERMIT EXPIRATION PERMIT EXPIRES IF WORK NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU" ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. UFER PREGUNITE PEHrmn VALIDATION jj Ll /— (--"� ff %/" ,'�,�,�•G ISSUANCE DATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED :JAN 91989 UNDERGROUND/SLAB PLUMBING City Of CUQETfIRO ELECTRICAL MECHANICAL LDG ❑ ELECT ❑ PLG. MECR ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR W VALUATION SIFT, PLUMBING MECHANICAL ELECTRICAL - PERMIT TO - FRAMING INSULATION STORIES TYPE CONSTR " OCC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID • - 5O IT FLOOR AREA q ��//'�� Z2JV iOTALACREAGE DIAPHRAGM BUILDING USE RES IND CON PB omr, ❑ ❑ 0 ❑ ROOF SHEATHING APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSORS PARCEL NO ROUGH SAN.N PLUMBING - ELECT. ENERGY' TRncT No PAHcc I. No TUBS 8 SHOWER PAN PLUMBING ENERGY MECHANICAL MECR ENERGY ACC GATE ACC. FILIi NO ELECTRICAL BUILDING ENERGY FRAMING ELECT. FINAL TEST ZONING f:Na. SITE No. INSULATION PLUMBING ' GAS TEST GAS FIRE SPIiINK I] TV ENERGY L24 0 E:l MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ' FLOOD ZONE Y E A.I;uc 1 ❑ DO EXTERIOR SHEAR ELECTRICAL. RELEASE INTERIOR SHEAR FIRE DEPT. FEE SUMMARY SHEETROCK GRADE EXTERIOR LATH BUILDING ING � INTERIOR LATH TEMPORARY APPROVALS SCRATCH COAT ELECTRIC CHECK IC FEEOCCUPANCY F GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR.OFILMARRANGE FOR INSPECTION BY PHONING 252-4505 'J ONE WORKING DAY BEFORE REQUIRED INSPECTION. OPLEASE GIVE JOB ADDRESS WHEN PHONING. Z -SEE PERMIT FOR EXPIRATION DATE - TRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! 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 V ,, O / Zz F• O c - LU CL 0 ::)z UO LL U Ow � a � Z A ' BUILDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL .PERMITNUMRER 16134 BoILDING ADORE s n (J OWNERS " E P � srNE -os GTY. ELECTRIC PERMIT FEE LAN CHECK VALIDATION 5�p)�-�" DATE OF APPLICATION" NOMrancron's C Luc No. S��y UTLETS-SWITCHES-RECEP 10.00/1.00 LIGHTING FIXTURES 10,00/1.00 CONTRACTORS ADDRESS v g- / � PHONE OL J; APPLIANCES- RESIDENTIAL 4.00 YJANELS 10.00 ARCHITECT`w � - - A J OR ..r/s/ PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ENGINEER .i uc. No. ANRE08 SS ENa SPECIALCIRCUIT .5.00 PERMIT VALIDATION TEMP. METER OR POLE INS. 20.00 zm (/ APPLICANT ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 LICGNSI!D CON '1'RAC1'ORS DECLARATION 1 hereby at that I am licensed under provisions of Chapter 9 (Commencing with Section 7000) of Division 3 Of the Business and PfnfeSS1U115 /"OIIe, Bn y he Ilse IC III toll IorCC-1 _ lite.�/� License Clas Lic. Numbers (•� UT� ISSUANCE DATE B G. ELECT. ❑ PLG. MECH. ❑ ❑ Date_�� Contractor GO of Cupertino BUILDING PERMIT OWNER -BUILDER DECLA(TrATION ` I herchy affirm that I am exempt from the Contractor i License Law lit the following reason.(Sec. 7031.5, Busine,ssand Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant tin such permit In file a signed Statement that he is licensed pursuant to the provisions of she Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or flier he is exampt theretrom and IIIe bassfor the alleged exemption. Any violation OI Secti I17O3 LS INFORMATION MISC.- c_ REFER TO ORD VALUATION •r- i� SIFT. � PERMIT ISSUANCE 10.00 ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO 10 F_ 1 GTY. PLUMBING PERMIT FEE STORIES TYPE CONSTR. ALTER -DRAIN -WATER (EA.) 5.00 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500).1. ❑ I, as owner of the property, or my employees will, wages us their sole compensation, will do the work, and the structure Is not intended or offered for sale (Sec. 7044, Business wed Professions BACK FLOW PROTECT. DEVICE 4.00 DEC.GROUP RES, UNITS DRAINS -FLOOR, ROOF, AREA, COND. 5.00 Code: 'file 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 himself Or through his Own employees, provided that such improve- mends are not intended Or offered for sale. IL however, the building L4� GAS - EA. SYSTEM - 1 1 NC. 4 OUTLETS 6.00 or improvement is sold within one year of completion. the owner. builder wOut.,ill have the burden of proving that be did not build or im- proveOrpurposeol'snla.l� ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an Owner of property who builds or improves thereon, and will, GAS - EA. SYSTEM - OVER 4 (EA.) 2.00 BUILD NG USE REs INo CON ere oer ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 ILAWN SPRINKLERS- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with a contmetons) licensed pursuant to file Contractor's License Law. SEWER -SANITARY -STORM EA. 200tt/10.00 TRACT N0. PARCEL N0. WATER HEATER W/VENT 6.00 ❑ lam exempt lender Sec. ,Is&P.C. for this reason Owner Date WATER SYSTEM 5.00 ACC. -DATE ACC. FILE NO, WORRERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that 1 have a certificate of consent to sell -insure, or a certificate of Workers' Compensation Insurance. or a certified ZONING ENG. SITE NO. copy thereof (See. 3800. Luh.C.). No. Company_ Cerlilied copy is l crcby' nish FIRE SPRINK ENERGY TQ4 Cenified co 1-9 he � inspection division. cant_ _ FPO v N ❑ ❑ v N ❑ ❑ MISC. - REFER TO ORD. CERTIFIC 'I'I> 1° .XFI I I�ROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A. L.U.C. PLG. CONTR. LIC. NO. r PLG. TOTAL E ' SURANCE (phis section need nor he completed it the permit is for one Y ❑ IN V ❑ N ❑ OTY. MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars ($100) or less.) 1 certify that in the performance of the work for which this per- not is issued, I shall not employ any person in any manner so as to become subject to Ole Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Cerlificale of Ex- ,mpliou, you should been., subject to the Workers' Compctlswim, provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall he deemed revoked DING L�a DU ALTER OR ADD TO MECH. 5.00 APPLIANCE 5.00 N CHEC AIR HANDLING UNIT (TO 10,000CF.M.) 4.00 AIR HANDLING UNIT (OVER 10MC.E.M.) 6.00 MIC FEE [ELECTRIC a2-� CONSTRUCT ION LIENDING AGENCY EXHAUST HOOD (WITH DUCT) 5.00 OFILM I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). HEATING UNIT (TO 100,000 B.T.U.) 8.00 HEATI NG UNIT (OVER 100,000 B.T.U.)9.50 Lender, Name Lender's Address I certify that I have read this application and state that the above infornmtion is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and VENTILATION FAN (SINGLE) 4.00 PLUMBING �^ BOILER -COMP (3 H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP (Over IXLGOO BTU)SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon (he .have-1 cos property for inspection purposes, MISC. - REFER TO ORD. CONST. TAX c ogre• o save, indannit' keep llannless the City Of u nil .in liabd" gmenrs, costs and expenses which y i ay ace against said City in consequence of the PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH. TOTAL TOTAL g `7 3 'I his card. Is.g _ � k - �� reo icunl/Contractor Dare OFFICE COPY