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12044I., POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD 7970 WOODLARK WAY JOB ADDRESS _ UNIT# LOT# OWNER STENGEL CONTRACTOR ATLAS HEATING PF RMITyl16 044 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM LASTCALLED INSPECTION. INSPECTION DATE INSPECTOR INSPECTION RECORD UFER PREGUNITE PERMIT VALIDATION (r\ r' f_ ,,;-r JJj� // r ` - / IssuarvcE Dare - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB PLUMBING ELECTRICAL MECHANICAL BLDG, ELECT. ❑ PLG ❑ MECH. ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR vnwnnoN siFT. PLUMBING ' MECHANICAL ELECTRICAL PERMIT TO _ FRAMING INSULATION STORIES TYPE CONSTR. OCC GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO I FLOOR WHEW TOTAL ACREAGE ' DIAPHRAGM a W LOI USE HES IND CONPB Other c) ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH _ ASSESSORS PARCEL NO. PLUMBING GAS TEST - THACTNO, PARCEL NO. MECHANICAL ELECTRICAL FINALS DATE INSP. ACC.OATE ACG FILE NO. FRAMING - SAN * ' INSULATION - PLUMBING ZONING ENG. SITE NO. GAS FIRE SPRINK ENERGY T 24 ° � "� MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING __ LATH—INTERIOR ELECTRICAL FLOOD zoNE Y CD No A.L.0 c. Yo No LATH—EXTERIOR FIRE DEPT. SHEETROCK - GRADE FEE SUMMARY SHEAR INTERIOR BUILDING f BUILDING SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS,. ELECTRIC PLAN CHECK FEE • AS. NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252.45051 HONE WORKING DAY BEFORE REQUIRED IMPECTION. 0� PLEASE GIVE JOB, ADDRESS WHEN PHONING. Z -SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL 'C '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 BU LDI NG PROJECT IDENTIFICATION - APPLICATION&PERMIT PERMIT NUMBER aUILGING ADDRESS UILDING -ELECTRICAL- PLUMBING -MECHANICAL 12044 OWNEP'a NAME � �/\!� `/ PHONE 6 OTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION CONTRACTOR _ ld� If LIC. NO, Iw UTLETS-SWITCHES-RECEP 10,00/1.00 LIGHTING FIXTURES 10.00/1.00 CONTRA t--r//il•1 ADDRESS RS eJ-� ala_ JAPPLIANCES -RESIDENTIAL 4.00 PANELS 10.00 AlWi PHOrvE DATE OF APPLICATION ARCHITECT OR ENGINEER LIc, No. PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.L. NO. SIGNS TRANS. 3.00 ADDRESS ervo. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION rrEMP. METER OR POLE INS. 20.00 ZIP APPucaNrsJ,�-^_ � � - ooREss-�✓V�1 MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 g E 77 LICENSE 'ON'TRACTO SDECLARATIONh4�� 1 hereby affirmthat I am licensed under provisions ofChapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codi. and my license is in full fort ) d c License Class y:epi .(J_- Lic. Numberlltill IS BLDG. ❑ ELECT. ❑ PLG. MECH. ❑ ❑ Date Contractor BUILDING PERMIT INFORMATION OWNER -BUILDER DECLARATION Contractor's License I hereby affirm that 1 ng so C%empl from the Business Professions Law finny city Code: Any city or county which requirese permit to construct alter, countywhchn. e. requires permitto improve, demolish, or repair any structure, prior to its issuance,statementalso requires the applicant for the permit to file a signed ctor'siThal he is licensed pursuant the provisions of the License MISC.- REFER TO ORD VALUATION $/FT. PERMIT ISSUANCE 10.00 EIEC. LONTR. LIC. N0. ELEC. TOTAL PERMIT TO DTV. PLUMBING PERMIT FEE oC Division 3 of the en WI'Division Law (Chapter 9 (commencing with Section is exempt therefrom and Business and Professions Code) or that he is GTORIE TYPE CONSTR. tion of the basis for the alleged exemption. Any violation of Section 703malty by any applicant for apenre dollatsthe 1500).licunl One Civil penally of oat more than Clva hundred dollars(1500).): ALTER-DRAIN-WATER(EA.) 5.00 O I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP RES. UNITS DRAINS -FLOOR, ROOF, AREA,COND. 5.00 intended or offered for sale (Sec. 7044, Business unit Professions Code: The Contractor's License Law does not apply to an owner of property who builds Or improves thereon, and who does such work himself or through his own employees, provided That such improve- ments are not intended or offered for sale. If, however, the building F IXTUR ES - PER TRAP 5.00 SO. FT. FLOOR AREA TOTAL ACREAGE GAS-EA.SVSTEM-1 6.00 or improvement is sold within one year of completion, Dse owner. builder will have the burden of proving that he did not build or im- prove for purpose of sale.), ❑ 1, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 IEA.) 2.00 BUILDING USE RES IND CON PB Cuba, ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply l0 an owner of properly who builds or improves thereon. and who LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 IEA.) 1.00 ASSESSORS PARCEL NO. contracts for such projects with u contractors) licensed pursuant to file Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt under Sec. ,B.&P.C. for this Eason WATER HEATER W/VENT 6.00 Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 WORKF.RS'COMPENSAT10N DECLARATION 1 hereby affirm thus I have a certificate of consent In self -in sure, or a certificate of Workers' Compensation Insurance, or a certified ZONING ENG. SITE NO. copy thereof S�ec.� Jj80ff,� Lab.C.). O _F•Cd� c }'S Policy Nza"3 MRPany O Certified copy ishereby furnished. entified co1ly is fled with the city inspection division. pplicant qg FIRESPRINK Y❑ N❑ ENERGY T-24 Y N❑ MISC.- REFER TO ORD. CERTIFICATE OI' EXEMPTION FROM WORKIiRS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. PLG,CONTR. LIC. NO. TPLO OTAL COMPENSATION INSURANCE (This section need not be completed if the permit is for one Y❑ N❑ V❑ N❑ hundred dollars (S 100) or less.) I certify that in the performance of the work for which this per- Mit is issued, I shall not employ any person in any manner so as to OTV. MECHANICAL PERMIT FEE FEE SUMMARY , BUILDING become subject to the Workers' Compensation Laws of Culiforniu. Date Applicant ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICANT: If, after making this Certificate of Ex. emption, you should become subject to the Workers' Compersullon APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with such provisionsor this permit shall be deemed revoked. AIR HANDLING UNIT (TO 10MC.F.M.) 4.00 FEE AIR HANDLING UNIT (OVER I0)000C.EM.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that There is a construction leading agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued Our. 3097, CN.C.). MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lender's Name HEAT[ NG UN I T(OV ER 100,000 B.T.U.) 9.50 ELECTRIC Lender's Address I certify that l have read this application and stale thin iha above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING BOILER• COMP (3 H.P. Or 100',000 B.T.U.) 6.00 BOILER -COMP (Over 100,000 BTU) SEE FEE SCH. MECHANICAL 3 �O hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. MISC. - REFER TO ORD.. CONST. TAX (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in ny way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 . grantin (his ermiL ECH. CONT. LIC. NO. MECH. TOTAL 3 ao Signature of Applies n Contractor Uutc OFFICE COPY