2881 (2) CITY OP CUPER11110 INSPECTIOC RECORD (Office Copy)
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2881 1? _ 10990 N. De Anza _
PCPdIIT No. SANITARY DIST. NO. LOT NO. ADDUSS
Sign & Elect. Mariani Group
PROJECT OWNER JOB SITE PHONE NO.
PERMIT ISSUED Date ELECTRICAL
Buildi_nr 12-9-82 Date Insp.
Electrical 12-9-82 Power Pole_
I'lambin,r, Under ,round
Mechanical Roug��h Wiring _
'temp. Gas/]Acct. 11al.l.s
Solar Ceiling;
Fire Sprinkler Fixtures Int/Ext
Sign [lotors
Grounding
Hisc. Temp. Power _
Other
FINAL. INSPECTIONS Not Approved
Date Insp.
r"'s PLUMBING
Electric Date Insp.
Plumbing Backflow
Mechanical Underground
Solar Underfloor
Pool Partial Rough
Gradinp Rough Complete
.
Phinning, Solar Rough
Fire Dept. Water & insulation
Health Dept. Main Drain
Building; R/of/S Drain
Other Gas
Other
BUILDING Not Approved
Date Insp.
Pad Certification H CIIANICAL
Foundation Date Insp.
Pre-Gunite Underfloor S.M.
Slab-Membrane Ducts & Insulation
Bond Beam Fire Dampers
Underfloor Girders Fireplace
Floor Steel Grease Duct & hood
Tiedowns One (lour Shaft
Di.aphrams Condensate Drain
Seismic Bracing EquipmenC Anchorage _
llal..ls-Panels Flues & Comb. Air
Frame Other
Lath Not Approved
11allboards Int/Ext.
Firewalls
Other
Not Approved
BUILDING .,
ELECTRICAL
PLUMBING
•
MECHANICAL
MISCELLANEOUS
APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — US BALL POINT PEN'ONLY
BUILDING PROJECT IDENTIFICATION PERMIT N
Y BUILDING
APPLICATION & PERMIT
ADDRESS ODRESSORE55 O O 1^'
. � O I UILDING —ELECTRICAL—PLUMBING—MECHANICAL. ._ (Vlo
NAME PLAN CHECK VALIDATION
C SN OTV ELECTRIC PERMIT FEE
k
~`�`�` l� PHONE SC" "1�
AME acroRs OUTLETS-SWITCHES-RECEP 5.00/1.00
uc.Na LIGHTING FIXTURES 5.00/1.00
ADDRESSTORS APPLIANCES-
RESIDENTIAL 4.00
PHONE PANELS 5.00 DATE OF APPLICATION
ARCHITECT - PLAN CHECK FEE P.C.NO.
OR SIGNS fi.00
ENGINEER
uc.No. SIGNS TRANS. + 3.00
AENG.
ADDDRESSDRESS SPECIAL CIRCUIT 5.00
PERMIT VALIDATION
ZIP TEMP. METER OR POLE INS. 15.00
nooA SSTs MOTORS ESCH.
SERVICE CHANGE 10.00
, 00 LICENSED CONTRACTORS DECLARATION
a in u I hereby affirm that I am licensed under provisions of Chapter 9 DEC q
ISSUANCE DATE
'G a (commencing with Section 7000)of Division 3 of the Business and -
BLDG. ELECT. PLG. MECH.
0 w z License Cla Code,and my license is In full force and effect. • P ❑ ❑ ❑
zo i ti o License Class Lie Number ..
m r w Date - Contractor
a wa OWNER-BUILDI'-R DECLARATION BUILDING PERMIT
°A0 MISC.— REFER TO ORD INFORMATION
X 3 LL 1 hereby affirm that I am exempt from the Contractor's License -O j Law for the following reason.(Sec.7031.5,Businessm-d ProfessiVALUATION n� (FT.
al u Professions VALUATION ISSUANCE 6.00 + f u
y'� Code;Any'city or county which requiresa permit to construct alter, s
lE ir 4 0 , -improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. TO
ELEC.
TAV
a o¢ requires the applicant for such permit to file a signed statement[hal - L F�TQTI�T
IF m" he is licensed pursuant to the provisions of the Contractor's License - U��G •1 O�
,Fzm� Law(Chapter 9(commencingwith Section 7000)of Division 3 ofthe
P x o Business and Professions Code)or that he is exempt therefrom and G— �
I-m the basis for the alleged exemption.Any violation of Section]031.5 OTV. PLUMBING PERMIT FEE T
STORIES it v CO
ofN7R.
by any applicant for a permit subjects the applicant toacivil penalty ALTER-DRAIN&VENT-WATER (EA.) 4.00 perJme
of not more than five hundred dollars($500).).
❑ as owner the property,or my employees with wages as BACK FLOW PROTECT. DEVICE 2,00 OCC.GROUP RES.UNITS
[heir sole compensation,will do the work,and the structure is ml
intended or offered for sale (Sce, 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 4.00
Code;The Contractor's License Law does not n apply to aowner of
property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 4.00 SQ FT.FLOOR AREA TOTAL ACREAGE
himself or through his Own employees,provided that such improve-
mentsare not intended oroffered'for sola It however.the building GAS-EA.SYSTEM-11NC.40UTLETS 4.00
or improvement is sold within one year of completion, the owner-
builder will have the burden-of proving that hu did not build or int- GAS-EA.SYSTEM-OVER 4(EA.) 1.00 BUILDING USE
Prove for purpose of sale.). RES 'IND CON PB O,he,
❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 20.00
licensed contractors to construct the projecl(Sec 7044,BusinessLAWN SPRINKLERS- 1 INC 5 V.B. 5.00 ASSESSORS PARCEL No.
and Professions Code:Th
e Contractor's License Law does ,at apply .
to an owner of property who builds or improves thereon,and who LAWN SPR IN KLERS-OVER 5(EA.) 1,00
contracts for such projects with a contractors)licensed pursuant to _
the Contractor's Ly ns Lawes• I ' SEWER-SANITARY-STORM EA.200ft/8.00 TRACT NO, PARCEL NO.
❑ lam dnignd rSeor. ,B.&p.C.for this WATER HEATER W/VENT 4,00
,,,_/1 reason 6/0`
/��:: Dme Owner WATER SYSTEM 4.00 ACC.DATE ACC.FILE N0.
WORKERS'COMPE"NSATION DECLARATION WATERTREATING EQUIP. 4.00
I hereby affirm that I haven certificate of consent to set-insure,
or a certificate of WOrkers'ICompensalion Insurance,ora certified ZONING ENG.SITE NO.
copy thereoffSee.3800,Lob.C.L
Policy No. Company
O ❑ Certified copy is hereby furnished FIRE SPRINK ENERGY T-24
ZZ 11Certified copy is riled with the city inspection division.
� O Applicant MISC.- REFER TO ORD. Y ❑ N❑ Y NE
N CERTIFICATE OF EXI,'NIPTION FROM WORKIi RS' PERMIT ISSUANCE 6.00 FLOOD ZONE A.L.U.O
W > COMPENSATION INSURANCE PLG.CONTR. .
uC.NO. PLG.
M O (This section need not be completed if the permit is for one TOTAL v❑ N� v N�
Z hundred dollars($100)or It.I -
0 O 1 certify that in the performance of the work far which this par- OTV. MECHANICAL PERMIT FEE FEE SUMMARY
LL F- mit is issued,I shall not employ any person in any manner so as to
U become subject to the Workers'Compensation Laws of Califontim
y Date Applicant ALTER OR ADD TO MECH. 4.00 BUILDING /O
} N NOTICE TO APPLICANT'. If,after makingthisCertificate of lis- -
F ? eruption,you should become subject to the Workerv'Conipensution APPLIANCE 4.00 PLAN CHECK
Provisions of the Labor Code, you must forthwith comply with U� FEE such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10=C.F.M.) 3.00
CONSTRUCTION'LE"NDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 5.00 SEISMIC FEE a Q.
I hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 2.00
the performance of the work for which this permit is issued(Sec. MICROFILM
3097,Civ.C.L - H EATI NG UN IT(TO 100,000 B.T.U.) 4.00 .
Lender's Name HEATING UNIT 100,000 B.T.U.)7.50
Lender's Address ELECTRIC
I certify that I have read this application and state that We above - VENTILATION FAN (SINGLE) 3.00
.� Information is correct I agree to comply with all city and county PLUMBING
-
mrimmees and state laws relating to building construction, and BOILER-COMP(3.,H.P.Or 100,000 B.T.U.) 4.00
hereby autu,ned representatives of this city to enter upon the BOI LER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL
hereby autiora property for inspection purposes.
(We) agree to save, indemnify and keep hornless the City of MISC.- REFER TO ORD.
e,,n,taliabilitiesjudgments, costs and expenses which pERMIT ISSUANCE 3 00 . AX.wayaccrue agal st sai Cify in consequece of[he is MECH.CONT. LIC.N0. MECH. (—�,(cTOTAL TOTAL a1 VVApplicent/Con[roctor Dafe
OFFICE COPY ',i• -