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15216 (2)_ POST THIS CARD NEAR FRONT OF'BUILID ING CITY`.OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD JOB ADDRESS 10991, North De Anza Blvd. UNIT# _LOT# • OWNER Mariani Develo ment CONTRACTOR PERMIT NUMBER - 521 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED 'WITHIN 180 DAYS OF PERMIT ISSU- ' OR 180 DAYS FROM LASTCALLED INSPECTION. + INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATIONANCE NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF CUPERTINO STANDARDS. - - • LIFER - PR EGUNITE J Pr. RMIT nLmpnON ;V JlY^f'- -•",, _ ! •. �� ^' - ISSUANCEUATE GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - - ' UNDERGROUND/SLAB PLUMBING ELECTRICAL MECHANICAL BLDG ELECT: I PLG. MECH. El 1:1❑ ' BUILDING PERMIT INFORMATION DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED �``� 6t WOOD FLOOR ALUA TION y SIFT. PLUMBING MECHANICAL• ELECTRICALA. PERMIT TO .%•"%✓LT`f ay,�, �,.4%J(-•A FRAMING INSULATION - STORIES TYPE CONSTR. - PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED OCCGROUPRES UNITS ROOF NOTE'. NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAX IS PAID - SO FT FLOORAREA TOTAL ACREAGE , DIAPHRAGM, ROOF SHEATHING BU'ry oUSE RES IND Q PB on..•, ❑ ❑' El If i ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. nssessoas PARCEL No. ROUGH SANA PLUMBING ELECT. ENERGY TRACT NO PARCEL NO I , TUBS & SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY- ELECTRICAL - BUILDING ENERGY ACC.OATE ACC. FILF.'NO FRAMING ELECT. FINAL TEST zoNlrvc- ENc. SITE No. INSULATION PLUMBING GAS TEST - - GAS - FIRESPRINK Y ❑ N❑ ENERGY T 2 Y ❑ NQ '- MECHANICAL 2 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOD ZONE .Y ❑ N❑ A.L u.a. Y ❑ N❑ EXTERIOR SHEAR _ ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. SHEETROCK - GRADE FEESUMMARY EXTERIOR LATH BUILDING BUILDING ,? ; INTERIOR' LATH TEMPORARY APPROVALS, SCRATCH COAT ELECTRIC PLAN CHECK. • GAS SEISMIC FEE r' 4 NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY OCCUPANCYOF BUILDING IS NOT PERMITTED'UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE,FOR'INSPECTION BY'PHONING 252-4505, 11 ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLEASE GIVE JOB ADDRESS WHEN PHONING. Z —SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL CONST. TAX IMPORTANT! PLEASE READ REVERSE SIDE BEFORE. CALLING FORTINAL INSPECTION. TOTAL OFFICE COPY y o¢z X00 QU V NZW Q a awz z L0 ac ¢ Q w V j 0 w;4 1--D f ¢ a T 4 0 es O 'wm u 5140 514 a 3 - l � a � Z A I,lje APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY ILOI NO PROJECT IDENTIFICATION - APPLICATION &PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER _. q [ L+. I J �J ADDRES - AOORF55 OWNER'S NAME COKIP PHONE y/�• OTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION NAM,ERAcroRs OUTLETS -SWITCHES -RECEP 10.00/1.00 ILIGHTING FIXTURES 10,00/1.00 Vr N uc. No.q3_7QAJL DATE OF APPLICATION CONTRACTORre - AOOREss . t1J4r%IftN PHONE PPLIANCES-RESIDENTIAL 4.00 PANELS 10.00 ARCHITECT OR ENGINEER LIC. No. PAN ELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P. C. NO. ^/ SIGNS TRANS. 3.00 ADDDRESS Ervc' _ zlv SPECIAL CIRCUIT 5.00 PERMIT V LI'' ,I,ON L� y EMP. METER OR POLE INS. 20.00 APPLICANT'S ADDRESS- MOTORS SEE FEE S.C.H. SERVICE CHANGE 20.00 ' LICENSED CON'T'RACTORS DECLARATION ' I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, anq my license is in full lorce�'Iy e t. License Class.Q l Lie. Number. 7 ISSUANCE DATE BLDG. ELECT. 1 PLG. MECH. , ❑ S Date 0" Contractor. - I NG PERMIT - OWNER -BUILDER DECLARATION 1 hereby ctire ollo That 1 apt exempt 031.5 the ices, Contractor's License Law fornycit followingreason.h.ch re quires a permit tocnd Professions Code: Any miry or county which sequiture permit to construct, issuance, aeq requires, he applic Or fop arc any rmit tole,e. si n T1saemnt talsohat requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's Licenser'77r4-� Law (Chapter 9(commencing with Section 7000) of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom and ORMAT10N MISC.- REFER TO ORD PERMIT ISSUANCE 10.00 VALUATION r $/FT. ELEQ CONTR. LIC. NO. ELEC. TOTAL �� PERMIT r0 S ✓C.a% OTY, PLUMBING PERMIT FEE STORIES TYPE CONSTR. the basis for the alleged exemption. Any violation of5ection 7031.5 . by any applicant for a Permit subjects the applicant too civil penalty of not more than five hundred dollars (S500f): ALTER-DRAIN&VENT-WATER , (EA.) 5.00 ❑ 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 F LOW PROTECT. DEVICE 4.00 DCC. GROUP REB. UNITS DRAINS -FLOOR, ROOF, AR EA, COND. 5,00 intended or offered for sale (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 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- meats are not intended Or offered for sale. if, however, the building GAS-EA.SVSTEM-11NC.40UTLETS fi.00 or improvement is sold within one year Of completion, the own builder will have the burden of proving flint he did not build or i. prove for purpose of sole.). O as owner of the property, am exclusively contracting with GAS - EA. SYSTEM - OVER 4 IEA.) 2.00 BUILDING USE RES IND 'Cory PB Oder ElEl❑,_ 11 1:1licensedd INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS -I INC 5 V.B. 6.00 LAWN SPRINKLERS -OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply In an owner of property who builds or improves thereon. and who contracts for such projects with a contractoos) licensed pursuant to lire Contractors License Law. S EWER -SAN ITAR V -STORM EA. 200ft/10.00 TRACT NO.' PARCEL NO. WATER HEATER W/VENT 6.00 ❑ I am exempt under SED., B.&P,C, for this reason Owner Date WATER SYSTEM 5.00 ACC. DATE ACC. FILE NO, WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of Consent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified ZONING -ENG. SITE N0. . - copy tire��egql1.��ef{'',�3j1QQQr I.A.C.l. (IIT �N PnllcyNAyU9LL7`YJ 1pany01 - FIRE SPRINK ENERGY T -I4 v ❑ N❑ ❑ Cerlilied copy is rereby furnished. §p Certified Sop I fle��jth }h' e't rspo' io Wslml. / Applicant_,j''!%[lMijJ00.'d�"BL$�-B➢YL't'D IMrTif. MISC. - REFER TO ORD. CERI'1171CATI: OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 ' A.L.u.C. ' PLG. CONTR. LIC. NO. PLG. TOTAL COMPENSATION INSURANCE 0 his section need not be completed if the permit Is for one ❑ Y N❑ CITY. MECHANICAL PERMIT FEESUMMARY - hundred dollars f 8100) or less.) 1 certify that in the performance of the work for which this per. mit is issued, 1 shut not employ any person in any manner So as to MBUILDING o (�Date become subject to the Workers' Compensation Laws of Calitornia. Applicant ALTER OR ADD TO MECH. 5.00NOTICE TO APPLICANT: If, after making this Certificate.of fix- emplion, you should become subject to the Workers' Compensation APPLIANCE 5.00 Kprovisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT (TO 10=C.F.M.) 4.00 AIR HANDLING UNIT(OVER I0=C.F.M.) 6.00 EI EXHAUST HOOD (WITH DUCT) 5.00 HEATING UNIT (TO 100,000 B.T.U.) 8.00 M hereby affirm that there is aconstruction lending agency for the performance of rhe work far which this permit is issued (See. 3097, Civ C.). HEATING UNIT (OVER 100,000 B.T.U.)9.50 ELECTRIC Lender's Name Lender's Address I certify that I have read this application and stale that the above information 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- COW 13. H.P. or 100,000 B.T.U.) 6.00 BOILER -COMP love, 100.000STU) SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. - (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in monsequenc of [he rantingof this permit i/ �� MISC. - REFER TO ORD. . CONST. TAX TOTAL p c// (� PERMIT ISSUANCE 10.00 MECH.CONT. ', LIC. NO. MECH. TOTAL Signature o Applicant Cmllraclor Dater- OFFICE COPY