Loading...
0626 (2)• C -A CITY OF CUPERTINO INSPECTION RECORD (Office Copy) 0626 902 E. Estates Dr. PURtIIT NO. SANITARY DIST. N0. LOT NO. ADDRESS Install Sprinkler System Gerard McGlinchey 252-2568 PROJECT OWNER JOB SITE PHONE NO. PERMIT ISSUED Date II ELECTRICAL FINAL INSPECTIONS BUILDING Date Pad Certification Insp. Foundation _ _ Pre-Gunite Slab-I9embrane Bond Beam Underfloor Girders Floor Steel Tiedowns _ D.taphra,ms Seismic Bracing Ual.ls-Panels --------------- Frame lath Uallboards Int/Ext. Firewalls Other Not A? roved PLUMBING Date Backflow Insp. Underground _ _ Underfloor Partial Rough Rough Complete Solar Rough Water & Insulation ".fain Drain _ R/of/S Drain Gas Other Not Approved HECIIANiCAL Date Underfloor S.M. Insp. Ducts & Insulation Fire Dampers Fireplace Grease Duct & hood One (lour Shaft _ Condensate Drain_ Equipment Anchorage Flues & Comb. Air Other Not Approved 9PPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALI_ P T PEN ONLY BUILDING PROJECT PDENTI FICATION APPLICATION & PERMIT `�. BUILDING -ELECTRICAL- PLUMBING -ME ANICAL PE RMIT NUMBER 0626 BUILDING ADDRuESS /� IOL E FVF& Ei pQ. OWNER'S 23.2- NAME GE2l�2D MG &UNci�DE?` tis 68 - QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION ' DATE OF APPLICATION NOMTRAcroRs LC, ND. OUTLETS - SWITCHES -RECEP 5.00/1.00 LIGHTING FIXTURES 5.00/1.00 CONTRACTORS ' ADDRESS ADDRESS PHONE APPLIANCES - RESIDENTIAL 4,00 PANELS 5.00 ARCHITECt oR ENGINEER •�� LIC. No. SIGNS 6.00 't PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 ADDREss END ZIP SPECIAL CIRCUIT 5.00 PERMIT VALIDATION DATE BLDG. ELECT. PLG. MECH. ❑ ❑ ❑ EMP. METER OR POLE INS. 15.00 APPLICANT Srs nDREss 6102 FC'fqTEr IV. MOTORS SEE FEE SCH. - SERVICE CHANGE 10.00 LICENSED CONTRACTORS DECLARATION I hereby affirm that 1 am licensed under mcnimuns ol'Chapter 9 (commencing with Section 7000) of Division 3.f the Business and Professions Code, and my license is in full force and effect License Class Lia Number Date Contractor OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031,5, Businessand PloTessions Code: Any city or county which requires permit to CnnStHICLalter. improve, demolish, or repair any ,structure, prior to its issuance, also requires the applicant I'or such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor License Law (Chapter 9(commencing with Section 7000)ofDivision 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of nmore ore than five hundred dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not 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 himself or through his own employees, provided that such improve- mentsarenotintendedoroffDred for sale. H, however, the building or improvement is sold within one year of completion, the owner- builder will have (he burden of proving that Redid not build or im- prove for purpose of sale.). ❑ 1, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sec. does, Business and Professions Code: The Contractor's ldsor License Law dues not applysf� to tr owner of property who builds t r improves thereon. and who L with a coniracmrts) licensed pursuant m contracts for such License License Law. the Col am exempt ❑ lam exempt under Sec.' ,B.3P.C. for this reason CITY OF CUPERTINO,ISSUANCE BUILDING PERMIT INFORMATION MISC. PAIIXEFER TO ORD PERMIT ISSUANCE 6.00 VALUATION g/FT. ELEC. CONTR. LIC. NO. ELEC. TOTAL PERMIT TO ' QTY. PLUMBING PERMIT FEE STORIES T E CONSTR. ALTER -DRAIN VENT -WATER (EA.) q,00 BACK FLOW PROTECT. DEVICE 2,00 oce. GROUP RES, UNITS DRAINS- FLOOR, ROOF, AREA, CON D. 4.00 FIXTURES - PER TRAP 4.00 GAS - EA.SYSTEM - I INC.4 OUTLETS 4.00 So, PT FLOOR AREA TOTAL ACREAGE GAS - EA. SYSTEM -OVER 4 EA.) ( 1.00 BUILDING USE RES IND CON PB Olh.r ❑. ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 20.00 LAWN SPRINKLERS - 1 INC 5 V.B. 5.00 ASSESSORS PARCEL NO. LAWN SPRINKLERS -OVER 5 (EA.) 1.00 SEWER -SANITARY -STORM EA. 200ft/8.00 TRACT. of PARCEL NO. WATER HEATER / 4.00 Dan Owner WORKERS'COb1PENSATTON DECLARATION I hereby alHrnt that I have a crtificute of emns, l to sell-inon, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (See. 3800, Lab.C.). Policy No. Company WATER SYSTEM 4.00 ACC. GATE ACC. FILE NO. WATER TREATING EQUIP. 4.00 ZONING ENG. SITE NO. MISC.- REFER TO ORD, ❑ Certified copy is hereby furnisheJ. ❑ Certified copy is filed with the city intipection division: Applicant FIRESPRINK v❑ N❑ ENERGY T-24 v❑ N❑ CERTIFICATE OP EXEMPTION FROM WORKERS' COMPCNSATION INSURANCE (This section need not be Completed if the permit is for one hundred dollars (81001 or I.0 w D 1 certify that in the performs of th or fo yr1 h his cr- mil is isst ed. 1 hull not emplo I y per. art 1jM s as to becomes bjee the Workers I ens' i a ✓ nia. Datc��Applicani NOTICG TO APPLICANT: II a cr making i s C li cane of Ex. emption, you should become w elto the Wor - o ion provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall he deemed revoked. CONSTRUCTION LENDING AGENCY 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.). Lender's Name Lender's Address I certify that 1 have read this application and state that the above information n correct, 1 agree to comply wire all city and county ordinances and state laws relating to building construction.adco and hereby uulhorHe represenlelives of His city to enter upon the aboa.-men Uoned property for inspection purposes. (We) agree to save, indemnify and keep hart less lire City of Cupertino against liabilities, d cots osis and expenses which ma any way a true J1l .rid it in conxegt mce f the gr li of 11 s pe i1, I __7 !0 PERMIT ISSUANCE 6.00 FLOOD ZONE Y ❑ N❑ A1.u.C. Y ❑ N❑ PLG. CONTR. LIC. NO. PLG. /• TOTAL /(, QT,. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING ALTER OR ADD TO MECH. 4.00 APPLIANCE 4.00 AIR HANDLING UNIT (TO 10=C.F.M.) 3.00 PLAN CHECK FEE AIR HANDLING UNIT(OVER 10=1C.EM.) 5.00 SEISMIC FEE EXHAUST HOOD (WITH DUCT) 2.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 4.00 HEATI NG UN IT (OV ER 100,000 B.T.U.)7.50 ELECTRIC VENTILATION FAN (SINGLE) 3.00 BOILER-COMP(3 H.P. or 100,000 B.T.U.) 4.00 PLUMBING BOILER -COMP (Oval 100.000 BTU) SEE FEE SCH. MECHANICAL MISC. - REFER TO ORD. PERMIT ISSUANCE 3.00 CONST. TAX MECH. CONT, LIC. No. MECH. TOTAL TOTAL 424H, of Applicant/C tr �(nr OFFICE COPY o¢z Foso � uck a z Xn�C h Q ozo0W FwF ¢ K ar U w 0 a F u O< J au LE ¢60p A w C, Vs 5140 i o ¢Fo ppm 0 O Z z F, O LU — ao Z, UQ LL V� OW } N � z A APPLICANT TO FILL IN INFORMATION WITHIN RED LINES — USE BALI. POINT PEN RNLY j BUILDING PROJECT IDENTI FICATION APPLICATION & PERMIT BUILDING — ELECTRICAL— PLUMBING — MECHANICAL PERMIT NUMBE 0 �` -v 18 eUILDiN h RU v� e''� O� it OWNER'S NAME / �-. QTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION !/l PHONE DATE OF APPLICATION CONTRACTORSUTLETS Nn E p (J y O � UC.No. 0 /�!, - SWITCHES -RECEP 5.00/1.00 LIGHTING FIXTURES 5.00/1.00 CONTRACTOR'S .il rr ���„E•/�� `2- PPLIANCES- RESIDENTIAL - 4.00 PANELS 5.00 ogcHl/TELT ENGINEER LIC. NO, SIGNS UPERT PLAN CHECK FEE P.C. NO. SIGNS TRANS. 3.00 AARCH, 08 DDRESS ENG, SPECIALCIRCUIT DD PERMIT VALIDATION EMP. METER OR POLE INS. 15-00 ZIP ^ 9-7/ APFUGAurs - AooREssSERVICE MOTORS E SCH. CHANGE 1000(,LICENSED p /�j CONTRACTORS DECLARATION 1 hereby affirm that 1 am licensed under provisions a fChapter 9 (conuncncing with Section 7000) of Dlviviou 3 of the Business and Professions Cod, y license is in full fore -' 4 Lieens las C.� Lie. Number ISSUANCE 6/ATE BLDG. ❑ ELECT. ❑ PLG, MECH. �f 1.� 1 11 4 Dale Comncmr ON BUILDING PERMIT INFORMATION OWNER -BUILDER D17CLARATION I hereby affirm that I am exempt from the Contractor's License following 703s a permit tocnstrct,aions—PERMIT Cow: Any city Code: Any city or county which requires a permit m construct alter, regains the applicant for such permitrmitstructure,prior its issuance, also improve, demolish, or repair any to file IO file a signed actor's i that he is licensed pursuant the provisions of the License MISC.— REFER TO ORD VALUATION $/FT. ISSUANCE 6.00 ELEC. CONTR. LIC. NO. ELEC, TOTAL PERMIT TO of Division 3 of the en ) ofDivision Law (Chapter 9 (commencing with Section is exempt Business and Code) or that he is therefromand QTY. PLUMBING PERMIT FEE W he alleged exemption. Any violation of Section 0 the basis for the alleged tion of a L$ STORIES TYPE CONSTR. a en subjects fit, applicant foacivil penalty by any applicant ore than fora hundred of not more than five hundred dollars lSS00)J: � - ALTER -DRAIN St VENT-WATER(EA.)q,DD 0-fJ ❑ h as owner of the property, or my employees with wages as their sole compensation, will do Ilse work. and the structure is not BACK FLOW PROTECT. DEVICE 2.00 OCC. GROUP RES. UrvrcS DRAINS -FLOOR, ROOF, AR EA, COND. 4.00 intended or offered for sale (Sec. 7044. Business and Professions Code: "Fire Contractor's License Law does not apply to an owner of property who builds or improves the Ron, and who dues such work himself or through his own employees, provided that such improve- ments are not intended or offered for sale. If, however, the building FIXTURES -PER TRAP 4.00 GAS - EA. SYSTEM -1 INC.4 OUTLETS 4.00 SO, FT. FLOOR AREA TOTAL ACREAGE or improvement is sold within one year of completion, the owner- builder will have the burden of proving (hat he did not build or im- GAS - EA. SYSTEM -OVER 4 IEA.) 1.00 BUILDING USE prove 1, as ownerose of sale.). ❑ I, as owner of the property, am exclusively contracting with RES IND CON PB OhM1er ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 20.00 licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law docs not apply' to an owner of property who builds or improves (hereon, and who LAWN SPRINKLERS- 1 INC 5 V.B. 5.00 ASSESSORS PARCEL NO. LAWN SPRINKLERS - OVER 5 (EA.) 1.00 contracts for such projects with a contrxetods) licensed pursuant to the Contractor's License Law. ❑ I am exempt under Sec. B.&I'.C. for this reason SEWER -SANITARY -STORM EA. 200ft/8.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 4.00 Date Owner t WORKERS-COMPF.N'SA-1'ION DECLARATION WATER SYSTEM 4.00 ACC.DATE ACC. FILE NO. WATER TREATING EQUIP. 4.00 1 hereby affirm that I have a certificate ofconsmst Io self -insure. ZONING ENG. SITE NO. or a cenifieme of Workers Compcns tion Insuranc or certified copy lh u, f 0, LaoC (may PolicyN �19 'ompiny ( Nat/ ❑ Ce robe cop is If �Cenifid is kR(Q AvtXtJ11 city inspection division. APPlicanl—IQ�/� FIRE SPR INK y❑ N❑ ENERGY T-24 v❑ N❑ MISC.- REFER TO ORD. PERMIT ISSUANCE 6.00 p CER IFICA'IE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sccndn neeA noI be completed if the peons( is for one hundred dollars ($100) or less.) FLOOD ZONE ❑ N ❑ A.L. U.C. V ❑ N ❑ PLG.CONTR. LIC. NO. pLG. TOTAL Q 0`:2!Y Kx`I certify that in the performance of the work for which this per- m is issued, I shall not employ any person in any manner so as to QTY. MECHANICAL PERMIT FEE FEE SUMMARY become subject to the Workers' Compensation Laws of California. ALTER OR ADD TO MECH. 4,00 Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Ex- BUILDING APPLIANCE 4.00 AIR HANDLING UNIT (TO 10,ODDCF.M.) 3.00 PLAN CHECK FEE emption, you should become subject IN the Workers'Contpensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (OVER FO=CF.M.) 5.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby affirm that (here is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). Lender's Name EXHAUST HOOD WITH DUCT) 2.00 MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 4.00 Lender's Address H EATI N G U N IT [OV E R 100,000 B.T.U.)7.50 ELECTRIC VENTILATION FAN (SINGLE) 3.00 BOILER -COMP (3 H.P. or 100,000 B.T.U.) 4.00 I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and stale laws relating to building construction, and PLUMBING 0� (� hereby authentioriee representatives ec this city to enter upon the above-mentioned property for sp of th purposes. BOILER -COMP (Over 100,000BTU) SEE FEESCH. MECHANICAL (We) agree to save, indemnify and keep harmless the City of Cup against liabilities, judgments, costs and expenses which m in 'ny y c tic against said City in consequence of -the gamin, (t pe IT L MISC. - REFER TO ORD. PERMIT ISSUANCE 3 00 CONST. TAX MECH. CONT. LIC. NO. MECH. TOTAL _ TOTAL ' igna(ure oAp licant Contractor Date OFFICE COPY