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11806 (2)POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO INSPECTION DIVISION JOB INSPECTION RECORD ' JOB ADDRESS 10325 FARALLONE DRIVE UNIT# • LOT# OWNER PHILLIP UNDERWOOD±CONTRACTOR VALLEY HEATING PERMIT NUMBER 11806 PERMIT EXPIRATION PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE'OR 180 DAYS FROM ' LAST CALLED INSPECTION. INSPECTION DATE I INSPECTOR INSPECTION RECORD FOUNDATION' LIFER PREGUNITE PERMIT VALIDATION ISSUANCE DATE .POUR NOCONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND'/SLAB PLUMBING ELECTRICAL MECHANICAL - BLDG. ELECT. PLG. MECH. DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED ' BUILDING F.K.I. INFORMATION WOOD FLOOR VALUATION -SIFT. PLUMBING MECHANICAL ELECTRICAL PERMIT TO // / FRAMING INSULATION i l ' STORIES TYPE CONSTR. ' OCC. GROUP RES. UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO. FT. FLOOR AREA TOTAL ACREAGE DIAPHRAGM - BUILDING USE RES IND CON PB O'nc' E:l 0 11El E ' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ROUGH ASSESSORS PARCEL NO, PLUMBING GAS TEST TRACT NO. PARCEL NO. MECHANICAL '. ELECTRICAL FINALS DATE INSP. ACC DATE ACC. FILE NO. FRAMING SAN # I t,SULATION PLUMBING ,3 ZONING ENG. SITE NO. GAS 3 72X— MECHANICAL FIRE $PRINK r .Y E] IN [� ENERGY TPA Y ❑ NO. C@VER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH -INTERIOR ELECTRICAL F LOOD ZONE Y 0 N[_ A.L.U.C. Yo NE] LATH -•EXTERIOR - - FIRE DEPT. SHEETiOCK - GRADE FEE SUMMARY SHEARINTERIOR BUILDING BUILDING SHEAR EXTERIOR ' TEMPORARY APPROVALS FIREWALLS ELECTRIC PLAN CHECK FEE - GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUI LDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM Lu ARRANGE FOR INSPECTION BY PHONING 252-4505, ONE ONE WORKING DAY BEFORE REQUIRED INSPECTION. z PLEASE GIVE JORADDRESS WHEN PHONING. -.SEE PERMIT FOR EXPIRATION DATE - ELECTRIC PLUMBING MECHANICAL CONST. TAX r 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 LD1 NG PROJECT IDENTIFICATION APPLICATION &PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER 11806 BUILDING ADDrWs�^ R\` ` �.-J I'[ �•-� OWNER1SJ1 E\11-rJ�g' 1111 V I eek1 0 PHONE DTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION (CONTEACTORnS '{� II ��` v A�` LIC. rio.VLpO UTLETS- SWITCHES -RECEP 10.00/1.00 LIGHTING FIXTURES '10.00/1.00 CONTRACTOR AooRE PPLIANCES- RESIDENTIAL 4.00 PANELS 10.00 vHON DATE OF APPLICATION ARCHITECTANELS(OVER OR ENGINEER LIC. No. 200 AMP) 20.00 PLAN CHECK FEE .C. NO. 'SIGNS TRANS. 3.00 ARC". OR ONE. SPECIAL CIRCUIT 5,00 PER MIT VALI DATION TEMP. METER OR POLE IMS -20 DO . ZIP AS ADDRESss DRE MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 A LICENSED CONTRACTORS DECLARATION 1 hcrtby offinn that I em licensed under provision of Chaply 9 ISSUANCE DATE (commencing with Section 7000) of Division 3 of the Business and BLDG. ELECT. PLG. MEC . Professions Code, and my license is in full force and effect. License ClassLic. Number ❑ ❑ ❑ Date &Contractor ' - BUILDING PERMI OWNER-BUILDFR DECLARATION d exempt from e Contractor's License I heeby affirm that 1 anth Lew lbr the followingrcasua(Sec. 9031.5, Businessand Prof sauna INFORMATION MISC. - REFER TO ORD VALUATION S/FT. PERMIT ISSUANCE 1000 Code: Any city or munty which requimsa permit locomtnlat,alter, Improve, demolish, or repair any structure, prior to its issuance, also ELEC. CONTR. LIQ NO. - ELEC requires the applicant for such permit to file a Signed statement that he is licensed purwant to the provisions of the Contractor's License TOTAL PERMIT To QTY. PLUMBING PERMIT FEE Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Blssiness and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation Of Section 7031.5 TYPE CONSTR. ALTER-DRAIN-WATER(EA.) 5.00 by any applicant for a permit subjects the applicant toa civil penally of not more than five hundred dollars (S500)J: 0 1, as owner of the property, or my employees with wages i s their role compensation, will do the work, and the structure Is not intended or offered for Sale (Sec. 7044, Business and Professions BACK FLOW PROTECT. DEVICE 4.00 r".FLWR RES. UNITS DRAINS -FLOOR, ROOF, AREA,COND. 5.00 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 EA TOTAL ACREAGE himself or through his own employees, provided that such improve- ments are not intended or offered for sale. If, however, the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or im- prove for purpose of sale.). . ❑ I, as owner of the property, am exclusively contracting with GAS - EA. SYSTEM -OVER 4 (EA.) 2.00 BUILDING USE RES IND CON PB Osber ❑ ❑ ❑ ❑ ❑ INDUSTRIAL WASTE INTER. 30.00 LAWN SPRINKLERS - 1 INC 5 V.B. 6.00 LAWN SPRINKLERS - OVER 5 (EA.) 1.00 ASSESSORS PARCEL NO. licensed contractors t0 construct the project (Sec. 7044, Business and Professions Code: The Contractor's LiLense Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contmclons) licensed pursuant to the Contractor's License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO. PARCEL NO. WATER HEATER W/VENT 6.00 ❑ I am exempt under Sec. ,B.&P.C. for this reason Owner Date WATER SYSTEM 5.00 ACC. GATE ACG FILE NO. WATER TREATING EQUIP. 5.00 WORKERS'COMPENSATION DECLARATION 1 hereby affirm that I have a Certificate ofcoment to self -inure, or a certificate of Workers' Insurance, oorr.0 ZONING ENG. SITE N0. pCoom�pensation �cerrtifiieed� copy tac";§ 4:IDy/ C�iG. lri�lhil-1 Policy No f�sL Cerriifiredd�cpoppyyyis hereby furnished. J FIRE SPRINK ENERGY T-24 ��y❑,.,�/ AppOhen f�-�'�5,�' •� �t�nspcction division. ❑ V N ❑ ❑ MISC. - REFER TO ORD.[3N CERTIFICATE 01: EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 - FLOOD ZONE A.L.U.O. PLG. CONTR. LIC. No.PLG. TOTAL COMPENSATION INSURANCE . (This Section need not be completed if the permit is for one Y [:] N[:] Y E] N❑ MECHANICAL PERMIT FEE FEE SUMMARY hundred dollars IS 100) or Lass.) - I certify that in the performance of the work for which this per -CITY ` mit is issued, I shall not employ any person in any mannerse, as to BUILDING become subject to the Worken' Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 NOTICE TO APPLICANT': If, after making this Certificate Of Ex- empliun, you should become subject to the Workers' Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. FEE AIR HANDLING UNIT (TO 10,DODCF.M-) 4.00 ' AIR HANDLING UNIT(OVER 10MC.EM) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY 1 hereby aifmm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work lin which this permit A issued (Sec. 3097, Ov.C.). MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 � HEATI NG UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC Lender's Name Lender's Address I certify flo, have read this upplication and state that the above VENTILATION FAN (SINGLE) 4.00 information IS correct. I wee to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING BOILER- CONIP(3 H.P. Or 100,000 B.T.U.) 6.00 BOILER -COMP (Oxer 100,000BTU) SEEFEESCH. MECHANICAL hereby authorrepresentatives of this city to enter upon the above-mentioned pruperty for inspection purposes. MISC. - REFER TO ORD. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which in any way accrue against mid City in consequence of the .CONST. TAX PERMIT ISSUANCE 10.00 Ireu ti IF this it. 1� MECH. CONT. LIG NO. MECH. ` Al TOTAL f p00 �J - I 0 TOTAL g1 lure of Applicant/Contractor Date OFFICE COPY