Loading...
C8238 (2) POST THIS CARD NEAR FRONT OF BUILDING • I. • /.PPRNIIT NUMBER CITY OF CUPERTINO INSPECTtt9N DIVISION / \8236 JOB IMISPECTION RECORD Y J�� PERMIT EXPIRATION I � I M Cel JOB ADDRESS ^ O C UNIT# LOT# � y PERMIT EXPIRESIF WORK OWNER5hffl OI �� CONTRACTOR �l J� Ceoxff'. IS NOT STARTED WITHIN INSPECTIO14 DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU FOUNDATION _ .��F / S ANCE OR 180 DAYS FROM LIFER U LASTCALLED INSPECTION. 7,1 PREGUNITE U-16 a PERMIT VALIDATION , AID POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB 211985 PLUMBING S ELECTRICA .0/I �- .CI sArJt�BA4E�D� 1 MECHANICAL - �„ BLDG. ELECT. PLG. MECH. © ❑ ❑ DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED g=J q- .Y 7- 16A_ -IL- BUILDING PERMIT INFORMATION WOOD FLOOR 42-5-$- 25i VALUATION slot. PLUMBING y2 -S� {),Ck:� �p.9�'�`- ' MECHANICAL „ EL@ICTRICAL v RMIr TO FRAMING INSULATION STORIES TvIPCCONSTR. OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF SO.FT.FLOOR AREA TOTAL ACHEAGL DIAPHRAGM BUILDING USE RES IND ,CON PB O'Re' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 0 0 0 11 ASSESSORS PARCEL NO. ROUGH PLUMBING GAS TEST , ) TRACT NO. PARCEL NO. MECHANICAL Z ACC.DATE ACC.FILE NO, ELECTRICAL FINALS DATE INSP. FRAMING SAN # ZONING ENG.SITE NO. INSULATION �Z/-yr PLUMBING ((, �� GAS MECHANICAL 10 - F —ENERGY T 2 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING v N11 Y E] NEI FLOOD ZONE A.LU.C. iTH-INTERIOR ELECTRICAL /t7—,;q-j) v� N� vl] N❑ LATH-EXTERIOR FIRE DEPT.' S F'IEETROCK GRADE FEE SUMMARY SHEAR INTERIOR - BUILDING 1112-3A41'kki SHEAR EXTERIOR TEMPORARY APPR VALS BUILDING , FIREWALLS ELECTRIC / PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE It OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNE D BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL , CALLING FOR FINAL INSPECTION. OFFICE COPY - _L APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY . BUILDING PROJECT IDENTIFICATION PE T NUMBER BUILDING r• . APPLICATION & PERMIT aooREsrti _, � 0010 8238 BUILDING-ELECTRICAL-PLUMBING -MECHANICAL OWNER'S �/ �� y - "' PLAN CN VA LIDATI 1 N-ME ( ///•777yyy„ OTV. ELECTRIC PERMIT FEE 1 �� PHONE NAAMERacTOR3 UTLETS-SWITCHES-RECEP 10.00/1.00 C• o� Co ..LIc.No, 70 LIGHTING FIXTURES 10.00/1.00 f,ONTRaCTOR's aoo`REss APPLIANCES-RESIDENTIAL 4.00 >p p 1 ONE PANELS 10.00 DATE OF APPLICATION 0gcHlTEcr PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. ENGINEER LIC.N0. SIGNS TRANS. 3.00 ARCH.OR ENG. PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT 5.00 _ ZIP ITEMP.METER OR POLE INS. 20.00 l _^'N ADDAiss TS MOTORS SEE FEE SCH. rf'►e�+' SERVICE CHANGE 20.00 w o o LICENSED CONTRACTORS DECLARATION TEMP.POLE 30.00 0:7 a u 1 hereby affirm that I am licensed under provisions of Chapter 9 Z commencing with Sehtion 7000)of Division 3 of the Business and70 B , ESSII C MECH. H N z rofessiuns Code,and my license is in full fo ce an c feet. /-76 ❑ ❑ ❑ Z O n - Licen Class Lic.Number 4 Z w Da[e C '��s-Contractor < y! ,/ ¢ It ¢ OWNER-BUILDER DECLARATION iT BUILDING PERMIT X ;¢ e U INFORMATION a y Illereby affirm that 1 am exempt from the Contractor's License MISC.- REFER TO ORD aOj Law for the following reason.(Sec.7031.5.Business Professions VALUATION g/FT, R - PERMIT ISSUANCE 10.00 1{ in Code:Any c].f orcounty whi(seeq 031. pn sines construct,alter, �(fD VALUATION ec X a p improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0. ELEC. ts 0¢ requires the applicant for such permit to file a signed statement that TOTAL a w m a he is licensed pursuant to the provisions of the Contractor's License P RMIT TO . Hiso Law(Chapter 9(commencing with Section 7000o'Division 3 ofthe P ¢o Business and Professions Code)or that lie is exempt therefrom and QTY. PLUMBING PERMIT FEE ¢ H$ the basis for tire alleged exemption.Any violation of Section 7031.5 STORIES, TYPE CONSTR. by any applicantfor a permit subjects the applicant to u civil penalty of not more than five hundred dollars(S500).): ALTER-DRAIN& VENT-WATER (EA.) 5.00 ❑ 1,as owner of the property,or my employees with wages as BACK F LOW PROTECT. DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,e will do the work,andemployees the structure is not intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,CON D. 5,00 Code:The Contractor's License Law does not apply to an owner of properly who builds or improves thereon,and who docs such work FIXTURES,PER TRAP 5.06 SO,FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. .cuts are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.4OUTLETS 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- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER3000 RES IND CDN PB Other . . ❑ 1,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts I'm such projects with a contmeortO licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO, PARCEL NO. ❑ 1 am exempt under Sec.-,B.&P.C.for this WATER HEATER W/VENT 6.00 reason Owner Date WATER SYSTEM 5.06 ACC.DATE ACC.FILE NO. W'ORKERS'COMPF-NSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm tha I have a certificate of wnsent to self-insure. or a certif�:o of We rs'Compensation Ireumnce,or wUlfial ZONING ENG-SITE NO. cop thou 11'�-(/ L��C?k n'/ I/As of No f�W-I � Cr plied copy is ereb' urmsl •J. ife a FIRESPRINK ENERGY T-24 Z 0 plicant y I e e city inspection nv si n. MISC.- REFER TO ORD. v❑ N❑ Y ❑ N❑ ~ h0.00 'B RTIPICATIi OI°EXCh1 PT N FROM WORKERS' PERMIT ISSUANCE 1FLOOD ZONE A.L.U.C. LU - COMPENSA'I'ION INSURANCE PLG.CONTR. LIC.NO. PLGCL 0 , CL Z (This section need not be completed if the permit is for one TOTAL Y❑ F]N Y [:] N❑ hq dred dollars(S 100)or less.) U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any manner so as to O L) become subject to the Workers'Compensation Laws of California. Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 3 } tab NOTICE TO APPLICANT'. If,alter making this Certificate of Ex- ♦- Z emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provision, of the Labor Code, you nest forthwith comply with FEE U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=r-F.M,) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE I hereby affirm that there is a construction Inuring agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM / 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Addy H EATI NG UNIT 100,000 B.T.U.)9.50 Lender's Address ELECTRIC 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 • Information n correct I agree tog to b 'kith all oily and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and sole laws relating to building construction, and hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTUI SEE FEE SCH. above-mentioned property for inspection purposes. MECHANICAL (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs an. expenses which PERMIT ISSUANCE 10.00 CONST.TAX may in any way accrue against said City in consequence of the grantor of this permit CH.CONT. LIC.NO. MECH. TOTAL TOTAL -App an Con rwlor Date OFFICE COPY