The URL can be used to link to this page

16176 (2)� I POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINOfil 76 INSPECTION DIVISION s JOB INSPECTION RECORD yynn �A{ PERMIT EXPIRATION JOB ADDRESS �.0�-60 /Z';�V(L�' /�!« UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER ((„ �LLe� CONTRACTOR - IS NOT STARTED WITHIN INSPECTION- DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS: ' _GARAGE SLABS - POURNOCONCRETE UNTIL ABOVE HAS BEEN SIGNED �• UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE'DATE MECHANICAL - BLDG ELECT PLG, ECH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION $/FT. PLUMBING ' MECHANICAL - PERMIT TO ELECTRICAL FRAMING - Mad fit.._ STORIES TYPE CONSTR INSULATION - _ ' I DEC GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED 50 Ft FI.0011 AREA TOTAL ACREAGE ROOF I NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE "6 ROOF SHEATHING - HES IND CON PB ou ' APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ 0 1 ASSESSORS PARCEL NO ROUGH SAN.# PLUMBING - ELECT.ENERGY . TUBS 8 SHOWER PAN PLUMBING ENERGY TRACT NOPARCEL NO MECHANICAL MECH.ENERGY ' ELECTRICAL BUILDING ENERGY ACC GATEACC.FILE NO FRAMING per co'Yre ELECT.FINAL TEST INSULATION PLUMBING ZONING ENG SITE NO. GAS TEST GAS MECHANICAL FIRE SPRINK ENERGY T.14 � COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING y [:D NY [] N[] EXTERIOR SHEAR B moo- ELECTRICAL RELEASE , 8 FLOOOLONE ALuc INTERIOR SHEAR FIRE DEPT, Y - N❑ Y ❑ N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH TEMPORARY APPROVALS BUILDING �76tv SCRATCH COAT - - ELECTRIC PLAN CHECK GAS FEE moo( NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE 70 OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM Lu ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC ONE WORKING.DAY BEFORE REQUIRED INSPECTION. PLUMBING z 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 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY f3Ul LDI NG PROJECT IDENTIFICATION - .PERMIT NUMBER _ all,LO, APPLICATION & PERMIT 1617 6 47 d7 ,l / UI LDI NG - ELECTRICAL-PLUMBING-MECHANICAL O/WWNNEER'SS ��,/� N/ PLAN CHECK VALIDATION //��!/7L'� ///� HonE OTY' ELECTRIC PERMIT FEE CAAMERACTORs UTLETS-SWITCHES-RECEP 10.00/1.00 i. uc.NO, LIGHTING FIXTURES 10.00/1.00 4-1-0 CONTRACTORS PPLIANCES-RESIDENTIAL 4.00 ADOR Ess' PHONE PANELS 10.00 DATE OF APPLICATION ORRCHfTscT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P:C.NO. ENGINEER LIC.No. ,- SIGNS TRANS. 3.00 ADDRESS ENG. SPECIAL CIRCUIT 5.00 - PERMIT VALIDATION ZIP. EMP.METER OR POLE INS. 20.00 AMOTORS SEE FEE SCH. ADDDREORESSSS SERVICE CHANGE 20.00 woo LICENSED CONTRACTORS DECLARATION ¢u w I hereby affirm that I am licensed tinder provisionsof Clmpter9 - ISSUANCE DATE w (commenen with Section 7000)of Division 3 of the Business and ¢ e g BLDG. ELECT. PLG. MECH. rw i Professions Code,and my license is in full force and effect. El E_ O m - License Class Lic.Number o N -D Dale Contractor P: y f a BUILDING PERMIT R ¢ a' OWNER-BUILDER DECLARATION a u+ v - - INFORMATION it. ;' N I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD LL o¢ Law far the following reason.(Sec 703 t.5,Business and Professions PERMIT ISSUANCE - �. VALUATION S/FT. '- - 0 J Code:An cit or count q p d w y y y which requires eros to itansuance,also SE ¢Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0. ELEC. i W'm a requires the applicant for such permit to file a signed statement 0m[ TOTAL PERMITTO he is licensed pursuant to the provisions of the Contractor's License n ¢ Business and Professions Code) i Law(Chapter 9(commencing with Section 7000)of Division 3 of the or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ¢ H$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to.civil penally ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars(55000.): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT. DEVICE4.00 OCC.GROUP RES.UNITS, their sole compensation,will do the work,and the structure is not intended or offered far Sale (Sec. 7044, Business and Professions 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 doessuchwork FIXTURES-PER TRAP 5.00 SQ FT.FLOOR AREA TOTAL ACREAGE himself re through his own employees,provided ev such improve-ilding WD moms ore not intended or offered for Salo.If,however,the building GAS•EA.SYSTEM•1 INC.40UTLETS 6,00 or improvement is sold within rine year of completion,the owner- GAS•EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,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 floacon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 - contraclsforsuchprojectswithacontractims)licensed pursuant SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor' L s i ase L'W TRACT NO, PARCEL NO. t exemp 'rid WATER HEATER W/VENT 6.00 rens n Own +e WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKIikS'COMPFNS,� I OF LARKUON� WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of cansenl tq self-insure. ZONING ENG.SITE NO. nr a certificate of Workers'Compensation Insurance,or a certified copy thercof(Sce.3800,Lab.C.). Policy No. Company O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 Z Z ❑ Certified copy-is fled with the city inspection division. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ 0 Applicant Y N Y N CC rn PERMIT ISSUANCE 10.00 UJ - CliRTI FICA11:OF COMPENSATION PTINS PROM WORKERS' FLOOD ZONE A.L.u.C. ' CL COMPENSATION INSURANCC PLG.CONTR. - LIC.NO. PLG. CL ClZ (This section need not he completed if the permit is far one TOTAL Y❑ N❑ Y❑ N U 0 hundred doll...(S 100)or less.) I I certify that in the performance of tie work for which this per. DTV MECHANICAL PERMIT FEE FEE SUMMARY LL P mit is issued,I shall not employ any person in any manner so as to O 0 become subject m We Workers'Compensation Laws of California. C. Dmc - Applicant _ BUILDING - } N NOTICE*1'0 APPLICANT:,If,after making this Certificate of Fir. ALTER OR ADD TO MECH. 5.00 l F.,z eruption,you Should become subject to the Workers'Compensation APPLIANCE 5.00 FEE PLAN CHECK La6 provisions of the Labor Code, you must forthwith comply with t..1 such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=11F.M.) 4.00 e CONST RUCTION LENDING AGENCY AIR HANDLING UNITI0VER 10,000C.F.M.) 6.00 SEISMIC FEE r Za I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this Femuir is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 / V Lender's Address ELECTRIC I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and County PLUMBING ordinances and state laws relating to building construction, and BOILER-cUMP I3 H.P.Or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the- BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mucirmned property for inspection rposes. (We) agree to save, indemnify ;ut ep Ilnrniless the City of MISC.- REFER TO ORD. Cupertino against liahil' s�sjudgme costs and expenses which PERMIT ISSUANCE 10.00 CONST.TAX m.y a ay ace against City in consequence of the r In is MECH.CONT. LIC.NO. MECH. TOTAL TOTAL } i ria Nr Applicant/Cont clor Date OFFICE COPY _