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18095 (2) ` r POSTTHISCARD NEAR FRONT OF BUILDING . PERMIT NUMBER CITY OF CUPERTINO 18095 INSPECTION DIVISION JOB INSPECTION RECORD � Z "E �cl t 1 U PERMIT EXPIR151DN JOB ADDRESS I �O�de �UNIT# _LOT#t - - -` 1- PERMIT EXPIRE IF WORK. OWNER { AMR LLSaI,t CONTRACTOR Sa IS�NOT� START.E� WIi'H IN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM NOTE: LAST-CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS tim - I z' r _ r POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED "1'� (2Ytr5 �— 7 " �. PLUMBING UNDERGROUND /SLAB - /l ELECTRICAL ISSUANCE DATE MECHANICAL LD', EL i.c. �`�E�c'y� 1. / L� DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED - BUILDING PERMIT WOOD FLOOR INFORMATION PLUMBING 1-i - �ZC/ 6 �ACUA TIN SIFT MECHANICAL1JL, iCv7lLI/z II [ l ' f� ELECTRICAL FRAMING INSULATION STORIES TYPE.CONSTR. E� � � - ` OCC GROUP RES UNITS P.LACE.NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ® ROOF NOTE:NO I AL INSP. ALL3t MADE BEFORE °T avrP. EA To AL DIAPHRAGM THE CONSTRUCTION TAX IS PAIDI (J/ y� f ING ROOF SHEATHING 14 �� GUILD� ❑ ❑N USE❑ 0111, APPLY N0'`ROOFING'UNTIL ABOVE HAS BEE SIGNED FINALS DATE INSP. ASSESSORS PARCEL No. -_ ROUGH SANA ,I PLUMBING 'LL ELECT.ENERGY , TUBS 8 SHOWER PAN '2,'j, INACT PLUMBING ENERGY NDPARCEL NO MECHANICAL MECH. ELECTRICALBUILDI ACC.DATE ,ACC FILE No � FRAMING . ' ELECT. ZONING ENG.SITE N0. INSULATION - Za l PLUMBI GAS TEST - GAS MECHANIC EIRE SPRINK ENERGY T 2 COVER NO-WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y NO _ ELOOD zoNE A.L u.c. • EXTERIOR SHEAR ELECTRICAL RELEASE - INTERIOR SHEAR � L_ � FIRE DEPT. N� ❑ N� SHEETROCK GRADEFEE SUMMARY EXTERIOR LATH - BUILDING INTERIOR LATH . TEMPORARY PPROVALS BUILDING SCRATCH COAT ELECTRIC PLAN CHECK GAS - FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED ocOUPANCY SEISMIC FEE OCCUPANCY OF�IBUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED.BV BUILDING INSPECTOR. MICROFILM ARRANGE FORANSPECTION BY PHONING 252-4505, ELECTRIC Lu ONE WORKING DAY BEFORE REQUIRED INSPECTI a PLUMBING o PLEASE.GIVE JOB ADDRESS WHEN PHONING. Z r ' - MECHANICAL - SEE PERMIT FOR EXPIRATION DATE - ' IMPORTANT! p ONST^i7pX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. /,D) OFFICE COPY ' APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BU I LDINGPROJECT IDENTIFICATIO PERMIT NUMBER BUILDING .'APPLICATION & PERMIT ' t' 18095 0 C aoDREs � r� - � J O� u ' BUILDING - ELECTRICAL-PLUMBING-MECHANICAL 1'1° y.� OWNERS OP�CHECK iALIpAT10N NaME , ' DTV. ELECTRIC PERMIT FEE "11✓�/ •� 1 f(�vE CDNTRACTOR'B j � �� .�C NA r OUTLETS-SWITCHES-RECEP 10.00/1.00 .IJP J Gr- LIC.NO- /�S LIGHTING FIXTURES - 10.00/1.00 (.0 ADDREA 'S p / in CONTRACTORS ONTRACTOR7i4-N ,SOBS 9�e^3�i s APPLIANCES .4.00 W ILJJ 1 a'r.Iai el: 1,11XV PHONE PANELS 10.00 DATE OF APPLICATION RCHITECT - PLAN CHECK FEE P.C.NO. OR PANELS (OVER 200 AMP) 20.00 ENGINEER kN CtI.U)./ E LIC.NO. Z 6 (}; SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIAL CIRCUIT 5.00 PERMIT VALIDATION Ao REssvO•-Q�-'`� D V zIv (J EMP.METER OR POLE INS. 20.00 q_Z� '_ . APPLICANT MOTORS SEE FEE SCH. AOOR Has ' SERVICE CHANGE _ 20.00 q �I ,w o o LICENSED CON'I'RACTORS DL'CLA RATION 2- a U u ,1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE y z La (commencing with Section 7000)of Division 3 of the Business and a y LOG ELECT. P G. WECH, H w z PPofessions Code,' I my license is in toll for n b'tY \p-M.(I/ Z z m; Liccns•CIeM __Lic tondo,r tl- CRYno Date Conlmctor um no Y s All ILDING PERMIT a a OWNER-BUILDER DFCLA RA ION a o t u INFORMATION X 3 u o I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD VALUATION $/FT. u 0 j Law for the following reason.(Sec.7011.S,.Buslness anA Professions 10,00 I- - g PERMIT-ISSUANCE. ✓..J� Code:Any mulish wunty whiny structur e p riot t o is issuance; also 0 improve,demolish,or rc au an structure,p ELEC. 4 p p' y riot to its issuance,also ELEC.CONTR. -LIC.NO. 7 `�7 a n O u he is les the applicant for such permit to file a signed statement that TOTAL l{l• ti PERMIT TO w m he is licensed pursuant to the provisions of the Contractors License Hit Law(Chapter and 9(cosigns Codeciam )or Section is exempt therefrom o m and 5�--btv L the f 4 o Business and Professions Code)or Blot he is exempt therefrom and QTY. PLUMBING PERMIT FEE a m the basis for'the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. e. by any applicant for it permit subjects the applicant in it civil penally ALTER-DRAIN -WATER (EA.) 5.00 of not more than five hundred dollars($500)J: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 their sole compensation,will do the work,and the structure is not OCC.GROUP RES.UNITS intended or offered for 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 does such work FIXTURES-PER TRAP 5.00 SO.FT,FL E himself or through his awn employees,provided that such iniprrvr- `- 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- GAS-EA.SYSTEM-OVER 4 IEA.1 2.00 0 AD builder will have the burden of proving that lie did not build or im- BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ES IND CON • PB Oma, '❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ hunts 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 Low dues not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contmctons)licensed pursuant to SEWER-SANITARY-STORM EA.200f1/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I am exempt under Sec..,[14P.C.for this WATER HEATER W/VENT 6.00 reason Owner _ Date WATER SYSTEM .5.00 ACC.DATE ACC.FILE NO' WORFLRS'COMPENSATION DECLARATION WATER.TREATING EQUIP. 5.00 I hereby affirm that I have a certificate of consent to self.insure, i� ZONING ENG.SITE N0. or a certificate of Workers'Com n 'ti a Insurance,Or certified copy there ( ec. 00,Lab.C.) It r� Pal i)ey N uapany , O O Cerifledcopyishemby urnishe FIRE SPRINK ENERGY T40 Z Z ''�.�''Certified co is tiled with elle cit int m-' division. MISC.- REFER TO ORD. O A�plic:ud y❑ N❑ Y ❑ N❑ cc: W CI:RTIFICATI:OP EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 2." FLOOD ZONE A.L.U.C. UJ > COMPENSATION INSURANCE PLO.CONTR. LIC.NO. PLG. CL Z (This section need not be completed it the permit is for one _ TOTAL -� V[3N❑ Y [:] N❑ h it n it red dollmr Ci 100)os less) U O 1 certify that in the Performance of the work for which this per. OTV MECHANICAL PERMIT FEE FEE SUMMARY UL U mit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. y Date Applicant ALTER OR ADD TO MECH.. 5.00 BUILDING >_ W NOTICE TO APPLICANT: If,after making this Certificate of Ex- Z Cnq .0c emption,you should become subject m the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall he reviled revoked. AIR HANDLING UNIT(TO 1Q000C-F.M.) 4.00 -7 CONST RUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,ODOOEM.) 6.00 SEISMIC FEE I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance f the work for which t is permit is issu•d(Sec. MICROFILM 3097,CivC) HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.19.50 711-76- 1 Lender's Address ,.4 ,ELECTRIC 1 cartity that I ha rf*Ad PPllea IifRa d. in that the above VENTILATION FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county BOILER H.P.OF 100,000 B.T.U.) 6.00 PLUMBING • '7 ordinances and.state laws relating to building construction, and hereby authorize representatives of this city to enter upon the BOILER-COMP Cear100,000 BTU)SEE FEE SCH. MECHANICAL abovomenlioned property for inspection purposes. (We) agree to Save, indemnify and keep harmless Ilie City of MISC.- REFER TO ORD. �ps� i upertino against liabilities,judgments, costs and expense which PERMIT ISSUANCE 10.00 CONS I.T f may in any way accrue against said City in conseq uen of lh• D� ranting of this ermi MECH.CONT. LIC.NO. MECH. TOTAL/ _7 TOTAL 14704 Sig eof Apph at l nt/Contractor D �1 / OFFICE COPY,