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15940 (2) POST THIS CARD NEAR FRONT OF:BUILDING PFRMIT.NUMBER CITY OF CUPERTINO -' 15940 INSPECTION DIVISION .c JOB INSPECTION RECORD L 1 PERMIT EXPI 'ATION JOB ADDRESS " ` hT_s`1____� �NIT# _LOT# r PERMITrF,XPIFRF F:WORK OWNER CONTRACTOR" hS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- FOUNDATION - ANCE OR 180 DAYS FROM . �b NOTE: ' .LASTCALLED INSPECTION. LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB tS�6•e�T Fit, dkt - / ' PLUMBING r ('��',,, ,ca,c,�.•� ELECTRICAL ISSUANCE DATE MECHANICAL RLUG ELECT I PLG, MECH. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT 4WOOD : INFORMATION FLOOR VALUATION SIFT. PLUMBING / MECHANICAL ` �OV✓7/ a ELECTRICAL - - ERMIT TO FRAMING - ' "' `B tAf INSULATION b9 M, Ildy OCT 2'8 1988 STORIES TYPE CONSTH. - - OCC GROUP RES UNITS City o Cupertino PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO IT.FLOORAHEA TOTAL ACIII [GLS a, ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM . THE CONSTRUCTION TAX IS PAID�. - KURD IN❑USE� $)'prROOF SHEATHING Hes IND aoN PE OIe., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ASSESSOHSPARCEL NO ROUGH SAN:N ., PLUMBING - ELECT.ENERGY nvncr No PARCEL No, TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECR ENERGY . ..{ ' ELECTRICAL - ' BUILDING ENERGY ACC GATE ACCFILE NO FRAMING - ELECT.FINAL TEST ONING LNG.SITE NO INSULATION PLUMBING GAS TEST rde� GAS �E LNEHG V,T.24 - MECHANICAL' ❑ v ED N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING FLOOOZONEA,L U.C. EXTERIOR SHEAR ELECTRICAL RELEASE I�I INTERIOR SHEAR FIRE DEPT. ° D NE] ❑ No SHEETROCK. GRADE - FEE SUMMARY . EXTERIOR LATH BUILDING BUILDING 4Q/� INTERIOR OATH - .TEMPORARY APPROVALS ��•�SCRATCH COAT' ELECTRIC a PLAN CHECK GAS FEE ' NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE F _ �OR INSPECTION BY PHONING 252-4505, ELECTRIC IW--� ONE WORKING DAY BEFORE REQUIRED INSPECTION. ' PLUMBING L e0 a PLEASE GIVE JOB ADDRESS WHEN PHONING. Z SEE PERMIT FOR EXPIRATION MECHANICAL IMPORTANT! DATE - - � 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 BUILDING PROJECT IDENTIFICATION -PERMIT NUMBER - r BUILDING . APPLICATION.& PERMIT AODRESs 1 n9 4 33 V� BUILDING-ELECTRICAL-PLUMBING-MECHANICAL , I O V T O : OWNER'S PLAN CHECK VALIDATION '+' NAME /S9y�-3/1 TY• ELECTRIC PERMIT FEE PHorvE .y CONTRACTORS �., NAME OUTLETS-SWITCHES-RECEP 10.00/1.00 1JC.NO. LIGHTING FIXTURES 10.00/1.00 CONTRACTOR'S APPLIANCES PHONE 4.00 D cY ODR ESS PHONE PANELS ' 10.00 DATE OF APPLICATION: , ARCHITECT PLAN CHECK FEE - P.C.NO. off PANELS (OVER 200 AMP) -' 20,00 ZT�E ��s ��III LIC. No. •SIGNS TRANS. 3.00 ENGINEER AODHESS ARCHLON ENG. / �1.�//� SPECIAL CIRCUIT 8.00 PERMIT VALIDATION 26,9 S �i(/-� EMP.METER OR POLE INS. 20,00 ADDRESS +, APPLICANTS [TEMP. SEE FEE SCH, SERVICE CHANGE 20.00 Tr wo o LICENSED CONTRACTORS DECLARATION " ¢ a I hereby affirm that I um licensed under Provisions of Chapter 9 - ISSUANCE DATE yw (commencing with Section 7000)of Division 3 of the Business and - ¢H BLDG. ELECT.' PLG. MECH., r m z Professions Code,and my license is in full force and effect. zo�,/1 License Class Lic.Number G m�_17�J Dale Contractor H - BUILDING PERMIT OWNER-BUILDER DECLARATION v INFORMATION js ; l hereby affirm that um exempt front rte Contractor's License MISC.- - tuo J Law for the followingreason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 �r✓) VALUATION $/FT. �• Code:Any city or county which requires a permit to construct, Law ELEC.CONTE. LIC.NO. improve,demolish,or repair any structure,Prior to its issuann0.also ELEC. ic D¢ requires nse applicant for the permit ns file a signed statement that TOTAL �C'S D � PERMIT TO t ' w $ he is licensed Pursuant to provisions of the Contractor's License T v/ xi Law(Chapter 9sions(commencingwith Section is7000) exempt Division3mane !LU 4 D Business and Professions Code)or that he is of therefrom and DTV. PLUMBING PERMIT FEE ¢ F the basin Rn the alleged exemption.Any violation of Section]031.5 STORIES TYPE CONSTR. u , by any applicant for a permit subjects the applicant toa civil penally ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner of the property,nr my.emtployees with wages as BACK FLOW PROTECT, DEVICE 4.00 OCC.GROUP RES.UNITS their sale compensation,will do the work,and rte structure is not 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 q eS-<' property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 ZE O(1 50.FT.FLOOR AREA 'TOTAL ACREAGE himself or through his Own runakyws,provided that such inmrove- mentsarenetintendedoroffeud for sale.•If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 8.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 O , builder will have the burden of proving that he did not build or ire. 1 O BUILDING USE prove for purpose of sale.). - INDUSTRIAL WASTE INTER3000 RES IND CON PB Our., El . . - 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 thereon.and who LAWN SPRINKLERS-OVER 5(EA.) .1.00 contracts for such projects with a corltractonsl licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ lam exe ptu erS ,B&P.C.I'orthis WATER HEATER W/VENT 6.00 on Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. RRS' KECOMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 I eby affirm that I have a certificate ofconsent to self-insure, or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.CJ. Policy No. Company O ❑ Cartified copy is hereby furnished. FIRESPRINK ENERGY 24 ZZ ❑ Certified copy is filed with the city inspeclion division. MISC.- REFER TO ORD. H O. Applicant Y.❑ N❑ Y ❑ N❑ PERMIT ISSUANCE 10.00 Lu-- CER'I'IFICCOMPENSATION ION PROM WORKIiRS' Zs FLOOD ZONE A.L.U.C. W� COMPENSATION INSURANCE PLG.CONTE. LIC.NO. I.G.P / ❑ CL Z th (This section need nal be completed if e f permit is for one TOTAL O BU Y❑ NY � NE] dollars($100).r less.) ) 0 1 certify that in the performance of the work for which this per- OTY. MECHANICAL PERMIT +FEE FEE SUMMARY LL H mit is issued,I shall not employ any person in any manner so as to O w become subject to tire Workers'Cnnspen nation Laws of California. 0. Date Applicant - ALTER OR ADD TO MECH. 5.00 BUILDING 1171 r W NOTICGTO APPLICANT: If,after making this Certificate of 1: F ? emption,you should become suRrel.to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK U rhprovisions ov iitmsthis Labor Code, you must forthwith comply with FEE permit shall be deemed revoked.. AIR HANDLING UNIT(TO 10=C.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 lending agency I'ot EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit Is issued(Sea D 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 Lenders Address ELECTRIC -pig5-0 RIo i I certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 B�ys !, information is correct. I agree to comply with all city and county PLUMBING V, f ordinances and slate laws relating to building construction, and - BOILER-COMPI3 H.P.Of 100,000 B.T.U.16.00 � hereby.authorize representatives of this city to enter upon the r� •@. above-mentioned property for inspection purposes, BOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL .0 (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against 'abilities,ju •nt Ost and expenses which PERMIT ISSUANCE 10.00 2 CONST.TAX ma ny wa 'ccr c a ' st i it t consequence of 1h rpO nhngo a cot MECH.CONT. LIC.NO, MECH. TOTAL 16's ' TOTAL Y Signa[ App i a ontructor utc OFFICE COPY