The URL can be used to link to this page

13771 (2) POST THIS CARD NEAR FRONT OF BUILDfNG - .. . CITY OrERnnl NUMBER F` CUPERTINO ` 13771 INSPECTION DIVISION JOB.INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS /�S/'�- `�tyC� `��'�/'��`I' • UNIT# LOT#.� PERMIT EXPIRES IF WORK OWNERr✓ CONTRACTOR IS NOT STARTED WITHIN INSPECTIOW E5ATE I INSPECTOR INSPECTION RECORD 18GDAYS OFPERMIT ISSU- FOUNDATION ANCE OR 180 DAYS FROM LIFER LASTCALLED INSPECTION. PREGUNITE PERMIT VALIDATION ' POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB W PLUMBING p C ELECTRICAL - SEANCE DATE MECHANICAL - - LEC'. PLO.L MEGR. DEC ❑' ❑ ,Q\ 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED µ� ING PERMIT WOOD FLOOR MV INFORMATION '2 VALUATION -S/FT PLUMBING . MECHANICAL ox 4,10 PERMIT TO ELECTRICAL - - FRAMING ~• _. •y dJ�. STORIES- TYPE CONSTR. INSULATION OCC.GROUP RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF • SO.FT.FLOOR AREA TOTAL ACREAGE , g DIAPHRAGM. euaomc USE RES IND CON PB Olney APPLY-NO ROOFING UNTIL ABOVE HAS BEEN SIGNED Il ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO. ROUGH . PLUMBING - TRACT NO. PARCEL No. GAS TEST MECHANICAL ' ACC.DATE, ACC.FILE N0. ' ELECTRICAL FINALS DATE INSP. FRAMING - SAN * INSULATION - PLUMBING ZONING ENG.SITE NO. GAS S(I�C�.ZL. MECHANICAL FIRE$PRINK• ENERGY T�]< COVER NO WORK UNTIL ABOVE HAS BEE SIGNED HEATING /Lv [:] NE] v E:] "o �� FL00020NE A.LU.C. LATH—INTERIOR ELECTRICAL v❑ N❑ v❑ N❑ LATH—EXTERIOR i FIRE DEPT. SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR L BUILDIN — BUILDING S�;/ SHEAR EXTERIOR TEMPORARY APPROVALS FIREWALLS ELECTRIC i - PLAN CHECK GAS FEE / NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING ISNOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTION. O� PLEASE GIVE JOB ADDRESS WHEN PHONING. PLUMBING i Z - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL CONST.TAX c, IMPORTANT! PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY A9PLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY rr BU I LDING PROJECT I DENTIF I CATION PERMITNUMBER OILDI DNG 11512 Seven Springs Lane APPLICATION & PERMIT ADDRESS 13771 DAt - 1 n BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNER'S PLAN CHECK VALIDATION NAME C(� �] /y� QTY. ELECTRIC PERMIT FEE Inc. PHONE 595-2100 Ir'Ps NOMeRAcrons UTLETS-SWITCHES-RECEP 10.00/1.00 ^� &M , Inc. LII:.ND. 430097 IGHTING FIXTURES 10.00/1.00 �s nooeeu TORS 220 Twin Dolphin Drive, Ste. C PPLIANCES-RESIDENTIAL 4.00 Redwood Cit CA 94065 PHDNE 595-2100 / PANELS 10.00 (� DATE OF APPLICATION ARCHITECT Aram Bassenlan, A.I.A. & Assoc. PANELS (OVER 200 AMP) 20.00 -PUN CHECK FEE .c.N . ENGINEER (y� h[� FM LIC.No. SIGNS TRANS. 3.00 ADDRESS 00 ENG. '39% Westerly Plane, 1/V SPECIALCIRCUIT 5. PERMIT VALIDATION LcegA�l I. Beach, CA ZIP 92660 TEMP.METER OR POLE INS. 20.00 AA'PL'CADDRESS Do 220 Twin1phin Drive / MOTORS SEE FEE SCH. n , L'pstr-R�n,J Redwood City, CA 940651 SERVICE CHANGE 20.00 p o o LICENSED CONTRACTORS DECLARATION <U v I hereby affirm the(I am licensed under provisions of Chapter 9 ISSUANCE DATE . (commencing with Section 7000)of Division 3 of the Business and BL 12ELECT. PLG. MECH. iProfessions Cod nd my license u in full furpq�p�,�.(fecl. f7� s, o fl- License Class Lic,Number 4.Ad11/ Iv v 0 z D Date Contractor a r BUILDING PERMIT ¢ ¢ i OWNER-BUILDER DECLARATION INFORMATION X r I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD ¢ 60[3 Law for the fo0owing mison.(Sec.7031.5,Businessand Professions pERMFI ISSUANCE 10.00 D� VALUATION f/FT. r - Code:Any city or county which requires a permit to construct,alter, / ¢ ir Q Q improve,demolish,or repair any structure,prior m it,isuanc0.alio ELEC.CONTR. ,IC.NO. ELEC. i V " 0 E requires the apphcallt fir AICh permit to Zile a LgnCd slater col that TOTAL , � PERMIT TO w $ he is licensed pursuant W the provisions of the Contractor's License H z i Law(Chapter 9(commencing with Sect too 7000)of D Msion 3 of t he V U - 4 Business and Professions Code)or that he is exempt therefrom and QTY. PLUMBING PERMIT FEE IF=0 the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE^CON�STjR. i ; - by any applicant for a permit subjects the applicant moa civil penalty ALTER-DRAIN& VENT-WATER (EA.) 5.00 of not more than five hundred dollars(5500).) ❑ I,es owner of the property,or my wnployees wi0m wages as BACK FLOW PROTECT. DEVICE 4.00 their sole compensation,will di the work,and the structure 6 not44 GROUP RES.UNITS intended or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND- 5.00 s - ! Code:The Contractor's License Law does not apply to an owner of A property who builds or improves themon,and who does such workFIXTURES-PER TRAP 5.00 5O,FT.FLOOR AREA TOTAL ACREAGE • himself or through his own employees,provided that such improve- menlsarenotintendedoroffered for sale.IL however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 � or improvement is sold within one year of completion, the owncr- rs.�; builder will have the burden of proving that he did not build or ire- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE prove for purpose of NHC.). INDUSTRIAL WASTE INTER. 30.00 Res IND CON PB 00F., ❑ I,as owner or the property,am exCiusivCly contracting with ❑ ❑ ❑ ❑ lice used contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORSPARCEL NO. and Professions Code rhe Contractor's License Law docs not apply / to an owner of property who builds or improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 -3 F 6- 4-3/f` -d contracts for such projects with a ontractoAs)licensed pursuant to the Contraclnr's License Law. SEWER-SANITARY-STORM EA.200ft/10.00 �� TRACT NO. PARCEL No. C1 and exempt under Sec.-,BAP.C.I'..this WATER HEATER W/VENT 6.00 ,v,Ison Owner Dale WATER SYSTEM 5.00 ACC.OATF ACC.FILE NO. WORKERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that 1 have a certificate of consent to self-insure. or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. Pony thereirB«.3gCo,ipany United-Pac./Rellance- Policy Ni. Conlpuny_ Q f] Certilied Po if lereby ed. - FIRE SPRINK ENERGY T-24 Z Z XI Cenifw tit the cit ivision. MISC.- REFER TO ORD. ❑ ❑ ❑ ❑ O Applicant _ V N V N CC y CERT CATE 017 EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE ALL-U.C. LU > COMPENSATION INSURANCE PLG.GONER. LIC.N0. PLG. d O (PIIS .,If.. need not he cumpluted if the Permit is for one TOTAL 3 Y❑ N Y ❑ IN E] Z) Z hundred dollars(5100)or I..) U O 1 certify that in the Performance of the work for which this per- QTY MECHANICAL PERMIT FEE FEE SUMMARY LL I- mil is issued,I shall not employ any person in any manner so a to become subject to the Workers'Compensation Laws of Calhomla. U /yS d Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING V V Ql } 0 NOTICE TO APPLICANT: If,after making this Certificate or Ex- F Z emptwm,you should beconme subject to the Workeri Compensation APPLIANCE 5.00 - PLAN CHECK provisions of the labor Code, you must forthwith comply with FEE ,`--7 ,P3 U such provisions or re isiprovisionsor this permit shell be dccmcJ ,.ked. AIR HANDLING UNIT(TO 10J]OOGF.M) 4.00 J CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE Q a� I hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 (he performance of the work for which this permit is¢sued(Sec. MICROFILM 3097,CivC) .t � .FIC HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATING UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address P - 1SCo,_ ELECTRIC �7 I certify (hat 1 hove read this application and state that the above VENTILATION FAN (SINGLE) 4.00 (p information is correct.I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING �. � 4 sLV ordinances and state laws relating to building conslraclion, and hereby aErhmoc representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above mentioned property for inspection purposes, sS (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. p Cupertino against liabilities,Judgments, costs and expenses which CONST.TAX O C may in any way accrue against said City in consequenPERMIT ISSUANCE 10,00 �A, ce of the granting 0. MECH.CONT. LIC.NO. MECH. ��/✓p 7 TOTAL J TOTAL SS-30 Signature pphcant/Contractor Da • yv OFFICE COPY