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14969 (2)
�.` POST THIS CARD NEAR FRONT OF BUILDING - PERMIT,NUMBER CITY OF CUPERTINO 14959 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS�Il�3Z 1J4--V�N (il lel �I IV�HNIT#. LOT-0 _ - - PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU" I FOUNDATION NOTE: ANCE OR 180 DAYS FROM ; UFER _ '/-13�g� ALL GRADING AND DRAINAGE SHALL BE INSTALLED LASTCALLED INSPECTION. - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT.VALIDATION PR EGUNITE CUPERTINO STANDARDS. r , GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED C t- UNDERGROUND /SLAB PLUMBING _ 'vl '� Cy ELECTRICAL ISSUANCE DATE MECHANICAL - BLDG ELECT. PLO. MTCR. . V' o, 121 ©. 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BWLDING PERMIT WOOD FLOOR AQR$FORMATION ALUATION 5/FT, PLUMBING, r MECHANICAL 00 ELECTRICAL PERMn TO FRAMING sm INSULATION STORIES TYPE CONSTR OCG GROUPZZU RES,UNITS LACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED _ ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO FT FLOORAREA TOTAL IF.EAGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID .2263 BUILDING USE 1% ROOF SHEATHING : RES IND CON _ Pa Ong>, APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 91 1-1 E ED El ASSESSORS PARCEL NO ROUGH SANA PLUMBING , 7 -Ov .ELECT.ENERGY . TUBS 8 SHOWER PAN / -�/- PLUMBING ENERGY TRACT NoPARCEL NO MECHANICAL MECK ENERGY ACC DATE ACC.FILE NO. ELECTRICAL BUILDING ENERGY FRAMING ELECT.FINAL TEST zoNlrvc ENC.SITE No. INSULATION PLUMBING k4Q, _ GAS TEST GAS - FIRE SPRINK ENERGY TZA MECHANICAL COVER NO WORK UNTILABOVE HAS BEEN SIGNED HEATING L—] NED I N[ 0. . EXTERIOR SHEAR ELECTRICAL RELEASE FLOOD ZONE A.1-U C. INTERIOR SHEAR FIRE DEPT. `[:] N❑ a 0 ND SHEETROCKw2p, GRADE FEESUMMARY EXTERIOR LATH n"eBUILDING INTERIOR LATH TEMPORARY'APPROV LS BUILDING916.00 SCRATCH COAT y.$ ELECTRIC -PLANCHECK GAS FEE ' "NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNEDBY BUILDING INSPECTOR. MICROFILM LU ARRANGE FOR INSPECTION BY PHONING 252-4505, ' ' ELECTRIC ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBINIG 0� PLEASE GIVE JOB ADDRESS WHEN PHONING. 6 8.51 Z ENA SEE PERMIT FOR EXPIRATION DATE'- IMPORTANT! PPLEASE READ REVERSE SIDE BEFORE 1500.01 ' CALLING FOR FINAL INSPECTION. OFFICE COPY CITY OF CUPERTINO CERTIFICATE OF COMPLETION BUILDING INSPECTOR'S OFFICE Date ...... ------- -------------------- 19.... Building Permit No. 1AVR The Building Located at ---- .......&10�---- ------------ 1lwnedby ... . .. .---- ...................... . 3.�--------------- (G mpleted) Has Been . (Altered) For Use As: ...........`5,.015,.0.........0..o..................................... ........................................................................................................................................... ............................................................................................................................................ ........................... ........................... ............------ PD-7 BUILDING INSPECTOR !`HILICANT TO FILL IN INFORMATION WITHIN RED LINES.- USE BALL POINT PEN-ONLY ^ BU I LDING PROJECT I DENTIFICATI ON 0' PERMIT NUMBER " aD,LD,NG "Ulve APPLICATION & PERMIT ADDREas Lot 132 Plan ZA - BUILDING-ELECTRICAL-PLUMBING -MECHANICAL - b r.. OWNER'S l�,,,,,,,� PLAN CHECK VALIDATION NAME �1�ecpry "'""F' Inc. & Ahrmnson OTs. ELECTRIC PEP11 FEE TORS PhENfS AdN5-595-2100 NAMEHACTOR'sy ^ UTLETS-SWITCHES-RECEP `10.00/1.00 G s Inc 11C.NO. B-430097 LIGHTING FIXTURES 10.00/1.00 CONTRACTORS 220-0 Twin Dolphin Dr. M PPLIANCES-RESIDENTIAL 4.00 1.alif. 940 ' ^111E 220-C PHorvE D., 415-595-21 PANELS IO.00 GATE OF APPLICATION ' ARCHITECT PLAN CHECK FEE P.C.NO. OR Aram Bassenian AIA & Assoc. PANELS (OVER 200 AMP) 20.00 ENGINEER //��,,,1�.,'',�,,,,�ra rye LIC. /N/OyC�-8395 SIGNS TRANS. 3.00 ARCH AOOREM ENG. 2031 VI ha U Dr. #100 SPECIALCIRCUIT, 5.00 PERMIT VALIDATION ' Santa Ana Hts. CA, zQ2707 T EMP.METER OR POLE INS. 20.00 - APD RE220 C Twwinn Dolphin Dr. RX CA MOTORS SEE FEE S.C.H.ADORE SS w 5 4065 SERVICE CHANGE 20.00 /vjV C o o LICI'-NSED CONTRACTORS DECLARATIONto ' a i W I hereby affirm that 1.,it licensed under provisions of Chapter 9 ISSUANCE DATE h a N (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. -MECH. F m Z I'rut'ssicn s Code.:yp{d my license u in full forac� 'ct. z 0 rn License Coss Lie.Number 4SL o H Date Contractor Clio a x 4 J - BUILDING PERMIT ¢ ¢ i u OWNER-BUILDER DECLA ION I ORMATION K r I hereby affirm that I am exempt from tire Contractor's License MISC.- REFER TO ORD u o j Law for the followin reason.(See 7031.5,Business and Profusions ON $/FT. - g PERMIT ISSUANCE 10.00 Code:Any city or county which requiresa permit tocunstrucl,alter, n re or < o improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTH. LIC.NO. ELEC. 1 79 0 0 C rc,airc,the applicant for such permit to file a signed statement that TOTAL ;W w m he is licensed pursuant to the provisions of the Conirnctor s License RMIT TO Hi > Law(Chapter 0(commencing with Section 7000)of Division 3 ofthe � a Business and Professions Code)or that he is exempt therefroln and QTY. PLUMBING PERMIT B i 0 ¢ '- $ the basis for the alleged exemption.is the applicant oto action en Ls STORIES TYPE CONSTR. by any omthafor a permit subjects the O).): ant toucivil penalty ALTER-DRAIN -WATER (EA.) 5.00 of not mase than foo the prop dollars(toy em): 2 5*P ❑ ole owner at the property,t e my employees with wages as - BACK FLOW PROTECT.DEVICE 4.00 their ode compensation,will do the work,and the structure n not OCC.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 dos not apply to an owner of R-3 property who bullus or Improve,thereon,and who dols such work FIXTURES-PER TRAP 5.00 50.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that,such improv,,- meets are not intended or offered for sale,If,however.the building GAS-EA.SYSTEM-I INC.4 OUTLETS 6.00 2263 or improvement is sold within one year of completion,the owner. GAS EASYSTEM OVER 4 (EA) 200 builder will have the burden of proving that he did not build or ire- GAS . - . . - BUILDING USE prove for purpnseof sale.). INDUSTRIAL WASTE INTER3000 'RES IND CON PB Omer . . ❑ "1,as owner of the property,am exclusively contracting with ❑ El 0 ❑ 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 huilds or ilnprove,thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 -1 contracts forsuch projects with a contractims)licensed pursuant to - the Contmcmr'sLlcans,Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ lam exempt ands sea ,B.SP.C.forthis ream.. WATER HEATERWNENT 6.00 8067 Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE N0. WORK ERS'COMPI�NSATION DFCLARATION WATER TREATING EQUIP. 5.00 1 hereby affnm that 1 have a certificate of consent to self-insure. or a certificate of Workers Campcnmtion hour...v,or a certified ZONING ENG.SITE NO. copy mega(See.3800,Lab.C.).United PdC1f1C Policy No: Company O ❑ Certified copy is hereby fumishN. FIRE SPRINK ENERGY T-24 z Z I( CertllieJ co ed with the city impection division. MISC.-' REFER TO ORD. O Applicant Y ❑ -N❑ Y N[_ CC T CFRTIFI 'F OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > COb1PENSATION INSURANCE PLG.CONTR. LIC.NO. PLG. � CL CI (Phis section red not be completed if tire permit e is for one TOTAL y N Y N hundred della..(S 100)or It - U O 1 certify that in the Performance of the work for whichthis per- Ty' MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is named,1 shall not employ any perwn in any manner so as to 0w b,,comceubject to lira Warkcri Cempcnsutiom LawsofColiforn,. - Datt, Applicant BUILDING CL ALTER OR ADD TO MECH. 5.00 916.00 } m NO'I'ICE TO AI'I'LICAN'f: II,alter making this Certificate of his. F Z emption,you should become subject to the Workers'Compensation APPLIANCE - 5.00 PLAN CHECK 15.50 U provisions f tine Labor Code, you must forthwith comply with FEE /energy_ p permit shall be deemed revoked. AIR HANDLING UNIT(TO 10=C.F.M.) 4.00 9 62.00 I CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVERIO,000C.EM.) 6.00 SEISMIC FEE 12.53 I hereby affrm that mer, is a comtruction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the "I'mmuce f the sun k fe}� hii, Iles)Wit is is}�ucd(Sec. MICROFILM 3097,CIv C.). �eCltrl�y Yac1Tic l-fl2 t Erca HEATING UNIT(TO 100A00 B.T.U.) 8.00 Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.50 68.5 Lender's Names4 .� _ ELECTRIC I ccrtlty that 1 have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 infennation k correct I agree to comply with all city and county PLUMBING 68.5 ordinances and state laws retating to building construction, and BOILER-CON'P(3H.P.or10QD00B.T.U.) 6.00 hereby aulhuriic representatives of this city to enter upon the68.5 v� nspection purfows. - 801 LER-COMP (over 1)0,000 BTU)BEE FEE SCH. MECHANICAL above-mentioned property for i (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupirtino against liabilities,judgments, costs and expenses which CONST.TAX 288.2 may in any way accrue against said City N;Cp. uencc of the PERMIT ISSUANCE 10.00 ..ting of this MECH,CONT. LIC.NO. MECH. ,� 8S TOTAL TOTAL 1500.0 Signature ocamOC, I Date I OFFICE COPY - - -