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15527 (2) POST THIS CARD NEAR FRONT OF BUILDING J PERMIT NUMBER • CITY OF, CUPERTINO 1552 INSPECTION DIVISION JOB INSPECTION RECORD • _7 PERMIT EXPIRATION JOB ADDRESS 11370 S. Stelling —UNIT# _'LOT# .. PERMIT EXPIRES IF-WORK' OWNER St. Andrew Armenian ChurAahTRADTOR IS NOT STARTED' WITHIN INSPECTION DATE I INSPECTOR INSPECTION RECORD 180 DAYS OF PERMIT ISSU- I FOUNDATION ANCE OR 180 DAYS FROM . NOTE% - LASTCACLEDINSPECTION. UFER - ALL GRADING AND DRAINAGE SHALL BE INSTALLED. ' PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARDS. J GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - UNDERGROUND /SLAB ' ' PLUMBING - .1 ELECTRICAL ISSUANCE DATE MECHANICAL - BI.Dr, ELECT. - .PLG. MEC., DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR "IWVALUATION SIFT. ' PLUMBING - � . MECHANICAL ' PERMIT TO y ELECTRICAL r I FRAMING - ; pRIEs iVPE CONSTH. INSULATION - '0cc.�CROUP RCS.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED - I ,• ' ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sn.F T,aooR Ai+EA _TOTAL ACRE AGE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BUILDING USE RLSIND CON ROOF SHEATHING • ON C.: PB' 0,1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED 'FINALS DATE INSP. ❑ El ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.N PLUMBING ELECT.ENERGY ' TRACT No; PARCELNO TUBS&SHOWER PAN' PLUMBING ENERGY MECHANICAL MECH.ENERGY. ' ACC DATE ACC.FILE NO, ELECTRICAL BUILDING ENERGY , FRAMING - ELECT.FINAL TEST mmmc - ENc.sIrE NWINSULATION PLUMBING GAS TEST GAS T • FIRE SPRINK ENERGY i.24 MECHANICAL Y COVER NO WORK UNTIL ABOVE HAS-BEEN SIGNED HEATING F L.0 c. v A❑ N� EXTERIOR SHEAR ELECTRICAL RELEASE FL000 zG�N+r ; . • ,- INTERIOR SHEAR FIRE DEPT.' YE] N� V L NO SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING . - TEMPORARY APPROVALS BUILD NG INTERIOR LATH -' - _ SCRATCH COAT - ELECTRIC -/y' PLAN CHECK ' GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUI LDING FINAL ISSIGNED BY BUILDING INSPECTOR. , MICROFILM ARRANGE FQR INSPECTION BY PHONING 252-4505J. . ELECTRIC F ONE WORKING DAY BEFORE REQUIRED INSPECTIPLUMBING zPLEASE GIVE JOB'ADDRESS WHEN PHONING.— SEE PERMIT FOR EXPIRATION DATEMECHnwcAL IMPORTANT! CONST.TAX PLEASE READ'REVERSESIDE BEFORETOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL-POINT PEN ONLY - BU LD1 NG PROJECT I DENTI FICATI ON 'PERMIT NUMBER BUILDING APPLICATION & PERMIT 15527 ADo Ess S ALL BUILDING —ELECTRICAL—PLUMBING—MECHANICAL , O NEH'S r A. I E..l IY/Y C-l4J, C PLAN CHECK VALIDATION QTY. ELECTRIC PERMIT FEE , CONTRACTOR s - UTLETS-SWITCHES-RECEP 10.00/1.00 LIC.No. LIGHTING FIXTURES 10.00/1.00 ADDRESsroR's APPLIANCES-RESIDENTIAL 4.00 PHONE PANELS10.00 DATE OF APPLICATION OR RCHUEcr - PANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE .Q NO. ENGINEER LIC NO, SIGNS TRANS. 3.00 ARCH OR ADDRESS E"0 SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. -----2U=ADDRE 'ZO ADDREPPLISS SS MOTORS SEE FEE SCH. o ¢_ SERVICE CHANGE 20.00 S ' 02 LICENSED CONTRACTORS DECLARATION , AW_ rt is u I hereby affirm that I am licensed under provisions of Chapter 9 NICE DATE y a w (commencing with Section 700of Division 3 of the Business and BLDGELECTPLG. MECH. F N z Professions Cole,and my licensee is in lull farce and effect. . . ❑ El ia o License Class Lir .Number Date � Contractor Qy E \, ¢ ¢w a OWNER-BUILDER DECLARATION R BUILDING PERMIT E ; u r 1 hereby afflnn that 1 um exempt from the Contaacnx's License MISC.s REFER TO ORD INFORMATION F a- a J Law for the following reason.(Sec 7031.5,Business and Professions PERMIT ISSUANCE �Tg00 L ATION - .$/FT. � w > Code:Any city orcounty which requires a permit to construct.alter, ¢ ¢ a 0 improve,demolish,or repairany structure,prior to its issuance,also ELEC.CONTO LIC.NO. ELEC. q E. 0 ¢ requires the appllcanl'for.such permit to file a signed statement that TOTAL r�eZ,� A w$y he is licensed pursuant to the provisions of the Contractor's License PERMIT TO r Law(Chapter 9(commencing with Section 7000)of Division 3 oflhe io Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE Cr/x"I O L� ¢ I- 0 the basis forthealleged exemptiou.Anyviolation ofSection7031.5 STO IES TYPE CONSTR. by any applicant for it permit subjects the applicant toacivil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 of not mom than five hundred dalIms(8500).): 0 I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE. 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the 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 • property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 SO FT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve- ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1 INC.4 OUTLETS 6.00 or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 builder will have.the burden of proving that Ire did not build or Co. BUILDING USE prove for purpose of sale.). INDUSTRIAL WASTE INTER3000 RES IND CON PB Omer .C 1,as owner.1 the property,am exclusively contracting wi0l . . ❑ 1:1 ❑ ❑ ❑ licensed Contractors to construct onstct the project(Sce.7044,Business LAWN SPRINKLERS-1 INC 5 00 ASSESSORS PARCEL NO. and Professions Code:The Conireuor's License Law does not apply V.B.. . to an owner of property who hunks or improves thereon,and who LAWN SPRINKLERS-OVER 5 (EA.) 1.00 contracts for such projects with a contmclor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCELNO. ❑ lumcxem tun Sc. ,B.&P.C.I'or[h'v WATER HEATER W/VENT 6.00 ' reason '�.Owner Date _ 1115 WATER SYSTEM 5.00 ACC.OATE ACO.FILE NO. WORKERS' OMPENSATiON DECLARATION WATER TREATING EQUIP. 5.00 ' I hereby affirm that I have a certificate of consent to self-insure, ' or a certificate of Workers Compensation Insurance,or,a certified ZONING ENO.SITE NO, copy thereof(See.3800,L.oC.). Policy No. Company O ❑ Certilled copy is lmrcby famished. .FIRE SPRINK ENERGY T44 Z 2 0 Certified copy is tiled with the city inspection division. MISC.- REFER TO ORD. O Applicmnt Y❑ N❑ Y ❑ N❑ ~ m I PERMIT ISSUANCE - 10.00 LU — CERTI I'ICATE F EAEION INS FROM WORKERS' FLOOD ZONE A.LU.C. W � - COMPENSATION INSURANCE PLO.CONTE. EL Z (This section need not be completed if the permit is for one TOTAL Y❑ N❑ Y E] N❑ hundred dollars(S 100)or less.) U O 1 certify that in the performance of the work for which this per CITY. MECHANICAL PERMIT FEE FEE SUMMARY LL F mit is issued,I shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. y Date ApplicamALTER OR ADD TO MECH. 5.00 BUILDING >_ N NOTICE'1'O APPLICANT. If,after nuking this Cerlilal 'ice of Ex- _ (_ 2 emption,you should become subject to 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 be deemed revoked. AIR HANDLING UNIT(TO 10/1170C.F.M.) 4,00 CONSTRUC'PIONLENDINGAGENCY AIR HANDLING UNIT(OVER 10MC.RM.) 6.00 SEISMIC FEE 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 permit "issued(Sec. MICROFILM 3097,Civ.C.), HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name H EATING UNIT(OVER E_R 100,000 B.T.U.)9.50 5�L..0,, Lender's Address � ELECTRIC a�U� Icerl,fy that l have7=1 hlsapplicutionand state Hal the above VENTILATION FAN (SINGLE) 4.00 • information correct 1 agree to comply with all city and county BOILER-OOMP(3 H.P.or 100,000 B.T.U.)�6.00 PLUMBING ordirdinanccessand sate laws relating to building construction, and hereby aulhorim rcpresenmtives of this city to enter upon the BOILER-COMP R•COMP IOver I OU,000 BTU)SEE FEE SCH. MECHANICAL above-mentioned properly for inspection purposes. , (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against I' bilities,ju gments, costs and expenses which - - CONST.TAX may in an y c e a st said City in consequence the PERMIT ISSUANCE 10.00 !anti 11 a n' . is MECH.CONT, LIC.NO. MECH. gS TOTAL TOTAL notur o Ap cant/ ontractor TDlic f , OFFICE COPY