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15248 (2)POST'THIS CARD NEAR FRONT OF BUILDING ' PERMIT NUMBER 1 ..CITY OF CUPERTINO 15248 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 10130 Westminister Court UNIT'# '.LOT# - - PERMIT EXPIRES IF WORK OWNER Jan Hull CONTRACTOR IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM INSPECTION DATE INSPECTOR INSPECTION RECORD FOUNDATION NOTE: ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF LASTCALLED INSPECTION. LIFER- PREGUNITE PERMIT VALIDATION CUPERTINO STANDARDS. - • " � GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND/SLAB ., k fLL PLUMBING DATE ELECTRICALISSUANCE MECHANICAL RLOc ELECT. PLc, mecH DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED UBUILDING pp n� PERMIT INFORMATION F—VAuiAnON SIFT. WOOD FLOOR PLUMBING - to Y� MECHANICAL ELECTRICAL PERMIT TO. FRAMING INSULATION STORIES TYPE.CONSTR OCC GHOUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ROOF NOTE: NO FINAL INSP. SHALL BE MADE BEFORE THE CONSTRUCTION TAXIS PAID SO FT FLOOR AREA TOTAL ACREAGE DIAPHRAGM BUILDING USE ROOF SHEATHING Hes IND CON Pe ❑ ❑ ❑ ❑ ❑ APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ROUGH SAN.N ASSESSORS PARCEL NO PLUMBING ELECT. ENERGY TUBS 8 SHOWER PAN PLUMBING ENERGY - TRnr,T No. PARCEL NO MECHANICAL MECH.ENERGY ELECTRICAL BUILDING ENERGY ACC GATE ACC FILE NO FRAMING ELECT. FINAL TEST INSULATION - PLUMBING ZONING ENG, SITE NO. GAS TEST - GAS MECHANICAL FIRE SPRINK ❑ No ENERGY T 24 ' ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING . EXTERIOR SHEAR ELECTRICAL RELEE AS FLOOD ZONE v N� A.LU C. v ❑ NQ' INTERIOR SHEAR FIRE DEPT. SHEETROCK GRADE - FEE SUMMARY EXTERIOR LATH BUILDING BUILDING - INTERIOR LATH - - TEMPORARY APPROVALS - SCRATCH COAT ELECTRIC - PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED 16ccuPANcY SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, " ELECTRIC' ! �� F_ ONE WORKING DAY BEFORE REQUIRED INSPECTION. . PLEASE GIVE JOB ADDRESS WHEN P,HONING. PLUMBING MECHANICAL.. Z — SEE PERMIT FOR EXPIRATION DATE —' CONST. TAX IMPORTANT TOTAL PLEASE READ REVERSE SIDE BEFORE CALLING FOR FINAL INSPECTION. OFFICE COPY • O Z_z N CC T W _ CL 1:3 :) z UQ LL U Oa F- N 7 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY I - aLMLDING PROJECT IDENTIFICATION APPLICATION & PERMIT BUILDING - ELECTRICAL- PLUMBING - MECHANICAL PERMIT NUMBER -. 15248 BUILDING 40or s ��I D - DINNER 'S- "AM �7_!f7 q 4 OTY. ELECTRIC PERMIT FEE PLAN CHECK VALIDATION CONTRACTORS N A �DOUTLETS • ♦ uc. No. 5 - SWITCHES -RECEP 18071'90 LIGHTING FIXTURES Id5_GG 1.0p C-DNTR ACTORS ADDRESS p .BOX-- 3a�3 APPLIANCES - RESIDENTIAL 4.00 PANELS 10.00 PHONE DATE OF APPLICATION ARCHITECT OR /� Jo.7� ENGINEER Y LIC.NO. PANELS (OVER 200 AMPI 20.00 PLAN CHECK FEE P.C. O. SIGNS TRANS. 3.00 ADDRESS E"G' ZIP SPECIAL CIRCUIT .5.00 PERMIT VALIDATION . �!-V EMP. METER OR POLE INS. 20.00 A ADDDRESSDRESS rs MOTORS SEE FEE SCH, SERVICE CHANGE 20.00 n,�,•�y LICENSFO CONTRACTORS DECLARATION - I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and my license is in full Ibr d f t� Professions Code/?J License Class-__ Lic, Numbur,�# Date ontracLty(,.rp,�. OWNER -1112 D - F:CLA RATION I hereby collo ing 1 am exempt from the Contractor's License Code:Law ny city followingreason.c. requires Code'. Any city or county which requirese permit t0 constant, a permit tconts and roft, Acs ISSUANCE DATE BLDG. ELECT. PLG. MECH. 0 BUILDING PERMIT INFORMATION VALUATION $/FT. MISC.- REFER TOO PERMIT ISSUANCE ELEC.CONTR. LIQ NO. ELEC, yv TOTAL -� QTY. PLUMBING PERMIT FEE issuance, also Imuires ite applic Or repay any hpermit tofile a Si nedto sementthat requires the applicant for such revisit IO file a signed statement that he is licensed 9 (coma to the with Sects of the Contractor's License with Section is7000) 3 of the Law (Chapter 9 (morons Code) Business and Professions Cade) or that he is exempt therefrom and exempt PERMIT TO .. EL�t7 STORIES TYPELON$rR. thenyaporthe alleged ermitsuon.Any of$action tsthealplica malty of It I applicant forapermit subjects lheapplicam toa civil penally of not more than five hundred dollars (S500).): ALTER:DRAIN&VENT-WATER(EA.)5.00 ❑ I, as owner of file property, or my employees with wagesas their sole compensation, will do the work, and the structure is not BACK FLOW PROTECT. DEVICE 4.00 OCC. GROUP' RES. UNITS DRAINS- FLOOR, ROOF, AR EA, COND. 5.00 intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's Licence Law does not apply to an owner of property who builds or improves thereon, and Who docs such work himself or through his own employees, provided that such improve- meats are not intended or offered for sale. If, however, the building FIXTURES - PER TRAP 5.00 30, FT, FLOOR AREA TOTAL ACREAGE GAS•EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion, the owner- builder will have the burden of proving that h e did not build or im-. prove for purpose of sale.). Las owner of the property, am exclusively contracting with - . -.. GAS EASYSTEM OVER 4 (EA) 200 BUILDING USE RES IND CON PB Other 1:1 ❑ 11 1:1 11❑ INDUSTRIAL WASTE INTER, 30.00 licensed contractors to construct the project (Sec. 7044, Business 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 - 1 INC 5 V.B. 6.00 - LAWN SPRINKLERS -OVER 5 MAJ 1.00 ASSESSORS PARCEL NO. contracts for such projects with a contractor(x) licensed pursuant to lite Contractors License Law. SEWER -SANITARY -STORM EA. 200ft/10.00 TRACT NO, PARCEL NO. ❑ lam exempt under Sec,-, BAVC. for this on WATER HEATER W/VENT 6.00 Owner _ Data WATER SYSTEM 5.00 ACC.DATE ACC. FILE NO. WATER TREATING EQUIP. 5.00 WORKERS'COMPENSATION DECLARATION 1 hereby affirm trial I have a certificate of consent to set Ginsure, or a certificate of Workers' Comp ution Insumace, or a cerlifteA ol'ISec. 360I -a .). copy thereof 0, Policy ere 00,Cornpan y ZONING - ENG. SITE NO. ❑ Certified copy is her by fnrO lshe ❑ Certified copy is 11 with the city inspection division. Applicant -y}�1�� _�/� FIRE $PRINK Y ❑ N ❑ ENERGY TZ4 Y ❑ N❑ MISC. - REFER TO ORD. CERT'TFICATEOF EXEMPTION PROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.u.C. PLG. CONTR. LIC. NO. PLG. TOTAL COMPI:NSAT10N INSURANCE (This section need not be completed if the permit is for one V ❑ N ❑ V ❑ N ❑ hundred letters IS 100) or less.) 1 certify that in the performance of We work for which this per- not is issued, I shall not employ any person many manner so as to QTY. MECHANICAL PERMIT FEE FEE SUMMARY BUILDING become subject to the Workeri Compensation Laws of California. Dale ApplicantALTER NOTICE TO APPLICANT: If, after making this Certificate of Ex- OR ADD TO MECH. 5.00 APPLIANCE 5.00 PLAN CHECK nnpti0ei, you should become Subject to the Workers' Compensation provisions of lite Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT (TO 10,000C.F.M.) 4.00 FEE AIR HANDLING UNIT(OVER 10p00C.F.M.) 6.00 SEISMIC FEE CONSTRUCTION LENDING AGENCY I hereby within that there is a construction lending agency far EXHAUST HOOD (WITH DUCT) 5.00 - rte performance of the work for which this permit is issued (Sec. 3097. Civ.0 r MICROFILM HEATING UNIT (TO 100,000 B.T.U.) 8.00 Lenders Name Lenders Address HEATING UNIT (OVER 100,000 B.T.U.) 9.50 ELECTRIC /� / T_ s' ` +j VENTILATION FAN (SINGLE) 4,00 I certify that I have read this application andsuite that the above information Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and PLUMBING BOILER- COMP(3 H.P. or 100',000 B.T.U.) 6.00 BOILER -COMP IDVef 100,000 BTU) SEE FEE SCH. MECHANICAL hereby authorize representatives of this city to enter upon the ubove-mentioned property for inspection purposes. MISC. - REFER TO ORD. (We) agree to save, indemnify and keep harmless rte City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the ranting of this permit. CONST. TAX PERMIT ISSUANCE 10.00 MECH. CONT. LIC. NO. MECH, TOTAL TOTAL Signature of Applicant/Contractor Date OFFICE COPY