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15197 (2) POST THIS CARD NEAR FRONT OE^BUILDING •� 1 � PERMIT NUMBER CITY OF, CUPERTINO 15197 ' INSPECTION DIVISION JOB INSPECTION RECORD I1 A PERMIT EXPIRATION JOB ADDRESS �d 96 d. V�/ �L�/'�(c�r'\�• /�'✓Ct UNIT# LOT# PERMIT EXPIRES IF WORK OWNER J / V, CONTRACTOR / 1/ IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 188 DAYS OF PERMIT ISSU- FOUNDATION - — - - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. • UFER _ (�-B �,`- 1 ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE - - - TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION CUPERTINO STANDARD . GARAGESLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING' ' ELECTRICAL . . ISSUANCE DATE MECHANICAL BLDG ELECT. PLG. . MECH . 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR \�OV� a\\n0 INFORMATION VALUATION PLUMBING _ vj wr. MECHANICAL '30 ELECTRICAL - PERMIT TO FRAMING INSULATION STORIES TYPE CONSTH w 114 ! \ OCC.GROUP RES,UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED , ' ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sa IT Pl.00RAREA ioTal.AalEAGC DIAPHRAGM ' THE CONSTRUCTION TAX IS PAID ROOF SHEATHING — z RES IND IU CON useED Otl , APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. El El 0 El ASSESSORS PARCEL NO ROUGH - - 'M_ a PLUMBING ELECT.EN RG '�r ti TRACT NO PARCEL NO B,. SHOWER PAN 1-r, PLUMBING ENERGY HAN ICAL MECH.ENERGY ACC.DATE ACC FILE NO ELECTRICAL - /- j BUILDING ENERGY r FRAMING ELECT.FINAL TEST INSULATION PLUMBING ZONING ENG.SITE NO. GAS TEST - GAS EIRE sPHINK ENERGY T 2 MECHANICAL Y E] N Y 0 N E COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING EXTERIOR'SHEAR I ELECTRICAL RELEASE FLOOD ZONE ALUC. r INTERIOR SHEAR OQ FIRE DEPT` Y❑ N❑ Y 0 N❑ SHEETROCK GRADE FEE SUMMARY EXTERIOR LATH BUILDING INTERIOR LATH O TEMPORARY APPROVALS BUILDING / SCRATCH COAT S ELECTRIC —,j./ PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMICIFEE OCCUPANCY OF BUILDING ISNOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR, MICROFILM'T ARRANGE FOR INSPECTION, BY PHONING 252:4505„ ELECTRIC / u ONE WORKING DAY BEFORE REQUIRED INSPECTION. F PLUMBING i O PLEASE GIVE-JOB ADDRESS WHEN PHONING. Z - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL IMPORTANT! rCONST.TAX' AX PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY FINAL1CRADE ! ROUTE,SLIP , ii File No. Dated O� Location Subject Notes ' Approv at Inspector _IL:ANT TO FILL IN INFORMATION WITHIN R_ED LINES - USE BALL POINT PEN ONLY - •+ BUILDING PROJECT IDENTIFICATION / A PERMIT NUMBER AUIOLRFSa �"� APPLICATIONii PERMIT 15197 C U 6 x ) #' BUILDING - ELECTRICAL-PLUMBING-MECHANICAL T' OWNER'S PLAN CHECK VALIDATION amE QTY. ELECTRIC PERMIT FEE ` n . PHONE NAME ACTORS UTLETS-SWITCHES-RECEP 10.00/1.00 LIC.No. LIGHTING FIXTURES 10.00/1.00 ADDRESSTORs APPLIANCES-RESIDENTIAL 4.00 PHONE PANELS 10.00 DATE OF APPLICATION. ARCHITECT PLAN CHECK FEE P,C.NO. OR PANELS (OVER 200 AMP) 20.00 ENGINE 1 LQ L.C.Nos I I SIGNS TRANS. 3.00 ARCH. s IU ENR. 1 SPECIAL CIRCUIT 5.00 PERMIT VALIDATION - IP EMP.METER OR POLE INS. 20.00 APPLICANT'S ADDRESS `J n�, MOTORS . SEE FEE'SCH. - MOO (I( IG ITII{. C SERVICE CHANGE 20.00 w 00 LICENSED CONT ACTORS DECLARATION a 0u I hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE y a i (commencing with Section 7000)of Division 3 of the Business and ELECT. PLG. MECH. r y m Professions Coda, my license is in full force and effect. Z 0 so License a Lie.Number _ B H r Date Contractor a x s \O 0 uQ ILD PERMIT ¢ ¢ w u OWNER-BUILDER DECLARATION Ca E ;LL H I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD -\ INFORMATION Hu0J Law for the following reason.(Sec.703 1.5,Businessamd Professions PERMIT ISSUANCE % VALUATION S/FT. Code:Any city or county which requires a permit to construct,alter, p Q 2O improve,demolish,or repair any structure,prior to Its issmi)ce,also ELEC.CONTR. LIC.NO. ELEC. �� O / ¢ requires the applicant for such permit to file a signed statement that PERMITTO Er m hTOTAL e is licensed pulsator to the provisions of the Contractor's License ,p1 H z ¢ Law(Chapter 9(commencing with Section 7000)of Division 3 oflhe S�'V (/-/ 4 C Business and Professions Code)or that he is exempt therefrom unit QTY. PLUMBING PERMIT FEE ¢ r$ the basis for the alleged exemption,Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant fora permit sdollars the applicant son civil penalty ALTER-DRAIN -WATER (EA.) 5.00 sN/< of not more cant five hundred dollars 155001.1: ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECTDEVICE 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 R� / Code:The Comrade is License Law does not apply to an owner of property who builds or improves(hereon,and who does such work FIXTURES-PER TRAP 5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve. // p •� 's ments are not intended or offered for sale.If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 r �/ �✓� or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4 IEA.) 2.00 build.,will have the hurden of proving(flat he did not build or im. BUILDING USE prove fo arpose of sale.). r INDUSTRIAL WASTE INTER: 30.00 RES IND CON PB Oona, as ,.net of the property,ran 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 improv s th does not apply �� -� to tracts owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a mmrumurls)licensed ptmuanl to SEWER-SANITARY-STORM EA.200ft/10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ I a exempt under S• . ,ILNrP.0 for hi WATER HE W/VENT 6.00 S% B noon ��f_, Owner ld6.CL Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE N0. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 I hereby ofrrm that I have a certificate of consent to sa(insure. ZONING ENG.SITE NO. or a certificate of Workers'Comtit Insurance, r a certified copy thereof(Sea 3900,Lub.C.). Policy No. Company O ❑ Ce fill- copy is hereby to used. etlill t 's lilcd� t the '1' U Division. FIRE SPRINK ENERGY T-24 C- O Applicant •MS- /_-!_I_L_)- - '� MISC.- REFER TO ORD. Y ❑ N❑ Y ❑ N❑ CC LO CERTIFICATE OF EXEMPTION FROM WORKERS' PERMIT ISSUANCEffJ��//p2 FLOOD ZONE AL.U,C. aQCOMP1iN5ATION INSURANCE PLO.CONTE. LIC.NO. TOTAL U (p o7 Y❑ NE] Y ❑ N[]Z (This section need not M1e completed if the permit is for one hundred dollars(s 100)or LssJ U O I certify that in the performance of the work for which this per- DTV MECHANICAL PERMIT FEE FEE SUMMARY LL ♦ mit is issued, I shall not employ any person in:uty m:umer so as to O Ubecome subject to the Workers'Compensalion Laws of California, a Dam Ap ttcant aBUILDING pS p ALTER OR ADD TO MECH. 5.00 �QO } ril NO'fl Cll TO APPLICANT: If,after making this Certificate of F, 2 emption,you should become subject m the Workers'Cnmpensalion APPLIANCE 5.00 PLAN CHECK provisions of the labor Code, you must forthwith comply with FEE U such provisions or this permit shall he deemed revoked. AIR HANDLING UNIT(TO 10=16.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10MC.FM.) 6.00 SEISMIC FEE 6 3 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 is issued(Sec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name HEATI NG UN IT 100,000 B.T.U.)9.50 0 Lenders Address ELECTRIC I certify (hat fhave read This application and stale that the above VENTILATION FAN (SINGLE) 4.00 information is correct. 1 agree to comply with till city and county g01LER•COMP13 H.P.Dr 100,000 B.T.U.1 6.00 PLUMBING ordinances and state laws relating to building construction, and' hereby authorial representatives inspection purposto esthis city es,enter upon the above-mentioned property for inspecBOILER-COMP(Over 100,000 BTU)SEE FEE SCH. MECHANICAL �(p 0 (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, Costs and expenses which PERMIT ISSUANCE 1 CONST.TAX '� D.3 may it any way accrue agains Suid City in consequence of the ,an g of lh is pennil' MECH.CONT. LIC.NO. MECH. TOTAL o7 TOTAL ( �O Signature of Applicant/Contractor pal OFFICE COPY